Seeking Help for Stress/Mental Health

SJT Textbook: Seeking Help for Stress/Mental Health

Seeking Help for Stress MSRA

This guide covers the professional duty of Seeking Help for Stress MSRA scenarios. In the Professional Dilemmas paper, you must demonstrate that looking after your own mental health is a key component of patient safety, not a sign of weakness.

🎥 Video Lesson (YouTube)

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🎯 THE CORE PRINCIPLE

Seeking help for stress or mental-health difficulties is a professional responsibility, not a weakness. When your health could affect patient care, GMC guidance requires you to recognise your limits, seek support, and take steps to protect patients. The priority in both real life and the SJT is immediate safety: safe handover and workload adjustment come before anything else.

High-scoring SJT options show you being honest about impairment, informing the nurse in charge or senior, handing over higher-risk tasks, and making sure patients are safely covered. They also show you using appropriate confidential support such as Occupational Health, NHS Practitioner Health, BMA counselling and peer support, and your own GP.

The exam will favour answers that link disclosure to a concrete plan: documented temporary adjustments, clear review times, and agreed escalation thresholds. Vague intentions, secrecy, informal coping alone, or disappearing mid-shift score poorly because they leave patients and colleagues at risk.

⚡ HIGH-YIELD ACTIONS (What Scores Points)

1. Inform the nurse in charge and relevant senior promptly if stress or mental health issues are affecting your fitness to practise.
2. Arrange safe handover of acutely unwell patients and high-risk tasks before stepping back or taking a break.
3. Take a brief, planned pause (with agreed cover) when overwhelmed or in acute distress.
4. Self-refer to NHS Practitioner Health and/or contact BMA counselling/peer support for confidential help.
5. Engage with Occupational Health and your GP to assess fitness for work and discuss treatment or adjustments.
6. Agree temporary rota or workload adjustments with supervisors (e.g. fewer on-calls, protected admin time, phased return).
7. Set a clear review date and escalation thresholds so everyone knows when to reassess or increase support.
8. Keep documentation factual and focused on safety, support, and agreed adjustments.
9. Encourage a team culture that normalises talking about stress and seeking early help.
10. If concerned about a colleague’s mental health, raise concerns sensitively and escalate if safety is at risk.

Trap answers usually minimise or conceal risk, delegate unsafely, or avoid formal support. The safest options combine honest disclosure, proper handover, and structured help-seeking.

💬 MODEL PHRASES (Use These in SJT Logic)

* “I’m going to self-refer to NHS Practitioner Health and contact the BMA counselling line today.”
* “Can we put a temporary adjustment in place and review it together at our next supervision meeting?”
* “I would like Occupational Health involved so we can plan safe, sustainable changes to my workload.”
* “I’ve documented the handover, temporary changes, and our agreed review time so the plan is clear.”

Hand over safely • Engage support • Limited disclosure (need-to-know) • Plan adjustments and review

Explain: Hand over urgent work first, then engage confidential services; share only what is needed to keep patients safe, and make a written plan with clear review.

📋 QUICK FAQ

Will asking for help damage my career or training?
Proactive help-seeking is viewed positively and aligns with GMC expectations. It demonstrates insight, responsibility, and commitment to patient safety. Avoiding help and working unsafely is more likely to cause problems.

Who can I talk to confidentially?
You can self-refer to NHS Practitioner Health, contact BMA counselling and peer support (available 24/7), speak with your GP, and engage Occupational Health. These services are designed for confidential support.

How much should I disclose at work?
Share enough information for your supervisors to keep patients safe and plan adjustments (e.g. that you are currently unwell and require modifications), without needing to reveal all personal details.

Can I step away from clinical work mid-shift?
Yes, if you are unsafe to practise. First ensure a safe handover and cover with the nurse in charge and senior, then step back. This is safer and more professional than continuing impaired or leaving abruptly.

