Combatting burnout — Keith Zullig
Keith Zullig's work helps people in stressful jobs be in touch with their emotions and to control their behaviors.
Mike McCawley said that although the unsheltered population in town is somewhat transient, there are people the project has been able to track, some for as many as 17 years. And while the Mushroom Project may see that ability to collect data over time as a benefit, first responders may repeatedly see people who have substance use disorder, commit burglary or assault or harass passersby on the rail trail.
The result of first responders seeing repeat unsheltered people in need can desensitize first responders to their plight, and their humanity while also creating burnout. According to Keith Zullig, that kind of fatigue among first responders was already high because of the opioid crisis when the COVID-19 pandemic added another layer of high-stress responsibility. Zullig is working with those first responders — law enforcement officers, frontline health care workers and social workers — to provide mindfulness-based resilience training to relieve the pressures of their day-to-day work.
Mindfulness training, which makes people aware of their thoughts and feelings while not allowing them to control behaviors, will not only help those frontline workers combat burnout, but also help them see the humanity in those “frequent flyers,” giving the EMTs, the police and social workers the ability to “box” any residual resentment for having to provide repeated services.
“We’re trying to teach them ways to reduce their burnout and keep the compassion in their occupations, where they bind themselves, so that we don’t lose that particular workforce,” Zullig said. “At the same time, we’re trying to develop the workforce in those populations to have these skills and share them with others, either personally or through their occupations by providing an enhanced level of service.”
Zullig’s pilot project did 10 training sessions around the state. After that, he said the second phase was to take a sub-sample of that group to engage in more intensive training. Using a rigorous application process, his team hoped to get 20 participants and wound up with 37 applicants for 20 slots.
“We were not anticipating getting that many; apparently people feel, qualitatively at this point, like what they received in our initial 10 trainings was very meaningful and that they want more of this," Zullig said. “I think any time you get more applications for something than you expect, it’s a significant win.”
Funded by the West Virginia Department of Health and Human Resources, the program’s value was apparent to the Department of Agriculture that will begin a similar resilience program for veterans in 2023. Zullig said there is a significant need for veterans, especially if they fall outside of VA care.
“The work is spreading,” he said.
Substance misuse and addiction can be an issue for the unsheltered and for veterans alike. The Comprehensive Opioid Addiction Treatment Program at the Chestnut Ridge Center is a different kind of mindfulness training — relapse prevention. Zullig and his team were able to recruit people who had been in treatment for 90 days and had hit a plateau with the cognitive behavioral therapies and medication. People in the COAT program, which is housed in the WVU School of Medicine, were split into two groups, one continued traditional therapies and treatments, the other was given mindfulness-based relapse prevention therapy for 24 weeks.
“We were able to bring people down from clinical levels of anxiety and depress to subclinical levels, where the ‘treatment as usual’ group stayed at higher levels,” Zullig said. “Now when people come into the program, they have a choice. (Mindfulness-based relapse therapy is) now a standing therapy that’s offered, and based on our research, quite sustainable. “
He notes that public health as a profession by its very nature is messy.
“We’re dealing with human behaviors and people who are part of complex social and physical environments that dictate, in many ways, what choices are available and how what is available is utilized,” Zullig said. “It’s a messy science, in some ways, but we’re living in it and we’re not an ivory tower.”