Executive Summary: Who Heals the Healer?

Page 1

EXECUTIVE SUMMARY

Who heals the healer? How might we equip and support Junior Doctors to start conversations about their mental health and not feel alone? Aim: To empower Junior Doctors to track, vocalise and feel supported in their mental health

(BMA, 2019)

80%

• Junior Doctors do not know where to access mental health and of doctors reported being well-being support. Support varies greatly across NHS Hospital Trusts at risk of burnout and Insight: 1, 3 Insight: 2,3,4,5,6 Insight: 1,2,5,6 Junior Doctors were the • Fear of reflecting honestly and speaking up. Juniors said they had ‘played down’ Insight: 1, 3 Insight: 2,3,4,5,6 Insight: 1,2,5,6 their feelings when talking about their mental health to supervisors out of fear of most vulnerable Persona Persona 2: Jenny Persona 3: Melissa Insight: 1, 31: Guy Insight: 2,3,4,5,6 Insight: 1,2,5,6 being labelled as not resilient or incompetent

(Copeland, 2019)

Psychiatry Trainee, 29

25%

O&G Trainee, 31

F1 placement in A&E, 25

Persona 1: Guy Persona 2: Jenny Persona 3: Melissa Persona 1: Guy Persona 2: Jenny Persona Melissa • Female Doctors are particularly susceptible to negative mental health. Guy, a Junior Doctor whose Jenny, a Junior Doctor from Melissa, a 3: Junior Doctor Psychiatry Trainee, 29 O&G Trainee, 31 F1 placement in A&E, 25from

Trainee, 29 the O&G Trainee, F1 placement inmust A&E,urgently 25 training rotation forced him London. Normally outgoing Birmingham. qualified As profession moves to a31 higher proportion of women, weRecently of all NHS sick leave is Psychiatry Guy, a Junior Doctor whose Jenny, a Junior DoctorJenny from has Melissa, a Junior Doctor from to move to Basildon for a new and bubbly, recently and finding her job in a hospital address this reality caused by stress, anxiety Guy, a Junior Doctor whose Jenny, a Junior Doctor from Melissa, Junior Doctor training rotation forced him London. Normally outgoing Birmingham. Recently qualifi ed placement, far removed from become anxious and stressed can be aoverwhelming atfrom times. and depression training forced London. Normally outgoing Birmingham. Recently ed to moverotation to Basildon forhim a new and bubbly, recently Jenny has and fifeels ndingher her job negatively in qualifi a hospital friends and family. When he due to back to back night shifts She work • Healthy deliver better patient outcomes. Data shows staff to move to work Basildon fornew afrom newDoctors and recently has and fibe nding her job inhealth awell-being placement, far removed become anxious andJenny can overwhelming athospital times. goes into at this andbubbly, being involved instressed a patient impacts her mental as a key indicator for high quality patient care outcomes placement, far removed from become anxious and stressed can be overwhelming at times. friends and family. When he due to back to back night shifts She feels her work negatively

3,000,000

IN

realities of being a doctor

IN

D E MI C

This places them at a significant disadvantage for seeking help and advice

Junior Doctors may have limited into their own mental Junior Doctorsinsight are increasingly or forced well-being due to the isolated whenhealth they are fast paced, high stress move job every six months. Junior Doctors often feel to they Junior Doctors often feel they environment they work in. Mental Close relationships, support are the only one not coping. are the only one not coping. health and well-being ebbs and rapport with seniors and They are less likely to speak up, They are less likely to speak up, ows over time. It is hard to cultivate for fear of being labelledpeers as are hardand for fear of being labelled as to keep track of mental health weak or not resilient. Many do weak or not resilient. Many do over a period of time in this not know where to accessThis helpplaces them at a significant not know where to access help disadvantage environment for seeking help and advice A private first step to vocalise A private first step to vocalise It is crucial to have an appreciation their own feelings is crucial to their own feelings is crucial to of when you are so down that you building the confidence to start a building the confidence to start a need to speak up conversation with someone else conversation with someone else

Concept An Slack Anonline online01 Slack*community community to simulate Doctor’s to simulate virtual Concept 01aavirtual E R M E N MEN S ODoctor’s D P O I R C Virtual Concept 01 R The NMess E N Mess through aaplatform that Mess through platform that T T EDoctors’ VI isissensitive responsive sensitive and responsive to The Virtualand Doctors’ Messto Insights Insights Insights An Slack* community Theonline Virtual Doctors’ Mess Concept 01 your realities of life ofworking working life relating to practical to relating toyour the realitiesrelating to simulate aDoctor virtual Doctor’s and physical aspects relationships or realities of aonline as Doctor An Slack* community as aJunior Junior of the workplace communication Mess through a platform that being a doctor Ansimulate online Slack* community The Virtual Mess to aDoctors’ virtual Doctor’s between people istosensitive and responsive to simulate a virtual Doctor’s Mess through a platform that your realities ofaworking life Mess through platform that An online Slack* community is sensitive and responsive to as a Junior Doctor is sensitive responsive to simulate virtual Doctor’s your realitiesaand of working lifeto your realities of working that life Mess through a platform as a Junior Doctor a Juniorand Doctor isassensitive responsive to Research Method & Process your realities of working life 1. Qualitative Semi-Structured Interviews as a Junior Doctor AL

Insights relating to the whole health system

R PER S O N

Junior Doctors are increasingly isolated when they are forced to move job every six months. Close relationships, support and rapport with seniors and peers are hard to cultivate

