From community

Practical help for you and your community during frightening and dangerous times

Are local or global situations causing you to feel distressed or anxious? Perhaps you’re at direct risk of social unrest, disease epidemics, terrorism, conflict, or police violence. This might be a recent emergency, or represent historic and systematic abuse and neglect. You may be being specifically targeted because of your race, gender, disability, sexuality, faith, or other factors beyond your control. You may have had some forewarning about events -or they may have come as a sudden shock. The threats you’re facing may be in the form of immediate financial, physical or emotional harm. Alternatively, it may be exposure to events via the media, through conversations with friends, or awareness of world events that are making you feel unhappy or afraid. If you already have an existing physical or mental health condition this may be exacerbated by knowing about other hazards that could be affecting you – or those you love. Maybe you aren’t even immediately familiar with people facing maltreatment but you are still distraught on hearing about their situation and wish to do something practical to help.

Below are a number of resources for you to use to help yourself, or to share with others who might benefit from them. All are designed to be adapted to suit different circumstances depending on where you are and what the problem(s) are that you are facing.

This guide to understanding and delivering Psychological First Aid (PFA) is created for all individuals and communities who are coping with disasters and crises (including the aftermath of war or terrorism) and includes free tools and resources for immediate use plus links to courses for training for those whose work as practitioners or activists may require longer term delivery of PFA. You may also find this guide from Jasmine Banks Brown on Self Care for People of Color After Psychological Trauma informative and comforting.

The Black Cross Health collective have specifically designed resources for those providing first aid during protests, demonstrations and periods of unrest. The BBC have produced these resources for First Aid in Hostile Environments, while the International Red Cross have produced First Aid in armed conflicts and other situations of violence available in multiple languages. Hesperian have a range of health guides in multiple languages on a variety of health and development topics for those who lack access to affordable and accessible services. Their most famous text Where there is no doctor may be essential to you or your community in emergency situations. Mental and physical health resources are also linked to alongside personal care and safety materials in What to do instead of calling the police (this is more of a US-focused guide but may still be adaptable to other country settings). In general the advice for anyone at risk of physical harm or with health problems is to call the emergency services (fire service, paramedics, police, or coastguard). Noting, also, that these may not be available – or that you may not feel you can trust such services.

It’s common during and after a crisis to not know what to do or feel so weighed down by events you cannot concentrate or care for yourself or others. These two guides may help. The first is from me, writing in the Telegraph, about how to cope when life seems frightening and upsetting the other is by therapist Tania Glyde on When the world has changed forever – self care in a collective crisis. Both of these posts provide ideas for tackling loneliness, isolation, fear and distress – with links to additional sources of support and help. They are particularly focused on those who are living in times of uncertainty or unrest.

Meanwhile, regardless of wider social or cultural situations happening around you, other life events can also keep on happening. These might be positive or negative – but you may still require assistance in coping with them – in which case a list of support services and helplines can be found here.

One step on from when you called me

Tree of Hands

In this month’s Lancet Psychiatry I’ve written a comment piece Agony, misery, woe: a new role for media advice columns about the history and purpose of media advice giving, the changing role of the agony aunt/uncle, and the agony aunt as witness to the crisis around austerity and poverty and the harms these bring.

Expanding on the comment piece I am joined by Lancet Psychiatry Editor Niall Boyce and journalist Anna Raeburn in a podcast where we talk about how advice giving has changed (or not), what it can deliver, and why practitioners may be missing this important media resource and the tools and experiences it may hold.

Anna starts the podcast talking about how advice columns have developed, with a particular focus on radio and the power of the voice in reaching out to others. In addition Anna touches on the problems posed to modern media due to financial cuts and a lack of investment in community programming/features and particularly local radio and press. Explaining that the need for advice and information is higher than before but the opportunity for advice givers to work effectively is “significantly less”.

From this Anna moves to talk about advice giving as storytelling, sharing experiences, and how it’s okay to say you aren’t sure about a person’s situation. While discussing the strengths and weakness of advice giving on television, newspapers, magazines and new media.

When asked what role agony aunts fulfill, Anna replies:
“I would describe myself as a bridge….I have a very modest idea of what I can do. I want you to walk over me to the next stage of your life….I want, very modestly, to move you one step on from when you called me”

This is helpful in the context of advice giving as it sets out very simply what advice giving can achieve. And highlights where it may be a bridge between individuals and services but also part of a wider chain of help seeking behaviours people engage in. We don’t assume agony aunts have all the answers, or advice columns can solve all our problems, but if we consider it as a small step forward it reminds us that advice columns should never be excluded or forgotten about in wider conversations on physical or psychological health, help seeking or behaviour change.

In the second part of the podcast Niall asks me about evidence and whether we can we be evidence based around advice giving? This echoes other questions I’m increasingly asked about how agony aunts know they are doing a good job – something I’ll be returning to in future blog posts.

I reflect in the podcast on what agony aunts and audiences think evidence means when it comes to media advice giving. Plus what we already know about media advice giving, what we don’t know, and where we can draw parallels of evaluated work on self-help and public health campaigns. I have a bit of a grumble about how academic and journalistic snobbery can lead to advice giving being overlooked or denigrated – and why this is improvident.

For me the crux of the podcast focuses on the issue of how cuts to benefits, austerity measures, poverty and funding problems within the NHS are leading to staff and patients/service users feeling increasingly pressured, distressed and excluded. This may be an area where agony aunts and mental health services might work together, particularly in poor communities who are far less likely to be able to access and use mental health services. Another agony aunt Denise Robertson had previously suggested to me one role of the agony aunt in modern times was to bear witness to the damage caused by poverty, inequalities, and the blaming and shaming of those in need. The podcast explores more on why this has happened and whether there is a role for advice columnists and NHS staff and patients to work together to highlight theses issues and consider possible solutions.

This brings us to what form advice might take and how the traditional focus of the advice column has often been to refer people to a charity or a GP (Family Practitioner/Doctor), or helpline. But how in these cash-strapped times people are arriving at their conversation with advice columnists by telling them what services they have already tried – and failed – to access. The podcast reflects on why this is and what we might do about it in ways that do not further denigrate either those in need or health/social care staff who are also under huge pressure and struggling to do their job.

Rather than just seeing advice giving as asking for help, reaching out or being supported by others the podcast considers advice giving as advocating models of activism and resistance using the example of Focus E15 Mothers campaigning for housing and rights.

By contrast examples from the global south where advice giving through radio, TV, text and newspapers has had particular success are shared as examples of good practice. Particularly around the ideas of citizen journalism and self-care. I talk about trailblazers such as Hesperian and BBC Media Action within this context (although other examples of good practice can be found within this site).

The podcast ends with a reflection that if services across media, health and social care and the third sector are massively stretched. And where there is no immediate change to the current climate then we need to think about ways to help ourselves

“No-one is going to help us at the moment. That’s quite obvious. So how do we help ourselves and what do we do together to make things a bit easier for those in need where there may not be immediate help available?”

The resources below are ones I use myself within these limitations, and may help those who want to know more about working effectively where barriers exist.

Although broadcast after this podcast the actor Michael Sheen also picks up on some of the problems around the NHS and ways for us to defend and stand up for it.

Further Reading
Psychological First Aid
In or Out?
Community Psychology
Augusto Boal
Paulo Friere
Kerry Frizelle 2011 What is critical community psychology?
Carolyn Kagan et al 2011 Critical community psychology. Critical action and social change