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Our Mental Health and the Coronavirus 2019 (COVID-19) Pandemic: Part IV

Dr Libby Artingstall & Dr Sile McDaid, Co-Founders & Directors Team Mental Health 

We want to start this blog by saying a massive ‘thank you’ to everyone who is working hard to keep our country going and to keep us safe. We hope that you will be remembered as heroes of this time.  

In the meantime, we feel that it is essential for us to do everything we can to support those in work to keep well, so they can continue to complete their vitally important roles.  

In our current circumstances, many people working across the frontlines of our communities are experiencing a significant increase in pressure and / or stress. We know that a certain amount of pressure at work can be a good thing. It can help us to remain motivated and push us to achieve our goals. However, when that pressure becomes too much, we experience stress and run the risk of burnout.  

Stress specific to our job is known as work-related stress (WRS). This has been defined as ‘a harmful reaction people have to undue pressures and demands placed on them at work’.Stress in work can have a negative impact on our performance and productivity. Whilst work-related stress itself is not a mental health disorder, if we experience it in excessive quantities or over a prolonged period of time, our risk of developing a mental illness such as depression or an anxiety disorder increases. 

It’s important to note that employers have a legal duty to protect employees from stress at work by doing a risk assessment and acting on it. 2 The Health and Safety Executive (HSE) have identified 6 key areas in the workplace, that if not managed appropriately, are associated with WRS and poor health.

These are demandscontrolsupportrelationshipsrole and change. 3 In order to understand and manage stress effectively, it is important to explore an employee’s experience of each of these areas and implement change when required. This can be done through completing a stress risk assessment. At times like this, it’s not unreasonable to suggest that processes like this may be considered time consuming and / or not a priority. However, if we fail to recognise and respond to staff who are experiencing difficulties, we leave ourselves open to the potential for increasing rates of sickness absence, increasing presenteeism (working when mentally unwell and being less productive and potentially more likely to make mistakes) and significant numbers of our critical workforces developing mental health problems. We have to prevent this, and we need to prioritise doing all we can to keep our workforces well.   

Employees also have a role to play. In order to effectively support or care for others, you must care for yourself first. It’s important to ensure that you are doing the best you can to maintain your physical and mental health. Self-care is a priority not a luxury. For those who perhaps think it’s not possible to prioritise this at present, the opposite in fact is true. You can’t afford not to take the time to care for yourself.  

Self-care comprises a number of different elements. In part II of our blog series, we highlighted the importance of bringing the ‘5 ways to mental wellbeing’ into our daily lives. Alongside these, there are other factors which have been shown to protect our mental and physical health. These include:  

  • Have a healthy diet: A Mediterranean diet rich in fibre, fruit, leafy greens and omega 3 fish oils (found in fatty fish like salmon, tuna and mackerel) has been shown to support positive mental health and there is evidence to suggest that vitamin D (also found in fatty fish) and selenium (found in brazil nuts) are protective. Try to limit the intake of highly processed foods, alcohol and sugary soft drinks. Healthy diet, healthy body, healthy mind! 4,5 
  • Stay hydrated: As our body weight is comprised of almost 60% water it makes sense that dehydration will have a significant impact on our mental and physical health.6 “When dehydration reduces body mass by more than 2%, it has been consistently reported that mood is influenced, fatigue is greater, and alertness is lower”.7 
  • Take time to relax: Deep breathing exercises, guided imagery, yoga and tai chi are examples of relaxation techniques which have been shown to counter the physiological response induced by stress.8 This can have a positive impact on our physical and mental health. Take time to explore what works for you and try to build regular periods of relaxation into your weekly or daily schedule. 
  • Establish a good sleep routine: On average adults need around 8 hours of sleep each night to support positive mental health. Sleep deprivation can negatively impact our mental health. The good news is, no matter what your current sleep pattern, you can change this by implementing a sleep hygiene routine.9,10 Good sleep hygiene includes several elements to be effective. Firstly, establishing a routine with a similar bedtime and wake up time is important. Caffeine should be avoided after 5pm and remember alcohol can act as a stimulant and impact on the quality of sleep. At least 1 hour before bedtime should be about starting to wind down and relax, avoid anything that stimulates the brain and try reading or relaxation exercises. Bedrooms should be comfortable, clutter free and screens with blue light should be switched off.9,10 
  • Seek support: It’s also important to seek support. If you are experiencing difficulties it’s so important that you speak to someone and seek support to ensure you get the right support, in the right place, at the right time. For details on accessing support check out this great signposting page on the Looseheadz website.

If you are a senior leader, it’s important to lead by example and talk about and model self-care. Ensure you and your team get regular, adequate breaks and rest periods. Consider rotating people between roles with the aim of limiting the same people picking up high stress workloads over prolonged periods of time. Implement a buddy system to ensure those who are less experienced, or who are struggling, feel supported by senior colleagues. Ensure and maintain a culture of openness and transparency. Keep your team up to date with important information. Good communication helps staff feel valued, increases a sense of community and belonging, and can reduce stress.  

The mental health and wellbeing of our workforces can also be positively influenced by informing and empowering people to look after and protect their own mental health. Through the delivery of meaningful mental health awareness across the whole of an organisation, we can educate all employees to promote good mental health; detect signs of work-related stress and mental ill health; and intervene early to limit the risk of more complex, long-term mental health problems from developing. That is why, as of today, we are offering our workplace foundation online module free of charge for anyone who wishes to learn more.  

As part of any public health strategy to address COVID-19, it is essential for us to consider our mental health an integral part of this. There’s much that can be done, and we all have a role to play. 

References: 

  1. Health & Safety Executive (2018). Work-related stress, depression or anxiety statistics in Great Britain 2017. Health & Safety Executive (online). Available from: http://www.hse.gov.uk/statistics/causdis/stress.pdf  
  2. Health & Safety Executive (2019). Stress risk assessment. Health & Safety Executive (online). Available from: http://www.hse.gov.uk/stress/risk-assessment.htm 
  3. Health & Safety Executive (2020). Stress at work: What are the management standards? Health & Safety Executive (online). Available at: https://www.hse.gov.uk/stress/standards/index.htm  
  4. Lassale et al (2018). Healthy dietary indices and risk of depressive outcomes: a systematic review and meta-analysis of observational studies. Molecular Psychiatry 26 September 2018. Available at: https://www.nature.com/articles/s41380-018-0237-8  
  5. Chatterjee, R. (2018). The Stress Solution. Penguin Random House UK 
  6. European Food Safety Authority (EFSA. Scientific Opinion on Dietary Reference Values for water. EFSA Journal 2010; 8(3):1459  
  7. Benton & Young. (2015) Do small differences in hydration status affect mood and mental performance? Nutrition Reviews 2015 Sep;73 Suppl 2:83-96 
  8. Harvard Medical School (2011). Understanding the stress response: Chronic activation of this survival mechanism impairs health. Harvard Health Publishing. Available at: https://www.health.harvard.edu/staying-healthy/understanding-the-stress-response 
  9. Harvard Medical School (2009). Sleep and mental health. Harvard Health Publishing. Available at: https://www.health.harvard.edu/newsletter_article/sleep-and-mental-health  
  10. Royal College of Psychiatrists (2015). Sleeping well. Royal College of Psychiatrists. Available at: https://www.rcpsych.ac.uk/mental-health/problems-disorders/sleeping-well 

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