Ep 9: Yes to World Mental Health Day

Ep 9: Yes to World Mental Health Day

 

Speaker Key:

MS             Mark Spraggs, Lifeways’ Managing Director of Mental Health

PC              Paul Crompton, Lifeways’ Marketing and Communications Manager

 

MS             I think the fact that we need a World Mental Health Day that says mental health is a universal human right says a lot. Why do we even need to say that?

 

PC              Hello, and welcome to Yes to You, the Lifeways podcast. Lifeways is the UK’s largest team of support professionals who provide support for adults living in the community. I’m Paul Crompton.

                   I’m Paul Crompton, marketing and communications manager at Lifeways, and your podcast host here. And for this episode I’m speaking to Mark Spraggs, the managing director of mental health at Lifeways. Thanks for being on the podcast, Mark.

MS             Hi. Thank you for having me, Paul.

PC              Our pleasure. Mark first qualified as a social worker in 1999. He then spent many years within integrated NHS and local authority mental health services. In 2015 Mark moved to SIL, which is part of Lifeways and specialises in mental health support, before becoming managing director of Lifeways’ mental health division just a few months ago.

                   So, in this episode, which is specially timed to coincide with World Mental Health Day, you’ll be learning about how we can make mental health service provision better for adults across the country. While doing this we’ll also be exploring the theme for 2023 set by the World Foundation of Mental Health, which is that mental health is a universal human right.

                   Mark, let’s start simply. Could you explain to me in the simplest, most practical terms how Lifeways supports people with mental health needs?

MS             Yes. Well, we’ve got a number of services across the organisation, but in principle, we’re supporting people to live in their own homes. So, we have partnerships with housing providers so that people have their own tenancy in a supported accommodation scheme, or sometimes in residential care or a shared house, or we’re providing support in an outreach capacity where people are living much more independently but receiving a few hours’ support.

                   So, we’ve got quite a range of options and support approaches across the organisation. In the main though, the supportive living model is the majority of the support we’re providing.

PC              Right. And how many adults with mental health needs do we support, would you say?

PC              And how many people does Lifeways’ mental health division support?

MS             So, within the mental health division, we’re supporting around 500 people, but across the whole of Lifeways, which supports around 4,500 people, many people will also have mental health needs alongside their other support needs around learning disability, autism or other needs.

PC              And what are the age ranges of people that we support with mental health needs?

MS             So, from the age of 18 upwards. We don’t have any upper age limit although, in the main, we are not supporting people into their older years at this stage. That doesn’t mean to say that as people become older and stay with us for longer, then we’ll continue to support people’s needs as they go through their life course.

                   Of course, many people will move on from our services into other less supported accommodation hopefully, so we may therefore not be supporting them throughout their life course. It would depend on what their needs are.

PC              Right. And you mentioned to me in a previous conversation before this podcast that in your time with Lifeways and SIL, that you’ve probably performed just about every support task imaginable. Could you go into some detail on your role here and how it’s evolved through the years?

MS             Yes. Well, I’ve had lots of fun and enjoyment in my years with Lifeways and the SIL services so far. So, you’re right, I joined the organisation in 2015 in SIL services. And SIL are a provider, as part of the group, of recovery-focused supported living services, working with people with quite complex mental health problems.

                   We’ve been very fortunate that the SIL services have grown from being quite small to now supporting around 350 people nationally, but when I joined, we were supporting 17 people. It was just starting up. So, when anything’s new, you’re doing lots of things. We were a small team.

                   So, it meant that I was having conversations with commissioners, working alongside the senior team in developing the buildings and what they looked like, getting referrals in, but also covering shifts and doing some of the much more practical things, supporting people with their day-to-day lives, cleaning the offices, just absolutely everything.

                   And I’m so grateful for that experience because, while I may be in the position of managing director now, I have covered plenty of shifts. I have done the direct support. I got in and rolled my sleeves up. And that’s the great thing about the organisation. We don’t have that kind of hierarchy where you’d be worried about going in and getting involved with things, or certainly, I don’t.

