What can the legal profession learn about supporting mental health from the NHS and social care?

Evaluation of service model

We evaluated our model, and it proved highly effective. We used the Warwick-Edinburgh Wellbeing Scale to measure outcome: the average positive shift in scores was 13.7, three points above what is classified as ‘meaningful change’, and there was a fivefold increase in those who reported a positive sense of wellbeing. We referred onto other services in only 11% of cases, which was considerably less than expected. We also had a big impact on sickness rates: 58% referring in were off sick or at high risk of going off sick; after consultation 70% of this group were back at work or no longer at risk of going off sick. This was unexpected because our agenda was not to get people to stay in jobs or return to work, but to provide a real focus on them and their wellbeing. Paradoxically, this seemed to improve staff retention.

I have become firmly convinced of the value of putting highly trained professionals on the frontline and the false economy of the stepped care model, which underpins many of the employee assist programmes marketed to law firms. I would urge legal colleagues to consider paying more to buy in high quality mental health services for staff, or at least to make sure they know about the difference between what is on offer from those with widely varying levels of mental health training and experience.

Personal and work problems interrelated

We learnt early on there was little distinction between personal and work problems – family life was impacting enormously on colleague’s ability to function at work and vice versa. I am sure these reciprocal influences are very similar for lawyers, even if they are not spoken about as openly as they might be. We also learnt about the power of vocation in healthcare to help and hinder: for many personal identity was closely bound up with work, motivating and giving them purpose, but costing them dear when tasks became overwhelming or impossible.

Teams and impact of work environment

Another important lesson was on the impact of the work environment, especially the team environment, on the mental health of colleagues. Psychological problems are often viewed as the responsibility of the individual and wider social and environmental influences are overlooked or underestimated. We often heard that being in a good, supportive team was what made colleagues want to come to work and kept them going when things got tough, and, conversely, could be the decisive factor in quitting. We heard about badly designed jobs, unsustainable workloads and highly distressing team dynamics.

As a result, I’ve developed a strong interest in how to support teams and improve team culture, which begins with identifying and overcoming barriers to the investment of time and resource in relationships at work. Psychological support for managers in supporting their teams is now part of our offer, alongside direct work with teams – facilitating reflective practice, or thinking about how to clarify roles and team structures.

I could go on – it’s been an incredibly difficult time, but the pace of learning and development in these new psychological services in health and social care across the UK has been enormous. It would be wonderful to be able to make use of these innovations in the legal sector.

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