{"id":2150,"date":"2017-06-05T17:43:41","date_gmt":"2017-06-05T16:43:41","guid":{"rendered":"https:\/\/blogs.canterbury.ac.uk\/discursive\/?p=2150"},"modified":"2017-10-04T09:04:29","modified_gmt":"2017-10-04T08:04:29","slug":"your-policy-is-my-life","status":"publish","type":"post","link":"https:\/\/blogs.canterbury.ac.uk\/discursive\/your-policy-is-my-life\/","title":{"rendered":"Your policy is my life"},"content":{"rendered":"

In the latest in our occasional \u2018Long Reads<\/a>\u2019 series, Mark Brown<\/a> considers mental heath professionals and political commitment<\/em><\/strong><\/p>\n

[NOTE:\u00a0The following piece originated as an address to clinical psychologists, but also is highly relevant to others working in mental health<\/em>]<\/strong><\/p>\n

Right now there\u2019s a lot of people losing hope. If clinical psychology is the industry of the promotion human wellbeing, there\u2019s a lot of people in need of your goods and services. I\u2019ve been asked to discuss what happens when clinical psychology gets beyond the therapy room. So first, a little scene setting. Imagine this as the pre-credits sequence where the camera zooms across the landscape giving us a sense of the scale and scope of the story we\u2019re about to see unfold. In just what kind of a land is this therapy room situated? Who are its inhabitants? What\u2019s the story? You can hum your own suitably stirring theme music. Or perhaps the Benny Hill theme if you\u2019re not as impressed with the direction I\u2019m taking.<\/strong><\/p>\n

<\/p>\n

Your policy is my life<\/em><\/strong><\/p>\n

People with long term mental health difficulties are some of the most vulnerable in society. And we hate it. We hate feeling that so much of our life depends on policy made in Whitehall or discussed in \u211610. We can\u2019t pull off a magic trick and become not-unwell.<\/strong><\/p>\n

Even when we\u2019re doing well it\u2019s often because we\u2019re getting the right help. That isn\u2019t an argument for the removal of that help; it\u2019s an argument for its continuation. While mental health as an issue has developed a growing profile in public debate; little of it has risen above \u2018be nicer to people with mental health difficulties; moar hospitals!\u2019.<\/strong><\/p>\n

Whether the focus on mental health sticks will depend on whether our new government cares enough about mental health to do the one thing that governments can do apart from trying to pass laws. It depends on whether they are prepared to spend money. It\u2019s easy to look like savings are being made if you find ways of shifting costs off the balance sheet. It\u2019s always possible to shift the costs of not investing in mental health and mental wellbeing off the balance sheet; to say that it\u2019s the fault of individuals for not getting better, not making the best of what is on offer.<\/strong><\/p>\n

Mental health isn\u2019t just something that is about treatment. For those of us that experience difficulties with our mental health, they\u2019re something that tend to seep into all areas of our lives. In common with other disabilities, mental health difficulties tend to make many areas of life more difficult. The ways in which those areas are difficult depend on the world that we live in and the people around us.<\/strong><\/p>\n

Strong social protections; benefits that offset the greatest hardships that come from having difficulties with your mental health; strong rights to treatment, support and to quality of life: all of these things safeguard the wellbeing of people with mental health difficulties. While mental health difficulty might happen in our heads; the solutions and causes are not purely in the individual.<\/strong><\/p>\n

What I\u2019ve seen, and experienced myself, is that everyday life with a mental health difficulty is often a struggle. One that isn\u2019t obvious; isn\u2019t headline grabbing; but one that makes a mess of lives if there isn\u2019t support, help and protections. And those messes, and people\u2019s lives, get worse. We know that having a mental health difficult means that you are more likely to end up poor. What it means to be poor changes depending on the prevailing political and social winds. Mental health difficulties can often make you feel vulnerable because when you are having difficulties you are more at the mercy of those prevailing winds. Having a mental health difficulty makes things more difficult.<\/strong><\/p>\n

Many people with mental health difficulties have lost the sense that it is possible to trust this, or any, government to put their rights on the agenda. The fact that with the right support, help and changes in circumstance some of us will be able to gain and stay in paid employment is used to suggest that others of us are malingers or just aren\u2019t trying hard enough. People have seen the accessibility of treatment they need reduced; seen the benefits they have been receiving both in-work and out of work dwindle; seen the fabric of local voluntary and statutory services and organisations fray and in some places collapse. Mental health began austerity in a condition of under-investment.<\/strong><\/p>\n

When someone first falls ill or is having problems our automatic response is to think \u2018there should be someone to help with this\u2019 but increasingly, as cuts hollow out social protections\u200a\u2014\u200aregardless of whether they are provided by the private, public or voluntary sector\u200a\u2014\u200apeople are finding that the help that every thought should be there just isn\u2019t.<\/strong><\/p>\n

When we\u2019ve lived with mental health difficulties for a while; our hope is that the crises will be further apart; that help and support will make sure that we don\u2019t lose sight of what we want our lives to be about. When we\u2019ve got the right treatment; the right support, enough money to live on and a balance between stretching ourselves and feeling safe\u200a\u2014\u200aeven then we\u2019re often just managing to keep our heads above water. The margin between doing OK and not doing OK can be very slim. Even a tiny policy change can tip life from being manageable into life being impossible.<\/strong><\/p>\n