PC              Right. It sounds like very much a team effort.

MS             Absolutely.

PC              And it’s 10th October, or it will be when this podcast is released, which is of course World Mental Health Day, and this year’s theme is, as mentioned earlier, that mental health is a universal human right. Yet, if you look at NHS funding statistics, it’s hard to argue that mental health has received that parity of esteem between mental health and physical health that was talked about as far back as 2012, if I’m not mistaken.

                   If I remember correctly, mental health still only receives I think around a tenth or less of total health funding in this country. What needs to be done here to ensure better mental health for all in this country?

MS             I think the fact that we need a World Mental Health Day that says mental health is a universal human right says a lot. Why do we even need to say that? We need to say it because we know it’s not seen in that way currently.

                   And I think therein lies the answer. We just don’t see it in the same way. We see it as somehow disconnected from our physical health, almost an add-on, or as a failure if we don’t have good mental health, as a personal failure maybe, when in fact there are so many reasons why we all have struggles and challenges with our mental health.

                   And just as most of us are aware of how we’re doing from a physical health point of view on a day-by-day basis, I might come in and say, oh, Paul, I’ve got a bit of a headache, I’m not feeling so great today, and I have no worry about telling you that.

                   You’re not going to take too much notice. You’re just going to say, well, that’s quite normal, not to worry. If I come and say I’m really feeling quite miserable today, I’m a bit down, will you see it in the same way? You might think, oh, is that how Mark always is? You might just view me slightly differently in that respect.

                   And until we can do that in a very normal way, I think we’ll be having this conversation. We’ve structured our services in specialist ways, so mental health is something separate and different, and rightly so. When you’ve got very specialist and complex needs, you need a team of specialists around you, in the way that we have for all of our major health conditions.

                   But we’ve almost had all or nothing. I think over the last few years the dialogue within society and culture has opened up, hasn’t it? We do talk much more about mental health. People are far more familiar with it. But there’s still so much more to go, and I’m not sure we’ve really incorporated the more enduring serious nature of mental health into that day-to-day conversation in the way that is that NHS funding and local authority funding that you’re talking about.

                   We still see that as something slightly separate, I think, and that’s what very much needs to fold into being far more ordinary and seen as the same value of importance.

PC              That’s very interesting. That’s something I hadn’t thought about. You’re right, the fact that we’re having that discussion, that mental health should be, is a universal human right, suggests that we’re really still quite far off. And is it perhaps the case then, from what you’ve said, that as individuals, our own possible predilection to downplay our own mental health needs is perhaps a reflection of the national priority or lack thereof of mental health funding?

MS             Absolutely. Yes. We are outraged when services are not provided for some conditions or illnesses, and I don’t want to downplay any of those, but when we become aware of somebody having cancer care, we are very focused on how well that goes. And there’s phenomenal support out there and phenomenal care, and many other health conditions. And it’s so open and transparent that anything that goes wrong, we highlight it.

                   We don’t do that within the mental health services. And things don’t go well a lot of the time. Right now, there are real shortages of inpatient psychiatric beds. We’re often supporting people who have been assessed as needing to be admitted under the Mental Health Act. So, they’re so unwell that they can’t make the decision for themselves, and as a state we’ve made the decision that they should be admitted to hospital.

                   It’s not uncommon for somebody to have no bed available to them for 12, 24, 36, 48 hours, sometimes longer, and there’s not a bed identified anywhere in the country for somebody to go to. In those situations, they remain within the services that we’re supporting them in, and of course, we continue to support them, but they’re not in the right place and they’re not getting the right support needs.

                   And I don’t know that we’re socially that outraged by that. I don’t know, beyond the immediate people who are involved, who knows about that. And yet, and again, it’s hard to draw a parallel without making it sound like you’re saying one thing is more important, but we hear a lot of the challenges of the ambulance services, where they can’t get to somebody who’s fallen and they’re on the floor in their own home, and they may be waiting many hours for an ambulance.