What kind of adjustments are reasonable?
Examples include reduced or no nights/on-calls for a period, temporary clinic reductions, protected admin time, phased return after leave, or additional supervision. All should be time-bound and reviewed.

📚 GMC ANCHOR POINTS

• Work within the limits of your competence and health; seek advice when needed (GMC Good medical practice 2024).
• Take action if you think patient safety is being compromised, including by your own health (GMC Good medical practice 2024).
• Look after your own health and get appropriate help so you can provide safe care (GMC Your health as a doctor).
• Support and raise concerns about colleagues whose health may pose a risk to patients (GMC Good medical practice 2024).

💡 MINI PRACTICE SCENARIO

You are an FY2 on a busy medical take. Over the past few weeks you have felt increasingly anxious and low. Today, during an on-call shift, you experience a sudden surge of anxiety and find it difficult to concentrate on drug charts. You correct one near miss but feel shaky and overwhelmed. Calls are building and a patient with NEWS2 of 6 needs review.

Best action: Inform the nurse in charge and medical registrar that you are struggling to practise safely, hand over the acutely unwell patient and high-risk tasks, arrange brief cover while you pause and ground yourself, then contact NHS Practitioner Health and BMA counselling later the same day, and agree documented temporary adjustments and a review time with your supervisor.
Why: This protects immediate patient safety, demonstrates insight, and uses appropriate confidential support and planned adjustments, which is exactly what the SJT rewards.

🎯 KEY TAKEAWAYS

✓ Seeking help early is professional and required when health might affect care.
✓ Safety first: inform seniors and hand over before stepping back.
✓ Use confidential services: Practitioner Health, BMA counselling, Occupational Health, GP.
✓ Agree clear, time-limited adjustments with supervision and review dates.
✓ Limited, need-to-know disclosure is acceptable; secrecy and avoidance score poorly.

🔗 RELATED TOPICS

* → Recognising Burnout
* → Recognising Own Limitations
* → Supporting Colleagues After Incidents
* → Managing Emotional Impact of Clinical Work

📖 FULL PRACTICE QUESTIONS

Example SJT — Best of 3 (8 options; choose three)

You are a CT1 in surgery. Over the past month you have noticed worsening sleep, racing thoughts, and episodes of panic. Today, halfway through an on-call, you experience palpitations and feel unable to focus on prescribing for a septic patient. You realise you are not safe to continue without support. There are multiple routine tasks outstanding and one sick patient awaiting review.

Options:
A. Say nothing to anyone and push yourself to work faster to clear the list.
B. Tell the nurse in charge and the registrar that you are struggling to practise safely, and arrange for the registrar to review the septic patient while your routine tasks are covered.
C. Leave the hospital immediately without telling anyone, and text a friend about how bad you feel.
D. Ask the medical student to carry the bleep while you sit in the mess for an hour.
E. Take a brief, agreed break after handing over the sickest patients, then return only if you feel able and the registrar agrees it is safe.
F. Self-refer to NHS Practitioner Health and plan to call the BMA counselling line later that day.
G. Email your educational supervisor about stress but continue working tonight as if nothing has happened.
H. Ignore your symptoms and blame the nursing staff if anything goes wrong.

Example SJT — Rank 5 (best → worst)

A GP trainee has been signed off sick for four weeks with depression and anxiety. They are now considering returning to work. They still have some symptoms but are engaging with treatment and support. A meeting is arranged with the training programme director to plan the return.

Options:
A. Agree a phased return with reduced clinical sessions, regular supervision, and a review date, and recommend ongoing support from Occupational Health and Practitioner Health.
B. Insist they return immediately to a full timetable including on-calls, to “get back to normal quickly”.
C. Discuss reasonable adjustments such as fewer on-calls and some protected admin time, and document the plan with clear measures and review points.
D. Advise them not to mention their mental health to any supervisors and to “just try to cope”.
E. Suggest they resign from the programme immediately rather than trying a supported return.