Mental Health Is More Than Self-Care: Four Ways We Can Improve Care Within Our Communities.

Our author today is Charli Skinner

Charli is an advocate for invisible and chronic illness. Here she writes about how mental health is more than self-care, and we must look to societal structures to help address the mental health epidemic we are facing now. Check out her website Www.charliskinner.com

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‘There is a reason why our minds don’t work properly in modern life’ (@mattzhaig)

If you’re unable to make a living, have a family to care for, and are overwhelmed by societal pressures how can you think twice about self-care? As we continue to catapult through an ever growing and more complex mental health crisis, we have to think about the forces throwing us into it. This is about more than isolation, lack of social connection and availability of spaces to open up and engage.

Mona Chalabi recently published a data visualisation on the number of daily meetings in 2019 vs. 2020, highlighting the illusion we are all living under that life has ‘slowed down’ since the pandemic. It actually showed that despite a shift to working from home/ remote working, that average hours spent on meetings, in the groups surveyed, went up. The concept of slowing down and time to ourselves is in many cases, a figment of our imagination. She also goes on to outline how ‘rest is a privilege’, not one many can afford. With the rhetoric of the importance of self-care, making time for rest, rest is productive etc. etc. surrounding mental health, we must remember these are freedoms not all have access to.

Mental health care is more than self-care, therapy and speaking out, but also about a competent and functional government; universal healthcare; access to readily available services that don’t take months to years of waiting: the Royal College of Psychiatrists found that two fifths of patients waiting for mental health services had to resort to emergency, or crisis services in 2020 - and that only covers the patients that get into the system in the first place.

"Mental health care is....access to unpolluted outdoor spaces for all"

Illustration by @howdoyoupeel

Mental health care is affordable housing; it is free travel to school for under 16s; it is free school meal vouchers that allow people the agency to choose according to their needs; wearing a mask out of respect for others’ and our own health; investing in creativity and the arts and diversifying the education curriculum; access to unpolluted outdoor spaces for all; collective living and community care; disability credit, universal credit and benefits that aren’t impossible to qualify for. Mental health care is people not having to hide their disability, gender, or any other status because it makes them more likely to be discriminated against. Mental health care is ending ableism and systemic racism for good.

"Disabled people have lived in a state much like the one the whole world is experiencing now, for years."

In times like these, it is clear we cannot rely on systems to provide a lot of the above. While this does not mean we should stop campaigning and fighting for a better future, in the meantime there is a lot we can do to facilitate better, more proactive and more effective care, that may eventually allow people more space to have the privilege of rest, speaking up and self-care. From a disability perspective, there are a lot of things I benefited from when I first became ill, that are the kinds of things that are being more readily adopted today, to help people cope with the strains and, in many cases, life-changing effects of the pandemic. And we need more of them.

Disabled people have lived in a state much like the one the whole world is experiencing now, for years. Whether they see themselves as activists or not, disabled people have adopted a not-so-radical approach to build mechanisms to address what is clearly an epidemic of mental health crises due to lack of access.

While all the care I received was on the NHS, that I had access to it and benefited from it as I did is a privilege. First, I am white and cis-gendered, giving me automatic privilege; Social Science and Medicine documented that ‘inequitable access, experiences, and outcomes continue to be documented for minority ethnic groups across a range of English NHS settings. Some contexts perform particularly badly, notably mental health’; second, I had the time and space to advocate for myself in the first place to receive the care I needed; third, I was referred with urgency to a nationally funded neuro-psychiatry service specialising in brain injury, the reason I had access to this?

Because I lived in a borough that qualified to be part of it. Fourth, I have a stable support network

Even still, while I was waiting to receive this care I had to search far and wide for other ways to treat my mental health. It was demoralising and led to a crisis point. What changed? I found and built a community around me of others going through the same thing: people who couldn’t access the care they needed in tbi (traumatic brain injury) and PCS (post concussion syndrome) recovery; people who understood the real-life concerns of loss of income due to disability and people who had lived experience of having to think outside the box to find a way to function in everyday society. It was the expertise, creativity and innovation of these people that got me where I am today.

So how can this be adopted elsewhere and what do we need more of?

1. Collective care - self care puts the onus on the individual, it also assumes capacity, ability and privilege to do so. Instead, we should move to a model of collective care. This does not mean to say people should not take time for themselves, but let’s think about how we frame our response to issues we are facing as a collective. If a capitalist, individualist, competitive system is what is leading to isolation and demise of mental health, then we should counter that - we must recognise that our health is inextricably linked with the structures and society around us.

2. Mutual aid groups - these are the kinds of groups that help people when they are in need through a sustainable and self-fulfilling model, an example would be a shared pantry for unwanted or not needed food for a local community or housing group; each household will at some point benefit from others’ participation.

3. Network, resource mapping, and information sharing - we must make the most of what we already have. So much exists out there that people do not know about

4. Accessible spaces, both financially and practically - not everyone has the time or money to travel to receive mental health or social care. We have seen a shift in a view of accessibility, while modern technology can be the root of isolation, it can also help us make care more accessible. Let’s focus on the benefit that it can bring to make change.

There are so many resources out there and so much that can be done to facilitate these things. While it is not the full solution, it is a place to start. Mental health care is fostering an environment, not just for us privileged, that does all the above before it’s too late.

To see more of Charli’s work at her website Www.charliskinner.com

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