Top tips for Managers and Team Leaders
Be a good role model
- Notice people’s strengths and speak about them
- Be honest, fair and transparent about the challenges and ambiguities staff are facing
- Buttress staff/teams for the challenges they face:
- Ensure safety and access to proper equipment
- Offer good supervision, regularly and when needed
- Make time for basic needs such as rest, food, and social connection
- Encourage ‘buddy-peer’ support within teams
- Allow time for questions from your colleagues
- Be aware of staff who are becoming vulnerable through work or home stress build ups. This means keeping up to date with key aspects of your team’s home lives
- Be aware of staff who are already vulnerable (eg., with pre-existing medical or mental disorders) and discuss with them what can be done to improve their situation
Decompression; post-event team reviews
- Decompression and structured (operational) post-event team reviews should be made routine. This is a good way to relieve the build-up of pressure during a shift through sharing and learning from each other
- These should follow the rules of no critiquing, and there should be no compulsion to speak but everyone should be given an opportunity to do so
- Ensure staff do not feel compelled to talk about experiences they do not feel ready to talk about
- The sharing has to be blame-free, reflective, kind and supportive. If you need to address poor performance, that should be done at another time
- Use what you say to open up sharing rather than shut it down. You will all learn more from each other this way
- This style cascades and helps foster compassion and positive attitudes to each other. It is sometimes called an operational team event review (debriefing is a term that can be misleading and result in unhelpful, overly psychologically focused approaches)
- Managers and team leaders should acknowledge their own limitations. They too may need to be looked after. Their wellbeing is a top priority; a stressed and burned-out leader will affect the wellbeing of all team members
Seek advice after stressful events from trusted peers, use buddy systems for team members and/or a mentor:
- Two minds can be better than one, especially when both people have walked in similar shoes
- Reflect carefully on what you say and what others say to you
Look out for signs of team stress. Early warning signs may include:
- Team members overworking and not attending to home or outside life
- Sick leave
- People become disengaged for example they may uncharacteristically fail to finish pieces of work
- Becoming irritable, arguing or increasing their use of unhealthy coping strategies such as cigarettes or alcohol
a) The Five Rs - a mnemonic to support relationships and psychosocial resilience
- This is a map, and mnemonic device, for the five key actions that will help your leadership and daily team working
- Remember to think about relationships, recognising distress, supporting reflection and self-awareness, supporting emotional regulation and building psychosocial resilience together
b) The four principles of “PIES” for support after trauma
- The four principles of PIES come from experience in the military. They can help you to provide quick support soon after a trauma
c) Psychological First Aid (PFA, World Health Organisation 2020)- simple ordinary steps for everyone
- Remember to look for signs of distress, listen and support, and consider further links and supports
- Use good listening skills
Each service should have clearly defined pathways to more specialised help and care
- Ensure access to occupational healthcare to enable staff in need to receive assessments of those needs
- Create service level agreements with agencies, that ensure ease of access for certain staff, to timely and reliable GP, and specialist mental healthcare
Resources and references
- Occupational Health
- External resources that may offer help:
- Jones, N, Fear N.T., Wessely, S., Thandi, G. and Greenberg, N. (2017) Forward psychiatry – early intervention for mental health problems among UK armed forces in Afghanistan European Psychiatry 39, 66-72
- Solomon Z, Mikulincer M. Trajectories of PTSD : A 20-year longitudinal study. American Journal of Psychiatry 2003 ; 1 63 : 659–666
- Stevenson D, Farmer P. Thriving at Work: The Stevenson/ Farmer Review of Mental Health and Employers. Department for Work and Pensions and Department of Health and Social Care; 2017
- Milligan-Saville JS, Tan L, Gayed A, Barnes C, Dobson M, Bryant RA, Christensen H, Mykletun A, Harvey SB. Workplace mental health training for managers and its effect on sick leave in employees: a cluster randomised control trial. Lancet Psychiatry 2017; 4: 850-85
- Other resources
- NHS Employers. NHS Staff Survey 2019. NHS Employers; 2020.
- Police Care UK. Policing: The job and the life survey Police Care UK; 2018
- Association of Chief Ambulance Officers. Supporting ambulance staff on mental health and wellbeing. Assocaition of Chief Ambulance Officers; 2019.
- College of Paramedics. Paramedic mental health and wellbeing: Your mental health. College of Paramedics; 2020.
- College of Paramedics. Guidance for managers on psychosocial support and mental wellbeing of ambulance personnel in a pandemic; 2020. Accessed 28 December 2020
- National Fire Chiefs Council. MIND Mental Health in the Emergency Services.
- Web resources:
- NHS People
- NHS Practitioner Health
- Psychological First Aid
- Mind: Blue Light Programme Research Summary 2016-18. London: Mind; 2018.
- March on Stress TRiM
- The Oscar Kilo Programme
- HeadFit - aimed at the military but trying to appeal to others too
- Critical incident stress management: Merseyside FRS
- MindEd Mindfulness e-learning session
- Other support groups and caring organisations you may find helpful include:
- The Samaritans – offers a 24- hour helpline for those in crisis. Tel: 116 123
- Cruse – Bereavement Care – Offers counselling, advice and support throughout the UK. Tel: 0808 808 1677
- Assist Trauma Care – Offers telephone counselling and support to individuals and families in the aftermath of trauma. Tel: 01788 551919.
- Drinkaware – offers facts, advice and support to manage drinking. Tel: 020 7766 9900
- Relate – offers relationship support for couples and families. Tel: 0300 0030396
- Stonewall – offers information, advice and support for gay, lesbian, bi, and trans communities. Tel: FREEPHONE 0800 0502020.
- Domestic Violence Intervention Project – offers advice and support to individuals and families who have experienced domestic violence as well as to individuals who want to change their behaviour. Tel: 020 7633 9181.
- The Ambulance Service Charity (TASC)
- Our Frontline
- Just B
- Shout – Mental Health At Work
- College of Paramedics
- The Fire Fighters Charity - offers a range of mental and physical health support, as well as residential stays.
- Assist Trauma Care - provides information and help for people with PTSD and anyone supporting them
- PTSD999 - support and training for serving and retired emergency services personnel
Further support is available from NHS England.
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