I was very pleased to read Clare Gerada’s article (‘Psychological PPE’ is what Britain’s health professionals urgently need now, 16 October). If the last wave was one in which doctors were seen as heroes going into battle, I hope that this wave will paint them in a more compassionate light. As a psychiatrist I have seen numerous medical colleagues suffering “moral injury”; we even jokingly wondered if feeling “guilty” was a symptom of Covid infection early in the pandemic. Moral injury is heightened when the sufferer feels that they should be an omnipotent hero. Heroes may find it hard to admit that things are hard; they may decline “psychological PPE” to maintain their self-image of a hero, ultimately risking worse psychological consequences.
Talking about feelings and recognising the psychological impact of working as a doctor is glossed over, if discussed at all, in medical training, to the detriment of doctors’ psychological wellbeing and their ability to care for their patients on an emotional level. I fear that many doctors will be unaccustomed to psychological PPE and find it more difficult to don than the physical protective equipment. This glaring omission is set to change in medical training, with training programme providers forced to recognise that they have recruited humans rather than heroes. I think this will be better for patients and healthcare colleagues alike: wouldn’t you prefer to find a human rather than a hero behind the mask and visor?
Dr Sophie Behrman
Oxford
• Everything Clare Gerada writes about the psychological needs of health professionals in the pandemic also applies to social care staff and many others. My colleagues and I have been providing confidential sessions online for hospital social workers and care professionals as well as other local government staff during the pandemic. They too experienced “moral injury”, following statutory guidance that they believed put themselves and their patients at risk, and they’re exhausted and deeply apprehensive as the second wave strikes. The health system can’t cope without them, so let’s remember their needs.
Prof Andrew Cooper
Tavistock and Portman NHS foundation trust, London
