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Why aren't enough UK Armed Forces personnel seeking help for mental health problems?

Posted By Clore Social Leadership, 28 February 2017
Updated: 04 December 2020
I’ve worked with the Armed Forces community for many years, both in military help-seeking research at the King’s Centre of Military Health Research and in healthcare policy at the Royal British Legion. I was fortunate enough last year to be a Forces in Mind Trust Fellow on Clore Social Leadership’s Fellowship Programme.

An area I care very deeply about is the mental health of our Armed Forces community. We live in a stressful world, there is no doubt. The World Health Organisation reports that mental health and substance misuse problems are the leading cause of disability worldwide, and one in four of us will experience a mental health problem in our lifetime.

In the UK Armed Forces community, the most common mental health problems are depression and anxiety. Most recent research suggests these may be experienced by Service and ex-Service personnel at double the rates of those in the general population. Despite much effort to improve service provision and mental health attitudes by the Ministry of Defence, the NHS and Service charities, help-seeking rates in the Armed Forces community continue to remain extremely low.

My provocation piece asks us to rethink our conceptions of mental health and help-seeking in the Armed Forces. The piece begins with an imagined character in the Armed Forces giving advice through a letter to those struggling with mental health problems. Whilst this letter is my creation and exaggerated for effect, it is based on some real views I have had recounted to me in my research interviews with the Armed Forces community. The language in the letter seeks to highlight some very important issues that prevent individuals from seeking help for mental health problems in the Armed Forces.

I highlight the main barriers to seeking help for mental health problems in the Armed Forces. These include mental health stigma, the preference to solve problems alone, a lack of social or family support, and finally the pervading culture of masculinity that equates help-seeking with weakness.

In terms of what can be done to address these barriers, I suggest that:

  1. We need to get talking about our mental health to one another and to our families;
  2. We need to educate ourselves on how to look after our own mental health, how to spot signs and symptoms of mental ill health and know what services are available that can support us;
  3. We need to challenge the weakness culture. We cannot continue to uphold the notion that seeking help is akin to failure. True courage is found in honesty, in facing up to problems, taking action to help ourselves and being strong through support found in others.

Our significance as leaders is measured by the courage of the questions we ask in order to confront and change negative cultures and attitudes that should not be promoted in our communities. The barriers and cultures that prevent Armed Forces individuals, past and present, from seeking help is a problem that all people in the Armed Forces community can take a stand upon and demonstrate leadership in promoting the type of environment we want to live in. It is time we changed the conversation and refuse to accept the state of things as they are now. I believe changing the culture around help-seeking for mental health problems in the Armed Forces will need all of our combined strength and leadership.

You can download Marie-Louise Sharp’s provocation piece here.

Please share your views and comments below, or you can contact Marie-Louise on Twitter.

Tags:  casestudy  change  crisis  fellow  future  health  socialsector  wellbeing 

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Social integration and 'British values': what's human about that?

Posted By Clore Social Leadership, 06 February 2017
Updated: 04 December 2020
"I am human, and nothing of that which is human is alien to me." Publius Terentius Afer 


At the end of his 2016 Reith Lectures, Kwame Anthony Appiah left us with this striking quotation. Written by a man who was ‘ a slave from Roman Africa, a Latin interpreter of Greek comedies and a writer from Classical Europe’, the words attest to a profound appreciation of what it is to be human, and how our humanity, once acknowledged, transcends concepts of nationality, identity or status.

The term ‘alien’, still used within US federal law to describe those born outside the country, is rightly considered an embarrassing and derogatory term in the UK, with connotations of dehumanisation and scapegoating that we prefer not to own. But in my experience of working with marginalised migrant and refugee communities, it’s often a term which recent arrivals, or even those who have lived here for decades, use to describe their treatment by UKBA officials, UK institutions, and even their lack of welcome by the Great British majority.

This painful reality is the opening precept to my Provocation Piece which I developed as part of my fellowship with Clore Social Leadership. The piece explores our current preoccupation with social integration and asks whether we can reconcile this with often fearful or nostalgic concepts of ‘British values’. If, as the Casey Review maintains, we are really looking for a ‘common life’, I argue that we need to be more questioning, more courageous, and more open to a reflexive discussion about ‘who’ we are and what ‘our values’ might look like in collaboration with those who arrive from abroad. What can we learn from people who have experienced themselves as ‘outsiders’; what reality checks can they give us about ourselves and our assumed cultural values; how might their experiences of migration and integration contribute to a dynamic model of cultural heritage for the future?

