What I’ve learned from working in mental health

Professional Social Work magazine - 31 October, 2020

Two years ago I made the decision to leave the arts sector to train to become a mental health social worker with Think Ahead.

It was a career move that didn’t make much sense to some people I knew at the time. If I’m being honest, life was pretty comfortable and a typical day included visiting art galleries, talking to music organisations or planning events at YouTube headquarters. Cushy, fun and everything I wanted my early 20s to be.

When I told those around me I was leaving to go into the field of mental health, I was met with mixed responses:

“You’re going to work in mental health? Isn’t that going to be…scary?”

“Just so you know, it’s going to be really hard, you’ll never get any credit for the work you do and it doesn’t get enough funding.”

“You’re going to work with people with mental issues? Wow, it’s amazing but… I could never do that.”

It highlighted a host of stigmas about mental health and the way society views professions in the field.  Something to be feared and marginalised. Something at the bottom of Government agenda.

Despite this, I knew that everyone has mental health in the same way everyone has physical health. If someone had a broken leg, it is visible and everyone can see that person going through pain. They might receive flowers from colleagues or get given a seat on public transport.

However, if someone experiences difficulty with their mental health, it is a silent battle. If they have the courage to disclose their struggles, it could be met with a lifelong label of rejection should others not understand.

One in four people in the UK will experience an issue with their mental health at some point in their life, so the likelihood of you or someone you know needing professional help is not as distant as it may seem. These factors inspired me to pursue a career in mental health.

The reality is that life is full of peaks and valleys, and the mind reacts to different events in different ways. There is no guarantee that anyone is immune to experiencing difficulties with their mental health. We all need to be aware of our wellbeing and grant it the same respect that we do with our physical health.

I don’t like inequality, I love seeing people flourish, and wanted a career that would push me to keep challenging myself and learning. There is no 'arrival point' of knowledge when it comes to working with people. When you're in the business of human beings every day is different and it's the unpredictability of growth that keeps things stimulating.

Two years on now, and I am a qualified mental health professional with a Masters specialising in Systemic Practice with Couples and Families. Far beyond getting good grades or recognition as part of a professional body, entering this kind of work has been the most humbling experience and one I’m still learning from every day.

Here is my list of what I have learnt from the people I have the honour of working for. It is personal to me and not definitive as it grows every day:

1. People are expert by experience

No professional, scientific research or Google search result can tell someone their exact experience. If you or someone you know is struggling with their mental health, please remember your experience is valid. Your story matters. Your voice is important and should be central to any help you receive.

Professionals should have the humility to learn from you as the expert of your experience. Some of the best (what I call) ‘sparkling moments’ have happened in my work after I have had the chance to fully listen to someone long before I even open my mouth to talk.

Often the stories people share show that humans are incredibly resilient and have strengths they sometimes don’t even see in themselves. Understanding what works best for you should be the building blocks for creating better mental health.

Give yourself time to reflect on what the experience is like specifically for you. Depression, anxiety (or any other diagnoses), does not look the same on everyone.

2. Attachment styles are important… but not that important

As said, I did my Masters’ specialising on techniques for working with families and couples. A lot of this work draws upon the importance of attachment styles.

Attachment Theory claims that the way you attach to other adults strongly corresponds with how you attached to others as a child. Four distinct styles of attachment have been identified and recognizing yourself in one of them has been suggested as the first step toward strengthening your relationships. Understanding attachment is useful for understanding mental health and your relationships with others because it may highlight why certain scenarios are triggering in your adult life.

However, I have learnt that identifying with one particular attachment style it is not the be-all and end-all. Humans are always evolving and reactive to their situations. ‘Attachment’ is actually more dynamic than four categories and can be like a dance in response to the behaviours of others (i.e. someone being avoidant can cause someone to be clingier and display more ‘preoccupied’ attachment). It is dynamic. If you identify with an attachment style other than ‘secure’, you are not odd, tarnished, or ‘weak’.

As a beautiful human being, you have the capacity to keep growing. It is possible to change every day to become more resilient with your attachments and mental health.

3) Diagnosis is not the end

Receiving a mental health diagnosis can be a welcomed relief for some, and a burdensome sentence for others. It is important to refer to point number one on my list and remember that a diagnosis is not your story. If you have been given a diagnosis of ‘PTSD’ for example, you as an individual are not PTSD, PTSD is something you experience but the label does not define you.

4) Compassion counts

Have compassion on yourself on the days that you don’t feel your best if you are struggling with your mental health. If you’re feeling tired, remember, thinking and feeling can be exhausting so don’t be hard on yourself for not feeling productive.

Have the same compassion on yourself as you would a child. If a child were upset and crying because they felt upset you would not tell it spiteful words, so try to speak to yourself with kindness.

