Clin­i­cal psy­chol­o­gist Ju­lia Ren­ton says the com­mu­nity must step up

The Jewish Chronicle - - FRONT PAGE - JU­LIA REN­TON

IREMEMBER WHEN my chil­dren were very young, want­ing to find the “Ready Brek” glow with which to en­velop them, to pro­tect them from phys­i­cal, so­cial and emo­tional harm. That wish was con­sum­ing, and, as they grew, only in­creased. While be­ing a clin­i­cal psy­chol­o­gist comes with some knowl­edge, there is no per­sonal or fam­ily im­mu­nity.

I’m de­lighted to be in­creas­ingly in­volved in con­ver­sa­tions about men­tal health with greater in­ter­est and open­ness about this is­sue. As a mother with four chil­dren, I find my­self on nu­mer­ous so­cial me­dia sites. It seems that men­tal health gives us yet an­other po­ten­tial threat about which to angst, while hav­ing lit­tle un­der­stand­ing of the size, shape, form or an­ti­dote. It’s easy to be the “ex­pert” at work but harder to en­sure set­ting up one’s own fam­ily with the reper­toire and skills to man­age their own phys­i­cal and psy­cho­log­i­cal health.

There is no doubt that mod­ern life throws us ever-in­creas­ing chal­lenges. Chil­dren worry about ev­ery­thing from school­work to re­la­tion­ships, peer-group ac­cep­tance to Face­book friends. We may dis­like Face­book, In­sta­gram or the pres­sure to own the lat­est pair of Yeezys but, short of re­lo­cat­ing to the Isle of Skye, this is the world in which our chil­dren live.

Re­silience is de­scribed as the “rub­ber ball” fac­tor, the abil­ity to bounce back in the face of ad­ver­sity. Put sim­ply, re­silience is the abil­ity to cope with, and rise to, the in­evitable chal­lenges, prob­lems and set-backs met in the course of life; to come back from them stronger, or, at least bet­ter pre­pared to face fu­ture chal­lenges.

Men­tal-health un­der­stand­ing has moved on from view­ing men­tal health purely as a fac­tor of ge­net­ics or bio­chem­istry. No one faces in­evitable bi­o­log­i­cal de­cline and no one is ex­empt.

There is a wealth of ev­i­dence in­di­cat­ing the nu­mer­ous risk fac­tors that can make some

This is the world in which our chil­dren live

more vul­ner­a­ble to men­tal-health is­sues. How­ever, there is no sin­gle cause and no in­evitabil­ity of poor men­tal health in re­sponse to ad­ver­sity. Rather, we have the im­por­tant knowl­edge that mit­i­gat­ing stres­sors, in­creas­ing re­silience and in­tro­duc­ing ev­i­dence­based in­ter­ven­tions can make a huge dif­fer­ence to well-be­ing. Risk can­not al­ways be re­moved but, with the right help, we can sup­port young peo­ple to cope bet­ter de­spite dif­fi­cult cir­cum­stances. As com­mu­ni­ties, we may rea­son­ably ar­gue that risk fac­tors such as fam­ily break­down, be­reave­ment or parental men­tal ill­ness are be­yond our con­trol. How­ever, recog­ni­tion and man­age­ment of this stress is within our gift and will, with­out doubt, im­pact on the well-be­ing of our young peo­ple. The good news is that re­silience can be learnt. But build­ing re­silience re­quires prac­tice. How­ever, as the num­ber of re­silient in­di­vid­u­als within a com­mu­nity grows, the strength of the whole com­mu­nity is en­hanced. We be­come bet­ter able to un­der­stand and sup­port each other and to en­gage in con­ver­sa­tions shar­ing our hu­man­ity and com­pas­sion.

The Jewish com­mu­nity is par­tic­u­larly well placed with Jewish schools em­brac­ing the im­por­tance of pas­toral care and Kvutzah (com­mu­nity). I feel grat­i­fied to see pro­grammes that are far wider than academia alone.

JCoSS, for ex­am­ple, proudly re­ports a pro­gramme of teach­ing stu­dents ev­ery­thing from res­o­lu­tion of friend­ship dis­putes, mu­tual re­spect, con­flict res­o­lu­tion and the ben­e­fits of com­mu­nity par­tic­i­pa­tion. Reg­u­larly, the syl­labus will fo­cus on ethics, di­ver­sity, sel­f­re­flec­tion, and self-re­spect. Life is tough but we can en­gage in prac­tice that will be­gin to im­mu­nise our fam­i­lies.

