Any other mental health professionals on here?

[ShrinkInterrupted]

Psychiatrist here. Not finding it easy at the moment (understatement) and thinking of leaving. Difficult to work out if it's me, or the job. Just wondered how everyone else is finding it.

I am a psychodynamic counsellor that’s always worked for non profit organisations. I’ve loved the work but the client group are bringing serious trauma.
They have no where else left to turn.
In January this year I decided to set myself up in private practice offering affordable counselling.
I’ve had so many enquiries. I was surprised.
I’m so glad I’ve taken the step and done this.
I feel I’m taking back some control in my life.

@CanteenCulture I was just talking to a colleague who has been in mental health a similar length of time to you, and he said exactly the same in terms of changes over time and acuity. I so agree with everything you said. This intrigued me:

That said, I still enjoy my job and am not thinking of leaving…

Can I ask how you manage it? I would like to get to this point. Deep down I don't want to throw in the the towel - I'm just really struggling to tolerate it all.

@TheDaydreamBelievers agree with the validating feeling that things have changed. I wonder if there is going to be a shift in expectations of psychiatry and firmer boundaries about what we are / are not accountable for, before there is literally no one left to do the job.

@ihatethecold that's so interesting. I have a lot of respect for the psychodynamic approach and feel a lot of the current push towards short-term therapies is financial rather than evidence based....

I would agree. I’ve seen this theory work so many times.
It doesn’t have to be long term to make a difference.
I truly believe it’s the therapeutic alliance between therapist and client that allows ego strength to develop.

[quote ShrinkInterrupted]@CanteenCulture I was just talking to a colleague who has been in mental health a similar length of time to you, and he said exactly the same in terms of changes over time and acuity. I so agree with everything you said. This intrigued me:

That said, I still enjoy my job and am not thinking of leaving…

Can I ask how you manage it? I would like to get to this point. Deep down I don't want to throw in the the towel - I'm just really struggling to tolerate it all.[/quote]
For me, a big plus point of nursing is the opportunity to move about in different clinical areas. I’ve worked in hospital settings, community teams, specialist services, day centres… I think this has helped put the brakes on burnout and has kept me on my toes; each different role feels ‘new’ and there is always more to learn.

I’ve never had ambition to climb the managerial ladder which has probably saved my sanity (totally get what a previous poster said about band 7 role in comparison to 6)

I try to be as boundaried as possible. I don’t do overtime, if I work late I record it and speak to my manager about taking it back in lieu. I am pretty good at saying “no” these days… HCPs are notorious people pleasers and at the end of the day, what you do for people will never be enough (as the demand never ends…)

I’m fortunate to have AMAZING colleagues who are supportive and motivated to provide decent care in really challenging circumstances. And managers who ‘get it’

Very lucky to have close friends who are also working in mental health, so we sort of end up informally supervising each other too.

It’s not always been like this and there are times I go home after a hellish shift feeling stressed out of my head! (Hence the Waitrose dream!)

Working in mental health is hard and we absolutely need to take care of ourselves first if we are to provide care and support to others - that old oxygen mask on a plane analogy is apt, isn’t it

Solidarity to you all

I’m a B7 psychotherapist/cbt therapist in a community psychology service - been struggling with it since the pandemic started if not before, we’re struggling to recruit and are being pressured constantly plus there’s the ever increasing complexity of the client group.

I’ve been pissed off about the way the nhs has handled certain things recently and it’s been difficult to stay as motivated, am currently signed off after surgery and trying to stop reading my work emails every day!

I set up a small private practice a couple of years ago alongside the nhs but I don’t think I enjoy it much really - I think I like the structure in some ways.

If I was even remotely qualified to do something else I would definitely consider it, but I’m not.

I do have a new opportunity to do something completely new with a private biotech company so am hoping that will inspire me.

@CanteenCulture

Totally agree with all you say.

I’ve been qualified 27 years, worked in urgent care for most of it.
Absolutely it has got more intense.

