Anxiety is at an all-time high. According to Mental Health First Aid, around 676 million people are affected by mental health issues worldwide. Brexit is looming, we’re living in a time of global climate crisis and some people can barely afford to make ends meet. It feels like we’re teetering on the edge of disaster, and experiencing a shared anxiety made worse by modern technology and social media.
Perhaps most shocking, however, is that while one in every four people in the UK will experience a mental health problem every year, a whopping 70-75 per cent of people with diagnosable mental illness receive no treatment at all. What is being done about this?
Despite our current Prime Minister suggesting that we should all just get on it with it, regain that stiff upper lip and head back to work, there are groups offering real, useful and lasting care. One such organisation is Manchester Mind which, this year, is commemorating 30 years of providing support across the city.
But how did the charity begin? In 1989 and against the backdrop of Thatcher’s Britain, local church clergy, community workers and activists came together to form the Health Advocacy & Resource Project (HARP) at the Zion Centre (now Z-Arts) in Manchester’s Hulme to tackle the underlying factors impacting on local people’s mental health. The group adopted a human-centred approach, which meant listening to individuals, and found that the common factors affecting mental health were poor accommodation, money or benefit problems, and lack of social support.
At the time, pockets of various UK cities were deemed ‘unrentable’. One of these areas was Hulme in Manchester. And so a vibrant group of artists, photographers, musicians and students moved in – but this was also the place where society’s most vulnerable, through no other choice, were living. For those with mental health needs who were struggling to access support, this meant a revolving door of hospital admissions, discharges and re-admissions.
John Butler was HARP’s first employee and still works as an independent consultant with Manchester Mind. “I was feral as a youth and avoided school. I worked in engineering as an apprentice, in retail and as a signalman. From there, I went travelling and met a great bunch of people from different countries who inspired me to go and study. I applied for a job as a trainee RMN (mental health nurse) and got in on the strength of an IQ test and an essay. It would never happen now. I was smart enough but not academic, so I struggled and probably got through because I was strong on the values and an excellent blagger.”
In what seems like a cruel twist of fate, six weeks after starting his new role Butler’s mother was admitted to an acute unit “apparently hearing voices and expressing some very strange ideas”. Over the years he “learnt a lot from her and she learnt to keep quiet and stay away from psychiatry”. She couldn’t tolerate the medication prescribed “so she got a job instead and suffered in silence”.
Through funding, HARP was able to source people with expertise and flourished as drop-in centre. Later a café opened, and HARP moved into the Zion Community Resource Centre where many of Manchester Mind’s workers are still based and the café remains. In 2011, recognising a gap in national mental health charity Mind’s network, HARP successfully acquired affiliation to become Manchester Mind.
Fast forward and the organisation’s initial values and focus on a person-centred approach remain at the core of the charity’s ethos – but unfortunately so do the issues. Still (mostly) based in Hulme, this independent charity now provides mental health support for more than 6,500 people per year across the whole city region.
Over the past few years, mental health awareness has been more prevalent in the media (particularly with people in the public eye opening up about their issues). But does Butler believe that attitudes are changing – and are they changing quickly enough? “Yes, attitudes are improving in some quarters. Manchester Mind is being approached increasingly by private sector organisations to provide training for their staff which might be one measure of that.”
Nevertheless, worries about money, jobs and benefits are being exacerbated by an acute lack of mental health services, making it harder for people to cope. The numbers of people who self-harm and have suicidal thoughts is still high.
“Somewhere, during the past 30 years, as central governments got too closely involved and mainstream mental health services have become more corporate, they have lost their heart and their way,” says Butler. “IAPT (Adult Improving Access to Psychological Therapies programme) is looked at as the answer to everything, but like most interventions it can help 10 per cent of people 10 per cent of the time. The prevailing model of in-patient units is broken and there is no evidence for it anyway.”
He continues: “The biggest problem is that the potential for good practice is strangled at birth by clinical governance and the overbearing corporate structure of NHS trusts where a lot of the people calling the shots have no experience of giving or receiving mental health support. I am told that a lot of newly qualified staff do not hang around long. So when people need help and turn up at A&E, they experience an impersonal service. Back in the day, practitioners were the therapeutic tool and what was important was attitude and approach. We need to train people and then trust them to get on with it and provide clinical support, rather than management supervision. At the moment, everyone is trying to hit the target, but are missing the point.
“I would like to see the initiative seized by people with lived experience. And empowered communities and local alliances of professionals who are open to a different more people-centred and less clinical approach.”
So, as Manchester Mind reflects on its three decades and thoughts return to earlier years, I’m reminded of an event I attended recently where writer David Constantine suggested, quite wisely, that only by looking back to the past can we finally move forwards. By celebrating their achievements and looking back at the good they have done throughout the region, the team at Mind Manchester continue to push forward with their person-centred approach to support, despite the issue being increasingly far down on the Government’s to-do list.
“Thirty years on, Hulme looks different,” says Butler. “But the pressures on ordinary people, and especially the hostile environment experienced by people with enduring mental health needs, have greatly increased while formal mental health services have been cut back and retreated from the community.
“The need for organisations like Manchester Mind keeping the flame burning has never been more vital. The culture of caring for each other at Manchester Mind makes it so much easier for people with lived experience to come and work or volunteer here and move on to better things.”
Nobody in Manchester should face a mental health issue alone. To help make a difference please text MM30YEARS to 70085 and donate £3. This will help the charity to provide free healthy meals to people in need at Manchester Mind’s community café.