Positive steps to wellbeing for doctors
COVID-19: The importance of mental wellbeing
Recurrent waves of the COVID-19 pandemic are having a huge impact on healthcare workers, and Medical Protection has called for more to be done to ensure medical professionals have quick access to mental wellbeing support.
The consequences of the pandemic for clinicians extend beyond treating patients with COVID-19, although the effects of this alone should not be underestimated. Adapting to changing policies and new ways of working can be exhausting and challenging, bringing about new medicolegal risks and concerns for clinicians to navigate. For doctors, this is compounded by financial pressures, concerns about their own health, as well as the health of their loved ones. All these add stress on clinicians, many of whom may already be suffering from, or are at risk of, burnout.1 Working in the context of the ongoing pandemic, and the intensity of exposure to the human suffering this can entail, is a huge emotional strain and may be devastating for some.
Mental wellbeing is suffering – what members have told us
A survey of more than 700 Medical Protection members showed that one in five doctors felt their mental wellbeing had worsened during the pandemic. Concern for the health of family and friends (50%), the health of patients (33%) and their own health (30%), and worries about family responsibilities (30%), were cited as having the most impact on doctors’ mental wellbeing.
The importance of the new initiatives is underlined by the fact that adrenaline is still carrying many healthcare workers through this pandemic. It is when the crisis recedes and there is time to reflect that the accumulated stress and trauma may surface, which is when doctors will be most at risk and need support.
Making help available to clinicians
While it is difficult for doctors to effectively provide care for others if they are not taking care of themselves, there are many reasons why doctors may struggle in accessing mental healthcare for themselves. These include a lack of knowledge of possible sources of support, concerns around professional implications, concerns around confidentiality, and intrinsic psychological barriers, such as shame.2 It is particularly important, therefore, that resources for mental wellbeing support for doctors are not only available, but also widely known, with access encouraged. It is preferable for doctors to seek the help they require at an early stage, rather than later, when they may be in a significantly worse position.
The UK is now approaching a second wave of COVID-19 and, as with managing the pandemic, we must think about the health of clinicians longitudinally, being alert to the present circumstances and planning for the future. The effects of different phases should be considered, and support offered to staff accordingly. During acute phases, the stress tends to be related to planning, concerns over personal safety, and exposure to suffering and distress. However, following the acute phase, when the pressures start to ease, is when exhaustion may set in.3 If clinicians are expected to be able to continue working through these cycles, it is essential that consideration is given to additional support required. Of course, even after the pandemic has eased, clinicians must be in a position to be able to go on providing healthcare to our communities.
Considerable research has been undertaken on supporting mental health of healthcare practitioners during the pandemic, and some helpful guidance has been produced.4-6 Some steps doctors can take include the following:
1. Know that stress at this time is normal and appreciate the importance of managing your health during this period.
2. Try to take care of yourself. Consider which coping strategies are healthy and helpful to you as an individual, and look out for each other.
3. Do not ignore basic needs such as eating, drinking and resting when possible.
4. Try to maintain social connections and sources of social support. Even though physical connectedness may be limited, it is important that social connectedness is not lost.
5. Those in leadership positions should acknowledge anxieties and concerns of colleagues and assist in managing these.
In addition to providing medicolegal advice and support, Medical Protection has been offering its members support for their wellbeing through podcasts, workshops and an online resilience hub. This support has been offered both before and during the pandemic. In response to the challenges of the pandemic, we have delivered webinars on self-care, and have extended our free and confidential counselling service to all members. However, support across the profession is required.
Medical Protection welcomed July’s launch of the NHS People Plan, which set out a range of mental wellbeing initiatives. It came after Medical Protection repeatedly called on the Government, NHS and private healthcare providers to plan for the mental wellbeing support doctors will need following the COVID-19 pandemic.
How Medical Protection is helping members
At Medical Protection we’re making it easier for members to assess their own wellbeing and get support if they need it. Whether it’s to lower stress levels, sleep better or reduce burnout, we can help members take positive steps to better mental wellbeing.
We’ve partnered with ICAS International to give Medical Protection members access to immediate practical support. Members can download the ECare app for a personalised wellness service and talk one-on-one to a licensed counsellor through a free and confidential service. There is also a range of other resources, such as webinars, advice articles and podcasts, available in our Wellbeing Hub at medicalprotection.org/uk/wellbeing.
1) BMJ 2017, doi: 10.1136/bmj.j3360.
2) J Ment Health 2011;20:146-156.
3) Williams R, et al, A discussion document: Top ten messages for supporting healthcare staff during the COVID-19 pandemic, 2020
4) BJPsych Advances 2019, doi: 10.1192/bja.2019.66.
5) WHO, Mental health and psychosocial considerations during the COVID-19 pandemic, 2020
6) NHS Clinical Leaders Network, Enhancing mental health resilience and anticipating treatment provision of mental health conditions for frontline Healthcare workers involved in caring for patients during the COVID-19 pandemic – a call for action, 2020