Put the words ‘Brexit’ and ‘mental health’ into Google and it doesn’t offer much. Given the state of uncertainty that surrounds this issue for millions of individuals and families, their workplaces and the nation as a whole, this might surprise us. But we live in strange times. Perhaps it’s indicative of the denial that’s endemic in our society as we face the consequences of the decision to leave the EU.
As a way of coping with life events, denial functions to protect us from an awful reality; the man sacked from his job who continues to get dressed for work and leave the house and return at the same time each day, saying that work was ‘fine’. Or the parent unable to utter the ‘d’ word that describes the unbearable absence of their precious child in the world. Impossible to accept or to speak, there’s a time for denial at times of personal and familial tragedy.
Systemically, denial can serve to negate the experience of others; think about how powerfully it worked to perpetuate the abuse carried out by Jimmy Savile, or in Rotherham and in relation to the Hillsborough 96 and their families. We’ve probably all witnessed how systems can work to silence whistle blowers or voices that dare to tell uncomfortable truths in organisations. Denial and silence shuts down debate and this should worry the therapy profession in relation to Brexit.
Counselling doesn’t happen in a vacuum, it takes place in a context; and ours is the workplace. Our work is funded by our clients’ employers and is not about an individual contracting for therapy and paying for it privately. Our livelihoods as therapists are also affected by economic conditions, by shifting organisational budgets, priorities and constraints. We need to talk about the political context to our work; and that means talking about Brexit, the threat to jobs, workers’ rights, conditions at work and the impact on mental health; because it’s all happening, now.
The climate out there is far from welcoming. Speaking out requires courage, more so when you are making an argument that cannot be grasped with a simple slogan. Therapy is both curiously simple and complex; it’s about the relationship, trust, meaning and context, past and present, about fear, anxiety, belonging, hope, recovery, and more. Delivered in a workplace context, counselling provides short-term psychological support at a point of need in the life of an individual and the organisation in which they work.
Supporting the workforce
Shortly after the EU referendum in 2016, counselling services at both Nottingham University and the University of Leeds prepared information and fact sheets for their staff and ran workshops to support staff whose lives were to be affected by the result. The University of Leeds employs approximately 800 EU nationals with all 8,500 staff impacted by the decision because of its relationship with EU partners for research (EU funding accounts for nearly 16 per cent of their research income), and EU students. To have not offered support after the referendum would surely have been a dereliction of duty.
Writing an article in The Times , Libby Purves expressed particular irritation at how the leaflets advised the staff at Leeds on what to expect during the stages of grief in the aftermath of the vote.2 Arguing that this encouraged people to claim grief and showed ‘evidence of our enfeebled attitudes’, she wrote: ‘Brexit is not personal, it is not necessarily catastrophic, it is not total war. Wobbly people should not be soupily encouraged to act as if it was. Brexit is a nuisance, a fresh source of uncertainty in a world always uncertain, a turbulent bend in the fast-flowing river of history.’2
The personal is political
Surely Brexit is pretty personal to anyone whose job, home, rights and citizenship depend on it? The article continued: ‘if the authors of these university leaflets are fully qualified mental health professionals – I rather hope not, because I thoroughly respect real ones who treat real mental illness – they are degrading the whole profession’s credibility.’2
Author of these leaflets, Nicola Neath, is Chair of BACP Workplace and staff counsellor at the University of Leeds. Responsible for issuing the guidance to staff, titled: ‘Strategies and tools to help work with change and uncertainty’, I asked her how it felt to find her service written about in the national press in such terms: ‘It was alarming at first, I must admit. Then I put my therapist and professional hat back on, and I also understood it. In our service, we work all the time to prepare our staff for all manner of change, helping them resource themselves and make any adjustments to face expected or unexpected change. I think our response was professionally appropriate.’
She continues: ‘However, the wider profession of therapy is still working against a culture of fear and scepticism of what it means to give care and receive care when we are managing ourselves. There’s fear that accepting care makes us weaker, not stronger or a fear perhaps that we might not be OK. We name the unnameable, and being proactive is part of the day job for an organisational counsellor. But not everyone wants that kind of conversation or is ready for it; it’s not for everyone and, importantly, it’s not needed by everyone. I think it’s also Libby Purves’ right to say she doesn’t like it, so long as one person’s view doesn’t stop others taking up the help and support they might need.’
The fact that a university counselling service fulfilling its duties and responsibilities to its 8,500 staff, was so derided, should give health professionals pause for thought. The anxiety of ‘not knowing’ is usually a difficult space to occupy, but Brexit has added so much anxiety for individuals and their employers, who struggle to answer some of the most basic questions: will I be able to stay living in the UK? Will I have a job?
