No health without mental health: The importance of nurses taking care of their own wellbeing

In 2011, the Department for Health and Social Care called on health-related organisations to sign a document pledging they would work together to improve the mental health and wellbeing of the population year on year. The document, 'No Health without Mental Health: A Cross-Government Mental Health Outcomes Strategy for People of All Ages', was underpinned by a 'call to action', as if all parties involved were going into battle, to fight for something, to wage war. I suppose we were, and we are.

This document title has been adopted as a strapline for the Mental Health lecturing team at the University of Derby, which I had the pleasure of joining in 2018 after 35 years of clinical practice. Our aim is to contribute to the education and training of nurses of the future, for the future. Compassionate, empathetic and caring mental health nurses who will be change makers and leaders of services for many years to come. Nurses who will champion the shift required in the paradigm of mental health services and deliver care to their patients with a trauma informed approach, not asking, "what is wrong with you?" but enquiring about "what happened to you?" Not exploring symptoms, but exploring in partnership what a patient (person) had to do to survive what happened to them.

Emotional strength and resilience

Mental health nursing students are also people; people who have made the decision to train and learn to care for others, to care for others who are experiencing their darkest moments, when all hope is fading or gone and often facing their hardest struggles. No Health without Mental Health also relates to our students, and all students across the country. Nursing students are different to other students in many ways: they work and study, they don't get long summer breaks and they are often more mature, with families and, at times, older relatives to care for. They arrive with enthusiasm, curiosity, vigour and ambition. They then realise that the challenges and demands of a full time nursing degree and having a life require good time-management skills, prioritisation skills and problem solving skills and almost boundless emotional strength and resilience. This is along with incrementally increasing academic expectations, working with patients in practice and all the emotional demands and risks of compassion fatigue, vicarious trauma and long hours.

Mental health nursing students are also nurses

Nurses are considered to be caring, compassionate professionals. Individuals, families, and entire communities seek nurses for support, healing, and encouragement during times of physical, emotional and spiritual anguish. A nurse’s innate capacity to nurture and embrace another’s suffering as if it is his or her own can be conceptualised as compassion. But, with the continuous giving of oneself, nurses are at risk of developing compassion fatigue. As nurses, we cannot give if we are fatigued and worn out.

What support is available?

The number of students who disclosed a mental health condition almost doubled between 2012 and 2015 to nearly 45,000, according to the Higher Education Statistics Agency.

Universities UK has published a framework - the "step change" framework - to help improve the mental health and wellbeing of university students, which the University of Derby is fully supporting.

We, as a lecturing team and the University, need to ensure we practice what we preach and offer care and support for our students as soon as we can when an issue is identified.

We offer many timely avenues for ensuring this, starting with a culture of inclusivity, belonging and acceptance. Every student will have a personal tutor from day one, someone who will travel along with them for the duration of their degree, and who will offer academic and clinical support. We have group supervision sessions, peer support workers, practice visits and one-to-one personal tutor sessions to reflect on practice, to firstly try and prevent or, if required, identify vicarious trauma and compassion fatigue.

We also signpost and access other supportive measures from within our student wellbeing service. This ranges from GP appointments to personal therapy for anxiety, depression and emotional trauma. There are a number of modalities used such as Cognitive Behavioural Therapy, Eye Movement Desensitisation and Reprocessing, and person-centred counselling. The support offered mirrors the support that our students are in training to deliver. A symbiotic relationship of mutualism. Students benefit, patients benefit, the nursing profession benefits and, ultimately, society benefits.

There can be No Health without Mental Health and we do need a call to action! We need a collection of people, so speak out, stand tall, be noticed and don't be afraid to ask for help when you spend your life helping others - it may be the most strong and courageous thing you do.