The same goes for a someone you may know that is struggling at the moment, but remember, silent struggles are not always visible so: ‘Be kind, for everyone you meet is fighting a hard battle’

5) Stigma is strong. Challenge it in yourself and challenge it when you see it

Despite October being the month for World Mental Health Day, it is also the month of Halloween for those that celebrate it. Every year there are uncomfortable costumes that only further stigmatise mental health.

In recent years, a number of retailers have sold ‘mental patient’ costumes, complete with bloody clothing, strait-jackets and face masks. In 2013, Asda and Tesco were forced to withdraw ‘mental patient’ costumes after customers complained. I love scary films and recently watched Halloween on Netflix but realised that a lot of horror genre films fetishize mental health which only adds to negative stigma.

Stigma around various diagnoses is also strong. For example, ‘personality disorder’ as a diagnosis is controversial and is subject to lots of misconceptions that can make individuals feel like there is something inherently wrong with who they are.

Be aware of your language and critical of the way mental health is represented in society. Empathy is an important step for understanding another person’s journey.

6) Society and social networks matter

Stigmas come from society, and society is built up of the institutions and people you have around you. Social isolation has long been known as a key trigger for mental illness, while supportive relationships with friends, family and neighbours are beneficial to the mental health of individuals and the population.

In a year like 2020, all of us have understood the importance of connection so try to make it a habit to reach out to each other and ‘check in’.

7) Treat trauma with gentleness

There are many different ways people can experience individual or collective trauma. It is important to remember that trauma is relative to the person’s experiences and values so should be treated with gentleness.

For example, I could say that in 2020 there have various collective ‘traumas’ such as the mass loss of life due to coronavirus, the struggles of the black community during Black Lives Matter protests, uncertainty about the future economy or political controversy. Maybe all of these things are equally distressing, or maybe one stands out more than another. This is relative to your values and your personal experience.

A study by Boals Journal of Psychotherapy Integration (2018) underscores the finding that the experience of trauma is in the eye of the beholder. It found that only 37 per cent of objectively traumatic events were experienced as subjectively traumatic.

So be careful if someone discloses something that they perceive as traumatic that you may not. Different people experience grief, divorce, becoming a parent or changing to a new job differently.

It is not always possible to anticipate someone’s triggers but we can be aware of this complexity and kind to one another.

8) Therapy is for everyone. And I mean everyone

It is a common stigma that you must have something wrong with you in order to go to therapy. Your mental health has to be really bad, there must have been some kind of life tragedy, someone must have done something terribly wrong to you, your relationship is on the brink of breaking up or therapy is for women to speak about their emotions and not for men.

Wrong.

Healthy bodies are maintained with physical health with exercise and correct nutrition.

Healthy minds are maintained with dedicated time for personal growth and self-reflection.

In the same way optimal results may be achieved with a personal trainer, nutritionist or physician that understands the human body. Optimal results can be achieved with a qualified therapist that understands the human mind.

I appreciate and acknowledge there can be practical barriers to accessing therapy such as finances, waiting lists, time or compatibility with current lifestyle, but if this is something that appeals to you I encourage you to have a look at some of the resources I have included at the bottom of this article.

Access to therapy is changing and it is worth it.

9) Anti-oppressive practice is something you should know about

‘Anti-oppressive practice’ is an approach primarily rooted in the practice of social work that focuses on ending socioeconomic oppression. It requires the practitioner to critically examine power imbalances to develop strategies for creating fair environments free from oppression, racism, and other forms of discrimination.

Although it is rooted in social work, it can be applied to all professional fields of mental health including psychotherapy or psychiatry, for example. We live in a society where unfortunately people’s class, age, gender, ethnicity or physical ability can open or close doors for you.

If you are experiencing issues with your mental health and seek professional advice, remember you have a right to ensure that any of your differences are not discriminated against.

10) It takes a village

It is important to seek professional advice about the best type of support for you, and there are various paths that may be recommended such as therapy or medication but often the best outcomes ‘take a village’.

It is a combination of beneficial things that will enhance your wellbeing. This varies from the support of professionals from a range of different backgrounds such as the medical approach, psychological approach and social approach) to activities that boost your self-esteem and your social networks.

11) Human dignity has the final say

Dignity and respect is at the heart of questions about mental health for me. It shapes how I relate to people as a professional and how I relate to friends and other fellow human beings that may be struggling.

It is also the marker for legal frameworks such as the Mental Health Act that shapes the way mental health processes are considered in the UK.

Your dignity matters, so does the dignity of others.

Being taken seriously at work and by professionals is a human right that should be respected as such.

Working in mental is an honour and I owe all the lessons I have learnt to the people I have had the chance to work with.

Mariah is a newly qualified social worker and blogger in south west London. Both her parents are mental health social workers. More of her writing can be read at www.riahwrites.com. Twitter: @riah_writes