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Dry January – A Message for Better Mental Health?
Reducing alcohol consumption is a favourite among New Year resolutions, and has added force this year with the ‘Dry January’ campaign. Maybe you are thinking about resolutions for Service Users that you work with, in particular how you might tackle problems associated with excessive drinking amongst service users with mental health problems.
Which comes first, drinking problems or mental health problems?
People often wonder whether it is excess drinking of alcohol that causes people to have mental health problems, or do mental health problems cause people to drink more? It’s the old chicken and egg question. Well there’s a lot of research that says both things happen.
In particular there is evidence to show that alcohol, rather being something that cheers people up, is a depressant and can be a cause of depression. Misuse of alcohol at its extreme can cause hallucinations, and after prolonged misuse a loss of memory. Equally we know that people with mental health problems use alcohol as a form of medication such as drinking when you are depressed or drinking to mask some distressing symptoms like hearing voices. This can lead to a vicious circle, drinking because you feel bad, this actually makes you feel worse and then you drink even more. We sometimes wonder how we can work with service users to break them out of this cycle which seems to be so destructive.
Bringing about change
One tool I have used with staff in training events is a force field analysis. The idea was developed by the psychologist Kurt Lewin. Think about a change you, or someone you are working with, might want to make, such as reducing alcohol consumption. On the one side of a piece of paper list all the forces for change, such as more money to spend or feeling physically better and on the other side all the forces against change. We might think it is obvious that the person should change, i.e. reduce drinking, but when you start to look at the forces against you start to see the pressures of resistance, such as pressure from friends, or how being drunk seems to make your problems go away for a while. The next stage of the exercise is to try and Identify possible action that the Service User can take that will change the balance so that progress can be made towards achieving change, usually by looking to try and reduce the pressures that are resisting change. Mark Connelly’s Change Management Coach website, features a force field worksheet that you could use to help analyse how change might be achieved with someone you are working with. You can find this at http://www.change-management-coach.com/support-files/force-field-analysis-app.pdf
David Beckingham – QCS Expert Mental Health Contributor