Caregiver identity and mental health shame: encouraging caring subject students’ self-care

Many students in caring subjects, such as healthcare, social work, counselling and psychotherapy, are inspired to gain knowledge and skills to help other people, but there are a number of challenges for them to overcome in order to become professionals who give compassionate care for others.

One of these is their own mental health: caring students tend to have high levels of shame about having mental health problems themselves. They can worry that other people might see them as weak, and can become very critical of themselves as a result.

High professional standards

This self-criticism may be related to the high professional standards students need to follow. Social work students, for example, have to follow the professional code of ethics of the British Association of Social Workers. The majority (70%) of social work students in the UK become social workers within six months of graduation, so can compare themselves constantly with this professional standard and identify areas where they are lacking.

Shame is experienced in relation to the expectations placed upon them, so being aware of this standard can trigger their sense of shame (for example, “I shouldn’t feel down because I am supposed to help others who are depressed”). Our recent research identified that the levels of shame felt by caring subject students were indeed high, and that those with stronger caregiver identities tended to feel more ashamed of having a mental health problem. Furthermore, unsurprisingly, increased shame was related to poor mental health.

Practising self-compassion

Enhancing self-compassion and self-awareness can be an effective alternative solution to caring students’ challenging mental health issues. Their high levels of shame may explain why mental health training has not worked so well for them: they feel shame about mental health problems, therefore are not willing to engage with such training. Instead of directly targeting mental health, it may be better to approach their mental health by enhancing self-compassion and self-awareness.

Our research revealed that self-compassion was a significant negative predictor of mental health problems, in that cultivating self-compassion may lead to better mental health. By nurturing kindness to themselves, students may be able to reduce their shame and self-criticism, leading in turn to better mental health. There are many exercises that can effectively enhance self-compassion, such as compassion meditation. Just 10-15 minutes of meditation every day for a week can have a significant impact on our mental health.

Compassionate imagery is another: one type of imagery is to imagine someone you associate ‘compassion’ with to be right in front of you, and hear what this person says about your problem. Or you can imagine a six-year-old child crying in front of you, and think about what you would say to them, and how. Notice how you would feel. Once you have done that, imagine you receive such messages. The word ‘self-compassion’ could sound extravagant, but it can be practised in many ways, and can be found in our daily life. We are currently conducting a study to examine the effects of self-compassion training on the mental health of social work students at the University.

The power of self-awareness

The other key construct, self-awareness, is about noticing their own values and the attitudes that affect their practice. Students in our research believed that they should not have any mental health problems because they aspired to become caregivers for those with mental health problems. They feel that they have failed to be a social worker if they have a mental health problem themselves. This is a wrong assumption: even professionals in this field need to ask for help, and self-aware professionals are able to ask for help appropriately.

In my professional experience, excellent clinicians tend to be those who are aware of their own values, potential biases and limitations. Having keen self-awareness is essential for long-term success in practice. Self-awareness training has been implemented in many caring programmes, but one that focuses on students’ beliefs about what it means to become a professional carer would be useful.

The University of Derby approach

At the University of Derby, we are constantly developing our research and practice to protect our students’ mental health. For example, our student wellbeing approach has been actively supporting students’ mental distress, and our careers team has been constantly exploring new methods to guide their careers, while reducing their anxiety and stress.

In online learning, more webinars and interactive events have been implemented to increase a sense of personal contact and so reduce potential student isolation, which is a risk factor of mental health problems. A number of research projects relating to mental health are also underway within Psychology and Health & Social Care, which together will help to protect students’ mental health here in the University, and further afield.

Read Yasuhiro Kotera’s full research paper in the British Journal of Social Work, also available at the University’s research archive, UDORA.