Wounded Healer Conference review by College of Paramedics' Mental Health and Wellbeing Steering Group members Bernice Hancox MCPara and Sasha Johnston MCPara.
On Thursday 4th October Bernice and I travelled to London to attend the ‘Wounded Healer’ conference held at the Royal Society for General Practitioners. The event was sold out and we were excited to hear what GP’s had to say about staff mental health and wellbeing.
The event was a real eye-opener. It was really inspiring to see so many people committed to making a positive change for staff and NHS England's CEO Simon Stevens announced that the Practitioners Health Programme (PHP) will be rolled out across England. The PHP started 10 years ago after Dr Daksha Emson killed herself and her 3-month-old daughter Freya.
The PHP offers a free, confidential NHS service for doctors and dentists with issues relating to a mental or physical health concern or addiction problem, in particular where these might affect their work.
There were a number of people who knew colleagues and very sadly their own children who had died by suicide and they had the opportunity to share their stories and contextualise the impact if mental health isn't well supported.
The reoccurring theme throughout presentations and discussion was the yearning for reinstating the staff canteen. Not just for the food, but to enable time to debrief, discuss and spend time together as a team. This is consistent with the needs of ambulance staff, who miss time in the 'crew room' that used to be our natural debrief/educational/stress relieving environment.
A number of comments made by the presenters did, however, leave me with the impression that the ambulance service is ahead of medicine as far as equality goes. In my 16 years of ambulance service work, I feel that I work in an environment where we see each other as humans and work equally regardless of gender. Maybe the ambulance service doesn't praise itself enough for how far it has come in the last 20 years in this respect.
The use of language was also interesting; the words 'committed suicide' made a regular appearance. The word ‘committed’ is associated with negativity and wrongdoing and hopefully will soon be eradicated from healthcare discourse related to suicide. The use of appropriate language – death by suicide rather than committed suicide – is vital to ensure stigma is reduced.
They also held an Alcoholics Anonymous meeting during the event which was attended by a number of delegates. The AA meeting alongside candid accounts from doctors during breakout sessions of their own struggle with alcohol addiction was great for breaking down a few barriers.
I do wonder whether the PHP may inadvertently perpetuate the stigma associated with mental ill health. The PHP has supported 6,000 doctors and dentists since it started 10 years ago, evidencing a real need for their services. However, I think that the El Dorado for staff mental health is a culture where you can seek help from your peers or organisation without fear of negative impact, rather than having to go to an external organisation due to fear of being found out. Presenter Dr Myers, an expert in suicidology from New York stated that stigma is killing staff and the World Health Organisation highlights that suicide is preventable if the right help is available in the right place at the right time. Therefore, a multi-faceted approach is required to ensure the right services are available and stigma is eradicated to ensure staff seek help for symptoms of mental ill health as readily as they would for physical ill health.
On a positive note speaker, Adam Kay who closed the first day was fantastic. His account of his own medical career and mental health challenges that led him to leave medicine was both very funny and emotional. I am definitely going to buy his book 'This is going to hurt'!
Three draft consensus statements were developed from the conference that chairperson Dr Clare Gerada will take forward:
1. This conference believes that there is a need for confidential services for clinicians with MH problems including addiction wherever they are in the world, to enable them to present for help without fear of stigma or an automatic need for formal regulatory involvement.
2. In particular, the treatment of addiction should be treated primarily as a health issue. Wherever possible it should be separate from the regulator, so as to encourage doctors to present early for help in order to safeguard themselves and their patients.
3. Medical students and clinicians should be treated with the same humanity as the patients they treat. NHS systems must allow space and time to reflect, support and learn together, and most importantly bring back the joy of caring (You'll never walk alone).
Overall the conference highlighted that Doctors are experiencing similar challenges to ambulance staff with respect to the impact of the workplace on staff mental health and wellbeing. Stigma about mental health and help-seeking affects medics in the same way as it affects ambulance staff, creating a situation where staff may not ask for help when they need it. There is a growing movement in both sectors to reduce stigma, develop positive change and better systems of support.