AL

S

E MIC YS T

TE

Insights relating to relationships or communication between people

Insights relating to the realities of being a doctor

EN

cal cts e

EN

AL

AL

NT

AL

Insights relating to the whole health system

AL

S

E MIC YS T

peers are hard to cultivate not know where to access help relationships or isolated when they forced Hypothesis 01 areInsight: 1, 3 Insight: 1,2,5,6 Insight: 2,3,4,5,6 Insight: 1,2,5,6 Insight: 1, 3 Insight: 2,3,4,5,6 communication Insight: 1, 3 Insight: 2,3,4,5,6 to move job every six months. Junior Doctors are increasingly Junior DoctorsPersona often feel they Hypothesis 02 between This peopleplaces them at a signifi A private to vocalise 1:Persona Guy 2: Jenny first step 3: Melissa Persona 1: Guy Persona 2: Jenny Personacant 3: MelissaPersona Persona 1: Guy Persona 2: Jenny Close relationships, support Junior Doctors are increasingly isolated when they are forced Psychiatry Trainee, 29 O&G Trainee, 31 F1 placement in A&E, 25 Psychiatry Trainee, 29 31 F1 placement in A&E, 25 are the only one coping. Hypothesis Psychiatry Trainee, 29 02 O&G Trainee, disadvantage O&G forTrainee, seeking help their own feelings isnot crucial to31 Guy, a Junior Doctor whose Melissa, a Junior Doctor from rapport with seniors and Guy, aand Junior Doctor whose Jenny, a Junior Doctor from Melissa, a Junior DoctorJenny, from a Junior Doctor from isolated when they are forced to move job every six months. Guy, a Junior Doctor whose to Jenny, athey Junior Doctor from They are less likely speak up, Junior often feel training rotation forced him London. outgoing Birmingham. Recently qualifi ed training rotation forced him London. Normally outgoing Birmingham. Recently qualifi ed NormallyDoctors and advice building the confi dence to start a training rotation London. Normally outgoing to move for aher new bubbly, recently Jenny has forced and fihim nding her job in a hospital to to move to Basildon forjob a newhard and bubbly, recently Jenny has to Basildon and finding job in a and hospital peers are to cultivate move every six months. Close relationships, support to move forbe a new and at bubbly, Jenny has foranxious fear ofto Basildon being labelled as placement, far removed from and stressed can overwhelming times.recently Junior Doctors often feel they are the only one not coping. placement, far removed from become anxious and stressed can be overwhelming atbecome times. conversation with someone else placement, far removed from anxious and stressed M E R E N friends When he due toO back to back night shifts She feels her workbecome negatively S P friends and family. When he due toD back toM backInight shiftsand family. She feels herR work negatively E O C N involved Nrapport friends and family. When heher mental due to back to back night shifts support and and Opportunity Area Opportunity R goesClose into work at thisher new being in a less patient impacts health E mental healthand into work atrelationships, new and being seniors in a goes patient impacts Ninvolved weak or not resilient. Many do Ewith are the only one not coping. They are likely toArea speak up, Tthisknow Tknow and this being hospital he doesn’t incident butnew is unsure whether is ainvolved in a patient hospital he doesn’t incident at work but is unsure whether this is a at work goes into work at this VI Opportunity hospital he doesn’t normal know feeling incident at work This places them atArea a signifi anyone andcant feels isolated at and rapport with and peers areathard to seniors cultivate anyone and feels isolated normal feeling not know where help They are less likely toaccess speakas up, for fear of being labelled Jenny is uneasy about speaking anyone and feels isolatedto at Jenny is uneasy about speaking work and at home work and at home Jenny is uneasy about speaking up to her colleagues as she Melissa tries not to think about upfor tocreate her colleagues as she help Melissa tries not to think about work and at home Opportunity Area How are might we aGuy How might wehershow them disadvantage seeking peers hard to cultivate Insights Insights Insights up toand herto colleagues feels lonely doesn’t them to think she resilient. mental well-being Guy feels lonely and doesn’t want them to think she her and mental well-being and to want for fear of being labelled as weak or not Many do as she Guy feels lonely andjust push through.doesn’t want them to think she unsupportedjust as he hasthrough. norelating work She does can’t cope. She desperately She does unsupported as might he has no workwe can’t cope. She push How create awhich relating to practical to relating to the working environment they are not alone in feeling and advice This places them adesperately signifi unsupported as he has no work can’t cope. She desperately friends tocant confi dewant in. He to be reassured that not want to be labelled as the friends to confide in. He really wants to at be reassured that not to really be labelled wants as the A Junior private first step toMany vocalise weak or not resilient. dothis not know where to access help and physical wants to build a sense of team anotheror Doctor that cannot cope wants aspects to build a sense of team another Junior Doctor would only onerelationships that cannot cope friendswould to confide in. Heone really wants to be reassured that realities ofwhich working environment How we only show them his new colleagues have acted in might the sameto way fosters supportive relationships way and facilitate aArea ďŹ to rst would spirit with his places new colleagues have same spirit way with wants build a sense of team another Junior Doctor This them at athe signifi cant disadvantage foracted seeking help Opportunity Area Opportunity of the workplace communication their own feelings isprivate crucial not know where to access help being aindoctor she did. She feelsspirit alone andhis new colleagues she did. She feels alone and with have acted in the same way fosters supportive relationships they not alone in feeling this Hypothesis 03 Hypothesis 03she up? doesn’tseeking know who to turn tohelp doesn’t knoware who to turn between people did. She feels alone and andadvice camaraderie? step towards speaking disadvantage for and building the dence AOpportunity private fitorst confi step to vocalise Hypothesis 01 Hypothesis 01 doesn’tto knowstart who to turna to Opportunity Area Area and camaraderie? Hypothesis way and facilitate a private ďŹ rst and advice How might weHypothesis create might we01 show them Opportunity Area Opportunity Area 02 a Hypothesis 02 fifeelings conversation with someone else AHow private rst step to vocalise their own is crucial to Junior Doctors are increasingly Hypothesis 02 step towards speaking up? isolated when alone they are forcedin feeling this working environment they are not their own feelings is crucial building the confi dence to to start a to move job every six show months. How might we create which a How might we them Junior Doctors often feel they Close relationships, support are the only one not coping. fosters supportive relationships way facilitate asomeone private ďŹ likely rst How might we create a Howand might we show them and rapport seniors and building the confi dence start a up, conversation with else Theyto are less to speak working environment which they are notwith alone in feeling this peers are hard to cultivate for fear of being labelled as Opportunity Area Opportunity Area and camaraderie? step towards speaking up? weak or not resilient. Many do working environment which theyand are not alone in feeling this conversation someone else This places themwith at a significant fosters supportive relationships way facilitate a private ďŹ rst not know where to access help disadvantage for seeking help fosters supportive relationships way towards and facilitate a private ďŹ rst and advice A private to vocalise and step up?first step Howcamaraderie? might01 we create a How might 02 wespeaking show them their own feelings is crucial to Concept Concept Concept 02speaking building the confidence to start a and camaraderie? step towards up? Concept 01 conversation with someone else working environment which they are not alone in feeling this fosters supportive relationships way and facilitate a private ďŹ rst The Virtual Share Your Story Share Yourspeaking Story up? Thecamaraderie? VirtualDoctors’ Doctors’Mess Mess and step towards