                   We hear about those stories, and we hear about them and we see the images, even if it’s on our local news. We don’t hear about those mental health ones. I’m not sure we’ve got that public perception, and often that’s what drives governments to have to respond, isn’t it? They kind of respond to the noise. And I think we need to make more noise.

PC              Right. And to dial a bit down or to go a bit deeper on making more noise, what can the average person do who’s passionate about making mental health a universal human right in this country? What steps can they take? For example, is that sending a letter to your local MP? What kind of grassroots activism would you suggest here?

MS             I think paying attention, because these articles are there in the news. They’re just not the shouting frontline ones. So, we need to pay attention to what we do hear. We need to talk about our own mental health a lot more, and although that might not feel like it’s got that direct link, I think it raises it up a bit, doesn’t it? What’s normal for us, the challenge with using the word normal, but what’s the average mental health support needs or average mental health status of us all?

                   I don’t know that we have that baseline. We seem to always be quite surprised when we say, oh yes, I’ve discovered that this person has been taking antidepressants for the last six years, and somebody will say, oh, I wouldn’t have known that. I wouldn’t have thought that of them.

                   Yet if we say, I’ve been taking statins for the last six years, which by the way I have, and nobody’s particularly interested in me taking statins because it’s so very normal. But if I say I’ve been taking antidepressants for the last six years, you might remember that a little bit more. And you shouldn’t. It shouldn’t be any different particularly.

                   I think we just need to level up what’s ordinary in order to know what is out of order, what’s not okay. I think that’s what we can do. We can all talk about it a lot more.

PC              Right. And it sounds like each of us taking that responsibility to reduce that stigma, in the sense that, not to put words in your mouth, but I gather from what you’ve told me, and I can certainly agree with you, I would happily tell the whole universe I was taking statins. I probably wouldn’t happily tell the whole universe I was taking antidepressants. But then, why?

MS             Why not? Absolutely. What’s the difference?

PC              And as I perceive mental health support, and I could have got this very badly wrong but this is just how I perceive it, the personal mental support which revolves around fairly what you might call light touch approaches, for example, IAPT courses, CBT courses, counselling sessions, and then of course there’s the more intensive, if you like, heavy approach of for example prescription medication, seeing psychiatrists, secure units in hospitals. There’s a sort of spectrum, as I see it.

                   And as Lifeways’ mental health division, where do our services fit here? Where do we come in?

MS             So, probably at the more significant end because people, in order to receive our services, do need funding from local authority or NHS. So, it comes down to therefore needing to meet the criteria for those, which all the agencies have.

                   So, we tend to be working with people for whom life has become challenging without support. That might mean that they’ve had some period of time in hospital, in perhaps a psychiatric inpatient unit, or they’ve had struggles in the community on a bit of a repeated pattern. So, people may have had tenancies or accommodation that has broken down on a bit of a repeat cycle.

                   So, we tend to be working with people who need that stability of accommodation and stability of support in order to get life back on track. And that might mean that, a history might be, somebody’s had four or five years in a hospital, and perhaps they had prior to that had some repeated admissions back into their own home and it broke down.

                   And after a while, the idea is it becomes clear for the person perhaps and everybody around them that another option is needed, and that’s where our services are a great option because people have their own tenancy, so they’re learning how to manage a tenancy, how to become a good tenant, but also all the social skills that we need, how to cope with our neighbours, how to cope with support, how to accept and receive and understand what our support needs are in order to then be able to move on, or over time reduce the support.

                   Often, we’re talking about changing and reducing the amount of support that somebody needs in order to support them to understand themselves better and then move on to their own accommodation or less supported.

                   I think we’re fitting not in that primary care everyday support need. We’re at the higher end of that, but not at the inpatient hospital setting. That’s a different type of care. We’re working with people usually after a period of time in hospital.

