STP Support | So, you want to talk about mental health on the STP?

Trigger warning // depression, suicide, suicidal thoughts

This post is the opinion and experience of the author

Truthfully, I never thought I’d get onto the Scientist Training Programme.

I believed it was for people who had PhDs, Masters, or loads of experience in the specialism. It was the stuff of legend, where only the most knowledgeable and pioneering young scientists of our generation would be granted a place. The competition ratios were terrifyingly high. The Student Room threads were filled with individuals applying for the third, fourth, fifth time.

I believed I would never get an offer as a third year BSc student, with limited laboratory experience in my chosen field. This was just a practice run: no one ever got in first time round applying as an undergraduate. Sure, I had somehow convinced the short-listers that I deserved an interview, but I had definitely messed up one interview station and barely survived the others.

“Oh my god. I got a place on the STP.”

I stared at my phone and read the email again and again, just to make sure I was reading it correctly. It was late May, and my friend and I were standing outside the examination centre, having just finished our last exam of our BSc degree. A few days prior, I had received an email informing me that I was on the potential reserve list.

New Offer, the email read. Thank you for attending the recent interview for the Scientist Training Programme. We are pleased to confirm you have been conditionally offered a post…

Oh my god. My mind reeled, struggling to take this news in. I got in.

Like many others who apply for the programme, I had ranked all the locations available – I was willing to move anywhere. It was so prestigious that I would have happily promised my first-born child to the NHS gods if that was a criterion. I opened up Google Maps and typed in the unfamiliar location.

Oh. I felt light-headed. It was only on the opposite side of the country, over 200 miles away.

Regardless, there was no doubt in my mind that I would accept it. This was an amazing opportunity, and I was extremely lucky to have been offered a place. I would learn how to be a clinical scientist on the job, study for a (free!) Master’s degree and get paid a Band 6 salary at the same time.

It was a dream position, providing an undeniable jetpack-boost up the healthcare science career ladder. I couldn’t wait to get stuck in and make the most of it, expecting the training to be intense, but nevertheless trusting that it would be well organised, structured, and supported.

(Spoiler alert. It wasn’t.)

*

The first few weeks were rough.

For the first time in my life, I was living away from my family and the friends I had grown up with. I was renting a flat alone, the thought of living with strangers completely terrifying me. It was a new city, with new people, and a new job – my first full-time job having just graduated two months prior.

I couldn’t drive and I didn’t know how the bus network functioned. Too exhausted to deal with looking like a fool at the front of the bus trying to figure it out, I walked to and from work every day. On the weekends, I would walk to the nearest supermarket and only bought what I could physically carry back to my flat. I didn’t know anyone in my new city, so I didn’t speak or interact with anyone all weekend, other than thanking the cashier at Aldi.

I felt overwhelmed, homesick, and lonely. I cried every day after work while walking back to my flat, and often cried while getting ready for work in the morning. My evenings were spent in front of my laptop mindlessly watching Netflix on auto-play, heating up my batch-cooked-on-Sunday dinner in the microwave, eating aforementioned dinner, and then getting ready for bed.

Needless to say, I struggled with adjusting to my new situation.

At work, I felt lost. Unsure. Scared. My department was not prepared for training me. Staff were unsure about what to do with me. They hadn’t had much experience in training clinical scientists, they said. In fact, there had never been a clinical scientist in my specialism at the trust. Nobody really knew what a clinical scientist did.

Through the grapevine, I heard that my department had not signed up for STP trainees (but that it was a decision made, unknown to them, on their behalf) and that previous trainees had quit the programme.

But that’s ok, I thought, rather naively. I’m here now, and this is an opportunity that I can’t give up. I’ll only be here for three years.

Quitting wasn’t an option for me.

My parents would ring me occasionally in the evenings, wanting to know how I was getting on. I’m fine, I would say. Work is busy. Yes, I’m learning a lot. Yes, everything is ok. Hey look, I have to go, speak to you soon.

In truth, I was in a dark place.

I was miserable.

Morbid thoughts of death had been crossing my mind.

*

I knew I needed to reach out for support.

Where I lived previously, I had interacted with my local NHS Improving Access to Psychological Therapies (IAPT) service for university-related stress, before relocating for the STP. A quick Google search for my new local IAPT service led me to filling in a relatively straightforward online self-referral form.

The process was largely similar:

• a telephone assessment appointment, made within a few weeks of self-referring,
• an x-months-long waiting list for low-intensity cognitive behavioural therapy (CBT) but being directed to online CBT workshops in the meantime,
• 6-8 sessions with a psychological wellbeing practitioner,
• a second telephone assessment appointment,
• a referral for high-intensity CBT sessions, again with an x-months-long waiting list,
• approximately twelve sessions with a CBT therapist.

I wish I could say that these therapy sessions boosted my mental health, giving me renewed vigour in confronting the challenges of the STP, that all is well and I’m living happily ever after.

But alas.

*

2020 was the year that I hit my lowest point.

Early on in the year, my sessions with my CBT therapist came to an end. At the same time, my therapist informed me that the waiting list for the psychotherapy service had re-opened for the first time in a while, and that she could refer me if I was interested. I had my reservations, but we both agreed that it would be a good opportunity to explore issues that CBT typically doesn’t address, and so my name was added to the waiting list.

