Lancashire Teaching Hospitals NHS Foundation Trust took steps to “be more proactive and change culture” around mental health in the workplace.

Chief Executive with pledge

Lancashire Teaching Hospitals NHS Foundation Trust signed the Time to Change Employers Pledge on 28th August 2018 because they “wanted to be more proactive and change culture, rather than just be reactive” to the need for mental health support at work.

Mental health has been a key focus for some time at the Trust, because it is one of the highest reported reasons for sickness absence (an issue reflected at a national level across the NHS).  The Trust also recognises that providing health care for patients can be psychologically and emotionally challenging, and it is important that staff are supported so that they feel well at work and can provide the best possible care.

The Trust had therefore already put in place support measures for their staff which included clinical psychology and counselling, as well as general Occupational Health support and mindfulness sessions.  However, the Trust were aware through feedback from staff, managers and local union representatives that sometimes staff are uncomfortable to disclose mental health issues and ask for support. This therefore suggested a need to tackle any stigma which may make it difficult for staff to honestly report mental health problems.

Signing the Time to Change Employer Pledge gave the Trust an opportunity to demonstrate a clear commitment to supporting and raising awareness of the importance of mental health in the workplace. Efforts to improve staff wellbeing “went up a gear” and became more proactive.

“Awareness-raising” seems to be having an impact as “more people are coming forward to seek support through therapy”.

Since signing the Pledge and proving their commitment to supporting workplace wellbeing with senior level buy-in, Lancashire Teaching Hospitals NHS Foundation Trust have made incredible progress in improving support for staff mental health.

Around 140 Mental Health First Aiders (MHFAs) have completed training, with a structure implemented to support these individuals through group supervision sessions. Supervision for MHFAs includes peer support, learning and guidance from a clinical psychologist and group discussions on issues such as the challenges arising from having to signpost colleagues to overstretched mental health services.

Support from a clinical psychologist is also offered to managers through focused consultation sessions, within which support tools such as Wellness Action Plans are offered.

Investment in in-house support for all staff has continued, with funding made available for an extra psychologist post and additional counselling sessions.

The increasing demand for this support is “probably an indication that awareness-raising is working, as more people are coming forward to seek support through therapy.”

A number of recurring topics such as sleep and menopause have been identified through these therapy sessions, with these feeding into themes for mental health drop-in sessions and staff newsletters offering advice and guidance.

Lancashire Teaching Hospitals have also taken the initiative to get creative by producing a podcast with a senior consultant, in which the consultant speaks openly about their lived experiences with mental health. The fact that the consultant featured in the podcast is male and of a senior-level is particularly significant, as this makes him representative of demographics who rarely speak out about mental health, but whose input is vital for tackling stigma against mental health.

Click here to listen to the podcast.

On the whole, there seems to have been “a noticeable shift in attitudes towards mental health, although it is hard to measure.”

Individuals and teams who historically tend not to access mental health support have been coming forward to ask for support more frequently. The catalyst for this often involves just one member of a team seeking support and relaying how helpful it has been to colleagues.

Mental health drop-in sessions seem to have encouraged people to talk more openly, although their impact is difficult to measure directly.

The impact of more reactive interventions, such as clinical psychology sessions, has been easier to measure. Surveys carried out before and after these sessions show a positive impact on staff wellbeing, with qualitative feedback suggesting that staff often feel able to return to work earlier after being off sick, due to the clinical psychology support they have received.

Proactive interventions, such as mindfulness courses, have also clearly had an impact. One of the mindfulness courses that the Trust delivers is based on acceptance and commitment therapy. It provides proactive strategies for wellbeing, thus intervening before issues potentially turn into staff having to take time off work. Mindfulness is a group-based activity; therefore, the costs of putting on sessions are relatively low, making mindfulness a particularly cost-effective intervention for other NHS Trusts with limited budgets to consider.

The introduction of mindfulness courses has received overwhelmingly positive feedback from participants.  A clinical psychologist at Lancashire Teaching Hospitals NHS Foundation Trust has “heard from people who have said it’s changed their lives.”