STP Support | Loneliness & the STP

This week (9-15th May) is Mental Health Awareness Week and this year’s focus is on loneliness. According to recent figures from the Mental Health Foundation, ‘One in four adults feel lonely some or all of the time’.

Unfortunately this is something that has become a much bigger issue over the past couple of years due to Covid, and we have likely all experienced loneliness to some extent during the pandemic.

Loneliness can be caused by a variety of different factors and there’s no one simple solution to resolve this, ultimately everyone is different and will respond differently to situations or difficulties they may face. We are all at risk of feeling lonely at times, however some people may be more susceptible to feeling this way. Feeling lonely frequently or for prolonged periods of time can increase a person’s risk of experiencing mental health problems. Additionally, those with mental health difficulties may be more susceptible to loneliness, therefore it can be somewhat of a vicious cycle.

Loneliness on the STP

The STP is a very challenging training programme and there are many factors that may put us as trainees at risk of experiencing feelings of loneliness. Due to the highly competitive nature of the STP and the relatively few available positions, many of us relocate in order to accept a post, which can mean moving away to a new city far away from family/friends/ support networks and not knowing anyone. This can obviously put us at an increased risk of experiencing loneliness.

The nature of the STP means we as trainees are in a very unique position, where we are working full time, whilst also being a trainee and a student, and trying to explain to others exactly what we do can be difficult. At times it can be slightly unclear or difficult for people to understand exactly what our role is. We are part of the team and contributing to the service our departments provide, but we are also ‘supernumerary’ and need to ensure we are getting all the training we need so shouldn’t be relied upon for service provision. We are also required to meet a set list of training competencies, including rotations in other departments, which can involve spending significant periods of time away from your home department/trust, which again can make you feel quite alone at times, when you are constantly moving between different departments. It’s such a unique programme and place to be in terms of the limbo of being a student/trainee/working full time; if you are the only one in that position it can be challenging and quite lonely at times.

My personal experiences

Some trainees are fortunate to have several other STPs at their trust or nearby who they can connect with, and there are also regional trainee networks which can help a trainee meet other trainees nearby. Unfortunately I didn’t have this luxury, and the first time I met another STP in person was in the April of my first year when I went to another Trust for my vascular placement. We also sadly don’t really have much of a trainee network in Kent, where I’m based, either (it’s such a small network that it wasn’t even mentioned at the STP induction…) and I think there were definitely times when I felt very alone because of this. However, rather than feeling sorry for myself I tried to meet and interact with other STPs via alternative routes, for example through social media. I’ve got to know so many other STP trainees, from all different specialisms and at various stages of the programme, via Instagram in particular.

The online STP community has been a huge support for me. Countless times when I’ve been struggling I’ve had another STP trainee message me and check in on how I’m doing. These are mostly people I’ve never even met in person, yet some of them feel like some of my closest friends. There is definitely a certain ‘bond’ with other STPs that I can’t really explain. It’s such a unique programme and I don’t think anyone can fully appreciate what it’s like unless they are on the STP themselves.

Additionally, as someone with ADHD, sometimes I feel there are certain struggles that most neurotypical people don’t fully ‘get’. This has been another area where social media has been a massive help for me! Engaging with other neurodivergent individuals, connecting over shared experiences and relating to so much of what one another are saying, as well as sharing tips on how to overcome some of our common difficulties (such as disorganisation, time blindness, overwhelm etc.) has been hugely helpful for me and helped me to not feel so alone in my struggles. And I think the same goes for when I’ve been struggling with mental health generally, and I am quite sure many others would agree. It can feel so lonely when you are in a constant daily battle with your own mind. It can’t be emphasised enough how helpful having someone just listen and empathise can be, someone who understands what you’re going through or can simply offer a listening ear (or read your messages) and offer some support. This has certainly been a massive help to me when I’ve been struggling.

The importance of social interaction

Being ‘alone’ with my mind is something I have personally always really struggled with and human interaction is very important in helping me maintain my mental health. One of the things I love most about my job is the amount of patient interaction and getting to talk to and engage with patients. As sad as it may sound, my job has been a lifesaver for me at times and helped reduce my feelings of loneliness*.

*Disclaimer: I think at points I have perhaps thrown myself into work too much and ended up burning out as a result – please try and avoid this!! It is definitely about finding the right balance (something I am still working on…).

