Improving the mental health of NHS employees

Medical staff meeting

Based on research into psychological therapies, a new workplace training programme is helping to cultivate personal wellbeing among a wide range of NHS staff.

In the UK, around one in six workers experience a common mental health problem, such as anxiety or depression, at any one time. This comes at a cost, both to employee wellbeing and to the economy through lost productivity. So there is rising interest in programmes that can help workers find a sense of psychological health and wellbeing, even when faced with the pressures of the modern workplace.

Acceptance and commitment therapy (ACT) is a mindfulness and values-based behavioural approach that has shown to be effective in the treatment of a wide range of psychological problems. With Economic and Social Research Council (ESRC) funding, Dr Paul Flaxman and colleagues in the psychology department at City, University of London created and delivered a new workplace training programme based on ACT.

The programme, which evidence demonstrates can improve employee psychological health, has been adopted in more than 30 NHS trusts, as well as other sectors in the UK and overseas.

About the project

Dr Flaxman’s research builds on an earlier ESRC-funded project, which demonstrated the effectiveness of a group-based version of ACT for improving people’s mental health.

Dr Flaxman explains:

The aim of ACT is to improve psychological flexibility. It’s not about getting rid of unwanted inner states, it’s about helping us find meaning in our actions and engaging with what and who matters to us, even when we are experiencing difficult thoughts and feelings.

A follow-on grant enabled Dr Flaxman and his team to transfer expertise in this ACT-based training programme, using a ‘train-the-trainer’ approach in three NHS trusts (Northumbria Healthcare, Central Manchester University Hospital and Royal Free London).

Dr Flaxman says:

We trained staff support practitioners – psychologists, counsellors and vocational rehabilitation specialists – in how to deliver ACT in groups, so that they could then train their own staff and service users.

This knowledge exchange means the NHS doesn’t have to rely on external agencies, given there is in-house expertise for delivering effective ACT interventions long after the initial project ends.

Extensive evaluation data was collected from organisations that used the training. This showed the programme leads to significant improvements in employee mental health and psychological wellbeing.

Impact of the project

The ACT-based training programme has been adopted across the UK by more than 30 NHS trusts, and thousands of NHS staff have participated. The programme has also been delivered to more than 200 practitioners working in schools, prisons, police forces and mental health charities.

Enhancing the support service on offer to NHS staff

The training of practitioners in the pilot project at three NHS trusts improved the psychological support service on offer to NHS staff. By creating in-house expertise that can be cascaded through the workforce, the benefits continue to expand.

At Northumbria Healthcare NHS Foundation Trust, for example, Dr Flaxman trained five members of the staff support team. Since then, the Northumbria team has delivered their ACT-based course to more than 2,500 members of staff, and it has become a central component of the organisation’s staff support offering.

The head of Northumbria Healthcare’s staff support team says:

ACT-based resilience training has transformed our trust’s provision of staff support… Since rolling out the training we have noticed positive organisational changes; for example, improvements in staff engagement scores on the staff survey.

From these initial collaborations, a high level of interest has been generated from other NHS organisations.

Dr Flaxman adds:

The training programme went from those three trusts to 25 very quickly, purely through word-of-mouth from the practitioners and staff that had taken part.

Improving the mental health of NHS employees

From data collected through the project, it was concluded that the training resulted in significant improvements in the mental health of those who took part. Employees who had undergone training reported an increased willingness to experience difficult thoughts and feelings, and an increased capacity to use personal values as a guide to behaviour.

A principal clinical psychologist from Lancashire Teaching Hospitals NHS Foundation Trust says:

A frequent outcome is that [staff] start to value themselves and take care of themselves more. This is really important for NHS staff who may often give a lot to others, to a point where they are at risk of burnout and going off sick.

Providing wider access to ACT interventions

Working with organisational consultant Ross McIntosh, Dr Flaxman has adapted the training for a wide range of organisations, including:

  • schools
  • universities
  • the prison service
  • police forces
  • local and central government

To meet growing demand for the train-the-trainer programme, the team has hosted large scale events attended by hundreds of staff support and occupational health practitioners. These sell-out events led to them introducing video-links, which enabled international delegates to attend.

These events have rapidly increased the number of practitioners trained in ACT-based interventions and generated greater awareness of its potential benefits in the UK and overseas.

Dr Flaxman says:

The reach of the training programme has now extended internationally to health, education and cultural organisations in Canada, USA and Australia. More recently, we’ve been working with colleagues in Uganda who are culturally translating the programme for their local healthcare staff.

Find out more

Read more about Dr Flaxman’s research into improving mental health in the workplace.

Top image:  Credit: sturti, E+ via Getty Images

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