HEAR Plus MINDBODYSTRONG: A Mental Health Resiliency Intervention for Nurses

Nurses regularly work in emotionally demanding environments shaped by long hours, chronic understaffing, repeated exposure to trauma, and high levels of responsibility for patient care. Over time, these pressures can contribute to burnout, depression, anxiety, and suicide risk, particularly when workplace cultures make it difficult for healthcare workers to prioritize their own well-being or seek support. Research has also shown that many healthcare workers avoid mental health services because of perceived negative attitudes (stigma), time constraints, or fears about professional consequences. Understanding how nurses themselves describe these stressors, and what they believe would meaningfully improve their well-being, is critical for developing suicide prevention efforts that are responsive to the realities of healthcare work.

With her AFSP-funded work, Dr. Bernadette Mazurek Melnyk analyzed responses from 464 nurses identified as being at moderate-to-high risk for mental distress, including suicidal thoughts and behaviors. Nurses described a wide range of overlapping stressors, including deteriorating mental and physical health, suboptimal work environments, financial insecurity, and strain within personal and family relationships. A central theme that emerged was what the Dr. Melnyk described as “the price of caring,” where the identity and expectations associated with being a nurse blurred the boundaries between professional obligation and personal well-being. Participants frequently described feeling unable to fully disconnect from caregiving demands, leading to exhaustion, guilt, and emotional depletion. Nurses identified several changes they believed could improve mental health and reduce distress, including stronger workplace support, adequate staffing, flexible scheduling, protection from workplace violence, increased pay, opportunities for career transition, and access to mental health services and evidence-based coping programs. Some also emphasized the importance of rest, therapy, social support, mindfulness, exercise, and reclaiming time outside of work. Overall, the findings highlight the importance of suicide prevention efforts that address both individual mental health needs and the broader workplace and systemic conditions shaping nurse well-being.

Citation: Hsieh, A. P., Cooper, A., Mayfield, C., Bauernsmith, I., Brown, K., Tucker, S., Melnyk, B. M., & Davidson, J. E. (2026). Nurses At-Risk for Mental Health Distress and Suicidality Describe Stressors and Strategies for Healthcare System Change: A Thematic Analysis. The Journal of nursing administration, 56(3), 127–134. https://doi.org/10.1097/NNA.0000000000001696

Nurses in the United States face alarmingly high rates of burnout, depression, and suicidal ideation, outpacing many other occupational groups. Despite increasing awareness, many nurses struggling with mental health concerns do not receive support or treatment, often due to negative attitudes (stigma), workplace culture, or fear of professional consequences. Suicide prevention in the nursing workforce requires more than individual coping strategies. It demands a systemic understanding of which work-related and personal factors contribute to risk, and which can offer protection. As health systems confront ongoing staffing shortages and workforce distress, identifying modifiable contributors to suicidal ideation is critical for both employee well-being and patient safety.

Dr. Bernadette Mazurek Melnyk examined data from 499 U.S. nurses identified as moderate-to-high-risk for mental health concerns, including suicidal ideation. Dr. Melnyk analyzed associations between suicidal ideation and a range of variables: burnout, depression, anxiety, PTSD, shift length, job satisfaction, workplace mattering, and more. She found that suicidal ideation was significantly associated with burnout, depression, anxiety, PTSD, working 12-hour shifts, and intent to leave the job. Protective factors included resilience, healthy lifestyle beliefs and behaviors, job satisfaction, and especially a sense of mattering in the workplace. Nurses who felt they mattered to their organization had 40% lower odds of suicidal ideation. This study highlights the urgent need for health care systems to address structural causes of burnout, invest in evidence-based mental health supports, and create cultures where nurses are valued –– not only to reduce distress, but potentially to save lives.

Citation: Melnyk, B. M., Davidson, J. E., Tucker, S., Tan, A., Hsieh, A. P., Cooper, A., Mayfield, C., & Hoying, J. (2025). Burnout, Mental Health, and Workplace Characteristics: Contributors and Protective Factors Associated With Suicidal Ideation in High-Risk Nurses. Worldviews on evidence-based nursing, 22(3), e70042. https://doi.org/10.1111/wvn.70042