Every conversation I am having is starting with something on the lines of “isn’t everything very strange”. Many of us, across the world, find our world has been turned upside down. Lockdown. Social Distancing. Isolation. Those of us who are having to continue working, continue going out there (sometimes to the most hazardous situations – to care directly for people with this virus, sometimes into situations that put us in closer contact with more other people than we might like, such as working in supermarkets, on public transport – wherever) – are having to cope with higher levels of risk than they might be comfortable with. Sudden loss of income. Wondering if we will get support, if so, what, will it be enough. Maybe our employers are not as supportive as we’d like, maybe they are being fantastic.
Most of us are experiencing something unusual. And we may be responding to that sudden change in a variety of ways, most of them based on fear.
Fear is normal. It’s sensible. Fear is acknowledging danger. You cannot be brave if you don’t feel fear. Bravery is feeling fear and dealing with it appropriately. Another word for fear is anxiety. Anxiety is a vitally important emotion, it means we are alert to threats. It also provides us with some tools to deal with those threats. Unfortunately it is not very sophisticated. It screams like a hypersensitive smoke alarm sometimes, and when we need tools it throws random things, rather than always something appropriate to the danger.
Fight Flight Freeze Flop Fawn Friend F***
A lot of effing responses. Direct and indirect ways of tackling or diffusing danger. Some perhaps the right response in different scenarios.
Fighting doesn’t always look like punching something in the face. Fighting can look like frantically checking social media, posting critical things about others who aren’t behaving as you think they should. Obsessively cleaning more than is necessary. Launching a free online daily yoga class and optimising your online presence. The need to doooo something.
Flight could be denial. It could be panicking and grabbing everything in the supermarket and pushing over the elderly lady because we are closing down our sense of protection. We fear scarcity, we subsconsciously decide who is our responsibility and leave others to fend for themselves. Yes, it’s selfish, but it’s not necessarily an active choice to feel like that. It’s something innate which will have kept our ancestors alive in some situations.
I have been frozen. Seeing all the activity online. Being overwhelmed in an avalanche of information and kindness. Wanting to do something, offer support, act. But struggling to concentrate, to focus, to think. To do even my usual coping techniques. Meditate. Clean. Walk.
I have also flopped. Some days I am so tired. I can’t find the energy to get dressed. Off the sofa. Do anything other than scroll endlessly
The other responses are more complex, and harder to parse to this situation but they will be there, or they will come.
There is no right response. There are those which are more or less helpful. For ourselves and for others. There are those which have more or less to do with the actual threat. Giving ourselves permission to freeze and flop a little might be exactly what’s needed. Not fighting against the restrictions which are meant to keep us safe, but which feel very uncomfortable.
Now though – we must come to terms with this new temporary reality. Take time to look at how we are responding and ask if it is really helpful, necessary, counterproductive? The impulse to hoard all the hand sanitizer and loo roll might feel sensible in that first jump to conclusions our anxiety is so good at – but it is no good being the cleanest person in the world if everyone else is covered quite literally in poo. We all need to be able to stay clean and clean our environments to keep each other safe. Can you do anything to rectify anything you have done which is unfair? Offer excess on local groups for those who need it. Forgive yourself for not being perfect. Forgive others for being human.
Be mindful. Look for the gifts in this time. Things will change, we have a chance to think – what will I be happy to go back to? What don’t I miss, what of this time would I like to keep?
Wash your hands. Don’t touch your face. Keep your distance
Exercise. Eat well. Avoid (too much) alcohol. Get sun on your face as much as you can in your circumstances. Don’t try replicate your usual day. Look for small things to be thankful for. Find ways to see the faces and hear the voices of your colleagues, friends, family. Talk to your neighbours. Connect. Do things you enjoy. Try new things. Learn something new.
Thank you so much if you are out there helping people, our beautiful NHS and Care workers, retail workers, cleaners, delivery workers, lorry drivers – anyone doing what has to be done. We must make sure the world we return to remembers and rewards and protects.
I am listening to the Chancellor’s response to the Corona Virus, Corvid 19. I won’t pass judgement as yet as it will take me a while to process and understand what is on offer. This outbreak is bringing the faults in our economy and society into sharp relief. It is also a useful exemplar to help us understand how anxiety works – how some of us live our lives in a state of fear.
I am self employed. I choose to be self employed, despite the lack of benefits I used to enjoy when working for someone else, such as sick pay, training, annual leave etc. It presents me with challenges. My work is irregular. I can have some months with a booking every week, and then I can go for months with nothing. January February was one such period. I have eaten through my savings, which had already been depleted by a similar hungry gap in summer. Then my washing machine died (of course, they always seem to know the worst time to go). So I need the next couple of months, I have plenty of bookings, and if it all goes ahead, I am ok. I can pay the rent and replenish my savings a little. But then comes this virus. The possibility of having to self isolate if I or my partner get ill. Or of a shut down making it impossible for me to travel to my bookings across the country. I am scared.
I am not alone in this fear. So many people are in dire straits after a lean winter. After floods, and poor weather, and low visitor numbers. We need a good Spring and Summer to make it through. But there are plenty of people whose incomes are not so erratic who also fear sickness like this. Who fear it every day – not just Corona Virus – any sickness. Because their employers do not pay decent sick pay (Statutory may be better than nothing but if it is not equal to a decent percentage of your usual wage it will not pay your bills and ease your concerns). Because they will lose bonuses based on 100% attendance. Because they risk discipline or losing their jobs if they have more than a few days sick a year. Because they are not paid enough in the first place to be able to save decent cushion to help them through crisis points like this.
