As a community we must continue to work towards a place where mental health is considered equal to physical health, writes Consultant Psychiatrist Dr Dominic Bishop.
"All this week our colleagues and partners across the Bailiwick will be sharing resources and stories to raise awareness of mental health issues and their impact on individuals along with their families, friends and work colleagues.
For those who work in mental health services, every week is Mental Health Awareness week. I work with a team of 255 dedicated mental health professionals from different disciplines and we work with around 1,850 service users split between Child and Adolescent Mental Health Services and Adult/Older Adult Mental Health Services.
It is important to have a shared understanding of what “mental health” actually means. Mental health is the emotional and spiritual resilience which enables us to enjoy life and survive pain, disappointment and sadness. It is a positive sense of wellbeing and an underlying belief in our own and other’s dignity and worth.
We all have mental health, just like we all have physical health. It is the job of our service to provide support and care to those with mental illness. It is the responsibility of all individuals and their community at every level to support and promote good mental health.
We must be mindful that life is full of stresses, strains and indeed levels of trauma which are part of normal human existence and to medicalise all of these into illness does not create a healthy, resilient, functioning population.
For those under the care of our HSC services, our level and length of contact with individuals is dependent upon their specific needs. This ranges from those seen frequently perhaps for many years, to those seen for a short-term, focussed piece of support work.
We always aim to provide services in the least restrictive and most acceptable manner, working with individuals and those who provide care and support to them. For the majority of cases, this will be in a community setting and in a collaborative manner. For us, helping people live independent lives is one of our core principles.
However, there are circumstances, when individuals will need to spend periods of time in our care, perhaps on our mental health wards when this level of care is appropriate. This is dependent upon severity of illness and if there are risks identified to someone’s health, safety or the safety of others. At the most severe end, this can include periods of detention under Mental Health Law, if the individual does not or is not able to agree to the admission. Admissions are kept to the minimum possible length to support people to live their lives, if possible, within the community.
For the majority of individuals working within mental health services, it is a true vocation but the complexity, difficulty and pressure of providing mental health services should not be underestimated.
This includes the challenge of managing services and setting effective mental health policy which must balance protecting the safety of the individuals and the community, but also the autonomy and rights of our most vulnerable citizens.
Stigma has reduced and there are now more open conversations about mental health, but, although this is a broadly positive trend, it can sometimes create confusion. Although many people understand mental health as it involves normal human experiences, the assessment, treatment and management of major mental illness is complex and requires specialist services and practitioners.
As a community, we must continue to work towards a place where mental health is considered equal to physical health. This includes us all taking responsibility for our own mental and physical health, seeking and giving support to each other and being confident to approach services when additional care and support is needed.
For those of us who work within HSC it is an area of work that is directed by States policy and strategy and it is delivered in partnership with others across our community. The key to our success is this partnership working, which involves colleagues in both Primary and Secondary Care, as well as with key organisations within the community.
Supporting good mental health is a whole Bailiwick responsibility and HSC recognises that its services are just one part of a complex jigsaw. We can see this in the Mental Health and Wellbeing Plan Mental Health and Wellbeing Plan - States of Guernsey (gov.gg) and the diagram below which shows the pyramid of needs and services collectively provided.
Awareness, Information, Access
Step 1: Universal Interventions
Individuals, family and friends, GP, Public Health, Third Sector, schools, employers, community services
Step 2: Guided self-management, brief talking therapies
Step 3: Medication, complex talking therapies, social support
Step 4: Community Outreach
Step 5: Intensive support Third sector, specialist mental health services
If you are struggling:
o Talk to someone you trust who might be able to help
o Contact your GP and explain you require an urgent appointment
o If already under the care of HSC services, contact your key worker.
o Contact the Samaritans either by their 24hr free and confidential helpline on
116 123 or email firstname.lastname@example.org or visit the website: http://www.samaritans.org
o If you are concerned you might harm yourself or someone else, phone the emergency services or take yourself to the emergency department.
Our team of dedicated staff provide care to some of the most vulnerable members of our community. We try to continuously review and improve what we deliver but we know that we don’t always get everything right. In fact, a brief look on various social media accounts in the Bailiwick might give the impression that we never get things right. I can honestly say on behalf of all my staff that this is not the case but will continue to work hard to improve the services we offer.
We also need to understand that sometimes, as with physical health conditions, and despite the best efforts of everyone, there can be tragic outcomes.
So, at the start of Mental Health Awareness Week, I would like to ask you all to take a moment to think about the people across our community who are working hard to manage their mental health issues. Imagine how exhausting it might be to battle with negative thoughts each day whilst trying to function in the community, hold down a job, go to school, care for children etc.
Think about the staff and teams throughout the Bailiwick (not just HSC) who work with our most vulnerable and stand side by side with them as they go through their treatment journey. And lastly, think about what you could do to improve your awareness and understanding of mental health or mental wellbeing issues. You never know, that knowledge might come in handy one day personally or for family or friends. Some understanding and support from you might immediately improve someone’s day, and ultimately their life.
This time last year Guernsey was in the grip of wave one of Covid-19 and I was part of the panel for one of the media briefings. To end, I would like to repeat what I said last year:
'Every day should be Mental Health Awareness Day and kindness should be compulsory'"
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