When I came to this Relatedness and Relationships (R&R) in Mental Health project about a year ago it was with some trepidation that we might be walking in to waters getting ever deeper and with no buoyancy aids in sight. What concerned me at the outset was that we would get in to something that would get too complicated and overwhelming, with a consequence that there would be no solutions that could be shown to be helpful to people experiencing mental health problems, their families and friends or to the services supporting them.
Relationships are fundamentally important to humans, and I wasn’t worried that we weren’t discussing an important topic. So, why is it that, in my opinion, the topic hasn’t featured more in mental health policy?
Across the workshops we had in this R&R project an obvious focus was on the relationships of the person living with serious mental health problems. This was their personal relationships, but also the complex nature of their relationships with those in services that are there to support them.
As we discussed the work of Professor Jacqui Gabb from the Open University and her research on enduring love and what sustains loving relationships between couples we began to see how aspects of mental health services, especially inpatient ones, are not very aware of how they might help to support loving relationships for people using their services. From Jacqui’s work we saw the importance to sustaining relationships of all kinds of everyday interactions between couples. Some of these were more routine, like regularly making a cup of tea for someone in the morning, or regular but very particular to particular couples, like dancing together. Other interactions were impromptu shows of thoughtfulness, like doing something helpful for the other person. In the workshops we discussed how if services were more mindful of this they might begin to see what modifications they could make to their practices and arrangements to be more helpful to people to enjoy such interactions between each other and, thereby, sustain their relationships.
In discussing the work of colleagues in mental health services, including forensic ones, we delved deeper in to complex relationships between those who work in services and those they are there to help. This was especially so where there was some legal compulsion between them. The work of Social Worker and Researcher Dr Anne Denhov from the University of Stockholm led us through what people living with serious mental health problems find most helpful about relationships with services and members of staff in them. A key to the relationships was a sense of making people feel valued as a person by, for example, going beyond the routine of practice and what the forms say should be done. Again, we started to think about what practitioners might do differently, and with little additional resources, if they were to be more thoughtful of this.
In the course of the project we also explored the relationships between staff in the services there to help people experiencing mental health problems. Mental health care depends on good working between colleagues. If they do not have good relationships between them, this work can be tougher and is less likely to deliver the best support and outcomes for those receiving the services. We talked about how bureaucratic requirements may hinder or undermine these good relationships between staff. We considered that organisations need to be more attentive to this and the impact on those receiving their services.
We covered a lot in the year of the project. As we reached the end of it I was more sure that relationships and relatedness are vitally important topics for mental health care to be more explicitly focused on. I was also more reassured that by doing this services and individual practitioners could begin to find different ways of helping people that would be more enabling of good, sustained relationships and better outcomes for people. I was also more convinced that relationships need to feature much more centrally in mental health policy.