Taking care of you - our work with emergency departments

Our key messages from our work with emergency departments

• There are high expectations of ED staff - there should be a focus on self-care when putting in place specific workplace mental health interventions within emergency departments.
• Emergency departments have a powerful performance culture - Good working conditions inspire loyalty and high performance from staff. Plus, they can also prevent people developing new mental health problems, and support those living with them to thrive. By positively managing and supporting employees' mental wellbeing, ED's can ensure that staff perform to their potential.
• Managing ED staff mental health is reactive rather than preventative- supporting staff mental health shouldn't just happen when they need to take time off. Equip staff with tools from day one.
• Support focuses on traumatic events - Put in place preventative measures to keep staff well at work as the cumulative effect of day-to-day stress is just as detrimental to wellbeing.
• Support interventions are not practical - Ensure that support is tailored to the needs of ED staff – support should be accessible, ensuring language is relatable, and that the actions are practical taking account of the working environment and culture.

Our recommendations based on our work with emergency departments

• Relentless caseloads, a high-performance culture, and a reactive environment are key drivers of poor mental health for ED staff. Support staff to consider their mental health so they can better manage in during busy periods. This should form part of an ED departments mental health at work plan, as set out in Thriving at Work (2017) core standard one 'Produce, implement and communicate a mental health at work plan'
• Senior leaders play a key role in supporting staff mental health. Thriving at Work (2017) enhanced standard two is advises senior leaders to 'demonstrate accountability'. They should promote employee wellbeing by speaking out about mental health, acting as role models for self-care, and being accountable in the implementation of support.
• Develop mental health awareness among staff by making information and tools available. Core standard of two from Thriving at Work (2017) encourages all organisations, including emergency departments, to make this a priority. For EDs this can be achieved by distributing resources in staff areas, or where teams wait for samples and test results, and even on the back of toilet doors. Ensure that the text is large so that information can be absorbed quickly on the go.
• Promote and invest in training in mental health awareness for all staff, including for junior and new clinical teams. Linked to the previous point, training is another way to 'develop mental health awareness among employees', core standard two from Thriving at Work (2017). ED departments should ensure mental health is incorporated in to current training programmes so that staff know that their wellbeing is a priority.
• Promote and invest in training for managers, this should include how to spot the signs and how to have supportive conversations with staff. Core standard five from Thriving at Work sets out that organisations should 'Promote effective people management through line managers and supervisors.' For ED's this needs to be extended to ensure that training is accessible, offered at times and in formats that meet staff needs.

Our research

Our research partner, Revealing Reality conducted an initial scoping exercise to better understand the specific pressures or problems that cause poor mental health in the ED and what kinds of intervention would (or wouldn't) work – you can read their findings here.

We also asked them to conduct an evaluation of our campaign – read Revealing Reality's full report here.