to do a lot of the work in the community. It saves real police for real
police work.
As discussed in the post two above the value of a trained therapist
using an evidence based therapy is limited. It is still important but
when money is tight effective solutions that are value for money are
more important.
The majority of psychological therapy trials show the controls to be as
effective or slightly less effective. As explained above I think part of
that effect is through social contact and can be achieved by people
taking on the responsibility to look after those ostracised or excluded
from their social network because of mental ill health or life crisis.
There's still the value of having someone who's trained though and
someone who has the label of a healer, i.e.I guess the Hawthorne effect
of a person being called a therapist causes part of the positive effect
seen in some people.
Just like the police leave the real work to real police officers, the
real therapists could deal with the patients with the more difficult
problems or ones with real psychiatric illnesses rather than the common
mental disorders that are often treated by therapists today. This is
where the idea of A Community Support Therapist is taken from. They're
roving therapists with training but volunteering or on lower wages. They
do what they do because they care. They provide support to local
communities wherever they're needed just like the CSO's do. Rather than
seeing a GP a person can contact their local CST first to assist or
assist a friend or loved one or themselves. The CST are also out and
about. Many a time I've noticed a person walking down the street crying
(and I'm afraid to admit that I walked on by but out of inadequacy
rather than lack of compassion usually). There are times I've been
crying in the street and no one stops to help. CSTs can be there as a
sort of outreach service patrolling the streets because of a lot of
mental ill health happens out there. I've seen it. There a story further
down about when I was in a local supermarket and a guy was having a
total meltdown. I think he may have hit one of the staff. Everyone was
shouting at him and they'd called the police. I walked in and spoke to
him, calmed him down, spoke to he staff and the police, waited while the
police interviewed him and tried to make them understand that he'd had a
bad day. I walked with him home (and broke into his house with him....)
and just chatted to make sure he was OK. It's also where the idea of a
CST comes from.
This provides a cheap way to offer the value of therapy. It offers
social contact and it offers the title of a healer. Those together may
offer the majority of the effectiveness seen in systematic reviews of
psychological therapies but at a fraction the price and covering a whole
new area where mental ill health happens.
This could extend to work places. I suggested the idea of a workplace
counsellor when I worked a graduate role at a blue chip company. Of
course they laughed at me all the way back then. But they had an
in-house financial advisor for staff. No therapist though. The economic
crisis that will ensue after the crash will mean a lot of mental ill
health will be seen in the work place. Many workplaces already have
people designated for first aid. CSTs could be introduced in large
workplaces (and small ones too because it's a volunteer or low pay
scheme) so when people are having a meltdown after they've been fired or
when someone wants to jump out of a window because their company they
spent their life building is on the verge of bankruptcy there's someone
right there who's trained enough to help at a critical moment.
There's going to be something like half a million less public sector
jobs. That's a huge number of people and I'm sure many of them would
like to take on the role of being a CST while they're out of work. Many
people who are severely mentally ill already do this role. It's another
place where this idea is spawned from. A good friend of mine looks after
everyone in her social circle. She's therapist, doctor and confidante.
She voluntarily ran a support group for a couple of years before the
burden became too much but she still supports her community even though
she's often unwell. These are people who exist on JSA or ESA. They're
people who don't get access to therapists. People with severe mental
illnesses. But she's their CST and she does it for free.
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