Assumption 1: "I know what's best for you"
It’s completely human to want to offer advice, especially when we think someone needs help. However, the problems arrive pretty soon after because our advice is always based on our own frame of reference. Even if you have personal experience of mental ill health, your own experience will be completely different from the person you’re advising. Sadly, we seem to be stuck on the idea that people who are experiencing mental ill health cannot look after themselves. They can and do.
What to do
Refrain from dispensing advice. Ask questions, listen respectfully, respond accordingly and leave volunteers to be responsible for their own behaviour and decisions. Empower people to assert themselves and ask for help as and when they need it.
Assumption 2: "These poor people need our help"
It’s often the side effects – both medical and social - of mental illness that make people seem weaker than we are. These side effects might include tremors and confused speech as a result of medication; the loss of social networks as a result of isolation and alienation; the popular perception that mental illness only afflicts those who ‘can’t cope with life’.
What to do
We need to step away from the idea that ‘these poor people need our help’. People who experience mental ill health are often some of the strongest in society, the most creative, the most dynamic, the most inspired and the most inspiring. Think of people like Spike Milligan and Winston Churchill. Treat people with the same respect and attention you would to any other volunteer.
Assumption 3: "Just pull your socks up!"
We sometimes treat people with experience of mental ill health as if their illness were self-inflicted and could be controlled by sheer force of will. Telling someone who is trying to cope with the day-to-day effects of mental ill health that they just need to ‘pull up their socks’ is like telling someone with a broken leg that they just need to get up and walk. It also assumes you know what they need to do to recover. You don’t.
What to do
Learn about how mental illness might affect people and how it might contribute to your belief that people just ‘need to buckle down’. Does their medication make it difficult to get motivated in the morning or concentrate for extended periods of time? Are they awkward and uncomfortable because other staff joke about the service users they come across?
The Spread Effect
Have you ever noticed how you tend to speak louder to people who don’t speak English? As if, because they don’t speak English, they’re also hard of hearing. That’s the spread effect in action. We make decisions about people’s abilities based on one, simplistic observation. With mental illness, it can get pretty ugly. Judgements are made about people’s intellectual capacity, their emotional state, their ability to work; all sorts of incorrect assumptions are made and limitations imposed as a result of the ‘mental illness’ tag. For example, just try to get travel insurance if you have a diagnosis of manic depression.
What to do
Look at behaviour patterns. People often try to simplify their language, in the mistaken belief that they’re making themselves understood to someone who doesn’t understand ‘normal’ instructions. Are people assuming that mental ill health co-exists with some sort of intellectual impairment? Make sure you and your staff are clear on the distinction between mental illness and learning disabilities. While some people with learning disabilities may also experience mental ill health, mental illness does not signify a learning disability.
Language
Even with the best will in the world, trying to ‘say the right thing’ can tongue tie the most articulate of us. It’s often not so much a problem of language as the embarrassment people feel if they think they’ve made a mistake. Should we refer to ‘people with mental health issues’ as just that, or maybe as ‘sufferers/survivors’, ‘clients’, ‘consumers’, ‘service users’ or just plain ‘users’? And do they ‘suffer from’, ‘experience’ or just plain ‘have’ ‘mental ill health’, a ‘mental illness’, a ‘psychiatric disability’ or ‘mental distress’?
What to do
We worry about causing offence by using the ‘wrong language’ and can end up with both feet in our mouths because we forget who we’re talking to and focus on how we’re saying it. A young volunteer with enduring mental health problems advised me recently, “I really don’t care if you call me a ‘service user’ or ‘sufferer/survivor’ or whatever. As long as you speak to me like I’m a real person instead of some kind of non-entity, I’m going to be happy.” Ask people what they prefer and be flexible. Focus on plain, clear, honest communication and bin the jargon.
The ‘Kid Gloves’ Syndrome
Many people with little experience of mental ill health worry about asking the wrong questions and making people worse. It’s hardly surprising. Mental illness is so taboo in our society that even approaching the subject can be awkward and uncomfortable. And we often think the ‘unpredictable’ nature of mental illness means all sorts of inadvertent actions might ‘push people over the edge’.
A lot of us unconsciously over-compensate:
by treating people as if they are vulnerable, fragile and less capable than other volunteers by acting as surrogate counsellor, psychiatrist or psychotherapist by ignoring the issue completely and pretending everything is ‘normal’ What to do
Don’t try to second-guess people in order to avoid ‘upsetting’ them. People with mental health problems are often used to being asked highly personal questions by medical professionals so they’re probably more comfortable with discussing their situation than you are. This is not a green light to invade people’s privacy! However, people will rarely be affected by what you might feel are ‘awkward’ questions if they’re being asked for a legitimate, relevant reason.
