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Happy International Day of the Midwife! #internationaldayofmidwife Conferences & Media coverage galore!

Ok, so today is , and I hope that my PhD research will go on to benefit all midwives and ultimately, women and their babies. It is indeed a time to celebrate.

So how did I celebrate??

Well this bank holiday weekend (May 2nd), I shared my work at the Virtual International Day of the Midwife Conference @VIDofM (). Coverage of this event quickly became widespread, and I certainly met some passionate midwives wanting to make a difference and follow my research – Thank you all for your amazing comments, feedback & support!

If you missed my presentation, you can watch the recorded webinar by clicking HERE – This presentation should also be on YouTube soon.

And so… as word spread, I was asked by Think: Health 2SER – Real Radio 107.3 FM to speak about my project and my presentation at the #ViDoM conference on their health show in Sydney, Australia.

You can listen to my interview HERE – The Full show can be heard HERE

Thank you for giving me the opportunity to share my work!

Sally Pezaro on Think Health 2SER Real Radio 107.3 FM

Sally Pezaro on Think Health 2SER Real Radio 107.3 FM

Midwives deserve every recognition for the amazing work that they do. They give everything they can because they care and want to make a difference. They put women and their families first, and sometimes forget to care for themselves and each other (Mensah et al, 2015).

So today is a great day to hug a midwife and celebrate their worth and value to the world.

Happy  !!!

Mensah, S. B., & Anderson, J. G. (2015). Barriers and facilitators of the use of mind-body therapies by healthcare providers and clinicians to care for themselves. Complementary therapies in clinical practice.

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Hospital Staff Absences for Mental Health Reasons Double – but do the Figures Add Up?

Today I was up early to watch Danny Mortimer NHSE_Danny (Chief Executive Employers) Speak on BBC Breakfast in light of new figures obtained via a Freedom of Information Act Request, that Hospital staff absences for mental health reasons has doubled across England in the last 4 years!

This information is obviously very relevant to my PhD study, and I will be reviewing it in time. However, the initial response that Danny Mortimer gave was that  staff feel comfortable talking about their . Hmm…

Has all of my research to date been wrong? Are #NHS staff comfortable talking freely about their mental ill health? (would love to hear your thoughts, but ironically you may feel unable to speak out – I tell myself this is the reason for a lack of comments on, and interactions with my blog all of the time :P)

Anyway, as you can imagine, I became worried that I was ‘missing something’ and asked Danny if he had any evidence for this? – See our conversation here

As you can see, he did not provide me with evidence for this statement, but agreed that we all need to do more to support our colleagues, and I know that we all share the same constructive goals. Unfortunately people don’t always have an answer, they just know that something needs to be done. I still believe that my PhD research could be the key to effective support, but this project is in its infancy and I will keep the readers of this blog as updated upon its progress as I am able.

So… the evidence provided by NHS Employers upon the mental health & well being of NHS staff is this:

MentalHealth Infographic WEB FINAL

A great infographic! However, one thing concerns me…. Apparently 76% of NHS trusts report that they monitor the well being of their staff (RCP, London). Yet 3 out of 4 people suffering from mental illness get NO TREATMENT AT ALL. (www.mentalhealth.org). So, are NHS trusts doing anything about the staff they find to be unwell? or are NHS staff fine? I think not. I worry that there is a lot of good rhetoric out there around NHS staff health and wellbeing, but not many interventions to support staff. The figures don’t add up, and seemingly only smarties have the answer.

I hope I have the answer coming… I hope its not too late.

http://www.mentalhealth.org.uk/content/assets/PDF/publications/fundamental_facts_2007.pdf?view=Standard

http://www.rcplondon.ac.uk/resources/nice-public-health-guidance-workplace-organisational-audit’

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#GoodbyeHeadclutcher campaign significant for Health care professionals in psychological distress

Wow – I have been so impressed with the #GetThePicture campaign this week -> 

I felt that this would also be pertinent for those working within the #NHS who may be struggling with poor mental health. To me, the head in hands image that is used so widely within the media has connotations of those in distress being out of control and unable to manage their condition. Of course there may be times when those in need do hold their head in their hands, but their story will be much wider than this single portrayal of despair. Within the healthcare services, one of the biggest barriers to help seeking is the stigma, and self stigma associated with ‘not coping’ in the professional sense (Renton, 2014). The fear that a healthcare professional may be judged as being professionally as well as mentally unstable means that many health care professionals never seek help or do it after years of suffering (Clark, 1999, Laposa et al., 2003).

