Re-imagine mental health care: we can all make a difference

This time 5 years ago I was sitting by a swimming pool in a hotel in Singapore. John Lennon, if he hadn’t been murdered, would have been 75 years old. This weekend, it’s his 80th birthday we are celebrating. It’s been great to hear once more the stories of what he lived for, promoting peace, love and understanding. His music is still played and enjoyed today. As a teenager, alongside Leonard Cohen and Keith Richards, John Lennon was one of my absolute heroes.

But back to Singapore. Not literately obviously, although given the awful weather, I wouldn’t mind some of their heat. I had flown into Singapore from Brisbane, Australia, having just attended the 41st International Mental Health Nursing Conference. It was a conference I had supported every year since 2001. However, it was the first time I had been back there since 2007 for reasons you can read about here in the blog I posted at that time. Sitting by the swimming pool in Singapore? Well I was there there with my co-author, friend and hopefully, my best woman, Professor Sue McAndrew, and had no idea as what I might focus that week’s blog on. I asked her if she had any ideas and, in a flash, she said ‘well it is World Mental Health Day, write something about that’. So, I did. And as yesterday was World Mental Health Day, I will again.

World Mental Health Day is celebrated internationally on the 10th October. Every year it considers a particular theme. This year the theme is ‘mental health for all’. In the year of the Covid19 pandemic, this couldn’t be a more appropriate area to focus upon. Most healthcare professionals have faced unprecedented challenges. Often working in conditions that will have been difficult, exhausting, and at times I’m sure, scary. Many will have dealt with seeing more people die than they might have ever encountered before. Some of those who died will have been colleagues they worked with as team members. There have been many stories of nurses and others being there for patients at the end of their life. They provided care and a presence when nobody else could or was allowed to. These are all factors that can have an impact upon an individual’s mental health and wellbeing.

Organisations have recognised and responded to these factors. We have seen the development of ‘wobble rooms’, free car parking, increased flexible working, psychological support apps, the provision of free food and drink and so on. See here for examples, and I have to say, I have taken the ‘on a go slow’ day to heart. All of which have been welcome and have helped. But nobody yet understands what the long term effect might be of working through such a challenging time. Stories are already emerging of the anxiety and depression many healthcare professionals are experiencing, both from meeting the challenges of the past six months and in anticipation of a difficult winter ahead of them.

Perhaps understandably, the focus has been primarily on those working in our acute hospitals, care homes and in the community. In some ways they were in the front line of dealing with the pandemic. But of course, there were other health care professionals, who were also working and providing treatment and care to others. These were those working in mental health services. Arguably, mental health services have long been thought of as the Cinderella of health care. Chronic underinvestment in mental health services has been a longstanding issue in the UK. There have been recent calls to increase the funding for mental health care. Indeed, the Department of Health and Social Care acknowledged what was required to achieve this as set out in the NHS England’s report, the Five Year Forward Plan, and funded an improvement programme.  

However, the pandemic disrupted the good progress made over the past few years. Sadly, that wasn’t all. Many mental health services were ill equipped to deal with the infection control and prevention measures required to keep people safe and cared for at the start of the pandemic. The restrictions on social contact (and visitors) had an impact on the therapeutic nature of care, and of course, would have increased stress for both staff and patients.

The pandemic has also brought to the fore the need to find new ways to address the growing mental health needs of the wider population. It is safe to say we all experienced a deterioration in our wellbeing as the Covid19 lockdown impacted upon our everyday lives. I know that it did for J and I. We like eating out and hosting dinner parties, both of which were curtailed. J missed leading her new team in person. Despite MS Teams and Zoom meetings, there was a real sense of isolation. And we couldn’t get married either, after months of anticipation and planning. I would argue that the mental health and wellbeing of the population is one of the greatest public health challenges facing our communities today. Preventive approaches will be the cornerstone to achieving this.

The good work developed in schools with children and young people is a great starting point. It helps teach the next generation what they can do to develop their resilience, and reduces the stigma associated with mental illness. There is much more to do with people of all ages, however. One of the positive things I take as a Non-Executive Director working in two acute Trusts, and being a Professor Emeritus in mental health care, is the opportunity to look for ways that I can do just this. But you don’t need to be a professor to make a difference to the wellbeing of others – everyone can do something.

Perhaps we should leave the last words to John Lennon:

You may say I’m a dreamer

But I’m not the only one

I hope someday you will join us

And the world will be as one

Imagine all the people

Living life in peace