I see the blogosphere is starting to consider digital differences as well as digital exclusion, please see http://sarahhartley.wordpress.com/2009/11/13/musings-on-the-week-a-north-south-social-media-divide/
I agree with posts in the above blog, that the people who were at the #leedssms were focussed on how to use the technologies, for the benefit of our service users and to promote our individual activism/vocations. Meeting individuals such as @dysconnection, who are truely like minds, is such a benefit when I work in an institution where not many people “get it”- and there is no way I would waste our brief time to hammer out the issues with self-congratulation.
It’s a week tomorrow since the #leedssms and it has given me some time to reflect on how social networking can be used from within mental health services.
Today, I was doing some training which considered psychological theories of attachment. These are based around the developmental process we all go through. Where we experience consistancy in our caregivers, we develop a “secure attachment” i.e. we can predict that our emotions can be named, attended to appropriately, and consequently we learn to regulate our own emotions as we develop. Many people with mental health issues may have grown up without a secure attachment figure in their caregiver- they may have been ignored, say, or dismissed as they attempt to get their physical and emotional needs met. This results in an “insecure attachment”- where because they lack the ability to self-regulate, they continue to display the emotion, escalating in intensity until the (physical or social) environment changes and regulates them.
We were considering the fact that many of our service users may have experienced insecure attachments during their childhood and the implications on this of our constant efforts in th ehealth service to move them on- to get them off our books, discharged, or sent off to a third sector agency- as soon as we considered the risks to be manageable. We had a discussion about the function of the old-style psychiatrists, who were attached to the old institutions. The “old guard” acted as attachment fgures for their service users- although someone was discharged and went back to their usual life, the door was left open for them to come back and re-connect, either at a time of crisis, or change, or even celebration. Some individuals would return just once a year to report on how they were getting on. This mirrors the developmental process of attachment, where children reduce their “clinginess” as they become confident that their caregiver is still there (why Peekaboo is such an important game cross-culturally). They became free to explore the other identities and possibilities of their life beyond that of “mental health services user”, because it was safe to do so.
Now, we have become focussed on community integration, a laudable aim in many ways. However, there remins the issue of attachment. If a service user has been ignored, rejected, dismissed and consequently failed to develop secure attachments in childhood, they are tasked with developing this skill as adults. Unfortunately, if we have insecure attachments, we are likely to seek out further environments that mirror our previous experience, i.e. further experiences of invalidation. This means that the mental health workers could be the only secure attachment figures in an individual’s life. What does it do to that dynamic when the worker is so focussed on discharge- at which point we remove all contact with the service user? It reinforces the experience of abandonment , of rejection, of being worthless. It confirms that other people cannot be trusted, that we only ever have conditional relationships.
I am not arguing for the return to the big old institutions- I wholeheartedly believe in social inclusion. But consider the use of social netwroking to develop attachment beyond an admission…..how would it change the experience of our service users to know they could continue to “check in” with their workers and peers, who may be the people they have shared with in groups- mirroring the family dynamics and allowing the possibility of developmental process…..
It’s my hunch that this could be revolutionary- within the mental health service we always will have people who require long term, continuous, intensive input. But these are a minority group. We have a lot more people who I believe would benefit from being able to keep that lifeline….for where or when they feel things are getting on top. If there was an easily accessible way of these people accessing mental health first aid- this would surely impact on their need to use more intensive and more expensive services. This digital service could comprise workers from statutory and voluntary sectors, and would lend itself to a huge degree of service user involvement. And compared to our primary mental health care at the moment, cheaper to deliver. Most importantly, the whole thing just intuitively feels like the right next step
I’m so excited by this, and this piece is a snapshot of my thinking… now, I have to work out where to go with this.
