Protecting nurses’ mental health during Covid-19

During this time of increased stress, pressure and workload, it is important to be kind to colleagues and to help identify those who may need additional support. Many organisations are currently offering increased health and wellbeing support for staff, including nurses, but the potential for long lasting implications on mental health including the possibility of post-traumatic stress disorder (PTSD), is significant.

During my NHS career I have developed a particular interest in the nursing workforce and in ensuring that nurses are well supported in their roles - through good staffing levels, an enabling infrastructure and an open, supportive culture. I have been alarmed to learn that rates of suicide in nurses are 23% higher than in the general population - and tragically 300 nurses ended their lives through suicide in the period 2011-2017 (ONS data for England).

Nurse suicide is a complex issue with a range of potential predisposing factors or stressors. These may be personal, for example relationships issues, bereavement, financial worries, gambling, dependence of drugs or alcohol, poor mental health, isolation and loneliness. Or they may be work-related, including workload, burnout, bullying and harassment, disciplinary issues, perceptions of competence and quality of available supervision.

Sadly high rates of nurse suicide have persisted for several years and consequently more targeted work is needed to address this. I am privileged to have been awarded a Winston Churchill Memorial Fellowship this year to research the work that other countries are doing to address nurse suicide, and to identify actions that could be implemented in the UK.

Sadly a high rate of suicide in nurses is not unique to the UK, and innovative work undertaken in the USA could help inform UK approaches. Through my Churchill Fellowship, I plan to visit the University of California and San Diego Health, to learn more about their successful Healer Education Assessment & Referral (HEAR) Programme. This pioneering programme was originally developed for doctors but recently expanded to nurses.

The HEAR programme is a replicable strategy to address mental health risk and workplace stress, comprising educational outreach, emotional incident debriefing and proactive screening for depression and suicide risk. This confidential initiative reaches out to nurses to identify those at risk and refer them for specialist mental health support. A range of initiatives have evolved from this programme, including a greater focus on staff emotions following critical incidents, not just the implications for patient safety.

The big change I hope to make through my Churchill Fellowship is to raise awareness of the factors contributing to suicide in nurses, influence action to reduce these and ultimately reduce rates of nurse suicides. As 2020 is the International Year of the Nurse and Midwife, it is an ideal time to undertake targeted work to develop a nurse suicide prevention strategy and toolkit.