The leading reason given for non disclosure in health care professionals is that staff are concerned that the disclosure of mental ill health may negatively affect their careers (Dewa, 2014). With images in the media implying that those with mental ill health are constantly unable to cope and sat in despair, we may see rates of self stigma increase, and rates of help seeking decline. This will paradoxically put patients at risk of compromised care, and drive secrets underground (Moberly, 2014). We all would like to see those in need receive help and feel well. To do do this, they must be willing to seek and receive help. With this in mind, I would be pleased to see future images of those with mental health issues smiling, seeking help, talking and being a part of every day life.

Health care professionals in psychological distress are doing just this, smiling ‘coping’ and working in the #NHS. If we can normalise help seeking, rather than the stigma of not coping, we may be that much closer to healing the healer.

@TimetoChange has suggested the following things to end #Stigma in this area:

  • Picture editors – look for an image that is truly relevant to the story; think about mental health problems as you would when portraying other illnesses; avoid ‘headclutcher’ shots; be sensitive when illustrating stories about suicide and self-harm.
  • Members of the public – take a fun ‘headclutcher’ selfie, and tweet it with #GoodbyeHeadclutcher; if you see a picture you think stigmatises mental health problems in the media, contact that outlet directly, and tweet them with #GetThePicture.
  • Picture agencies – weed out ‘headclutchers’ and other stigmatising pictures from your image libraries; make sure your categories and keywords can help picture editors find appropriate images easily; commission your own range of positive images.
  • Photographers – think of new creative ways to portray mental health problems; use a diverse range of people; take more shots of people being listened to and supported by others.

#TimeToTalk #TimetoChange @TimetoChange

Clark, D. (1999) Anxiety disorders: why they persist and how to treat them. Behaviour Research and Therapy, 37 (1999), pp. S5–S27

Dewa, C. (2014) Worker Attitudes towards Mental Health Problems and Disclosure. The international journal of occupational and environmental medicine, 2014, Vol.5 (4), pp.175-86

Laposa, J. M., & Alden, L. E. (2003) (1). Posttraumatic stress disorder in the emergency room: Exploration of a cognitive model. Behavior Research and Therapy, 41,49–65.

Moberly  , T (2014) GMC is “traumatising” unwell doctors and may be undermining patient safety, Gerada says, BMJ Careers. Available from http://careers.bmj.com/careers/advice/view-article.html?id=20017662 (Accessed 11.11.14)

Renton, T., Tang HEnnis NCusimano MDBhalerao SSchweizer TATopolovec-Vranic J. (2014) Web-based intervention programs for depression: a scoping review and evaluation. J Med Internet Res. 2014 Sep 23;16(9)

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A failing NHS… A self fulfilling prophecy?

“If you want others to be happy, practice compassion. If you want to be happy, practice compassion” (Dalia Lama XIV, The Art of Happiness).

I would firstly like to point out in this post that I am not a psychologist or psychiatrist, but I have always understood the power of the self fulfilling prophecy. It therefore baffles me how the media, political leaders and top think tanks can demonize the NHS front line staff by telling them that they are failing on a daily basis!

These sandbaggers continue to display a strategy, involving the false prediction or feigned demonstration of inability in NHS staff (Gibson et al, 2000). The danger is that NHS staff will begin to believe what they hear, and perhaps even become the terrible people they are being currently described as. Thus, the false prophecy will be fulfilled.

Negative press is inevitably damaging the self esteem of NHS staff, and low self-esteem in itself can become a self-fulfilling prophecy, leading staff to act in negative, unhelpful ways (Marshall et al, 2015). So why does this continue? Has nobody told them of the damage they are doing? (I think not!)

We all deserve compassion, and most of all, self compassion. Nobody goes to work to be mediocre or fail.