PC              Right. And on this occasion, I wanted to ask about a few nuances of that actual support that is delivered, so to talk more about individuals we support. And you might call it the power of purpose. Do people we support, who come to us, sometimes struggle with finding purpose, at least as much as many of us do who do not receive mental health support?

                   And also, it’s a double-pronged question, I’m afraid, how do we steer people towards finding their purpose, if we do, that’s meaningful for them? And does having a purpose really make a difference?

MS             Absolutely. So, perfect question because that is fundamentally one of the things that it’s really important for us to do. So, we often refer to the concept of recovery, and it’s a concept that has got many meanings and different approaches for different people, but the idea of having purpose in life, something to do, we all need that, whatever. We all need a reason to get up in the morning and to feel motivated.

                   And if you’ve got a number of challenges through mental health and also not having the experience of what that’s like, if you haven’t through your teens or twenties, thirties, developed the routines and the patterns of getting out and doing something, it’s a hard skill to develop, even if you haven’t got other reasons fighting against you, your own needs.

                   So, having purpose is key, something to do every day. And often, people haven’t had that opportunity. They’ve been in hospital or, as I say, they haven’t developed the skills. So, that sometimes starts really small. It might mean developing a relationship with the team around them, with our recovery workers and our staff, to just learn trust. In order to be able to go out and offer something and do something, you have to trust that you’re worthwhile, believe you’re worthwhile, believe you’re worth purpose.

                   Sometimes we’re starting from a very small place of beginning to build up that trust and having hope, having hope that life can improve, can be better, and often it’s on us to have that hope when somebody may not have it themselves, and we maybe need to hold that for a little while and bring people along with us.

                   So, it’s absolutely key that we have purpose and identity in life, and that needs to be beyond just out there in ordinary life, out there in the community, not necessarily in a closed setting or within mental health-defined services. While that has its place, of course, because people may feel safer there, you’ve got understanding, really, we want to go beyond that to ensure that everybody’s just engaged in the community in the same way that any of us are.

                   So, one of the things we will do is work with people on goals. It’s as simple as that really. What would you like to do? And often it’s hard for people to know what they might like because they don’t know what’s possible. They may even have been told things aren’t possible, you can’t work, you won’t work, whatever it might be. And nothing’s beyond possible, and I know from the last eight years of working in these services, the phenomenal things I’ve seen.

                   We have an internal communications board, and all the time colleagues are sharing achievements that people have made, of saying, I didn’t think that this would be possible, and yet here I am. I’ve become a befriender for the local Mind service.

                   I saw somebody recently who’s up in the Yorkshire area who’s become a volunteer on Emmerdale, the soap set. And that was somebody who only a year ago I don’t think could have even thought that was possible, but it was building a trusting relationship with their staff team to then say, I can go one step further, I can go one step further.

                   So, it is key, because that person’s identity begins to change and see that it’s possible. So, purpose is absolutely important and something we’re all about trying to support people to develop.

PC              Right. And to go a bit deeper on that trusting relationship, let’s say if somebody’s going through or has been going through for a long time a mental health crisis, their problems may of course be very clear for everyone else to see, but they may not always be clear to the individual.

                   And how do we support individuals in a way that builds trust but, at the same time, that doesn’t ever end up being preachy or, even worse, controlling, telling people how to live their lives, but guides them instead in that person-centred way to find solutions, if that makes any sense? There’s a nuance here between supporting people and actually just sort of telling them what to do, if that makes any sense.

MS             Absolutely. We are working with people who have the ability to make their own decisions, in the main. They may have mental health diagnoses, mental health conditions, mental health support needs, whatever you want to call it, and that might mean that there are some areas of life that people don’t have much experience in or maybe even don’t have capacity in relation to, although in the main, the people we’re working with have capacity to make their own decisions.

                   They might not always make the best decisions. So, our role is to support people to see other ways of deciding, what are the consequences of these actions? What might you do differently next time? Most of us learn through making mistakes or having people around us to guide really and coach. So, we very much take that guiding, coaching, let’s rehearse that, let’s talk it through. What will happen if you go down this road? What will happen if you do this?

