LEBANON — In the eight years Melissa Chase Levesque has worked as a psychologist for Dartmouth-Hitchcock’s primary care service for employees and their families, she has learned a great deal about the culture of medicine and what it takes to care for a workforce.
While health-care providers at D-H, and elsewhere, are often lauded as superheroes for the work they do caring for others, they may have trouble asking for help for an addiction or mental illness when they need it, she told a crowd of about 75 gathered in an auditorium at Dartmouth-Hitchcock Medical Center on Tuesday evening.
“Perfectionism, strength and endurance are rewarded, and when someone’s fallibility is revealed — because we’re not superheroes — there is often deep shame and, in the case of an error, sometimes litigation,” Chase Levesque said.
Chase Levesque’s comments came during a discussion about what employers can do to support employees struggling with mental illness and addiction. The event was one in a series D-H is hosting while an art exhibit, “99 Faces Project: Portraits Without Labels,” is on display at DHMC. The exhibit, which includes unlabeled photographs, videos, paintings and sculptures of people who experience mental health challenges and their loved ones, aims to break down the stigma associated with mental illness.
At least in part because of the stigma providers may face in seeking help themselves, physicians complete suicide at rates higher than any other profession, Chase Levesque said. In addition, substance use rates of nurses and physicians are no different and may be higher than that of the general population. And providers in some fields may be subject to higher rates of workplace violence, she said.
“This is a hard place to work,” Chase Levesque said. “In the culture of medicine, there is a lot of suffering in silence and a deep reluctance to receive care.”
To counter this, Chase Levesque said she and others within D-H’s employee health service have learned when to suggest that someone apply for leave under the federal Family and Medical Leave Act and how to help employees access various job aids.
The goal, she said, is to help the employee retain the job and the employer retain the employee. One of the things she’s learned in her years of healing D-H employees is the importance of work in people’s lives, she said.
It “provides a lot of stability for people,” she said.
Work can provide meaningful relationships and offer a structure for someone to use in organizing their life, she said. So, when someone gets sick — be it an episode of major depression, mania or an addiction — Chase Levesque said she often finds she is working to protect their job.
“Employees should be able to have an illness (or an) episode of illness and still have a career,” she said.
Having a supportive manager in these circumstances can be “one less thing that they have to worry about,” she said.
Some in the audience, however, said they thought D-H could do more to help employees struggling with addiction issues. One employee, Ellen Dijkman Dulkes, whose daughter is in recovery from a heroin addiction, said she has had to drive to Brattleboro, Vt., to find a Narcotics Anonymous meeting (though some are offered in the Upper Valley).
“I feel like we can do more for the employees,” she said.
Dr. Peter Mason, a retired family doctor at Alice Peck Day Memorial Hospital in Lebanon who most recently provided addiction treatment, described a D-H employee to whom he prescribes buprenorphine to curb her opioid cravings.
Another D-H worker recognized Mason’s patient at a group meeting and told the patient’s supervisor. Though human resources said that she could continue to do her job while on the prescribed medication, her supervisor took away one of her responsibilities, which was orienting new employees.
“She was devastated,” Mason said.
He suggested that D-H hold a seminar for all its managers about reducing stigma in their dealings with employees who are struggling with mental illness or addiction issues.
Others who joined Chase Levesque on Tuesday’s panel spoke of their personal experiences with addiction.
When Jackie Mitchell’s son died in a car accident in 2011, the outpouring of support from her colleagues at the Gilsum, N.H.-based W.S. Badger Co. helped her get through a difficult time. But she also could have used support during the six years prior in which her son struggled with a heroin addiction, she said.
With a mind to helping people going through similar struggles, Mitchell, Badger’s chief operating officer, said Badger brought in consultants to conduct stigma training for the company’s workers. The session inspired some difficult conversations, she said. Managers also were trained in how to talk with employees about difficulties they may have.
The company’s policy is broad and allows Badger, which makes balms and other body-care products, to handle employees’ individual situations differently. Employees are allowed to shift their work schedules if they need to get to a meeting or health appointment. In some cases, employees have been allowed to use their time off to go to jail for crimes such as DUI convictions, Mitchell said.
Company leaders make an effort to “meet them where they’re at,” she said.
They’ve also focused on some small details. They offer hand sanitizer that doesn’t smell like alcohol. At company events, they make sure to have non-alcoholic beverages other than water and coffee. At holidays, they make sure that gift baskets don’t contain alcohol.
Matt McKenney, a workforce development manager at Hypertherm who is 10 years sober from an alcohol addiction, said the Hanover-based company that makes industrial cutting tools stood by him while he found sobriety.
“My employment was my identity,” McKenney said. “I could go to work and be really successful. That’s all that really mattered.”
At the same time, his personal life was messy. He became an outpatient at Headrest, a Lebanon-based addiction treatment provider. McKenney now serves on Headrest’s board and works to help colleagues who are struggling with addiction.
Despite his experience with addiction, McKenney said that in his human resources role, he initially found that he had to execute company policies that required firing employees struggling with substance use.
Since then, Hypertherm has developed policies that connect employees who are struggling with community resources such as Headrest.
The effort began with printing cards with lists of resources and putting them in the company’s bathrooms, said Stacey Chiocchio, Hypertherm’s community citizenship manager.
Eventually, with new leadership, Hypertherm human resources officials saw the value of the effort and the company changed its policies for addressing addiction. More recently, Hypertherm has sent some of its employees to be trained as recovery coaches to assist people who may be struggling. It also is working on a pilot project to have a licensed drug and alcohol counselor onsite to answer employees’ questions.
There’s “always more we can do,” Chiocchio said.
One small employer from the audience, who declined to identify herself or her company, said that with 18 employees she has had to fire workers she suspects may be struggling with mental illness or addiction, rather than giving them time off, even unpaid, to get help.
“I can’t have a job vacant for long periods of time,” she said.
While she was open to the ideas she heard the panelists share, she said, “from a capacity point of view I’m just struggling with implementation.”
Nora Doyle-Burr can be reached at ndoyleburr@vnews.com or 603-727-3213.