IN

Insights relating to practical and physical aspects of the workplace

IN

T

EN

R

AL

VI

AL

EN

C

ON MEN

hospital he doesn’t know incident at work but is unsure whether this is a friends and family. When heat due backinvolved to back in night shifts She feelsfeeling her mental work negatively goes into work at this new and to being a patient impacts her health anyone and feels isolated normal goes work new health and being involved indeteriorate a patient impacts her mental health • at this ‘Mental isincident not static; it can it can improve too andis there Jenny isat uneasy about speaking but hospital he know work but is unsure whether this a workinto and atdoesn’t home number of lost NHS working hospital he doesn’t know incident at colleagues work to learn is unsure whether this is a their upfor to her as she Melissa tries not to think about anyone and feels isolated at normal feeling are opportunities doctors from and but support each other through days in 2018–2019 alone Jenny is uneasy about speaking anyone and feels at normal feeling Guy feels and doesn’t want them to think she her mental well-being and to work and homeisolated own experience’, (BMA, 2019) Insight: 1, at 3lonely Insight: 2,3,4,5,6 Insight: 1,2,5,6 Jenny uneasy aboutas speaking up to is her colleagues Melissa tries not 25, to think about work andGuy, at home unsupported asJunior he hasDoctor no work can’t cope. She just push through. She does Persona: 29, Persona: Jenny, 31,desperately Juniorshe Doctor Persona: Melissa, Junior Doctor up to her colleagues she Melissa tries not to think about Guy feels and doesn’t them toasthink her and friends tolonely confide in. He really wants towant be reassured that she notmental want towell-being be labelled as to the Guy feels doesn’t want them to think she her mental well-being to unsupported he has of noteam work can’t cope. She desperately just push Sheand does Hypothesis 01 asaand Hypothesis 02 Hypothesis 03 cannot wants to lonely build sense another Junior Doctor would only one through. that cope unsupported heto has noreally work can’t desperately just She does friends to confi de in. He wants to beShe reassured that not push want through. to be labelled as the Insight Themes | Three Three Concepts spiritPersonas with hisasnew colleagues havecope. acted in the same way Junior Doctors increasingly Junior Doctors may have limited friends to build confiare de in. Heofreally wants to be reassured that not want to be labelled as the Junior Doctors often feel they wants to a sense team another Junior Doctor would only one that cannot cope she did. She feels alone and isolated they are forced insight their owncope mental are the only one not coping. wants to when build a sense of team another Junior Doctor would only oneinto that cannot spirit with his new colleagues have acted in the same wayto Hypothesis 03 doesn’t know who to turn R D E MI C R P Espirit toS O move job six months. health or well-being due to the They are less to speak up, Nwith hisevery new01 colleagues have acted inlikely the same way EN she did. She feels alone and TE Hypothesis Close relationships, support fast paced, high may stress environment for fear being labelledand as Junior Doctors have limited she did.of She feels Hypothesis 03health doesn’t know whoalone to turn to and rapport with seniors and they workinto in. Mental and weak or not resilient. Many do Insights Insights insight their own Hypothesis 03 mental Junior Doctors are doesn’t know who Hypothesis 01increasingly relating to Hypothesis 02to turn to relating to the

Junior Doctors may have limited insight into their own mental health or well-being due to the fast paced, high stress environment they work in. Mental health and well-being ebbs and ows over time. It is hard to keep track of mental health over a period of time in this environment

It is crucial to have an appreciation of when you are so down that you need to speak up

