A colleague – Richard – from the British Psychological Society’s Division of Clinical Psychology who I admire hugely jokes that he is taking a population approach – one person at a time. And he is, I think, right in that. He’s doing his bit. (He’s inspirational.) Which always makes me think what are we public health folk doing in return? We live in a system, our health is something which exists in a system. So if we want a mentally healthy society we need to do our bit for that.
Having just finished reading the Oxford textbook of public mental health (moderately loving it but a review coming soon elsewhere) and the Oxford textbook of nature and public health, the area I remain dissatisfied by is the fact we still are in very early stages of describing things as systems and building responses, when they clearly are systems.
Some time ago, we started work on what a Complex systems approach to mental health might be, as part of our public mental health work. The underpinning principle was simple: responding to symptomatic illness just doesn’t cut it and won’t get us where we need to be.
Beyond that, principles of systems approaches and principles of population health, some derived from the Venerable Geoffrey Rose, and others derived from Sandra Galea, have informed our approach. These helped us derive a number of different domains of action which we distilled and developed into twenty. Since then various people in our team especially Piers Simey who has worked hard on collating this, have taken us into a range of pieces of action.
Not so very long ago, I had the privilege of presenting awards to three young people at our HAFLS – Adults and Family Learning Service awards. You can watch a video of the highlights here. There are many memorable things about that evening not least the sheer determination of some of the learners to overcome challenges. The three young men I presented awards to had come through real struggles. One of them, who spoke publicly on stage, had never spoken publicly before and to the great emotion from his family, spoke that evening. And afterwards, I was talking to one of the winners and his granddad and we discovered a shared interest in weightlifting. That young man – to the unending pride of his granddad – has gone from major difficulties in his life to starting a career. It was an emotional event which stuck with me. It struck me then and it strikes me now that a genuinely public health approach to mental health has to be focused on functioning, resilience, recovery and flourishing. No amount of mental health services – essential though they are
If we genuinely believe that there is no health without good mental health, I think we have to work on these approaches. This is just one evolving contribution. We will make mistakes, and have gaps. And we’re still working out dynamically how best to determine whether and how all this will make a difference. (Help welcomed.) But for all that, I think we have to start applying these approaches.