Practitioner insight: How complex cases can impact our mental health and wellbeing

29 October 2019

Operating within frontline roles, our practitioners work directly with individuals and families experiencing mental health problems and/or multi-complex needs. Following World Mental Health Day, we ask our practitioners to share experiences relating to mental health and wellbeing at work, including the impact of working on intense cases and proven ways to support their own mental health and wellbeing.

There is a strong link between our mental and physical health and just like our physical health, our mental health needs looking after. Research indicates that one in four of us will experience some form of mental ill health in the course of a year. What’s more, MHFA believes mental health lies on a continuum, which like a spectrum, can change overtime depending on early identification, prevention and treatment.

Having delivered a range of specialist programmes that address key barriers to housing security, employment and education, our practitioners understand the importance of providing appropriate support to people experiencing mental ill health as part of their person-centred, holistic approach. However, we often forget that support professionals – be it, social workers, health professionals or support workers – who provide vital support to others, can also be affected by the intensity of the cases they work with.

Multi-complex needs and intense support

Rujia, our dedicated school-based practitioner, explains how the complex nature and intensity of certain cases means that some personal impact is almost inevitable: “In general, I think when working in this field it is difficult not to be impacted by other people’s circumstances because of the compassion we feel for others.”

“Previously, I worked with someone from our drop-in sessions who needed emotional support on an issue I have experienced myself. I felt a lot of empathy for this client and instantly found myself checking whether I am over-identifying with what she is saying and how best I can help her.”

“It’s important to reflect on our feelings and emotions and check where our responses are coming from to ensure our focus is the client. Being aware of our feelings also helps us to recognise the impact clients can have on us as it can trigger emotions in us that we then need to work through.”

Liz, our NLP practitioner echoes this: “In relation to the type of work that we do my first instinct is to support those who need support the most. Even when I feel like my cup is half empty, I find myself still pouring from my cup because I feel like someone else needs it more.”

Whilst drawing from experience and tapping into our positive traits can offer insight when dealing with cases, it’s important to check what impact a client’s situation is having on us, adds Rujia. “It’s very important to be mindful of whether we are over-identifying because that could make us move away from fully recognising what the client needs. We have to remember that everyone is different and therefore may experience things differently and need different things.”

A reflective approachA reflective approach

As a practitioner, Rujia highlights the importance of reflecting on our own feelings and emotions and check where our responses are coming from: “This ensures our focus is the client. Being aware of our feelings is also very important so we can recognise the impact clients have on us, as it can trigger emotions in us that we then need to work through,” she says.

“Sometimes even when I’m not working, I am thinking about the family and what else I need to do to support them! This can become unhealthy because it can become mentally and physically draining and we all need our break away from work and spend some time in our personal lives,” explains Rujia.

Fortunately, this is something Rujia recognised during a de-briefing session with a colleague: “Upon reflection, I was able to identify why I was feeling so tired. I then had to consciously make the effort to put some healthy boundaries in place by agreeing what goals I can work on with the family, as well as sticking to my working hours unless working evenings was planned for a specific reason. The families we work with often have multiple issues and we are working with for a limited time period, so having boundaries helps me work more effectively and not spread myself too thinly.”

“The families we work with often have multiple issues and we are working with for a limited time period, so having boundaries helps me work more effectively and not spread myself too thinly.”

The impact of mental health has huge social and economic costs; studies reveal the total economic cost in England is estimated at £105 billion per year and that 84 percent of UK line managers believe they are responsible for employee wellbeing, but only 24 percent have received relevant training. “It’s that energy and love which is fine but I think if you start to feel like it’s affecting you outside of the workplace it will affect the amount of time you spend at work,” says Liz, “I’ve learnt to lean on some of the support of my manager and team, especially if I feel like I’m having a day where there are a lot of intense cases or I just need some support.”

Mental health in the workplace

When it comes to looking after our mental health in the workplace, Liz and Rujia have found peer supervision particularly helpful. “It’s an opportunity to reflect on my work and the impact of the work on my own well-being and the importance of our own well-being in this field of work. Having a supportive supervisor who understands the impact of working with intense and complex cases is very important, not just for our own wellbeing but the wellbeing of the families we support,” says Rujia.

Reflecting on past cases, Liz adds: “In supervision, we can talk through difficult cases and dissect the different barriers and/or the crisis that individual is experiencing. In that space you kind of offload everything going on at work or personal life.”

“One thing we learnt was the Mental Health Continuum – that our place on the scale is constantly changing and that most of the time there are no absolutes in mental health.”

Mental health in the workplaceSince completing the MHFA training, Tam, Comms Officer at Kineara, believes that she is better equipped to offer a listening ear and support to our team of practitioners, and more aware of what signs to look out for. “I now understand how and why dealing with complex and intense cases can impact the wellbeing of our support practitioners. One of the most important things we learned was the Mental Health Continuum – that our place on the scale is constantly changing and that most of the time there are no absolutes in mental health. Sometimes it’s just taking the time to check in, ask twice and listen.”

The power of mediation

Despite the intense workload, our practitioners are passionate about the work they do. “Once I started seeing work as helping anyone in need which could even be myself, then I started seeing work/life balance as one thing. Supporting people and practicing self-love is part and parcel of who am, so I don’t really see it as I’m leaving work on the coat hanger and going home, I see it as just a part of me,” says Liz.

Crucially, both Rujia and Liz highlight the importance of looking after our own wellbeing to be able to give their best to the people and families they support and be emotionally available for them. “I spend some time over the weekends when I am not working to do something relaxing, this can be something as simple as having a long bath or going out for dinner with a friend,” says Rujia. “This allows me to support people in any capacity in any way I can, even in my community/block or within my family – it doesn’t stop at work! It’s like a way of life – when you see it as a way of life you see beyond the crisis or the issue and you see the person for who they are,” adds Liz.

“Having someone facilitate our thoughts that are there but just need writing down on paper, so it’s seen and heard. Everyone needs encouragement and mediation, nobody can function without the support from another, including us as practitioners!”

Liz adds that practicing self-awareness to inspire the best in herself and others is so important: “I believe everyone is an expert in their own life, they are the only person who has experienced what they are telling you in entirety and full context, so the most important thing is to listen because every situation is a new situation and may require a new way of approaching things. Once they tell you their stories and their journey you realise that anyone could be in that position.”

She adds: “That’s why mediation is so important; having someone facilitate our thoughts that are there but just need writing down on paper, so it’s seen and heard. Everyone needs encouragement and mediation, nobody can function without the support from another, including us as practitioners!”

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