A Need for Compassion when Encouraging Young People to Engage in Mental Health
Special note from the editors: Please enjoy reading the first blog of our brand-new series, The future of mental health as seen by the future leaders in mental health, written by the 2020 ‘Psych Stars.’ Selected by The Royal College of Psychiatrists, Psych Star ambassadors are a group of final year medical students awarded for their particular interest and commitment to psychiatry. During the year long scheme as Psych Stars, students are nurtured in their interest in psychiatry through assignment of mentors, by gaining access to learning resources and events, and by becoming part of a network of like-minded students. More information on the Psych Stars scheme can be read here. We have decided to invite each of the Psych Stars to write a blog on how they envision the future of mental health by choosing an area in which they are passionate. We have decided to run the series as a celebration of these student’s success and to provide an outlook for each of the awardees to share their passion. With a new blog published each Friday, the series will run over the next few months.
It has been well established that there is inevitably a clash between generations when it comes to how one should behave, think or even live in society. This has become continuously more fragmented between ‘baby boomers’ and ‘generation X’ versus the incoming ‘millennials’ and ‘gen z’. The former often accuse the latter of being ‘snowflakes’ whilst in reverse there have been emotionally fuelled claims of destroying hopes and dreams.
Despite this continuous back and forth debate, we must all remember that we’re only human. To forget this could be devastating for our mental health.
Why am I presenting a debate as to why ‘boomers’ and ‘snowflakes’ should take time to listen and understand each other? Because I believe it follows one of the essential rules which has both saved my life and lives of others: compassion.
By being compassionate and truly going one step ahead of a ‘them versus us’ philosophy, we are able to grow as individuals and delve into the root of issues. Therefore, intergenerational understanding and compassion are topics which need to be understood in the psychiatric world and beyond.
At the risk of sounding condescending: we were all born on the same planet with the same foundational DNA. However, what is different, are the challenges we face today; particularly in an era where uncertainty is greater than ever.
The fact that challenges faced by incoming generations today are different largely invalidates the excuses older adults give for not listening to those who are younger. These excuses can range from distrusting a lack of experience, to the desire for creating a hierarchical society of fear.
On the flip side, it also likely exposes a vulnerability the young tend to fail to consider: as everything is different and unknown, it is likely it is unfamiliar to us all. By criticising older generations for dealing with issues differently due to the unique challenges of the past and the (often contradictory) life lessons gained from this, young people fail to empathise as to why this may cause older individuals to struggle.
These struggles can stem from the simple concept of having extensive experiences to refer to, to tangible, societal issues facing older people today. Both sides therefore become more divided and disillusioned despite the irony that we are often foundationally very similar and working towards aligned goals.
Hence the need for a new ‘generation game’ (I have not watched the show, but I am sure my mother would be proud of the reference). For those who are unaware, the Generation Game was a 1970's television show hosted by the late Bruce Forsyth, where teams of two, containing different generations, would put against each other. At the time, it was unique as it encouraged intergenerational conversation and cooperation.
Interestingly, the 70's were also a pivotal time for changing attitudes towards mental health. Although the original show has long past, the lessons and concept behind it should not be forgotten about. From taking on a new ‘generation game’, we can be encouraged to work with all ages in a symbiotic and productive manner. This is particularly important when it comes down to our own mental health and wellbeing.
Mental health is something we all have, yet it is all too often that a limited age-group of individuals shape its treatment during illness.
Keeping mentally healthy is something so important yet unique to us all, so it is vital that different generations and experiences are able to work together in both how we respond to our mental health and how it is treated once it becomes illness. This will not only mean the incoming generations can make their voices heard; but also ensures we can treat our parents, grandparents, uncles, and aunts in a way that is meaningful and effective to them.
Compassion is about working alongside an individual, to understand, reason with, and support them in solving a problem (not to be confused with empathy, which does not include the additional step of helping others). This can apply to many areas of life. With mental health, it means working cohesively with others to ensure it is maintained whilst being non-judgmental if their reactions or thought processes are different to our own.
I can understand that, to many, this may appear like a theoretical enlightenment which fails to come to practice in reality. I thought this too.
As a medical student, we are often encouraged to use compassion and its synonyms to show that we really understand what our patients are going through. Videos of actors display how the correct posture and occasional concerned nods should be enough to do the trick.
It simply did not add up to me: how could acting a certain way translate to how I felt and cared for that other person?
Was it just to make the patient feel more at ease?
