Negativity and preferential treatment may deny mental health support for NHS staff

Negative work cultures and discriminatory support based on profession could be stopping NHS staff from getting the mental health support they need, according to a new report.

In recent months, reports have surfaced as to rising mental health concerns among health and care staff during the COVID-19 pandemic.

Some have shown increases in staff absences, while others have revealed worryingly high levels of anxiety and depression among critical care nurses.

Now, a report from the Healthcare Safety Investigation Branch (HSIB), which offers guidance on areas for development in the NHS, has highlighted issues with the support provided to staff following incidents in the workplace.

According to the report, which is based on insights gained through interviews and focus groups of NHS staff as well as latest research, support for staff following workplace incidents is lacking.

The report cites research that shows that the long-term psychological impact of incidents, like accidents or abuse, can lead to staff taking increased and prolonged absences from work, ending of careers, reduced morale, or even self-harm.

When looking at studies into existing support services, peer support was the most commonly described programme available, which was received well by most staff, however, other methods like counselling were less desirable for some.

Findings from interviews with staff highlighted work culture issues preventing appropriate support, with some saying that a negative work culture often led to poor responses to safety incidents altogether.

Some participants even gave examples where staff members were blamed for safety incidents, leading to removal from their working duties and isolation.

Some also suggested that the level of support provided differed between profession and seniority.

Read more: Almost half of ICU staff are likely dealing with mental health issues as a result of the pandemic

One account from a junior doctor described the burden they carried after a patient's death and the nature of the post-incident interview:

“I knew deep down that my actions were not responsible for this patient’s death, but the conduct of the interview cast severe self-doubt once again. At the time, I felt torn between seeking help and just keeping quiet. I felt that seeking support would be an admission of wrong-doing and inadequacy.

“The aftermath of a patient safety incident quite rightly prioritises the patient affected and their family. It should be remembered though, that the staff involved in the incident will continue to care for others with a burden of emotion, as it was never their intention for things to go wrong."

The pattern of long-term psychological harm resulting from these incidents was clear in much of the available literature on the subject, according to the authors, with all of the staff consulted for the report saying that "support systems are needed and are likely to have a positive impact."

Dr Lesley Kay, Deputy Medical Director at HSIB commented on the report's findings: “We recognise the challenges faced by organisations when developing programmes to meet the differing needs of all staff – both in the short term, immediately after incidents and the longer term, the process of being involved in investigations or inquests.

"Providing the best level of support to all minimises distress and psychological harm, reduces the risk of further negative impact on patient care and improves safety across the NHS. This is particularly important as the Covid-19 pandemic places enormous pressure on services and has brought the wellbeing and safety of staff to the fore.”

To read the full HSIB report, click here.