In a Masiviwe webinar (https://www.youtube.com/watch?v=Uqp374XkQN8&t=267s) Misha Naik, a Mental Health Occupational Therapist at Groote Schuur Hospital, explored what psychological safety in the workplace means and why it is essential.
Healthcare workers are trained to respond when someone is physically injured. If a staff member slips, falls and breaks a bone, the workplace knows what to do: report the incident, assess the environment, investigate the cause and put measures in place to prevent it from happening again.
But when a healthcare worker experiences psychological distress, the response is often very different.
A nurse who is burnt out, or a doctor who becomes depressed may be told to “get help”, “be more resilient” or “come back when you are ready”. Too often, the focus falls only on the individual, rather than on the pressures, systems and workplace culture that may have contributed to their distress.
This is where psychological safety becomes essential.
Psychological safety means that staff feel able to speak up, ask questions, admit mistakes, raise concerns and seek help without fear of humiliation, punishment or discrimination. In healthcare, this is not simply about staff comfort. It is directly linked to patient care.
Healthcare work is emotionally demanding
Healthcare workers face pressures that are built into the design of the work itself: long shifts, high patient loads, staff shortages, traumatic events, distressed families, resource constraints and constant change.
The webinar highlighted six workplace factors that shape stress and wellbeing: demand, control, support, relationships, role clarity and change. Each is highly relevant in healthcare.
Demand is often extreme. Nurses work 12-hour shifts. Doctors in public facilities face overwhelming patient loads. Control may be limited, with staff having little say over rosters, rotations or workload. Support may vary from strong supervision and team care to isolation and overstretched managers. Relationships can either protect staff or harm them, especially where bullying or conflict goes unaddressed. Role clarity is vital in complex health systems. And change — from COVID-19 to shifting protocols and staffing pressures — needs to be communicated and managed well.
A practical example from Groote Schuur Hospital
One of the most useful examples shared in the webinar was Groote Schuur Hospital’s staff health and wellness programme.
During the COVID-19 pandemic, the hospital recognised that staff needed more than occasional support. Thousands of employees were working under extraordinary strain. On-site counselling was introduced, including support for staff working in COVID wards. This helped make mental health support more visible and accessible, while also reducing stigma.
From 2021, Groote Schuur established a permanent staff health and wellness programme, employing a psychologist and occupational therapist. Its aim was to create a hospital that prioritises wellbeing and fosters healthy, safe, collaborative and responsive environments where staff feel heard, seen and that they belong.
The programme includes on-site counselling, anti-bullying workshops, workplace wellbeing champions, departmental interventions, stress and trauma management, team cohesion workshops, conflict management, psychological safety workshops and leadership training.
It also includes a staff wellness centre with activities such as a gym, yoga, fitness classes, meditation, massage chairs, support groups and informal coffee chats where staff can speak with trained peers in a non-threatening space.
This matters because healthcare workers often struggle to access help. They may feel ashamed, too busy, or afraid of being judged by colleagues. Bringing support into the workplace helps normalise help-seeking and makes care more accessible.
A health system issue, not only a personal one
For hospitals, clinics, NGOs and donors working in health, healthcare worker wellbeing should be seen as part of health system strengthening.
A health facility cannot provide compassionate, high-quality care if its staff are exhausted, fearful, unsupported or traumatised. Staff wellbeing affects retention, morale, teamwork, patient safety and service quality.
The lesson from the webinar is clear: mental health in healthcare workplaces requires a proactive, systems-based approach. This includes visible support services, trained managers, peer support, anti-bullying measures, return-to-work planning and a culture where staff can speak honestly without fear.