Great fun today talking to GP surgery staff in Horley about mental health and all the small things it’s possible to do to make a GP practice more mentally healthy. These are the gateway for so many people struggling. It’s a huge privilege to be able to work with practices in this way too, helping them recognise the experience of those with mental health issues and the influence staff can have on them. This builds on work I have been doing in Worthing with GPs and surgery staff to promote greater understanding of mental health and ways of managing chronic stress.
Perhaps this learning will help GPs recognise and manage their own mental health. Research undertaken by Mind finds 40% of GPs have experienced a mental health issue. The Office for National Statistics tell us that 430 GPs died by suicide between 2011 and 2015, female GPs being particularly at risk, having four times the risk of suicide in comparison with the general population.
1 in 3 of those visiting their GP do so as they have a mental health issue, many more because they have a physical issue caused, or exacerbated by problems with their mental health…insomnia, cardiac concerns, headaches, digestive issues, spurious aches and pains. However, despite this, just one of the GP mandatory training modules (there are 21 of them) focus on mental health. Shocked? I was.
These facts I came across whilst preparing to give a talk to a group of GPs, Practice Nurses and Managers as part of a Clinical Commissioning Group GP joint education session. On this occasion the topic was “Creating a Mental Health Friendly Practice”. The talk was aimed at helping promoting good practice to benefit both staff and patients. I’ve worked in mental health for around 30 years, and thought little could surprise me anymore, but I was wrong. When I discovered these facts I was deeply shocked.
I’ve been talking to people to try and figure out how it has come to this, conversations that have highlighted the problem all the more. The friend at the weekend that told me the tragic story of her friend, a young female GP with two children taking her own life earlier in the year. The GP who told me today how she had struggled with her mental health and that it wasn’t until she reached out to NHS GP Health Service for support and heard the words “I know how you feel” that her journey to recovery could begin.
There is much we could despair about here. One of the most obvious questions is how can we even remotely expect our GPs to help those with mental health issues when so many of them are struggling themselves? Just take a look at a few social worker serious case reviews to see the impact stress can have on the capacity to make good decisions and judgements.
However, surely this obvious level of need presents an incredible opportunity. If GPs can be educated to understand how to protect and care for themselves and each other, and CCGs and practices be encouraged to implement workplace policies and procedures to better promote staff wellbeing it seems obvious to me that both GP health and patient care and outcomes will improve. There is no quick fix. There is no one size fits all solution that is going to work for all practices, and of course I haven’t even mentioned the need to address the workplace factors such as the unsafe workloads so clearly contributing to poor mental health. However, there are many things that are quick, inexpensive and easy to implement that can make a real difference such as the Happy Board photo above. I am going to continue my work with surgeries and look forward to helping all staff understand some of the practical ways of managing mood and emotion.
Helping advise Skills for Care on the content of their free e-guide to resilience gave me some insight into some of the actions and learning that might help surgeries too, so take a look if you are working in a practice and would like some ideas, and if anyone has any other ideas do please share them. No idea is too small, or too insignificant. As the great Margaret Heffernan says, “its the small changes that make the big impact”. And finally if you yourself are struggling, please, please reach out for help and support, and remember, you are absolutely not alone.