Good mental health and wellbeing is now seen as an essential part of a well-functioning society and economy. There is greater awareness of the impacts of poor mental health on the lives of people, their families and communities. We also have a better understanding of the many social, economic and environmental factors that can adversely affect mental health and wellbeing. This openness is to be welcomed. It has focused minds on the need for action so we can all live fulfilling lives and feel able to cope with the challenges life can throw at us.
So far so good….. but we all know that despite our good intentions people experiencing mental health problems cannot get the support they need when they need it. Too many people feel unsupported, abandoned and isolated and our society is missing their valuable contribution as citizens.
However, when we start to talk about solutions we seem to favour one part of our available toolkit. Most of the discussion is about increasing access to existing NHS mental health services. These services were unable to meet demand before Covid and continue to struggle. It’s time to recognise that the NHS is one part of a much wider picture.
What is missing is an honest and open conversation about what we can do to support people for as long as they need it. This is where the contribution of people living with mental health problems becomes crucial. Our work shows that when we ask people what helped them they talk about family, friends, community, structure and getting control back over their lives. This is echoed across the country and backed up by robust research. An international study looking at what people said helped their recovery emphasised five key factors (CHIME):
Connections – good relationships, community networks, peer support
Hope and optimism – knowing that things will get better
Identity – positive sense of self rather than being defined by mental health diagnosis or problem
Meaning – having structure, doing things that matter to us, contributing to our families, communities and society
Empowerment – having control over our lives and believing in our strengths
Why don’t we use this insightful lived experience to design a mental health system which walks alongside people on their recovery journey?
We know change isn’t easy but we are not starting from scratch. There are many great examples of good recovery focused approaches that we can build on. This includes the Distress Brief Intervention initiative expanded during Covid, link workers or community connectors, peer support services and groups and recovery learning approaches.
Many of these are the result of innovation in the third sector informed and shaped by lived experience. Rebalancing our system to recognise the valuable role of the third sector and lived experience as well as the NHS will result in a more accessible, joined up approach that helps people find their own solutions and supports them in a person-centred way.
There will be many challenges ahead for us as individuals and for our mental health services and supports. However something that has emerged from the recent difficult period is that change is possible and often very positive. Let’s learn from the resourcefulness, innovation and adaptation over the past 18 months to create a mental health system that values and nurtures the NHS, third sector and lived experience.
Together we can ensure that people can get the support they need, when and where they need it.
Together we can make mental health recovery real for everyone.
This article was sponsored by the Scottish Recovery Network.
Leamy, M et al, Conceptual framework for personal recovery in mental health: systematic review and narrative synthesis; BJP 2011, 199:445-452.
