Mental health support for frontline staff

Elizabeth Parkin; Philip Loft; Tom Powell

1. Mental health support for frontline staff

The Commons Library has published the related briefings:

Mental Health policy in England (July 2020)
Mental Health statistics: Prevalence, services and funding in England (February 2020)
The impact of coronavirus on health and social care workers (May 2020)

The Parliamentary Office for Science and Technology have also published Mental health and well-being during the COVID-19 outbreak (May 2020). The House of Lords Library has published Coronavirus: The impact on mental health (June 2020).

In early April 2020, NHS England and NHS Improvement launched an emotional, psychological and practical support package for all NHS staff. This was commissioned by the Department of Health and Social Care, in recognition of the “need for additional mental health support for NHS staff”. The package includes access to wellbeing apps and online resilience support. There is also a dedicated support helpline operated by the Samaritans and 24/7 text service, and a helpline offering bereavement support. The Government have said that wherever possible they have ensured the same offer is included in the support package that developed for the social care workforce.

NHS England and NHS Improvement’s ‘We are the NHS: People Plan 2020/21’, published on 30 July, sets out further action that will be taken to support staff health and wellbeing. This includes introducing wellbeing guardians in all NHS organisations, offering support for staff through sickness and providing psychological support and treatment:

Psychological support and treatment:

Employers should ensure that all their people have access to psychological support. NHS England and NHS Improvement will continue to provide and evaluate the national health and wellbeing programme developed throughout the COVID-19 response. NHS England and NHS Improvement will also pilot an approach to improving staff mental health by establishing resilience hubs working in partnership with occupational health programmes to undertake proactive outreach and assessment, and co-ordinate referrals to appropriate treatment and support for a range of needs. [page 18]

The Government published guidance on health and wellbeing for the social care workforce in May 2020, which includes advice to build resilience, manage stress and support mental health. A dedicated app for social care workers was also launched in May, which included mental health toolkits .

The initiative Our Frontline, led by mental health charities, offers mental health and bereavement support to all key workers. This includes 24-hour telephone and text support with trained volunteers as well as online tools and resources.

Public Health England (PHE) has also published guidance on supporting mental health and wellbeing for the wider population:

PHE, COVID-19: guidance on supporting children and young people’s mental health and wellbeing (updated September 2020)
PHE, COVID-19: guidance for the public on mental health and wellbeing (updated September 2020)

PHE has also updated its Every Mind Matters platform with specific advice on maintaining good mental wellbeing during the outbreak.

The UK Government has increased funding for mental health charities during the pandemic. In March, the Government announced a £5 million grant, administered by Mind, to fund additional services for people struggling with their mental wellbeing during the coronavirus outbreak. In May, the Government announced that a further £4.2 million would be awarded to mental health charities, such as the Samaritans, Young Minds and Bipolar UK, to continue to support people experiencing mental health challenges throughout the outbreak.

Further information on the impact of the pandemic on population mental health is provided in the Library briefing on Mental health policy in England (September 2020).

2. UK Parliament Proceedings

2.1 Early Day Motions

Psychological support for NHS and social care workers

EDM 382 (2019-21 Session)

27 April 2020

Primary Sponsor: Dr Lisa Cameron MP

That this House notes the unprecedented situation that NHS staff, social care workers and all frontline support staff are dealing with in responding to the covid-19 outbreak; expresses concern at the psychological strain and trauma they are exposed to on a daily basis and the long-term impact this will have on the workforce; calls on the Government to work with the British Psychological Society and other mental health professions to ensure that all possible action is taken to protect the psychological, as well as physical, wellbeing of these vital key workers during the pandemic; and asks that they have access to appropriate psychological supports during and after the pandemic including Psychological First Aid in line with World Health Organisation guidance, to prevent and address negative emotional consequences such as Post-traumatic stress disorder.

2.2 UK Parliamentary Proceedings

HC Deb, Testing of NHS and social care staff, 24 June 2020, cc1387-1420

HC Deb, NHS Workers: Mental Health, 23 June 2020, c1156

2.3 UK Parliamentary Questions

Mental Health Services: Coronavirus

28 August 2020 | PQ 82463

Asked by: Munira Wilson

To ask the Secretary of State for Health and Social Care, what progress the Government has made in developing post-covid-19 plans for increased mental health and psychological support for (a) people who have contracted covid-19, (b) family and close friends of people who have contracted covid-19 and (c) frontline health and care workers.

