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Midwives in distress: Working towards a consensus in the solution

Firstly, the reason that it has taken me a while to write here is that I have been buried in the most fascinating data from round one of my Delphi study to achieve consensus in the development of an online intervention designed to support midwives in work-related psychological distress. I won’t spoil the results for you, as I hope to be publishing the results in the new year, but suffice to say, there were many conflicted opinions, new ideas and strong voices within this expert panel.

I am very excited to move forward with this project in light of these responses!

This project now feels as if it is starting to belong to the people who have been a part of this so far. They are shaping the vision for this, and growing it with their support…. Its awesome!

Last month I was also finalising the revisions for my latest paper , ‘Midwives Overboard!’ Inside their hearts are breaking, their makeup may be flaking but their smile still stays on. This latest output was kindly co-authored by Wendy ClyneAndrew TurnerEmily A. Fulton, and Clare Gerada. I for one am very proud of this piece of work, as it shines a light upon the current situation, in which midwives all around the world are indeed suffering in psychological distress. Writing this piece not only became cathartic in resolving my own professional experiences, but it has also reinforced to me that there is a real need and desire to design an intervention to support midwives….and now I am a little closer to turning this vision into practice.

You can reach the 2nd round of the Delphi study here (This study is now invite only, but watch out for new opportunities to become involved in more research soon)!

I have been submitting papers to conference so that I may begin to share these results in person…but I will not have this opportunity until the ‘Great Minds Don’t Think Alike’ – Nursing and Midwifery Conference, in January 2016.

I hope to meet some of you there!

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What is the Future of Psychological Support for #NHS Midwives? My interview with @MidwifeDiaries

This blog was originally posted by Ellie from www.midwifediaries.com on June 2, 2015. We spoke in May 2015 about my research project and the issues surrounding midwives (and student midwives) in psychological distress.

What’s The Future Of Psychological Support For Midwives? Interview w/ Sally Pezaro
She wrote :”Who is this researcher?”

This was me, a few weeks ago stumbling across a blog. This woman was sharp, driven, and had all her energy focussed on supporting the mental health of midwives.

She really got how unchallenged the assumption is that midwives are ok to keep going 24/7/365.

Sally Pezaro is doing her PhD on supporting midwives in psychological distress. Her project is exciting, and if it gets launched, will be something we can all use to keep healthy.

In this interview, we talk about why it’s so important to look after midwives, bullying in midwifery, and some strategies for mental wellbeing.

Most awesome quote from this interview: ‘Don’t give everything you have until your batteries run out. Yep – must put that on twitter.

Here are the links we discussed, ’cause I bet you’ll ask!

What’s Sally’s doing is so brilliant because she’s noticed something that is wrong in midwifery – and is doing something about it. Her project reminds me of that quote:

“Be The Change You Want To See In The World”

It’s so good to know that we do have researchers on our side, trying to make things better.

Now, Sally and I would love to hear from you. What’s your answer to the question I posed at the end of the interview?

“What do you find most challenging in looking after your mental health as a midwife, and what do you think could be changed to help with this, both on an organisational trust level, and on a personal level?”

Thanks so much in advance for all the kind, insightful and inspiring comments that are left. I’m excited to hear what you find hardest, and what could help you look after your mental health better.

As always, thank you for your time and attention, sharing and being so brilliant. MidwifeDiaries is turning into an incredible, supportive place for midwives, and I’m so grateful.

Ellie xxx

-> I would also like to add a link to the newest NMC Code (2015) as midwives can now use the power of the code to challenge psychologically unsafe professional behaviour in the workplace. The code now states that midwives must be supportive of colleagues who are encountering health or performance problems. Midwives also have a duty to care for themselves under this new code, so please do not feel guilty for giving self care. We must all work to create therapeutic working environments….

Five experiences are judged necessary for health. Primary emotional development, attachment, containment, communication, inclusion and agency. These can be deliberately recreated in therapeutic environments to form a structure for ‘secondary emotional development’. Failure to recognise the importance of these qualities of an environment can cause unhealthy, or frankly toxic, psychosocial environments in various settings (Haigh, 2013).

Haigh, R. (2013) ‘The quintessence of a therapeutic environment’, Therapeutic Communities: The International Journal of Therapeutic Communities, 34 (1): 6 – 15.

