With how the world is right now, it has become more apparent how difficult it can be to be isolated. Loneliness is a growing problem. Due to COVID-19, a lot of us are spending more time at home; which is highlighting the difficulties of being housebound.
I often hear people say, ‘that give me anxiety’ or ‘I feel really depressed’ and whilst I know it is important to acknowledge how people are feeling, it is also important to differentiate between feeling an emotion and experiencing a condition/disorder. Everyone can feel these ways at certain points, but that does not mean they have a mental health condition.
On October 10th, every year, the World Health Organisation recognises World Mental Health Day which is a day they dedicate to raising awareness of mental health issues. Each year they have a theme which helps guide the focus for that particular year due to the broad nature of mental health as a whole. By organising the day to a have a theme, this allows special focus to be placed on that specific area, but that does not mean that other aspects should be disregarded. Some people may not resonate with the particular theme, or they wish to share their own specific stories that may be unrelated to the thematic topic. To completely disregard those other stories would be a disservice to the people who are sharing their stories, and also to the intent behind the day as a whole.
THEME FOR THIS YEAR
This year, the theme is “mental health for all”. This seems like such a broad topic when first considered, however, when we reflect on the current state of the world at the moment – Coronavirus/COVID-19, presidential elections, job losses/economy issues, etc – then it seems very appropriate. I think that we will see a huge impact upon mental health going into these next few months due to the uncertainty, fear, and isolation which people are experiencing as a result of all of the situations currently underway. So this is a good time to raise the profile of mental heal issues and support that is available.
NOT EVERYONE IS HAPPY ABOUT AWARENESS DAYS
These efforts are not always seen positively; this is seen particularly in those within the mental health community. This community – which comprises of; professionals, academics, those living with mental health issues, and their loved ones – sometimes feel as if these ‘awareness days’ are a gimmick, and can be used by companies as a way to make a profit without contributing fully to the spirit of community which is the aim of the day. This is a similar complaint which is levied at companies around Pride season, and the so called “Pink Pound” (https://www.crunch.co.uk/knowledge/running-a-business/pursuing-the-pink-pound-how-big-is-the-uks-lgbt-market/) – which is something I may discuss in a later post.
BUSINESSES AREN’T THE ONLY ONES TO BLAME
It’s not just businesses which are sometimes seen to be using these days for their own gain; sometimes it is felt that people use these days as a way to attempt to portray themselves in a good light. This phenomena – which can be termed “Virtue Signalling” – is viewed as a way for people to demonstrate just how much of a good person they either perceive themselves to be, or wish to be perceived as. These people make big shows of their support, but then do not continue to work to support these issues throughout the rest of the year. Here are some tweets from people who are dissatisfied with the true level of support which is extended:
Do medical professionals take mental health seriously (A&E, etc).
Questions are regularly raised about whether mental health issues are taken seriously, or with the proper level of care. People are finding it increasingly difficult to access the support they desperately need, particularly when it comes to inpatient care. Whilst there is a big push for community support to minimise the admission of people into inpatient care, this can lead to some people feeling as if they are cast adrift. They may feel isolated or as if their issues are not taken seriously enough. Consequently, they can experience high levels of distress and worsening of their condition.
Of course, community care can be beneficial for people, but inpatient care is available for a reason. Additionally, despite the drive for community care, it can be hard to access the care when required. Sometimes it can be difficult to contact the professionals supposed to be on hand to support those being treated in the community. A person may be experiencing severe psychological distress, yet be signposted from one professional to another. This leads to a breakdown in confidence and relationships between the individual and professionals. Subsequently making it even harder for the person to reach out, as the bond of trust is damaged, possibly irrevocably; which is not good enough.
Are professionals underfunded, or do they just not care?
This difficulty in accessing support raises the question of whether the help is unavailable due to lack of funding, or because the professionals have their own concept of how the treatment should progress. Personally, I think it can be a combination of both factors, alongside other issues too. Yes, there may be less funding to provide care, which reduces the amount of support available – but that is not the only issue. The professionals who are actually available, sometimes do not have the proper awareness or mindset. Some patients have reported being referred to professionals who have not looked into their case, so that the patient must retell their whole story again to catch the new professional up to speed.
All of this can be overwhelming for someone in emotional distress, as they are already mentally (and even physically) exhausted from the strain of living with their health issues. Another issue is that some professionals will attempt to put words into the mouths of patients, in an attempt to fit the patient into a mould so as to prescribe a set treatment; this is opposed to tailoring the treatment for each individual person. Again, is this due to the resources being unavailable for fully tailored treatment options, or due to preconceived notions of how a specific condition should be treatment? It is hard to differentiate the reasons.
Yes, I understand the need for evidence based treatments – so as to ensure that treatments are provided in a safe manner – but sometimes patients are not listened too when they tell their professional that a nurse of treatment is not working for them.
The severity of this issue can differ depending upon the professional seen, even within a small area. A person who sees one doctor at a GP practice may find that the GP is willing to adjust treatments readily based upon the feedback from the patient, whereas another person may find their GP (from the same practice) may dismiss their concerns and encourage them to progress with a course of treatment that they are not happy with. This is why it is important that people are aware that they are entitled to seek a second opinion, if they are not happy with the treatment they receive. Additionally, complaints procedures should be made clear and accessible to all – with complaints handled effectively by the relevant people.
