Findings from the British Psychological Society (BPS) and New Savoy staff wellbeing survey in 2015 show that 46 per cent of psychological professionals surveyed report depression. 49.5 per cent report feeling they are a failure. One quarter consider they now have a long-term, chronic condition, and 70 per cent say they are finding their jobs stressful.
All these findings are increased from 2014, with reported stress at work up by 12 per cent. Incidents of bullying and harassment had more than doubled. The overall picture is one of burnout, low morale and worrying levels of stress and depression in a key workforce that is responsible for improving the mental health of the public. Whilst the majority of respondents made negative comments about their work environment, 10 per cent of comments were more positive:
- "Being target driven is the bane of our lives."
- "IAPT is a politically driven monster which does not cater for staff feedback/input in any way. All we are told is TARGETS!!! and work harder."
- "It is invigorating to work in a team where thoughtfulness, understanding, support & compassion are central to what we do, not seen as an optional extra or a luxury."
- "I am so disappointed I have just resigned."
- "I carry my resignation in my diary now as I feel that I'm on the verge of giving up battling."
The results and analysis of the survey of over 1300 psychological professionals in the NHS will be presented today, Wednesday 9 February 2016, at the 9th Annual Psychological Therapies in the NHS conference.
From being one of the most attractive careers with high levels of satisfaction, the survey shows psychological therapists now have lower levels of job career satisfaction than other NHS staff, with poor employee engagement and loss of autonomy. This reflects a worrying trend. Last year the British Association for Behavioural and Cognitive Psychotherapies warned that "an NHS management culture of bullying and intimidation, [is] preventing us from openly raising our concerns, and undermining our clinical judgment".
Common themes identified by our survey were a managerial fixation on targets, complained about by 41 per cent, and workplace environments creating stress and burnout, complained about by 38 per cent. Extra administrative demands, an increase in having to work unpaid hours and staff being prevented from providing adequate therapy due to resource cuts were other frequent themes.
Figures yet to be published by NHS England show some commissioners spend three times less per patient on therapy than others. Our document 'The Case for a Charter for Psychological Wellbeing and Resilience in the NHS' sets out why this is now becoming unsustainable.
Leading organisations in the mental health field are committing to support a collaborative effort to improve the wellbeing and resilience of psychological staff who deliver key services.
They include the mental health charities Mind and Rethink, together with mental health trusts the South London & Maudsley and Tavistock & Portman NHS Foundation Trusts; the British Psychological Society, the Royal College of Psychiatrists, the British Psychotherapy Foundation, the British Association for Behavioural and Cognitive Psychotherapies; leading third-sector providers Westminster Pastoral Foundation, the Tavistock Centre for Couples and Relationships, and the Anna Freud Centre; organisational research consultants and care quality bodies Quality of Working Life, the Tavistock Institute and the Care Quality Commission; digital provider Ieso and the UK's major provider of employment and health support, Ingeus; the NHS in Greater Manchester and Greater Manchester Combined Authorities.
Today, we launch a Charter that aims to reset the balance. The findings of our survey call for urgent action. The Charter aims to reset the balance in the drive to improve access. It asks for a greater focus on support for staff wellbeing to sustain the impact we know psychological services have when delivered effectively. Those services which have good staff wellbeing will be more sustainable and make the most difference to those they are helping.
Politicians and Public Health England welcome the new Charter for Psychological Wellbeing and Resilience
In response to the warning signs in 2014 the Leadership and Management Faculty of the Division of Clinical Psychology, British Psychological Society, jointly with the New Savoy conference, consulted with leading professionals on a way to turn this around. The launch of the Charter and setting up of a new Learning Collaborative Network supported by key providers is our response. We are delighted that this is being supported by Public Health England and the NHS in Greater Manchester, as well as by leading providers.
