My solution to chronic mental health disservice
Imagine a service that met our needs, where our mental health was as important, if not more important, than our physical health. Where the relationship of the worker and trust and consistency of care is central to supporting an individual, and communities are built around strength and resilience.
Better service, that we deserve
A better service – one that we deserve, would value:
A perfect service would start by being humble and recognizing that it is perpetually disappointing and not providing adequate care. Listening and acting on the constant feedback from the service users on parts of the service that are not working would also help. Mental health care should embody participation at all levels to ensure that feedback is acted upon swiftly and that projects are co-produced with the very people that will be attending them for help. It needs to be noted that society is changing around us all the time, and with it the needs of the individual are fluid and not static. Adequate mental health care could start by being flexible.
As humans we are innately social, and the relationships around us are key to our wellbeing. I for one notice that as my self-worth improves, the quality of the people around me improve, and they treat me better, hence feeding into further boosted self-esteem, and healthy relationships build. This process can be started with consistent, healthy figures. Support workers should be just that. They should be reliable, transparent, caring and focus on building trust. Teach me how to navigate one healthy relationship and maybe I can apply that framework to my personal relationships too. Strings of overworked, tired, underpaid workers that are on short contracts when I need long term care is not conducive to relationship building. This leads to a service that is not transparent, workers that disappear, workers that do not turn up to appointments and leave me sat in the rain on my own – all of this reinforces negative experiences of relationships where trust is broken. Institution fatigue follows, where faith and hope in a service that acts as a lifeline for those in crisis, is broken. A stellar mental health service would bring relationship building to the core and see trust building as precious and vital for recovery.
For those with mental health problems isolation often ensues. In particular many of us still feel the hangover of over a year of lockdowns that cut us off from the outside world. This was challenging for the strongest, healthiest minds, and to those already struggling or vulnerable to mental health problems it was harrowing to lose support networks. My ideal mental health service would value community building to mitigate against the impact of COVID-19 lockdowns on mental health, specifically loneliness. People generally are keen to support each-other, and conversations around shared experiences can build empathy and make people feel seen and heard and not feel like they are on their own. When in the depths of depression, this building of connection can be a light at the end of the tunnel and provide a route to which someone can trust and ask for help in crisis. Community building would look like gardening groups, day trips, cooking and eating meals together, online activities, what’s-app groups. This would provide a framework for people who have withdrawn socially to attend and create new, positive relationships, and strengthen their support network.
Changing narratives around people who have experience of poor mental health – please stop calling me broken and ill. We all have mental health, and hence are vulnerable to the risk of poor mental health. We all have needs and I wish I could be seen as an individual that has needs to be met, individual specific needs, not generic needs. As soon as you label me as broken it is degrading and introduces a narrative of me being someone that will never get better and need to be prescribed a one size fits all care.
Asking for help is often a turning point in someone’s mental health journey. It takes courage to firstly accept that you are not in a good place, and then it is a vulnerable moment to speak up and go to the GP. Underfunded services mean that referrals to mental health services often lead to year-long waiting times. The news of this is so devastating at that crucial point of asking for help. This moment is not the start of recovery, this moment comes after a long time of being very ill, and the internal processes that lead to someone having the courage and seeing that they are worthy of getting better, despite a nasty internal monologue saying otherwise, are precious. The news of long waiting lists can lead to people shutting down, in a moment when validation and reassurance is needed.
The service received is then often prescriptive like a sticking plaster on a paper cut, but by the time it is delivered people are often better and not needing the help (hopefully) or their health has deteriorated, and that service may no longer apply to them. The services offered are rigid and do not see that individuals need tailored support. There is nothing more deflating than to wait a year for 6 weeks of CBT that doesn’t hit the spot in terms of helping. It is damaging to feel like I should be grateful for a service I get for free that does nothing to address the trauma in my past and makes me feel guilty for the behaviour I exhibit. Please keep your one size fits all CBT and stop calling me broken.
Give me agency instead. The space and option to make positive choices about my future, as small as they may be, would put me in the driving seat of the narrative of my life, and help me shape my future around my own values. Support me to play to my own strengths and to embody the best vision of myself that I can be. Having complex mental health needs means I have to be insightful and understanding to myself. This becomes a superpower when I start to learn how bring myself back when I start to get unwell. I know what works best to make me well better than a service that prescribes me a one size fits all solution will.
Options and choice are so important. I need to be actively engaged in my own recovery so that when I am discharged from the service I know the things I need to do to make myself feel better – agency is a pathway to me being independent in creating a support system in my life beyond what mental health services could ever offer me.
It is worth investing in an ideal mental health service because society runs smoother as people become healthier and more stable. This leads to positive contributions to our community and a collective momentum of better public mental health ensues, and societal impact greater that would be greater than the sum of one individual state of mind improving.
Fundraising and Youth Engagement Trainee