Conceptualising Mental Health for an Improved Care Sector
You cannot measure the success of a health sector by the number of services it delivers. On the contrary, a genuinely successful model would help regulate a thriving population needing fewer services. Unfortunately, we have become so removed from wholeness that the amount of people in, or heading towards, crisis mirrors a system that itself is struggling to cope. But, as our health services exceed their capacity, what can we do about it?
Consider a time when youngsters require minimal safeguarding, the elderly have firm ability, and poverty is swiftly dealt with—when every aspect of human existence has eco-logical synergy. To arrive at this point, we have great work to do.
Rosponsability is a Heavy Responsability
Viewing the current landscape, it seems our response-ability is fading. Most people have positive solutions for change, yet nearly as many feel they are losing the ability to improve things. The consensus is that a systemic shift is needed to take care of people more humanely. But if the system has numerous radicals that have answers for change, where are we going wrong? To answer this, we have to journey deep within the human psyche and learn how we got here in the first place.
As with most journeys worth travelling, we need to know the terrain to navigate the pitfalls. Therefore, you can view this work as a process for clearing the road less travelled. Our cruise together, along this autonomic highway, will present some considerations to guide you towards unfolding your truth—which the writer believes we are all destined to do.
The Current State of Care
The stark reality is that we have a service delivery, governance and management crisis on our hands. Combine this travesty with a set of disembodied work ethics, and we have a large pothole to fill. As patients, we’ve been brainwashed to believe that doctors fix us when we’re poorly and that a spoon full of sugar helps the medicine go down. As a result, we have handed our internal response-ability, our immunity, to something outside of us.
The human immune system is multi-dimensional and not governed by genetics alone. Your current state of immunity was shaped by various childhood experiences and will continue to develop into your senior years. We develop new sensory awareness for future biological adaptation as we respond to specific situations. Your survival response is well-equipped to handle short, intense periods of stress, which helps you build resilience. However, our nervous system, like our immune system, is paradoxical; it has a beneficial role that sometimes displays adverse side effects.
When over-primed by stress, these survival pathways become dysregulated and can quick-fire out of context. The impact of pressure on the nervous system also impacts our mental health, and no one is immune to this. For workers in the care sector, those carrying the load of others as well as their own, the need for balancing stress is far greater. To develop a well-balanced, fully functional health force with the response-ability to care for others requires a journey back to wholeness.
Compassion and Performance Fatigue
It is documented that many front-line care workers and managers are certain types of people. The quest to put others first is an admirable quality that not everyone aspires to. The psychopathology of such individuals mainly guides the reason they want to help, heal or support those in need. Their drive often stems from an unpleasant childhood experience they once endured. The event, no matter how small or large, was too harsh to deal with, causing their psyche to part fragment. As a result, they develop a subconscious drive to save others from similar emotional pain in a bid to make things whole again. The autonomic nervous system of such people has been primed to excel when the ubiquitous chips are down. However, people of this calibre often hit burnout long before reaching higher-paid positions without the proper training and support.
The tenacity and purpose of front-line workers rarely meet the respect, dignity and validation they deserve. Such ignorance can seem insulting, which agitates unhealed emotional wounds. A definition of trauma is the inability to process and manage a set of events to a reasonable level of acceptance. Trauma fuels a lack of empowerment and beliefs of not being understood or seen. A single trauma is not necessarily traumatising, but the fragmentation of an individual is. Over time, if further emotional insults continue, a victim’s psyche can end up in a land of confusion—death by a thousand cuts.
Methods are many–principles few
The motive to fix something that’s broken lies deep within all of us; we are wired for compassion and connection. Those who reach positions of power are not exempt from emotional dysregulation, although it may often seem this way to those further down the food chain. The amount of collateral damage caused by getting to the top can be measured by how those that get there conduct themselves. Some people fight to maintain their position, while others thrive on control. But these survival tactics eventually take a tumble and are often exposed. The critical issue at this level is ‘performance fatigue’. In the game of snakes and ladders, players experience emotional intensity through wins underpinned by the dread of sliding back down. Welcome to the corporate care sector, governed by policymakers, commissioners and project managers that often live a similar ordeal.
As a result of the above examples, we have stressed-out leadership governing a hyper-sensitive workforce. With pressure mounting, we need reform for those delivering and monitoring services. A functioning system requires all of its components to flow harmoniously. The human heart requires fresh oxygenated blood to fuel our movements and thoughts—the result of fragmentation between mind and body propels trauma.
Crisis Conflict and Systemic Fibrosis
Fibrosis is a lattice-like formation that starves tissue of oxygen and fluidity; as a result, the surface area becomes dormant and stagnates. Fixation is a form of fibrosis; it lacks room for pliable adaptation.
A corporate approach similarly diminishes the care sector of resilience and pliability. Resilience is a process, not a destination. However, the process does not imply we work up enough gumption to ‘carry on regardless. On the contrary, enduring gumption fuels compassion fatigue and survival fatigue.
To combat these debilitating traits, we must learn to monitor and regulate our stress levels by titrating bearable loads in accordance with homeostasis. In other words, we work to maintain a grounded and flexible nervous system at all times.
When we apply business methodology to care we tend to isolate problems in order to fix them and move forward. Corporate business thrives on growth generation and cutbacks—sometimes to the detriment of customer care, but never its shareholders. Similarly, our medicare-system isolates disease in the name of efficiency. Generally, a single specialist is employed to focus on a specific organ or injury before a solution meets medicinal sedation or removal—but is this cost-effective? For example, a cardiologist focuses on the heart’s functionality over the source of inflammation that drives congestive heart failure. With more emphasis on the surrounding soft tissue, heart rate variabilty improves. We all perform better when our heart feels supported.
