I’m 58 years old and, to date, I have yet to experience a sustained mental health crisis or period of overwhelm; I feel blessed by my good fortune. Nonetheless, in my 30-plus years of work within the mental health system, I’ve tried to help and support numerous people who were suffering mental anguish and emotional turmoil. Based on what I’ve learnt from these interactions with highly distressed human beings, together with my awareness of the fundamental deficiencies within the traditional psychiatric system, I’ve asked myself: What sort of help would I want if I was to suffer a major mental health crisis?
Below I list 6 key elements of an optimal response to my distress and overwhelm.
1. Friends who I feel able to confide in
As my mood plummets and/or my confusion and psychic pain escalates, I feel able to speak openly about my problems to some family members, friends or work colleagues. My social network, and people in the wider community, already grasp the central idea that so-called mental health problems are merely normal human responses to difficult life circumstances; they no longer buy in to the idea that the primary cause of my crisis is some intrinsic brain aberration. As such, I don’t feel stigmatised by my emotional distress, and my associates experience no fear or reluctance to simply ‘be’ with me at this difficult period in my life.
2. Peer support
I’m immediately offered the opportunity to speak to someone who has had first-hand experience of living through a similar crisis to my own. This befriender has endured comparable emotional pain but has survived and reconnected with life, thereby conveying a hopeful message from the outset that things can and will get better for me. My peer supporter is available – via telephone and/or face-to-face – for as long I need them to be, allowing for the development of a trusting relationship with a familiar person.
3. Local crisis house
If the response from my social network and peer supporter is insufficient to contain my distress, and I feel unsafe and out of control, I’m offered instant access to a 24/7 safe house within my local community. Importantly, this crisis facility is not hospital based and provides a non-medical setting staffed by people displaying the core human qualities of genuineness, empathy, respect and compassion. A significant proportion of the supporters within the house have experienced mental health problems of their own and fully grasp what I am going through.
The crisis house provides a safe space for me to regain my equilibrium. The milieu is calming and not too risk averse; the close relationship with other human beings helps counter any self-destructive urges, so there’s no need for any bureaucratic risk assessments. The ongoing message is that I possess the resources and skills to find the solutions to my problems and others will devote their time and support to allow me to do so. I’m allowed time to recuperate, while always retaining the responsibility for my own actions.
Throughout my time in the crisis house, normalising language is used and I am not labelled or tagged with a ‘diagnosis’.
If I’m experiencing high levels of agitation and/or sleeplessness, I’m offered the opportunity to consider a short-term drug regime with a knowledgeable prescriber. As part of this process, I’m fully informed that psychotropic drugs do not offer a ‘cure’ – after all, I’m not suffering an ‘illness like any other’ – but will reduce arousal by creating an abnormal state of mind that might be preferable to the one I’m currently enduring.
In addition, the side-effects and dangers of long-term use are shared with me, both verbally and in written form. The decision as to whether to take psychotropic drugs is 100% my own; no pressure is placed on me to do so. Nor is there any suggestion that drugs represent a necessary component to my recovery.
5. Community links
Throughout my mental health crisis, and in the aftermath, I am encouraged and supported to maintain links with my friendship network, work base, and community leisure activities. Every effort is made to sustain me in the valued roles I enjoyed prior to my overwhelm. As I stabilise and gain in strength, I’m offered the opportunity to become a peer supporter for other people experiencing mental health problems.
6. Making sense of my experiences
If my mental health crises are re-occurring, I’m offered a menu of talking therapies as a means of enabling me to make sense of my experiences and to become an active participant in finding a sustainable resolution. The range of approaches on offer includes: person-centred counselling; cognitive behaviour therapy; psychodynamic approaches and systemic methods such as Open Dialogue. I’m provided with a concise overview of what each therapy involves so that I can make an informed choice about which is most likely to suit me.
In addition, I’m given the opportunity to develop a formulation, an individualised map of how my problems developed, what triggered their onset, and the factors that might be maintaining them.
So that’s my attempt to outline what I would consider an optimal response to a mental health crisis. What elements would you ideally like to see in the reaction to your distress and overwhelm?
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