Another “mental health” promotion stall

 Another “mental health” promotion stall

 

I’ve sat behind many tables in public places in my time, ready, waiting to hand over leaflets, pens and keyrings. I’ve visited many stalls collected mints, a stress ball, useful information packs (amazing packs by PRIMHE), a chocolate orange, and cupcakes and most importantly post-it notes. The people on the stalls have been friendly, warm, kind, tired and bored, as you would expect to find. The reason is we want to connect with people who might benefit from the services we provide. We want to talk to the general public - people who don’t come to our services, or might, or have previously, and might again. It’s a recruitment campaign hidden behind smiles and free gifts. A well-meaning campaign, but is it effective and are we missing something obvious?

 

As I walked away from talking to the stall holders (my organisation had a stall there too) I reflected. The people I knew on the stalls had clients, new clients every day and week. In their natural habitats they were meeting new people, connecting, listening, caring, helping and navigating to other services. What the community based services provide connects with new people everyday, it works. Then I remembered the problems we face everyday. People who have access to services, but don’t receive the support they need, Or are placed on a waiting list or drop out of mental health services. IAPT, the national psychological talking therapies service has a 56% drop out after the assessment and first session. I’m a supporter of psychological therapy, so this is a concern and a worry. So what’s going on?

 

It’s complex, but understandable and solvable. So let’s run through the issues and start to consider them. Most people experiencing “mental health problems”don’t seek help or support. Ok let’s start again (another blog will dive into the issue – keep a lookout for it). People face difficulties living their lives - challenges and distress. We might name these problems of living. The distress is experienced in our bodies, in our head (brain and mind – let’s not go there now) and behaviours. This is very broad, if 1000 factors influence this human distress, maybe we need 1000 (variability controls, variability in systems thinking), then some of these people need to deal with specific factors, or aspects of their lives, that cause human distress. If debt is a primary factor, then debt counselling (not psychological counselling) seems the obvious answer, without excluding other services or support. If a person is lost, feeling alone, then finding out why the person is lost should be the focus and key to helping the person? If the person lacks direction in their life, then form a relationship, listen and explore the options that could be a way of the current situation, such as volunteering, education & career guidance. Then discuss personal development, emotional education (where does this take place – schools, art galleries, coffee shops or home?) and maybe some counselling. Start with the primary and move to the secondary and thirdary (is that a word?).

Okay, I’m using obvious and easy issues. Let’s move onto abuse and neglect, which has been highlighted with the work of ACEs (adverse childhood experience). If a person has been sexually abused, neglected, adopted, and might have a learning difficulty, then I would expect them to be experiencing extreme distress in the body, mind and relationships. If the abuse starts at a young age, then developmental issues around communication, emotions and relationships would be expected. How would you design support services to help this person? As many psychologists and psychiatrists would ask “what happened to you” (but not all do). Instead, people might be given a label (that hides the painful story) such as a personality disorder or schizophrenia and so on.

 

So if what is called  “mental health” is an issue, then we are moving people to a funnel where mental health professionals are at the narrow end. Some people don’t want this approach, this funnel and some of the people at the other end of the funnel. Then, we might make people wait (12 months for psychological therapy) or label them, asking them to hand over their story, their resources, skills and abilities and walk around with this new label? It doesn’t sound attractive to me but I do know people this approach helps, so let’s not ban it, but broaden it. Provide a wide array of options, allow people to decide on the approach and the implications of it and work within people’s preferences. When we need to step in and save a life or stop someone hurting themselves and others, then do it. I’ll even help if I can, but don’t start with the mindset of incarceration, restraint, reduction and removal of the person’s core identity.

 

We need to move away from “mental health” awareness, towards “mental health” activism. Then drop “mental health” (again see the next blog). How do we as a society deal with poverty, abuse, stress of modern living, loneliness, the illness (dysfunction, disorder) narrative? Are the services designed in the way you would like? Should we have an open conversation, an honest conversation? Next time we are asked to set up a stall or walk towards a stall, let’s have this conversation. Let’s use the time to talk, reflect and maybe design a better way of dealing with the problems of living.

 

Iain Caldwell