Even robots break down. We are not robots. We get sick. Some of us more than others. Stress (such as the above concerns, not to mention workload, interpersonal issues, other financial concerns, family problem) affects our immune response and makes it more likely that we will get ill, that it will be harder to recover. Simply telling people not to get ill doesn’t stop it happening, it just makes it harder for people to do what they need to do to get well.
Presenteeism (that’s people going into work when they are not well enough) has twice as big an impact on the economy as absenteeism (taking time off sick). Corvid 19 is showing us one reason why – making us think about the spread of disease. This is a particularly nasty illness, but it spreads just like the flu, like colds, like stomach bugs. If we go into work when we are contagious, and are not wearing Haz-Mat suits, we infect those around us. We do not perform at our best. We make mistakes. Sometimes if our mood and demeanour is affected by our illness, this can also spread, discontent, poor morale, deteriorating relationships. It’s no good for anyone.
We need a different approach. We need to encourage wellness, but not punish sickness. No one wants to get sick. Good health and wellbeing programmes to help people have the best chance of staying well, but also good protections and compassion for those who become unwell. Occupational Health, Employee Assistance Programmes, even Private Medical Care to take the load off the NHS. Give flexible and home working options where possible – sometimes you might be well enough to work but still infectious, or well enough to do a few hours if you can nap between. Don’t make it something people need to beg for. Make it an easy choice. People assume working from home means skiving. But the evidence suggests the opposite, that you get increased discretionary effort, that people are less distracted, more focused, and are able to get straight on to things instead of having an hour or more commuting before they even think about work. Granted, they might be in pyjamas sometimes, but what you don’t know doesn’t hurt you.
Not everyone can work from home, I get it. But think creatively. How can you diversify your workforce’s jobs – give them variety – so there are options. Invest in technologies where you can which will make life easier. One of the biggest problems we have – across the board, is that everything has been pared down to the barest essentials. We need redundancy in our systems. We need more people, so we can cover each other if we get ill. We need spare beds in the health system. We need a few more pounds in the pay packet so we can put something aside to cope with rainy days.
We have got used to convenience. To paying peanuts. To complaining about the cost of food and services. The knock on effects are clear to see in this crisis. The break down of the supply chain, the fear that an already overstretched NHS will not be able to cope with the potential impact, and that people will die. The impact that isolation will have on businesses across the land who rely on people being able to go out and spend money.
It’s not an easy thing to fix. We need bold choices. We need people to have more money in their pockets, to be able to afford, and prepared to pay more for the things they need, so people can charge the prices they need to charge to reflect the cost of a product or service, factoring in decent pay rates, sickness pay, and extra capacity in the system to ensure we can escape an economy based on fear and scarcity and precarity. An economy which is making us ill, and which cannot cope.
Last Friday I ran my first MHFA Refresher course. Aimed at people who completed the MHFA England Mental Health First Aid (Two Day), or Mental Health Champion (One Day) Courses three or more years ago – this half day, four hour course allows people to revisit their understanding of mental health and the skills to provide first aid support to someone experiencing mental distress.
I love training at the best of times, the opportunity to reach people and have really important conversations normalising attitudes to mental health and asking for help if we need it – but honestly sometimes it’s a scary business. You never know, when you walk into a classroom, how you will be received. You don’t know who’s in the room, why they are there, what their attitudes to mental health, or other issues might be – are they in a good mood? Will they take an instant dislike to me because I look like their evil aunty Mary? You never can tell.
People do Mental Health training for all sorts of reasons. Sometimes because they have personal experience, because someone in their family is going through some form of mental health challenge and they want to understand how to help. Sometimes because they want to support staff or colleagues – but lets be honest, some people come because they have been “sent” by the boss. Or because it’s a day off from the daily grind. Sometimes even because they have ingrained preconceptions that they don’t really believe in all this mental health stuff and they want to come and tell us all to get over ourselves. It’s fun! It’s even better when I can see I have made a difference with people like that, and helped them to understand and better support their loved ones.
If you are looking at rolling out Mental Health First Aiders in your workplace though – it might be a good idea for you to put thought into who the best person to receive the training might be. Some employers do have an application process, and I’d be more than happy to help you think about what you need.
Friday was different though. We were only a small group – but the difference with a Refresher course is that everyone there is definitely interested, committed, engaged. They’ve already done the initial Mental Health First Aid or Champion training, and they have gone away and used it in some capacity – and also noticed they now need to update that qualification. So the feeling, and the questions and energy in the room was fantastic.
It’s great to hear about organisations who have Mental Health First Aiders in place, about how they support staff, and support the Mental Health First Aiders in turn. Mental Health First Aiders alone cannot solve all mental health related issues within a workplace but they can be fantastic canaries in the coal mine to flag up issues and patterns of concern so they can be addressed on a more systemic level.
The refresher course is a great new part of that systemic approach – add to that some ongoing CPD to boost understanding of different mental health issues, keeping tied in to the information and resources offered by MHFA England, which can be used to raise awareness in the wider organisation, all help to effect that culture change that we need to see in our society as a whole.
I’m pleased to be able to announce a selection of courses in Yorkshire and Lancashire over the next six months –
Mental Health First Aid – Adult – 2 Day Course Qualify to be a Mental Health First Aider Wakefield @ The Art House – 24th / 25th February 2020 Rochdale @ Lock 50 Business Centre – 2nd / 3rd April 2020
MHFA Refresher *NEW FOR 2020* Refresh your existing Mental Health First Aider qualification, skills and knowledge Wakefield @ The Art House – 6th March 2020 Rochdale @ Lock 50 Business Centre – 29th May 2020
Mental Health Champion One day course Wakefield @ The Art House – 4th May 2020 Rochdale @ Lock 50 Business – 19th June 2020
Mental Health Aware Half day course Wakefield @ The Art House – 29th June 2020 Rochdale @ Lock 50 Business Centre – 10th July 2020
The sun may not be warming our hearts much this summer but this is a fantastic chance to become a Mental Health First Aider at an amazing discounted rate (60% off the RRP!)