Even when everything is in place we can still become ill. Mental health difficulties tend to be treacherous like that. When that happens we need to feel that it\u2019s possible to access help quickly before everything that we\u2019ve managed to build up is washed away.<\/strong><\/p>\n

But remember: mental health treatment and support needs to a be a partnership. You can\u2019t \u2018do\u2019 mental health to people. It\u2019s not a \u2018pull your socks up\u2019 situation. This government needs to rebuild that lost trust if it is to get anywhere with people with mental health difficulties. As much as we may want to be self-reliant, we also have to rely on the society in which we live.<\/strong><\/p>\n

Many people feel this acutely. People are scared and worried that what little security they\u2019ve managed to achieve in the face of mental health conditions that make a mess of the things you might want to do can be swept away by a single policy announcement, an edit to a cell in a spreadsheet, a policy focus on one aim rather than another.<\/strong><\/p>\n

If the scale of cuts suggested is to put into action; the human cost of those cuts aren\u2019t collateral damage. The human costs of those cuts are the core business of any government: the duty to protect its citizens or subjects. And for many who feel closest to those cuts, the prevailing wind is bringing not a warm breeze of spring but a harsh chill of a never-ending winter.<\/strong><\/p>\n

 <\/p>\n

The frontline<\/em><\/strong><\/p>\n

So, our scene is set, some, not all, of the people of the land are losing hope: but what is the role of our glorious saviour Clinical Psychology? Where does she fit? Discussions about mental health and wellbeing during times of austerity become discussions about preserving the frontline. We\u2019re watching ideas of a mental wellness services slowly changing into a mental illness services and then often not even that. It\u2019s all about the frontline. Save the frontline. Hold the frontline. But just where is the frontline for mental health and wellbeing? Can we really, given the fact that frontline is a military metaphor, really reduce the battle against mental illness and the battle for mental health to a series of of dug in trenches where we battle fixed enemies until they are all gone?<\/strong><\/p>\n

I think the frontline in mental health is a bit more complicated, the frontline of wellbeing even more so. The frontline is everywhere for mental health and wellbeing because mental health and wellbeing happens between people and the environments in which they they find themselves, backwards and forwards, all of the time.<\/strong><\/p>\n

There is nothing that doesn\u2019t have a bearing on mental health and wellbeing. For clinical psychology; the entire world is outside of the therapy room. But what should you do? The therapy room is safe. People pay you money to do a job and you do it. But you want more. Your conscience tells you that there is more that can be done. But what?<\/strong><\/p>\n

 <\/p>\n

We always vote for ourselves<\/em><\/strong><\/p>\n

If clinical psychology wants to step out of the therapy room and provide a further service to the people of this country and to the people of the world it needs to work out where best to help and how best to do so.<\/strong><\/p>\n

Clinical psychology is not just a field of work; it\u2019s also a field of knowledge and experience and skills. All of you who can describe yourself as clinical psychologists have tied up in you a huge pile of different resources that can be put to uses other than the thing you get your pay cheque for at the end of the month.<\/strong><\/p>\n

There\u2019s an interesting thing that happens in every single discussion of the future of mental health, from dystopian visions of psychologically tortured ghost people walking mechanically around an ultra-consumption based techno dictatorship to discussions of a post scarcity future where every person can unlock the inner potential, overcome their trauma and awake each morning as a fully actualised human being, leaping out of bed to carry out superhuman feats of compassion and productivity and artistry. Regardless of the tone, regardless of the context, the conclusion is the same: what we need is more people from our profession doing more of the job our profession does.<\/strong><\/p>\n

Through the work we have been trained for, and the work we feel confident in carrying out, we shall redeem the world from its fallen state. If we just had more clinical psychologists, then eventually we wouldn\u2019t need clinical psychologists because everyone would be better. Eventually. While it\u2019s entirely understandable to feel that the work we do is indispensable and to champion its role in the world, it\u2019s not correct to see that as being the only way that we can use our skills to make change happen. In part this way of thinking comes from being unable to see what clinical psychology might contribute beyond staying in the therapy room where it\u2019s comfortable.<\/strong><\/p>\n

But to what other ends should we put those resources to? How would you decide? I think there\u2019s a number of things we need to think about. Clinical psychology, and the wellbeing of people both collectively and individually do not happen in a vacuum.<\/strong><\/p>\n

 <\/p>\n

We need new helpers not new\u00a0leaders<\/strong><\/em><\/p>\n

One of the challenges of thinking about how clinical psychology might better serve society is that it\u2019s very hard to think of yourself as a helper not a leader.<\/strong><\/p>\n

More than ever we need people who can bring understanding into the mainstream of trauma, of difficulty, of sadness, of frustration, of despair, of prejudice and marginalisation and being thwarted at every turn in the attempt to have a better life. We need people who help people with power to understand not just the positive effects of their actions but also the negative. We need people to put the humanity back into the understanding of the effects of policy and practice.<\/strong><\/p>\n

We need a new generation of public professionals and a resurgence of older ones. We need people powered by psychological knowledge who can hold the world to account and say \u2018hang on, stop acting like utter dicks\u2019. In a country that seems to many to either be becoming more polarised or more unequal depending on who you talk to; we need people who can speak up for people\u2019s wellbeing.<\/strong><\/p>\n

We need, more than ever, public professionals who can help us to understand and public professionals who can help support the legitimacy of the problems raised with society from those with least power and least influence. As professionals and as people we need more who:<\/strong><\/p>\n