Meanwhile, my training was still non-existent. My department still hadn’t figured out what to do with me, and I still didn’t know what my role was meant to involve. Multiple meetings with my training officer to try to address these issues failed to change anything. My attempts to organise my own training were met with excuses and empty promises.

Then the virus-that-shall-not-be-named struck the UK and the country went into lockdown.

We had to socially distance and keep two-metres-apart from all beings. But only if you were outside, and it was fine if you were with work colleagues. Or was that the one-metre-plus rule? Stay at home, but don’t stay at home. Not to mention the rule of six, and you could only go outside once a day. Basically, we could meet other households in a park, but only if you stayed at home and you washed your hands while singing ‘happy birthday’ and clapping for our carers.

It was the accumulation of not being able to see my family and friends in nearly half a year, the uncertainty of the virus, and an escalating conflict with a work colleague – while still trying to keep myself on top of the STP, compounded with the lack of appropriate training and support – that led me to breaking point mid-way through 2020.  

I did not want to be alive anymore.

Constant, never-ending thoughts of wanting to die. I can’t cope. I can’t do this anymore. It’s too much. There’s no point in living. I want to die.

Eventually, these thoughts consumed me. I felt numb. Empty. I couldn’t focus. Everything was slightly foggy, like I didn’t really exist.

This continued for two weeks until I finally accepted that they weren’t going to just disappear.

I reached out to my former CBT therapist, and I was assessed by the crisis team. I was prescribed anti-depressants and diagnosed with depressive disorder by my GP.

I wish I would have accepted that I needed help sooner.

*

I am still trying to rebuild my mental health.

I like to use the imagery of an ocean to help self-assess how I’m currently feeling or coping.

On a good day, the waves are calm and I’m drifting along on the surface of the sun-glittered water.

On other days, the waves are a bit rougher, and I need to work a bit harder to stay afloat, but I am still afloat.

When I start to feel like I’m drowning, sinking further towards the bottom of the ocean, and I’m struggling to breathe, or think, or focus – I know I have to take steps to prioritise and take care of myself. This can look different for everyone, but for me, it can be taking the time to paint, sing along to my favourite songs, Face-Time family and friends, cook my ultimate comfort food, tend to my houseplants, or even just take a moment outside to unwind and reset.

On my worst days, I have sunk too far beneath the surface to see any light, the darkness is smothering, and I can’t breathe. This is when I know I need to reach out for help. It can be the hardest thing to do, to admit that you’re struggling – but no matter how hard your body is telling you to give up, you deserve to breathe, to see the sunlight, and to know that it gets better.

To me, the the pastoral care provided by the National School of Healthcare Science feels inadequate

The procedures in place to address issues with training don’t feel clear and transparent. There is no-one dedicated at the School to reach out to if we’re struggling, even after bringing up problems with our training officer (Editor’s note – since the time of writing, the National School has appointed a Training Support Case Manager who performs this dedicated role of trainee support). I don’t feel that there is a guarantee that any action or decision made will be in the trainee’s best interest. This is despite my opinion that the School is responsible for providing support in these areas, including pastoral care for trainees.

**Editorial note** The NSHCS is contactable through nshcs@hee.nhs.uk. All emails are triaged to the appropriate people who are able to help. All contact is treated fully confidentially. Since the time of writing, the National School has appointed a Training Support Case Manager.

Your mental wellbeing is important to us, the School claims at our STP induction. It’s ok to feel stressed. We know the STP is demanding. If you’re struggling, reach out for support.

But I don’t believe it is enough to provide numbers for helplines, links to wellbeing apps, or be advised to visit Occupational Health. It feels as though they don’t value me, my health, and wellbeing. Taking a break, stepping off, or deferring, has never been presented as an option to me.

It feels impossible for me to approach the School for help, for fear that it will reflect negatively on me and be detrimental to the image the School is upholding. It feels like it is portrayed as a failure on my behalf, for not being able to cope with the pressures of the STP.

It concerns me that suicide rates are widely reported and discussed among doctors and medical students, but not among healthcare scientists and trainees. No-one should ever think that the only way out is suicide. My heart aches for those who have lost their lives. Those who could not think of another option, choosing a permanent solution to a temporary problem.

It may come as a surprise, but I truly do believe in the STP, in what it can do for healthcare science, and the life-changing opportunity that it provides. Many also think this way, which is why we think quitting isn’t an option.

So, I only want to ask one thing to the National School of Healthcare Science.

Do you believe you are doing your best to provide the support we need?

*

For free confidential advice and support, call the Samaritans on 116 123, or email jo@samaritans.org for a reply within 24 hours. You can also text “SHOUT” to 85258 to contact the Shout Crisis Text Line.

If you require support urgently, contact your local NHS urgent mental health helpline, call 111, or ask for an urgent GP appointment.

If you feel like you are unable to keep yourself safe right now, or have seriously harmed yourself, please call 999 or go straight to A&E for immediate support.

For more information on NHS mental health services, visit: https://www.nhs.uk/using-the-nhs/nhs-services/mental-health-services/

Editor’s note:

• This post is the experience of the author
• The editors would like to stress that you can and should contact the NSHCS (via nshcs@hee.nhs.uk) if you are struggling. All emails are triaged to the appropriate people who are able to help, all contact is treated fully confidentially and a properly trained member of staff will respond to you. Since the time of writing, the National School has appointed a Training Support Case Manager to help to improve trainees wellbeing