In recent years the profession has made great strides identifying and aiming to get ahead of mental health issues. It is a campaign that continues to evolve, and during a panel discussion, convened by Practice Plan and chaired by Creative Director, Les Jones, Dentist and founder of Psynergy Mental Health, Ritesh (Rick) Aggrawal, Co-founder of Mental Health Wellness in Dentistry, Fiona Ellwood, and Mahrukh Khwaja, dentist, positive psychologist and founder of Mind Ninja, the topic of mental health was high on the agenda.

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Les Jones

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Fiona Ellwood

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Dr Ritesh Aggarwal

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Dr Mahrukh Khwaja

LJ Businesses are growing, patients are coming through the door, there's a lot of positivity around. What's your sense at the moment about the extent of potential mental health issues? Is the situation getting worse, is it stable or is it getting better along with that renewed positivity?

RA I think it's improving. I own a one surgery private practice and private dentistry is booming. We are getting patients through the door, which is absolutely fabulous. Fighting back from the pandemic has been difficult. And then as soon as you get through the pandemic, you then get hit with a cost-of-living crisis and energy crisis. There's always something that comes up. However, I do think from a positive perspective that the way we are handling things is improving. And I think that gives us better tools to then deal with the adversity that comes our way.

MK: I agree. There is a lot more awareness around mental wellbeing than there ever has been before, especially post pandemic. There's a lot more interest amongst teams and organisations. I'm seeing a lot more uptake around mental wellbeing.

There's more conversation around how we can keep ourselves mentally fit, what things can we do to create positive health as well as things like happiness and engagement, using our strengths and living a life of meaning and using our values. And all of these other aspects that sometimes get missed in the conversation around mental health because it becomes a conversation about mental illness.

We're all on a continuum that's constantly shifting and changing according to what's going on in our lives. I think prevention is crucial when it comes to changing these stats. It's quite exciting to see that happening with the work that Fiona, Rick and I are doing and others, as well. So, it's quite an exciting time for mental wellbeing in dentistry in terms of taking positive steps forward.

FE We've had mental health illness within dentistry for many years and the pandemic gave us the opportunity to shine a light on it. We opened the door, and it was almost a permission to talk about it, to reach out. It was an excuse to be able to talk.

But what we're finding in some of the arenas that I'm talking with and working in, is that people are starting to draw back. They're not feeling that they should be talking about it any longer. Particularly as we're hearing that the NHS is taking down the hubs for mental health.

So, from one perspective, it's been fantastic. We've been able to shine the light on it. The tools and the resources have all come to light, but there's a part of me that worries we're going to go backwards in being able to feel that we are able to talk about mental ill health.

LJ What would you say are the impacts of mental health issues within a dental practice? On a personal level, for an individual that might be suffering, and what are the outward effects of that?

FE I think there are lots of impacts. And one of the things when we were setting up the Mental Health Wellness framework was talking to the regulators and looking at how we could bring in that side of things. Because things like fitness to practise, defensive dentistry, all have a huge impact on clinicians, and a knock-on effect onto the teams, and potentially to patient safety. If we have a clinician or a team member who is on the edge of going into this sort of crisis area, but they haven't recognised it, then there's an issue that it could affect patient safety. Especially if they know they're in difficulty, but have chosen to deny that, and are trying to work and hide it in order to cope.

But let's not forget we are in a time where we have issues with retention and attracting new people into the business and keeping them in the business once we've got them in. And mental health, wellbeing, and stress and anxiety all have huge parts to play in that.

LJ So, let's look at some of the approaches, and let's start with the individual. Are there any ways that individuals can spot the early signs and can tune into themselves to realise that perhaps their mental health is starting to suffer?

FE I'm really keen to explore the fact that we need to understand our teams. We need to look at the individuals and recognise the individual, and how they are. There's no closer relationship, I believe, than a dental nurse and a dentist or a clinician, when you're having a good day working together. And yes, you can have the odd bad day, but when that becomes two, three days, then you need to take it on the chin when somebody says to you, you are not your normal self. And that might be difficult. But I think it's important.

Also, not every problem is a mental ill health problem. We do have anxiety, and stress, and we shouldn't look at them all with the same umbrella term. The HSE (Health and Safety Executive) covers stress management, and it should be something we're addressing in our workspaces all of the time, but hardly any of us do it.

RA It's very important to understand the signs and symptoms of certain mental health conditions, so then we can then try and be honest with ourselves, which is quite a hard thing to do. But we can then start to understand what's happening within ourselves and be in tune with our emotions. So, improving our emotional intelligence about us and those around us too is important.

Like Fiona mentioned, it's picking up on people who you work closely with who may be acting out of character, or out of sorts. So, I would recommend people educate themselves to understand the signs and symptoms. And whilst it's not a blanket approach, as it's different for everybody, it'll add to your repertoire of being able to understand things and then hopefully positively influence them, for yourself and for your team members as well.

MK I do think having regular check-ins with yourself is useful. Taking a deep breath and just asking yourself, how am I feeling? What's going on with my thoughts? What's going on emotionally for me? How is my body feeling? How can I support myself better? And start noticing when things aren't good for you, when you don't feel quite right, and you notice a lack of motivation.

It could be that you are eating more than you normally do, or not eating as much, or you're having trouble sleeping or sleeping more. Trouble with the simple things that normally come much easier for you or you're withdrawing from others. It's important to check in with those aspects.

Part of what I'm doing with Psychoeducation is helping people learn those aspects, but it's certainly a journey for everyone to explore. People might want to do this through journaling. So just writing down their emotions and thoughts and what's going on for them. It could even be bullet journaling, which is just listing a few phrases, or a few words. It doesn't have to be prose.

There are ways that you can connect with yourself. It might be for some, it's about going for a run and that gives clarity, a bit of space to connect with their inner self. So, finding ways where you can be quiet, connect with what's going on emotionally, and physically is important and I think it's part of taking a preventative approach.

If you'd like to read more about how to take care of your mental wellbeing, visit the YouHub section of the Practice Plan website: practiceplan.co.uk. â—†