Join me in Hebden Bridge on 25th / 26th July at the Quilt Cabin – see link below for full details.
Hebden Bridge is easily accessible by Road or Rail – on the West Yorkshire / Lancashire border within easy reach of Halifax, Huddersfield, Bradford, Leeds, Burnley, Rochdale and Manchester. It’s great place for a visit if you fancied extending for the weekend – ask me for pointers on places to stay, where to eat & drink or what there is to see and do.
Are you a medium sized business looking to roll out mental health training in your workplace? Or perhaps you could group together with other small businesses to benefit from this offer.
The Mentally Healthy Workplace package offers a range of different levels of training, from basic mental health awareness to fully qualified Mental Health First Aider to equip your employees with the understanding they need to support each other and look after their own wellbeing.
Including two half day awareness courses, one Mental Health Champion (one day) and one Mental Health First Aid (two day) course – you can train up to 72 people for the all inclusive cost of £3,750 – which comes in at less than £53 per person for this high quality accredited training.
Contact email@example.com for bookings or more information
When I was in the market to buy a house, many moons ago when that was a vague possibility before it all went awry – one of the properties we looked at caught my eye. It had a fantastic red kitchen. Those who know me know I love a bit of red.
However as I was looking around I realised that there was something off. This fantastic kitchen, with a great hob and belfast sink and other nice features was, well, a little low. The surfaces, the hob, the sink, all were at a level around the top of my thighs. Such that to chop things, or wash, I would have to lean forward considerably or squat down a bit. I suddenly understood when I met the lady of the house, who was about 4ft 6in tall. I’m not an extravagantly tall person, pretty much average height, and it had never really crossed my mind that things like tables, chairs, kitchen units, were usually designed with some “average” height, weight, width in mind. And that if you fall significantly outside that average then you might face discomfort or difficulty. This lady had, when getting her lovely kitchen designed, demanded it be designed with her in mind, so she could chop, wash and cook with ease without needing to stand on a step.
We don’t always realise how things are designed, unless we fall outside the average of the notional person they are designed for.
When I first heard about the Social Model of Disability, it reminded me of this kitchen. Michael Oliver, who passed away this week, introduced the idea that “disability” is not always about the physical or mental condition we may have. That while we may certainly face pain, difficulties, impairment, distress and discomfort as a result of whatever our personal circumstances – sometimes the disability we experience – the experience of not being able to do certain things, or go somewhere, or meet expectations – is not down to our situation, but instead down to elements of design or attitude, policy or usual practice.
If you are invited to an interview in an office on the seventh floor of a building, and you get there and there is no lift – if you are a wheelchair user for instance, or have mobility issues, or other health condition which makes climbing seven flights of stairs an impossibility, then you are rendered “unable” to attend that interview by many factors. The fact the architects did not put in a lift. The fact the people you are meeting did not consider that this might be a problem. The fact they did not think to ask and make alternative arrangements. The assumption that the people who will be invited will not have a problem. If the designers of a building had not deigned to put in any stairs either – then more of us would be “disabled” by this lack of consideration. Unless we are fantastic climbers, or super heroes who can fly. On the other hand, features such as ramps and lifts which make a place accessible to people with the kind of conditions I mentioned above – do not disadvantage those who might otherwise use the stairs. They are useful for all – people with prams or suitcases, heavy bags, a temporary injury, or even just when feeling a bit tired and unfit. While we would hope and expect people to give priority to those who need the lift / ramp or space on the bus due to disability – (and also to remember that disability is not always visible to the observer) – there is no ban on using it at other times if you don’t fall in that category.
As I said, we don’t necessarily think of our world and our days as “designed”. But at some point we have settled on certain averages because they suited someone. Lets think of our working days. That average 9-5, or whatever our shifts are. Originally, unfortunately many employers would expect staff to work whatever hours, in whatever conditions they could get away with. Poverty combined with the ready availability of alternate workers meant that people put up with horrendous conditions and barely having a life outside of work because there was no other choice to put food on the table or a roof overhead. Thankfully over time good people decided this was wrong and campaigned for change and brought in legislation to impose boundaries and expectations on employers as to what they can, can’t and must do in terms of their duty of care over staff.
Four miles up the road from me is Todmorden, birthplace of MP John Fielden, who is celebrated in various places throughout the town for his achievements which included the restriction of the working day in the 10 Hours Act, or Factories Act 1847 – and also campaigning for minimum wages / recompense, and against the employment of children. Since then, we have campaigned for and acquired more rights and protections, further “designing” our working lives.
One of the most powerful pieces of legislation which has helped to ensure we can challenge any unfairness or lack of consideration in our working lives is the Equality Act 2010. Covering many different aspect of equality – most notably in this regard this Act takes over from the Disability Discrimination Act 1995 in placing a duty on employers to protect disabled staff from discrimination, – and also requiring them to make adjustments to try and overcome any barriers a person may face as a result of their disability. This latter is essentially acknowledging the social model – that sometimes there are things we can do which remove the barrier or difficulty and enable us to get on with our lives and jobs just like anyone else.