These questions have framed my Clore Social fellowship in a tumultuous year for issues and debates on migration, culminating in what can only be described as a crisis of national consciousness. Amidst the confusion and strife, it has also encouraged me to look for good practice in advocating for a model of social integration which addresses how we welcome and learn from new arrivals at ground level. From this, I’ve come up with four suggestions:

  • We need to acknowledge that citizenship is not a birthright, but is earned by those who want a stake in society. Instead of an Integration Oath, why not use a Citizenship Celebration which brings together and rewards anyone who actively contributes their values and culture to their local community?
  • Developing relationships across cultures takes curiosity, empathy and patience. Whether at work, in your neighbourhood or in the school playground, simply making eye contact, exchanging a friendly word is a great start; thereafter, accept that the normal social codes don’t necessarily apply – ask, explain, invite, explore, adapt, exchange and don’t give up.
  • You can’t support social integration simply by saying nice things on social media. Stepping out of our comfort zone is what enables us to appreciate what it’s like to feel like an outsider: offer to teach English to your neighbour; ask them to teach you how to cook their cuisine; provide a night stay for a homeless refugee; join in with local or school activities which seem to be ‘for minorities’- you will be amazed by what you learn.
  • Let’s offer experiential diversity training for our statutory services which doesn’t balk at exploring cultural difference and can promote empathy, intercultural awareness and cross-sector collaboration.
Whilst it’s a good thing that we starting to have ‘difficult conversations’ about values and identity, we have a long way to go on understanding the dynamics of privilege and power. Step into the shoes of a new arrival, question yourself and your assumptions in relation to those different to you, and you will awaken your own precious humanity.

Please share your comments about Emma’s blog and provocation piece below, or you can join the conversation on Twitter.

Tags:  casestudy  change  culture  diversity  event  fellow  future  politics  research  socialsector  speech 

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Putting the Place into place based health

Posted By Clore Social Leadership, 10 January 2017
Updated: 04 December 2020
When I began my year as an older people’s specialist Clore Social Fellow I was interested in looking at asset based community development (ABCD) in relation to social care. My interest had been sparked by what I heard about how this was being put into practice in Leeds. During my Clore year, while shadowing in a hospital which is leading on one of the NHS Sustainability and Transformation Plans, (STPs) I started to wonder how relevant these ideas were for the NHS.

STPs are place based plans, and planning guidance from NHS England talks about ‘creating new relationships with patients and communities’. This made sense to me. How can you develop place based plans without talking to the people who make up that place? I discovered a range of organisations working on community and citizen engagement in health. I also discovered a lot of criticism of STPs for failure to engage. Looking at some of the STP plans I found the extent to which they mentioned engagement with citizens or communities varied enormously. I could also see some obvious barriers to engagement, including the speed at which the plans have had to be drawn up.

Almost all STPs are led by NHS bodies but the partnerships include local authorities. However, the extent to which they have played a major role varies. Local authorities could play a crucial role in linking STPs with communities. They are not just relevant as the lead for social care and public health; housing, accessible street, community development are all relevant to health, and all part of local authority responsibilities.

The voluntary and community sector is also a key way into place and community. Most STPs refer to their role as providers of quality person centred interventions. Not all recognise the role of the voluntary and community sector as a way to engage with local communities, particularly with disadvantaged groups.

My thoughts on the barriers to citizen engagement in STPs and some possible solutions are set out in my report. I don’t believe this is a challenge solely for STP leadership. It’s one that leaders across health, local authorities and the community and voluntary sector need to grasp.

Please click here to read Sue’s full Provocation Piece, developed as part of her 2016 Clore Social Fellowship.

Share your views by commenting below or contacting Sue on Twitter.

Tags:  casestudy  culture  elderly  fellow  partnership  socialsector 

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Difference is the key: reflections from a Fellow

Posted By Clore Social Leadership, 01 July 2016
Updated: 04 December 2020
As I have sat amongst the other 2016 Clore Social Leadership Fellows one thing is for sure, I am not like anyone here. When I began my Fellowship journey, this state of affairs concerned me - we are all supposed to be people who want social change and want to learn how we can be more effective in leading these changes amongst the communities we work with and the social sector in general.

From several of the different tools we have used within the programme to understand our strengths, our styles of working and ‘areas of development’ (apparently we don’t call them weaknesses anymore), I found myself as an outlier. I was one of a handful of reflective thinkers in my learning. This means I like to hear many people’s views before making my mind up on an issue, I don’t like to be rushed into a judgement without having some good facts and it seemed to explain why I don’t particularly like telephone calls where I have to make instant decisions! But looking to the rest of my cohort I saw that the majority of the group were ‘activist learners’, people who want to get up and do things, lots of energy, lots of trying things and not worrying if they don’t work.

We also looked at another tool called the ‘Four Seasons Model’ - which is essentially a less complicated Myers Briggs type test - and I found myself within a smaller group of the ‘Summer’ category. For Summer people their drive, and what gets them up in the morning, is all about people and relationships. Summers generally like balance and harmony in teams, they dislike conflict and like consultative decision-making. Amongst the other Fellows there was a large bunch of ‘Springs’, people who are very creative and love to get new projects off the ground. There was also a good set of ‘Winters’, those who want to get things done who are efficient and take decisions quickly, and each of these seasons obviously have their strengths and weaknesses.

So as these things emerged, and I found myself and my experience to be very different from everyone else's, I had a medium-sized charity existential crisis. I thought to myself, ‘What on earth am I doing working in the charity sector?! I am so different, perhaps I don’t have the right qualities to do this big thing called ‘social change’, and am I failing the Armed Forces communities I work with because I am nothing like any of these other Fellows, Fellows who I admire and am inspired by, and should be more like!’

