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The ‘Magic’ #Resilience Pill

There are no consistent definitions for what resilience actually is, yet I am beginning to actively dislike the word. It is beginning to sound as though it might be the magic pill everyone within the #NHS might need to take in order to survive. I am not so sure.

We don’t know much about resilience, yet it has been suggested that healthcare professionals need to be supported, not trained in resilience. I am inclined to agree.

Resilience building has a hidden cost in that “By introducing this focus on developing ourselves into “happy”, “positive” leaders one could argue that we are merely buoying ourselves away from, and in effect delaying, what is inevitable – the call to deal with the reality of our current state of play.”

Having ‘resilience’ puts the ownership of survival upon the beholder….. Does this mean that “You have had your resilience training (or ‘pill’) therefore you should be resilient now”? …. Will there be no room to show anything other than a new found ability to ‘cope’?

The NHS is a challenging place to work, and healthcare professionals are doing their best to survive and deliver the compassionate care that they wish to give. So should we be making the NHS a less challenging place to work? or be toughening up those who work there to become ‘resilient’ to adversities?

This is going to be a relatively short post, but I wanted to write down a few analogies that may help us all in thinking about what ‘resilience’ may really mean for us.

If you were being punched repeatedly in the face, would you:

A) Try to become resilient to the pain?

or

B) Try to reduce/stop the punching?

Perhaps a bit of both, but you see my point. The girl in the street who gets attacked does not need to wear a longer skirt, fight back harder or scream louder. Her attacker needs to stop attacking her.

The danger comes when staff feel that they should become more resilient rather than seek support for any pain they may be suffering. NHS staff health is vital to safe and effective patient care, and we would all like to see staff engaging happily with their work.

Yet perhaps the ‘Magic’ #Resilience Pill may actually be the placebo that masks our incredibly valued sensitivity as healthcare professionals.

It has been suggested that:

“The notion of resilience in midwifery as the panacea to resolve current concerns may need rethinking. Resilience may be interpreted as expecting midwives ‘to toughen up’ in a workplace setting that is socially, economically and culturally challenging. Sustainability calls for examination of the reciprocity between environments of working and the individual midwife.”

Whatever the case, it is time to be kind to each other. Always.

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#InternationalNursesDay celebrated during #MentalHealthAwarenessWeek… coincidence? #MHAW15

So… this will be a short blog for me today as I am working to get two new papers published so that I can do equally exciting, but different things next week 😀

I just wanted to sketch some quick thoughts down here about #InternationalNursesDay and  , as these events both fall within the same week and indeed #MentalHealthAwarenessMonth.

 celebrates self care and mindfulness this year, both extremely valuable tools (IMHO) to maintain ones own well being. The awareness week also brings our attention to the eternal war on stigma, which again IMHO is the biggest killer of all. This year was indeed an amazing #MentalHealthAwarenessMonth and I very much enjoyed reading and seeing the buzzing communities becoming involved on twitter.

Equally, #InternationalNursesDay  was celebrated with vigor, yet I saw this event in a different light.  saw those with mental ill health explain to the world how it feels to manage their mental health every day. They implore the world to take notice of their needs and  recognise mental ill health as being equal to physical health. They draw upon the importance of mental health awareness and the need for action. They are fighting for their rights and more. It was inspiring to see 😀

However, those celebrating #InternationalNursesDay seemed to share a different message. The main campaign which took my attention was the hashtag #whyInurse. This involved nurses from all over celebrating their work, acknowledging their privileged position and providing examples of the pride they share in nursing. It was really quite jovial. They were celebrating what they wanted to give, rather than anything they wanted to take for themselves.

This is seemingly a consistent pattern for health care professionals….they give all that they have….

Do they ever have time to look after themselves? Allow self care? practice mindfulness?

Many nurses celebrating their profession also celebrated #MentalHealthAwarenessWeek…Do they practice what they preach?

Although there is much to celebrate, I worry that health care professionals are placing themselves upon high ground. Through my research and the statistics I am seeing, I know that there are many health professionals who may be suffering in psychological distress. When these celebrations shout to the world that nurses are ‘having a ball’, it may make it that much harder for those in pain to speak out.

It may even make people think that health care professionals are much too happy in their jobs to be in psychological distress.

As it is #MentalHealthAwarenessWeek… I want to raise awareness about the healthcare professionals in psychological distress. They are dealing with horizontal violence, emotional and moral traumas, traumatic incidents, stigma, compassion fatigue and much more.

Remember that 1 in 4 people in the UK will experience a mental health problem each year. This figure also applies to health care professionals working within the NHS and all over the world.

I would like to bring #InternationalNursesDay and #MentalHealthAwarenessWeek together, so that healthcare professionals can become aware about their own mental health needs and the needs of their colleagues.

These are only my personal views. There is never any offence intended. Please see the support page of this blog if you have been affected by any of the content within this blog.

Thank you  for reading 🙂 

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#BringBackTheNHS Event – London 2015

So, yesterday I toddled on down to Westminster to attend the #BringBackTheNHS event and see what it was all about. The event was filled with great speakers, including some famous ones like: @IanMcKellen @charlottechurch and @marcuschown. This was set to be a ‘Non Political Event’ to celebrate the NHS. Nevertheless, there were some passionate words spoken.