Concept 02 ‘That ‘Thatstory storyresonates resonateswith with me’. Share your story with a a Concept 02 me’. Share your stories with Concept Share Your02 Story community of Junior Doctors community of Junior Doctors who unable to Share Your Story whoare are unable toidentify identifyyou you Share Your Story Concept 02 That story resonates ‘and are not affi liatedwith to your

and are not affiliated to your me’. Share your stories with a employer. you ‘That story By resonates with employer. Byrealising realising youare are community of Junior Doctors Share Your Story ‘ That story resonates with not alone you learn and also me’. yourlearn stories not Share alone you andwith alsoa who are unable tostories identify you me’. Share your with a support others community of Junior Doctors support others and are not affi liated to your community of Junior Doctors ‘who Thatare story resonates with you unable to identify employer. By realising you are whoare arenot unable to identify me’. Share your stories a and affiliated towith youryou not you learn and also andalone are not liated to your community ofaffi Junior Doctors employer. By realising you are support employer. By learn realising are who are others unable to identify you not alone you andyou also not alone you learn and also and are not affi liated to your support others support others employer. By realising you are with Junior / Senior / Retired Doctors, Medical Students & a Medical not alone youLayer learn and also support 2. Four separate Co-design Workshops with Designers, Juniorothers & Senior Doctors DEPRESSION

good evening,

share your stories and support others you are not alone

DEPRESSION

good evening,

RECENTLY RESONATED

share your stories and support others you are not alone

STRESS

ANXIETY

ELATION

RECENTLY RESONATED

STRESS ANXIETY STORIES FROM OUR COMMUNIT Y

T H E PAT I E N T I CANT FORGET

ELATION

TAKING IT HOME

LONELINESS

g o oS d gM , OUR COMMUNITY T OeR v I EeSn Fi Rn O

share your stories and support others you are T Hnot E Palone ATIENT I LONELINESS

TAKING IT HOME

CANT FORGET

On one of the days when I was feeling the lowest, if anyone asked me a question I would go red and get really ustered. I couldn’t get home without On one days when I stopping on of thethe way home feeling the lowest, if anyone andwas crying. asked me a question I would Onego ofred my and F1 colleagues get really turned ustered. to me and saidget ‘you literally home without D E P R E IS couldn’t SION always look so is home there stopping onhappy, the way everand a day where you aren’t crying. On one of the days when I was happy?!’ feeling the of lowest, if anyone asked turned One my F1 colleagues me a to question I would redliterally and get me and said go ‘you reallyalways ustered. I couldn’t get home look so happy, is there D Ewithout P R E Sstopping S I O N the way home ever a dayon where you aren’t one One of theofdays when I was and On crying. my F1 colleagues happy?!’

3. User Testing Workshops with Junior and Senior Doctors The outcomes of the Co-design Testing Workshops have directly *Slack is an and onlineUser messaging service. Its workspaces allow you informed the Key Recommendations and Proposed Design Intervention it might be the key to helping someone else

share your stories and support others TRESS ELATION o onot d e v e n iAnNgX, I E T Y youSgare alone

On one of the days when I was share your stories and support others feeling the lowest, if anyone you S H Aare R E not Y Oalone UR STORY i t m i g h t b e t h eme k e y t o h e l p i n gI would someone else R E C E N T L Yasked R E S O NaAquestion TED go red and get really ustered. STORIES FROM OUR COMMUNIT Y I couldn’t get home without SR TE R ATION C EE SNST L YOn R E SAON NXAITEETdays DY whenEIL was stoppingone on of thethe way home the Llowest, anyone TAKING T H E P A Tand I E Nfeeling T I O N E LifI N ESS g oC o icrying. n g, HOME Ad N Te FvOeRnG E T S T R E S Sasked me AaNquestion X I E T Y I wouldE L A T I O N One of my F1 colleagues turned go red get really ustered. share your stories and and support to me and said ‘you others literally you are not alone I couldn’t get home without always look so happy, is there S T O R I E S F R Ostopping M O U Ron C the O Mway MUN ITY home ever a day where you aren’t and crying. happy?!’

TAKING IT HOME

IM LR OC NOEM L IM NUE N Sturned SI T Y ofA my colleagues SETENOTPRLAIYET ISREEN FOne R E TCH SRTOON TOE UDF1 CANT FORGET

Inside it was far ‘you fromliterally what to me andsosaid

IP had feeling. S H SATRTREH U TR SN TAO RI X Y I Eso always there EYSO A I Ebeen T Nlook LMaybe O N E LisEI N ES T Yhappy, L AE TS ISO N

Clare Summerfield ¡ Royal

IT

On one the days whengoI red and get me look aofquestion I would always so happy, is there ever a was really feelingustered. the lowest, if anyone couldn’t get home day where you aren’tIhappy?!’ asked me a stopping questiononI the would without way home Inside it was so far from what I had go red and get One really ustered. crying. of  my F1had colleagues beenand feeling. Maybe everyone I couldn’t getme home and without saidno‘you beenturned feelingtothe same but oneliterally was stopping onlook thesoway home always happy, is there ever a letting the cracks show. Onday onewhere of theyou days when I and crying. aren’t happy?!’ was anyone DEP R EInside Sfeeling Smy IO Nthe itF1 was solowest, far fromifturned what I had One of colleagues asked me a question I would feeling. Maybe everyone On of ‘you the days when had I to mebeen andone said literally Has this story resonated go red and getthe really ustered. been feeling same noifone was was feeling the lowest, anyone always look so happy, isbut there with you? I couldn’tthe getcracks homeshow. without me a question I would ever letting aasked day where you aren’t Onstopping one of theon days was thewhen wayI home happy?!’ go red and get really ustered. feeling lowest, if anyone asked and the crying. You are not I couldn’t getalone home without me a question I would go red and get the story way home Onestopping ofThis mystory F1on colleagues turned Has this resonated resonated with really ustered. I couldn’t get home 32 others in the community with you? and crying. to me and said ‘you literally without stopping on the way home always so happy, isIthere On one oflook themy days One of colleagues and crying. One of F1 my when F1 colleaguesturned everfeeling a daythe where you ifaren’t was lowest, anyone to and said ‘you literally turned to me methe and said ‘you You are not alone On one of days when Iliterally was happy?!’ asked me asoquestion I would always look happy, is happy, there ever always lookresonated isathere feeling the ifso anyone asked Youlowest, have This story resonated with go and really you ustered. with 5aren’t stories day where you happy?!’ a get day where aren’t mered a ever question Iother would red and get 32 others ingo the community of experiencing anxiety On one of the days when I was Ireally couldn’t get home without Inside itwas sodepression far what I home had happy?!’ and at get work ustered. I from couldn’t feeling the lowest, if anyone asked stopping on the way home been feeling. Maybe everyone without stopping on the wayhad home me aHave question would go red and get you Iconsidered and crying. been same butF1 no colleagues one was andfeeling crying.the One of my

