Staying well in times of crisis

Staying well, both physically and mentally can be difficult at the best of times, let alone at a time of crisis.

The coronavirus pandemic has put immense stress and pressure on people from all walks of life and in all sorts of ways. Key workers in particular are in our thoughts as they are on the frontline of this crisis delivering health and care to sick and vulnerable people who depend on their good judgement and skilful actions for their very survival.

The world that many key workers occupy is not surprisingly very stressful and involves, for many, facing significant personal risk and heart wrenching life and death decisions, as they try to manage this threat in our communities and hospitals. It is inevitable that a significant proportion of workers will be exposed to potentially traumatising experiences; and while many will adapt and bounce back from these experiences, others will need help and support now and in the future to manage and come to terms with their experiences.

People in caring and helping roles are not invincible; most of us signed up for personal reasons which often means we are complex; meaning that while we are strong and resilient, we are also fallible and fragile. We just don’t like to acknowledge the latter very often.

What we can’t deny however is that stress and trauma have a cumulative effect if we don’t deal with them proactively: processing things, diluting it by engaging in reflective and restorative supervision, offloading to others who understand your world and with all of that achieve some useful perspective. We all have a point where we can’t cope and stop functioning at our best. With our resilience depleted, stress has a negative impact on our mind and body and we begin to suffer the consequences; psychologically, physically and socially.

This isn’t something we can ignore and hope for the best.

Acknowledging that something is difficult or that we are upset or struggling is healthy and positive. Accepting ourselves as vulnerable at times is important and makes seeking help easier. It’s a sign of real strength to be able to accept that we need support and to ask for it. It’s just not easy to do, especially when you are in a helping role and the pressure is relentless.

Supporting frontline workers

I recently contributed to the MindEd Coronavirus Staff Resilience Hub which provides advice and guidance for frontline staff on managing their mental health and wellbeing.

It is a valuable resource, which covers a range of topics, including stress and fear, trauma and distress and end of life and bereavement. Just reading the topics on the site brings home the enormity of what frontline workers are facing and dealing with each day.

My contribution (which you can read below) was used in this resource which was produced from contributions by a range of experts and will hopefully help individuals and teams take care of themselves and one another in a proactive way.

Join the conversation. You’ll find me on Twitter @warren_larkin and LinkedIn.

Staying well – managing your mental health and wellbeing

Stress and fear – delivering health and care during Covid-19

For those delivering care and providing essential services at this time – try and focus on the things you can control and set daily goals for your own wellbeing each day. For example, taking a 10-minute break to practice mindfulness, to stretch, practice yoga or to be quiet and alone. This is not selfish, it’s self-care and an investment in staying well.

Make time to talk with your colleagues and debrief before going home each day – chances are your family can’t or won’t understand the work you do and the pressure you are under like colleagues will. So, try and have time to connect and decompress with colleagues.

When things feel chaotic or you are in the middle of a crisis, try and make a conscious effort to slow yourself down and find some kind of calm amid the chaos.

When we are feeling anxious we typically underestimate our ability to cope and over-estimate the risk in most situations – be your own cheerleader – you will cope, you have always found a way before and there are people who will help you if you ask.

Toxic stress and trauma during the crisis

If something bad or traumatic happens, it is really helpful to understand the way we react to trauma, so some information about what to expect can be really helpful and reassuring.

Most people recover from traumatic experiences without specialist input, but that doesn’t mean the process isn’t painful, and it can take time. It really helps to offload and process what has happened – talk and talk some more, to someone you trust when you feel able, or use a service like the Samaritans.

Write down your thoughts about what has happened when you feel ready. This can help process the information and help you make sense of what happened. Finding talking or writing about traumatic events upsetting is natural and understandable but can be hugely beneficial in processing and making sense of things. Be kind to yourself and give yourself time and space to adjust and make sense of what has happened.

If things aren’t getting any better for you, talk to a professional and ask for advice. Your mental health is just as important as your physical health.

We have a tendency to search for meaning after a traumatic or highly stressful life event and usually we try to work out why the event happened. We tend to blame ourselves, someone else or a set of circumstances in the world for what happened. A lot of the time we attribute the cause of the event to our own actions or character.

This is usually not true or accurate, but we do it as this provides certainty and the explanation we are desperately seeking in order to feel secure in the world again.

So, this very common thinking error is one to watch out for in ourselves and in our colleagues, friends and family members if they experience something potentially traumatising.

Saying to yourself or someone else, “it was not your fault”, “this happened to you, not because of you”, “you did everything you could, most people would have done the same” or “you would never be this hard on anyone else” are useful ways to counter the tendency toward self-blame and re-introduce perspective.

Loss and bereavement

Understanding that moving through loss and grief is a personal process and looks different for each of us can be helpful. There is no right way to grieve or mourn a loss. Feelings like numbness, shock, disbelief, anger, frustration and insecurity are all common and understandable.

Some people don’t process or grieve a loss until immediate actions or tasks are completed, such as arranging a funeral, supporting family members and communicating the death of someone to the people that ought to know. Similarly, if you have to carry on working after experiencing loss at work, recognise that at some stage you will have to process the loss and make sense of what happened, and you will need time and space to experience this.

Marking the event in some way is helpful and a ritual can form a part of this. If you cannot be present at a funeral for example, observe a minute of silence, make and share a virtual book of condolence or connect with family via video or phone.

If you are struggling to function at work following a bereavement, talk to your manager, employee assistance programme or GP. It takes real strength to ask for help. You have to look after yourself if you are going to be able to effectively help others.

Helping other staff with their mental wellbeing during the crisis

Team reflective practice / supervision sessions are an effective way of processing what is happening, helping colleagues to feel connected, understood, valued and supported. Reflection on what went well or what went wrong is important and allows for improvement and learning.

Make self-care a top priority for your team or service. It is not helpful to burn yourself out and then ask for help. Ask for help, problem solve with colleagues, take a break, be proactive about staying well. We are human, we need looking after too and that is the number one priority so we can carry on performing our role or service in the long term. This is a marathon, not a sprint.

Have things to look forward to in your personal life and as a team – plan things in that are fun, rewarding or a distraction from the work you do. Try to maintain the social interactions you had before. If you enjoyed going out for dinner, quiz nights or going to the pub, you can achieve social interactions in a similar way by holding a virtual dinner party, online quiz night or simply getting together over a video chat with your favourite drink. This is going to be the new normal for now, so we can and should still relax and socialise together if that’s what we did before.

Make sure as a manager you know what support is available to you, and your team.

Use online support such as Big White Wall, Xenzone or other local services if you want mental health support and prefer anonymity. Many primary care groups provide access to these online services free of charge for people registered with GP practices in their area.

Samaritans, Sane, Young Minds, PTSD UK, Mind and Rethink all provide advice and a range of support too.

Finally, give yourself credit for your contribution, kindness and dedication. And acknowledge that sometimes we just can’t cope with any more stress and need to stop and reset. Doing this proactively before you reach crisis point is your duty of care to yourself. You are not a super-human because you are in a caring role and have years of experience and training under your belt or because you are a manager, or you are newly qualified and ‘should just be able to cope with this stuff’. It is my experience and sincere belief that our shelf life in any caring or helping role is directly proportionate to the care and support we ourselves receive.

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The ideas, phrases and suggestions presented here do not replace professional judgement, medical advice or guidance provided by your employer. They may not be appropriate for, or apply to all workers and you should seek help from the relevant organisations or agencies if you need it. WLA accepts no liability associated with the use of ideas, phrases and suggestions.