Listening to Professor Neil Greenberg, a professional psychologist and forensic psychologist at King’s College London, you might think that he is describing the psychological conditions of a war zone, not the NHS in 2021.
He talks about frontline psychiatry; the risk of “moral injury” in the line of duty; the need for military-style harmonization to protect traumatized NHS staff; the importance of companionship, psychological action plans and a “buddy system” of guidance for NHS staff under supervision.
Prior to entering King’s College, Greenberg spent 23 years in the armed forces, researching and developing new ways of treating victims of battle trauma. His work in the field of trauma risk management (TRiM), including through the specific trauma treatment consultation he established in 2001, has treated conditions such as post-traumatic stress disorder to a depth of understanding. new. And since last April, he’s been putting those lessons into the battle against Covid-19 at the new Nightingale hospitals.
“The reality is that many people are in distress [in the NHS] right now, ”he says. “There are NHS staff who have been damaged by this. We need to make sure they get the right level of care. ”
To that end, last week a team from KCL published the results of a major study into the impact of the Covid-19 crisis on intensive care unit staff, which Greenberg says should be a “wake-up call ”To NHS Leaders and politicians.
Of the 709 health care workers from nine English ICUs surveyed anonymously in June and July last year, 45% showed signs of “possibly clinical importance”, indicating conditions leading to -into depression, extreme anxiety, drinking trouble, thoughts of self-harm and suicide, and PTSD.
The decisions are worrying enough in themselves. But taken as they were at a time when infection and hospitalization rates were relatively low, what has been the impact of the past six months on healthcare workers?
“By November and December things had gone back to where they were [in July], ”Said Greenberg. “We expect that when we study now it will be harder than back in June and July. The more obvious your trauma, the higher the dose [of trauma]. ”
Further rounds of mental health checks to be carried out in September, November and December will reveal the numbers and new studies are set to begin this month. With the alarming rise in diseases, admissions and deaths since September, it is inevitable that additional time and pressures will have to do the trick.
And not just on NHS staff, or even just in intensive care. Although the KCL study in July focused only on ICU staff, since then the team has expanded its remit to include a wider range of health service workers. And it can’t stop there, says Greenberg, the social care system is a “major concern” too.
“There is a wide range of specialties that cannot deliver the care they want. The implications for this are huge across the whole health and social care system. The challenges they face [in social care] they are terrible. ”
With weapons reference points ever far from the mind, even with the release of the Covid-19 vaccine now underway, Greenberg compares the current atmosphere for NHS staff psychologically to the military base he experienced in Iraq – a base that was subject to intense daily barking.
“We live in a state of perpetual uncertainty,” he said. “When we had troops in Iraq they were often in locations that were rocked 10 or 15 times a day. In those situations you need to learn to live with that uncertainty, and focus on things that you can control. ” Health and social care workers need to learn the same skill.
At an individual level, Greenberg says the way health and social care workers can take control of their own approach to mental health. They can do this by sharing painful experiences with colleagues and loved ones, creating a “meaningful statement” for dealing with difficult issues, and engaging in practice sessions. professional meditation – safe places to open about inner psychological stress.
At ward level above it wants better support for staff. “Hospitals need to ensure that staff have sufficient‘ psychological PPE ’, working through the pandemic to prepare for the difficult nature of their work,” he says. “Together with proper preparation, the provision of effective team support, better identification of vulnerable workers, and timely access to evidence-based treatment is likely to make a significant difference.”
In July the Department of Health and Social Care launched the NHS People Plan, with a wave of new initiatives and support systems focusing on mental health and wellbeing, involving 2,000 former leaders trained to recognize signs of psychological stress in frontline staff.
But NHS leaders and politicians are certainly pondering why it has forced this scale to introduce such measures. Greenberg has acknowledged that schemes such as management and the buddy system have acknowledged “variable” from trust to trust. “But this is just the beginning,” he says.
It may take months or years to assess the true psychological tolls of pandemic on NHS and social care staff. In the meantime it is inevitable that many more doctors, nurses and health care assistants will suffer. The only hope is that they will get the support that the KCL study shows is desperately needed.
“It would be a very serious moral issue if in two years’ time you report the case of an NHS worker who could not get into care, someone who was damaged by a life-saving one,” he said. Greenberg. “These people have done their best for the country.”
curriculum vitae
Age: 52.
Life: Portsmouth.
Family: Married, two daughters.
Education: Atholl Grammar School, London; Lowland Sixth Form College, London; University of Southampton, (biochemical sciences); University of Southampton, (medicine); Royal College of Psychologists (MRC Psychiatry); University of Leeds (Master of medical science, psychology); University of London, (MD).
Position: 2013 – present: professor, defensive mental health, King’s College London; 2009-2013: co-director, Academic Center for Defense Mental Health and professor of mental health protection; 2007-2009: departmental director and senior lecturer, armed psychiatrist, Langdon, Dawlish and South London hospitals and the Maudsley, London; 2005-2007: consultant, senior psychiatrist / honorary lecturer, armed psychiatrist, assisted in the development of the trauma risk management (TRiM) system, Department of Community Mental Health, Royal Portsmouth Navy and King’s College, London; 2000-2005: specialist registrar, general psychiatry, forensic and liaison roles, Langdon Hospital, Dawlish and Royal Navy Portsmouth; 2001-present: founder and managing director of specialty trauma consulting, March on Stress; 1997-2000: senior house officer, Duchess of Kent Military hospital, Catterick Garrison and Bootham Park hospital, York; 1994-1997: Royal Navy medical officer, ships, submarines and Royal Marines; 1993-1994: professional pre-registration house officer occupations, Haslar and Royal Bournemouth hospitals.
Interests: Keeping pigs healthy, family and guinea.