to organize communications by channels foronline groupmessaging discussions *Slack is an and allows for private messages service. Its workspaces allow you to *Slack is an communications online messaging share information, files, and by more to organize *Slack isIts an online College Art 2020messaging ¡ allow hello@thejuniordoctorcircle.com service. workspaces you all in of one place channels for group discussions service. Its communications workspaces allowby you to organize and allows for private messages *Slack is an online messagingby to to organize communications C A N everyone T F ever O R Gahad Eday T been feeling the where you aren’t

same but no one was letting the happy?!’ cracks On one show. of the days when I was Inside it was so far from what feeling the lowest, if anyone I had been feeling. Maybe I would S T O R I E S Fasked R O Mme Oa U question R COMM UNITY everyone had beenresonated feeling the this story S H A R E Ygo OU R and SHas T Oget R Yreally red ustered. i t m i g h t b e t h e same k e y with t obut h eyou? lno p i none g s owas m e o letting n e e l s e the home T H E P A TI Icouldn’t E Ncracks T I get L O Nwithout ELINESS show. C A N T F stopping ORGET S H A R E Y O U RonSthe T Oway R Y home i t m i g h tand b e crying. the key to helping someone else On one of the days when I was You are not alone One of my F1 colleagues turned feeling the lowest, anyone Has thisifstory This story resonated withresonated to me and ‘you literally with 32 said others inyou? the community asked me a question I would On one of the days when I was always so happy, isustered. there go red look and get really  feeling the lowest, if anyone ever a day get where youwithout aren’t I couldn’t home asked me a might question I would You notresonate alone happy?!’ stoppingYour onstory theare way home with and other members in ustered. go red get really This story resonated with and crying. SHARE YO UR Sthe T Ocommunity R Yget I couldn’t home without from i t m i g h t b e Inside t h e k e yitWould t was o h 32 e lso pothers i nfar glikesin otothe mshare e community o what n eit? e l s e you of my feeling. F1oncolleagues turned theMaybe way home IOne hadstopping been

Concept 02 confidentially Record and The Work Emotion Diary tell your employer how to Concept 02 The Work Emotion Diary Concept 02 improve your work Record and confi dentially experience. Find ways to The Work Emotion Diary tell yourand employer how to Record confi dentially The Work Emotion Diary Concept 02 leverage the power of the

improve your workhow to tell your employer Record and confi dentially data set generated byto the experience. Find improve your workways Record and confi dentially The Work Emotion Diary tell your employer how to to Junior Doctor community leverage the power of the experience. Find ways to tell your employer to improve your work how affect data setchange generated bythe the leverage the power of improve your work Record and confi dentially experience. Find ways to Junior Doctor community data set employer generated by the experience. ways to tell your how to leverage the Find power of the to affect change Junior Doctor community to leverage thework power ofthe the improve data set your generated by affect change data set generated by the experience. Find ways to Junior Doctor community to Juniorchange Doctor community leverage the power of the to affect affect data setchange generated by the Junior Doctor community to affect change HOW ARE YOU FEELING ABOUT GOING TO WORK TODAY?

HOW ARE YOU FEELING ABOUT GOING TO WORK TODAY?

HOW ARE YOU FEELING ABOUT GOING TO WORK TODAY?

dread

Today I feel

about going to work

HOW ARE YOU FEELING ABOUT GOING TO WORK TODAY?

Today I feel

HOW ARE YOU FEELING ABOUT GOING TO WORK TODAY?

dread

about going to work

HOW ARE YOU FEELING ABOUT GOING TO WORK TODAY?

Today I feel

about going to work

HOW ARE YOU FEELING ABOUT GOING TO WORK TODAY?

HOW ARE YOU FEELING dread ABOUT GOING TO WORK TODAY?

Today I feel

TAKING IT HOME

TAKING IT HOME

discussing feelings really ustered.your I couldn’t get home letting thetowith cracks show. You have resonated someone at work? turned meF1 and said ‘you literally One of my colleagues turned without stopping on the way home with 5 other stories looksaid so is thereanxiety ever a of happy, experiencing toalways meand and ‘youofliterally crying. One my F1 colleagues and depression at work day where you aren’t happy?!’ always look there turned toso mehappy, and saidis‘you literally Has this story Inside waswhere so far from what I had ever a itday youresonated aren’t Have you considered always sowhen happy, is there ever a On one ofwith thelook days I was you? discussing your feelings been feeling. Maybe everyone had happy?!’ you aren’t happy?!’ feelingday thewhere lowest, ifsomeone anyone asked with at work? been feeling the same but no one was Inside it Iwas so far what me a question would go from red and getI had letting the cracks show. Not You sureare who toalone talk to in your Trust? not feeling. Maybe get everyone really been ustered. I couldn’t home had Can we direct you to someone? been feeling but one was (Don’t confi dential to no access without stopping onthe thesame way home Thisworry storyit’s resonated with our directory) 32 others in the letting the cracks show. and crying. One of mycommunity F1 colleagues

Has this story turned to me and said ‘youresonated literally Have you thought about external with you? support services? always look happy, is talk there a Trust? Notsosure who to toever in your The Practitioner Health Program?

