Supporting the mental health of our workforce

In her April blog post Lade discusses the Prime Minister’s recent comments about ‘sick note culture’, mental health stigma and pressures on our members’ own mental health.

NHS figures published today (25 April) show that mental health problems accounted for the loss of 6.5 million NHS staff days in 2023. Although extremely worrying, this is not particularly surprising.

Recently there has been a lot of discussion about the value of services supporting the mental health of our workforce. These discussions led me to thinking about the changes to our working environment in the past few years.

Growing pressures

Even before COVID, we were struggling with high workloads, administrative pressures, challenges with working environments and inadequate equipment, time-pressures and poor work-life balance.

These pressures have only grown in recent years. As the frontline in the pandemic, we faced unimaginable strains in both our personal and professional lives. And without time to process this, we are now dealing with winter crises that seem to last all year round.

Too many doctors have experienced burnout and have sometimes needed professional support for mental illness. The services that provide this support are crucial for everyone working across the whole of the healthcare sector, but particularly for doctors who find it especially hard to accept that they might need help for mental health problems.

When NHS England recently announced they were cutting the NHS Practitioner Health Service, we heard many powerful stories from doctors about the vital care the service had provided. These views are backed up by evidence suggesting that around 80% of professionals treated by the service in 2023 believed it had a positive or very positive impact on their ability to work. And, perhaps more importantly, 75% of those supported by the service were able to return to work.

Even the costs of these sort of schemes are outweighed by the benefits, with research showing that for every £1 we spend on workplace mental health interventions, we save £5.30.

In response to the announcement, I wrote a letter, co-signed by other key health leaders, to the Secretary of State and Chief Executive of NHS England. We re-emphasised the value of services designed to support health professionals with mental health problems.

I’m pleased NHS England listened to these concerns. Following confirmation they would extend funding for 12 months during a review of services, we asked to be involved. We also sought reassurances that there will be adequate mental health and wellbeing provision for staff while the review remains underway.

Meeting our mental health and wellbeing needs is critical for staff retention and recruitment, particularly in the context of the NHSE Workforce Plan. The NHS Practitioner Health Service is just one of many services that can help us. The College has also been campaigning for comprehensive mental health support for staff through funding for other schemes like mental health and wellbeing hubs.

Tackling the stigma

In addition to leading calls to provide more mental healthcare for our workforce, it is imperative that we tackle the stigma and discrimination that exists around mental illness.

It has been disappointing to see leaders, including the Prime Minister, conflate those suffering with a mental illness with people who have a ‘sick note culture’. It was reminiscent of the “strivers vs skivers” rhetoric of old. This undermines and dismisses the reality of mental illness and plays into old-fashioned tropes that people with mental illness are simply lazy or feckless and should just pull themselves together. It is unsurprising, therefore, that I challenged his recent comments.

So far, no one has described NHS Staff accessing mental health support in these terms, but such language adds to a view that people with severe mental illness are not really sick. As healthcare professionals, we can sometimes share the same view about our own health. Doctors are especially bad at admitting when we may need help. Yet the facts are that in the UK one doctor takes their life every three weeks and one nurse takes their life every 5-7 days. This is tragic. These deaths are avoidable. Hopefully, challenging these stigmatising views will help.

As Psychiatrists, we work with some of the most sick, vulnerable and distressed patients, and there are rarely instant fixes. This can take its toll.

I would like to remind all our members and affiliates experiencing personal difficulties about our Psychiatrists' Support Service (PSS)  which provides free, rapid, high-quality peer support by telephone to psychiatrists of all grades.

We also, alongside the Oxford Centre for Suicide Research, recently produced guidance for all mental health organisations for the pastoral care of staff after a patient has died by suicide.

As President, one of my key priorities is nurturing and supporting you in your roles. We often say there is no health without mental health. For me that especially rings true here. If we are not willing to support the mental health of our staff, we will undoubtedly struggle to provide an effective health service for our patients.