There are fewer beds and a much shorter duration of care from CMHTs once you have sat on a waiting list for months.

CAMHS not fit for purpose, underfunded and understaffed - so disproportionate number of 17/18 year olds coming straight into ‘crisis’ having not been effectively treated or supported earlier on.

Day hospitals shut down due to (from where I am standing) a mixture of budget cuts, changing fashion/opinion Covid etc.

Desperate lack of provision for patients with autism some of whom haven’t been able to get a diagnosis.

High sickness levels - and quite honestly at the risk of sounding callous some of those staff are possibly in the wrong job anyway. But they can be off sick for months on end and back for a few months until it becomes overwhelming for them again. This of course isn’t great for their own long term health and well-being and it certainly isn’t great for their colleagues and managers who have to cover the work.

Drug/alcohol services privatised which is problematic in many ways such as when they were NHS based we had some ‘sway’ for example insisting on joint working. They can and have also suspended face to face working for months during Covid leaving those service users with literally nowhere to go.

During the pandemic so many healthcare providers prime example being G.Ps moved towards very little face to face intervention. Some departments aren’t able to safely do this so the pressure then piles further onto inpatient care, urgent care such as home treatment, hospital liaison etc.

Knock on effect to our police colleagues, A&E staff and walk in centres…

Everything becomes a ‘crisis’ as patients desperately want to be heard and can’t get to see (for example) a GP or a CGL worker.
Complaints are rising too imo. Patients and carers wanting to voice their dissatisfaction but (not their fault) it’s being directed at the wrong people.

During this pandemic I have seen examples of kindness and people going over and above day after day after day. Some of it has made me cry. I’ve also (sorry to say) seen staff avoid work, find ‘loopholes’ in terms of maximising time off work, and behave in ways that lack integrity and cause further pressure on colleagues.

It’s so nice to know I’m not the only one! It’s a different kind of stress, normally I can find a solution or see a way out. This feels different.

On a much more positive note I am looking forward to commencing my new band 6 role.

I have no doubts or regrets I am doing the right thing for me and my family. PP completely correct about self care and boundary setting. I’m banning myself from doing NHSP for 3 months, I will ‘just’ do full time hours…

I’m passionate about patient care and I’m good at what I do.
If I don’t move I’m on the way to burning out (and I have never felt this way ever before)

Mh nurse burnt out

I'm a children's therapist, qualified in 2019 so vast majority of my work has been in Covid times! I feel like I never really found my feet and am always quite overwhelmed. I absolutely love the work itself and I'm lucky in that I'm not restricted in the number of sessions I can offer, but there is just so much shit stuff going on that it can be such a challenge to manage waiting lists and think about all those who could benefit.

I do fantasise often about a having a job with no emotional labour, responsibility or consequences, but don't think I would actually be happy! I can find it tough to leave work at work.

I work in CAMHS. We seem to be getting loads of new funding and development at the moment.

Things are tricky as we see the impact of the pandemic on children and young people, but most of my team feel positive about the kind of service we will be able to deliver with all the changes.

We seem to be attracting a lot of AMHT staff at the moment. They like that we offer development in terms of various therapy accreditations and a service beyond just fire fighting and case management. For me, I’ve always enjoyed working with children more as there is so much opportunity for change and growth, especially with adolescents.

Things sound really hard where you are @ShrinkInterrupted. I hope you find a change that works for you.

@AlbatrossSociety I think the ‘leaving work at work’ is something that gets easier as you become more experienced.

I really feel for newly qualified staff who have had to consolidate in Covid times. So difficult

Working in an area that I don’t particularly like, just because it is a very rare 9-5 nhs job that’s local. Even then, I’m rushed off my feet and arrive home knackered.
When I think about how much my friends earn in other jobs (the non medical / non nhs ones) I think actually I must be mad. I suspect I’m getting burnt out, and then some. But don’t know what else realistically I can do, as I’m not young enough to retrain in anything else.