Today I feel

HOW ARE YOU FEELING excited ABOUT GOING TO WORK TODAY?

Today I feel

HOW YOU HAVE FELT ABOUT GOING TO WORK

dread

Jan Feb Today I feel

HOW ARE YOU FEELING ABOUT GOING TO WORK TODAY?

dread Today I feel about going to work

about going to work HOW YOU HAVE FELT

Week

Month

Year

Jan

Jan

2020

HOW YOU HAVE FELT ABOUT GOING TO WORK

Feb

Month

Today I feel about going to work

Feb Mar about going to work

Today I feel

about going to work Week

excitedMar

HOW ARE YOU FEELING ABOUT GOING TO WORK TODAY? excited HOW YOU HAVE FELT ABOUT GOING TO WORK

HOW YOUARE HAVE FELT HOW YOU FEELING excited ABOUT GOING TO WORK ABOUT GOING TO WORK TODAY?

dread ABOUT GOING TO WORK Today I feel

Jan

excited

about going to work

HOW ARE YOU FEELING ABOUT GOING TO WORK TODAY?

about going to work

about going to work

Mar

Feb

Mar

about going to work nervous Today I feel

HOWARE YOUYOU HAVE FELT HOW FEELING ABOUTGOING GOINGTO TOWORK WORKTODAY? ABOUT HOW YOU HAVE FELT ABOUT GOING TO WORK

Year

Jan

2020

Feb Mar about going to work

¡ thejuniordoctorcircle.com HOWApr YOU HAVE FELTMay ABOUT GOING TO WORK

Jan

Week

Feb

Month

Jun

Mar

Year

about going into work over the last

ABOUT GOINGFeb TO WORK Jan few months HOW YOU HAVE FELT

Week Month ABOUT GOINGYear TO WORK

Today I feel

nervousMar

Jan YOU FEELINGFeb HOW ARE ABOUT GOING TO WORK TODAY? HOW YOU HAVE FELT ABOUT GOING TO WORK

about going to work

2020

AprYou’ve May beenHAVE feeling less positive HOW YOU FELT

Jun Mar

nervous What Icould your employer Today feel

HOW ARE YOU FEELING

Jan Feb Mar to improve yourTODAY? feelings ABOUTdo GOING TO WORK

about going to work?

•

Abolish Resilience Training and Remove the Culture of Blame Resilience culture perpetuates the cycle of shame and secrecy surrounding a doctors mental health. It shifts the blame on to the shoulders of the Junior Doctor and leads Junior Doctors to feel unworthy if they cannot cope

•

Focus on Prevention and Monitoring not Intervention Junior Doctors need a continuous support tool. Ongoing, active mental health support is crucial, to acknowledge, track and signpost to support before doctors present with serious mental health issues. We must pre-emptively support doctors before they burn out or are forced to take sick leave

•

Prepare Doctors at Medical School – Mental Health and Well-being Curriculum is a must Many Junior doctors described arriving at their first post and feeling overwhelmed and unprepared for the realities of being a doctor. By preparing them, we can equip and empower them

•

Create spaces for Junior Doctors to come together at work Hospitals must provide physical spaces for Juniors to come together to build commeraderie, support eachother and combat social isolation.

•

“Medicine would be transformed if doctors were able to admit freely to vulnerabilities, fears and failings. Yet no one does, despite the terrible costs. If even one of my peers had taken me aside and encouraged me to seek help, or even just let me know they were concerned and cared for me, I might have been able to halt the march of my depression before it became utterly devastating.�

Senior colleagues sharing their experiences is a key factor prompting Doctors to seek help

The Proposed Design Intervention Nancy, Junior Doctor

“The ďŹ nal straw came when I worked 17 days in a row including ďŹ ve 25-hour shifts. [‌] Never had I experienced such darkness and hopelessness. I found myself angry at the patients for being sick, and another night wishing that a sick patient would die so I could close my eyes for 10 minutes because I was so desperately tired. ‘I did not feel like myself on the inside anymore.â€?

The Junior Doctor Circle

An app for Junior Doctors to share ‘I’ve seen Junior Doctors their stories with a community of other Junior desperate to tell these stories. Doctors. They are unable to identify you and And it’s completely eating them Doctor to your employer areGreta, not Junior affiliated By realising you are not alone you learn Junior Doctor, 27 “Medicine would be transformed if doctors and support others were able to admit freely to vulnerabilities, fears and failings. Yet no one does, despite the terrible costs. If even one of my peers had taken me aside and encouraged me to seek help, or even just let me know they were concerned and cared for me, I might have been able to halt the march of my depression before it became utterly devastating.�

Key Insights

 �

Â? Â? Â? Â? Â?

DEPRESSION by Clem, Junior Doctor, 29

The Junior Doctor Circle

The Specialty Today, this Traineehappened... Circle Depression

Stress

Has this story resonated with you?

a story of life on the wards

Disclosing privately and safely with professional peers motivated Junior Doctors to seek support more than talking to friends and family. Resonating with people who ‘really understood’ or ‘had been there’ facilated opening up. The knowledge that another in the community could relate to your disclosure provides an emotionally safe space to be vulnerable.

