Sunday, 14 May 2017

A growing awareness of mental health issues

I think of my Father as being a wise man. Of course this may well only be true in the Cartesian sense of ‘I think, therefore I am’. He is however practiced in the use of Socratic Questioning something he’s helpfully challenged me with all my life. Socrates believed that questioning was the only real form of effective teaching. He believed that it could help students to explore what it is they know and not know and that the space created (new knowledge) was the place of greatest learning. I and my long-time collaborator and wonderful friend Sue, developed a slight twist on these ideas in our own thinking and writing. We believe that the space between knowledge and knowing (that is) not knowing, is where the greatest learning can occur.

Socratic questioning allows all the information available in a current situation to be gathered, and connected to prior knowledge in a thoughtful way so as to create new understandings. As I have told my students many times, I can teach you the signs and symptoms of a heart attack, and I can provide you with the knowledge of how to treat that condition. What I can’t teach you is how the individual might be experiencing that heart attack – that is the ‘not knowing’ and an opportunity to create new knowledge. As my friend Jane and lover of all things French might say – je doute, donc je pense, donc je suis– I doubt, therefore I think, therefore I am – and in the example above, I am a person-centred nurse.

Interestingly in mental health care, Socratic questioning underpins some therapies – mainly in therapies such a Cognitive Behavioural Therapy (CBT). It is enables a reframing of negative thought cycles. Our thinking about a certain situation will affect the way we feel, both physically and emotionally and how we act in response. Unlike other talking therapies, CBT deals with the here and now’ and doesn't  start by exploring the past. The evidence shows that CBT is very effective in treating anxiety and depression.  

Last week was Mental Health Awareness Week, an annual event that has been celebrated since 1990. Every year a different theme is used to explore mental health care and how people might experience mental health problems. This year the focus wasn’t so much on surviving mental health problems as in finding ways in which we can thrive and enjoy good mental health. On social media, my #earlyrisersclub friend (and Head of Public Health Commissioning at NHS England) Kenny, shone like a beacon in raising awareness and promoting approaches we can consider in order to achieve and maintain good mental health.

It would seem that in the UK very few of us report living with high levels of good mental health. Indeed it is estimated that 1 in 6 people will have experienced a common mental health problem last week. And if you are female; a young adult; living on a low income; living alone (or in a large household), the risks of experiencing mental health problems are significantly higher than for other folk. Poor mental health is an international issue. Mental health problems are one of the major causes of disability worldwide, with the predominant mental health problems being depression, anxiety, schizophrenia and bipolar disorders. The awareness raising information showed that there is much we can do to keep ourselves mentally healthy, increase our wellbeing and when our resilience is too challenged, there are many interventions available to help recovery. These range from medication through to talking therapies such a CBT. Hopefully, you will also now know some of this information. 

As a Professor of mental health care for the last 11 years, and a mental health nurse lecturer and practitioner before that for some 30 years, I was also aware of these facts, but I was quiet during Mental Health Awareness Week, and I am sorry that I was. I know from experience, that my voice can make a difference. And yet even with all my knowledge and experience it has taken a while to know something wasn’t quite right in my world. Over the past 6 months my usual energy has melted away, I’ve lost interest in many of things I’ve enjoyed doing, my mood has often felt low, I've become easily irritated, had no appetite and sleep was an elusive memory. It was becoming increasingly difficult to concentrate and my self-esteem was at an all-time low. But I've kept on smiling.

So last week when the tears that had so often fallen silently during the darkness of night started to fall in the sunshine of the day, I realised I had to stop my ‘watchful waiting’ and do something about the black cloak of depression that was wrapped so tightly around me. For me the first step was to acknowledge that there was something wrong. I have some good friends and I have told them, I’m telling you dear reader, and I will talk to my GP next week. And with W, my lovely wife, best friend, and tear catcher alongside, I am sure it will be easier now to find my pathway back to thriving rather than simply surviving.