@onepieceoflollipop - best of luck in the new role, sounds like a great move for you.

Your post completely resonated with me, sounds very familiar to my current experience

@CanteenCulture - thank you

I’ve done my absolute best to make a difference as a manager and in some ways I have - but the emotional/physical cost is too high. I’ve also had the immense privilege of doing some really meaningful and fulfilling clinical work but not as much as I really want to do. I have feedback from patients that I will treasure as I move on.

If it wasn’t for the fact I think you mentioned you work in a city (and I don’t) I almost wondered if you worked in my Team! Certainly sounds like we have many similar experiences, all the best to you.

I'm an older peoples psych consultant
I always used to love my job however hard it was but post pandemic I am big time burnt out
I just don't have the energy for the struggle any more. It feels like groundhog day. I am phoning it in now compared to the effort I used to make.
I would love to quit or just do tribunal work or something but I am the main wage earner in our family so I can't

The things that contributed are
-Any ideas I have to improve our service are squashed because of funding and Covid. We have retrenched to a bare minimum acceptable service with no chance to do anything value added. That's depressing. In my appraisal I have to pretend that I have some development ambitions but we all know its impossible

• we were coshed from all sides by Covid. We had a ward outbreak in which all my patients and colleagues were ill, many of my patients died and one of my colleagues was in ITU and never came back to work. It was truly traumatic to be helpless in the face of all my patients sick and dying and the grief of their families. I am not the same after that experience.

Then came the tsunami of mental health need after lockdown, social isolation, and suspended services and we are in no position to cope with it.

• my colleagues are leaving in droves which is sad when it's people I like and puts more pressure on the mugs still standing.
• on a personal level I lost my mum in the midst of Covid with no proper funeral or chance to grieve and all the things I look forward to and use to cope were cancelled. They are coming back a bit now but I had so many cancellations and disappointments that I have lost hope and can't get excited for anything now.

I don't know how to pick myself up again
I have wondered if a bit of exogenous serotonin would help.
Physician health thyself.

I was recruiting some band 5/6 nurses recently.
One has worked on an inpatient setting since qualifying - most of it during the pandemic. This nurse recognises the risk of burn out in the setting they work in. However they also turned down an urgent care community job as they have decided to go and work in rehab for a bit and have some space to reflect and recharge.
I found that quite sad -they would prefer to continue in urgent care. this nurse is a strong and very resilient person, did a student placement with me. The pressure of the ward on them has been immense,

Yes ward manager here really want to go down a band but can’t afford too.

Hate it so much, cry on way in most days

@PeggyGa could you consider a sideways move? Say a clinical band 7 rather than a managerial one?

@CovoidOfAllHumanity

Some of us on here can hear you

I hope some of what I say will be taken in the spirit which it is intended (kind and caring) and not telling someone their own job.

I wonder if you have considered really that you may be depressed?Those of us in the field are often reluctant to consider this.

I tried to do a bit of a detached self assessment at 4am this morning on myself (!) It was uncomfortable to realise that if a patient had told me half the stuff that I admitted to during my “self assessment of my mental state” I would be giving some clear guidance on medication and time off work…
I would be having firm words about not going into work for the 9th day running after 2 weeks of very disturbed sleep. But because it was “only me” and not a “proper” patient it somehow doesn’t matter!

Look at what we do to ourselves…

Genuine question is it worth giving an anti depressant a try? If after a few months it has made no difference then you’ll know it was rubbish advice…

@PeggyGa this sounds really hard for you.

As a ward manager are you mainly working Monday-Friday?

If so a move to a band 6, if it is a role where you cover some out of hours, there will likely not be much difference. As I’m sure you know you’d be on top band 6 £39k approx if you did move.

This is something I considered when I decided to make my move.
Also to consider - as a ward manager it is likely you’re doing some unpaid overtime? I’m going from top band 7 to top band 6.

Going down a grade you would potentially have more spare time and could pick up a bit of NHSP maybe a night or two a month.