Amy and Aryeh are two of the Centre’s Community Connectors. They work in Tower Hamlets as part of the Centre’s social prescribing team and are funded by East London NHS Foundation Trust. Here they talk all things mental health and how they support people to access the vital services they need.
1. Do you think people today have a better understanding of mental health and is there still a stigma that prevents some people from seeking help?
Awareness is improving in many ways because more people are speaking opening about mental health and sharing issues in broadcast and social media. This is particularly true of younger people. In our work, we still come across a lot of confusion about what mental health is and where to seek help, yet 1 in 4 people will experience a mental health problem each year according to Mind.
During our daily work in East London, we see a lot of variation in different cultural and religious backgrounds. In some groups, mental ill health can be viewed as a weakness, particularly for men and this inhibits a lot of people seeking the help they need. There is still too much shame around mental health and we need to keep talking and normalising it to reduce this, including in the workplace. People are entitled to statutory sick pay for mental health conditions but very few people are aware of this and many are still scared to tell their employer they are struggling.
Many people have difficulty relating to mental ill health in others, simply because they can’t see it the way they can see a physical health problem, and yet it will affect us all at some point. Overall, progress is being made but there’s still a long way to go. Mental health needs to be normalised.
2. Are mental health issues on the increase or is it because we are talking about it more?
Definitely on the increase but awareness is also helping more people come forward for help. There are a range of interrelated factors that impact our mental health. Some people have a biological or genetic disposition and a long term diagnosis that needs managing. Others may be dealing with trauma or just trying to cope with their difficult daily lives but most issues are interlinked and interwoven. The causes of mental ill health are often complex.
What we’re seeing is a huge increase in social and economic problems that cause people to become mentally unwell; insecure housing conditions, money worries, rising costs and energy bills and family breakdown. We meet many people who simply don’t have enough to live on. It would make any of us anxious and depressed and fearful for the future.
Undoubtedly the pandemic has had a traumatic effect on people’s lives and it is far from over for many. We find many people are still very anxious about engaging fully with the world and have become isolated. They need a lot of compassion and encouragement to help build their confidence and start connecting with others again.
3. Mental Health Awareness Week this year is focused on loneliness. Is this a big factor in mental ill health?
Loneliness has a really big influence on our mental health. Human beings are social creatures and yet with a more fragmented society, isolation is becoming much more common. Researchers suggest that loneliness has the equivalent effect of smoking 15 cigarettes a day on our health and that people are more likely to die prematurely than those with healthy social connections.
It is very normal to want to stay at home and away from the world when you are experiencing depression, anxiety or low mood. Getting out and being with people again feels counter-intuitive but it’s really important, even if it’s just a short walk and a hello to the local shopkeeper. It makes more of a difference than we all realise.
We work hard to support people to connect again. It’s often the hardest step. Once they’ve faced their fears and done it, they will often start to engage more regularly and this forms part of their recovery and helps alleviate the loneliness that contributed to their mood.
4. Do you think there are enough services for people who want support with their mental health?
Mental ill health has really become a public health crisis and, let’s be honest, there are huge societal problems in play that make people unwell. Many more people need support but find it hard to access talking therapies without a long waiting list and most can’t afford private fees. Doctors are able to prescribe a variety of medications which are helpful to many and the growth in self-care apps can be helpful to some but they rarely address the underlying issues from someone’s background and living conditions.
If people are accruing debt or about to be evicted, we link them with as much crisis support as we can to address these urgent problems. At least half of all people referred to us have some sort of social welfare issue and these have to be addressed first before we can start helping them find other ways to improve their mental health. If you’re worried sick you can’t think clearly.
5. How do you, as community connectors, support people who are experiencing mental ill health?
People come to us in a number of ways, referral from GP practices or hospital settings plus through other services. We work in close collaboration with our health colleagues as part of a team. At the Centre we have a variety of support services to refer people to, including Bow Food Bank, energy and benefits advice, employment support, groups and activities so we can support the whole person.
First of all, we take time to listen to people and understand the interwoven elements of their life that are impacting their mental health. Many people who come to us are struggling to cope and feel overwhelmed so we help them break things down into manageable chucks. This in itself helps alleviate panic and anxiety and helps people identify their next steps.
There is flexibility in the way we work which is important. Some people may need one session and to be connected with an appropriate community service, others will need far more support. Mental ill health affects every aspect of a person’s life and we try to work holistically with these.
Far too many people with mental ill health are ‘bounced around’ the system, trying to find the help they need and we provide a safe, compassionate space. It really helps people to know someone is on their side and to be able to come to a safe place.
We help people understand that their reactions are completely understandable. If they feel like they can’t go on and feel like ending their life, we talk about it and get it out in the open in a non-judgemental space. How we respond is important and by sharing distress, people can find ways to feel understood and find ways take steps forward until their situation improves. Of course safeguarding processes are always in place and as community connectors we have regular clinical supervision and peer-support for our own self-care and reflective practice.
6. What type of support do you connect people with and is there enough out there?
It depends on the person and what they are dealing with and how ready they are to engage. Sometimes we will work with them individually for a while to help build trust and confidence. If the person is in a housing or financial crisis we help them access help as soon as possible. Without addressing those essential needs, we won’t be able to support them with other issues such as finding work, linking with others or becoming more physically active which has a positive impact on mental health.
We try to link people with groups as much as we can whether it’s for energy advice, mindfulness or talking about their mental health. Realising that others are dealing with similar issues helps people feel less alone and expressing themselves to the group can help people feel validated.
Part of our role is becoming skilled at navigation of services in the local community but the right services are becoming harder to find due to cuts. For instance, many statutory services have no culturally specific services in an area as diverse as ours! There is no such thing as one size fits all. In many public services there is still a power imbalance with people being told what to do rather than working to develop a solution together. People need to feel part of their own care and recovery and then they are more likely to engage with services that have meaning for them.
Something we’re aware of is funding periods for services are becoming shorter. Short term funding for mental health support is unhelpful and can be damaging. It means that people start to open up, find support and meaning in their lives and then the service stops and leaves them vulnerable and unsupported. People’s issues don’t just stop in the same way.
7. Do you feel you can do anything to help prevent people becoming unwell in the first place?
Let’s be honest, investment in preventative care is at an all-time low and there’s so much that is needed in this arena. For instance, we are working in schools to help educate young people around mental health and how to seek support but there is so much more that could be done.
We are very lucky at the Centre because of its long history of working in an integrated way between the charity hub and local health practices and partners. This means that GPs and other healthcare professionals have a whole host of services on site to link people with because physical and mental health is primarily driven by social factors, not just medical ones. Medicine for some mental health conditions is essential but longer term, it’s about building a more meaningful life with personal connections that help prevent or mitigate further crisis.
Community Connectors are funded by East London NHS Foundation Trust and are part of the national Community Mental Health Transformation programme within the NHS. The programme aims to achieve greater positive impact on the health and lives of people, groups and communities living with mental ill-health.