Yet as I’ve progressed through my Fellowship year, a new perspective is seeping in which has calmed my crisis. If I take nothing else from my time on the Clore Social Leadership programme I will take this: difference is beauty and difference is strength.

Most of my life I have been told to concentrate on the things I am not good at. No doubt this has helped me pass some exams I might have otherwise failed, however this norm has definitely been to the detriment of celebrating what it is that I can do. I have learnt over the Fellowship that ‘positive psychology’ (hear me out) would say to focus on the very things I am good at and to make them excellent. This is because the things we are not very good at we will likely only make mediocre if we try to improve them. Now this doesn’t mean I can just ignore the areas I am uncomfortable with. The lesson however is: understand where you excel, where you don’t and try to put a team around you that is VERY different to you who can fill in the strengths you don’t have.

As I stood on my own at the second residential with the other Fellows playing some active games, we were asked to stand along a scale of 0-5 on what we felt about risk taking. I stood at zero or perhaps 0.1 - the rest of the Fellows stood at least at 3 and many around 5. Previously this difference would have made me feel awful, but that day with the Fellows I felt very important because I realised that this difference could make me invaluable to a team where that trait is not present. It also impresses upon me that in my work life, I need to have people around me who are further up the risk taking scale - if we give ourselves the space to learn from each other, we will be able to pull each other up and down scale to achieve our collective goals.

It may seem like such a small change in perspective as to how I look at myself and others, but it has freed up my mind to embrace what I am good at and stop berating myself for the things I am not. The beauty of Clore Social Leadership is in the diversity of its Fellows. It is all their experiences and skills and life histories that matter. It is the strength found in the difference of where Fellows have worked or currently work, whether grassroots organisations, small and large charities, social enterprises and the private sector. Our difference is how we learn to be better, learn to ally with people that help us to step out of our comfort zones and who challenge us to do more exciting and impactful things for the communities we serve. As the Fellowship moves forward, and new Fellows look to apply for places in 2017, I urge Clore Social Leadership to continue to enable diversity and access to the Fellowship. I finally encourage potential applicants to embrace and bring their difference to the group, because this is the gold dust on which to build success.

Here's a short video of Marie-Louise describing what makes a good leader.

Tags:  culture  difference  environment  event  fellow  reflection  skills 

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Tree-hugging in Birmingham: reflections on my Fellowship residential

Posted By Clore Social Leadership, 13 June 2016
Updated: 04 December 2020
I have to confess, I am a tree-hugger. Ever since I was a small child, looking up into a dizzying canopy of branches and leaves reaching to the sky has filled me with awe, and I often succumb to the urge to wrap my arms around the trunk, make a connection and, well, hug the tree.

So for me, the second Clore Social residential week at the Woodbrooke Quaker Study Centre in Birmingham was a gift. Not only were the mature trees in full leaf, but there was an intoxicating array of plants and flowers, copses, hideaways, meandering paths around a serene lake – all inviting that same sense of connection and empathy with my surroundings, myself and my fellow Clore Social Fellows.

Over the course of the week, we questioned Clore Social, questioned each other, questioned society and the future of the social sector. We tried to listen, forgot to listen, became embroiled in our own individual anxieties associated with who was leading the group and why and where our place was within it. At one point, I engaged in somewhat exhaustive discussion with a facilitator about the definition of empathy itself: do we have to agree with the values and feelings of another, or is the key simply to acknowledge and respect the lens through which they experience the world – which may actually be very different to our own?

This discussion felt crucial to me because I sensed on some level, we were all negotiating the complexity on offer. I don’t think I was the only one to retreat somewhat bruised at times, wondering why I was here and what I could possibly offer. Neither do I think I was the only one who occasionally thought, deep down, that I have the answer, if only everyone would listen to me. Some of us were ready to go, leaping out of our chairs and practically out of the door in our bid to change things. Others of us sat quietly, immersed in our own internal dialogue, perhaps wondering whether to speak at all: did we have enough to say on behalf of the group, could we take our place in our own way or should we be more this, or less that? And what experiences had brought us here – did they include education, privilege and entitlement or trauma, poverty and marginalisation: how much was any combination of these influencing our ability to engage properly with others?

Our struggle at times to seek out, respect and harness different lenses within the group seemed to mirror a wider considerations within the social sector – whose voice get listened to, who gets the (dwindling) money and what about those who have neither the voice nor money to convince us that their needs and their cause are important?

Never has it been more imperative that we are able to think and behave tactically, influence funders, purchasers and policy makers, sometimes using our empathy for perhaps more Machiavellian purposes. Equally, never has it seemed wiser to engage our empathy in adaptive leadership, able to bring our organisations and beneficiaries with us as we negotiate ever more choppy seas. Against my collectivist, tree-hugging nature, I could see how, as individuals, we need to be able to stand up to these challenges regardless of our individual drivers, play the game on behalf of those less powerful than us and, dare I say it, take the lead.

Tags:  casestudy  challenges  environment  event  fellow  nature  trees 

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