Professor Jamie Hacker Hughes, BPS President, in endorsing the Charter and, through the BPS's Professional Practice Board, seeking to pursue acceptance for the Charter across the devolved administrations during 2016, says:
"Health and wellbeing at work are vital issues which we of all people should be particularly concerned about. This is an area close to my heart ... I have worked in, led and managed NHS services and have seen the effects of stress, overwork, inadequate supervision and consequent burnout at first hand."
The Charter, which is endorsed by Public Health England, will be launched by Professor Kevin Fenton, National Director for Health and Wellbeing, Public Health England, who says:
"The work behind the Charter being launched today is invaluable in highlighting some of the challenges present amongst the NHS workforce. The detailed statistics and figures quoted make the case for action clear ... Public Health England is strongly supportive of such efforts emerging from clinical leaders, which will help address the needs of NHS staff from an informed perspective. It is a real statement that BPS members are committing to bring the skills of psychological therapy experts within the NHS directly to bear on its own needs. Not only will this improve the wellbeing and productivity of NHS staff, but ultimately outcomes for patients."
Former Care Minister, the Right Honourable Norman Lamb MP has welcomed the Charter saying:
"Psychological staff play an invaluable role in the drive to rectify the imbalance between mental and physical health in the NHS, but we know all too well the enormous pressures that they face. Quite apart from the clear moral argument for taking staff wellbeing seriously, we cannot hope to achieve equality for mental health unless the psychological workforce is properly supported. The Five Year Forward View highlighted the importance of staff wellbeing in NHS organisations, and I welcome the launch of this charter as a timely and important contribution in this area."
Current Shadow Cabinet Minister for Mental Health, Luciana Berger MP has welcomed the Charter saying:
"I am delighted to welcome the Charter for Psychological Staff Wellbeing and Resilience. The mental health of people in the workplace, and particularly of those who provide psychological support, is of the utmost importance. It is unacceptable that the dedicated psychological professionals who provide vital support to those in need, are themselves increasingly suffering from stress and other mental health conditions. The Charter will play an important role in helping employers promote and improve the wellbeing of their staff. I wish all the organizations signed up to the Charter every success in fulfilling its aims."
What are we intending to do with the new Charter?
The importance of parity between psychological and physical health is now widely recognized by policymakers. Dr Geraldine Strathdee, the current National Clinical Director for Mental Health, has driven the sea-change in priority given to mental wellbeing. The economic case for this agenda is well established: depression alone costs £7.5bn. Over 75 per cent of these costs fall on welfare.
At the conference, the Minister for Community and Social Care, the Right Honourable Alistair Burt MP will make a speech to set out how he expects the NHS to meet this challenge. On the second day Lord Freud, Minister for Welfare Reform, will also make a speech to set out how better joined-up investment led by the Joint Unit for Work and Health can contribute to improving wellbeing. We will ask them what role they see for the Charter in their plans.
The BBC's Mark Easton will be chairing plenary sessions with both Ministers in which frontline clinicians can ask the questions.
It is to their needs and concerns the Charter speaks directly: if the new target is to move from 15 per cent access to 25 per cent by 2020, within new waiting time targets of six weeks from referral to treatment, where is the workforce plan from Health Education England for this? Unless there is a significant increase in capacity to deliver the full range of evidence-based therapies before the government's Work Programme comes to an end in 2017, leaving large numbers of people with depression still without support, there will be a huge crisis. The Charter Network has a vital task to understand how teams with good staff wellbeing can step up to this challenge. We will report back from a Round table discussion what some of the key leaders see as next steps for taking the Charter forward.
The former Health Secretary, the Right Honourable Alan Johnson MP, who launched the national IAPT initiative in 2008, has welcomed the Charter saying:
"The introduction of IAPT was one of the highlights of my time as Health Secretary and I'll never forget the help I received from the BPS in formulating the policy or the reception it received at the New Savoy Conference. It was and remains the most important mental health initiative for a generation and I fully support your ongoing work through this Charter to sustain the wellbeing of its staff who are the key to its success."
To do this the Charter must help reset the balance.