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Partnering with the Colombo Institute of Research and Psychology – Sri Lanka…

colombo institute of research and psychology

colombo institute of research and psychology

I apologize for the lack of posts over the last 2 weeks. I have been to visit the wonderful people in the Colombo Institute of Research and Psychology and the National Institute of Mental Health, Angoda.Then of course I had to deal with copious amounts of work/emails upon my return, which I am sure will fill exciting posts to come.

When I embarked upon this research journey, I also signed up for the Global Leaders Programme at Coventry University. I did this to become a part of the global healthcare community and reach key opinion leaders with the same directive goals as myself…Starting the conversation has always been the most productive way to make change happen. Indeed, it has already put me in touch with some inspiring people, and this trip proved to be no different.

I have always had a keen interest in getting to know how the various healthcare systems across our globe work. We are all human… so what works best? I have already visited the Royal Victoria Teaching Hospital in Banjul, The Gambia and the Gimbie Adventist Hospital, Ethiopia. With the help of Maternity Worldwide and clinical work placements, I was privileged to have the opportunity to see how our health care systems contrast and compare to other healthcare systems around the globe. I was excited to take part in this visit, which promised to enlighten us all to the mental healthcare provisions and psychology research in Sri Lanka.

National Institute of Mental Health, Angoda Colombo, Sri Lanka

National Institute of Mental Health, Angoda Colombo, Sri Lanka

Speaking with the researchers in the Colombo Institute of Research and Psychology, it was clear that their research shared the same concerns as western research. Healthy debates generated interesting insights into the work they were forming in breaking stigma and securing new funding for the people of Sri Lanka. However, their population base faces some new and very real challenges:

-Less than 1% of Sri Lankas healthcare budget is spent on the mental health care of the nation.

-Sri Lankan communities often use astrology and homeopathic remedies to treat mental ill health rather than access medical facilities.

– There are only 2 psychiatric consultants for the whole of Colombo and surrounding areas.

-Limited facilities for mother and baby units, which need more space for mentally unwell mothers and their families. (In Sri Lanka, reported maternal death due to suicide is notably high) – See Puerperal Psychosis.

– The stigma around mental health issues remains great in Sri Lanka, therefore many of those who may be ready to re-enter their communities following treatment have no where to return to. They become rejected by their families.

– This stigma creates a culture where those in need are reluctant to seek help.

– Families are keen not to disclose the mental ill health of loved ones and may isolate problems.

-Mental health facilities are used as holding places for those on remand following the identification of the antisocial behavioral symptoms of ill mental health.

Speaking to one of the consultant psychiatrists about these issues was so valuable to my research. Comparing the etiologies of psychological distress with the cultures and social norms of both populations highlighted how our UK populations may face triggers for distress which are entirely unique to the UK. Although some of these factors will also translate to other populations, it may be that specific factors correlate only with our own health care professionals, within western society.

From the point of view of research, this leaves much to be explored. How do we breakdown the populations into completely homogeneous samples? Is it ever possible to?

After speaking with Dr Shavindra Dias from the University of Peradeniya, (which by the way is the most beautiful university campus I have ever seen!) it is clear that the connections I have made throughout this research trip will last throughout my career as I continue to network with and learn from some of the most outstanding and inspirational leaders who take pride in making changes to ensure a brighter future for all. The struggle to improve the overall well being of society by authenticating and placing value upon the needs of those in psychological distress is hard. Yet I still believe that is the most noble and kind thing we can do for humanity. The connections I have made throughout this trip will forever remain a part of my professional journey going forward, and I would like to thank @PsychColombo again for hosting such an amazing trip of discovery in partnership with @covcampus.

In addition to this wonderful experience we also visited:

-Galle Face Green

-Galle Fort

-The National Museum of Colombo

-International Maritime Museum in Colombo

– The National Elephant Orphanage

-The Temple of the Tooth

-Anuradhapura

-Botanical Gardens

-Tea Factories

View from the World Trade Centre in Colombo

View from the World Trade Centre in Colombo

Sri Lankan Elephant Orphanage

Sri Lankan Elephant Orphanage

I hope to reunite with the amazing people I met here soon…. Perhaps for my up and coming Delphi Study?