My aim in counselling is to understand my client as fully as I can. Understanding goes hand in hand with empathy. The better I can understand a clients life, experience and perspectives, the better I can imagine what life might be like for them.
For me, part of that work is understanding the context in which a client lives their life. So on one hand, tuning in to and responding to the client as they sit in front of me, while at the same time zooming out to get the macro view of their life.
We all live within in structures, societies, histories, communities, social rules and constraints. Some of the effects of these on our lives are obvious, and others are harder to spot. Some of how the society or context we live in can effect our lives can have everything to do with other parts of our identity. Two people can live in the same geographical location but be having very different experiences in life depending on their ethnicity, gender expression, social class..and so on.
All of that is to say, I have been thinking alot recently about the context in which we lives our lives in Northern Ireland in an effort to understand what effects our mental health. Although I do work with clients in other parts of UK & Ireland, the majority of client are based in Northern Ireland.
I came across two studies of interest on the subject; Mental Health Foundation: Mental Health in Northern Ireland: Fundamental Facts 2016 and Review of Mental Health Policies in Northern Ireland by Professor Siobhan O’Neill, Professor Deidre Heenan and Dr Jennifer Betts in conjunction with Ulster University.
There is ALOT of information in both documents, pointing to a complex issue with lots of different areas for consideration and I’m not even going to try to summarise it here. However there were a few things that jumped out at me.
The first, and probably most obvious one, that is mentioned alot in correlation to poor mental health here, and that the effect of living though conflict, and/or living in a post-conflict society (depending on how old you are now).
Transgenerational trauma. Living through events that are disruptive and traumatic has an impact on mental health. But also living in a society that has been though a traumatic event in it’s recent history, even if you were too young to really understand what was happening, or weren’t born yet, can also have an impact on mental health.
Best illustrated in The Body Keeps The Score by Bessel Van Der Kolk, the idea is that trauma can be stored in the body and stays there until the person can find a way to release or discharge it. And that trauma can also be passed down on a genetic level, to the next generation of people. So even if they didn’t experience it directly, or weren’t even alive at the time, they can still feel the effects.
This is widely accepted as a huge contributing factor to the overall picture of mental health in Northern Ireland.
Other factors highlighted in the reports as contributing factors to poor mental health are lack of funding and investment in NHS mental health services and community based services which leads to difficulties in accessing help, higher levels of deprivation and social need, austerity, chronic stress, living in a polarised and divided society and the fear of difference.
On a personal note, I could add into that our frustrating and depressing political landscape, the lagging behind on womens, LGBTQ and BAME rights. And actually I would maybe also count the weather, I always feel the mood and spirit of the place lift on a sunny day.
One of the things I found really interesting about reading the documents is just how much we don’t know, and are still to find out about the experiences of older people, younger people, women, peri natal experiences, the LGBTQ population and the Black and Ethnic minority population. There are gaps in the knowledge of the mental health experiences of large sections of the people that make up our population.
So I guess my point is that it feels helpful to understand all of this when working with clients. And maybe it’s helpful, reassuring even, to place mental health in a societal context rather than to any lack or failing on the part of an individual. And here in Northern Ireland, there definitely some things that are specific reasons for where we are with our mental health, and so many gaps in the experiences of a diverse range of people that are still to be understood.