                   We are working with people who may well be taking substances and recognise that that isn’t good for them, but find it difficult to stop that. Now, we can’t prevent that. We can’t stop people from taking substances. We’re not in a locked environment where that’s going to be… Even in those environments, in fact, it’s not always possible to stop it.

                   What we can do is try and support people to understand what impact that might be having on their life and how it might be stopping them from getting to their aspirations.

                   I think you also alluded to sometimes people not being aware of the impact of things happening on their own lives. Of course, people can become very unwell and lose touch with reality at high points of perhaps a relapse.

                   And in those moments, ideally, we’ll have spoken with people in advance to work out how they would like us to support them so that we’re doing on their behalf what they’ve asked us to do and who they’ve asked us to contact, how they’ve asked us to approach them.

                   So, we’ll often use what’s referred to as a wellness recovery action plan, a WRAP plan, to have understood how we should do that. That isn’t always in place, so we have to have those principles of, in this moment we’ve still got a duty of care, we’ve got to think about the risks that somebody might present to themselves, possibly to others, but generally to themselves, and work around that.

                   So, there are times when we need to be, if you like, a little more interventionist. That’s usually short-lived, and we need to then very quickly step away from that to encourage people to begin to take that ownership, accountability and responsibility for their own lives, and not, as you say, become too paternalistic and make those decisions for people or try to say how they should live their life, even if that life doesn’t quite look how hit should.

                   I’ll caveat that with often we need to really support people to develop skills. We work with a lot of people who may not know how to look after their environment, their flat, because maybe they’ve never had one or they didn’t get to learn those skills at a point in life of how you mop a floor, how you do the washing up, how you just keep on top of day-to-day life. And we can get into thinking that that’s a life choice because we don’t want to be too judgmental about things and say, well, it’s up to you how often you do your washing up.

                   We in fact need to tread a very fine line there because a big part of our job is to support and coach people to do that. You talked earlier about the things I may have done while working for the organisation. That’s something I’ve done quite a bit of, is getting alongside people. Right, I’ll go and wash the dishes. You dry them up, you wipe down the surfaces. I’ll sweep up, but you go and get the black bag so that we can put it in together.

                   Often it is just supporting people to know the routines and the processes that they have to go through to get their living room tidy, because nobody’s ever really shown them how to do it. They’ve been in hospital. It gets done. They’re thought not to be capable. It just gets done. And I love seeing the progress that people have made.

                   Again, on our internal communications board it’s not unusual to see pictures of somebody with their living room tidy. And might just not look like a massive achievement, and yet it is such a big achievement, because it’s everything else that goes with that. You said about purpose, identity. There’s that sense of, I can do things, I can achieve things. And the staff team around me have supported me to get there. And from there, you’re on the great steppingstone to the next thing.

                   I think I went off on a bit of a tangent to what you asked me, but it’s a really crucial part of support.

PC              Right. And let’s talk technology. While in the NHS, when I was working for the NHS, I read a report that said there’s never really been an Uber, this is a few a years ago, there’s never really been an Uber of mental health apps, or you could have said also a Just Eat of mental health apps.

                   And then in recent months, since the launch of ChatGPT, which I’m sure you’ve heard about, you hear about some people using platforms like ChatGPT AI platforms as essentially free makeshift therapists. The demand for personal mental health support is clearly there, but it doesn’t appear that any firm or company or organisation, at least in the UK, has made a lot of progress implementing technology in aiding in mental health support.

                   Why do you think this is? Is it simply that technology really can’t do a lot here, that mental health support has to be a human there with you at all times? What’s not connecting here that you think should connect?

MS             I guess if I knew, I might be the person developing it and answer the question. I think there’s so many different facets that we need to work with that it’s probably hard for that. Uber is very specific, isn’t it? It’s very clear what it does.

