MHM Magazine

Issue 5 | 2021 | MENTALHEALTHMATTERS | 35 MHM es, including formal mindfulness practices (i.e., specific time for practices such as breath aware- ness, bodyscan, mindful walking or mindful movement/yoga) as well as informal opportunities to weave mindfulness into ordinary daily activities such as washing dishes or eating mindfully. Some practices were specifically developed for use during Covid-19, for example hand washing. All practices were offered in English and ranged from just under three minutes to 10 minutes. Participants were encouraged to do practice daily and offer feedback regarding their experiences. Additional inspiration was through the medium of poetry specific to the attitudinal quality of the week. Each week a didactic article on current research pertaining to the value of mindfulness-based self-care for nurses and/or HCPs provided academic grounding to the practices, for example “Mindfulness, Self-Compassion, and Empathy Among Health Care Professionals: A Review of the Literature” by Kelly Raab (2014) and “Coronavirus Disease 2019 (COVID-19) and Beyond: Micropractices for Burnout Prevention and Emotional Wellness” by David Fessell and Cary Cherniss (2020). Small visual elements relating to the science of mindfulness, as well as mindful self-compassion and self-care, were also interspersed. Each week would close with inspirational words and an invitation to reflect and share feedback of participants’ experience(s) and/or to contact facilitators privately for further support. FINDINGS AND KEY LEARNING As facilitators, our experience and findings from the three pilot groups were very similar. While engage- ment was in general both minimal and sporadic, each group indicated they were stretched beyond ca- pacity, with no time for themselves, needing a break and fearful for their lives. They also expressed they valued the offering and found it supportive. The mindfulness prac- tices offered them a small space of ‘time-out’ from their relentless schedules. The major challenges were the absence of in-person sessions and lack of substantial feedback - meaning it was often difficult to know how materials were being received. This could have been because participants found it difficult to respond or comment anonymously, due to the nature of WhatsAppTM – and digital communication. Participants used private messaging to communicate with facilitators on personal matters. We also sensed some “digital fatigue” with so much information flooding into a smartphone daily from online platforms. We learned that WhatsAppTM offers an affordable, accessible and efficient platform to run a digital mindfulness-based intervention. Going forward, it could be valuable to include live one-on-one audios or video calls before the programmes, to connect with participants, and offer an opportunity for them to raise any personal queries or concerns. In addition, a Zoom session (or similar) would be supportive in terms for the facilitators to outline ethical issues, particularly regarding confidentiality, and to create a safe space for sharing. There is also potentially a need to explore – in the context of the WhatsAppTM platform – how to establish the creation of a “safe container” for participation, considering the nature of and high levels of trauma in South Africa. It’s important to stress the essential value of having a psychologist on the facilitation team, or that facilitators are supervised and supported by a psychologist. As part of laying the pre- programme groundwork, it would be valuable to obtain agreement from participants to offer regular feedback, possibly at the end of each practice, or end of each week, as well as providing more detailed feedback at the end of the intervention, and six months/one year after to establish if and how they carried the practices forward in their lives. It would be useful to conduct a study on what HCPs themselves perceive as their support needs, and then design mindfulness-based practices meeting these needs. We feel there is a need to further consider ethical issues regarding facilitating a programme on the WhatsAppTM platform. CONCLUSION While there’s plenty of scope for further research and much work to be done, it’s clear from the pilot projects that there is poten- tial in using WhatsAppTM-based mindfulness interventions, both for HCPs as well as within other arenas. Based on the feedback, challenges experienced and les- sons learnt, we look forward to conducting formal research using similar (or refining) interventions to expand this field of knowledge. It’s our sincere hope that those who engaged in the pilot initiatives have been able to find a means to meet their daily challenges, especially their work, with greater accep- tance and kindness, and step into each day with a greater sense of well-being.