How did it actually ensure I was compassionate and treated the patient in such a way that really reflected their needs?
From my first few years as a medic, followed by being a patient first-hand due to mental illness, I quickly learned that this was unfortunately an institutional misunderstanding. Just because you look like you care, does not necessarily mean this translates into acting compassionately.
However, there is hope.
Following a period of leave due to my own mental illness, I unfortunately felt disillusioned by my fellow medics. Despite constant reassurances that ‘it will get better’ and they ‘understood’ my explicit difficulties, I became hospitalised and relied heavily on my personal support network to recover.
Through this, I was inspired to publicly write about my mental health journey.
Not only was this an incredibly cathartic experience, the feedback was simultaneously inspiring and heart-breaking. Every day, I received feedback from individuals, often at the same stage of their careers as myself, stating they felt so relieved to finally hear (or read) that somebody else had similar thought processes, struggles, questions and reflections to themselves, as shown in the blog.
Although not all had experience of mental illness personally or with loved ones, what was appreciated was the openness of discussion; the balance and understanding of how others reacted to my situation and how I constantly reassessed my recovery.
The feedback taught me more than my reflections: that there was more to compassion and supporting others than just the behavioural adjustments taught in medical school.
The experience inspired me to launch a mental health peer support group for my fellow medics, which I named a WellMed (a conjunction of, you guessed it: Wellbeing for Medics). Not only to provide a safe space for individuals to openly talk and question mental health and illness - destigmatising its occurrence in such a competitive discipline — but to share information and experiences on how to engage with such issues.
A year later, and we have become the university’s largest peer support group (with an award thrown in). Even more significantly, our most well attended event has been established into a reoccurring series called ‘A Blether at Black Medicine’. It involves the ‘boomers’ (often experienced consultants) and ‘millennials’ (often timid medical students) meeting at a coffee shop (called Black Medicine) one evening to discuss (blether) anonymised questions around mental health.
This has completely changed the dynamic of how we speak to each other, and how we want to be spoken to, alongside what this means for our behaviour as clinicians. Students are no longer scared to speak up when their feelings are excluded, as it is done at an approachable level, rather than relying on decisions made by their seniors.
The playing field is leveled to expose the simple fact I discussed at the beginning: we are all humans with new challenges reacting in different ways. Consultants are able to listen to raw feelings to honest questions, and in turn give realistic and effective responses.
Now, I realise (and have been reminded continuously), that medics are perhaps not the most ‘normal’ breed. As a future physician, I wanted such compassionate support to expand beyond the medical sphere. This led to me conducting a thesis as part of my intercalated degree in Global Health Policy. I looked into the challenges of involving young people in mental health policy nationally. By involving individuals in health policy, governments, and therefore health systems and their physicians, are able to completely reform how they react to patients and their treatment. It hereby follows that this has the potential to completely transform how doctor-patient relations and patients themselves are viewed.
For the small group trialed by the government and analysed for my study, the young people finally felt empowered and understood. The biggest challenge? After the trial, when the communication lessened from Scottish government, the young people started feeling that their ideas were no longer being translated in the manner intended. It meant that, although their ideas were taken on, they were potentially being interpreted by policymakers in a manner different to the young people.
This strongly suggested that for different age groups to effectively interact and engage in each other’s thoughts, work and ultimately mental health, the listening and understanding is something which must go beyond the use of a trial group or initial consultation.
Although WellMed and the group analysed as part of my study are relatively small groups representing young people wanting to change mental health in a society often governed by older adults, they show that young people are keen to be engaged in change. However, it is so important that this is done in a manner which is accessible, a manner which truly understands what their thought processes are and a manner which can work alongside older age groups.
This can also allow for mutual peer support between generations as it allows it allows all individuals the opportunity to discuss their personal challenges in a sensitive way. Such a working mechanism creates a refreshing dynamic which can allow all groups involved to be enthusiastic in creating and understanding mental health as a concept for all.
The best bit? Compassion is a practice which everyone can take on board.
Looking forward, I truly am enthusiastic that the generational divide is changing and, slowly, closing. We all have our differences but we also all have mental health.
So, no matter who you are, your background or experience, it is something that can be discussed over an activity as simple as going to a coffee shop.
I think that everyone does, to some extent, care about others: they just may react and rationalise their reactions in a different manner. By showing compassion, we can acknowledge this whilst also supporting the most vulnerable in the way which is the most adaptive and engaging for them.