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Who's caring for the carers?

A new pressure group aimed at ensuring the mental health and wellbeing of people working in caring professions has been launched

Poor mental health caused by work-related stress in the caring professions must be tackled, says ACWW

A pressure group aimed at protecting the mental health and wellbeing of people working in the caring professions has been launched.

Made up of organisations from across the social and health care sector, it includes social workers, doctors, nurses, paramedics, psychiatrist and psychologists.

The group, which has a working title of the Action for Care Worker Wellbeing (ACWW), will seek to raise awareness of working conditions and the way management cultures impact on the workforce.

Those behind it were spurred to act through a sense of frustration and irony that people who choose to work in caring roles often end up ill themselves through lack of support and uncaring managers.

Former social worker Mike Bush, who came up with the initial idea after suffering a mental breakdown due to stress and bullying at work, said: “Upon my recovery I wanted to prevent this happening to others and raise awareness of the pressure on social workers and all those in caring professions caused by a perfect storm of ever-increasing demand and diminishing resources.

“The quality of the care people we work with get is dependent on the psychological health and wellbeing of the people providing that care.”

Research, including that from the British Association of Social Workers and the Social Workers Union, consistently identify the pressures driving workers to become ill, quit work or even commit suicide.

Speaking at ACWW’s launch on World Mental Health Day in London Dr Ruth Allen, chief executive of BASW, one of its founding partners, said: “A resilient long-serving and well supported public sector is essential for a civil compassionate society. It is extraordinary we need to restate this, but we do.

“We must stand together for our own needs and ethics and values to provide those services and be part of the innovative future. But we can’t do that if we don’t look after ourselves and are on our knees.”

Professor Mayur Lakhani, President of the Royal College of General Practitioners, said it was “not acceptable anymore to allow the wellbeing of frontline health and care workers to be neglected”.

He added: “Two local doctors I worked with committed suicide. I know both the families and after many years I still meet them and see the angst on their faces and the questions.

“In the caring professions, stress, burn out and mental health is a big unrecognised problem and we need to talk about it.”

He said systems that don’t value people or give them autonomy to do their job was one of the biggest causes of work stress.

Prof Lakhani added: “The culture in the NHS can be very ruthless. It’s the blame culture. People who go into medicine tend to be perfectionists. We take failure badly. We don’t like to say no. We keep giving and giving and running on empty and that is when burnout comes.”

Dr Jermaine Ravalier, senior lecturer in Psychology at Bath Spa University who carried out BASW and SWU’s working conditions and wellbeing study, highlighted a case of a newly qualified social worker who was leaving the profession after only a year.

“She said I am working 9-5, putting my kids to bed and working evenings and every single weekend.”

Such struggles mirror the findings of a follow-up to the 2017 working conditions study due to be launched at the end of this month which shows things are getting worse, said Dr Ravalier.

“Social workers love the job they do and love making a difference but these working conditions are leading to so many negatives and people eventually having to leave due to stress.”

Dr Francis Winton, a consultant psychiatrist said the wellbeing of health and social care staff was the “elephant in the room” that wasn’t discussed enough.

“How can it possibly be that in a caring organisation that is caring for patients you have staff being badly treated?” he said.

He highlighted the Francis report into the mid Staffordshire Hospital scandal which found a management focus on targets rather than people contributed to low morale and poor patient care.

He said research showed positive work cultures increased productivity. One study showed it rose by 18 per cent while another suggested 30 per cent.

There was also a correlation between the way staff were cared for and performance of companies Listed on the London Stock Exchange, he said.

“The research shows good firms cared passionately about quality of customer satisfaction. Leadership was open, accessible and visible. There was an apparent lack of hierarchy, leaders were very aware of being role models and emphasised knowledge sharing and frowned on knowledge as power.

“They had simple decision-making processes so if something went wrong it could be rectified quickly. There was less talk of steering committees and project groups. The structure tended to be flatter.”

The worst performing firms on the London Stock Exchange were characterised by having an “emphasis on structure, bureaucracy, finance-driven, low passion, low focus on sharing knowledge and a tick-box approach”.

One unique and often unrecognised aspect of jobs in the caring professions is secondary or vicarious trauma – trauma transferred onto workers from the distressful situations they work in.

“I have experienced it myself,” said one professional at the launch event.

“I grew up with issues. Organisations don’t understand that overwhelmingly people come with their own experience to this work and have different levels of working on it. It’s no use saying ‘self care’ or ‘be more resilient’ when the framework does not understand the issues practitioners have in the past and how this may be triggered by secondary trauma.”

Dr Sri Kalidindi, a consultant psychiatrist, said she also knew of two colleagues that had committed suicide.

“They were warm, bright, hardworking people who didn’t get the help they needed because they feared for their jobs, jobs they had spent the last 20-25 years working towards,” she said.

She called for incentives and sanctions to “encourage employers to prioritise the mental health and wellbeing of staff”.

Among its key objectives, ACWW says it wants to lead public debate on wellbeing among caring professionals, challenge the stigma of mental health, identify common problems workers face, collect and share data about work conditions and challenge decision makers, employers and regulators to provide better support for staff.

As part of its lobbying, it highlights figures showing 446 care workers committed suicide in the UK between 2011 and 2015. As well as the human tragedy, the economic cost of this based on calculations by The Samaritans is estimated to equate to £500 million.

The evidence

  1. Public Health England estimates that the cost to the NHS of workforce absence due to poor health is £2.4bn a year – accounting for around £1 in every £40 of the total budget. This figure excludes the cost of treatment or the additional expenditure on agency staff who are contracted on short-term basis to replace staff absent due to ill health from stress 
  2. In social care, it was estimated that in 2016-17, there was a 27.8 per cent turnover of staff and 6.6 per cent vacancy rate, while a recent British Association of Social Workers (BASW) supported study found high levels of stress, ‘presenteeism’ and adverse working conditions in social work https://www.basw.co.uk/what-we-do/campaigns/professional-working-conditions
  3. A recent report from the Office of National Statistics, shows that men in the ‘caring professions’ were one of two occupational groups with an above average suicide rate to the rest of population. Regarding females, the ONS report notes “…the other occupational group with an elevated risk of suicide was health professionals”. Among this cohort, the rate of increase above the national average for nurses was 23 per cent.