Concerned about the number of children living in squalid conditions in temporary accommodation, Jane Williams decided to do something about it. A year on, she has some learning to share with service providers
Photo: Teri Pengilley for the Guardian
A will attempt to get a good night’s sleep sharing a double bed with her 18-month-old twins and her grandmother
F will watch her 2-year-old daughter, already traumatised by domestic violence, kept awake and cowering by the shouts of drug users and drunks outside her door in B&B accommodation
L will listen to her 3-year-old wheezing again because the window by her bed is cracked and mould on the wall is growing faster than she can clean it off.
The doctor wants to charge £65 to write a letter confirming that her wheezing is made worse by the poor housing
In December 2017, there were 1,994 under-fives living in temporary accommodation in the London borough of Newham. This number represents a need that is never-ending. It is refreshed weekly with the churn of new families being housed in Newham while others are moved away.
I am able to give you a number thanks to a FOI request made by a newspaper. I’m not sure what the most up to date figure is as there is no agency that keeps track of the under-fives swilling from borough to borough, effectively homeless. I imagine it is likely to be about the same.
Social disadvantage and inequality tug at the very fabric of what makes society functional. It is time to reflect this in our conversation about mental ill health
First published on 20/5/2018 by The Independent during Mental Health Awareness week. Republished here on World Mental Health Day (Photo by Tom Parsons on Unsplash)
Annabel Head and Jessica Bond
In 2018, mental health and psychological distress are high on the agenda. And this is great progress. The increased awareness of mental health issues and the willingness to discuss them that we are currently seeing is vital. It keeps pressure on policymakers to fulfil their promise to put mental health on an equal footing with physical health.
To really make a difference, though, we need to take the conversation to the next level – to raise a different kind of awareness that leads to a different kind of action. Awareness about the root causes of psychological distress. We need to spread the message that the society and communities we live in and the way they are organised by social, political and economic forces play a significant role in our wellbeing. We need that message to become part of the conversation around mental health so that the ideas are built into the heart of all of our society’s policies, not viewed as only relevant to NHS mental health services.
The case for the role that social, economic and environmental factors play in mental health and distress is robust. Psychological distress (often categorised as “mental disorders” and other terms we, as psychologists, are not always comfortable with) is not distributed equally across society. People lower down the socioeconomic ladder suffer more mental distress than those higher up, with the gradient particularly pronounced for women. Inequality is also associated with poorer wellbeing for those at the sharp end.
Multiple studies have shown a link between low socioeconomic position and increased rates of depression and anxiety. Debt and having a poor-quality job – such as those with zero-hour contracts or where there is little control or reward to be had – are risk factors for experiencing distress.
Unemployment is associated with a higher risk of suicide. Similarly, poor quality or overcrowded housing is linked to poorer mental health in adults and is worse for children’s educational and health outcomes. Living in a neighbourhood blighted by violence or with a high crime rate is associated with trauma. Those experiencing oppression through living in communities in which there are high levels of racial inequality and discrimination are more likely to feel distressed.
Social injustice and inequality in the care system Part 1: How professionals can inadvertently make things worse
Psychologists and social workers who see risk rather than need are doing families living in poverty a disservice
Photo by Emma Goldsmith on Unsplash
On August 16, the British Association for Social Workers (BASW) and Psychologists for Social Change (PSC) co-hosted an event to highlight social injustice and inequalities within the child protection and care systems.
I work as a clinical psychologist in a service for people with a learning disability and have been an active member of London PSC for three years. At the event, the audience heard presentations based on research and practical experience of psychologists, social workers and people with lived experience of the care system. I agreed to summarise the points that resonated with me, along with some of my own thoughts.
After the main presentations small groups discussed what they had heard and came together to think about individual and collective action. I've collated our ideas in part 2 of this blog: "We need to be more 'counter', committed and personal". You can read BASW's Eve Wilson's take on the event here and watch a recording of part of the event here.
What does the research say?
Professor Anna Gupta discussed her research, alongside that of Paul Bywaters, Andy Bilson and Michal Krumer-Nevo. Professor Gupta explained that a child is ten times more likely to be taken into care if they come from an area of high deprivation compared to an area of low deprivation. (Deprivation refers to a community's access, or lack of access, to important resources such as income, education, employment or health). This is also the case for children on a child protection plan, which is drawn up by the local authority and the family after an investigation to keep a child safe or improve their living conditions.
As local authorities have continued to be hit by austerity, there has been an increase in the numbers of children on protection plans, most often for emotional abuse or neglect (the proportion of children in care for physical or sexual abuse appears to stay the same). Despite this increase, a large proportion of children are not being offered any service after the investigation. So, families are labelled as not providing “good enough” care but not “bad enough” to warrant support, a situation that Professor Gupta suggested has contributed to the relationship between services and families feeling increasingly authoritarian and coercive.