Self compassion is described as “being touched by and open to one’s own suffering, not avoiding or disconnecting from it, generating the desire to alleviate one’s suffering and to heal oneself with kindness. Self-compassion also involves offering nonjudgmental understanding to one’s pain, inadequacies, and failures, so that one’s experience is seen as part of the larger human experience” (Neff, 2003).

When we are predicted lower performance we are more likely to actually perform worse – it works as a self-fulfilling prophecy.

The media and key leaders thus have the capacity to shape the confidence of NHS staff and influence their performance in both positive and negative ways. In particular, by showing that they believe in “our team,” leaders are able not only to make “us” a psychological reality, but also to transform “us” into an effective operational unit (Fransen et al, 2014).

So please, stop battering the NHS staff, but lift them up to believe they are the best thing ever! (which they are by the way)!

Give them a new prophecy to fulfill, and make it a good one.

Gibson, D.A. Sachau (2000) Sandbagging as a self-presentational strategy: Claiming to be less than you are. Personality and Social Psychology Bulletin, 26 (2000), pp. 56–70

Fransen, Katrien, et al. “Believing in “Us”: Exploring Leaders’ Capacity to Enhance Team Confidence and Performance by Building a Sense of Shared Social Identity.” (2014).

Marshall, Sarah L., et al. “Self-compassion protects against the negative effects of low self-esteem: A longitudinal study in a large adolescent sample.”Personality and Individual Differences 74 (2015): 116-121.

Neff, K (2003) Self-compassion: An alternative conceptualization of a healthy attitude toward oneself. Self and Identity, 2 (2003), pp. 85–102

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Should NHS Staff really ‘have’ to be resilient?

Firstly, I was very happy to see the issue of NHS staff stress and burnout recognized within the Lancet this week

Trawling through the literature this week and talking to colleagues, I find the word ‘resilience’ being thrown around as an offerable solution to stress. Resilience training has seemingly been offered as a tick box exercise to ‘equip’ staff with the right weapons to defend themselves, but should they have to be at war with the system?

‘Resilience is essential now for a nursing leader; you just won’t survive without it,’

Are we to be on guard at all times?

The word ‘resilience’ conjures up images of holding up the fort, guarding the gates and resisting some kind of attack. We are giving our warriors weapons for a fight.

So…after we have received our resilience training, are we expected to then cope?

Following any other form of NHS training, this would be the case. Training day = See one, do one, teach one…..right?

So, having been to resilience class, we no longer have any excuses NOT to cope…do we?

Suggesting that resilience is the remedy to cope with stressful situations, is to suggest that some people can cope, and others just cannot. ‘You either have it or you don’t’

Can it really be taught?

What if you have been to resilience training and you are still struggling?

With the stigma associated with ‘not coping’, the majority of clinicians will not feel able to seek help (Munro, 2011).

I am concerned that the focus of remedy seems to be based upon the resilience of clinicians and their abilities to cope rather than the fact that some of the things they have to deal with on a daily basis, should not be occurring in the first place. (Bullying, stigma, name, blame and shame cultures, punitive action and burnout etc..)!

There are obviously daily events which put a strain on our NHS workforce that are outside of any control. Can we ever prepare ourselves for coping with such things?

Sometimes, no amount of armor will protect us from the pain of experiencing a traumatic incident. Therefore, suggesting that there is a magic weapon to protect us from such things may be a dangerous thing.

One cannot fix the pressures of NHS work with training alone.

We all suffer from the condition of being ‘human’ – Should we ‘have’ to be resilient to a toxic work environment?

Or should the NHS be remedied to care for us when no amount of resilience training can catch us when we fall?

Resilience is a dangerous word with many connotations. There should be no bar set for what it takes to ‘cope’…the price of expectation is too high.

I would be interested to hear your thoughts on this – please see the support page if you have been affected by anything discussed within this article.

Munro, R (2011) Sick day scrutiny: as the NHS seeks to slash its 3 billion [pounds sterling] annual staff absence bill, nurses are facing tougher checks on leave taken; Nursing standard [0029-6570] Munro, Robert yr: 2011 vol:25 iss:18 pg:24

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The Founders Network – The Birth of Creating a healthier NHS

The Founders Network was founded in July 2014 on the initiative of Clare Gerada, Lambeth GP, Medical Director NHS Practitioner Health Programme, and Rex Haigh Medical Psychotherapist and Institute of Group Analysis Board Member. I am a proud member of this network and I can see it growing from strength to strength.

