Each morning I scan the international headlines. Along with conquering Wordle (yes, I do it every day) — it’s a habit. A smartphone makes it quicker, plus I have breaking news alerts from many of the world’s media outlets.
Lately, the international news messages have been consistent — the cost of living. We’d be forgiven for thinking it was just in our patch, as the sometimes-feral mainstream media couch their inflation headlines to focus exclusively on domestic audiences. In fact, among OECD countries, most European and Scandinavian countries far exceed New Zealand and Australian inflation hikes.
There’s no denying that we’re in the midst of a cost of living crisis: people are struggling with higher food bills and petrol costs as the price of everything consistently rises. But there’s been another crisis going on for years, one that in my new role at the Hope Centre I’m witnessing up close. This is the crisis in our mental health system — a system which wasn’t great to start with, and now seems to be crumbling under the weight of underfunding and over-demand. I’d like to dwell on what it’s like to be vulnerable and poor and suffering mental distress right now.
I work half-time for a mental health service in Dunedin. The Hope Centre is funded through community grants and donations, not through “official health funding” because it offers people peer support. Peer support has only recently become recognised as an important and legitimate way to support people, which is why it’s more likely to be offered through a non-government organisation than through the taxpayer-funded health system.
Peer support is about building a connection with someone and walking alongside them through their journey, being a listening ear, non-judgmental and empathetic. Most peer supporters have lived experience of mental distress, which gives them unique insights into a person’s pain and struggles. There’s “mutuality” — benefit being drawn by both the supported and the supporter. It goes to the core definition of peer — “of equal standing."
Most times in the mainstream mental health system, the support offered perpetuates vulnerability and low self-esteem. Peer support aims to do the opposite.
Take Imogen (not her real name), who came to the Hope Centre in desperation due to an inability to get adequate care and support through clinical mental health services. She expressed distress and isolation. She felt the system was against her. Her situation and relationship with mental health services is complex and longstanding. Events over the last two years during Lockdowns have left her feeling disenfranchised, powerless and even frightened by the mental health system. One after another, her mental health providers either left the system (and weren’t replaced) or discharged her from services as the system was too full. Even getting an appointment with a GP took weeks and was often conducted by phone due to Covid restrictions. The Hope Centre welcomed her and offered an opportunity for her to explain her situation and be listened to.
Imogen isn’t “fixed”, but she feels listened to and validated. She visits us weekly and is able to take more steps to wellness because she knows she’s not alone.
In Aotearoa there are commitments to reform the mental health system, but the reality of transforming a paternalistic medical model is a decades-long undertaking. Meanwhile, a pressure cooker situation has developed for many people who experience anxiety and distress as they come up against stigma and barriers to getting help.
We see variations on Imogen’s story repeated every day at our service. Lack of skilled workers in the mental health system is a big factor. But a significant and more insidious reason is the embedded attitude towards people in mental distress: they are “problems” or they are “too complex” and cannot be “fixed”. These people will not be “fixed” by a patronising, paternalistic system. Instead, they are left to their own devices as they struggle towards wellness, or to deteriorating mental health and sometimes suicide.
Mental health is essential. Using peer support in the mainstream system, too, offers a further way of including everyone in the community.
Tui Motu Magazine. Issue 274 September 2022: 3