Anxieties from mental health system fragmentation, under current underfunding strictures, echo and vibrate from back office to front line, from top to bottom and back again, threatening the destabilization of each interlinked containing unit; client/support network, client/staff, staff/supervisor, supervisor/management/organisation. I include those using services as part of the organisation.
What happens in this big group? Some parts distance to preserve, some parts hold an overload of anxiety, some parts fight hard to persevere. Each of us has different valencies in a group, we may pick up on these roles at different times to cope, and sometimes feel entrenched or pinned in them, finding ourselves 'being' in ways that can feel less authentic to how we usually are.
it'll can be difficult to know quite why we are acting in certain ways in groups, or understand the power and influence of organisational structures and messages under stress. It feels like all the things that are written between the lines, or what is left unspoken in silences. Whilst it is important to attend to the thoughts, feelings and behaviors that we have, and the content we bring individually, not giving credence to the power of what happens in groups can lead to over individualisation of problems and denying of organisational responsibility.
Staff and clients, whichever we are at the time, can become subject to positioning within organisations which is not entirely of our own making and can start to feel inflexible and constraining.
One way to find movement is to try to speak about it at all levels from client and staff. But what we hear, is that stressed systems can receive such speaking as an unusual threat to it's tied up way of coping. Feeding-back can be, and has been, met with hostility or attack, covert or otherwise. Splits and divides occur.
These are the kind of complex systems issues we need to think about when we think about the welfare and mental health of staff and clients in mental health organisations.
Organisations could be seen as living, breathing human organisms with thoughts and feelings travelling through all parts of it, each echoing the other. Vulnerabilities and strengths in all parts, intimately connected and not entrenched in just one part. For a system to find homeostasis it's connections must be cared for and allowed to flow and move, it's feelings understood as integrally mixed in each part. To understand this is to understand that we share, not that we separate, disown, dismiss, disavow, cut off, stop thinking, stop feeling; then flexibility has a chance to return.
Humans will always use defences to protect parts of themselves, it's inherent and can be very important, and so with organisations. But when these defences become very deeply embedded under continued stress to a concerning level of blindness to pain, suffering and need, the cost is high for all those involved.
Organisations need to incorporate safe breathing spaces in their systems, like parks in cities, where walls can be lowered and it can replenish. Shared reflection time for all parts of the system across all levels and roles helps develop awareness of thoughts and feelings from all parts, engenders creativity, and integrates information from important feedback loops.
Organisations can find ways to breathe through the impacts on staff and clients of funding restrictions, but after too long, it's at asphyxiating cost to the wellbeing and mental health of both.
It is hard to be a part of living in these straitened times in the NHS. Trying to function in a strung-out organisation and witnessing the same in others. But if we don't witness, reflect or feedback, how do we help ourselves and each other become unpinned, so our organisations and all the individuals in it - clients and staff - can flex and flourish? How do we try to see through division and splits of strength and vulnerability in systems that make no sense when compared to the individuals that we know? How do we protect the good work when it feels like the house is burning down?
People come to this work because they intend to do good at all levels, people approach in great strength when they ask for help. Whichever position we find ourselves in, in the middle of all this it's important to hold onto the heart at the centre of it.
Natalie Kemp