“He [the mental health professional] is like a father to me. He guides me and makes decisions that will help me to get better. The mental health professionals always have to be on top. Because they studied to be like that. I believe that they should be on top and I should just trust in them.” – Mental health care receiver.

Over the past few years, the mental health sector in Malta has been gradually receiving more attention especially in view of the introduction of a new Mental Health Act and the preparatory plans for a national strategy that promises to revamp current service provision.

In this aspect, it is heartening to realise that a topic which had been largely considered taboo, has started to slowly ascend the societal ladder and is now moving towards the realms of at least meriting understanding if not yet total acceptance.

This is mostly due to the combined effort of various entities and well-meaning individuals. These have dedicated tremendous energy to place Malta on the map with regards to the ability to offer effective and humane mental health care against the historical backdrop of macabre explanations and horrific treatment of mental health ailments.

However, one voice still seems to be somewhat missing from this encouraging picture. Surprisingly enough, it is the voice of those very same people that we are trying to help – namely, individuals who are experiencing mental health problems.

While there are local entities which are indeed striving to encourage these people to move to the forefront, overall thereis still a screamingly evident lacuna in this regard.

A recent study carried out by Grech et al. (2019) on behalf of the Department of Mental Health (University of Malta) and the Office of the Commissioner for Mental Health, involved an exploration of the main discourse-types and themes related to mental health found within main local newspaper articles that were published over the past year.

One prominent finding highlighted the fact that although some of the articles were written in collaboration with people with mental health problems, these were found to be scarce. Such articles that could be found were mostly addressed at eliciting the person’s experience of mental illness. Thus it is felt that there is an urgent need to empower people with mental health problems to speak up and act as community spokespeople and direct informants to journalists.

This may help to put a human face to mental health problems.

As a population, we are indeed known to be mostly close-knit and tend to be very protective of our vulnerable ones

Such involvement should not be solely targeted at eliciting the experience of the mental illness itself but should also explore what actual people with mental health problems feel that they need from services and from the general community in order to enjoy a better quality of life.

Easier said than done – which brings us back to reflect on the introductory quote.

While such a quote seems positive and sheds a bright light on the close bond between care providers and recipients, there may also be a tinge of the notorious custodial approach that instils dependence rather than independence in care receivers.

While viewing your mental health professional in terms of a totally authoritative father figure may express respect and a feeling of safety, it may also point towards passivity and an aura of ‘the professional who knows everything and the patient who simply obeys and remains a passive recipient of care’.

However, this is an issue that probably goes beyond the perimeters of the mental health field and may, in fact, be better understood in terms of cultural norms and values. Let us not forget that as a population, we are indeed known to be mostly close-knit and tend to be very protective of our vulnerable ones.

We are the ones of the miskin and jaħasra popular discourse which, while conveying sympathy and warmth, may not be doing much to promote hope and an attitude of active involvement in the recipient.

Let us then allow and encourage people to speak up for themselves in addition to speaking on their behalf.

Perhaps, we are too quick to say that people with mental health problems are overly vulnerable and so involving them as direct spokespeople may be detrimental to their health.

Indeed, each case merits its own exploration and the person’s wishes and well-being should take full priority. However, it is also true that everyone has a voice and with the right support structures, that voice can be amplified and used to shape reality.

For more on this topic, please join us for an event that will be held on April 30 from 3.30 to 5pm at the Central Auditorium, Mater Dei Hospital. For further information and/or registration send an e-mail to paulann.grech@um.edu.mt.

Paulann Grech is a lecturer at the Department of Mental Health, Faculty of Health Sciences, University of Malta.

This is a Times of Malta print opinion piece


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