With funding cuts, long hours and working in stressful environments, it is hardly surprising that over half of NHS workers have suffered from poor mental health.

Frontline19 recently ran an advertising campaign with the tagline: ‘Sicker than the patients.’  It highlighted the rates of poor mental health in the healthcare sector, and advocated for NHS workers to look after their wellbeing.

When your job is to care for others, it can be extremely difficult to prioritise your own health and realise when the burden is too great.

One of the most notable instances of healthcare workers coming forward to discuss their own struggles with mental health was Adam Kay’s novel and subsequent TV series ‘This Is Going To Hurt.’

Told through Kay’s own diaries while training to be an obstetrics and gynaecology doctor, the book explores the often taboo subject.

In the TV miniseries released in 2022, the character of Shruti is added to further explore the tragic occurrence of healthcare workers dying by suicide because of the job.

The series couldn’t have come out at a more apt time. The pandemic had significantly worsened mental health for NHS workers and the effects are still being felt by many.  

One GP trainee told the British Medical Association (BMA): “The psychological impact was huge - not seeing family or friends who were a massive support system for me in my job as a doctor, and not being able to socialise or do anything that usually helped reduce stress and cope with work, was really difficult.”

As well as this, a junior doctor reported that since catching Covid at work and being bed bound most of the time, life as they knew it has ended.

“These are supposed to be the best years of my life,” they said, “but I’m spending them alone, in bed, feeling like I’m dying almost all the time.”  Over half of NHS workers have suffered from poor mental health and one in four NHS staff having considered suicide, according to the mental health charity Mind. 

Additionally, poor mental health accounted for more than a quarter of all sickness absences in the NHS in England last year.

This could be attributed to a variety of factors including experiencing traumatic events at work, being overworked and underpaid, and a feeling that they cannot speak about how they are feeling to their colleagues.

Trade union GMB also warned that it is a similar situation in social care, as workers are dealing with crushing workloads, violence in the workplace and terrible terms and conditions in a recent survey.

They said 70 per cent of care workers say understaffing is negatively affecting their mental health.

In a poll of almost 900 care workers, 50 per cent said the abuse they received at work – mental, physical or even sexual, has negative impacts on their mental health.   

In part because of pressure from work, the UK Parliament said that 17,000 staff (12 per cent) left the NHS mental health workforce in 2021-22.  

There is no easy fix for reducing stress in healthcare, in the same way there is no sure way to.

It is hardly a surprise that The Standard found that the health and social care sector tops the list of the most stressful jobs, with 3,530 people per 100,000 employees experiencing work-related stress.

Health Business spoke to the experts from organisations such as Blue Light Card Foundation, and the previously mentioned organisation Frontline19, on how real change can be made to improve the mental health of NHS workers. 

Challenge the stigma

The BMA stated that nine in 10 people who experience mental health problems said they have faced stigma and discrimination as a result. 

The stigma around mental health is obviously not just limited to working in healthcare. Many people feel unable to talk about whether they are truly struggling, especially at work.

Claire Goodwin-Fee, co-founder of Frontline 19, said that a mixture of perfectionism and feeling like they should not discuss concerns over workload are the main contributors to why there is an added stigma around mental health in the healthcare sector.

Healthcare workers can often feel an extra pressure to not let their mental health problems show as they do not want to appear “weak” in front of patients.

“They are dealing with traumatic events every day, and they need a way to offload it,” she said.

Goodwin-Fee said it was a “potent mix” of all these factors that significantly contributed to NHS workers’ mental health.

Starting the conversation, especially from those at the top, can make a huge impact on the wellbeing of NHS workers. This is partly because it makes staff feel that they will not be judged or blamed.

Connection is key 

Naomi Adie, general manager of Blue Light Card Foundation, has seen first-hand how essential mental health is for frontline workers.

After being medically discharged from he Royal Air Force, Adie later decided to transfer her skills to work with Blue Light Card Foundation.

Founded in 2022, it is the only charity to provide funding and support for all blue light workers, from cave rescuers to paramedics.

Their funding has supported 27 projects so far. Adie said it may sound simple, but connection between different emergency and frontline services is the best way to improve the wellbeing of staff.

“We have seen even by providing a space for emergency service workers to relax, that 15 or 20 minute break improves their mood.

“Even having good quality tea and coffee can make a big difference to their days,” she said. 

Blue Light Card Foundation works closely with other organisations and they learn from each other about how best to look after staff’s mental health.

She said: “You don’t need to re-invent the wheel.” Adie commented that more effective mental health services are in place in the military, and the NHS is only just starting to catch up with a lot of policies.

“At the moment,” she said, “NHS workers only have the opportunity to get an internal referral or go to the doctor if they are struggling with their wellbeing.”

In comparison to services like Op COURAGE which are specifically for people who are or have been in the Armed Forces, she said there is a shocking lack of help for healthcare workers. 

Support from both sides

Goodwin-Fee said that while the mental health hubs provided by the NHS are a good step, the reduction of funding means they are simply not enough to support healthcare staff single-handedly.

She also suggested that many NHS workers are concerned about discussing problems internally as they are worried it will be leaked.  Instead, she said that getting support both externally and internally is a more effective way to support staff. 

“Emergency service workers need in-house and exterior support,” she said.

“The blame culture of workers being punished for not meeting targets has to go.”  With NHS targets being increased and staff stretched thin, she said NHS managers need to know when a target is simply not achievable.

In terms of external support, there are a selection of charities and organisations for frontline workers to choose from.

At Frontline19, for example, they offer one-to-one counselling for emergency service workers with counsellors who are trauma-trained.

They also provide group therapies, as well as ‘Difficult Conversation Training’ where leaders are taught how to properly debrief staff when something traumatic has happened in the workplace or to their colleagues.

Organisational change

Goodwin-Fee said that first and foremost, healthcare workers “desperately need compassion and understanding.”

“They need to feel respected and supported,” she added.

For her, even improving the little things in the lives of NHS workers from an organisational perspective can help to make them feel supported by the organisation as a whole.

She said that “things like not having to pay for parking at work and getting free coffee” can really make a difference. She also said that more funding needs to be given to the NHS, so that they can provide fast, accurate support to staff and do their best to alleviate stress from the job. 

This is not an easy job. But change must start from the inside so that the conversation around mental health is open and honest.  “Mental health isn’t always a bad thing, it is also about teaching people ways to look after themselves and recognise when things are getting worse,” Goodwin-Fee said.

Adie added that while change from the top would make a difference in terms of funding and policy changes, staff working on the frontline need to be listened to first.

“There is no sticking plaster for wellbeing,” she said. “They need to show staff members that they care, and treat people healthily instead of catching people when they have fallen in the water.”

For Adie, the answer is simple. “If you give people the resources to deal with stressful situations, there will be less staff sickness, less absences, and better quality of care for patients.”