You CAN talk about mental health! So do!

Today is #WorldMentalHealthDay. 

Perhaps too often, people experiencing mental health difficulties are expected to take the lead on talking about mental health. Days like #WorldMentalHealthDay and #TimeToTalk day are an encouragement to open the conversation about mental health across contexts and to recognise the potentially damaging and corrosive effects of silence.

For a long time in my own life, silence was as much a refuge, a place of peace and freedom - a sort of home – as it was problematic.  Until it wasn’t. The first time I remember knowing on some deep level that I needed to talk was the week before my fourteenth birthday.

This is what I wrote:

March 31st, 1992.

Where is it all going?

I hate March, and I hate the waiting. Wait for Easter, wait for exams, wait for Summer, and then for Summer to end, and back into the cycle of waiting. I wish so much I could skip school, or die or just finish this incessant waiting. I hope and wish that when I die, I will rest in peace. No eternal life, no reincarnation. Nothing other than a quiet, uninterrupted and unending peace. Real peace, like in a graveyard. Where there is no room for anything other than eternal silence.

 God, I'm tired. It has been a long time since I have been at peace.

I like to think I am truly happy, but so much of me needs to be finally laid to rest, into eternal silence.  

I need to talk to someone. Someone who'll understand and offer advice without judgment.

I don't know if such a person exists, but if they do, I really need them.

I will be OK. I may be a worrier, a panicker even, but I am also a coper, and cope I will.

In reality, it would take a few months of wandering the streets of my home town with pills in my denim jacket pocket before I was lucky enough to be seen, to find someone who could hear and give me space to talk what was happening in my life in the aftermath of family breakdown and with my father drinking ever more heavily.

As often happens, help took an unexpected form.  My Religious Studies teacher caught something in my tone or expression in something I had written and approached me after class one day to have a chat.

For the next year and a half, anytime I felt things were getting too much, I would catch her with a note in the hallway and we would meet in a piano room in the old convent, and have a cup of tea. I have no idea now what we spoke about, but I can sometimes remember the dancing dust in the light of the old heavy windows, the shapes and patterns on the linoleum floor.

One Good Adult

Here in Ireland, a national large-scale five-year study of children and young people aged 12-25 called the My World Survey found that having access to One Good Adult to support and protect a young person at a time of turmoil and distress changed the trajectory of lifelong mental health and wellbeing.  In addition, researchers found that while talking about problems reduced the risk of suicide and sharing through communication improved wellbeing, many young people were not accessing support when needed, often turning to alcohol as a crutch in problematic ways.

This information was not available to my teacher back then. She had no special skills and had most probably not accessed Mental Health First Aid or training from professionals, but she had a kind heart, eyes and ears, and the time and willingness to listen. She taught me that speaking to someone outside of the family was an option, that my feelings were important and that I did not have to carry them alone.  

Speaking up is not easy for anyone, but is harder for some. 

For some children and young people, finding someone who can hear and offer such listening can be much more challenging than it was for me. Many young people with social, emotional and behavioural difficulties are not only disadvantaged by the traumas and difficulties of complex and chaotic lives that bring difficult emotions and make it difficult to speak about emotional experience, but also find the very act of finding words, putting them together, making sentences  and understanding others particularly challenging. 

We know that many of our most vulnerable young people in the youth justice system, or who have grown up in seemingly intractable cycles of intergenerational poverty, abuse and addiction, are far more likely to find it hard to communicate with adults in ways that reduce access to support and disadvantage them further.  The experience of complex trauma in childhood affects every area of development and language and communication are no exception.   

When I trained as a Speech and Language Therapist in the UK, I knew nothing about how trauma or adverse childhood experiences - my clients or my own - or how it could impact upon human communication.  That has changed and the role of the Speech and Language Therapist in supporting young people's mental health is increasingly recognised and supported. For a helpful overview, the Royal College of Speech and Language Therapists provides a report on how access to Speech and Language can support better mental health outcomes for children and young people here.  

