Ritesh Aggarwal looks at the importance of being mentally healthy and why it’s key to a successful practice and happy team.
COVID-19, SOPS, AGPs (now talked about as AGE), FGDP, BDA, GDC, CQC, CDO, fallow time, argh! Welcome to the last two minutes of my headspace! I can’t think straight and I can’t focus. I’m jumping from one thought to the next 10 for jobs to do, without actioning any of them, and then forgetting the first thought.
I’m now berating myself for forgetting this and the harder I try to remember things the more I forget. This happens several times per day. I have lists, sublists and lists of lists all over the place. Does this sound familiar? Now breathe! Inhale slowly and exhale even slower so it takes longer to exhale than inhale.
Now let’s start again. The pandemic has possibly been the strangest thing we have all experienced. There is no right or wrong way on how to handle the situation and we will all deal with it in our own way. Someone said to me: ‘We are all in the same storm but travelling through it in different boats.’ This is so true. We should be very mindful of this as we slowly transition out of lockdown and return to work.
Returning to dentistry will again be unique to your own practice and the individuals within it. Some practices will have been supported financially throughout this time by NHS payments others, such as private-only practices, will be worrying whether their business will survive (I fall into the second bracket as I own a one-surgery private practice).
There are several emotions and worries that people may be feeling and below is a list of things that may be troubling specific individuals. These worries may crossover into all of us (this list is not exhaustive – unlike me who is exhausted!)
Members of the team will have worries and anxieties due to uncertainty about the ‘new normal’. Uncertainty tends to be associated with danger and we end up creating our own narrative about how things will develop. These predictions normally centre around negative outcomes and this negativity then fuels the cycle of stress and worry.
Practice Principals – may have worries about finances, safety for staff and patients as well as themselves and the families of all associated with the practice. Have they got everything right? Can we improve on anything? Agonise over the slightest thing that may be wrong (even though the consequences are negligible) due to our perfectionist nature.
Associates, therapists and hygienists – they are generally all self-employed and may have worries about job security. Are rising practice costs passed on to them or will they have to accept a pay cut? Will there be enough work to sustain a living particularly in the short term?
Nurses and receptionists – can they cope with more duties bestowed upon them? What is it going to be like? Again, job security will be praying on people’s minds especially if associate and therapists are released.
Practice managers/head nurses/line managers – can they keep everyone happy from the practice principal to their teams? Are policies and procedures up to date in line with the new standard operating procedures? How are the staff coping? Is all the PPE in place and constantly available to practice safely? Can patients be seen in a timely manner?
The key to creating certainty and reducing worry is:
- Empathetic, transparent and honest communications
- Creating factual assurances can help alleviate anxiety but never overpromise
- Have regular contact and involve all members of the team
- Explain new safety measures implemented in detail via official documentation and ensure that all team members understand them including the rationale behind them
- Invite suggestions for improvements from team members
- Creating a buddy system may help pairs or small groups stay connected and share experiences. It is not always the responsibility of managers to make sure everything is ok. As a result, a buddy system allows everyone to be involved in moving forward as we transition from these testing times.
Having an overall action plan that is well communicated with honesty and empathy will help create certainty and alleviate fears for all members of the practice.
Changes to job role
Some of us may feel vulnerable as we may think that we have de-skilled over the past few months. We may also question our purpose or value especially if there are significant changes to our roles and responsibilities. There may also be a drop in standards whilst we get used to working again in a new way.
- Initiate 1-1 meetings during the early stages of transition back to work. You may wish to find out about an individual’s personal goals and values and plans for career progression. Compare these with the overarching practice goals to see how they align and formulate a plan to move forward together
- Increase the number of staff meetings during the early stages and discuss organisational purpose and values. Communicate changes to these and work together to create the right culture within your environment
- Be sympathetic to mistakes. We are all going through so much at present and we will all make mistakes. Discuss these mistakes and learn from them for the next time. Also discuss the successes no matter how small. This will build confidence and create positivity around our new working life.
The way an organisation is managed has a big influence on the mental health and wellbeing of its workforce. Getting the right culture is of paramount importance to creating a happy workplace.
Another change of routine
We have been in lockdown for almost 4 months and we are now being asked to transition back to work. Some of us have enjoyed the benefits of lockdown – more time with family, more autonomy of our daily schedule, less time pressures and a slower pace of life. This is now going to change again.