“Disability” under the Act is where a condition, physical or mental, has a significant and long term impact on our ability to carry out the activities of daily life. This – and what is classed as a “reasonable adjustment” – are deliberately vague – and only truly decided in court or tribunal. Should this person’s condition be considered a disability and therefore protected, is this adjustment reasonable – these are questions which some employers get wrapped up in. It is a puzzling approach, to be prepared to take the risk of prosecution for discrimination, in an attempt not to have to help someone do their job better. Because that is what a reasonable adjustment is there to do – overcome the barriers that are making it hard for someone to do their job as they would like to.
Mental ill health can certainly be a disability, and can impact our ability to do our jobs, or to get out of bed, or look after ourselves. However in many jobs the kind of adjustments which might help us are quite simple to implement, and cost nothing. Changes in attitudes, trust, support, flexibility. The more flexible we can be and willing to try alternative approaches, the more likely our workplaces will be suitable for a wide range of human beings rather than just some notional “average” person. I don’t like the phrase “reasonable adjustment”. I would rather instead that we acknowledge that we make provision for every employee in one way or another. We provide them with equipment, a desk, a computer, protective gear, training, a manager – whatever the requirements of the job. What I would like is for us to think about “appropriate provision” for each employee according to their needs, rather than adjustments from an average provision which is often ill thought out and doesn’t fit anyone very well. If our world is designed with us in mind, and we don’t face any unnecessary barriers, that is when we can all start to thrive, and achieve whatever we want to in life – including optimum performance and productivity which benefits our employers and society as a whole.
I hear a lot of comments as I do the rounds of my training, a lot of thoughts and opinions, pre-judgements about mental health. Some thoughtful, insightful, some stigmatised/stigmatising, offensive and downright wrong. That’s ok. People come to learn about mental health, I want them to air their thoughts and preconceptions so we can discuss and challenge them. So we can educate and correct opinions which have been based on misleading information or social conditioning.
One of the main offenders is that lovely phrase “what do they have to be depressed about”? It can be applied in many scenarios, often when celebrities with their admittedly privileged lives talk about their experiences with mental health. Of course it is based on a complete misconception about what depression actually is, that it is something that cares a jot about your bank account, your good looks or wonderful life.
It is also used when it comes to young people and children. After all, as I remember adults being so fond of telling me when I was young, school / college / university are the best years of your life. Aren’t they? And of course kids don’t have any of that nasty 9 to 5 grindstone, mortgages and responsibility to deal with. So why on earth should they be depressed. Or be anything other than footloose and fancy free?
Again – aside from being wishful thinking (and perhaps a huge case of amnesia about the realities of being a teenager), this is based on an enormous misapprehension about mental health and how and why it can sometimes deteriorate to often quite dramatic extents, regardless of how old, or young, we are.
Other choice examples are that people self harm or develop eating disorders because it’s trendy. That it’s all the fault of social media – (before that it was television btw). That no one ever self harmed or got depressed or killed themselves when they were young. Just like no one was gay. Right. Ok.
Of course what they mean is that they never experienced these things, and no one they knew of told them that they did. It wasn’t spoken about at school or on the television programmes they watched. Rather than seeing the increased mention or report of these things as a result of increased awareness, openness, people feeling less ashamed to be open about it – it is something that to them has just appeared out of nowhere.
Then there is the question, are these children really depressed, or are they interpreting a bit of sadness or loneliness as depression because they have read about it. Actually if you think about it – this is an interesting one – because it’s progress – I’m not going to say that some vulnerable children might not do this. How we respond is so important. If we respond, as some might, with “Don’t be silly, of course you’re not depressed” – we need to question really carefully why we would think that. Are we assuming that our precious, delightful child could never really suffer with mental health difficulty? If so – why? Is it because we have not observed in them any signs or symptoms that might indicate that? Or is it because we think “DEPRESSION” is some big scary evil monster that only happens to other people. That Mental Illness is a spectre that could never stalk our home? Or do we think it’s all a load of snowflake nonsense?
Obviously the latter options require a bit of a reality check – that we all have mental health and many of us will at some point experience mental ill health to the extent we may need some help with it. Mental health issues come with varying severity and affect us in different ways – but most importantly around 75% of those of us who develop mental ill health, will start experiencing those difficulties before the age of 18. However even those of us with more understanding, who maybe know what to look out for might be prone to underestimating the challenges our children are facing. We haven’t seen little Joey looking sad or crying, they go to bed and get up the same as ever, go out and see their friends or play online just like they always did. We hear the loud music or get annoyed at their phone time and think everything is normal.
Hey. I might be alone in this but I don’t think I am. My parents knew diddly squat about my life when I was young. Part of that is another story, but even before things became problematic – after a certain point the last person who would know about my innermost feelings would be my parents. They didn’t know about my friendships, relationships, drinking, drugs, bullying, arguments, worries, self hatred, and emotional turmoil. They may have had inklings. And I don’t blame them – the primary reason they did not know is that I didn’t tell them. I didn’t want them to know. I actively hid problems I was going through from them. I pretended to be OK. I certainly didn’t tell them about self harm and suicide attempts. We do it as adults, we bottle it up and hope no one will notice that we’re struggling. For all sorts of reasons, most rooted in stigma and fear of discrimination or recrimination. But when I was young it wasn’t stigma about mental health, because i didn’t know that that was what was going on with me. It was the simple separation of parent and child. Their world and my world. And also their power and inclination to stop me doing things I wanted to do. Even if they were bad for me. So – just because you haven’t seen the signs, don’t dismiss it. It could be that things have finally got so bad that they are reaching out to for you for help. That’s such a gift and a privilege. Talk to them with sensitivity, kindness and empathy. Maybe they aren’t really depressed. But they clearly aren’t feeling great and talking to them about how they are feeling, what’s going on in their lives, and how long they have been feeling like that is important. Look at mental health resources to try self help techniques to deal with stress and negative thoughts, boost positivity etc. Help them build healthy habits. But most importantly – give the option of talking to the doctor about it. If they aren’t depressed they can still get some useful education about managing mood and also you are teaching them that it is ok to seek help if things do get bad. Rather than making it seem like a big deal and something to be ashamed of.