I feel lucky that I have at least had my job and had that opportunity to be physically in work, rather than working from home. During December 2020 I had to isolate for 2 weeks due to someone at work having Covid. Then after only a week back at work I tested positive myself (3 days before Christmas) and had to isolate again and my mental health took a huge dip as a result. This really highlighted to me how important work and human interaction is to me and my mental health! I have been lucky that my colleagues have made an effort to message/call me at times when they’ve known I’ve been particularly struggling.

Also, working within respiratory, many of the patients I see have been shielding due to being clinically extremely vulnerable and sometimes I can be the first proper human interaction these people have had in weeks or even months. It seems like such a small thing, but just having a bit of a chat with them between tests and providing them with that social interaction can mean a lot to some of our patients and this does feel very rewarding. However, it is also slightly heartbreaking at the same time, hearing how lonely some of them have been in isolation and this just further highlights how important human interaction is in preventing loneliness.

Loneliness linked to feeling unsupported

One thing that I think perhaps isn’t addressed enough is the loneliness caused by trying to access support but not receiving it. Nothing makes you feel more alone than being turned away by people or services that are meant to help, or having your feelings and experiences dismissed or invalidated. I can’t tell you how many times I’ve experienced this when trying to get help and this is certainly one of the biggest factors that has often contributed to me feeling alone. As someone with 10+ years of repeatedly trying (and failing) to access support via my GP and consistently being let down, there is nothing that makes me feel more hopeless or alone than being told to go back to my GP for help**.

**Disclaimer: Not all GPs are bad. There are good GPs out there who can provide useful support for a lot of people and you should seek support from them if needed, in the first instance. However this is is simply a reminder not to give up if they don’t prove helpful as there are always other people willing to help.

It is so demoralising when you’ve spent ages building up the courage to ask for help and then get made to feel like your problems aren’t valid or there’s nothing they can do to help. Unfortunately, due to my repeated bad experiences I often have a tendency to not reach out for help when I’m struggling and can instead isolate myself (hello loneliness my old friend). However, I think it is important to emphasise that there is always support out there, but sometimes you just have to search for it a bit (a lot) more. Just because one person (or several) have turned you away, try another option (be that a different GP or a different source of support entirely). Some of my loneliest points have been when I’ve tried (unsuccessfully) to seek help from ‘professionals’ and been repeatedly dismissed/rejected, but nearly every time without fail someone else like a fellow STP, colleague, or friend has offered me support and made up for the lack of support from other sources so there are always other people willing to help.

Tips for avoiding loneliness on the STP

The STP is tough and can feel very lonely at times, especially as you can be in that limbo of being ‘supernumerary’ and perhaps not quite feeling like a true part of the team at times, and this may be especially hard if you’ve moved across the country away from all your previous support networks (family, friends etc). However, there are certain strategies/things you can do to try and avoid or cope with this as much as possible, including:

1. Find something you enjoy that can help to take your mind off things (I personally enjoy colouring, doing sudokus, listening to podcasts)
2. Do some form of exercise – this can be as simple as going for a walk, or dancing in your bedroom, or going to the gym
3. Call/message a friend
4. Connect with others on social media
5. Join a sports team or local group

Sources of support on the STP:

Sometimes we are able to deal with these difficulties alone by putting some of the above strategies in place. However sometimes we may need a bit more support (which is nothing to be ashamed of) and there are various support options available to us as STP trainees if needed. These include:

1. Training officer – part of their role is to support you if/when you’re struggling.
2. Other colleagues
3. Other trainees – no one is likely to understand as much as they do about what you’re going through.
4. Occupational Health
5. NSHCS – They have a team specifically dedicated to training support. I have personally found them to be very helpful and supportive and would recommend reaching out to them if you need. They also have a lot of useful resources on their website, including self-help materials, sign posting to other sources of support etc. https://nshcs.hee.nhs.uk/training-support/https://nshcs.hee.nhs.uk/training-support/

Additional sources of support for if you are struggling with your mental health

Samaritans – For free confidential advice and support, call the Samaritans on 116 123, or email jo@samaritans.org for a reply within 24 hours. https://www.samaritans.org/

SHOUT – You can text “SHOUT” to 85258 to contact the Shout Crisis Text Line, which offers confidential support via a text messaging service. https://giveusashout.org

Mind: https://www.mind.org.uk/

Papyrus: https://www.papyrus-uk.org/

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.