MIND MOVES:Recognising different perspectives is crucial, writes TONY BATES
THERE ARE encouraging signs that we are growing up as a society in regard to mental health. After a century of shame and stigma, where we barely acknowledged the reality of mental health difficulties, this issue now features regularly in media discussions, Oireachtas debates and public awareness campaigns.
There are diverse perspectives on mental health, each of which needs to be given a place in our national discourse. Given how personal and deeply emotive this issue is, we should not be surprised that people will bring to these discussions their own particular values, expertise and experiences, which often makes for a heated exchange of ideas.
How service users understand their mental distress may differ from how service providers view their distress; those who advocate a policy of early intervention in community settings may be challenged by those who would rather prioritise hospital beds for people in crisis.
One of the challenges we face in debating the issue of mental health is how to talk to one another. What rules of engagement might turn our conflicts into conversations that broaden the perspectives of everyone involved? How can our conversations be more than heated monologues where each party privately resents the other and finds them an obstacle to allow their particular view to predominate?
The philosopher Martin Buber once said that the crisis of the 20th century was that of a meeting that never happened.
In attending various public and professional debates on mental health, I have often left feeling disappointed. While powerful opinions were aired, all too often there was no real meeting of minds, no real change in what each side believed.
I witnessed something close to this recently. A visiting speaker from the US with expertise in health service reform addressed an audience of people who were genuinely committed to mental health reform. While the speaker engaged the audience’s attention, the discussion that followed became a little stuck.
The speaker was coming at the subject from an economic cost-saving perspective, but the audience were speaking from a position that viewed mental health support as a human right. I wondered if part of the problem is that we fail to recognise that we are each coming at the issue from very different perspectives?
We may argue from a need-based, a cost-effective, value-based or an evidence-based perspective that is entirely valid in its own right, but our opponent may be looking at the issue through a different lens. When we are unaware that we are coming to the discussion from different perspectives, we can become locked in frustrating conflict.
And let’s be realistic: when it comes to debating mental health, not all perspectives carry the same weight. There are clearly perspectives that hold greater currency in our culture than others. The context in which we discuss these matters is not a level playing field.
How might our discussions achieve a better outcome? Modern thinking on conflict resolution has some pointers that may help. It suggests that: Those involved should consider conflict as evidence that each of their views are incomplete, and not that one of them is wrong;
Protracted conflict results when one of those involved become over-attached to the view they hold, imagining it to be the only valid view;
We need to tolerate conflict and focus on ways to let it transform the parties involved rather than focus on the parties resolving the conflict; and,
A satisfactory outcome rarely involves an ideal solution, but rather a compromise that allows everyone to move forward.
As I left the debate that I referred to earlier, I wondered what would have happened if the clear, concise speaker had been a little more willing to tolerate the tension and the ambiguity of adopting a perspective that was both cost-saving and rights-based? And what if the audience had been able to move from an impassioned human rights position to one that considered how basic human rights could be ensured within a sustainable economic framework?
Tony Bates is founding director of Headstrong – The National Centre for Youth Mental Health (headstrong.ie)