A report to the UK Commons by the Royal College of Speech and Language Therapists on the green paper on Transforming Children and Young People's Mental Health Provision shared the following concerning facts:

• 81% of children with emotional and behavioural disorders have significant language deficits
• 60% of children in Youth Justice services have Speech, Language and Communication Needs
• Children in residential care have been found to present with previously unidentified communication impairment
• Children with vocabulary deficits at age 5 are three times as likely to have mental health problems when they reach adulthood
• Children with language difficulties have lower quality of life in terms of moods and emotions
• Children with language difficulties are more at risk in terms of social acceptance and bullying
• People with a primary communication impairment are at greater risk of a secondary mental health disorder, commonly anxiety or depression

You can access the full report here. 

What's important to note is that while these needs can make communication harder for young people with SLCN, they do not make it any less vital for their health, wellbeing, growth and flourishing. If anything they make it more so.  

Supporting adults around young people who have both speech, language and communication needs and social and emotional needs to support conversations and enable them to be the #OneGoodAdult they hope to be is important. 

Affording young people with language and literacy needs access to appropriate therapies through adapting spoken language and the written word is not an option: it is a matter of equality, dignity and affordance of basic human rights.

 

Speech and Language Therapists can and should be part of teams supporting young people with these needs to achieve their full potential. 

Our Common Humanity: We all want to be heard, seen and understood.

We all have mental health, and we will all experience struggles and challenges in this human life of ours. Whether today is an easy or challenging day for you and your mental health, or for those around you, when we stop and consider the importance of communication, we know how vital it is in our everyday worlds as surely as adults as we did as children.

Just knowing and being in the presence of someone who will listen and respond in an emotionally courageous way opens a different space for experience, in which the storylines that most agitate us to sometimes just dissolve, drain away, flow from the head through the heart and the belly and down into the floor, and away.

When we know we will be heard, it removes so much pressure from our nervous systems: from our heads, from fearsome or tiresome or distressing thoughts we feel we just can't climb out of.

The space this offers can open us up, whether we are speaker or listener,  to true emotional courage, so that we can live not only with the absence of mental illness, but in a way in which we can embrace our experience fully as Susan David, Author of Emotional Agility eloquently puts it in her new TED talk:

[Saying yes] to a lifelong correspondence with your own heart. And in seeing yourself. Because in seeing yourself, you are also able to see others, too: the only sustainable way forward in a fragile, beautiful world.

That is the power of true communication.  In giving, we receive. That is the power of making #TimetoTalk.  Our ability to engage in communication with others is a true gift to those who need to speak, and also to us as we listen. It is easy to forget that it does not come easily to everyone. Today is a reminder to cherish it and use it when and where we can, and to make space for those who might be finding things more challenging to communicate right here, right now, in this moment, at this time, as best as we can. 

Further Resources:

Caroline Jagoe and Irene Walsh have edited a helpful volume on communication and mental health across the lifespan: 

Communication and Mental Health Disorders: Developing Theory, Growing Practice

Language for Behaviour and Emotions: A Practical Guide to Working with Children and Young People by Anna Branagan, Melanie Cross and Stephen Parsons is a practical guide designed for professional working with children and young people with SLCN and SEMH

A range of helpful guidance on understanding the impact of communication needs in children and young people with social and emotional needs is available from the RCSLT. 

 For insight into how Speech and Language Therapy informed practice might "look" with children  and young people with social and emotional needs, Talking Mats provide a range of helpful short practice blogs, such as this one on supporting young people's communication in Child and Adolescent Mental Health Services.

Tom Tutton also provides this very nice blog on how to recognise signs of trauma in children with learning disabilities who are not being met where they are and may not be able to share this in traditional ways

Course Beetle run CPD masterclasses for professionals with Consultant Speech and Language Therapist Melanie Cross on identifying and responding to social, emotional and mental health needs in children and young people informed by Speech and Language Therapy practice.