It’s also important to remember that some more severe mental health conditions can also emerge in the teenage years. They often start out with anxiety or depression, but if someone’s behaviour or beliefs become unusual or erratic, don’t jump to the conclusion that it is drug related – remember that some people may develop Bipolar Disorder or psychosis relatively young, and if we can catch it and ensure they get help at that early stage it is massively beneficial for their chances of recovery.
What have they got to be depressed about, they wonder. Lets talk about some of the things we know make it more likely that someone might experience depression. First of all our biological make up – Genetics – the structure of our brains. The tendencies we inherit from previous generations. Even the impact of traumas experienced by our parents and ancestors. Some research suggests that the effects of trauma can be handed down to our children. However, genetics do not mean we are cursed to definitely become ill. Even the rawest deal can be offset by our environment and experiences growing up. The first few years of our lives are crucial, shaping our adult persona, our emotional tendencies, beliefs and behaviours. How we deal with change, form relationships, handle difficulty. If those early years are not good – if we do not get the love and attention we need, if we are abused or neglected, if we are witness to aggression or violence, or if there are other ways in which things aren’t as they should be (even in some quite minor ways, if they unfortunately fall at crucial developmental times), then our risk of developing mental health issues increases.
And then we come to our education. Our relationships. The events of our lives. This last is perhaps what adults mean when they say “what do they have to be depressed about?” Situational depression is ok. It’s understandable. Your wife leaves you, you have money worries, you lose your job, somebody dies.
Actually what people get is grief. Sadness. Irritation. Bereavement. And indeed these can sometimes lead to depression if someone isn’t able to process the problem in a reasonable amount of time and return to a more level state of mind. But the idea is that something tangible must cause, or trigger your depression. And they suggest that nothing that happens before the age of 18 could possibly be significant enough to be worth noting.
How patronising. Never mind that so much pressure is placed upon us in those years to learn and perform and pass exams and decide what we want to do with our lives and who we want to be and how we want to live and what we believe. Never mind that we fall in love for the first time and have our hearts broken, or are bullied and victimised if we don’t fit in. Or that we are maybe realising that we are gay, or lesbian, bisexual, transgender, non-binary – or forming opinions and beliefs that differ from our parents and we find it difficult to talk about it because we are always shouted down. Or maybe worse. Maybe we have been or are being abused, maybe we went through something awful and we haven’t been able to tell anyone. Maybe we are frightened for what the future holds. Maybe the pressures of social expectations are too much, always on social media society has many positives and many negatives but the only certainty is that our parents don’t really “get it”. Not what it means to us and our friends. Maybe we look at the world and we see it. The people in their twenties and thirties and forties who are struggling, divided countries, war, climate change, extinction, increasing hatred and risk of disaster that looms closer than it has in generations. Maybe when someone asks us what we want to do when we grow up we’re not so sure there shouldn’t be an “if” in that question somewhere.
But yeah. What have they got to be depressed about. Someone who maybe has genetic risk factors, and early development risk factors – maybe finds some of that other stuff harder to handle than others. Maybe they think more deeply, or feel more existential threat because their systems are primed to do so. It’s really important we do not dismiss it. We need to educate ourselves and our children to understand our emotional patterns and responses and learn how to manage our anxieties and negative thoughts if we are prone to them. We need to talk to our kids, make it safe for them to talk to us. Love your children for who they are. Let them tell you who they are rather than trying to fit them into some box you assumed they came in – and learn what you need to do to support them along the way. There are plenty of haters and trolls and bullies in the world who will make the life of children who are different or sensitive difficult – their parents shouldn’t be among them.
Children and young people’s mental health services are strained and struggling, but there are positive changes afoot. Regardless – ignoring or avoiding the issue will not make it go away, and we need to start on the road to learning about our mental health and what helps us as early as possible if we are to have the best chance of recovery. I wish I’d understood what I was going through at 10, 11, 12, 13, 14, 15 …. as it was I was 20 when I first saw a doctor about mental health, and probably 25 before I got any real help. 35 before I properly understood what I do now. Don’t let that happen to your children.
I don’t get to spend Christmas at home every year, we alternate, as do many people, between parents and in-laws and home. So far I think we’ve spent only two here together, and we’re trying to develop some traditions.
Every year Hebden Bridge Picture House plays “It’s A Wonderful Life” on Christmas Eve. Last time we went I admit I wasn’t totally taken with it. We were upstairs, it was full, and hot – I felt rushed and too conscious of my discomfort squishing into the old seats. But this time it was lovely. We went for the matinee showing. I settled down with a cup of coffee and a cake (which I didn’t eat but it’s worth mentioning a cinema where you can have a nice mug of coffee and home made cakes – or, as many others were partaking, beer or wine. I can’t imagine most matinee performances sell as much beer but it was Christmas after all.)
