Mental Health Assessments &why they need to change. (TeaTalks S01, E02)
& community conversations
When you feel invisible, worthless, without purpose or motivation they may over time seek, be persuaded or, in some cases, forced to seek medical help. For most of us (without huge disposable incomes), the process of seeking relief usually begins with your Doctor or your GP surgeries Registered Mental Health Nurse. Actually, on reflection, it's most likely to start with a very inquisitively quizzical Doctors receptionist.
The moment you take that step to seek help is both courageous whilst simultaneously filled with a feeling that can best be described as terror. You have this burden, this heavy pressure like rushing water a moment before the dam bursts. It takes every ounce of self to hold it back and appear normal, appear OK. That is just how it is for us as humans, we always try to act like things are much better for us than they seem.
You just want to get it off your back, out of your mind, away from your soul. You have been carrying this invisible black suffocating cloud for a long time, you're buckled at the knees and your soul is ragged and dragging on the floor behind you. Your stumbling through life trying to hold it all together, you just cannot carry it anymore, alone, invisible feeling abandoned without meaning, every nerve ending is frazzled to the point of raw.
You know what you need, you need to let the damn burst, cry, tell your story until you can feel yourself breathe again. To have someone tell you it is going to be OK again, someday. You know you need to talk to someone, someone that feels real, like they care deeply about your story, a person that listens with compassion, with intent with purpose. A person that really hears you and looks you in the eye. A cup of tea and a conversation, self-discovery through therapeutic exploration. We know this inherently as a species after all for millennia people have gathered around cups of tea and kitchen tables to share a story and heal each other through meaningful conversation.
Less Questions, More Conversations.
What (some) citizens of Blackpool say about Mental Health Assessments
Episode 2 of our TeaTalks & Community Conversations highlights the experience of 7 people who have accessed Mental Health Services as the point of contact via GP's. It doesn't fare well for the present system. “You say, seven people”? (yes 5 are off camera for identity reasons).
We followed this up by interviewing in person and on paper over 157 other citizens of Blackpool who have accessed Mental Health services via their GP surgeries over the last 18 months for particular symptoms of anxiety and depression. This is the most common set of illness in Blackpool today and has the biggest impact on our community well-being, finances and motivation.
The results for Blackpool
The Journal Project interviewed a total of 164 adults who had accessed support via their GP surgeries.
56% (91 people) experienced poor initial contact with the GP receptionist service.
Most reported feeling rushed, that the professional was only interested in them answering their list of questions and interrupted and deflected from their story. Further to this 21 of those (17% of the sample) reported no eye contact at all during the interrogation. 3 people even left half way through the assessment and only 1 of those 3 was followed up by the GP practice to see if they were OK. To add a further footnote 2 people reported the Mental health nurse as consistently getting their name wrong throughout leaving them feeling even less valued and indivisible.
100% (164) felt overwhelmed with questions that didn't allow for their story to be told in the way they needed to tell it.
89% (146 people) were immediately given prescriptions for antidepressants
After what is only a short assessment were, as you see, most report not being able to or allowed to tell their whole story. Instead, they are given chemicals for their mood that affect the brain and carry side effects even though no formal assessment by a registered psychologist or psychiatrist has been given.
25% (46 people) were offered some form of therapeutic intervention either as an alternative to or at a later point, in conjunction with medication.
Of these 46 people, only 32 were offered 1-2-1 counselling via the NHS but all had to self-refer. (The average mean time that they then found a second wind of strength to self-refer was between 3-5 months the longest being nearly two years). A few pioneering Doctors had referred patients (8 in total) to community services and charities that had specific one to one counselling services for their particular story (Interestingly this group both reported that their GP or MH Nurse had given them time, looked them in the eye put their pens and forms down and listened to their story.
100% (164) also reported interestingly that they did not tell the whole truth in their assessment
The assessment process did not help them feel safe or trusting.
They feared the consequences of honesty.
They worried about being judged wrongly.
They did not feel the questions asked were relevant or the right questions to be asked.
Of everyone we talked to, we asked the question “What would you do differently if you could change one thing?”. These are the solutions they offer from the coal face.
People prefer 1-2-1 Counselling or opportunity to talk and tell story
People wanted support to access their community
Nobody tells the truth at the assessment.
Mood Scales may need some attention.
It is important to make people feel visible.
Be kind, patient and help people feel valued and important to you
Get to know people, make eye contact, smile, make a cup of tea
Hear the story then make your assessment from this
Consider prescribing less pills, instead prescribe more opportunities
A little bit about Season 1 and our Conversations.
Journal's TeaTalks & Community Conversations is a process of generating and recording real honest conversations about peoples lives and the systems and communities they live with and within. Season One looks at peoples lived experience of Mental Health & Mental Health systems, the good, the bad and the solutions that may help shape and change things for the better. Season One has been filmed with Crafty B's a peer-led project set up by two ordinary citizens from Blackpool who after their own lived experiences decided they wanted to end isolation and loneliness over a cup of tea, laughter and some arty stuff. Season 1 has been filmed with Tracey & Sherri of Crafty B,s along with 5 other citizens (off camera) and many other citizens as an unexpected pop-up audience. A further 157 people have taken part in off-camera off audio conversations and surveys.