‘Reflections on psychological well-being from a community psychology perspective’…

15.01.2021: As the now third national lockdown continues in the UK, it has been hard to avoid this being at the forefront of my thoughts and reflections this week as the Lead for Psychologically Informed Environments (PIE) at the national youth homeless charity Centrepoint. As I have connected (now back remotely again) with our staff in meetings or reflective spaces, one topic that has been consistent, whether working ‘frontline’ in our supported accommodation services or from home in our ‘support’ teams, has been our ‘psychological well-being’ as this global pandemic continues. As noted by Keats et al (2012) in their key paper (c.f. https://eprints.soton.ac.uk/340022/1/Good%2520practice%2520guide%2520-%2520%2520Psychologically%2520informed%2520services%2520for%2520homeless%2520people%2520.pdf), the ‘definitive marker of a PIE is simply that, if asked why the unit is run in such and such a way, the staff would give an answer couched in terms of the emotional and psychological needs of the service users, rather than giving some more logistical or practical rationale’ (p.5). I would also argue that within a PIE, the emotional and psychological needs of the staff working in that environment are also important, particularly at the moment.

This week I have also been thinking about psychological well-being in our Centrepoint well-being working group, whose remit is to develop, plan, deliver and review interventions to address the psychological well-being needs of our staff. This is important not just because it is the right thing for any organisation to be actively looking at ways to improve and promote staff psychological well-being, but also because supporting staff enables them to better support the homeless young people that are referred to Centrepoint. Our staff and their relationships with young people (as well as each other and external stakeholders), are the ‘magic’ that allows Centrepoint to do what it has done so well for the past 50 plus years in addressing youth homelessness. Consequently, I have been reflecting this week on the concept of psychological well-being more broadly, and utilising some principles of ‘Community Psychology’ to inform my thinking. This is because ‘community psychology offers a framework for working with those marginalised by the social system that leads to self-aware social change with an emphasis on value-based, participatory work and the forging of alliances … it is a way of working that is pragmatic and reflexive’. Moreover ‘it is community psychology because it is concerned with how people feel, think, experience, and act as they work together, resisting oppression and struggling to create a better world’ (Burton et al, 2007; p.219).

Psychology as a discipline, and certainly my early clinical training, has often traditionally focused on the individual level of analysis or ‘What is wrong with me if I am feeling sad, anxious or fearful?’ This can sometimes lead to an undue pressure or responsibility on an individual to change (when the system they are in, or have been in, may actually be what is causing an issue). Taking a more community psychology approach considers an individual in their context. Moreover, instead of just focusing on an individual’s ‘deficits’ or ‘problems’, community psychologists would argue that we also need to focus on their ‘strengths’, particularly when (like many of our homeless young people) they may have been living in or have survived significantly adverse conditions (Rappaport, 1977). Consequently, when thinking about psychological well-being this week, rather than focus solely on the problems or difficulties we may be experiencing at the moment, I have been thinking about how we can also recognise the amazing resilience and strength that many of us (and our staff / young people) are demonstrating as we all continue to try to cope with the ongoing COVID-19 pandemic.

In addition, Community Psychologists suggest that when considering the concept of psychological well-being, we need to understand that this positive state is actually brought about by more than just our individual effort. Prilleltensky et al (2001) specifically note that well-being is a state brought about by the satisfaction of not just our ‘personal’ needs, but also our ‘relational’ and ‘collective needs’ in synergy with each other. This can of course often be the challenge, as we live and operate in systems and societal structures that may not be that positive for our well-being due to significant structural inequalities. Consequently, where possible when thinking about how to improve our psychological well-being and that of those we are working with, it is important to consider these multiple aspects; personal, relational and collective. Of course, we may have the most influence on the personal, and perhaps the relational rather than the collective, but we should strive to be aware of all the needs that can affect our psychological well-being and those we may be working with.

According to psychologists (e.g. Prilleltensky & Nelson, 2002), our personal wellbeing is effected by the following values — ‘self-determination’, ‘caring and compassion’ and ‘personal health’. Specifically, the value of ‘self-determination’ or autonomy refers to the ability of an individual to pursue chosen goals in life without excessive frustration or a lack of control over our lives. This reflects the concept of ‘empowerment’ (e.g. Zimmerman, 2000). Therefore, maybe as you read this blog you can think about what areas of your life you have some control or self-determination in, and how you might encourage those you are working with (whether staff or young people) to develop theirs? Of course, at the moment one of the challenges of living within the lockdown restrictions of COVID-19 is this lack of control over our own lives and hence this is why there is a completely normal and expected impact on our psychological well-being! Consequently, it can be helpful to reflect on what we can control or have some autonomy or growth in, however small at the moment and focus on this, rather than the wider uncontrollable nature of an ongoing global pandemic!

Another value that effects our personal well-being is ‘caring and compassion’. When we express concern for the well-being of others (and are compassionate to ourselves!) and/or receive this from others, then our needs of attachment, attention, acceptance and positive regard are met, which increases our sense of personal well-being. It can sometimes feel hard when we are overwhelmed or exhausted to offer this care and compassion to ourselves or others, but the act of doing this, and receiving it in return can increase our personal well-being. This value perhaps underlies why many of us who work in the homeless sector or other ‘caring professions’ undertake this role because to help others actually helps our own psychological well-being too. Even the terminology ‘keyworker’ during the current global pandemic highlights this for some of us, our role is ‘key’ because of this care and compassion we provide to others. As a result, I wonder how can we offer (and be open to receive) care and compassion from others right now to get us through the next few difficult months?