                   However, I was at a conference recently, and there were at least three presenters at that conference and at the stall there who were a form of technology or app provider. So maybe that is beginning to develop more so. And I know there are some out there that are that kind of online therapy, checking in.

                   I think it’s probably very much a developing space. And I suspect the pandemic and our use of technology maybe has jumped that forward, as well as a generational thing perhaps, maybe not so, but of becoming more familiar.

                   I think you need the whole range. There is without doubt that need for interpersonal relationships. It can be very easy to feel that an online relationship is giving us everything we need because it has that sense that it does, but I think that human connection is really important. I think there’s space for everything across the range, but developing the relationships is crucial.

                   However, being able to access therapy or a counselling approach online from your own home when you may have struggled to get out of the house and do that before is going to make a phenomenal difference to people. I only hope these things do grow and develop. I don’t think I’m the person to develop them though. It’s beyond my technological understandings.

PC              Right. And going back to what we were saying earlier about all these conversations that we aren’t having around mental health, that we probably in many cases should be having, what are struggles, battles that you never hear about, struggles that individuals with mental health issues face that aren’t talked about?

                   For example, some individuals in Lifeways’ mental health services that I’ve talked to have mentioned about how it feels to go from, say, living for a long time in a secure unit in a hospital to suddenly have your own apartment to call your own, the absolute massive positive life change that can be for individuals. But equally, at the same time, of course that must be an enormous change, when you suddenly have that independence. That also at the same time might be difficult to handle.

                   So, can you think of some factors here, if you like, unsaid, untold struggles that people face that perhaps aren’t also given enough attention?

MS             I think loneliness, or even if not that experience of loneliness, knowing how to be on your own and to be in that own space. I think you just said many people might have spent time in hospital where privacy is quite a challenge. You might have your own room and maybe your own bathroom, but otherwise you’re in common areas.

                   When you’ve got your own flat for the first time and you shut that door, it can feel a bit isolating. One of the things we’ll often need to work with people on is locking their door, because people will often leave it open. And that’s not because they don’t understand the security implication. It’s because it feels like a big barrier if they’ve locked that door. At least there’s the possibility that somebody might come in.

                   That might seem strange, but I think it speaks to what you’ve just said there, that sense of I’m on my own for the first time, this feels big and scary. So, the knowing how to be in your own space is difficult.

                   Too much space. We’ve worked with people who’ve come to look at some of the flats before, and they’ve chosen the smaller one. Many people would think, why would you do that? That one’s much bigger. It’s got bigger windows. It’s got a better outlook. And the answer is, because it feels too big. It feels like too much, I want that smaller space, which I found interesting.

                   Little things. I remember speaking to somebody who’d moved into one of our services, and he was really proud of having a fridge, his own fridge that nobody else was going to interfere with or make a mess in or spill. And he said, I’ve never had my own fridge. And that was quite some years ago but that’s always stuck with me.

                   So, we can get so focused on the big things of what’s your job going to be, when are you going to start taking less medication, look after your flat. Just having the basics, having that space for the very first time, I think we need to appreciate the enormity of that at times, and that can be difficult.

                   Transition is really important as well, building up relationships slowly. Usually, before somebody’s moving into a service, they’ll have some time to come and visit, to spend some time getting to know the team, getting to know the area, but crucially, getting used to spending a bit of time in their flat.

                   When people move into one of our services, they’ll have all the white goods provided, for example, but in the main, they need to provide their own furnishings. And that’s very intentional because, again, often people haven’t had their own belongings before. They’ve just moved around, and you get what you’re given.

                   And the sense of identity you can get from choosing your own cushions, sofa, wardrobe, bed, whatever, is phenomenal, and the proudness that people can develop. I particularly love it if I go to a service and somebody will want to invite me to their flat for coffee or a chat. It’s their space, and they’ve decorated it, they’ve put things up on the wall, they’ve been out and bought the mugs. They’re making coffee for somebody in their mugs for the first time ever.

                   So, those little things that we all take for granted every day are so crucial to appreciate.

