Calling Code Lilac for Mental Health Support 

It’s not always easy to ask for help – especially when the help needed involves support for your mental health.

Through a program called “Code Lilac,” Memorial Hermann Health System aims to provide easy access to mental health support for nurses and other staff and perhaps relieve any stigma associated with seeking it.

According to a press release, the program began at Children’s Memorial Hermann Hospital in 2015 after staff attended a workshop on vicarious trauma. The program expanded systemwide in March 2022. The program is a “multidisciplinary peer-to-peer support program designed to offer emotional support to workforce members who have experienced stressful patient- or work-related events,” according to the release. It’s also among the country’s most extensive and robust hospital-based peer responder programs.

Some 500 Code Lilac peer responders are part of 17 teams trained in psychological first aid. They provide support to both clinical and nonclinical staff.

“Nursing is heavily integrated with the team,” says Leah Blackwell, MSN, MBA, RN, NEA-BC, vice president and chief nursing officer for Memorial Hermann – Texas Medical Center, in an interview. On both the campus and system level, nurses are engaged on the steering committees to make sure that they’re providing that voice of the bedside nurse.

“The thing that I like about nurses being engaged in this initiative is their encouragement and normalization of calling Code Lilac,” says Blackwell, an executive sponsor of the program. “They’re trying to reduce that stigma. We all need support for mental health and well-being. They do an excellent job of trying to normalize Code Lilac with their peers.”

Code Lilac also helps build connections among nurses, notes Blackwell. “It’s great when you have an ICU nurse peer responder who responds to an ER Code Lilac. They see each other across the campus and say, ‘Oh, we’re all the same,’ even if we work in different places. It helps build camaraderie among nurses.”

Code Lilac Providing Relief 

Code Lilac “is for a wide variety of work-related scenarios,” said Blackwell. “Whether it’s burnout and you’re just having a hard time getting through the day, compassion fatigue, moral distress, or anxiety. People call because they’re not sleeping well before their shifts.

Whether it’s a patient death that just occurred or a slow buildup of stress, “that’s where Code Lilac can intercede and provide immediate relief or help direct them to the right place on the continuum, whether it’s counselors or other things that we have available.” According to Memorial Hermann, those resources can include individual and group support sessions.

Most often, nurses call a Code Lilac due to workplace violence or moral distress, according to Blackwell. Initiating a Code Lilac can be as straightforward as calling a system hotline or the chaplaincy department. A trained responder may arrive within the hour, according to Blackwell. Or, if a team needs support, sometimes the response will be at the end of the shift when the team can gather.

Blackwell says the peer responders receive comprehensive multi-day and quarterly training on trauma-informed care. The preparation includes role-playing and scenario-based training.

Helping Out on Tough Days 

Blackwell notes that the work environment, long hours, and patient care intensity make nursing a high user for the Code Lilac program. “I appreciate having it as a resource to offer nurses on those really, really tough days.”