Management in Practice speaks to Alex James, mental health expert and co-creator of a new online tool for NHS staff, about psychological practices to help working health professionals cope during the Covid-19 pandemic. 

Alex and fellow cognitive behavioural hypnotherapist, Slee Parrish, recently launched the ‘NHS in Mind’ website after a conversation just two weeks ago about the stresses and strains facing frontline staff. 

Slee, who is also a senior nurse in the NHS, was concerned for her mental health and that of her colleagues as workload increased, but could not find any resources for them to access. 

The two set about creating a tool to address the issues NHS workers may be facing, particularly ‘anxiety, panic and fatigue’. 

Ways to cope with stress

The website offers a range of video exercises to help with relaxation and focus. 

A ‘box breathing’ exercise is popular and ‘very easy for GPs to implement between seeing patients,’ for example, suggests Alex. This involves visualising a square and following a cycle of taking slow and deep breaths. 

‘It’s the kind of thing you can draw on your leg, you can doodle it. It can be done inconspicuously if you’re in a room full of people and you’re feeling some pressure,’ he adds.

‘We know that when we’re faced with fear, we go into fight or flight and the thinking functions of the brain shut down. The long exhalations within box therapy helps engage the thrive state of the body again.’

‘Notice five things’ is another short exercise to help ease the mind if you’re ‘feeling anxious or having intrusive thoughts or feelings’. 

‘It involves stepping out of a busy mode of mind and into the now. We like to say — disconnect to reconnect. This is what mindfulness-based therapy is all about,’ Alex explains.

The important thing is to incorporate it into your daily routine as ‘practice is the first step in mindfulness’, he adds.

While brushing our teeth in the morning can be a good place to start. ‘We do mindful brushing. We sense the taste and the smell and how the water feels instead of how people normally brush their teeth, which is thinking about what they’re going to do after and trying to get it done as quickly as possible.’

More useful exercises can be found on the NHS in Mind website here: www.nhsinmind.co.uk 

There are currently eight mental health tutorials on the website, and more will be added in the coming weeks. 

Important practices

Sleep is, of course, very important to general health and wellbeing. Adults are recommended between six and nine hours of shut eye a night. However, as Alex highlights, NHS workers are, particularly now, working very long hours, and this could present a challenge. 

He also recommends the Jencks time progression exercise (described on the website), as a way to restore a feeling of rest quite quickly.

A 10-minute breathing meditation is a good way to train the mind to respond to negative thoughts after a difficult day, he says.