It’s a funny choice for a Christmas film really, where the pivotal scene is a man’s suicidal crisis. But it got me thinking all the way through about what it says about mental health, suicide prevention, self care, society, capitalism, selfishness and selflessness. It may be one catastrophic circumstance that pushes George Bailey to a bridge over a churning river, contemplating his death to solve other people’s problems with his life insurance – but before that he is not really a happy man. It may be that night of desperation, and the prayers of the townsfolk send up in his name which attract the attention of God, the Universe, and Joseph, and lead them to send Clarence Oddbody, (Angel, 2nd Class) down to save him – but as with many people – George’s suicidal thoughts come as the culmination of a long period of distress, made up of a variety of different problems.
Clarence is helpfully given a crash course in the key things we need to know about George’s life. Of course there is plenty more to a person’s life, but we can all look back and see these crucial moments which have significant impact, or switch the points on the railroad tracks of our lives to send us down a different path than that which we expected.
First up for George is saving his brother’s life. Playing on a frozen pond, his younger brother crashes through the ice and George doesn’t hesitate to dive in and rescue him. This leaves him with a nasty cold and ear infection which eventually takes his hearing in one ear. This illness will have had some impact on his development – the disability certainly impacts him later in life when it prevents him from fighting in the war like his hero brother and friends. That early teenage time – when we are forming out adult identity – is important, and problems in this are often involved in later issues of self esteem or dissatisfaction. We see George post illness working in the drug store, oblivious to the youthful admiration of his future wife Mary and good time girl Violet. His thoughts are not on anything so mundane as a girlfriend – George dreams of travelling the world, exploring the wonders shown to him in his National Geographic magazine. That is his idea of his identity. Who he wants to be, what he wants for his life. However our mind is trickier than that, it doesn’t necessarily give us what we want. Something subtler is happening in our subconscious, the result of our genetics, our early education and experiences. George’s rescue of his brother is merely the first example we are given of him saving someone else’s bacon. He is a good guy, desperate to do the right thing, prepared to disregard the negative consequences for himself if it will prevent the the other coming to harm or losing out. Next up he realises that his boss, Mr Gower the pharmacist, blind drunk and out of his mind with grief at losing his son, has made a grave error in filling a prescription, inexplicably filling a packet with poison pills instead of whatever cures diptheria. Unable to get the advice of his father (and sparking a life long enmity with Henry Potter by defending him in an argument) young George goes back and braves the wrath of Mr Gower, gets a beating on his bad ear, but is able to make him realise his mistake, averting disaster.
George is a talented man. He wants to be an architect, after his travels. He is intelligent and innovative, with an eye for opportunity. But instead of greedily keeping those ideas to himself, he shares them liberally. He comes up with the idea to put a swimming pool under a moving floor in the school gymnasium, he recommends his friend invests in plastics, and build his factory near Bedford Falls where there is both cheap real estate and a large pool of available labour. So why is it that George is on the bridge wringing his hands and praying for help, rather than luxuriating in a skyscraper he built after years of globe trotting?
Sometimes life gets in the way, doesn’t it. Things happen. In George’s case, his father dies suddenly on the eve of his graduation. He forgoes his year travelling – presumably to help comfort his mother, and also to help at the Building and Loan which his father had set up to allow working men a chance to own a decent home and get out of the grips of slum landlords like Potter. He is about to head off to College, but at the crucial moment the board insists he stay to run things as his father would have wanted, or else they will bow to Potter’s demand to liquidate the whole operation. So. He stays. Even though his Uncle and others urge him to go – say it’s not the end of the world. He sends his brother off instead, figuring he will come back and take his turn at the Building and Loan and release George from his obligations in four years time.
But no. Of course it isn’t to be. Harry returns with a wife, and a fancy job offer. For all his pledge that he’ll reject it if George wants him to – he clearly hasn’t told his wife that. He knows George, Good Guy ™ that he is, wouldn’t want him to lose out on such a chance. George will let go all his dreams and stay in Bedford Falls, consoling himself in the waiting arms of Mary, marrying and building a family, helping others to achieve their dreams building homes in the affordable haven of Bailey Park. He doesn’t even get to go on Honeymoon, ending up using his savings to stave off a run on the bank in the Great Depression.
You could say he seems happy at certain points in the retrospective. He clearly loves his wife and children. His essential goodness is innate, not forced. He doesn’t hold it over people, expect gratitude or reward as some people might. But he is tired. And there is a bitterness, a resentment, that runs deep within. He doesn’t want it. Most of him doesn’t really feel that way – but he has never let go of his dreams. His table is full of models and plans for buildings he will likely never build. He sees the glass half empty – not the beautiful home they have created out of a broken down ruin, but the creaks and draughts that remain, the loose knob on the banister, not the warm hearth and music in the air.
That resentment has eaten away at his joy. He doesn’t blame his father, his mother, his brother, his wife – Sam “Hee-Haw” Wainwright (though God knows I do, the annoying creature). He has chosen at every step. But even though we might accept that we wouldn’t choose differently even if we could go back – it doesn’t stop us mourning for what might have been. Always yearning for the greener grass of alternative futures. (Notice how we never think that those different choices would go wrong).
So when it seems that yet again he is going to feel the need to take the fall for someone else’s actions – when his hapless Uncle Billy “loses” the $8000 he was meant to deposit in the bank on the day the bank examiner comes to check their affairs, George erupts. He sees himself lose it all, his business, home, family, liberty. In the first moments he shouts “it won’t be me that goes to jail for it” – but quickly he reverts to type and starts to try and dig his way out. Debases himself to his enemy in vain, begs funds from a wealthy friend but can’t get in touch. And when this fails he thinks of the insurance, and makes his way to the bridge in despair.
It’s undeniable that George has problems. A long history of trials, disappointment, debt, depression, which colours our view of life, building to a final trigger which pushes him to consider final, drastic action.