Flowing with constant adaptation may seem impractical for those dominating community care. The current system that manages and monitors health budgets is fibrotic, and its rigidity filters down the grapevine. Fixated on monitoring and evidencing reports to satisfy isolated targets, it fuels the neurosis of those it governs. Like the process of autoimmunity, where human cells overreact and begin attacking themselves, the system itself is the root cause. To address change, trauma awareness must ink a new set of blueprints.
It is evidenced in biology and science that the human form is a multi-faceted bio-psycho-spiritual organism that does not perform well alone. A cancerous cell is a wandering cell striving to align its structure with other cells. In isolation, cancer cells manipulate blood vessels to survive, but this causes them to metastasise and spread—the ‘as within so without’ theory.
For the autonomic highway to flow, we must remove the roadblocks that isolate people and bridge the criteria for achievement. Of course, we need academics and strategic think tanks to help monitor, measure and evaluate progress. But a top-down, hierarchical approach that fails to engage on the cellular level is disenfranchising on all levels. The control depth must be shallowed as the government leans on community groups to spread the load.
Questions for inquiry might consider how we can focus less on immediate outputs and more on lasting outcomes. What will it take for the language of compassion to be fluent across trusting partnerships? How can the monitoring and evidence process be more relaxed and operate on a case by case need?
Tenacity is the ability to see and focus on the bigger picture, even when distracted by short-term wins. Destiny is aligning our life lessons with passion and purpose to the point that we detach from anything less significant or ego-luring. The struggle between accountability and trust comes into play here. Outputs may hit targets, pay higher salaries, satisfy commissioners and sign off budgets. But outcomes instil confidence, build trust and foster resilience—remember the isolated cell striving to survive. Initially, the former may seem more tangible, but with scrutiny, the latter evidences a more responsive and functional formula. Community care must be led tenaciously by the passion and purpose of moral community members.
Let’s look at the integrative medicine model, where the doctor employs a holistic and ethical practice. Integrative medicine treats not a single dysfunctional organ but the pathway of disease. Diabetes is a good example, where the overwhelmed pancreas loses its ability to produce insulin in response to blood sugar levels effectively. Due to too much stimulation, over time, the pancreas becomes dysregulated and sluggish. The outcome is that the diabetic has to introduce insulin exogenously or take medication to counteract the impact of sugar on the body.
If we address the root cause of why the pancreas of community care is overwhelmed, we gain a more polarised understanding of the problem. You see, numerous factors can cause dysregulated blood sugar. It could have its roots in the overindulgence of carbohydrates and refined sugars, causing the pancreas to overwork. But what drives the patient’s emotional need to binge this way? Another possible driving factor is the stress hormone cortisol which could be flooding the body, causing glucose to mobilise the fight or flight response. If so, what’s driving this hormone release—is it bacterial, pathogenic or toxicological? When we understand that Diabetes involves all of these issues, new treatments will emerge.
Similarly, an integrative approach to community care will address people’s current life stance and pathology before giving a prognosis. How can the system prescribe a cure without identifying the origins of how it impairs its people?
The point being made is that the intangible often governs the tangible. Corporate care looks good on paper, but the nuances of authoritarian care result in an oppressed population. We must reduce the breeding ground for control, inability, safeguarding, gender and racial inequalities. It is evidenced in medical science that improving the terrain significantly impacts pathogenic activity and supports homeostasis, our state of feeling whole.
Heart Math Sums Things Up
The emotional barometer of the heart has a magnetic field that reaches out several feet; It scans for vibrational congruency and safe bonding. Your heart truly is a device for seeking love. Our heart valves filter around 6,000 litres of dirty blood daily to reimburse us with the gift of life.
How hard the heart works emotionally reflects how much it lacks externally. When we live and work in a stressful environment, the heart has more toxins to filter. The role of a trauma-informed community is heart care.
If promoting the intangible sounds a little whimsical, if the idea of a psycho-spiritual human being sounds a bit hippified, you need to look no further than the greatest intangible asset known to man—your breath. A hypoxic cell is one starved of oxygen; it can’t breathe or relax. The lungs and vascular system are our first line of defence. When we ingest the outer world, we either tense or relax, and our heart responds accordingly. The biology of your mind and body rides on the back of your breath. This rich commodity cannot be touched, seen and barely heard; we take it for granted, but if it didn’t exist, neither would you.
The system must relax and bridge things by addressing the lungs and heart of the matter. The answer is person centred, non-clinical, informative interaction around the impact of oppression. Trauma awareness is social work.
Community Ecological Care
Community Ecological Care is when we work collaboratively, and togetherness becomes the main lead — we work for the collective heart. As established, when led by collective purpose, human cells flourish. When focused on the totality of their efforts, communities thrive from the standpoint of we over I.
Mental health may be the current focus, but until we treat this as a biological problem we remain fragmented. Due to the monitoring, proofing and evidence process, medical research takes many years to establish new protocols. But, we humans, in our wholeness, can address change today. Reformation thrives on wholehearted connectivity and communication. How we interact with ourselves, others, and our environment is the way to systemic change. Pulling out of the fast lane and travelling the autonomic highway with dignity and grace requires deep reflection on the legacy of a traumatised system. When we and the system itself have the agency to recognise that we have been traumatised, we will reduce our outwardly focused frustrations and ease our inner conflict.
What is clear is the fact that how future generations heal is down to how we redefine our purpose today. The role of a trauma-informed community is to reduce the amount of sick care intervention needed for us to become whole again.