Psychologists suffer mental strain from more cases of ‘distress and hardship’ Austerity has left its mark on many patients’ mental health and the professionals who treat them feel the knock-on effects

Psychologists have a challenging job. They often work closely with people who are in deep distress. They are trained for it and they cope. But there are signs that many may now be close to breaking point. The increase in demand for psychological help and the impact of austerity on many of the vulnerable people they work with is, it seems, piling pressure on psychologists themselves.

The findings of the British Psychological Society’s “most comprehensive ever” survey, released last November, highlight the increasing pressure under which psychologists must now work. “Under-resourced and increasingly stretched by demand,” the society’s chief executive Sarb Bajwa says, its members are suffering “unprecedented levels of overload, emotional exhaustion and poor work-life balance.”

Last week Professor Michael Marmot’s review, Health Equity in England, reported that 10 years of austerity has even caused life expectancy gains to stall in England.

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Yet shouldn’t psychologists themselves have a plan on how to stay positive despite the challenges of austerity? What about self-compassion, the system that psychologists encourage their clients to adopt to aid their psychological health?

The limits of self-kindness

Practising self-compassion “will do nothing to change external stresses,” says Professor Paul Gilbert, the Derby-based clinical psychologist who founded compassion-focused therapy with the 2010 groundbreaking book The Compassionate Mind. “But it can help psychologists to avoid the tendency to self-criticism for failures in care that are caused by government policy.”

It is a myth, Gilbert says, that you need self-compassion to be caring. “I’ve met brilliant, high-achieving clinicians who are also perfectionists or narcissists,” he tells i.

Further, self-kindness won’t change external pressures. For many psychologists today, he says, this means “the ever-growing numbers of difficult, complex cases and the pressure to provide more-for-less, factory-style conveyor belt therapy by numbers”.

Where self-compassion can help, he says, is in enabling psychologists to challenge “the deep sense of inadequacy fostered by today’s competitive environment and increasing tendency to ever higher expectations”.

‘I can feel lonely and useless, which I know will cause my stress levels to rise’

Psychologists should be praised for their sensitivity to distress and hardship and their commitment to trying to relieve it, he believes. “It’s courageous to turn towards suffering and not turn away. But it can be painful – especially if you allow your inner critic to take over when you believe that you have failed. Anxiety and anger are both very sticky emotions – and used against yourself can quickly create a permanent threat system,” he says.

Gilbert is retired but provides trauma care for Help for Heroes, the charity for injured men and women in the services. He is also developing compassionate educational strategies to be outlined in a forthcoming book, Education For Survival: The Pedagogy of Compassion. “I can still feel lonely and useless,” he acknowledges. “But I’m aware that these feelings generate cortisol that will cause my stress levels to rise.”

Being aware of that, he says, enables an individual to review “your emotional relationship with yourself, to encourage friendly feelings towards yourself and use the same soothing methods that a parent employs to calm down a child in distress,” he says.

Dealing with the impact

Alongside such strategies, for many facing the challenge of working with vulnerable people, it is the feeling of a job well done (and worth doing) that can help psychologists to cope with even the most stressful job. Like anyone, psychologists benefit from the feeling that their work is having an impact. That requires a systemic approach, according to Julia Faulconbridge, vice chair of the division of clinical psychology at the BPS. “No doubt individuals have devised coping mechanisms to [manage] stress but a truly meaningful solution has to be systemic,” she tells i.

One systemic solution currently garnering positive responses across the board is Glasgow’s 15-year-long Nurturing City initiative. It has the aim of supporting schools to replace traditional discipline with “wellbeing planning” that “gets it right for every child” in supporting the often precarious mental health of pupils in Glasgow’s 139 primary and 30 secondary schools.

At the helm is a team of educational psychologists who battle with the impact of austerity every day – yet who claim to experience joy on a regular basis.

As deputy principal psychologist at Glasgow City Council, Maura Kearney is based in Govan and acknowledges the impact of austerity in a city where “extreme generational poverty is the norm and where we now see more and more children who are distressed and who come from significant deprivation”.

The initiative aims to intervene to halt these cycles of poverty and poor physical and mental health by encouraging and training school staff “to focus on pupil’s strengths and resources rather than on their needs. It’s not a fancy initiative, it’s simply investing in nurture,” according to Glasgow’s director of education, Maureen McKenna, in a statement earlier this year.

At the heart of successful nurturing is leadership from the head teacher down, Kearney tells i. “What makes my job a joy is working with a head teacher who gets it, who understands that a nurturing approach can help to support skilled and attuned staff – while generating an engagement in education for many disenfranchised families. It changes everyone’s life.”

It’s not just the mental health of the educational psychologists involved that is improving. Earlier this year, Glasgow reported that school exclusion figures had dropped by over 80 per cent from 8,000 to just 1,000 since 2006. And the first study investigating the experience of pupils and their parents or carers, due to be published early next year, shows that whole families had “a growing sense of belonging”. They had the feeling of “staff acting as a consistent group who welcomed the children as they came into school, being approachable and supportive and respectful of parents and carers.”

“Yes there are huge stresses in my job,” says Kearney. “But I wake up every morning looking forward to the challenges of the day ahead.”