PC              Right. And who are your mental health heroes, and what kind of sayings stick out to you? For example, for me, it would be the wartime concentration camp survivor and psychiatrist Viktor Frankl, the author of Man’s Search for Meaning. And he writes in the book, and I quote, forces beyond your control can take away everything you possess except one thing, which is your freedom to choose how you will respond to the situation. So, you have the idea that we always have the freedom to choose how we respond to situations in life.

                   That’s just something that personally stuck out to me, but do you have, if you like, stock sayings like that that you keep in the back of your mind, or people whose books you’ve read who continue to inspire you?

MS             I do, so many over the years.

PC              Perhaps share a couple of highlights.

MS             Yes. Goodness, it’s really hard to narrow down. I’ve been interested in mental health from the day I started working as a nursing assistant in a hospital in the mid-90s, and along that journey, I think at every stage and every job I’ve had, I’ve learned about other people’s mental health and mental wellbeing and my own. And my own mental health and wellbeing has massively developed and improved over those years, and lot of it has just been from colleagues. And it’s often been the strategies to wellness.

                   In my probably second job after qualifying as a social worker, I had a time of really struggling. I didn’t know how to manage as a social worker. I didn’t know how to draw the boundaries and stop worrying about everything all of the time and going home and thinking about things. Waking up, it was on my mind.

                   And there were a couple of the nurses in the team there who were a really great help to me at the time in saying, you’re going to be no good in a very short period of time. If you want to do this, you’ve got to learn how to manage this, and you’ve got to learn. We can help you, we can give you some suggestions.

                   But I think for me, I took from that I’ve got personal accountability to take ownership for my own, as you’ve just said, your own responses and your own wellbeing, and we’re absolutely in charge of that. We don’t always get it right. I think I’ve learned a lot from colleagues. I’ve got a number of friends who are therapists and counsellors, so I’ve learned a lot from them.

                   There’s one thing I learned from a psychotherapist who taught me to sometimes hand things back or to not accept things. Often, people want to give you things or they want to put problems on you, because they think that you maybe should own them or they’re theirs and they don’t want to own them, so they want somebody else to.

                   And I think I learned from him that you can bring that towards me, you can show me that you don’t want it, and you can show me that you think I should have it, and I can in return show you I understand that, but it isn’t mine. And so, I’m not fully accepting it, but I’m happy to acknowledge it sits between us, but it’s got to get closer to you than it is to me. But I’ll support you with it until you can get it back.

                   And I found that very freeing, to have that sense of you’re just trying to give me all of your problems, and I’m not going to take them. But that doesn’t stop me being supportive, understanding and caring. Quite the opposite in fact. It gives me the freedom and the space to be able to support you, because I don’t feel overwhelmed and now, I’m in a good place to support you.

                   I think that’s really the same thing though as you’ve just said. It’s that sense of we’ve got to protect ourselves to look at other people, like when you go on the aeroplane, isn’t it, and the masks come down. You put your own on first. We have to look after ourselves in order to be able to support others. And I think that’s crucial for me.

PC              Right, which leads us very well to the final question, which you may already just have answered, which is, you’ve just got one message, one sentence to share with the whole world around mental health, about mental health. What is that message?

MS             Take it more seriously, appreciate that it’s part of us all, it’s not something separate from our physical health and our physical wellbeing. We’re people. We’re so interconnected between our emotional wellbeing, our physical wellbeing. They’re not separate entities. So, value it and talk about it, and ask other people about it. Ask people how they’re doing and be open to whatever they say.

PC              Right. Thank you very much. And, Mark, it was really great to have your insights on supporting people with mental health needs, so thank you very much for taking part on this podcast.

MS             Thank you very much.

PC              And thanks to you, the listener, for tuning in to this episode of Yes to You, the Lifeways social care podcast. We’ll be releasing new episodes all about adult supported and residential living over the year, so if you haven’t already, please do subscribe to this podcast on Spotify, Apple Podcasts or wherever you listen to your podcasts. See you next time.