Our personal well-being is also impacted by the value of ‘personal health’. This is probably what comes to mind first when we think about our psychological well-being. If we are physically and emotionally ‘well’ or ‘coping’ then our personal well-being is higher than if we are perhaps struggling with physical health issues (e.g. chronic long term conditions, COVID-19) or we are experiencing distressing emotions such as grief, loss, sadness, anxiety, low mood or fear. In a global pandemic, it would be quite normal to experience distressing emotions at times and perhaps coupled with physical health issues, the impact on our psychological well-being is bound to be significant. Therefore, being ‘kind’ to ourselves about the challenges we may be facing and taking time to look after ourselves with ‘self-care’, time off and reaching out for support from others when needed, will be important to get us through the current challenges.

The importance of ‘relational’ well-being to our overall psychological well-being is also arguably critically important at the moment. Although much of the world seems to have become increasing politically divided in recent times, COVID-19 has highlighted that we live in a globalised and connected world. Thus, we are more likely to get through this pandemic by working together and supporting each other (e.g. many of the current restrictions are all about the wider impact on society, such as avoiding overwhelming health care systems such as the NHS). The human species is innately social, and there is plenty of psychological research noting the positive impact of social support on our psychological well-being (e.g. Turner & Brown, 2010). In other words, as Weiner (2008) notes, ‘there is no such thing as personal happiness … happiness is 100% relational’ (p. 324). As a result, as you read this blog, maybe reflect on how we can reach out to those we know personally (e.g. friends and family) as well as those we might be working with professionally (e.g. homeless young people, work colleagues) to offer support. In addition, ensuring we reach out to those who support us, remains critical at the current time to improve our psychological well-being and get through the challenges we are facing right now.

Community psychologists also argue that relational values such as ‘participation and collaboration’ and a ‘respect for diversity’ impact on our psychological well-being. In other words, ensuring that we are able to participate and collaborate fully with others in a meaningful way to make decisions affecting our lives improves our psychological well-being. Again, reflecting on whether we enable these processes when we work with others and/or that we feel our voices are heard, can suggest where we might need to make some changes to improve the psychological well-being of both ourselves and others during this pandemic. Often when we are feeling overwhelmed, it can be easy to revert to a model of ‘just doing to’ to get things done, rather than perhaps the more time consuming process of ‘doing with’ or ‘co-production’. However, the impact on psychological well-being of those we are trying to help by adopting the former approach can be quite negative and may also adversely affect our relationship with them in the longer term. In addition, respecting diversity in ourselves and in our relationships with others also strengthens psychological well-being by providing dignity, self-respect, self-esteem and acceptance (Dudgeon et al, 2000).

Finally, and perhaps most importantly when taking a community psychology perspective, there is also an influence on our psychological well-being from ‘collective values’. COVID-19 has unfortunately highlighted the vast inequalities that exist within our current society, in terms of education, finances, health, digital access, employment, housing and more (e.g. https://www.weforum.org/agenda/2020/08/5-things-covid-19-has-taught-us-about-inequality/). For many people, including perhaps many of the homeless young people we support, a lack of access to resources has had a significant impact on their psychological well-being. Individuals exist within and are effected by their wider context. Consequently, without ‘social justice and accountability’ and ‘support for community structures’ that promote the fair and equitable allocation of bargaining power, obligations and resources for those who are oppressed to facilitate the pursuit of their goals, there will be a negative impact on an individual’s psychological well-being (Dalton et al, 2001). As a psychologist working therapeutically with clients for many years, it was very obvious to me that I whilst I might have provided the best individual therapy in the world, without changes to social circumstances that were impacting on the individual’s mental health (e.g. lack of housing, employment opportunities), it was much harder to significantly improve their psychological well-being beyond just ‘coping’ with a current situation. Psychological well-being is therefore arguably the result of having enough psychological, physical and social resources to deal with any psychological, physical or social challenges faced (Dodge et al, 2012). Hence, the work our policy team at Centrepoint do in campaigning to #endyouthhomelessness and address many of the significant factors that can create it, such as issues in the welfare system for young people, is so critical (e.g. https://centrepoint.org.uk/what-we-do/policy-and-research/).

In summary, taking a community psychology approach suggests that it is important to consider what effects our psychological well-being, and those we work with, within a broader lens than just the individual. The relational and collective context in which we find ourselves now is also important. This is a difficult time for many people, with a sense of feeling ‘stuck’, and therefore it is not surprising that many of us may be struggling with our psychological well-being. So many personal, relational or collective needs influence this. Are we safe and secure? Are we fit and healthy? Do we have enough resources or social support? Do we have any control over our current situation? Do we feel cared for? Can we participate in life and be respected or valued for our contribution? Many of these questions are challenging enough to answer in normal times, let alone in a global pandemic! However, if we are currently struggling, keeping doing those things that we know help us even when it feels difficult is important. Moreover, remembering that we are part of a wider community (albeit perhaps virtual at the moment) that we can reach out to share our thoughts, feelings and experiences with, can help us to get through this period until such time as it will hopefully be just a distant memory and maybe even a catalyst for positive social change…