Of course at this point Clarence falls from above into the waves, triggering George’s instinct to save him, and giving him a chance to see the value of his life. George admits he doesn’t want to die – again he’s thinking of others, the impact on his family – but instead he wishes he had never been. And in this Christmas classic it is not the Scrooge like Potter who gets the vision, not Christmas Past, Present or Yet to Come – but what might have been, had George never been born.
Clarence helps George to see what he has. How the world is a better place for him being in it. He helps him through that terrible, lonely moment. Gives him the insight he needs to have hope. Coming back to his home George still has all the problems he had before, but he now sees all that he missed before. Blessings large and small. The recognition of friends, the familiarity of his home, his wife, his children, the annoying loose knob on the banister.
I found myself pondering the messages of the film. What might have prevented George from reaching that moment of doubt and pain? What could he have done differently? What could others have done to help him?
Of course there is the Disney do-over, where nothing bad happens, and everyone behaves as they should. Harry doesn’t smash through the ice so doesn’t need saving, the pharmacist’s son doesn’t die, so there is no mistake with the pills, their father doesn’t die of a stroke so George goes travelling, goes to College, builds his skyscrapers. But would he have been happy?
Lets gloss over the Disney-ness of the actual ending, and come back to it in a bit.
You can’t say it’s wrong for George to make the sacrifices he does. Everyone has the right to put others first. It is a message to all of us to think about, and be grateful for the sacrifices others make to give us the opportunities and privileges we enjoy. To consider the needs of those we love. Much as Mary loves him and makes him a happy home – when they as teenagers throw stones though the windows of the old ruined house that would later be their married home, making wishes for the future, she doesn’t hesitate to wish away his dreams in favour of her own.
Then there are those whose actions hurt us. The models of how we should not be. It is clear from the outset that Potter has no care for anyone’s wellbeing except his own, but for the most part he is just a typical Free Market Capitalist, making hay on the misfortunes of others, blaming them for not being able to get out of the trap he has devised. But mostly he stops short of actual criminality, still causing enough woe along the way. Sam Wainright shows us (as far as we can see) a model of someone who does well without being so deliberately selfish and malign.
We are reminded that sometimes people can still do harm to others even though they think they are just “looking out for themselves” – like the man in the Building and Loan during the scene where George keeps the place open through the run by doling out his own money – who insists on having every penny of his savings, not just what he needs – thus meaning it is harder for George to help others and risking it all falling apart. But Potter oversteps finally. He keeps the mislaid money, and goes further to call in the police. Some men do evil by doing nothing, others on purpose.
Of course George has his part to play. Being honest – saying no – making sure his needs are met. Imagine if instead of allowing that resentment to build he had been able to acknowledge his frustrations earlier in his life and find a way to find fulfilment, but also take strength and happiness from the help he gives to others. To see the riches in his life without needing a celestial intervention.
On the other hand sometimes we do our loved ones no favours when we act the martyr and seek to solve all their problems, or never correcting their bad behaviour. Should Uncle Billy be allowed to take the consequences of his actions? The most recent example of his forgetfulness, his ineptitude. His family has made excuses for him and carried him along – given him a responsible job he probably isn’t equal to. Assuming he were able to take the blame – legally speaking – why wouldn’t George let him? Without George, it all falls apart. A family struggles. Without Billy it all might run better. Of course he should have been given a chance to stand on his own two feet and find a better path earlier on. Maybe opening a sanctuary for his animals. Much as we love people sometimes for their sake and our own, we must let them see the consequences of their actions, learn from their own mistakes.
So George might have reached his pivotal night with a stronger sense of self, better coping strategies, a more positive view of his life. But still – the crisis might have happened. Whether we see the accident of Billy misplacing the money in Potter’s paper, or the deliberate malevolence of Potter keeping the money despite knowing how it could ruin an avalanche of lives. Bad stuff happens. How do we respond to it?
George casts around in his despair, he asks some people for help – but not everyone. Crucially, he doesn’t tell his wife, doesn’t explain to her his problem, allow her to comfort him or try to find a solution. He doesn’t tell the people who might be in a position to help investigate the situation (the police) or give leeway (the bank examiner). He panics, as we do when we are desperate. But while he rails and reels his wife finds out and pulls together all the people of the town who have been helped by George through the years, and comes up with a sum to exceed the missing money.
Luckily Clarence has pulled off his side of the bargain and George is still there to see the miraculous and heartwarming show of goodwill. Sometimes we need someone to be there for us, to listen, to help us through the darkest moments, be our Clarence Oddbody.
Enjoying this Wonderful Life is a many faceted thing, sometimes we have to overcome more hurdles than others, deal with more challenges. We have to remember to look after ourselves as well as carry out our duties and responsibilities, know when to say no – not ask too much of others, consider their needs. Remember to look at our lives every day and see the good, not just the difficult bits. Be grateful and take joy from the littlest thing. But no matter how swimmingly things may go, sometimes life will throw things at us it is near impossible to deal with alone. So when we are struggling, we must, we absolutely must – talk to people, ask for help, allow people to help us look at things from every different angle and find a way through. Most of us are here to help, whether we end up with wings or not. For every Potter there are a million George Baileys. We need to find them and let them lift us up.
If you are struggling and need someone to listen – ring, or email the Samaritans, text “SHOUT” to 85258 – talk to your GP, or check your local NHS / Council / Mental Health Charity pages for crisis services in your areaand please, please talk to your partner, family & friends.
