How psychology services and care for children might look like in a Wellbeing Economy
Sep 24, 2020
By: Kitty Forster, Assistant Psychologist & Researcher, Wales
Statistics suggest 1 in 4 people experience mental health disorders and mental health issues are on the rise amongst younger generations. Our pace of life has evoked unprecedented levels of stress, anxiety and depression in our modern societies, specifically in the younger generation.
Various causes have been named as hypotheses for increased mental health issues; trauma, housing concerns, financial insecurity, working hours, poverty, social media, reduced connection to nature and communities.
There is enormous cost to society as a consequence of mental health issues; treatment costs, societal issues or missing workdays. These expenses are projected to increase significantly.
The World Health Organisation calls for reduction in stigma in mental health, and greater focus on prevention strategies.
Thankfully, mental health has become less of a taboo in the last couple of decades, along with increased access to evidence-based therapies available on the NHS, such as Cognitive Behaviour Therapy (CBT) and Dialectical Behaviour Therapy (DBT), as well as traditional psychotherapy.
In addition, Mindfulness and other stress-reduction techniques are being promoted in the mainstream.
This is a valuable shift in perception and action.
The NHS is facing a significant increase in costs for social care services for Looked After Children due to parents struggling, crisis mental health cases, physical health costs of drug and alcohol abuse and judicial services and rehabilitation.
This spending is reductionist response to symptoms; rather than a holistic preventative approach, which would attempt to alleviate the prevalence of human suffering in the first place.
As well as providing mental health services for crisis cases, who are obviously prioritised on NHS waiting lists, there should be a greater allocation of funding for access to psychological services. The irony is that preventative services could cost less than patching up the societal ills of an unsupported community further down the line.
A wellbeing economy would be designed to prevent mental health issues, where possible, by providing dignity, connection and fairness to all.
Psychology, social care, mental health, education and childcare services are themes at the heart of a wellbeing economy and could be positively impacted by a change in public spending, focusing on valuable services for the psychological wellbeing of our communities.
Mental health is a spectrum. You’re not either totally well balanced or completely ‘insane’. Everyone slides around on the spectrum according to their personal histories, current lifestyle choices and circumstances. Our current society doesn’t seem to provide support until someone is further down the spectrum towards total mental health breakdown.
There is a huge proportion of society who could be feeling more emotionally stable if given education about simple tools for wellbeing, and this decreases the chance that some of those people might slide towards the danger zone end of the spectrum.
Psychology Services & Care in a Wellbeing Economy
Services for All
There are charities, Relate and Mind, currently focusing on providing mental health services for less ‘crisis’ cases, when the NHS is unable to allocate support.
A wellbeing economy could advocate for greater access to psychological and wellbeing services available for all – to facilitate all citizens to access healthy coping strategies, psychological education and counselling support.
I would envisage psychological educators, mindfulness teachers, parenting specialists, relationship counsellors, CBT therapists available for group sessions in all villages and community halls on a weekly drop-in basis. Clearly additional specialist one-on-one services would still be required, and these community sessions could signpost individuals to more intense support when needed; including support for domestic abuse, alcohol or drug issues, and referrals for cases requiring specialist one-on-one mental health intervention.
Psychological education could be provided on the following themes: how CBT works, how mindfulness works, the nature of healthy and unhealthy relationships, the psychological benefits of exercise/diet/sleep, the alternative coping mechanisms to try for stress, anxiety and depression.
This would reduce the likelihood of maladaptive coping strategies or unhealthy behavioural patterns becoming habitual. There are huge number of CBT resources available online, which are safe for the general public to use on a self-help basis after initial direction.
Additionally, the provision of wellbeing services such as Mindfulness and yoga classes available in each community centre on a regular basis would be helpful as a baseline measure to promote emotional wellbeing. The NHS now promote Mindfulness and endorse a specific online course Be Mindful.
A relatively new strand of research is demonstrating that the concept of Interoception – ‘the 8th sense’ – plays a huge role in people’s abilities to notice their own physiological bodily signals, that subsequently manifest as emotion. The ability to notice your emotions as they arise is hugely advantageous in terms of emotional regulation, making positive behavioural choices and personal agency. Interoceptive awareness can be enhanced with positive psychological benefits through meditation, mindfulness, yoga and other body-based contemplative practise (note: specialist interoceptive interventions are required for those with a history of trauma).
If delivered at scale, these services could hugely benefit the wellbeing of society. This increased emotional self-awareness and plethora of coping strategies could potentially alleviate a lot of unnecessary human suffering.
