I think this is important and laudable but more needs to happen. It isn't enough to encourage people to seek help. We also have to do the work to ensure that proper supports are actually in place when they do. This starts by attending to the fears and concerns that may be holding people back, and asking ourselves whether there might be some validity to some of them. There might be some aspects of our culture that need to be changed before the help that we tell people is there is actually meaningfully available to them.
If we are to have any hope of accomplishing this, in my view, we need to acknowledge that the process will sometimes be quite difficult, both for the people who may need the support and for the profession that seeks to revise its culture so as to adequately provide it. Properly attending to the mental health needs of ourselves, our colleagues, and our professional culture will require careful planning and self-examination. It isn't just a feel good exercise in telling people we care and cheerily encouraging them to cast aside their misguided fears and step into the arms of a profession that is eager to embrace and support them (although I'm in no way mocking or diminishing these messages--they too are important as outreach and also play a key role in changing the culture).
In particular, as I have written before, it will require an exercise in listening: with the goal of undertaking a painstaking exploration of the complexity and diversity of our colleagues' backgrounds, needs, and potential challenges; the systemic flaws in our existing culture; and the barriers that stand in the way of some people seeking help. It is an exercise that requires significant thought, effort, attention and care. We need to be open to the possibility that sometimes with the way things currently are, the support that should be there isn't, the stigma that shouldn't exist is still all too prevalent, and the onus is on us as a profession to undertake the difficult task of ensuring meaningful change before our colleagues can feel safe coming forward to access our help and support.
Ultimately my point is that if we are directing all our attention towards the people who are suffering and putting the onus on them to take the steps that are necessary to get help, while assuming that any failure on their part to successfully do so must just be another sign of their sickness and inability to accurately assess the available supports, then we are failing. Yes, many people who reach out to those around them and access existing supports will have a very positive experience and will recover without incident, and we need to reach out to those people and encourage them to access those supports. I therefore absolutely agree that overcoming people's resistance to reaching out and accessing available supports is a really important step and will help a great many people. But we are fooling ourselves, to the detriment of those who suffer, if we don't acknowledge that sometimes it won't be that easy. Sometimes the barriers, anxieties and fears that people perceive as standing in the way of getting help are unfortunately well-grounded in reality. We don't do them any favours by ignoring or minimizing these very real obstacles. In fact, from my perspective, such unnuanced outreach efforts can sometimes have a gaslighting feel (albeit unintentionally).
When we send the message telling our colleagues to reach out and seek support, in my opinion, we therefore need to ensure that the message has two prongs (1) Reach out! Supports are there! You can do it!; and (2) We are here to learn from you what your concerns are! We are open to acknowledging their validity and making changes to our culture when the challenges are as real as you feel they are!. Or in other words, we acknowledge that we don't live in a perfect world. Some barriers are real. Some aspects of our culture are genuinely problematic and we all commit to engaging in the long slow difficult work of changing and adapting so that everyone who reaches out will be meaningfully supported, not just those who are fortunate enough to already be surrounded by the right kinds of supports for their needs.
Again, I'm all about raising questions and discussion points, rather than the answers, but here are some places I feel we need to start:
- Given the prevalence of trauma in our society and its role in increasing our vulnerability to a number of mental health issues (e.g., PTSD, complex PTSD, vicarious trauma, depression, anxiety, substance abuse), we need to put the effort in to ensure that our professional culture and available mental health messaging and resources are trauma-informed;
- We need to also actively take steps to ensure that our messaging and available resources are culturally sensitive and culturally appropriate so that all members and potential members of the profession can benefit;
- We need to make sure that supports are accessible to everyone regardless of such factors as disability and geography;
- We need to ensure that outreach is directed not just to those who may be suffering but also to the profession as a whole. We need to teach people not only how to reach out for help but also how to help (or at least not harm) colleagues or employees when they step forward and identify as being affected by a mental health issue. In this regard, the aim would be to ensure that when people do reach out (as we often encourage them to) they actually are received with compassion and genuine support, not just further stigma and/or awkward silence;
- We need to practice the art of listening and learning, so that we can better understand what works and what doesn't, and constantly improve the supports that are available, rather than just assuming they are adequate and the problem lies with the unwillingness or inability of those who are suffering to do their part in reaching out for help; and
- We need to actually learn and teach each other about the realities of mental illness, so that we can better understand the challenges facing those who suffer rather than just make assumptions. Even if our professional culture is perfect, there will still be obstacles for some who seek treatment since medical and mental health sciences do not have a perfect answer for every circumstance. Properly supporting such people will require some degree of understanding of the scope and limitations of the available treatments. Even with adequate support, it will sometimes be very difficult, and solutions may not be obvious. People facing complex mental health challenges will sometimes have tough decisions to make about their treatment and don't need easy answers from those who may not understand. We can't properly empathize with and support each other if we aren't prepared to hear about this, acknowledge the complexities of more difficult health challenges, and learn from the struggles of those facing them.
As always, please note that I am a lawyer, not a mental health professional of any kind. I have no expertise in trauma or mental health. Also, please note that any opinions and views expressed in this blog are solely my own and are not intended to represent the views or opinions of my employer in any way. For more information about the purpose of this blog, please see here and for a bit more information about my personal perspective on this issue, please see "my story" here
I am very grateful to have received a "Clawbie" Award for this blog (which reflects the importance of this topic): https://www.clawbies.ca/2019-clawbies-canadian-law-blog-awards/
For some of my external writing on this topic, see:
- https://www.canadianlawyermag.com/news/opinion/a-more-inclusive-discussion-on-the-impact-of-trauma-on-lawyers-mental-health-is-needed/276166
- https://www.cbabc.org/BarTalk/Articles/2020/February/Features/Speaking-Up-About-Trauma-and-Mental-Health
- https://www.canadianlawyermag.com/news/opinion/changing-the-conversation/326240
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