Two years on from the vote, Nicola Neath explains what is now happening in her workplace: ‘I am seeing the organisation tirelessly communicating about how the possible Brexit routes might affect our work, and engaging with staff who are debating on whether to leave their jobs or start new collaborations with EU colleagues. Some have left already, with a focus on doing what is best for their families because that’s the bit they can control. It’s so complex. We simply can’t engage with it all the time because the university has to do its day job and continue to create a positive environment for our diverse community of staff and students.’
At the time of writing, we are told that the Government is working towards getting a good deal, while preparing for all eventualities and the possibility of crashing out of the EU without a deal. Members of the three biggest trade unions now support a referendum on the final deal. A survey of more than 2,700 members of Unite, Unison and the GMB by YouGov, for the People’s Vote campaign, also found that a clear majority of members of the three unions now back staying in the EU, believing Brexit will be bad for jobs and living standards.3
For those who voted leave in the hope of giving the NHS an extra £350 million a week, the British Medical Association (BMA) has warned that ‘a no deal Brexit could have potentially catastrophic consequences for patients, the health workforce, services and the nation’s health.’4 In the UK in 2017, for the first time in a decade, more nurses left the profession than joined and in the NHS in England there are approximately 40,000 registered nursing vacancies and 10,000 doctor vacancies.5,6 In February this year, the BMA reported that doctors are struggling with unsustainable workloads in an NHS that is understaffed and chronically underfunded. This is having a huge impact on their morale and wellbeing, often leading to stress and burnout. Brexit also poses a risk, with almost half of EU doctors considering leaving the NHS following the referendum result.7
When the Chief Executive of Jaguar Land Rover, Ralph Speth, warned that tens of thousands of jobs in the automotive industry were at risk if there’s no deal, he was accused by pro-Brexit MP Bernard Jenkins of ‘scaremongering’. Just hours later, the company confirmed that 2,000 of its employees were moving to a three-day week due to difficult conditions in the industry, partly caused by Brexit.8 This summer, the UK’s aerospace,9 haulage10 and car industry11 all spoke out about their concerns of a potential no-deal Brexit, while the Department of Health outlined the very real possibility that if the supply of EU care workers is severed after Brexit, women will be forced to quit their jobs and look after sick or elderly relatives.12 Mayor, Sadiq Khan, instructed the body tasked with planning for terrorism attacks and disasters to start making preparation for a no-deal Brexit, to assess whether London could face potential shortages of medicines and food.13 Whitehall has discussed asking police chiefs to cancel leave for two months after Brexit in readiness for social unrest caused by no-deal Brexit,14 and according to a series of Freedom of Information requests, local authorities are also preparing for civil unrest.15
Fear and the far right
Francis O’Grady, General Secretary of the TUC, spoke out about how the failure to tackle some of the root causes of Brexit will fuel the far right: ‘Ten years of austerity, wage stagnation and cuts to public services and standards of living have led to a concoction of fear and anger, and which remain unaddressed.’16 This backdrop is important. So too was the warning in August, from Mark Rowley, ex-counter terrorism chief to politicians and the media that, ‘for the first time since the second world war, we have a domestic terrorist group, which is right wing, neo-Nazi, proudly white supremacist, portraying a violent and wicked ideology,’ with online materials advising on how to sow tension and discord in communities and evade police surveillance.’17
Francis O’Grady, fears that many of the workers she represents will find their lives made even harder by Brexit: ‘The Government’s own leaked advice shows that there’s a big price to pay; the question is, how big?’16
Support for EU citizens
Aware of the toll on EU citizens living in the UK with such uncertainty, the writer and psychotherapist, Professor Emmy van Deurzen, has stepped in to fill a void that exists in psychological support. Along with five colleagues, she has established the Emotional Support Service for Europeans, a voluntary counselling service for the 3.6 million European citizens living in the UK. Together they are offering a national telephone and online therapy service for those feeling distressed, uncertain and, in some cases, suicidal. She explains: ‘EU citizens were not given a vote on something that has ransacked our future. So many people have no security about their future and a fear of being told they will have to leave the UK. We know from the research that migrants have a higher probability of mental health problems, but when they are under threat by a government challenging their right to be here or taking away their rights, then it is going to be worse. The3million (a group set up to protect the rights of the 3.6 million EU citizens living in the UK) undertook some research, and found that 80 per cent of EU citizens in the UK now don’t feel welcome and too many are experiencing depression, anxiety and insomnia.’
The people that van Deurzen speaks to, tell her that they need more support from their employers, she explains: ‘People are now so worried that they will not be able to stay, so they leave because they just can’t live with the levels of anxiety.’ Robin, (not his real name) an aerospace engineer for 20 years, tells me: ‘Many of our EU colleagues have already left. You go into an office and ask, “where’s Carlos or Phillippe?” and they’ve gone, back to Spain or France. These are engineering professionals, mid-career, highly skilled and with young families. They can’t wait for clarity and certainty from government; they’ve left.’
