Libby Learmond
Service Manager – Penumbra Western Isles
IS IT TIME FOR A NEW APPROACH TO DELIVERING MENTAL HEALTH SERVICES IN UIST?
What do you think of when people mention mental health or wellbeing? These phrases are thankfully more commonplace in our everyday language these days with many more public conversations taking place. It feels like there is less stigma in talking about how we are feeling. This has to be a good thing, hasn’t it? And it is to an extent … but I worry that this could have the unintended consequence of almost masking the immense impact on lives when someone experiences mental ill health… There is hope though. With care and support the impact can be minimised, and wellbeing restored. Recovery is possible.
My lived experience is of having a family member being very seriously ill and needing intensive medical and psychological support for over two years. She is well now and did get amazing care, but it changed the lives and perspective of our whole family. We were lucky, I had a very understanding and flexible employer. I also, to put it bluntly, had the money to take her to Stornoway on a weekly basis and to Inverness to receive treatment. A person’s access to the support they need should not be dependent on their ability to afford the transport costs or the time from work to get to the help they need.
During the pandemic, (I’ll get to the psychological impact of the pandemic in a moment), we were all taught about the value of preventative care. For a physical, potentially serious condition you can take precautions, washing your hands, keeping your distance, staying at home and taking lemsip or suchlike if you feel unwell. There was an emphasis on how to look after ourselves and knowing what we could do to get through the symptoms. The seriously ill got treatment, most of us had a grotty couple of weeks, others needed ongoing help or hospitalisation, some, sadly, died. We need to take the same proactive, recovery focused, approach to our mental health and for there to be the support services available to enable us to do so.
The statistics tell us that each year in Scotland, one in four people have a mental health issue. Some are medical conditions, some brought about by life experiences, others by a sudden shock or a change to a person’s way of life, stress, addiction, losing a job, relationship issues or bereavement. If a person can receive compassionate support through a crisis or to manage longer term anxiety their prognosis can be changed. They don’t need to be “medicalised” or dependent on the stretched statutory services. They can be supported through their own, person-focused recovery, here in Uist and Benbecula in their own timescales.
Now, I do need to make it clear that I am definitely not criticising any of the people out there providing much needed support. The medical folks, Community Psychiatric Nursing Service (CPNS), Child and Adolescent Mental Health Services (CAMHS), Social Workers and support staff do an amazing job in incredibly difficult conditions. At times I worry for the stress they are under and have nothing but respect for their commitment and how they work with as many people as they do. But they will tell you themselves that they are stretched beyond belief. We need another way of doing things to get the people the help when they need it and not to burn out the health of professionals that we have.
I can almost see you rolling your eyes and saying that’s all very well but where is the help and support going to come from? The Comhairle has no money, the NHS is understaffed, there are precious few Care Assessors in the Social Work department. All that is true. But what is also true is that Uist has a very strong and capable third sector, providing mental health support, befriending, substance use counselling and a range of services. As a community we could do more if third sector activities were coordinated with the Integrated Joint Board for Health and Social Care . This joint approach could prevent a crisis in someone’s life becoming a life- threatening emergency. The problem is that while there is minimal grant funding, it isn’t enough, nor coordinated or targeted effectively towards the mental wellbeing of our community. While I would never put a price on a person’s mental health, local early support is far cheaper than emergency intervention or a long stay in a mainland hospital with all the disruption to families and services that causes. A more holistic view needs to be taken towards where and how the money is spent.
In the apparent absence of mental health objectives, targets or intended outcomes from either the Comhairle or locality planning, it is becoming increasingly difficult to be confident that we know what our communities need in respect of mental health and wellbeing treatments or recovery.
The last two years, during the pandemic we suffered a marked increase in social isolation and indeed anxieties around our own health and vulnerability. People were not able to or didn’t want to ask for help for what they considered minor or unimportant symptoms; we are seeing the consequences of this now. People are struggling when they deserve to be able to enjoy life. It is not too much to ask.
I am not asking for a magic wand or for hard-working professionals in the health and social care sector to try and do more. But I do believe with new and emerging national strategies on mental health and wellbeing, suicide prevention and selfharm, community partners have an opportunity to come together to plan a Western Isles response that meets the needs of our people. We know money is tight – it is for everyone – but if community partners work and plan together, I am confident they can address much of what is needed to make a real difference to the wellbeing of our community.
