A Safe Return

It’s hard to imagine a time after this when going back to normal seems like a healthy option.

For many working people returning to old patterns of working life is a stomach sinking prospect seen through the lens of the psychic paint stripper that the pandemic has applied to our employment relationships. For those of us who have experienced the trauma of working within toxic structures the prospect of returning to the them in their now raw state is triggering. As our social contract with work has become broken(click here to read a fantastic paper arguing for a new social contract by Keith Sisson) many wait with anticipation for the re-traumatisation ahead.

Systemic failure? Really? Are you angry? You seem angry. Try mindfulness. Lose weight. Give up on actual change. 

Every year during mental health awareness week I have to dig deep to survive the white well-being noise about speaking up at work. Like many people, lived experience has meant that my policy on disclosing mental distress at work is just not to. Unless you’re on a permanent contract, in a strong trade union with a track record dealing with mental health and a boss who is absolutely decent many of us keep our distress completely separate from work. 

This bleak reality can be devastating for the people working in health and social care. The ones who deal on a daily basis with patient distress are themselves often completely unable to make use of well-being services or the people they work with because of the fear that it will only compound the pervasive culture of fear that they already work within. 

One of the obvious problems is that we just aren’t prepared to pay for decent care services, including the remote mental health services such as Frontline19 and Shout 85258 set up to deal with the growing number of workers with PTSD. 

Grand claims are made about investment in services for NHS staff but I just go round and round in my head trying to cognate the perversion of a system that sets up mental health support for health workers based on a model of unwaged and insecure work. Driven by Covid-19 and the culture of solutionism in the brochures of the digital health companies that now dominate the NHS, we offer mental health ‘support’ manned by people who aren’t themselves supported. 

It’s literally maddening to think about that statement. 

I spend a lot of my time trying to calmly clearly say something about the crisis in mental health services that is strikingly obvious to the people in it.  The reason I do this is because simple statements of fact are often body blocked from articulation.  For many of the individual and institutional actors in healthcare it is essential that truth is not heard. 

Probably the most important thing I’ve ever written is about to be published. It's an academic article about emancipatory education used in my work with healthcare workers and representing ooooh three decades of my working life including Surviving Work. I wish I found it funny when I say it took five years to get this published. Rewritten nine times during a pregnancy and single parenting, three jobs and three different homes, heatwaves, three nurseries and their immunology boot camps, personal loss and a pandemic. Three years in I found an editor who was prepared to give me a developmental space where I could analyse my working experience and make it coherent. Despite this biblical journey to get lived experience and keywords mentioning racism and bullying into a bonafide academic peer reviewed journal, it was honestly worth it for one reason. 

That despite the brutal performance-management-targets-ranking-n-metrics that exist for all public sector workers including academics, sometimes its a good idea to really think about what you’re doing and go on a developmental journey with people who know a lot more than you about something you care about. As we say to our students, this is going to hurt but real friends are the only people who are going to drag you kicking and screaming away from your own delusions and denials and help construct some truths.

Agreeably that’s a lot of effort for an academic paper that only your mum will read but you get the idea.

Far from wellbeing-at-work-jazz-hands this is the gritty stuff of collective action towards material change. An emancipatory education model, based on the work of the Brazilian pedagogue Paulo Freire, used to promote the wellbeing of frontline healthcare workers. A three-stage PIP model (problem, information, planning) used widely within trade union education programmes is a methodology based on the principles of critical action learning (CAL) in that it adopts a critical perspective and examines power relations, explores emotional experience and is action oriented. Because this model of learning is based on collective reflection it is a methodology which prioritises building relationality. I argue that addressing wellbeing in the current healthcare context, highlighted during the Coronavirus crisis, requires a critical and relational approach that supports healthcare workers to collectively address problems at work.

Viewed from a critical perspective, addressing the causes of low wellbeing amongst healthcare workers necessarily involves an analysis of the systemic factors and power dynamics within which they operate and given that this is never actively encouraged at work I argue that the wellbeing agenda provides a ‘relatively safe laboratory for learning’ where a critical action learning framework can be utilised.  Since we can anticipate a growing resistance to positive psychology and individualistic and technical ‘solutions’ to the wellbeing of frontline healthcare staff following the complexities and uncertainties raised by the Coronavirus crisis, we have to be realistic about what is going to be needed to address the underlying causes. 

Although PIP as a practice is not for much longer because OF COURSE the government has cut the main UnionLearn funding for the largest workplace training scheme in the UK, which kind of tells you everything you know about how anything that combines critical thinking with action walks a thin line. 

These societal fault lines have for so long been covered up within the language of individual well-being. All the infographic-toolkit-onlinetraining in the world won’t protect you from what lies ahead for us as we return to work. So the proposal is that we have been left to our own local devices, to attempt to build frontline processes with the people we work with involving truths and reconciliations in order to be safe at work.

To read Wellbeing on the Healthcare Frontline: A safe laboratory for critical action learning published in the Academy of Management Learning & Education (AMLE) click here.