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What to do when you are struggling with mental health problems

What to do when you are struggling with mental health problems

Fiona Brand gives her advice on how to handle personal mental health difficulties as a nurse

Working in the health industry is hard. In the current climate, particularly hard. With shortages and cuts, workloads that seem to be ever increasing and more posts filled with agency staff, the expectations are high.

So when, as a healthcare worker, you are struggling with mental health difficulties this is an added pressure. It is noted that working in human service occupations such a nursing can contribute to mental health difficulties and occupational stress has been found to be one of the major work-related health problems.1

What should you do?

Firstly, recognising that you are struggling is paramount to managing the difficulties. It is hard to put yourself first and nurses are notoriously bad at doing this, but when your health or mental health is at risk, this must be a priority.

Secondly, from a work perspective it is important to try and talk to someone – ideally your manager or a supportive colleague – to be able to share the problem and discuss the implications. There are obvious fears and concerns relating to this – fear of the stigma associated with mental health problems, fear of the mental health problem making you unable to effectively do your job, and fear of the future implications for your career. This should not be a barrier in seeking help.

An Nursing and Midwifery Council (NMC) spokesperson said: ‘There is no evidence to suggest that anyone with a mental health problem – bearing in mind how broad the term is – would be incapable of being a good nurse’.2 This is an important statement to hold onto; the term ‘mental health problem’ is very broad and the spectrum of mental health disorders is vast. So, it depends on the individual and their particular difficulties or diagnosis as to whether or not they are capable of carrying on with their work at any particular time.

Have a think: is work a contributory factor in your mental health problem? Is it making things worse? For some people their job is a protective factor which helps to keep their mental health stable. Consider the impact of your work on your mental health at the current time, as well as the impact of your mental health on your work, could there be another role you could be supported in carrying out while your mental health is not 100%?

What would help? Have you experienced these problems before? What helped then? A break from work? A change in a certain routine? Some intervention from a talking therapy or medication? Consider consulting your occupational health department or GP for further assessment, advice and support.

The NMC continue to say that If employers are serious about the health and well-being of staff, they have to be encouraged to look at all aspects of health and create a climate whereby staff feel able to disclose a mental health problem. This is particularly important when they are caring for vulnerable people.

This is a very important statement, all NHS trusts put the wellbeing of their staff as a high priority and it is imperative that staff feel able to disclose health problems, of any kind, without fear of a negative impact on themselves.

Mark et al conducted a study looking at stress in the nursing profession and found that job demands, extrinsic effort, and over‐commitment were associated with higher levels of anxiety and depression.3 This is further evidence that nursing can be a highly stressful profession and supports the NMC’s call for employers to create an environment wherein disclosure of health problems is encouraged, and support is available.

When they are struggling with mental health difficulties, some people have a tendency to use maladaptive coping strategies that may have a negative impact on the current difficulties they are experiencing. For example, alcohol is often used to cope with low mood, anxiety or sleep difficulties. Sadly, the short-term benefits of increased alcohol consumption, such as alleviated anxiety or helping sleep, are often outweighed by the longer-term negative implications. Alcohol is shown to increase anxiety post-consumption and disrupt sleep.

There are many non-statutory organisations that can provide excellent advice and support, as well as the professional regulatory bodies and union organisations. It may be worth looking into the support that they can offer if you feel that is the level of help that you need.

Finally, it is important to put yourself first. Look after yourself. Think about the things you enjoy doing and see how you can fit more of them into your life. What makes you feel good? Can you gain additional support from family and friends?

Mental health difficulties are extremely common, and most can be managed effectively and have minimal impact on people’s careers and overall lives.


  1. Vilija Malinauskienė, Palmira Leišytė, Romualdas Malinauskas (2009) Psychosocial job characteristics, social support, and sense of coherence as determinants of mental health among nurses. Medicina (Kaunas); 45(11)
  2. last accessed 22nd September 2019
  3. G Mark, A. P. Smith (2011). Occupational stress, job characteristics, coping, and the mental health of nurses. British Journal of Health Psychology. 10.1111/j.2044-8287.2011.02051

Fiona Brand is a psychiatric liaison nurse and research nurse at Oxford Health NHS Foundation Trust

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Advice on how to handle personal mental health difficulties as a nurse