Answering Member: Ms Nadine Dorries | Department of Health and Social Care

There is broad consensus that there is the potential for an increase in demand for mental health services as a result of COVID-19 and we are working with the National Health Service, Public Health England and others to ensure ongoing assessment of the potential longer-term impacts and to plan for how to support mental health and wellbeing throughout the ‘recovery’ phase.

Mental health services are provided according to clinical need, regardless of whether an individual or a member of their family has previously contracted COVID-19.

With regard to frontline health and care workers, we have ensured comprehensive packages of emotional and psychological support are available to all social care and NHS staff, building on existing support. This includes free access to a confidential helpline operated by the Samaritans.

Coronavirus: Mental Health

28 August 2020 | PQ 82253

Asked by: Mohammad Yasin

To ask the Secretary of State for Health and Social Care, what additional support the Government is providing to support the mental health of (a) frontline workers, (b) people from different Black, Asian and Minority Ethnic communities and (c) young people in response to the covid-19 outbreak.

Answering Member: Ms Nadine Dorries | Department of Health and Social Care

The Government recognised at the start of the pandemic the need for enhanced wellbeing support for National Health Service and social care staff and commissioned NHS England and NHS Improvement to develop a comprehensive emotional, psychological and practical support package for NHS staff. Wherever possible we have ensured the same offer is included in the support package that developed for the social care workforce.

NHS England and NHS Improvement are working closely with key stakeholders and people with lived experience to support information sharing to encourage timely access to NHS mental health services and improve people from black, Asian and minority ethnic (BAME) backgrounds’ experiences of these services.

We are working to ensure that all children and young people who have or who develop mental ill health can access support if they need to and that schools and colleges, parents and carers can support children and young people’s mental health and wellbeing over the coming weeks and months.

The Government has also provided £9.2 million of additional funding for mental health charities to support adults and children. This includes charities that offer support to BAME communities and charities like Young Minds.

The Government’s £8 million Wellbeing for Education Return programme will support school staff to respond to the emotional and mental health pressures some children and young people may be feeling.

Mental Health Services: Coronavirus

22 July 2020 | PQ 78866

Asked by: Munira Wilson

To ask the Secretary of State for Health and Social Care, what additional mental health support his Department is making available to (a) frontline workers, (b) people from Black, Asian and Minority Ethnic communities and (c) young people as covid-19 lockdown restrictions are eased.

Answering Member: Ms Nadine Dorries | Department of Health and Social Care

We have ensured comprehensive packages of emotional and psychological support are available to all social care and National Health Service staff, building on existing support. This includes free access to a confidential helpline operated by Samaritans.

Recent reviews have confirmed the disparity of the impact and risks that COVID-19 has on those from black, Asian and minority ethnic (BAME) backgrounds. We have set out our intention to take forward further work under the Parliamentary Under-Secretary of State for Equalities (Kemi Badenoch MP) and through the Prime Minister’s Commission on Race and Ethnic Disparities. NHS England and NHS Improvement are working closely with BAME experts and others to encourage timely access to NHS mental health services and improve BAME people’s experience of these services.

NHS children and young people’s mental health services have remained open throughout the pandemic and have deployed digital tools to connect with young people and provide ongoing support. We have published guidance to parents and carers on children and young people’s mental health and wellbeing on the GOV.UK and Every Mind Matters websites and we have provided additional funding of £5 million for mental health charities to support adults and children, including those from a BAME background, as well as a further £4.2 million, as part of the Government’s United Kingdom-wide £750 million package of support for the voluntary sector.

Mental Health Services: Health professions

29 June 2020 | PQ HL6224

Asked by: Lord Jones of Cheltenham

To ask Her Majesty’s Government what plans they have to increase the number of mental health specialists who can treat post-traumatic stress disorder and other mental health impacts suffered by (1) health and care staff, and (2) patients who have recovered from COVID-19; and what plans they have to provide 24-hour access to mental health support for health and care staff through a dedicated helpline.

Answering Member: Lord Bethell | Department of Health and Social Care

Growing the psychological professions is a priority for this Government and is essential to fulfilling the vision set out in the NHS Long Term Plan for mental health services in England. Health Education England and NHS England and NHS Improvement are working with employers and professional bodies to ensure we continue to have the pipeline of staff we need to support patients and to accommodate any increase in demand.

NHS England and NHS Improvement have put in place a support package for all National Health Service staff during the COVID-19 outbreak including helplines that offer counselling and help with bereavement. It incorporates learning from past traumatic events and will help NHS staff to recover long after the COVID-19 response has subsided.

