A brave new world

As we approach the seventh week of lockdown, the nation’s thoughts are starting to turn towards what’s going to happen on the other side, when all this is ‘over’. Some are excited for a return to normal, but there is a growing realisation that it will be virtually impossible to circle back to what has been. Instead, the world will emerge from this crisis as a different version of itself and it will be up to humanity to determine whether this adaptation is to be an improvement on before, or not. We will have to decide, at both an individual and societal level, whether we embrace this opportunity as a gift, or ignore it. 

Take the health and social care sector, for example. Many services up and down the country, including the mental health service I work in, have had to figure out new ways of providing support and interventions. A small proportion of our service activities have had to stop entirely, but almost everything has continued in some form, with a fair few adaptations. The next step, then, is to think about the quality of both those adaptations and the resulting, transformed service. How do video links and telephone calls measure up to traditional, face-to-face appointments?

For my colleagues and I, this is an ongoing debate with both benefits and challenges of the new systems being noted. We have spoken about how difficult it can be to hold therapy sessions over video link. Some clients can find it more intense without a shared physical environment to glance around once in a while and it is often more demanding for both client and therapist to remain focused on each other in this way. Equally, there is no means of being able to collaborate with each other using physical materials - gone are the days of scribbling a shared formulation on paper between you, or using objects to map out someone’s life story visually. Gone too, are the days where you can take more than 2 steps in any one direction, which can limit certain therapeutic activities and restrict clients who like to move.

However, on the positive side, some of the options we are now offering families have suited people and brought therapeutic gains that we may not have seen using more traditional approaches. Teenagers who disliked being asked to come away from their screens to see us in the clinic are now chatting away quite comfortably over text, or via video calls, with the camera turned off during the most emotionally laden conversations. People with social anxiety or autism have started opening up more freely in sessions over the phone, where they don’t have to look at anyone as they speak. As a staff team, we are able to see more people now that we are no longer spending time travelling to meetings, visiting schools or offering home visits. Many of these will be clinically necessary and missed; others, though, were being held face-to-face mostly because of a preference for the status quo. 

Bu this preference cannot continue. The Coronavirus pandemic, for all the challenges it has brought, has forced us to be more creative in the way that we work with clients and each other. It’s expanded the way we think about service provision and left us with ways of making services more accessible, efficient and effective - if we choose to use them. But for change to happen, activity is required. It is not enough to passively sit back and hope that adaptations put in to make do in a crisis will continue once it is over, even if they represent progression. Without an active push and ongoing momentum, people and organisations will naturally revert to comfortable, predictable territory, preferring to stick with the substandard than brave the unfamiliar. 

So this is my advice to you - you as an individual and you as a member of a society that has much to gain from change: take this gift of opportunity. Sure, reinstate the parts of your life and your community that were working well before the pandemic, there will be many important things to delight in rediscovering. But what’s equally important is not to forget the developments that you’ve made in lockdown. Try not to get so wrapped up in taking back the things you thought lost that you forget to take with you the things you’ve gained - there is room for both. Embrace this gift.