In my previous job, as a librarian, I knew well the importance of metadata. Of correct labelling. Sometimes, the labels and descriptors that we assign to an item help us to put it in its place, in context amongst other things. Help us to understand more about the item, than what we can see on the surface. I once did an exercise, thinking about how I would be described, what keywords would be attached to me, were I to be catalogued and put on a shelf in a great library of lives.
What would we include? Title (Name) Originator (Parents) Physical description (Height, weight, sex, hair/eye colour) – beyond that though, the subject keywords – become a bit qualitative. But important – if you want to get the measure of me. My physical and mental health experiences would definitely have to be touched on. They have impacted my life and who I have become, and to varying extents still do.
So what do I put? How do I label this mess that has been in my head? Some would say – well, what’s your diagnosis? And there’s the rub. Do these things not exist before a doctor gives a name to them? I have, in my time had diagnoses of severe anxiety and depression. I still walk an ongoing tightrope with the symptoms that led to that diagnosis. But – I’ve also had conversations with doctors which suggested that there was more going on, that there was a possibility of Bipolar II, or Cyclothymia. Many times I was dismissed by doctors who didn’t want to engage. One doctor, when I persisted, said they would refer me to a psychiatrist for assessment – but never did. And I was in such a bad way at the time I didn’t follow it up. Latterly I have had much better doctors but concluded that as I seem to be managing my mental state better these days, and didn’t feel any need for medication – (which I would probably react badly to) – that I would leave the appointments to those who needed them more.
As I’ve learnt more about certain mental health conditions and understand my attachment issues, and the impact that events in my life may have had to contribute to some of “the way I am” – I can throw in other possible diagnoses that I might have been given. Or not. Recent years have given cause to think I may be on the autistic spectrum. But again – it’s not easy, quick or cheap to access diagnosis if it is not instantly offered to you on the NHS – so it is only something I would pursue if my issues, symptoms or behaviours started to significantly affect me in a negative way again. For now, I just use that tentative information in my head – to help me understand myself better. I might react like this, feel this way, find this difficult – for this reason. Sometimes that helps me find new coping mechanisms.
Diagnosis, after all, is just a label. A name agreed on by a bunch of doctors to describe a set of symptoms which seem to occur together in some people – and be helped by particular medications or therapeutic approaches. They change their minds over time. Fine tune their understanding.
The problem comes, if you need a diagnosis to access help. For instance – if my anxiety and depression were not “simply” that (not that it is ever that simple) – but were instead part of a Post Traumatic Stress response. Without someone recognising that, and referring me for appropriate treatment, perhaps EMDR – I may find myself revisiting medications and therapies that never quite help me to get the breakthrough I need to have a chance at recovery.
If my anxiety or depression affects me to such an extent that it impacts my work – maybe I am late a lot, take sick leave, or find certain tasks impossible. Perhaps my boss knows this, can see it, and wants to make adjustments to help me. But the HR department insists upon medical reports and Occupational Health visits to “prove” I am really ill – not faking it. But I am too nervous or stigmatised to go to the doctor, or cooperate with Occupational Health. The boss feels he is not “allowed” to help. Even in simple ways which are easily manageable across the team.
Problems don’t become real when you go to the doctor and get it labelled. I had lived with depression for 10 years at least before I even spoke to a doctor. Those other issues, for which I have no approved diagnosis – have had no less impact on my life and work for the fact they are not mentioned in great detail on my medical records if at all. I am fairly certain that the Equality Act does not require diagnosis for an employer to be expected to consider what adjustments can be made to help someone overcome a disability. Sometimes those around us recognise there is something amiss before we do. Sometimes we are in denial.
One of the things I like about Mental Health First Aid is that it doesn’t seek to make you a counsellor, a psychiatrist, a doctor. While it teaches you about some diagnoses that people may get – it doesn’t expect you to figure out what exactly is going on with someone. It helps you to understand possibilities – but emphasises that actually – diagnosis isn’t your job. Maybe sometimes it is going to be a necessary part of someone’s recovery – but figuring it out isn’t our role. Our role is recognising that someone is in distress, offering support, a listening ear, practical help – and signposting to services which may help – and may involve diagnosis. Or not.
There are many roads to recovery. Diagnosis may give access to some wonderful new build bypass that gets you there quicker. But it also might prove to be a dodgy sat-nav that takes you off a cliff, or down a dead end road. Finding things that help with the feelings and symptoms we are experiencing, and learning to understand why we are experiencing them – could be more helpful for some than knowing the precise name a psychiatrist might put on that catalogue card. Especially knowing they might change their mind a few years down the line.
That being said – assessment and diagnosis need to be more accessible for those with severe and enduring mental health issues. It is more luck than judgement that I am still here to write about this. My teens and twenties were dangerously volatile at times – and I really should have been assessed. Who knows what life would have been like if I had. (Though I am under no illusions that it would necessarily have been better had I been further entrenched in “The System”. I’ve seen enough nightmare stories not to be that naïve) Sometimes, we can catch things early, we can make changes, we can learn techniques. But sometimes it is too late. Sometimes it is too much for us to bear alone. Sometimes the issues are much more complex.
In theory, if everyone experiencing mild or moderate mental health issues is helped to self-manage better, helped to access medication or short-term support, then their issues will not deteriorate and become “severe”, and things might free up down the line. Though those being trained to deal with those quick fix interventions are not going to be qualified to help in more complex cases, and it is no good telling those with severe mental health needs now that things will get better in 10 years time.
It is not a simple picture. More money, more people, and a wholly different system approach are needed to even scratch the surface. I do still think the more we can do to support each other at all points along the way, in work and in the community, is worth doing – if only to provide comfort through dark days, and help us to remember we are not alone.