Social Perspectives on Mental Distress – promoting recovery
Duration: 8.53 mins
Speakers:
Interviewer, Colin Burbridge
Dr Jerry Tew, Institute of Applied Social Studies, University of Birmingham
I’d really like to talk about recovery now. How do you feel that your perspective can help to promote people’s recovery?
The first angle I think which is really important is for a lot of people, their recovery is about getting back into valued social roles of different sorts, whether it means getting back into work, whether it means taking a caring role, a relationship role, a role in the community, whatever, and that’s the bit that tends to get missed in a lot of mainstream mental health services and I think the social perspective is absolutely central in terms of finding out what is the social context that the person wants to live in and what are the barriers that may be in their way in terms of accessing those roles? And looking around for potential allies or change agents. So it’s not saying to the person that’s going through it ‘right, you’ve got to do all the work now’
Yes.
Recognising, going back to what we were saying about the social model of disability and so on. A lot of what needs to change is in the outside world, not in the person’s inner world and it’s about whether it’s challenging the attitude of the local college, whether it’s working with employers, whether it’s working with family or neighbours or whatever. It’s about saying who are the allies who can actually start to change things, so the doors start to open and people have a social life that is right for them.
Yeah.
The second area goes back to what we’ve just been talking about really which is, again for a lot of people, their recovery journey starts with a point where they have a way of understanding their distress that makes sense to them and puts them in some way or another in the driving seat, that they can actually do things for themselves. That gives them an opportunity to take charge of where they’re going and obviously that’s not a total thing, I mean there’s still areas of our lives where we haven’t got a clue what we’re doing but that glimmer of ‘I think I know it’s about this and this is where I’m going’. So if a social perspective is helpful in terms of enabling people to make those links, those connections between their distress experiences and where they are at the moment with things in the outside world that they relate to, that could be quite important for some people in terms of giving them control over the journey to think ‘ah, it’s not very nice but that’s one of the issues I’ve got to deal with and these may be the people that may be around me that will help me deal with that’ and that then starts to set somebody, give them the tools to move forward with their recovery.
That’s it. So what tools or strategies can carers give to people to help them on this journey do you feel that this model provides as well?
I think that goes back to the two points that I’ve just made really. Carers can be fantastic allies in terms of if they know what the doors are that you want opening, they can be out there doing it. If you’re the service user in that situation, what is totally what you don’t want is somebody who’s acting off a different script as it were and saying ‘I think what you need is this’ and suddenly you’re doing aerobics and that’s the thing that you probably least want to do in your whole life. It’s getting the agenda from the service user, from understanding what their distress is about, what the stresses are and once people have that clarity, then they can be fantastic support in enabling people to achieve the sort of things that they want to achieve.
And talking from a practitioner’s point of view, what tools and strategies can they use? I mean you’ve mentioned – is there anything else you can expand on do you feel?
I think there’s an issue around advocacy, which is always a tension, that there are times when I think as practitioners we have to act as people’s advocates. If we take over then we get in the way of the recovery journey. So it’s being very sensitive in terms of being there to advocate at times but as far as possible, giving the control and the power back to the service user and actually enabling them to advocate and take power for themselves rather than us doing the directing. But there may be situations when people are in a situation of very acute distress where we’ve got to do certain things.
Yes.
But again, a social perspective can be helpful in terms of being clear what are the likely things that we may need to do in terms of helping somebody go through a period of acute distress and hold onto as many of their social roles and connections and so on as they can do so that when things get a bit better, they haven’t suddenly found that the whole world has moved on and left them, which I think is what a lot of people can feel.
And at what stage in a person’s recovery, their journey, do you think that this perspective is most useful?
I think that’s a very interesting question. What tends to happen is that when people are at their most acute phase of their distress, a medical approach is seen by most people as ‘well this is what we need to do to deal with the situation’ and it can be an important part of it. I think if we don’t have that social perspective at the same time, then the sort of thing I’m just mentioning in terms of people’s social worlds can crumble very quickly, family can get very frightened, family can feel that they’re not involved when somebody goes into hospital, relationships can break up. All sorts of things can change really very quickly and even in terms of how do we handle a crisis, there may be social ways of handling a crisis that mean that somebody doesn’t need to go into hospital and identify who are safe people, who can be involved in somebody’s care if they stay in their own home, making arrangements. Making that sort of support system work for somebody can actually mean that a crisis is not the same sort of crisis as it might be. And also identifying what are the social triggers that are pushing somebody over the edge? If you’ve got somebody in the flat above you who’s playing their music till 4 in the morning, that’s rather an important party of understanding. So they may not need to go into hospital but they may need to move to a friend’s where they can actually get a decent night’s sleep.
Yes.
Basic things, but making sure that even at that stage we’re using our social perspective rather than just looking at what may be going on internally within a person.
And that person will still be there when they come back out of hospital.
Yes.
Still upstairs in the flat making the noise, so it’s a rolling thing isn’t it really rather than looking at the one part. Looking at the whole I think.
Yes. So I think as somebody is moving on from that period of acute distress then social perspective is really important in terms of the recovery journey, where are you going. But my plea would be we need to have that thinking right from the start, or else a lot of people do find at the point where suddenly the medics are saying ‘right, we’ve done our bit, over to you’, a lot of damage has taken place. Not through anybody acting maliciously but by neglecting that social perspective things have fallen apart in terms of somebody’s life.
Thank you for that, Jerry, thank you.
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