With so much still uncertain, van Deurzen makes the point that even the best of employers can’t really offer the reassurance their employees need, because they simply don’t know what’s going to happen. ‘There are a lot of UK citizens who this is affecting too, decent people, who are feeling shame at the process, and who are worried about their own future working in companies facing uncertain futures and who are under pressure because of staff shortages.’
Robin is one of those, he explains: ‘I’m in my 50s and I thought I had a pretty rock-solid secure job in aerospace. I know that’s a fortunate position to be in, but Brexit has changed that. I honestly don’t know if or for how long my job is secure. Perhaps if my company pulls out of the UK, there could be options for me to work elsewhere in Europe, but with Brexit, I’ve lost my right to work and live in the EU. Ideally, I wouldn’t be moving abroad now with my children at this point in their education. I never thought this would happen in my industry. It’s hard to get your head around.’
Robin’s wife, Karen (also not her real name), has worked in the public sector for children’s services during the last 10 years of austerity and is not optimistic about the road ahead. ‘I can’t see that my job will survive the funding shortfall and a shrinking state that would ensue as a result of a no-deal or hard Brexit.’ Given that local government leaders are warning that they face a financial black hole, with county councils citing a £3.2 billion funding gap over the next two years, Karen has cause for concern.17 Recently, council leaders also warned that children’s services face a tipping point, with 90 children entering care every day but repeated appeals for additional funding from the Treasury rejected.17
Costing us jobs
I asked therapists on Twitter to contact me with their experiences of Brexit in the counselling room, and much of what they told me focused on the immediate aftermath of Brexit, rifts in families and decisions about whether to stay in the UK or leave. Interestingly, the question I was asked most was, ‘why are you writing this now?’ That’s easy. Whether you voted leave or remain, we are facing the consequences of that decision and when it comes to Maslow’s hierarchy of needs, this is not about self-actualisation but about our homes, our jobs and security, including those of our clients, our friends and family, and probably our own. Facing additional costs and the need to save money, employers in the public and private sector, look at what can be dispensed with. The first casualty is usually staff wellbeing and support, which is of course, where the counselling profession sits.
A call to speak out
A growing understanding of the consequences is what is shifting public opinion, says Van Deurzen: ‘People are beginning to see that they didn’t have the right information at the time of the vote, and the Brexit they voted for and the Brexit they get may put them into dire situations.’ It is still not easy to speak out in this environment. However, more voices are doing just that. I ask van Deurzen what she thinks about the silence of our profession: ‘I think the counselling and psychotherapy profession has been too silent. Our profession owes it to itself to stand up for people and we should be doing that and be proud to be doing so. I have been trolled online and people have threatened me and it’s a kind of emotional blackmail to silence me, but it won’t work. I’m in favour of a well-informed democracy, which is why I’m backing a People’s Vote on the final deal. The people have the right to have another vote once they have all the facts.’
Trust is a central pillar of our relationships with our clients and our organisations. It’s through the trust that we establish in our relationships, that we allow people to feel safe enough to speak their truth and to change lives. It’s quiet work, still sometimes derided and not always well understood.
One reason why it’s taken me so long to write about Brexit in the context of mental health at work, is simply fear. The febrile atmosphere out there is silencing. In a wider culture of hostility towards those who name difficult truths, stand up for liberal values and to those who are different or other, fuelled during and since the referendum, we must stay vigilant. This summer, the police watchdog warned of a ‘real possibility’ that Britain’s exit from the European Union next year will trigger a spike in hate crimes.19 History offers us too many lessons on how quickly prejudice and discrimination can emerge in our communities, schools and workplaces, becoming normal, threatening peace and our way of life.
They say that bad things happen when good people do nothing. Members of BACP Workplace are mental health professionals, and BACP Workplace will actively encourage debate and discussion about the impact of Brexit on our mental health at work. As the UK faces its biggest peacetime challenge, we need to explore how as a sector we support both our clients and the organisations we work in with the anxiety being faced, while standing up for our livelihoods and the values of our profession.
Whatever you choose to do, I hope you’ll join me in not doing nothing.
Nicola Banning is a BACP accredited counsellor specialising in working with individuals and organisations, and is editor of this journal. She has a background in broadcasting with the BBC and writes on counselling, mental health at work and professional development.
6 https://www.bma.org.uk/news/media-centre/press-releases/2017/september/staffing-crisis-in-nhs-laid-bare 7 https://www.bbc.co.uk/news/uk-politics-
18 https://www.theguardian.com/commentisfree/2018/sep/06/the-guardian-view-on-public-services-the-state-has-abandoned-itsresponsibilities? CMP=Share_AndroidApp_Gmail