Turning wellbeing research into wellbeing reality: Mind Matters symposium

As a member of the Mind Matters Initiative (MMI) taskforce, developed by the RCVS, I was very pleased to take a couple of days to attend the recent research symposium held at Edinburgh University. The symposium was opened by Neil Smith, MMI Chair, who explained that its purpose was to bring together those carrying out valuable research, to understand what has been discovered, and to develop a community that shares, discusses and thinks about future research needs.

At the outset I wondered how easy it would be, as a practitioner, to interpret pure research findings in a way that might help us support our own employees. I have seen very capable recent graduates thrive in our busy first opinion practice, but I have also seen people struggle in the same environment with the same level of support available. I wondered if the reasons for this might become more evident.

Managing mental health in the workplace

One of the buzz phrases associated with vets struggling in a high intensity job is “burn out”. I think if we believed we had staff members in danger of burn out we might try to counsel the individual and perhaps look for some CPD or resilience training. Professor Debbie Cohen from the Centre for Psychosocial Research at Cardiff University takes a very different view.

She is firmly of the opinion that burn out is a workplace issue and not a diagnosis. The message to practitioners is: if staff are reporting or showing signs of burn out you should look to your systems of working to change the drivers rather than try to increase coping and resilience.

I don't think I will be alone in worrying that I might miss signs of distress or that team members will try to tough it out and not disclose an issue of mental health. Professor Cohen advocated the simplest of measures to encourage people to disclose their issues: an act of kindness. Often a simple kindness can facilitate a disclosure if you suspect someone may be struggling, and I guess if you create a culture of kindness then disclosure may simply become the norm in your practice or workplace.  

It is self-evident economics that absence from work due to poorly managed mental health would be a cost on the business. Chris O'Sullivan from the Mental Health Foundation put forward an estimate that "presenteeism" in a similar situation can cost a business twice as much. He also suggested that in real world situations Australian studies have shown returns on investment of 2.3:1 for money spent on better management of mental health in the workplace. I suppose there is no reason it should be dissimilar in veterinary businesses.

In our practice we do our own out of hours and we know that some team members find that a particularly challenging part of the job – a subject I’ve blogged about before. We have long thought it is a barrier to recruitment, despite our investment in imaginative arrangements for reciprocal time off. Carolyne Crowe suggested that swapping nights on duty for long days with late evening finishes has proved to be even less attractive to some vets, and had a deleterious effect on work:life balance. So perhaps we need to be even clearer about the compensations of 24-hour in house cover with sympathetic time off.

Sources of workplace stress

Our practice is not in a particularly high income area and rates of insurance are relatively low. A presentation from Dr Elinor O'Connor from the University of Manchester Business School ranked sources of workplace stress from an interview study. The top three were:

• working with clients
• financial issues
• managing staff 

This immediately struck a chord with me. Many of my clients think veterinary care is too expensive, I suspect most of my staff feel under paid (with some justification), and to try to remedy this we are tempted to work too hard to square the circle.

Seeing it from the client's perspective

A final elegant piece of work helped me to understand why some of my vets may have struggled with general practice. In a very contemporary approach Elizabeth Armitage-Chan (RVC) had 12 new graduates post on social media in their first eight months of work. At first, all the posts looked like small case reports, rarely mentioning the client except in expressions of frustration when circumstances prevented them from handling and working up cases as well and successfully as they had hoped.

Over time some vets began to exhibit an appreciation of their complex role and included more of the client perspective in their social media posts. And it was these vets who demonstrated lower levels of frustration when handling difficult cases. I have instinctively felt that including the clients’ individual wants and needs in my case management has given me greater satisfaction even with less-than-ideal outcomes, and I feel this work alone was worth the trip to the symposium. It has given me real evidence to use in our reflective sessions when we are trying to help our less experienced colleagues develop a fulfilling career.

The day turned out to be a great experience and I was particularly pleased that much of the information presented could be easily and directly applied in a general practice like ours. The symposium was superbly organised by mental health researcher and veterinary surgeon Rosie Allister and coordinated by the tireless Lizzie Lockett, Director of MMI. It is a great testament to the work of these, and other, advocates for veterinary mental wellbeing, along with Neil Smith, that these issues are now gaining such prominence in the general veterinary conversation.