NHS Trusts: Training

16 June 2020 | PQ 59895

Asked by: Zarah Sultana

To ask the Secretary of State for Health and Social Care, what role his Department has in ensuring there is adequate mental health training for staff across all NHS trusts.

Answering Member: Helen Whately | Department of Health and Social Care

NHS England and NHS Improvement are supporting line managers, supervisors and teams to have psychologically informed conversations. They are also offering peer support training as well as a range of resources to help teams decompress and process their experiences. When National Health Service staff require additional professional support, they will be offered evidence-based treatment by trained and qualified mental health practitioners.

Additional psychological support has also been made available for all NHS staff during and after COVID-19 response and can be accessed online at the following link:

people.nhs.uk/help

NHS staff, frontline workers, and volunteers can now access a new psychological first aid training course developed by Public Health England and launched on 15 June 2020. There has been significant interest in the course; 8,700 learners have enrolled as of 17 June.

First aid: Mental health

2 June 2020 | PQ 53549

Asked by: Dr Rosena Allin-Khan

To ask the Secretary of State for Work and Pensions, what assessment the Government has made of the potential merits of reviewing the Health and Safety (First-Aid) Regulations 1981 to (a) strengthen the provisions on protecting mental health within existing legislation and (b) enshrine parity of esteem for mental health in law.

Answering Member: Mims Davis | Department for Work and Pensions

Under the Health and Safety (First Aid) at Work Regulations 1981 employers have a responsibility to consider the physical and mental health needs of their staff as part of their first aid needs assessment and decide what support is necessary, regardless of whether or not the cause is work-related. HSE published clarified guidance in November 2018 to increase employers’ understanding of their responsibilities and what factors to consider when undertaking a first aid needs assessment.

Mental Health Services

18 May 2020 | PQ 48376

Asked by: Tim Farron

To ask the Secretary of State for Health and Social Care, whether his Department has plans to introduce 24 hour and seven days a week mental health support for (a) health and (b) care workers.

Answering Member: Helen Whately | Department for Health and Social Care

Mental health support is currently available 24 hours a day, seven days a week for National Health Service and social care staff. All keyworkers, including NHS and social care staff, can access ‘Our Frontline’. ‘Our Frontline’ is a collaboration of charities providing 24 hours a day, seven days a week one-to-one mental health support, via call or text, from a trained respondent.

NHS and social care staff can also access a free wellbeing support helpline, available 7am-11pm, providing emotional support and onward signposting to specialist financial advice, bereavement care and coaching. If health and care staff call outside of these hours, they will be able to speak confidentially to a Samaritans volunteer.

Coronavirus: Disease Control

11 May 2020 | PQ 45452

Asked by: Stuart Anderson

To ask the Secretary of State for Health and Social Care, what plans he has to provide mental health support for non-clinical front line workers helping to tackle the covid-19 outbreak.

Answering Member: Helen Whately | Department for Health and Social Care

‘Our Frontline’ – a collaboration between Mind, Samaritans, Shout and Hospice UK – provides information, emotional support and access to a crisis text service for people working on the frontline.

In addition, the Department has commissioned NHS England to develop a comprehensive emotional, psychological and practical support package for all NHS staff, including non-clinical frontline workers, during and following the COVID-19 response. This currently includes: free access to well-being apps, a confidential staff support helpline, and a dedicated helpline offering bereavement support. The Department is working to extend this package of support to the social care workforce.

3. News articles and press releases

3.1 Press releases

Keep health workers safe to keep patients safe: WHO

World Health Organisation

17 September 2020

Attacks on health workers in the context of COVID-19

World Health Organisation

30 July 2020

More mental health support for health and social care staff

Scottish Government

20 July 2020

Psychological first aid in emergencies training for frontline staff and volunteers

Department of Health and Social Care

15 June 2020

Mental health support scheme for doctors extended to every frontline healthcare worker in Wales

Welsh Government

16 April 2020

Coronavirus update: First Minister’s Speech [incl. mental health support]

Scottish Government

14 April 2020

NHS launches mental health hotline for staff tackling Covid-19

NHS England

8 April 2020

3.2 Commentary, journal articles and reports

The following is a selection of reports and other articles relevant to the debate. Please note that the Library is not responsible for either the views or accuracy of external content.

Mixed signals about the mental health of the NHS workforce

The Lancet

D. Lamb, N. Greenberg, S. Stevelink and S. Wessely

3 September 2020

Covid-19 and the female health and care workforce

NHS Confederation

25 August 2020

BMA Covid-Tracker survey (England and Wales)

British Medical Association

13 August 2020

Mental health services and Covid-19: Preparing for the rising tide

NHS Confederation