Care for Carers: Mental Health in Healthcare Must Be Prioritised Beyond COVID-19

Article | Dr Nick Taylor unmind.com

Healthcare workers have been on the frontline of the fight against COVID-19 for over a year now, working round the clock to slow the spread of the virus and save lives.

And while their efforts have been praised by the British public, the pandemic has seen a surge in mental ill health, especially post-traumatic stress disorder (PTSD), among healthcare staff.

NHS workers have been overworked and are continually confronted with extremely traumatic situations. Recent research conducted by King’s College London reports that 45% of intensive care staff in the UK now have poor mental wellbeing, including 40% with PTSD. And it’s likely that these numbers will grow as we emerge into the new normal.

As recovery continues, the wellbeing of healthcare workers is vital. The added exertion they’re having to make will have a dramatic impact on their mental health, unless mental wellbeing is prioritised not only right now but also post-crisis.

We need a call for measures that offer proactive psychological support, taking into account the specificities of the trauma and experiences frontline workers have faced in the last year. Why?

Because the stakes are too high and if we don’t address this issue now, there will be long-term ramifications. The goal is as much to help healthcare workers thrive and live fulfilling lives as it is to prevent mental health challenges from arising in the first place.

Build Resilience to Fight Burnout

The World Health Organization defines burnout as “A syndrome [...] resulting from chronic workplace stress that has not been successfully managed” . There’s a misconception that burnout happens all of a sudden. Instead, it’s a steady drip of negative experiences and stressors that erode us bit by bit.

Over the last year we’ve seen more burnout than ever. As the NHS fought the sudden outbreak of COVID-19, nurses and doctors were plunged into long, intense, and mentally and physically demanding workloads. Facing psychological conflicts between their responsibilities as healthcare workers and the need to look after themselves and their families meant that occupational stress, anxiety and depression were all on the rise.

In fact, the British Medical Association (BMA) found that 67% of doctors in the UK reported that current levels of fatigue and exhaustion were higher than normal – both factors that lead to burnout.

We need to redefine and build resilience by taking care of the many aspects that impact our ability to live mentally healthy lives – whether that’s looking at our sleep cycles or how we connect with people. This helps us to reduce the level of stress we experience and avoid burnout, cultivating a fulfilling life, both at work and outside. This is why all healthcare workers – and their employers – must focus on building adequate resilience and coping mechanisms.

After all, we all have mental health that we need to nurture, just like we do with our physical health. Reactive, treatment-focused solutions help to break the negative cycle of low resilience, high stress and low performance.

To build resilience, the NHS needs to focus on proactive prevention for every employee, offer support from dedicated and experienced specialists, and have a mental health strategy rooted in psychology.

Stop PTSD in its Tracks

Looking towards our ‘new normal’, it’s known that PTSD tends to appear once the traumatic situation is over. So, to avoid long-term and potentially debilitating consequences, it’s important to monitor how frontline staff are coping once we come out of lockdown.

With mental health conditions already accounting for up to 20% of absences at leading hospitals, the BMA has warned that the mental health crisis stemming from the pandemic could lead to a mass exodus of doctors and nurses once the worst has passed.

Creating a proactive strategy to tackle PTSD means understanding where it comes from: a bug in the process that enables us to create and store memories.

Normally, memories are stored neatly away in our mind, with a timestamp. But this process doesn’t happen with a traumatic memory.

When we’re exposed to a life-threatening or intensely fearful situation, our brain goes into an automatic, defensive fight-or-flight mode that suspends normal sensory processing.

As a result, the memory is fragmented into parts, without a clear beginning or end, and it doesn’t get filed away neatly with our other, neutral memories.

This lack of coherent processing has ramifications down the line, including random triggers and a strong sense of ongoing threat. It can leave people feeling on edge, physically jumpy and overly vigilant. There are numerous other symptoms of PTSD, including feelings of anger or shame, low mood and sleep disturbance. After such a traumatic year for healthcare workers, the risks of developing PTSD will be high, so closely monitoring the situation by enabling healthcare staff to regularly check in and assess their mental wellness, and to discuss it openly with colleagues and managers, will be crucial in the next year and beyond.

Prioritising Mental Wellbeing Post-COVID-19

While it’s difficult to minimise stress during a pandemic, it is possible to effectively cultivate proactive strategies for recovery.

To prioritise the mental wellbeing of healthcare workers now and after the COVID-19 crisis, the NHS – as a business and an employer – will need to focus on a proactive strategy that addresses the mental, emotional, physical and interpersonal aspects of its employees’ health and wellbeing, including:

• A whole-person approach:

Staff should be encouraged to regularly assess their mental wellbeing and discuss it with their managers so that any issues can be spotted early on and adequately managed. All three elements of our wellbeing – psychological, social and physical – need to be nourished and looked after.

• Engaging every employee:

We all have mental health, all the time, so the right mental health programme will need to be inclusive and engage everyone in the workforce. This can be done through the use of preventative tools, resources and support – tackling the whole spectrum of mental health needs.

• Support built on measurable psychological insight:

In order to prevent mental ill health, the NHS needs insight and data. The programme and platform used should be measurable, helping to deliver value, personalisation and accessibility for all employees.

If everything goes well, the COVID-19 crisis will start to ease. But for frontline workers, it will continue as they process the impact of what they have gone through. A long-term mental health strategy that focuses on prevention – rather than reaction – needs to be in place to help them through this process, building the right mechanisms and habits to prioritise their mental wellbeing in the long term.

After all, how can people in our healthcare system care for us, if they aren’t cared for themselves?

Dr Nick Taylor

Co-founder and CEO of Unmind

Dr Nick Taylor is the co-founder and CEO of Unmind, a workplace mental health platform that provides clinically-based tools and training to create healthier, happier and more human organisations.

Drawing on an early passion for the human mind, Nick studied psychology before gaining a doctorate in Clinical Psychology and embarking on a career with the NHS as a Clinical Psychologist, where he became interested in corporate wellness. Nick then co-founded Unmind in 2016 to address a gap in helping organisations provide their employees with the right tools to look after their mental wellbeing at work.

unmind.com