Depression, anxiety, stress and burnout, accounts for a quarter of all sickness absence in the NHS (NHS Survey, 2016). We know that emotional traumas and burnout associated with caring work often remain unrecognised, and therefore can leave staff feeling unsupported and isolated (Wilkinson, 2015). Midwives in psychological distress can often “suffer in silence” (Deery and Kirkham, 2006).

Maternity staff are an NHS group that don’t always experience workplace trauma, the same way that other NHS professionals do. Traumatic events in maternity are always tragic, rarely expected, and in predominately young generally healthy women and babies. These events can sometimes result in death or life long, life limiting disability, and on occasion due to errors (not necessarily disease progression/illness).

The whole maternity team often have to wrestle with trauma exposure, experiencing the initial trauma and then ongoing with the investigation, and then the accountability of that, often resulting in sometimes long lasting psychological distress. Midwives and maternity staff can be described as ‘second victims’ due to this, this area is well researched and evidenced (Perzaro, et al 2015). Midwives can struggle with the accumulation of multiple exposures to ‘smaller’ traumatic events, or one large traumatic event which all of which may result in psychological distress, or indeed midwives can experience psychological distress due to the more day-to-day occupational stressors (Fig.1).

It is therefore of paramount importance to highlight midwives’ experiences and support the needs of staff in psychological distress, midwives deserve access to evidence-based support and care in their workplaces. There are clear direct correlations between staff health, wellbeing and the quality of ‘patient’ care delivered by staff (Francis, 2015). Perzaro et al (2015) called for urgent research to explore and develop new, evidence-based solutions to support midwives in work-related psychological distress.

Project

This application is for support to initiate an innovative project attempting to optimise the wellbeing of midwives, by developing and delivering a package of ‘psychological first aid’ and peer support through Professional Midwifery Advocates (PMAs).

This project will develop and pilot an innovative hybrid package of interventions; (psychological first aid and on-going peer support) for support midwives in psychological distress.  The package will be designed and developed in collaboration with leading mental health professional Professor Greenberg (Occupational, academic and forensic psychiatrist) and March on Stressã (Psychological Health Consultancy).

March on Stressã currently offer two excellent different training programmes; TRiM and StRaW®.

• TRiM is a trauma-focused peer support system designed to help people who have experienced a traumatic, or potentially traumatic event.
• StRaW: Sustaining Resilience at Work is a peer support system to detect and prevent occupational mental health issues and boost psychological resilience.

However, it was felt that midwives required a different programme to TRiM and StRaW, requiring a specifically tailored programme to their occupational needs, covering both aspects of whether the psychological distress was due to exposure to workplace trauma, or the consequence of other occupational stressors (Fig.1).

The programme/package will be designed and developed by Professor Greenberg, March on Stressã and the senior Midwifery Team at Northampton. The package will be based on the most current research and the growing evidence base around peer support and trauma response.

March on Stressã will deliver the newly designed training programme to the Professional Midwifery Advocates (PMAs*) at Northampton. The PMA team will implement the interventions/package to the midwifery team (and to the wider maternity team as required). The project will include evaluation of the training programme, evaluation of the package of psychological first aid and peer support, both in terms of the experience of delivering the interventions and experience of receiving them.

This project is innovative in that this has not been previously done before, it uses the newly developed PMA role, the issue is highly current in the light of maternity safety, healthy midwives are paramount for the delivery of high quality maternity care (Perzaro, et al 2015), and if successful has the ability for mass roll out.

Project Aim and Objectives

• To build resilience by safeguarding the psychological wellbeing of midwives (and wider maternity team) through the prevention, detection and treatment of occupational and operational stress, including exposure to traumatic events.
• To develop, deliver and evaluate a specialised hybrid training programme for PMAs, to be able to address midwives in psychological distress needs in the workplace.
• To develop, pilot and evaluate a package of ‘psychological first aid’ and peer support interventions for midwives in psychological distress.