In this guest blog, Executive Director for External Affairs at Changing Lives, Laura Seebohm, talks about the impact of deprivation, discrimination and trauma on people’s lives. She suggests there is a growing need - especially since Covid-19 - for a radical re-imagining of how we can better support the mental health of people going through challenging times such as homelessness, addiction, contact with the justice system and violence against women and girls. 

Most people walk through our doors at Changing Lives because they are going through challenging times in their lives.  We support people who are dealing with experiences of homelessness, addiction, the criminal justice system, exploitation and abuse (often all of these).  For most, these issues are manifestations of what has happened to them in their lives, the trauma of deprivation, discrimination and abuse.   

We know that too many people find themselves stuck in a revolving door, depending on services such as ours, rather than having the chance to recover and rebuild a flourishing life in a way that is meaningful to them. Our theory of change is called Being, Becoming, Belonging and it has developed over many years from seeing first-hand what leads to meaningful change, and ensures we are absolutely focused on breaking these cycles. This includes challenging the harms caused by the system in which we operate so people can live a good life of their choosing.

Mental health services – the missing piece of the jigsaw?

People often come to our services at Changing Lives at a point in their lives when they feel little sense of hope and extreme emotional distress. What services and people want is to relieve that distress, which is often labelled as mental illness, so mental health services are seen as the solution.

As we all know, this year has had an impact on us all in terms of mental health, and even more starkly on the people who use our services. In the first six months of this pandemic, the number of incidents of self-harm in our services has increased by 62% compared to the same period last year. Our women’s services have seen an increase in reporting of sexual violence to support workers by as much as 179%. There has been an 83% increase in women who sell sex asking for support from our teams since the start of lockdown, with many women selling sex both online and on the street for the first time as a direct result of financial hardship caused by Covid-19. We are seeing rising levels of emotional distress and poverty, in a system that is already not working for many people. 

The reality is that for the majority of people we support at Changing Lives they either cannot, or do not, access formal mental health services; they do not reach thresholds and if they do, they are unable to fit into the system which is offered. This creates great frustration for people we support, their families, for our teams and other people involved in their care. Lack of adequate mental health provision is the overarching narrative we hear over and over again.    

The way that the pandemic has impacted people’s mental health is well documented; the Centre for Mental Health has estimated that up to 10 million people may need support for their mental health following the pandemic. We are all affected, not just those of us who are already using services. Perhaps we should see this less in terms of mental disorders and instead as a response to the turmoil of our recent human experiences.

Similarly, for people we support, the emotional distress they suffer is often a response to what has happened to them in their lives – the trauma of abuse, poverty and discrimination. This is of course only exacerbated by Covid-19. 

Fundamentally, many people we support seek mental health treatment but probably do not fit within any diagnosable psychiatric classification. Even if there was infinite resource they would not and should not be treated by statutory mental health services in a one-size-fits-all approach. Their coping and survival mechanisms are responses to what has happened to them and their circumstances. 

Rather than waiting for an imagined solution where our specialist mental health services are equipped both with the resources and understanding to help the people we work with at Changing Lives, we look to ourselves. We need to begin with what has happened to people in their own lives, taking seriously their narratives and recognising that they are experts in their own circumstances. 

A compassionate response to trauma

Changing Lives has recently received #CommunitiesCan DCMS funding through The Vardy Foundation to re-imagine mental health support for people facing the most extreme disadvantage and social exclusion.

Our premise is that so long as our teams that support people in getting through these tough times have a deep understanding of trauma and work within a culture of continuous listening, reflecting and learning to ensure wellbeing for everyone, we – and many other charities and community groups – can help people build their own way out difficult situations. Our teams respond every day with empathy, consistency, boundaries and do so much therapeutic healing often without even knowing it, as they support each person to build their own sense of belonging and connection. In this space we can have a real impact on recovery whilst a psychiatric diagnosis and monthly appointment in a clinical mental health service may remain unattainable.

Changing Lives is one of many in the voluntary sector with a deep understanding of trauma. We believe that the way to recovery can also be found outside of the world of statutory services, where people are connected to others.

Read more about Changing Lives' theory of change here.

Laura Seebohm sits in the Large provider seat of the Reducing Reoffending Third Sector Advisory Group (RR3). Find more information about this work here, or read about Clinks' work on health and justice here.