World Mental Health Day 2020: Growth, resilience and self-determination: essential pillars of future mental health services

“To be a human is, precisely, to be responsible. It is to feel shame at the sight of what seems to be unmerited misery. It is to take pride in a victory won by one’s comrades. It is to feel, when setting one’s stone, that one is contributing to the building of the world. “ - Antoine de Saint-Exupéry, Wind, Sand and Stars

This year’s World Mental Health Day comes at a time when our daily lives have changed considerably as a result of the COVID-19 pandemic. For people with lived experience of mental ill-health, this time is an opportunity to reflect on some key points and barriers in the functioning of our mental health systems, such as recovery, human dignity, individual growth and stigma.

Each person is able to lead a mentally healthy and meaningful life, provided there are appropriate conditions that form an enabling environment. Most often, the underlying condition is the person themselves and the opportunities they allow for growth and recovery. The mental health crisis they face may often become chronic and disabling, not only on an individual but also on a social level. The social understanding of disability, especially in the psychosocial model of mental health, emphasises the disadvantaged position of a person in a society. This approach highlights the individual needs of a person experiencing a long-term mental health crisis or mental health difficulties, rather than medical categorisation in the form of a “typical case”.

Therefore, multidirectional support, respecting the patient’s decision-making autonomy should be a standard of work, not a unique privilege. The model of community support in a person’s natural environment, including complementary forms of assistance (e.g. professional activation, day care support, including care for somatic health), ensures that a person recovering from a mental health crisis can find their place in the social reality. Mental health systems need to be able to offer possibilities to support individual growth, build resilience and strengthen self-determination in the recovery process. All this helps a person with lived experience feel in control of their own life.

A real dialogue between all the parties involved is another critical element of the recovery. It can also help understand available options and expectations.

Stigmatisation and perception of the experience of “mental illness” as repugnant may seem like another barrier. For many people with mental health problems, chances of finding employment decrease with the increasing number of hospital admissions. “Psychiatric patient” is a label that often stays with a person for life. Often this label is an experience of the danger, humiliation and violence experienced in the mental health systems. After a long time, a person begins to feel fear and anxiety about themselves and ceases to feel hope. They lose the sense of involvement in social roles and their social value.

Individual recovery and growth are difficult because they require faith in our own agency and the feeling that we are strong enough to take responsibility for ourselves and make decisions. This is why we need a shift at the level of the key concepts on which our mental health system is based. The key is to move away from isolation, even the symbolic one, so that people experiencing a mental health crisis can still fulfill their social roles within their environment.

The experience of a mental crisis and contact with the mental health care system in Europe, which is not fully based on the principles of recovery and respect for human dignity, changes the perspective. It allows me to put forward these conclusions. What we need now is a real investment in the mental health system, but first, we need to consider how we want it to function. We will all benefit it if our services are based on strengthening our human dignity and control over our own health.

Mateusz Biernat, member of Mental Health Europe and a Director of Foundation “Human”, Poland

To see what our member Mental Health Europe (MHE) has in store for World Mental Health Day 2020, visit their website.