Les Jones talks to Fiona Ellwood and Laura Hannon about mental wellness and how it can be maintained within the dental practice.
Recently, Practice Plan’s creative director, Les Jones, hosted a session on staying mentally fit with Fiona Ellwood BEM, executive director and emeritus chair of the Society of British Dental Nurses, and Laura Hannon, chief executive of the BDA Benevolent Fund.
Les Jones (LJ): From the work that you do, Laura, what do you see as the drivers or the underlying causes of poor mental health?
Laura Hannon (LH): I think it’s important to note that mental health and wellbeing are slightly separate things. So, obviously if you are struggling with your mental health, you should speak to your GP and there are support mechanisms out there for that.
In terms of general wellbeing, we are all dealing with anxious people in our work life. Dentists make a lot of decisions every day and it’s a stressful job. So, it’s taking on all that stress, and then not having the tools to support yourself with your own wellbeing such as having adequate breaks, eating healthily and not processing stress. That all builds up.
That’s when people come to us because they’ve let things go too far. They’re overwhelmed and they don’t know where to go and they find they’re struggling. They feel as if they’re at the bottom of a pit.
So, we try to help them solve the immediate problem with their finances. But that can also involve their wellbeing. So, we try to help people understand how they’ve got to where they are and what they need to do to get back out again.
LJ: There’s been a stigma around mental health or wellbeing issues in the past. Where do you think we are with that now? Are the real or perceived stigmas that have existed in the past diminishing?
LH: I think people understand more about mental wellbeing and they are supportive in a way, but that doesn’t necessarily translate to support at work.
I think there’s still more to be done to help people to support their colleagues, particularly when there’s a hierarchy or different levels in teams. So, you are all working at different levels, and supporting each other but you’re not really peers. That has an implication and people may feel like they’re on their own even though they’re with people all the time.
We have evidence from a student survey that suggested there’s performance anxiety from a very early stage, and even dental students and their colleagues are worried. They’re worried about the regulator and how if they ‘fess up’ to something it will have consequences about whether they can carry on with their job. I don’t think that problem has been solved.
LJ: What’s your view, Fiona, on the stigma surrounding mental wellbeing?
Fiona Ellwood (FE): The stigma’s interesting because the discourse, the language that we all use is quite negative. If you look at the pictures that illustrate mental health, it’s always somebody who’s in a heap with their head in their hands looking really distressed. We try to move away from that and look at the positivity and talk about mental health wellness rather than mental health illness.
Stigma is something that’s been around for a long time. And I hate to say this, and to be gender specific, but I think men have always found it harder to talk about mental health issues.
Touching on Laura’s point, hierarchy is a real problem. In a small environment, in a closed network of practices, then sometimes the hierarchy is the employer. You’ve only got one other person above you who’s got power and hierarchy. So, it becomes difficult, hence the model [Mental Health Wellness in Dentistry Framework] that we were involved in building.
LJ: We’re encouraged to become resilient. What are your views on that, and also on the importance of recognising the signs of poor mental health in ourselves and others?
FE: Sometimes these things creep up on us and we believe we’re coping. I’m a little bit hesitant about using the word ‘resilience’ because that means we’re tolerating things and we really shouldn’t have to tolerate them.
We work in such a tight-knit community that others tend to notice differences in us first. I believe the work I’ve done, along with my other colleagues as part of Mental Health Wellness, is about early intervention and signposting. So, it’s about recognising what’s perhaps not normal.
But there are people who will just go into denial. So, I think it’s a real fine line here and we need to rely on our teams. Psychological safety’s a big thing of mine.
LJ: What about you, Laura?
LH: I would say that it’s about having a conversation with someone. Asking them: ‘Are you sure you’re okay, because you seem a bit off or tired?’
It’s about having the confidence to say: ‘I think things are different with you. Do you want to have a chat about it in a safe space or do you just want to be able to have a break and come back to it later?’
There are tools out there. I’ve worked with a collaborative group to produce wellbeing support for the dental team. It is an online guide that can be downloaded from the wellbeing page on the BDA Benevolent Fund’s website or it’s on website – supportfordentalteams.org. It includes a section on how to have conversations with people.
It’s about being a friend and not just a boss. Being a supportive colleague and saying: ‘I’ve noticed things are different with you. Let’s have a chat.’
LJ: Thank you both.
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