'Key relationships with at least one caregiver are as important as the air that we breathe'

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By Dr Patricia Tumelty

THE popular Happy Valley drama series is an extreme but realistic illustration of how key relationships with at least one caregiver are as important as the air we breathe. The portrayal of the life Tommy Lee had compared to that of his son Ryan was an almost perfect storyline of what a child can be and attain despite traumatic experiences, provided there is at least one person always rooting for them – in this case Ryan’s gran.

The increased demand for our services and diminishing resources, pandemic recovery and cost-of-living crisis, are all combining to make working in mental health a challenge right now for all involved. In such circumstances it would be all too easy to stop rooting for the people who need us most. As we continue to move through these challenges it’s important that front-line workers are trained and supported to be able to listen and learn from people young and old who need us to root for them.

Last year, Mind Jersey supported over 2,000 people aged between seven and 92 years. Some people who cross our paths just need reassurance that what they are experiencing is normal and they go away with a spring in their step and a few tips to manage anxiety or low mood. Others have much more severe and enduring mental-health challenges that are shaping the way they are thinking, feeling and behaving towards a particular event, person, life, work and family. For some, the trauma or incident may be reactive to some change-in-life circumstances and for others it may be far deeper rooted and complex and need more expert support and treatment.

As in Ryan’s case, some trauma stories are connected to fractured attachments with key caregivers. The influential psychologist J. Bowlby described attachment as the lasting psychological connectedness between human beings. Bowlby was particularly focused on understanding the impact of anxiety and distress experienced by children when the bond of attachment is interrupted by separation from a caregiver. This is an important distinction as not everyone who experiences trauma goes on to experience tragic consequences. However, some people who have experienced a major trauma, and who do not get the appropriate support or treatment, may go on to manifest their trauma in different ways. Sometimes this may mean people coming before the courts for violence or addiction-related crimes or having a crisis or acute mental-health breakdown.

Nearly six years since the Independent Jersey Care Inquiry, it would be interesting to know how all of us delivering front-line services are doing in identifying and putting in place the right support at the right time for people telling us and trusting us with their stories. Opening our new drop-in centre next to the St Helier Town hall was part of Mind Jersey’s ambition to increase and support access to mental-health services for people who may otherwise miss out. Daily at the drop-in centre, we witness how people who have had similar mental-health challenges are often best placed to help others manage. Others need more specific support, and we are now better able to help them link with the newly designed adult mental-health services.

We know from the recent insightful reports released by the public health service that we need to work more closely with public health and think again about so-called social determinants of poor health. It’s heartening to read that finally the impact of poor housing, the lack of meaningful employment, the lack of cash to have a hobby or consume a healthy diet is now appearing alongside narratives of blame, exclusion and poor lifestyle choices.

We also know that the complex transformation of health and social care involves addressing waiting lists for people needing physical procedures, but at Mind Jersey we also need to keep on the agenda the waiting lists for mental-health services and to get quicker access to the right help for people with enduring mental illness.

We look forward to working with the public sector and other voluntary sector colleagues in developing a mental-health strategy that focuses on addressing inequalities in health. We are encouraged by the government-supported community initiatives in creating an environment where communities decide for themselves what needs to change and how best to do this, free from the oppression of experts.

Ongoing shaping of mental-health support will no doubt involve extensive debates and desire to balance the books within the charity space and public sector. We will continue to campaign to ensure it also involves sustained investment in high-quality person-centred support for mental health and social care services. We will argue that a percentage of spend always needs to be dedicated to preventative mental-health interventions, working with, and developing alongside, people who are more likely to experience a mental-health difficulty.

We will continue to campaign because, despite all the media attention to mental health, the people with the highest level of need are still not getting the support they need and the level of stigma is still harmful. We will continue to be more ambitious for people and their families who are negatively impacted by long-term mental-health problems, and we will keep rooting for them. We need to be standing up with communities, not standing up for communities.

  • Patricia is executive director at Mindjersey and can be contacted at P.tumelty@mindjersey.org

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