NHS Reset: The importance of protecting everyone's mental health during COVID-19

People have been deeply affected by stress, anxiety and personal loss during this pandemic. Rates of depression have doubled. Those with a diagnosed mental illness have reported higher levels of symptoms. Research evidence suggests mental health problems in the local communities we serve have increased substantially. The uncertainty we are all learning to live with (or at least trying to) can be profoundly worrying and unsettling in equal measure.

Health and care staff are not immune from the psychological impact of COVID-19. We are not superheroes, we are human. We have asked so much of staff during this pandemic. Being out and about across our clinical services, I am so proud to see the lengths people have gone to in order to keep patients, families and carers feeling safe, supported and cared for.

In the stories I hear from staff and the feelings they share about their experiences, I am sharply reminded never to underestimate the strain this has placed upon them, as it has with all of us. Our staff are family members too. They are mothers, fathers, brothers, sisters and grandparents. They have seen and felt the impact of the pandemic both at work and in their personal lives. This is what makes their contribution to patient care so humbling and inspiring.

The power of those stories - if we really listen to and act upon them - will help us shape our response to this next phase of the pandemic.

Even before COVID-19 consumed our every waking moment, there was stark evidence from the annual NHS staff survey about the level of stress felt by our staff. As the weight of the pandemic continues to take its toll, we must be mindful that people have been working under sustained pressure for some time now. That includes staff who have been seeing patients face-to-face at the point of care as well as those who have been working remotely to support clinical services. Everyone has played their part, nobody has had it easy.

Many are tired. A significant proportion may be at risk of psychological trauma from their experiences. Some will have experienced personal loss during this pandemic. Others will be caring for elderly relatives, worried about children returning to school or university and wondering what the next few months will bring. Behind the badge with the job title, we are all people with concerns, preoccupations and struggles outside of the workplace.

Winter is coming and there will be further challenges ahead. I know our staff will continue to do their very best for the people we care for. As leaders, we have a duty to safeguard their wellbeing and the wellbeing of our wider communities. I want to highlight three key aspects to this.

Firstly, we need to ensure that mental health remains very firmly at the heart of national health and care strategy planning, policy development and resource allocation.

I believe this is an area where we have made much progress.

The NHS Long Term Plan sets out a clear vision for the ongoing development of both mental health and learning disability services. Over the last few years a huge amount of work has happened to challenge stigma and discrimination through public awareness campaigns. While 'parity of esteem' might not quite be the commanding call to action you'd place on your banner if you really wanted to inspire people to rally to it, it was at least coined as a serious attempt to change the nature of the national conversation about mental health policy, service provision and funding.

The development of our integrated care systems provides a further, critical opportunity to gain traction on complex, longstanding issues which have a profound impact on the quality of life of some of the most vulnerable within our society. Our mental health and housing strategy in Sussex, for example, is the first its kind from an integrated care system in England.

Our ambition to create a dedicated housing support workforce and a range of supported housing-led services - integrated across all adult community mental health service teams and inpatient care - is designed to increase the capacity and capability of the mental health system to meet the diverse needs of our local population. A key underpinning principle of this integrated mental health and housing offer is the basic need to view housing support colleagues and clinical colleagues with equal respect as professionals with different but compatible and complementary roles.

Moving beyond the traditional, outdated outlook that 'the NHS knows best' will help place us in a better position to embrace mental health as issue that is everyone's responsibility, thereby helping us focus together on getting help to people earlier.

Secondly, we need to be relentless in focusing on the wellbeing of our staff.

In the midst of a situation like COVID-19, it can be temping for leaders to revert to the traditional, testosterone-fuelled approach to leadership where we order people what to do. We must avoid this at all costs: it's old fashioned, ineffective and guaranteed to exacerbate the strains our staff are working under.

Health and care leaders need to pay more attention than ever to the wellbeing of our workforce. Compassionate and inclusive leadership is required where we role model empathy and understanding. At the same time as giving direction, we need to listen and to act on feedback we receive from staff.

This is about culture. It is about embedding the values and behaviours that support staff wellbeing and promote positive patient outcomes. Our words, behaviours and actions as leaders have particular potency in the midst of a crisis. Just as you can only be courageous when you are fearful, you can only be authentic about your values if you strive to stay true to them when you are tested under pressure. This applies to individuals, organisations and healthcare systems. It involves focusing - exclusively and relentlessly - on doing the things that will make most difference to patients, and having the collective courage to push back about anything we are being asked to do that does not do this.

Thirdly, we need to keep talking about mental health and wellbeing.

You still get the sense, from time to time, that mental health is seen by some as a bit of a 'soft' issue that can feel like an afterthought to weighty discussions about more 'serious' healthcare matters like cardiology and cancer care. When we talk about healthcare, mental health (and learning disabilities) should be implicit with this, because they matter to people's lives.

The social and economic impact of metal ill health are profound. Non of us is immune to the risks. We need to encourage our staff, our families, our friends and colleagues to remain alert to the risks to wellbeing that COVID-19 brings to bear for all of us.

At Sussex Partnership NHS Foundation Trust, our #Ten4Ten campaign is designed to promote awareness, understanding and conversations about the things we all need to do to look after our mental health and wellbeing. In the run up to this year's World Mental Health Day on 10 October, we want to get people talking about this. I can't think of a time when there has been a greater need for this.

The theme of this year's World Mental Health Day is kindness. Let's be kind to ourselves, each other and the people whose needs we are here to meet.

Acosia Nyanin is chief nursing officer of Sussex Partnership NHS Foundation Trust. Follow her on Twitter @AcosiaNyanin

Get involved in the NHS Reset campaign 

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