The collective network recognizes that there are serious problems with working life in the NHS and these must be urgently addressed if the NHS is to have a secure future. This sentiment provides the basis for my PhD work, and I am extremely grateful to Clare Gerada for advising me on my project as it moves forward. The infamous paper compiled by Clare introduces the succinct notion that “If the NHS were a patient, it would have Depression” and as such, we have much work to do in order to ‘fix’ this.

It became apparent that action was needed. A series of active listening events collectively named as the Creating a healthier NHS project, facilitated by the Founders Network and the Institute of Group Analysis were arranged as a platform to hear NHS staff and explore solutions to remedy the toxic cultures within the health care system. I attended three of these listening events and as a result, have met many inspiring people with illuminating stories to tell!

The most poignant idea that stemmed from these for me personally was this:

(I have added some extra thoughts to this!)

  • The NHS is the burnt out and overworked mother of the nation, her internal struggles are endless.
  • She is not kind to herself.
  • The father of the nation is our government.
  • Father may well want a divorce, but the alimony payments would be too high to bare.
  • Mother is having to care for more and more children with more complex needs, but with less resources. She is constantly adjusting her purse strings, but someone always loses out.
  • The father is frustrated and entertaining a mistress (Privatization) – shes alluring and dangerous, so he keeps quiet about her.
  • The children continue to tug at mothers apron strings, demanding more and more.
  • There is only so much more mother can take before she breaks. SHE is the one who needs to be cared for.

And that is why I feel passionate about this drive to value NHS staff. They need to be cared for if the patient is to receive quality care. Staff may not be very good at caring for themselves, and therefore it is imperative that we keep this conversation going, take action via the Founders Network and move towards appointing a national lead for NHS staff health and wellbeing. Please consider joining this network if you feel able to.

Here are some of the videos from the listening events if you could not attend, I will share the outcome of these listening events as soon as they become available to me and open to public viewing.

If you have been affected by any of the issues discussed within this post, please visit the support page.

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#mybluelight Campaign

Today, Mind Charity published its Blue Light Campaign to provide mental health support for emergency services staff and volunteers from police, fire, ambulance and search and rescue services across England.

One quarter of a million people who work and volunteer in the emergency services are even more at risk of experiencing a mental health problem than the general population, but are less likely to get support.

As usual, they found that it was stigma that was the biggest issue in staff seeking help. Stigma truly is the real killer, and I will be writing a blog on it soon. The campaign will do the following to help our emergency services:

  • An anti-stigma campaign, working together with Time to Change, and guidance for employers to improve the way they support their staff
  • A bespoke mental health training package for managers as well as frontline staff and volunteers across the emergency services
  • A pilot approach to build the mental health resilience of emergency services staff and volunteers
  • An information helpline and resources just for emergency service staff and volunteers, and their families.

The support will be available from April 2015 and the Blue Light Programme will run until March 2016. It is being developed in consultation with individuals from across the emergency services.

The Twitter hashtag for this campaign will be #mybluelight

It is so refreshing to see this issue (which as you know I feel super passionate about) being addressed. Although I hope this project will extend to all health workers who may all at some point be exposed to the same psychological traumas. A great perspective on other Blue Light professions is given by The Mental Health Cop who was also part of the advisory board for this campaign.

Although this work is amazing, it also involves empowering staff with resilience, and this concept concerns me. It may suggest that there are some who can cope and others who are weak. It may imply that if you have resilience, then you will not be affected. In other areas of work based psychological distress, you shouldn’t have to be resilient. For instance to bullies, blame and scapegoating cultures, it should just stop. We will always be affected by traumatic incidents, and I know that this anti stigma campaign and valuable resource guidance will improve the mental health and well being of NHS Staff.

Why not ask your NHS Trust to sign the Blue Light Time to Change pledge and develop an action plan. Commit to support better mental health in your workplace – get in touch with Mind and give your name, job title, the service you work for and your contact details.

Email bluelight@mind.org.uk with your name, organisation and contact details and Mind will send you updates on the programme.

If you have been affected by anything discussed within this post please see the support page on this blog.