What did you think of, when you stood on your doorstep clapping last year? Were you feeling grateful for public healthcare, or angry that you could do little more than bang pots and pans? Were you among those calling for urgent pay rises for health and care workers? Did you wonder who was caring for the carers?


For psychotherapist Claire Goodwin-Fee, whose father had not long recovered from a spell in ICU, the pressure on medical staff seemed clear. At the same time, she understood more than most the challenges they’d face accessing mental health support – shockingly, frontline staff endure the same waiting times for therapy as the rest of us, up to two years in some areas before the pandemic.


And so, on March 22 last year as the nation prepared to enter its first lockdown, Goodwin-Fee took matters into her own hands, posting the offer of pro-bono therapy for key workers on her Facebook page and asking a handful of industry friends to get involved. Almost a year later, the organisation that post spawned – Frontline 19 – has recruited around 3,000 volunteer qualified therapists, and provided more than 50,000 hours of free therapy.


Claire Goodwin-Fee


“I think my hair must be singed at the sides given how quickly we’ve rocketed forward,” Goodwin-Fee tells me, laughing uproariously as she mimes an explosion somewhere around her pillar box red crop. “I mean, last month we helped around 1,000 NHS staff and frontline workers with one-to-one counselling. This month, I think we’re probably going to go over that. I just didn’t realise the enormity of what we’d done.”


Caring for carers


Essentially, Frontline 19’s fully qualified and registered volunteer therapists have stepped forward to fill a gap in support that, so far, the government has been unwilling to fill itself – that of urgent access to trauma support for frontline staff working at the coalface of the pandemic.


Demand, unsurprisingly, is off the charts. Back in April 2020, studies suggested half of all health staff were already experiencing stress and trauma. By January this year, new research led by King’s College London demonstrated a mounting mental health crisis on the frontline, with nearly half of intensive care staff showing symptoms of severe anxiety and depression, and a staggering 40 per cent showing signs of PTSD.


“This will be the shell shock, the Vietnam, of our generation,” Goodwin-Fee says, simply. “It might sound like a soundbite, but it’s true.”


Image: JC Gellidon/Unsplash


She tells me about a doctor she talked to who, having previously never had to break news of a loss to a family, had to deal with ten deaths in one shift. “By about the eighth or ninth call, he said, ‘I literally put my head on the desk and sobbed’,” she sighs.


Another time, after Goodwin-Fee had appeared on a radio phone-in, the service received a message from a veteran nurse who was, at that moment, sitting in her car ready to end her life. She was speaking to one of Frontline 19’s therapists within 20 minutes and is still in touch with them today.


A big part of the problem, Goodwin-Fee says, is that those on the frontline – from medical and care workers to police and paramedics – don’t want to frighten or upset their loved ones, and so bottle up their experiences. “One lady that works in a care home lost about 60 per cent of the people she looked after,” she says, sadly. “Her job one day was washing and dressing the bodies of all the people she’d looked after for years, and then at the end she put on her coat to go home. When you’re in that situation, how do you answer the question ‘How was your day, dear?’ What on Earth do you say?


“There’s this feeling around people not wanting to share, wanting to sanitise what they say, because it’s almost like poison. If I share with you just how raw and gritty this is, you’ve then got that on your mind too. Their stories are horrific. So, people don’t want to talk to their loved ones – but they also then don’t know how to manage it.”


Finding funding


Since stepping into the fray last year, Goodwin-Fee and her friend Ellen Waldren, who came out of retirement to join the cause as COO, have met everyone from Boris Johnson and Matt Hancock to the heads of huge, established mental health organisations who were shocked by the numbers Frontline 19 was seeing. Still, financial help has not been forthcoming, all government funding so far having gone into the pot for mass, rather than frontline-specific, mental health services.


“Most of the people I’ve spoken to, they don’t particularly want a pay rise – although it’d be nice,” Goodwin-Fee insists. “What they want is to be supported and looked after. They want things like an independent safe space to say, ‘This is awful. Please help me.’ They need a quick service.”


Goodwin-Fee with Frontline 19’s COO, Ellen Waldren


But while Frontline 19 has attracted the services of more than 3,000 professionals offering up their expertise for free, Goodwin-Fee admits the pro-bono aspect of their work has not been universally well-received in her industry.


“It’s amazing what people have offered, and I feel so proud of all of our volunteers, because 50,000 therapy sessions is a huge, huge contribution. But there’s a very small section of the therapist community that don’t like what we’re doing.


“We’ve worked really hard to get our qualifications and the expectation that therapists will work for free needs to change. I agree with that. But the way I see it is, we are in a pandemic. I have a choice whether or not to support somebody that may not be here without that support, and so for the moment, I park my need for money and everything else to one side.”


A ten-year plan


Nonetheless, she says, the longer this crisis continues, the clearer the case for long-term strategic planning. With intermittent lockdowns and disease spikes having already gone on longer than anticipated, demand on Frontline 19’s volunteers is only growing, and the need to access funding from somewhere in order to maintain the service (and hopefully pay therapists for their time) is becoming more keen.


“PTSD is going to be a massive reality,” Goodwin-Fee says, looking forward. “Anxiety and depression too. And the good thing with all of these conditions is the quicker you get treatment, the quicker you can recover in a safe way. So, we need the infrastructure to manage the outpouring, and it has to be on a ten-year plan.


“It has to be, because we know that after any kind of psychological event, the effects emerge over time. You might feel unwell emotionally six months down the line, it might happen to me five years later. There’s going to be people that don’t speak up until there’s an alcohol problem, or a drugs issue or gambling or something else, years down the line.”  


Image: Ed Ehimetalor/Akhere Unuabona/Unsplash


That’s a lot to take on, I suggest – so who’s caring for the carers of the carers? Are the Frontline 19 volunteers holding up ok? While Goodwin-Fee insists their training has equipped the team to handle the pressures of pandemic therapy provision, she admits she is not immune to worry.


“What keeps me up at night is, when you and I have had our vaccine and we go back to going out shopping and having lunch with friends and all of those things, what happens to these people we’ve relied on? Once they’ve sustained moral injury and difficulties and emotional pain, where will they go?


“I just want them to know that they’re not on their own.  When you’re all really busy, and you’re all really stressed, it’s so easy to miss the signs. And my fear is waking up one morning and reading in the headlines that another doctor or nurse has taken their own life because of what they’ve been through. And that is just something that would be heart-breaking.”


To find out more about Frontline 19, to access free and confidential support for a frontline worker, or to donate to the cause, visit the charity’s website here.

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