Improving staff mental health with mindfulness
Sussex Mindfulness Centre (SMC), a team of mindfulness researchers, trainers and teachers within Sussex Partnership NHS Foundation Trust, has been providing mindfulness courses for NHS and other public sector staff for more than 20 years. The team evaluates and evolves its courses regularly and rigorously, contributing to the research evidence base in this field and ensuring what's on offer is as effective as possible for those taking part.
Key benefits and outcomes
- Research shows mindfulness courses help reduce stress and improve wellbeing and mental health in healthcare and other employees; SMC have contributed to this research evidence.
- The National Institute of Health and Care Excellence (NICE) recommends staff in all organisations across all sectors have access to mindfulness courses.
- SMC mindfulness course evaluations have found significant improvements and meaningful changes to staff mental health and wellbeing following course completion.
The challenge of stress in the NHS
Even before the COVID-19 pandemic, stress was a major problem for the NHS. During the annual NHS Staff Survey in 2016, 37 per cent reported feeling unwell in the past year due to work-related stress. This had increased to 44 per cent of staff by 2022.
Healthcare employee stress has an impact on patients too. A global study published in the British Medical Journal indicates that doctors suffering from burnout are twice as likely as their peers to have been involved in patient safety incidents, to show low levels of professionalism and to have been rated poorly by patients for quality of the care provided.
This mental wellbeing epidemic in the sector also affects economic and performance productivity. In the 2023/2024 Labour Force Survey, the Health and Safety Executive identified the human health and social work industry as having statistically higher than average rates of self-reported stress, depression or anxiety caused or made worse by current or most recent job.
NHS Digital has consistently shown mental health as the single most reported reason for sickness absence.
Combatting stress through mindfulness
SMC has been offering mindfulness courses to NHS staff for over 20 years. Its primary offering is a nine-week course, which has particularly strong research evidence supporting mental health and wellbeing. The course begins with a 1.5-hour orientation session, followed by weekly two-hour sessions for groups of up to 15 staff members.
Participants are guided to practice mindfulness and to reflect on and discuss their experiences of the practice. They are also encouraged to practice mindfulness and other exercises at home for 30 minutes daily. The courses are primarily offered via videoconferencing.
More recently, the SMC team has adapted the courses for different staff groups taking needs and preferences into account. It now offers mindfulness courses with varying levels of intensity and time commitment, including taster sessions (one hour, online) introductory sessions (mostly self-guided, plus three hour-long online support sessions) and live meditation sessions open to all NHS staff.
SMC also offers the eight-week Mindful Self-Compassion course. In the weekly, two-hour online sessions the course teaches core principles and practices that enable participants to respond to difficult emotions with care and understanding.
SMC acknowledges people need to keep practising mindfulness to retain its benefits long-term. It offers a series of free, post-course sessions to support this, including online drop-in sessions where staff are guided in a mindfulness practice, as well as one-day in-person retreats twice a year when staff can learn to deepen their practice.
Compassionate leadership training
SMC has recognised the growing need to support managers and leaders to strengthen compassion for themselves and their teams in the NHS and other public sectors. The modern-day situation in the NHS can mean staff’s capacity to be compassionate to themselves and others can be severely challenged.
Compassionate leadership is linked with improved learning and innovation, and reduced staff stress, injuries and absenteeism, and even reduced patient mortality. SMC offers a six-weekly 1.5 hour sessions for managers and leaders in the NHS and social care. Follow-up sessions are available to all past participants to review our learning and practice.
Watch a short video from NHS colleagues who have attended the training and find out more information about the next course.
Results and benefits
- One randomised controlled study funded by Health Education England found that NHS staff allocated to attending a mindfulness course had significantly improved mental health, stress levels and wellbeing following the course compared to staff still on the waiting list.
- The evidence is so compelling that the National Institute of Health and Care Excellence (NICE) now recommends staff in all organisations in all sectors have access to mindfulness courses.
- SMC routinely evaluates its courses through self-report questionnaires and open-ended feedback. It has found significant improvements to NHS staff mental health and wellbeing following course completion. Participant feedback is consistently positive and demonstrates important and meaningful changes to mental health.
Example comments from participants include:
"I was cynical (about the course), not sure how it would help, but my mood improved significantly. I am calmer, less irritable and crying less."
"The stress we are under with targets and pressures, I think this course gave us the tools to deal with these."
"(I learned) to bring myself into the moment when I'm feeling overwhelmed. To accept difficulties for what they are and treat myself with kindness when I need to.”
Overcoming obstacles
Obstacles to delivering mindfulness courses can occur at two key points - commissioning and sign up.
- Commissioning - A key challenge can be to convince potential commissioners, such as HR leads, on the value of offering mindfulness courses to staff. There can be scepticism, often related to misperceptions about mindfulness or what it entails. Stressing the rigorous research demonstrating the benefits of mindfulness courses in the workplace is key here.
- Sign up - Staff can feel too busy and stressed to put aside time to attend a course. This is best overcome with support from team leaders and managers to proactively encourage staff to take time to look after their wellbeing. This can be most effective when the leaders themselves participate in the courses. Buy in from senior management is important and helps create a culture where staff wellbeing is valued and prioritised by the whole organisation. Effective communication about what is involved, presenting mindfulness as a human, non-stigmatising activity, is very helpful. Word of mouth endorsements from peers and colleagues who have completed the course can also be persuasive.
Top tips
A major national study on mindfulness in the NHS showed that successful implementation required grassroots facilitation and top-down organisational prioritisation of mindfulness.
Successful implementation of mindfulness requires:
- Well-trained mindfulness teachers who know the NHS context and teach mindfulness courses in line with national good practice guidelines.
- Enthusiastic executives, service and HR managers who provide cultural endorsement and funding.
- Strong relationships with and support from leaders in the organisation.
- Participant support before and after courses. This can include taster sessions and drop ins, whole days of follow-up practice, as well as opportunities to train to teach mindfulness.
Further information
For information about this research and how to commission Sussex Mindfulness Centre (SMC) to deliver mindfulness courses for your staff, see the at work page on the SMC website or email Kate Webb at kate.webb14@nhs.net or spft.smc@nhs.net.
You can also see more on training to teach mindfulness and mindful self-compassion on the SMC website.
