Globally, mental health and resilience has been brought into sharp focus for us all this year. Be it isolation, the fear of the unknown, the loss of structure, work, or purpose, or indeed myriad other reasons, the importance of good mental health has become a talking point.
In 2017 a report from the House of Commons Communities and Local Government (CLG) Select Committee highlighted 'severe' shortages and challenges in the care workforce. The impact of which has 'manifested in high vacancy and turnover rates, which result from low pay not reflecting the amount or importance of the work involved, poor employment terms and conditions, lack of training and lack of opportunities for career progression’. (1) It goes on to suggest that in real terms that this means that nearly half of care staff (48 per cent) leave their jobs within a year of starting, with the social care sector replacing more than a third (36 per cent) of its nurses every year. (1)
With a combined 60+ years in social care, Ruth, Nicky and Alex, the team behind Sustainable Source, have lived with and experienced the impact of being asked to do too much for too little for too long. On the face of it we did what we needed to do. However, behind the scenes, in the safety of our homes, we eventually burnt out; experienced major mental health break down. We say this here, because this is our story, the reason for Sustainable Source coming into existence - we came together to do what we could to be in service to the people who show up every day to do this work.
At the height of Summer this year, after lockdown restrictions lifted, the three of us met up to reconnect. We sat under the dappled shade of trees, drinking hot tea – despite the raging summer heat beyond the tree-line, to look at what we can do now. We talked about how, as the crisis hit, the full impact began to bear down on those working in caring roles, paid or unpaid; the toll it has taken on NHS Staff. All of the challenges social care face were laid out before us with the recognition of just how hard the sector was being hit.
We know that the public showed unwavering support, people clapped for the NHS, partly because it bought people together, partly as they were at a loss as to what else to do to demonstrate their solidarity, yet clapping did not change the situation. We know for certain that:
“The social care system [...] entered the pandemic [...] underfunded, understaffed, undervalued and at risk of collapse.” (2) a Health Foundation report stated recently, affirming what is already well understood. It concluded that “any response to COVID-19 – however fast or comprehensive – would have needed to contend with this legacy of political neglect.” (2).
It is interesting that the report is written in a way that implies that the time to respond has passed. Our conclusion was different. Now we are more aware of what the situation is, now is the time to respond. When in a stressed state, the capacity to take on new or different information, regardless of its potential benefit is impaired (3). Short term stress is life saving – it activates the body in such a way to get you moving – long term, the impact is life limiting (4).
The current crisis is thrusting many people into the realm of ‘moral injury.’ With its origins in the military, moral injury is “the social, psychological, and spiritual harm that arises from a betrayal of one’s core values, such as justice, fairness, and loyalty”.
As highlighted by stories that have made it into the papers, staff in the care sector have routinely been unable to protect the people they care for and work with to the standards they want to, or would expect to. They have systematically failed to be protected by leaders, and through adhering to the guidelines, may have harmed people, emotionally or physiologically, when their intention is to do anything but.
Mental health for all has to include a recognition of what is being asked of people and to ask better questions about what can be done. Yes more pay, more recognition, absolutely, but what about time for people to grieve when someone they have been caring for passes, what about time to talk about the impact this crisis has had on who they are, and what they stand for, what about time to rest, without work pressures. If in keeping the country alive, the care staff are killed through an unwillingness to make space for them to be – what does this say of how we value health?
Caring in a time of crisis has highlighted that compassionate caring people who come to this work because for most, it is their vocation, not just a job, have edges, sharp, sheer edges that they navigate daily. This really matters. Care is something that will touch all of our lives at some point or other. As a society we need to consider and reflect upon who cares for the carers. If you know that you are valued in your role, you are more likely to value yourself and this is a founding principle of self care. Since we conceived Sustainable Source back in 2016, our big dream and vision was to ensure that caregivers were well resourced within themselves before they gave to other people. You cannot pour from an empty cup.
Keeping well is a daily dynamic balancing task. This is where self care comes in. World Mental Health Day reminds all of us that the body and mind are interconnected and that the statement “I have mental health” or conversely, “I have mental ill health” are just as valid as statements about bodily health. Self care is the best care.