Now the clapping has stopped, let's be ready to fight a pandemic of mental ill health among NHS staff

It's no surprise that the mental health of NHS staff is under increasing strain. If we are to face a second wave of coronavirus, then these key workers must be given better support, says Jennifer Hawkins

Friday 14 August 2020 11:00
NHS data shows a worrying increase in sickness absence due to mental health issues
NHS data shows a worrying increase in sickness absence due to mental health issues

In the year the NHS celebrated its 72nd anniversary, it was wonderful to see millions clapping for carers every week during lockdown. This showed how the country recognises the dedication and hard work that staff displayed to get the country through a hellish five months.

There is however another story which also needs to be told. A story about the hidden NHS work pressures which had been high for a long time before Covid-19. This pandemic has only made them more apparent and exposes the increased pressure on an already overburdened health service.

It leaves us asking a question – now the clapping has stopped, is the country and this government ready to stand up again for our amazing NHS staff in a new fight? A fight to help our dedicated and deserving NHS and social care workforce deal with the aftermath of this terrible disease.

It should not come as a surprise that the mental health of NHS staff is under increasing strain. The nature of the work carried out by the caring professions is psychologically demanding, and staff face unique challenges which expose them to the risk of burnout. Pressures of the job are obvious if you have ever visited a hospital or GP surgery. Staff shortages, lack of resources and workload are at the top of the list but if you add high levels of stress, feeling undervalued and lack of staff support the job is made even harder.

Mental health support network The Laura Hyde Foundation was named after a Royal Navy nurse working in Plymouth’s Derriford Hospital who, in 2016, took her own life. It was a tragic loss and her death highlights the mental health challenges which have a significant impact on care professionals.

Sickness absence rates in the NHS are higher than the rest of the economy. Figures from the NHS sickness absence data (2015-2019) show a worrying increase in absence due to mental health issues: an increase of 23 per cent for doctors and nurses, and 29 per cent for other workers. The most reported reason for sickness absence was anxiety/stress/depression/other psychiatric illnesses and this amounts to a cost of £500m a year. Ambulance trusts had the highest sickness absence rate at 5.8 per cent.

The nature of the work of NHS and care staff is demanding but high sickness absence rates should not be accepted as the norm. There needs to be a workplace culture change that prioritises staff health to enable future care.

Only last week, our support service helped a 26-year-old male nurse with suicidal thoughts as he battled with the guilt of not being able to provide the care required to the children he looked after as they battled cancer due to Covid-19. Just four days ago, we supported a social care worker based rurally who has suffered panic attacks and anxiety over seeing 12 of her patients pass away in just four weeks.

In 2019, an NHS staff survey showed an improvement in staff morale from previous years but a more recent questionnaire shows one in four members of staff said they had experienced harassment or abuse from patients or the public. One in seven had experienced physical violence and 7.2 per cent faced discrimination, with racism being the most common form.

Imagine working for a big corporate company and being exposed to this type of harm on a daily basis. Would a good employer tolerate their staff being treated this way? I think not. Good employers know that low staff morale can be destructive in a business setting and can lead to poor productivity and high staff turnover.

Past studies of the health effects of pandemics show an association with long-lasting decline in mental health. A study of over a thousand healthcare workers who cared for Covid-19 patients in China revealed a substantial proportion of staff reporting symptoms of depression, anxiety, insomnia and distress. UK studies have shown increased feelings of anxiety and depression amongst the general population.

As a consequence of Covid-19, staff have lost colleagues, often under difficult circumstances. Many have been struggling with anxiety about their own welfare and that of their families. The normal stresses of the job have been exacerbated by the increased workload and difficult working conditions.

NHS professionals report for work in the most challenging of circumstances because that is the job. Recent research from the Society of Occupational Medicine says a stigma still exists which makes it hard for staff to disclose mental health problems to their employer out of fear that they will be treated differently. Healthcare professionals also often continue to work when they are sick. This is mainly out of responsibility to their patients and loyalty to their colleagues.

With the threat of a second wave of Covid-19 on the horizon, combined with the annual demands of winter pressure, staff who are already struggling with their mental health will become unwell or leave the NHS. This will not only have a devastating effect on our NHS workforce but affect patient care and put increased strain on an already overburdened NHS health service.

The frustrating thing is that staff mental ill-health is preventable. NHS employers should not wait until someone goes off sick and becomes unwell to intervene. The signs of stress are usually there long before someone goes off sick and strategies need to be in place early to prevent the illness becoming protracted.

The Laura Hyde Foundation recently launched a successful campaign entitled “No Mask for Mental Health” which was rolled out across the UK and raised the emerging threat of mental health on our healthcare workers.

The foundation not only provides, but advocates for a dedicated mental health wellbeing service for all healthcare workers to ensure they have access to the right mental health support 24/7. If you are to prevent psychological injury to NHS staff, then you must start at the top of NHS trusts and involve staff at every level.

If employee health and wellbeing is discussed regularly at board level it will ensure a proactive approach to mental wellbeing at work and include employees in a collaborative way to find solutions. Good leadership from senior staff, as well as having integrated work teams and good supervisory support is essential. Health and wellbeing policies need to be in place and staff must have easy access to mental health support if staff health is to be taken seriously.

Whether it is a paramedic, nurse, doctor, physiotherapist, community carer or domestic, the NHS cannot function without every one of them. They are all members of an important team and deserve to have the same support as their patients.

Jennifer Hawkins is the clinical lead for The Laura Hyde Foundation

The Laura Hyde Foundation provide 20,000 hours of clinically supervised and independent mental health support to all healthcare workers free of charge. If you need help and want to speak to someone, click here.

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