I try not to get too political in my every day research, but it is so important that we all understand the healthcare climate in which we are working, living and healing. I also feel it is important for me to understand the continuously evolving health policies, rhetorics and visions if I am to contribute positively to the #mentalhealth and well being of Healthcare workers.

And so I came to learn about the The Campaign for the NHS Reinstatement Bill 2015 (  ) currently championed by @AllysonPollock among many others!

In a nutshell: The Health and Social Care Act of 2012, forced a commercialised model upon the NHS in England.

This new Bill aims to reinstate the founding vision for the NHS (Freee at the point of use, regardless of a persons ability to pay). A worthwhile cause to become involved with.

However, throughout the event and in listening to the speakers share some powerful NHS stories, I personally was struck by the stories involving NHS Staff. I would just like to summarise the key things I took from the evening.

– The NHS Staff will carry on giving every part of themselves to the care of others.

-The NHS staff do not go to work for themselves, but for the service of others

– NHS Staff are bound to protect/defend/obey the mother of the nation (ie. The NHS) –  as the well being of their family, friends, mothers, aunties, children etc….depend upon it.

– Front line NHS staff see the true nature of life and death. Their eyes see what others cannot comprehend or identify with. They then go back to changing beds….

-They work hard, despite being underpaid (and arguably undervalued).

-They work unsociable hours, any time, anywhere.

– Where resources are strained, they make sure that people still get what they need.

– They are still willing to give more.

The cultures of our healthcare systems and staff clearly show that ‘to give all’ is not enough. They will always give more…..Yet in times of strain, change and challenging circumstances, how will this effect the mental wellbeing of healthcare staff?

Who puts healthcare staff first?

Who makes sure that they are cared for?

Worryingly, this ‘carry on regardless’ mentality may put our healthcare staff on an even higher pedestal to perform and deliver. Will this make it even harder for those in psychological distress to seek help?

Does this ideology accept failure? – Healthcare staff are good people. They will give their all. I just hope there is someone there for them if they fall.

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Naming Mental Health as the Cause for Disaster means a Reversal of Gains to Reduce Stigma

I am almost at a loss for words when I see the headlines in relation to Andreas Lubitz and the tragedy of Germanwings 4U9525. The horror is unbearable, but the press coverage surrounding the story has been abhorrent. I am scared to write this post as I do not want my words to detract from the pain that the families involved must be feeling…and I am sure I will not cover this issue as well as @MentalHealthCop or @BlurtAlerts… but I must share my thoughts.

Relating this story back to my own PhD research in supporting health professionals in psychological distress, this story should remind us all that high profile jobs in high pressure environments placed in the public eye can produce adverse health problems. Many people have been questioning what ‘Burnout’ actually is. For clarity I will define this as follows:

Burnout is a syndrome of emotional exhaustion. Burnout has been defined by Maslach as a syndrome consisting of emotional exhaustion, depersonalization, negative thinking towards others and a reduced sense of personal accomplishment (Maslach, 1986, Maslach, 1996).

Moving on to depression:

“Depression is a common, disabling disorder characterized by a period of at least two weeks in which a person loses pleasure in nearly all activities and/or exhibits a depressed mood“(Stewart et al, 2004;19).

Symptoms of major depression include feelings of sadness and hopelessness, diminished pleasure, changes in weight, changes in sleep patterns, lack of interest in life, chronic fatigue, a sense of worthlessness or guilt, muddled thinking and poor decision making (APA, 2013).

Sadly depression can affect all areas of a persons life, and yes some of those with depression will die by suicide. However, the headlines seemingly suggest that depression is the cause of this ‘Murder’. It will not be the only cause of this tragedy, and nothing is confirmed as yet. It frightens me to think that these assumptions are coming up so thick and fast before the facts are known. This highlights to me the stigma still apparent and surfacing in the wake of fear.

We do not know all of the facts, perhaps Andreas dissociated from everything around him and any decisions he may have been making, perhaps this is something completely unrelated. Whatever happened, the headlines of this story are damaging and risk the reversal of any progress we have made in reducing stigma.

Some news companies are scaremongering and stating that nobody with depression should be allowed to fly a plane. This at least makes a change from them saying that all those with depression are ‘fit to work and lazy’ – but I digress.

This idea is ridiculous as those with mental health issues can achieve great things… remember 1 in 4??? Do we get rid of 1/4 of our pilots?

What if our pilots have a headache? what if they have a brain tumor? what if they have a seizure whilst in flight? – the ridiculous parodies may continue…

I was hoping this would get people talking about what can be done to support those in *potential* psychological distress in order to improve overall services, instead it has led to an immediate reaction of fear. I am hoping the long term story will be a different one.

American Psychological Association (APA) (2013) Diagnostic and Statistical Manual of Mental Disorders (V) American Psychiatric Association, Washington, DC (2013)

Maslach C, Jackson SE. Maslach Burnout Inventory Manual, 2nd edn. Palo Alto (CA): Consulting Psychologists Press Inc; 1986.

Maslach, C Jackson, S Leiter, M, Schaufeli, W, Schwab, R (1996) MBI: The Maslach Burnout Inventory: Manual. Consulting Psychologists Press, Palo Alto (1996)

Stewart Donna ; Gucciardi Enza ; Grace Sherry (2004) Depression BMC Women’s Health, 2004, Vol.4(Suppl+1), p.S19

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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)