THE CONFUSION AROUND FINDING HELP
It can feel like you are going around in circles when reaching out for support. You can be passed from pillar to post, without getting any further forward, until finally being offered ‘self-help’ and peer support groups. Subsequently, many feel dejected and lost before even getting to this point. Also, whilst the Improving Access to Psychological Therapies (IAPT – https://www.england.nhs.uk/mental-health/adults/iapt/) programme seeks to make it easier for people to get assistance, many people may be unsure of how to actually access the service. They may feel that they must go through their GP, only to be disappointed to find that they need to self-refer to the service.
This can lead to feelings of time being wasted, and that the information is hard to access. Another issue is that IAPT services tend to have waiting lists, which can be quite extensive. This can further delay the receipt of support, leading to a deterioration of the mental health of the individual in question. Again, this is a major failing of the system.
As waiting lists can be so long, it has led to many seeking private therapy, but this can become expensive. It can also be difficult to find the therapist that works for you. This is because each therapist will work in a different way, and you may find it easier to adopt certain styles. It can be quite an undertaking to find the right therapist. It can also be quite disheartening to feel like you are finally getting the support you want only to then have to go back to looking for a therapist because that one didn’t work for you, so I will give some tips on how to find the right therapist for you in a future post.
SOURCES OF SUPPORT
Whilst there are IAPT services, private therapists, and medication available, there are other types of support available. It can be hard to know where to go to find these support channels, so here are some ways you can find information about what is available in your area:
- Hub of Hope (https://hubofhope.co.uk) – A website and app developed by Chasing the Stigma (https://www.chasingthestigma.co.uk)
- Mind (https://www.mind.org.uk) – A charity which provide a range of resources and also an infoline/signposting service.
- NHS 111 (https://111.nhs.uk) – A service offered by NHS which is for when you need help in a non-life threatening case. This can be for physical or mental health reasons. The service can either be accessed through their website, or via telephone at 111.
- Local Council Support Databases – Your local council or health authority may have a database of local support groups and organisations which you could access, depending upon your needs. For example, County Durham (where I am based) use the Locate (https://www.durhamlocate.org.uk) service. But you can find your local database on the UK Government website HERE (https://www.gov.uk/find-a-community-support-group-or-organisation)
WHAT DO WE REALLY WANT?
Hopefully it is quite clear now what people suffering with mental ill health would hope to actually get from these awareness days. We want more than token acknowledgement and empty promises of support. We want more than just sharing of a post or attractive infographics. We want real support. We want it be easier to find the support we need, and we want to be able to get the support when we need it. We also want the support to actually be of good quality and to respect us as an individual, with all the nuances and characteristics which come with that. We want to feel listened to, and to have an active input on the care we receive.
We don’t want to feel abandoned, and we don’t want to feel as if we are a burden to those around us. We don’t want to have these conditions, and we don’t use these conditions for attention. In fact, there is a significant amount of guilt and shame which is still carried around having a mental health condition. This is something we need to work together to overcome in order to make it easier to speak about these conditions. It is time to stop suffering in silence, and to be able to reach out for the help which is needed without feeling like we will be discriminated against or dismissed.
HOW YOU CAN HELP
Educate yourself on some of the warning signs of mental illness
By doing this, you will more easily be able to identify if someone you love is struggling. It can also be beneficial to know these warning signs for yourself too. Some mental health issues can slowly creep upon you, so you don’t realise what is happening until you are in too deep. I know there is something going on with me – for example – when my appetite starts to change, I lose interest in things which used to make me feel inspired (reading, music, etc), and when I become more withdrawn because I feel I don’t have the energy to socialise. That said, it means when I am MORE withdrawn, because I am naturally an ‘extroverted introvert’ – also sometimes called an ‘ambivert’. This means that I can be outgoing and sociable, but I also need alone time to recharge.
Listen and learn
Listen to your loved ones and understand how they experience their mental health issue themselves. Even people with similar issues may experience it in different ways. For instance, depression and anxiety can manifest in some people as withdrawing and becoming tearful. For others, they become aggressive and hostile to others as their body responds to the perceived threats with the fight/flight/freeze response. So, by listening, you can learn their individual ‘red flags’ and also how they best feel supported when they are struggling.
If you feel that someone is at risk of hurting themselves or another person, then ask them. Just do it. Ask them something along the lines of, “have you had any thoughts of hurting yourself?” “do you want to hurt anyone else?” or “do you want to take your own life?”. You will not be ‘putting an idea’ into their heads, and this directness can cut through the emotion – whilst showing that you are taking them seriously. But, please, do not ask the question in any way which asks if they want to ‘…do anything stupid’. This is incredibly dismissive and can be belittling to the emotions that the person is feeling. They may be already feeling as if they are ‘stupid’ or ‘worthless’ and asking any questions in such a way can further add to their distress.
Hold the space
One of the best things you can do for someone who is feeling emotionally distressed is to just hold the space and let them feel, whilst also knowing they are supported. You do not have to try and fix the problem (and many times the ‘problem’ cannot be fixed), you just have to let the person know that, whatever they are going through, they do not have to do it alone. Just be there for them.
These steps will ensure that you are equipped with the basic tools to support someone in distress. If, however, you have serious concerns for their welfare and safety then do not hesitate to seek emergency medical help. It is important that, when necessary, crisis support is delivered as quickly as possible.
Thank you for reading, and I hope that together we can improve the landscape of mental health support in our society.