- Be mindful that some personnel may want to hold onto these newfound benefits
- Try and be flexible and understanding, where possible
- Acknowledge and normalise these mixed feelings about returning to work. We will all miss some of the benefits from lockdown. Ask team leaders and management to discuss their feelings and what they have done to help manage these feelings
- Maybe consider new working hours for some people if the operations and productivity of the organisation allows you to do so. This way you will help create a balance beneficial to the individual whilst maintaining productivity levels. Whilst at work these individuals are more likely to remain engaged and focused
- Discuss commuting for team members – some may have fears about using public transport. Come up with ideas to help with this and alleviate these worries and stresses.
Having personalised strategies and action plans for all team members, specific to their job role, will be beneficial as they return to work.
Specific mental health issues
Previous large-scale disasters have shown increases in mental and physical disorders within populations in the immediate aftermath and beyond. It is highly likely that there will be a substantial increase mental health conditions such as anxiety, depression, OCD, stress, panic and PTSD. As stated earlier, the pandemic will take its toll on us all in different ways with varying affects. For example, some people may have had to deal with bereavement, relationship breakdown, financial worries. And others may have increased amounts of health anxiety.
We need to acknowledge this:
- Develop an open culture within our practices to encourage conversations either as a team or in confidence
- Give all team members the opportunity to educate themselves and enhance their skills in recognising mental health symptoms and signpost appropriately. This is essential for managers or at least one member of the team
- Encourage team members to check in on each other and make support readily available to all team members, especially managers. Ask all team members what support they need so you can create bespoke strategies and interventions specific to your practice
- Carry out regular workplace surveys so you can actively track the wellbeing index within your practice.
Consider appointing a designated mental health champion who will take the lead for developing your mental health and wellbeing strategy.
Mental health charity Mind reported that 65% of adults with a mental health condition have said it got worse during lockdown. Additionally, Nuffield Health showed that 80% of people working from home reported that lockdown had a negative impact on their mental health.
I cannot stress the importance of carrying out a one-on-one return to work discussion, in a safe space, with all of your team members. By ascertaining as much information as possible, you will be able to support them accordingly by understanding their personal needs. This will allow the transition back to work to be much smoother and start you off on the path to creating a mentally healthy workplace.
Creating a mentally healthy workplace
Value mental health and wellbeing as core assets of your organisation:
- Commit to protecting and improving the mental health of all employees
- Commit to supporting employees experiencing distress and mental health problems
- Designate mental health first aiders or champions
- Ensure all line managers take an active role in the responsibility for implementing mental health programmes
- Regularly review the culture in your business to be as mentally healthy as possible
- Provide mental health promotion tools available to all staff
- Carry out regular staff surveys and mental health risk assessments to ensure you have an evolving mentally healthy environment
Support the development of compassionate and effective line management relationships:
- Provide opportunities for managers to attend relevant training to support staff living with mental health problems and the wellbeing of all staff in general
- Provide appropriate support for line managers to ensure they remain mentally healthy
- Recognise that line managers who experience mental health problems themselves are an asset to the company.
- Ensure that discrimination on the grounds of mental health status is seen to be unacceptable
- Encourage reporting of any discrimination or harassment they witness or experience
- Support national and local anti-sigma initiatives such as Time to Change, Time to Change Cymru, See Me and Mental Health Awareness Week.
Give value to the diversity and the transferable skills that people who have experienced mental health problems:
- Encourage disclosure of this experience and provide support as appropriate
- Include mental health in diversity and inclusion strategies
- Recognise the mental health component of wider equality initiatives
- Ensure your business creates opportunities to enable people with mental health problems to join your workforce
- Give people positive incentives to disclose any mental health problems, by establishing an open culture that values authenticity
- Set up peer support and mentoring programmes for staff with lived experience of mental health problems.
As we transition back to work, we are in a unique position to define our new practice life. We should not try to just recreate our businesses as they were pre COVID-19. But instead try to embrace this opportunity to create a new and improved practice for the future. With mental health and wellbeing at the heart of our strategy.
It is exciting to think that we can get to know our colleagues again within the workplace as well as outside. Reconnect by carrying out questionnaires based around each other’s interests outside of work.
Find out about everyone’s experience of lockdown. What they liked and what they didn’t like – and why. And take this information forward to help create a happier environment.
Encourage an open culture and provide training to all team members so they can support each other. We all have mental health and we should focus on a preventative approach just as we do in dentistry. And so by adopting a mental health strategy, bespoke to your own work environment, you can create a workplace that allows people to thrive and be mentally healthy together.
Thank you for reading, take care and stay safe.
Ritesh (Ricky) Aggarwal is a dentist and practice owner in Sheffield. He is also the managing Director of Psynergy Mental Health – a company dedicated to positively changing the landscape of mental health. He hopes to develop a more robust objective assessment process that allows us to improve mental health for all by adopting a preventative approach.