Of course, we can’t ig­nore the fact that some peo­ple will de­velop more sig­nif­i­cant dif­fi­cul­ties and will need to seek help from spe­cialised agen­cies.

There is an over­whelm­ing ev­i­dence-base show­ing that early and speedy ac­cess to the right treat­ment is key in help­ing peo­ple suf­fer­ing from men­tal dis­tress. Timely ac­cess to the right treat­ments im­proves prog­no­sis and pre­vents a vast range of sec­ondary prob­lems.

Three weeks ago, the com­mu­nity par­tic­i­pated in the first “men­tal health Shab­bat” led by Rabbi Daniel Ep­stein. It in­volved more than 80 syn­a­gogues of all de­nom­i­na­tions across the coun­try and was de­signed to pro­vide “a suit­able launch-pad for dis­cus­sions on the na­ture of men­tal health”. There has al­ways been a stigma around men­tal health and sadly, although im­prov­ing, this is still the case in the Jewish com­mu­nity. In the words of Bill Clin­ton, “men­tal ill­ness is noth­ing to be ashamed of, but stigma and bias shame us all”.

Sadly, it isn’t just the stigma that we need fear. It’s what the stigma does. It in­hibits in­di­vid­u­als from seek­ing help; it es­ca­lates self­loathing; and it con­tin­ues to al­low men­tal-health ser­vices to re­main un­der-re­sourced.

The World Health Or­gan­i­sa­tion (2013) es­ti­mates that world­wide, 20 per cent of ado­les­cents in any given year may ex­pe­ri­ence a men­tal-health prob­lem and 75 per cent of those with a men­tal-health con­di­tion start de­vel­op­ing it be­fore the age of 18. Although men­tal

ill-health ac­counts for 28 per cent of the to­tal bur­den of dis­ease (and al­most 50 per cent of the bur­den for those un­der 65), it gets just 13 per cent of the NHS’s bud­get and just 5.5 per cent of to­tal UK health re­search spend­ing. This is scan­dalous but this in­equal­ity is placed on those who have un­til now been shamed and hid­den. Imag­ine if our NHS told us that, while guide­lines showed us ef­fec­tive treat­ments for can­cer, there was no re­source to de­liver them.

So what can we do? Firstly, we can con­tinue the fan­tas­tic work of Rabbi Daniel Ep­stein and of Jami, the Jewish men­tal-health char­ity. Let’s take the fear out of men­tal­health prob­lems and en­sure that ev­ery­one in our com­mu­nity un­der­stands that it’s not ter­ri­ble; you won’t be locked in an asy­lum; your friends and fam­i­lies will not cross the road to avoid you, and you are not doomed to a life of de­cline and dis­abil­ity. Men­tal health is treat­able and re­cov­ery is ex­pected. Statis­tics show us that the out­comes for those who seek help are ex­cel­lent.

Re­search con­sis­tently shows the pos­i­tive im­pact of one sup­port­ive per­son whom you know is there for you. A sense of be­long­ing is crit­i­cal to our well-be­ing, the well-

Men­tal ill health gets just 13 per cent of the NHS bud­get

be­ing of our fam­i­lies and our abil­ity to fully en­gage with all as­pects of life. We all like to feel lis­tened to and im­por­tant. “That’s ob­vi­ous,” I hear you say but are we sure that we re­flect that mes­sage to those who are clos­est to us?

All of us are good at some­thing, but per­haps we more read­ily ac­knowl­edge some achieve­ments over oth­ers. This isn’t good for those who fail to at­tain the cov­eted A* grades but it also has prob­lems for those who do. I’ve seen many a high-fly­ing aca­demic who has been crushed by de­pres­sion for feel­ing that noth­ing else they do was wor­thy of ac­co­lade.

Beth, a 21-year-old with out­stand­ing aca­demic achieve­ments (4 A*’s and a first from Ox­ford) was off work from her high-pow­ered job with a ma­jor firm of man­age­ment con­sul­tants. De­spite Beth’s amaz­ing aca­demic achieve­ments, her own stan­dards were so high that no man­ner of suc­cess was ever good enough.

Fur­ther­more, her nar­row fo­cus on academia meant that no other ac­com­plish­ments, friend­ships, quirks or ac­tiv­i­ties added to her sense of self, pride and worth. Any fail­ure to achieve “per­fec­tion” was met by an in­ter­nal sense of judg­ment, neg­a­tiv­ity and catas­tro­phe.

If we don’t cel­e­brate the lop­sided cake, the good film found


Ren­ton wants more talk about men­tal health

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