Here at Te Pou o te Whakaaro Nui, we’re celebrating the launch of the refreshed and revitalised Let’s get real, the Ministry of Health’s framework of values, attitudes, skills and knowledge for anyone working with people and whānau experiencing mental health and addiction needs.
This framework, originally for people working in mental health and addiction services, now developed to work across all of health, has always included values and attitudes as an integral component of effective service delivery. The values and attitudes were identified through consultation with people who access services, family and whānau, support and peer workers, clinical workers, managers and leaders.
As a person who not only works in mental health and addiction but also accesses services, the values and attitudes of people I work with or who support me make a profound difference to my life. I have experienced mostly the good but sometimes the bad and the even the downright ugly. I have also found reflecting on and discussing my own values and attitudes is a gift that keeps on giving in terms of both professional and personal development. These are things I have control over and choices in.
I really like the refreshed values, I think they are so apt and potentially powerful in the work we do. I have feelings and thoughts about all of them. Here is what they mean to me:
One of the original values of Let’s get real. In the many values workshops I’ve facilitated, respect and what that means to people who access services and people who work in them, is the cornerstone of human relationships, building trust and being effective. It is all about being fully seen and valued no matter where you are and experiencing the feelings of valuing. The biggest reason to disengage in relationships is when people feel what is important to them is not being heard or acted on.
I fully love the concept of Manaaki. The sense given of having an innate worth, a being that is welcomed and cared about. Often shown in the small things we do everyday for the people around us, the cup of tea and chat, making things more comfortable during the most frightening, chaotic, distressing times. Noticing what is needed and providing that. These are things we remember long after and make our hearts feel warm even in memory. For instance, I have a false front tooth and if it isn’t in, I don’t look at myself - not even on Halloween night! After an operation recently, I was in intensive care and about to have visitors - no tooth in. I didn’t care because I was morphined to the gunnels and in a very different reality! My nurse ensured that my tooth was in and my glamourous hospital nighty (not!) was well in place and not likely to startle anyone. I didn’t care then but I SO did later! Dignity and mana intact.
How do any of us ever survive the dark times if there is no hope of something better? Why would we bother? What happens when we believe and fear there will never be something better? That’s when the relationships around us pick up the slack. To do that with hope though, it needs an authentic and deeply held belief that there is better for that person - in hard times and gloriously happy times, there is always better than now. We work to make the pathways to that clearer, more available and importantly, relevant to the person’s meaning of what better is. Protracted times of hopelessness are some of the toughest things people and those around them experience. People die from this. Staying hopeful for other people can be depleting when things feel stuck. Good supervision, using tag team approaches to protect your own wellbeing and noticing and finding celebration in the tiniest things can really help. Hopelessness can be very contagious but so too is mindful hopefulness.
I’m a fiercely independent person and free spirited. In saying that, the relief I find in sharing roles and responsibilities as part of a team or partnership is immense. Bringing varied knowledge and expertise together towards an agreed outcome is both powerful and can be mutually enhancing. Within well formed partnerships there is an ability to challenge and compromise and to agree not to agree and still be in respectful partnership. There are always leaders of bits, but it is flexible and not static. Power and responsibility are identified, agreed and shared. And, in my experience, it’s a lot less lonely.
Given the awful statistics about people who experience mental health and addiction needs dying up to 25 years earlier than the general population, a more holistic approach to wellbeing is urgently needed. The current silos of health have not been useful for most people. Relationships and belonging to communities of our choice are portals to satisfaction and happiness for most people. For me and many others our spiritual beliefs are equally important and yet I’ve only once been asked about them in more than 40 years of accessing services. Making meaning of our lives and what has happened to us is a healing path. Wellbeing incorporates our whole lives and looks for ways to have meaning, things we value plus health in every aspect, even during the worst times.
For most people it is our relationships and communities that give life meaning and depth, providing the motivation and resilience to live and live well. I have had times of not wanting to exist anymore, not being able to see the potential ‘better’. It's not easy to ‘live’ that way. What made it possible to live and even do well in spite of this was my children, my family, my friends and my work. Not every person has these, and yet we all need to connect and belong in ways that matter to us. It is central to working with people experiencing mental health and addiction needs that we support and foster relationships and connection. Loneliness kills people, it steals their life force and breaks their hearts. It takes the colour out of the world and stretches time to an endless grey. We need to do something about that.
These are the values of Let’s get real. What do they, or could they, mean to you? They could just be words on a page or they could be something profoundly meaningful to you in the work you do. It’s up to you.