•

You are not alone

Nancy, Junior Doctor

This story resonated with 32 others in the community

One of my F1 colleagues turned to me and said ‘you literally always look so happy, is there ever a day where you aren’t happy?!’

Inspiration & Success

Why I love being a doctor

“Inside it was so far from what I had been feeling.�

On one of the days when I was feeling the lowest, if anyone asked me a question I would go red and get really flustered. I couldn’t get home without stopping on the way home and crying.

“The ďŹ nal straw came when I worked 17 days in a row including ďŹ ve 25-hour shifts. [‌] Never had I experienced such darkness and hopelessness. I found myself angry at the patients for being sick, and another night wishing that a sick patient would die so I could close my eyes for 10 minutes because I was so desperately tired. ‘I did not feel like myself on the inside anymore.â€?

May we show you coping strategies that others in the community are using who have resonnated with this story?

Anxiety

SUPPORT SERVICES EXTERNAL T H E PAT I E N T I C A N T FORGET by Lesley, O&G Consultant, 63

Taking it home most Most resonated resonnated

T H E PAT I E N T I C A N T FORGET

T H E PAT I E N T I C A N T FORGET

by Lesley, O&G Consultant, 63

by Lesley, O&G Consultant, 63

“I can still see her face... and it’s thirty years ago.� a story of remembering and questioning

ou become an F1 and like shit hits the fan�

56

a story of feeling out of control

“Its been thirty years and I can still see her face� a story of remembering and questioning

ot he rs re s on n at e d

INTERNAL

T HE BRIT ISH M E D ICAL ASSOCIAT ION

Very, very poorly educated and extremely bright. She came to me in Cambridge and I tried to stop her coming because I knew I was leaving for London, but

“Actually no, this has gone a bit too far, I need to speak to someone about this.� a story of developing clinical ability to acknowledge my mental health

“I didn’t want to let my guard down. I guess for anyone to know that I felt I wasn’t competent at my job.� a story of bottling it up

32

ot he rs re s on n at e d

28

ot he rs re s on n at e d

WE BSIT E LIN K

The BMA wellbeing services are available to all doctors and their spouses and chilldren, 24/7 and free of charge

P E E R SUP P OR T / COUNSE LLI NG / P SYCH OTH E R A P Y / GMC I NVE STI GATI ON SUP P OR T /

I had these two patients who had followed me from Cambridge, where I had been a senior registrar and one was a trapeze artist and she was the most extraordinary character. She really was.

you go throughout your entire you know, from like secondary school, you’re the best in your class and you always get A’s in your GCSEs. You study, you get your A levels you study, get your A’s and get into university, you go through medical school, you pass every exam, you’ve done really well. You’re on sports teams, you’re just doing you know, you are acing life. You

I had these two patients who had followed me from Cambridge, where I had been a senior registrar and one was a trapeze artist and she was the most extraordinary character. She really was. Very, very poorly educated and extremely bright. She came to me in Cambridge and I tried to stop her coming because I knew I was leaving for London, but

A DVI CE FOR YOUR SLE F OR A COLLE AGUE

T HE PRACT ICION E R HE ALT H PROG RAM M E

Practitioner Health is a free, confidential NHS service for doctors and dentists across England with mental illness and addiction problems, who are working or looking to return to clinical practice. The service can help with issues relating to a mental health concern, including stress or depression or an addiction problem.

Greta, Junior Doctor

COUNSE LLI NG / P SYCH OTH E R A P Y / A DDI CTI ON TR E ATME NT/ CBT /

I NDI VI DA ULI SE D CLI NI CI A N LE D CASE MA NAGE E NT / GR OUP SUP P OR T

“It’s incredibly distressing and when things go wrong you do take it very personally.� a story of remembering and questioning

ACAD E MY OF M E D ICAL ROYAL COLLE G E S

19

ot he rs re s on n at e d

The Junior Doctor Circle is an app for Junior Doctors to share their stories with a community of other Junior Doctors. No one using the app can be identified and the app is not affiliated in any way to your employer

up inside.’

•

An online community gives Juniors the space to take a first step to track and understand their mental health and well-being privately, without fear of judgement.

 �

Â? Â? Â? Â? Â?

DEPRESSION

by Clem, Junior Doctor, 29

The Junior Doctor Circle

The Specialty Today, this Traineehappened... Circle

Stress

You are not alone

This story resonated with 32 others in the community

One of my F1 colleagues turned to me and said ‘you literally always look so happy, is there ever a day where you aren’t happy?!’

Inspiration & Success

By realising you are not alone you learn and support others

Has this story resonated with you?

a story of life on the wards

On one of the days when I was feeling the lowest, if anyone asked me a question I would go red and get really flustered. I couldn’t get home without stopping on the way home and crying.

Depression

Why I love being a doctor

“Inside it was so far from what I had been feeling.�

May we show you coping strategies that others in the community are using who have resonnated with this story?

