Mental health staff and services under pressure

Cuts to mental health leave staff facing violence and aggression, says UNISON

A recent UNISON survey of staff working in mental health service has revealed that
mental health services have been hit hard by cuts to NHS funding, which has a damaging effect on service users and staff. The new publication reports that Service users have been struggling to access the help they need, while mental health staff working in under-resourced areas are left vulnerable to violence and aggression, and unable to provide the level of care needed.

The report, Struggling to Cope, is based on a survey of over 1,000 mental health employees across the UK, who work in a range of roles – with children and adults in hospitals, in secure units and out in the community.

More than two in five (42%) said they had been on the receiving end of violent attacks in the last year. Over a third (36%) said they had witnessed violent incidents involving patients attacking their colleagues.

While the majority (86%) felt they had the knowledge and training to carry out their work safely, more than a third (36%) said they had seen an increase in violent incidents in the past year.

Mental health workers blamed staff shortages (87%) and the overuse of agency staff (49%) as the main reasons behind the rise in violent attacks.

Full report: Struggling to Cope: Mental health staff and services under pressure

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The future of the mental health workforce

 The future of the mental health workforce | Centre for Mental Health

This report is based on insights from service users, carers and professionals and outlines a list of recommendations for a sustainable mental health workforce.

It emphasises the importance of prevention, including the role of GPs in supporting people before they reach crisis point. It describes commissioning of mental health services as in “crisis” with a “shrinking workforce, growing expectations and exhausting demands” putting pressure on staff across the country.

The report makes 22 recommendations for policy, practice, education and training, highlighting 4 key calls to action:

  1. For mental health careers to be promoted in schools and colleges: to build on growing awareness and understanding about mental health to encourage young people to aspire to work in the sector when they’re considering their career choices
  2. For all mental health service providers to support the mental health and wellbeing of their staff: to become ‘compassionate organisations’ that care for the people who work in them
  3. For mental health workers to get training in the skills they will need in the future, including in coproduction, community engagement and psychological interventions
  4. For people to be able to build their careers more flexibly, working in a range of different settings and sectors, and taking on new roles as they get older

Download the full report: The future of the mental health workforce

Improving work health for a healthy economy

New initiative launched to support small businesses in improving work health

Illness among working age people costs the UK economy £100 billion a year. About 330,000 every year become unemployed because of health-related issues.

However, workplace health and wellbeing programmes such as exercise, healthy eating and stop smoking support have been shown to make a real difference. Successful programmes such as these have been found to return £2 to £10 for every £1 spent, benefiting staff wellbeing and economic productivity.

Most big employers already have some plans in place that help to improve and protect their staff’s health but many small and medium enterprises (SMEs) do not currently benefit from such programmes.

PHE and Healthy Working Futures, a workplace health provider, has set out advice for SMEs, which account for 60% of private sector employment.

PHE has also created a series of guidance for employers on important issues, such as musculoskeletal (MSK) and mental health, impacting on employees with Business in the Community. Further advice is being developed covering issues including:

  • physical activity
  • diet and weight
  • drugs
  • alcohol
  • tobacco

Full press release at Public Health England

Mental health at work

This report finds that mental health problems in the UK workforce cost employers almost £35 billion last year. The largest part of this business cost is in the form of reduced productivity among people who are at work but unwell: or ‘presenteeism’.

This costs businesses twice as much as sickness absence relating to poor mental health.

The updated figures highlight that the overall costs are broken down into:

  • £10.6 billion in sickness absence;
  • £21.2 billion in reduced productivity at work, or ‘presenteeism’
  • £3.1 billion in replacing staff who leave their jobs because of their mental health.

NHS staff have become shock absorbers of an NHS under chronic strain

‘Behind Closed Doors’ argues that the hard truths learned through the Francis Inquiry are in danger of being forgotten in the light of unprecedented, continuing, and seemingly endless service pressures | The Point of Care Foundation

The Point of Care Foundation calls on organisations to prioritise staff experience and strengthen efforts to protect staff from stress and burnout, because the way staff feel at work affects the way they care for patients.

The briefing presents evidence on current pressures and staff experience:

  • From 2004-16, the number of attendances at A&E increased by 18%, from 12.7 million to 15 million.
  • Only one in two staff feel their NHS employer values them and their work.
  • 2% for health and social care staff suffer work-related stress anxiety and depression in the NHS compared to around 1.2% of the overall British workforce

The Point of Care Foundation wants to see every patient treated with kindness, dignity and respect all of the time, but in an environment in which staff themselves don’t feel cared about, it is hard to deliver personalised care.  A positive staff experience is fundamental if staff are expected to be at their best with patients.

Read the full report here

Workplace Mindfulness Program for Public Sector Employees

Mindfulness training appears to reduce stress and distress, but little is known about whether its appropriateness as a workplace stress management intervention for a large and distributed public sector workforce.

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This study evaluated a pilot 5-week Mindfulness at Work Program (MaWP) for acceptability, feasibility, and efficacy in relation to stress and related mental health and productivity problems for public sector employees.

The intervention thus appears to have potential merit as a workplace intervention for public sector employees across a range of outcomes. Obtaining informant observations was feasible and while qualitative analyses indicated positive changes that supported self-reported outcomes, quantitative analyses returned ambiguous results. A seven-item scale adapted from a popular self-report mindfulness scale for use by informants showed promise, but further work is needed to establish validity, reliability, and scalability of this method of assessing observable changes following mindfulness training.

Full reference: Bartlett, L. et al. (2017) Acceptability, Feasibility, and Efficacy of a Workplace Mindfulness Program for Public Sector Employees: a Pilot Randomized Controlled Trial with Informant Reports. Mindfulness. 8(639)

Mental health issues higher in public sector workers

Survey from Mental Health charity, Mind finds a higher prevalence of mental health problems in the public sector, as well as a lack of support available when people do speak up.

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The charity surveyed over 12,000 employees across the public and private sectors and found that public sector workers were more likely to say their mental health was poor than their peers in the private sector (15% versus 9%), and far more likely to say they had felt anxious at work on several occasions over the last month (53% compared to 43%).

Public sector workers were more likely to disclose that they had a mental health problem (90% versus 80% in the private sector), were more likely to be honest about the reason for needing time off (69% versus 59%), and more likely to report that the workplace culture made it possible for people to speak openly about their mental health (38% versus 29%).

However, when public sector employees admitted mental health problems, less than half (49%) of them said they felt supported, compared with 61% of staff from the private sector.

Full story: Mind reveals shocking differences in mental health support for public & private sector workers