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Skip to 0 minutes and 0 secondsSo many organizations have brought forward. I'm really good plan for looking at psychological first aid and enhancing well being, and I'm using those terms very specifically because I think that that's what we need to be focusing on at the at the moment. This is as we said before, still in the trauma were not at time zero of recovery yet, and they can often be a push, and I think there are all kinds of really interesting reasons why that might be for people to want to get out there and start offering therapy and debriefing and getting people to talk about what's happened. Actually, the evidence is that is not the way to be managing this right now.

Skip to 0 minutes and 50 secondsAnd when people talk about psychological first aid? This is, I think, one of the things that I've seen has been done really well as a community response, as it said about helping people to be able to eat to sleep when they need to, to be able to rest, to be able to look after themselves, to have some time off. I think some of the simple uhm self care well being things that have put in and put in place around allowing people access to simple relaxation to encourage things like as much as possible sticking to a routine, doing a bit of exercise, some of the online joger and meditation.

Skip to 1 minute and 30 secondsI think they're all wonderful ways for us to be looking after the people we really need to be looking after. Now of course we know from when I was talking about risk factors before that social support is really important, and during the trauma we have evidence from quite a lot of research. A lot of it coming from veterans. Actually that when people feel that there is good team cohesion and good leadership, that is also something that protects them from later traumatic symptoms. And so the focus on being able to help teams stay connected even in the current situation is really important.

Skip to 2 minutes and 18 secondsSo I've heard some lovely ideas about very informal virtual connecting groups that allow people to come together when and if they want to, and whatever way they want to. And this is not about a kind of reflective practice or violent group, or getting people to go through things. It's about connection. It's about saying, yeah, you know, it sounds like you've had a really bad day now. What are you going to do when you get home? Are you gonna manage coming back tomorrow? Nothing more than that really. But to feel connected and to feel that it's possible that. You can have other people around you who understand what's going on is really important.

Skip to 3 minutes and 7 secondsI think it's a great question and I think there is something about being able to just notice when people look like they might be at the end of their tether it well, I think we all have what we might call a kind of tipping point at which, yeah, you know we're under stress with struggling room really giving it our all, but at some point something starts to give and we have to sort of first of all, be aware enough of what's going on in ourselves to notice it, but to be looking out for it now. Colleagues as well.

Skip to 3 minutes and 40 secondsNow when I was talking about that nurse earlier, I thought there was also something in that story, a story that might provide other clues to lookout for is one thing that I think made it really difficult for her was to feel that not everything was done. That could have been. But she held some guilt around that. And I think more than that and a lot of people are starting to talk about this. The kind of hard question about moral injury. So when people feel that there is something about the situation that their placed in that doesn't feel ethically right to them.

Skip to 4 minutes and 18 secondsAnd I think this has been part of why it's been so important that there's been open discussions about how to doctors make decisions about who gets treated with Ventilators and who might not be offered that treatment. That as a community, we need to hold that as a society we need to hold it and not just have it on one or two people, because that is also likely to lead to their tipping point being much sooner. So we need to lookout for those sorts of things in in our colleagues as well. I also think there's just something about when people are starting to shut down. I think that there is.

Skip to 5 minutes and 0 secondsIn that kind of connection that we all need to have of, people are beginning to avoid. It's a really big sign.

Skip to 5 minutes and 11 secondsI think to be taken out of your usual setting and your usual supportive container can be really difficult, even if it feels like you have volunteered. I also think that trying to find your way into a new team and sometimes for the team to feel it's alright for you to be there and to be settled in their new team can be really difficult in that might put you a bit more at risk and to feel that you're trying to learn how to do something you when everything is so pressured and also be problematic. So redeployed staff might just need a little bit of extra help too.

Psychological first aid in organisations

Dr. Stubley outlined psychological first aid for organisations, considered how we can target those needing support, and explored the possible impact of redeployment and role changes.

Psychological first aid involves humane, supportive, and practical assistance for people who are distressed, in ways that respect their dignity, culture, and abilities. This approach considers our basic needs, including sleep, food, rest, and human interaction.

Notably, these link back to the core principles of health and wellbeing that Chris reviewed at the start of this week. The concepts of maintaining a routine, social connection, and time to rest and relax also relate back to Susan’s and Carol’s respective stories.

To give examples, providing food, physical space to rest, and the opportunity to relax and connect with colleagues are highly important for organisations of key workers. For other organisations, supporting interaction and relationships while remote working, providing guidance on work-life balance and disconnecting from work, and revisiting working hours and routines are practical steps.


Dr. Stubley also raises the important point of identifying and supporting those who we may be able to see are struggling. The first step here is to notice what is going on for people, ask how people are coping, and consider how to support those who may not speak up.

While key workers may be able to notice changes in behaviour more easily, organisations working remotely must consider how to check in with staff. Likewise redeployment for key workers, or role changes for others may be challenging. There will be more on managing this in subsequent steps.

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This video is from the free online course:

COVID-19: Psychological Impact, Wellbeing and Mental Health

Maudsley Learning