However, promoting these wellbeing services is not a panacea. These suggestions are certainly not sufficient to eradicate societal problems such as poverty, inadequate housing, poor social mobility and inter-generational trauma. More systemic interventions are needed for the most disadvantaged members of society. Interventions for children are needed to help break the recurring dysfunctional patterns in disadvantaged parts of society, as well as adequate government funding for housing, education, health and childcare.
Services for families
These aforementioned psychological services could help support a healthier generation of adults in our society, and this vicariously would have a positive impact on their children too. A parent’s poor mental health understandably influences their children’s wellbeing. A parent who is more emotionally stable within themselves is likely to be more able to provide emotional co-regulation for their children, to scaffold these capacities for the future generations, as well as being positive role models. Providing parents with the resources to manage their own emotions and help their child to develop emotional awareness is key.
In addition, a wellbeing economy could consider how to support families in whatever way suited their personal choices. Either to enable greater financial support for child are services, if mothers chose to return to work; or to support mothers to stay at home to raise their children during the early years.
Despite this being a personal choice for families, and hugely positive that it’s now socially acceptable to return to work, reportedly there is some judgement felt if women choose to remain at home with their young families. Some women report to be made to feel they are not contributing to society; yet they are raising the next generation, our descendants!
This role in society should also be valued. Incentivising a quick return to the workplace and to pay for childcare may be entangled in an economic system that doesn’t have families’ wellbeing at heart. Both options should be a financially viable choice for all families. At present women feel judged for returning to work and judged for staying at home!
Services for children
These broad themes within childcare services and the educational system could arguably have a greater impact on the wellbeing of our future as sociological culture evolves, than merely introducing new services for adults. A child growing up in a society where there is access to psychological education and wellbeing services as an accepted norm, has a greater chance of developing into a well-adjusted adult, with self-awareness and a repertoire of positive coping mechanisms to be resilient to life’s challenges. The reformation of the Welsh curriculum to incorporate health and wellbeing is hugely encouraging.
Wales has an amazing opportunity to promote mental health awareness from an early age, whilst children are receptive to new concepts. Some countries have ‘Interoceptive Awareness’ curriculums in mainstream schools, to teach children to notice their internal bodily signals and to learn to notice their emotions.
In Personal, Health and Social Education subjects, there needs to be a greater focus on psychological education – techniques for managing anxiety, stress, depression; which could encompass CBT resources, breathing and meditation techniques and the benefits of physical exercise. Children could also be taught about healthy and unhealthy relationships and how to negotiate difficult relationships they may encounter.
A film focusing on resilience in children cited a programme called ‘Miss Kendra’, developed to provide children with opportunities to express things that upset them, which they couldn’t safely express in day to day life. It was delivered in neighbourhoods with a propensity for a high proportion of Adverse Childhood Experiences (a significant predictor for both physical and mental health issues).
Other aspects of the film focused on how schools can teach children to have healthy expectations for how to be treated with respect and advocated mindfulness and meditation techniques to manage stress. Some schools have incorporated Mindfulness and yoga into their provision.
Mental health aside, in a broader sense, schools could have a huge impact on the wellbeing of subsequent generations if working in alliance with the Wellbeing Economy. Moving away from a competitive indoctrination of children to try for the best grades academically and feel that they are less worthy if they don’t achieve this.
Schools should ideally have the freedom to value the range of skills in a group of children, to foster their individual strengths. Some may take the typical academic path, others may be more practical, mechanical, artistic, or a very caring and nurturing person who may end up being an excellent ‘keyworker’ in social care services. Covid-19 really highlighted the inequality in our society – social and health care workers are not adequately valued or financially compensated for the vital services they deliver. Building an Education system that incentivises and values equally all roles in society – and an economic system that financially compensates roles which are crucial for functioning communities – would create a more diverse range of jobs that are considered to be valuable and aspired to.
Our current achievement and wealth-based status system is elitist and damaging to the self-worth of the majority of working people. We are led to believe that if we aren’t earning top wages, we haven’t achieved our potential. There needs to be a radical shift in social values, which could start in schools; to promote a more diverse acquisition of interests in children, with the ultimate aim to support long-term wellbeing in society – rather than creating worker bees who will grind away at the cogs or our current economic system.
Education should teach children to have the confidence to voice their opinions, promote creativity, promote and value positive personality characteristics, normalise emotional difficulties and provide time and space for children to indulge in the ‘being’ mode, rather than rushing them into the ‘doing’ mode of Western civilisation – with no time to develop towards their true potential. Children should feel pride for whatever skills they’re blessed with and not only if they are built to win the rat race.
Kitty’s Bio: I have a Psychology Bsc and MRes in Psychology. I have worked in the children’s social care sector, the NHS and within the Psychology department at Bangor University. I like to consider the macro perspectives in mental health issues and consider how these could be addressed systemically for the wellbeing of our society.