What then is driving these differences in the involvement of child protection services? There is no evidence to suggest that parents in Blackpool (an area of high deprivation) love their children any less than parents in Wokingham (low deprivation). Is it down to the differing levels of deprivation?
Professor Gupta talked about the direct and indirect impacts of poverty on children and families – both of which play a role. A direct impact would be the inability to buy food for your family if you do not have access to money. An indirect impact would be the lack of power that people living in poverty hold, blocking their access to roles, rights and opportunities as well as having an impact on the way professionals interact with them.
Social injustice and inequality in the care systemPart 2: “We need to be more ‘counter’, committed and personal”
There are lots of things psychologists and social workers can do to ensure that families are treated more humanely by the care system
Photo by João Rafael on Unsplash
On August 16, the British Association for Social Workers (BASW) and Psychologists for Social Change (PSC) co-hosted an event to highlight social injustice and inequalities within the child protection and care systems. This is the second part of a blog responding to the event. You can read the first part 'How professionals can inadvertently make things worse' here.
While there might always be cases when children need to be taken into care, the focus of the event was on “reclaiming humanity” in child protection services. How can we ensure that families are treated more humanely? How can we ensure that services don’t worsen their situation?
Care leaver, social work student and children’s support worker Aijannah de Nisci shared an initiative in her workplace which challenges the assumptions underpinning the labelling and “othering” processes at work in the system. She explained that whenever “neglect” is discussed in meetings, other team members ask “what do you mean by that?” and “what does that look like”? This opens up a wider discussion of the family’s experience and allows for the possibility of change at a preventative stage. This led us to consider how professionals can help tackle smaller problems for families, before children are put onto child protection plans or taken into care.
Shoda Rackal, a breastfeeding peer supporter and member of Legal Action for Women, shared some of the community groups available to support families in the child protection system. She spoke about a monthly support group for mothers whose children have gone into the care system, and the monthly picket held outside a family court on the first Wednesday of every month. She also recommended the Legal Action for Women dossier, available online, on the unjust separation of children and their mothers.
Professor Gupta presented a quote from Michal Krumer-Nevo which encourages social workers to become more comfortable resisting – or countering – “the system”, more committed to social action, and more personal in their interactions, standing alongside families. As a psychologist, these are aspects to our practice which I think we can all incorporate, both those working in the care system and in other areas of health and social care. We could also look to Community Psychology. Community psychologists have long acknowledged the importance of working with marginalised groups to challenge social conditions, through both therapy and activism. Sue Holland’s social action model of psychotherapy is often used as an example of this, and I wonder whether some of the psychologists involved in the event might be able to incorporate some of the examples of collective action listed below into their clinical practice.
Far from being "transformational", the plan fails to address the fundamental barriers to long-term improvements to the nation’s mental health
Photo by Redd Angelo on Unsplash
Jen Daffin, Sally Zlotowitz and Jessica Bond
By 2023, children in about a quarter of UK schools will learn about mental health and wellbeing in their PSHE (personal, health and social education) classes. Those who are struggling with their mental health will be identified by a trained staff member and will be supported by new Mental Health Support Teams or directed to the right specialist service - services that will be more accessible thanks to four-week waiting time targets.
At least that’s the plan. The finalised proposals, announced by the government at the end of July after a public consultation, are an attempt to improve the mental health of children and young people in the UK. They will be rolled out in pilot areas from the end of 2019, with the aim of reaching between 20% and 25% of the country’s children four years later.
From the beginning, the Department of Health and Social Care and the Department of Education have made much of their “transformational” plan’s focus on early intervention and prevention and the “brand new workforce” that will be created to carry it out. In our view, their initial proposal, published as a Green Paper in December, was woefully inadequate in this regard. As part of the public consultation, Psychologists for Social Change submitted an open letter signed by 1400 psychologists, teachers, social workers, counsellors, as well as young people with lived experience of mental health issues and their parents. We explained that the proposal was a huge diversion away from the real issues surrounding children, young people and families’ mental health because it failed to address poverty, reduced social mobility and the growing number of people living in inadequate housing. These issues have been indisputably linked to poorer mental health. We urged the government to “take a genuinely preventative approach” by acknowledging and addressing these societal risk factors and bringing an end to the austerity policies that have exacerbated them.
