It's coming to the end of Mental Health Awareness week and, quite rightly, there's been a lot of powerful stories of people living and surviving with mental illnesses. Many moons ago I was a mental health blogger and the difference in the way that these stories are able to be shared now is heartening and encouraging. We are now much more able, once we are in positions of relative security for the most part, to talk about the chronic conditions we live with or the acute experiences of the past.
In the communications arena, many charities are focused on stigma reduction and outreach - at getting those with mental health issues that are currently untreated or hidden to enter treatment pathways, either as part of their own offer or via health and wellbeing services. It can seem therefore, to the rest of us not directly associated, that there is not much that we can do beyond solidarity and signposting both of which can at times feel like empty gestures. Indeed, solidarity especially needs to be offered selflessly, and when no-one opens up to you despite your offers one has to remember that it is not about the offer itself.
Beyond outreach, however, the charity sector is well positioned to make the sorts of small, almost invisible changes that will make lives just that little bit better. Mental health, or rather mental illness, is embeded into the life of the sufferer, present throughout. For many it is a series of minor but continuous course changes in their daily travel which can add up to larger swerves, or be adjusted for as they come. Strict beaurocracies that do not allow space for these missteps cause us to falter further, while space held for us to recalibrate can ensure life continues as relatively normal.
The state often requires a strictness and a lack of deviation within its decision making, as money is accountable to systems rather than to people, but charities are able to work around the state's apparatus. It is here that the changes can be made, the adjustments held and the discretion used. I used to be the funds manager for an NHS charity, before they became famous. The question about NHS charities is often 'why do they exist' because the NHS itself is not a charity. There are a lot of reasons why they exist that I won't go into here, but in terms of what they are capable of I have one example that I'd like to share.
The hospital I worked at had a long-standing cash fund, administered and paid for by the Charity, which was available for social workers to use to buy bus tickets or items of food for patients who couldn't be discharged safely to their homes but were otherwise not in need of continued hospitalisation. This was something that the NHS Trust clearly could not pay for, and institutionally their only choice was to keep the patient in a hospital bed, at a vastly higher cost than the price of a bag of groceries. And so, we paid for it.
Whilst working with the social work team, who had had this arrangement in place for many years, they mentioned that the mental health team had a similar problem discharging people in A&E, and so we set up a scheme for them as well. It was a small change, but with possibility to make many lives just that little bit easier. From A&E staff who were not the right people to be treating these patients and had other things they needed to see to, to the patients themselves, able to make the small course correction they needed with the help of a team who understood them without being drawn into the instituionalised system of NHS MH care.
This is just one way in which we in this sector are able to complement the work of the state sector. The big gestures are great, but the small, incremental changes are worth everything. See the good that you can do, and then do it.