Anxiety

•

The Junior Doctor Circle can help Junior Doctors to develop the confidence and vocabulary needed to start a conversation in real life. SUPPORT SERVICES

EXTERNAL

T H E PAT I E N T I C A N T FORGET by Lesley, O&G Consultant, 63

T H E PAT I E N T I C A N T FORGET

Taking it home

most resonated Most resonnated

by Lesley, O&G Consultant, 63

“I can still see her face... and it’s thirty years ago.� a story of remembering and questioning

ou become an F1 and like shit hits the fan�

56

a story of feeling out of control

o thers reso n n a ted

INTERNAL

T H E PAT I E N T I C A N T FORGET by Lesley, O&G Consultant, 63

“Its been thirty years and I can still see her face�

a story of remembering and questioning

T H E B R I T I S H M E D I CA L ASS O C I AT I O N

WEBSITE LINK

The BMA wellbeing services are available to all doctors and their spouses and chilldren, 24/7 and free of charge

P EER S UP P O R T / CO UN S ELLI N G / P SYCHO THER A P Y / GM C I N V ESTI GATI O N S UP P O R T /

I had these two patients who had followed me from Cambridge, where I had been a senior registrar and one was a trapeze artist and she was the most extraordinary character. She really was. Very, very poorly educated and extremely bright. She came to me in Cambridge and I tried to stop her coming because I knew I was leaving for London, but

“Actually no, this has gone a bit too far, I need to speak to someone about this.� a story of developing clinical ability to acknowledge my mental health

“I didn’t want to let my guard down. I guess for anyone to know that I felt I wasn’t competent at my job.� a story of bottling it up

32

o thers reso n n a ted

28

o thers reso n n a ted

you go throughout your entire you know, from like secondary school, you’re the best in your class and you always get A’s in your GCSEs. You study, you get your A levels you study, get your A’s and get into university, you go through medical school, you pass every exam, you’ve done really well. You’re on sports teams, you’re just doing you know, you are acing life. You

I had these two patients who had followed me from Cambridge, where I had been a senior registrar and one was a trapeze artist and she was the most extraordinary character. She really was.

Very, very poorly educated and extremely bright. She came to me in Cambridge and I tried to stop her coming because I knew I was leaving for London, but

A D V I CE FO R YO UR S LEF O R A CO LLEAGUE

T H E P R AC T I C I O N E R H E A LT H P R O G R A M M E

Practitioner Health is a free, confidential NHS service for doctors and dentists across England with mental illness and addiction problems, who are working or looking to return to clinical practice. The service can help with issues relating to a mental health concern, including stress or depression or an addiction problem.

CO UN S ELLI N G / P SYCHO THER A P Y / A D D I CTI O N TR EATM EN T/ CBT /

I N D I V I DA ULI S ED CLI N I CI A N LED CAS E M A N AGEEN T / GR O UP S UP P O R T

“It’s incredibly distressing and when things go wrong you do take it very personally.� a story of remembering and questioning

ACA D E MY OF M E D I CA L R OYA L CO L L E G E S

19

o thers reso n n a ted

excited

Today I feel

feeling the lowest, if anyone asked turned to Eme DEPR S and S I Osaid N ‘you literally

Rg N Si O NT ,A oCA oE R d ET eLYYvOeRUEnR nSg SEH OTREYD

it might be the key to helping someone else

well-being and ows over healthDoctors or ebbs well-being due to the Junior may have limited time. It is hard to keep track of Insight: 1,2,5,6paced, high stress fast Junior Doctors mayown havemental limited insight into their mental health they over work a period of Persona 3: Melissa environment in.to Mental insight into their own mental health or well-being due the F1 placement in 25 time inA&E,this environment health and well-being ebbs health or well-being due to the fast paced, high stress Melissa, a Junior Doctor from Birmingham. Recently qualified andpaced, ows over time. It is fast high stress environment they work in.hard Mental and finding her job in a hospital is keep crucial to have an appreciation canIt be overwhelming at times. to track of work mental environment they in. health Mental health and well-being ebbs She feels her work negatively Opportunity Area ofover when you are of sotime downinthat impacts her mental health a period thisyou health and well-being and ows over time. Itebbs is hard but is unsure whether this is a normal feeling to speak up need environment and ows over It is hard to keep track ofencourage mental health How might wetime. Junior Melissa tries not to think about her mental well-being and to to keep track ofofmental over a period time inhealth this their Doctors to vocalise and track just push through. She does not want to be labelled as the Opportunity Area It that is cannot to have an in appreciation over acrucial period of time this environment well-being? And leverage the data only one cope Opportunity Area of when you so down that you environment set so that it are becomes a meaningful Hypothesis 03 Opportunity Area How might wehave encourage Junior need to speak up an ItOpportunity is crucial to appreciation personal and transformative metric? How we encourage Junior Junior Doctors might may have limited Area insight into their own mental to vocalise and track their ItDoctors crucial to have appreciation ofis when you are soan down thattheir you health or well-being due to the Doctors to vocalise and track fastHow paced, high might stress we encourage Junior environment they work in. Mental well-being? And leverage the data of when you are so down that you need to speak up well-being? And leverage the data How might we encourage Junior health and well-being ebbs to vocalisea and track their andDoctors ows over time. It is hard Opportunity set so it speak becomes meaningful need up Area to set keep track of to mental health so that becomes a meaningful Doctors toit vocalise and track their over a period of time in this well-being? leverage themetric? data environment personal andAnd transformative personal and transformative metric? well-being? And leverage the data set so that it becomes a meaningful It is crucial to have an appreciation How might we encourage Junior of when you are so down that youit becomes a meaningful set so that Concept 02 need to speak up personal and transformative metric? Doctors to vocalise and track their personal and transformative metric? well-being? And leverage the data The Work Emotiona meaningful Diary set so that it02 becomes Concept personal and transformative metric?

Key Recommendations

HOW ARE YOU FEELING ABOUT GOING TO WORK TODAY?

By sharing and relating to others, you can find the words to ask for help.

The Junior Doctor Circle is an app for Junior Doctors to share their stories with a community of other Junior Doctors. No one using the app can be identified and the app is not affiliated in any way to your employer By realising you are not alone you learn and support others