Matt Hancock should listen to NHS staff about the impact his predecessor's decisions have had, and learn from it
While celebrating its 70th birthday, the NHS found it had a new captain at the helm. Matt Hancock, former Culture Secretary, has been re-shuffled into the role of Health and Social Care Secretary. But in what state does Mr Hancock find the UK’s health and social care services? What aspects of these services should he look at addressing?
Over the last five years, there has been an inescapable gulf between the experiences of NHS workers, and the statements given about the NHS by those at the top. PSC urge Mr Hancock to take note of the experience of NHS workers and address our concerns.
After more than half a decade under his predecessor’s leadership, the NHS has never been in worse shape. Patient safety has been put at risk to such a degree that last year the Red Cross said that the NHS was in a “humanitarian crisis”. At the time, underfunding had reached such crisis levels that NHS services in North London were facing a £183m deficit, leaving 1.44 million people living under commissioners who were forced to choose service delivery options “that impact on quality of care”. Things have not changed, with a Kings Fund analysis in May showing that the NHS has one of the lowest levels of doctors, nurses and hospital beds in the western world.
Yet there are those making profit from this atrocious state of affairs. Tenders are being given to private companies at a rate never before seen in the history of the NHS. Worse still, where private companies don’t win tenders, they are now suing the NHS for lost profits.
We aim to use psychological knowledge, galvanise psychologists and support others to campaign for a more equitable and psychologically healthier society
In our first blog post, we outlined our vision for a more equitable and psychologically healthier society. Here, we are going to talk about how PSC has been working towards this.
First of all, who are we? Psychologists for Social Change, PSC for ease, is a network of applied psychologists, researchers, citizens, academics, therapists and students, and anyone else who is interested in applying psychology to policy and campaigning for progressive social change.
The group formed in London in 2014, originally as ‘Psychologists Against Austerity’, after a meeting of like-minded community psychologists. We now have groups across the UK - in Northern Ireland, Wales, and northern England. In 2017, we changed the name to Psychologists for Social Change, so it could become the umbrella group from which we could run different campaigns, with Psychologists Against Austerity being the first. Psychologists Against Austerity is still a campaign in its own right and people use both names depending on what fits best. Although PSC initially came out of a meeting of community psychologists, not all of its members define themselves as community psychologists. However, the values of PSC very much align with community psychology – namely social justice, stewardship, and community.
You can read more about the development of the group from an article that some of us wrote for Critical and Radical Social Work: An International Journal which is available here
What would one look like? What needs to change? The PSC blog is a place to discuss issues and stumbling blocks on the road to creating a society that works for everyone
Photo by Samantha Gades on Unsplash
A more equitable and psychologically healthier society. A society which is more socially just, more peaceful, and more ecologically attuned. A society that, at its heart, encompasses the beauty of the human spirit, enhancing the values of compassion, solidarity, interdependence, and cooperation. Such a society would lessen psychological distress and would bring better individual and collective well-being, including for people who are currently marginalised.
Sounds good, doesn’t it? But what would such a society look like in reality? Day to day? Would yours be the same as mine? How do we create one? What is it about the current system that needs changing? These are some of the questions that we are hoping to address on this blog, ideally with your help.
We have some ideas, but we want to discover what this vision means to other people and other groups, and the ways you think we can get there. We want to hear from people for whom the current system is not working, from people who have an idea for how to change it, from those who have made it happen, and from people who can argue for a different way of doing things from their personal or professional stand-point (whether they are a psychologist or not). We will also post blogs about PSC campaigns and about how we work as an organisation.
At PSC, we believe psychology, mental health and well-being services - and the discourse around them - has become too ‘individualised’ in UK society. We believe people are being offered medication and talking therapies in a way that can obscure and downplay social issues, such as being overwhelmed at work, being poor, living in insecure housing, experiencing racism, feeling chronically stressed, and bearing the brunt of political policies like austerity. We are not advocating that psychologists should abandon individual therapy, nor should our stance be read as tacit support for the continued cuts to services. We are simply trying to move beyond the over-emphasis on individual mental health treatment.
If this sounds inspiring, please get in touch by emailing email@example.com or giving us a shout-out on Facebook or Twitter. Tell us what you’d like to see on here and, even better, if you would like to write it. We can send you some guidance we’ve put together for writers.
As PSC does not have access to funds, we cannot pay you for your blog. We hope that any subject you would want to write about for this space would also be relevant to you, so by publishing and promoting simultaneously, we can ‘signal-boost’ the message. We are happy to include links to campaigns or fundraising pages. We hope that you feel that this is a decent trade but please let us know if there is anything else we can do in exchange.
PSC is a network of people interested in applying psychology to generate social and political action. You don't have to be a member of PSC to contribute to the blog