How can ‘Mindfulness’ be used in a local community setting?
What is mindfulness and what are the benefits?
Mindfulness has been defined as…
“a mental state achieved by focusing one's awareness on the present moment, while calmly acknowledging and accepting one's feelings, thoughts, and bodily sensations, used as a therapeutic technique.”
Although this sounds a little soft when confronting some of the larger issues in community mental health, there have been some interesting studies which have shown mindfulness to have a powerful effect on our mental health. Our mind is the lens through which we see our world, it also is inextricably linked to our physiology so it is not too much of a surprise to find evidence which shows mindfulness to be of great benefit to individuals.
Mindfulness has most commonly been associated for use as a treatment against depression. The work conducted by Professor Mark Williams at Oxford has show to have benefits in this area so that mindfulness is now recommended by the National Institute for Health and Care Excellence (NICE) as a way to prevent depression in people who have had three or more bouts of depression in the past.
Long term physical conditions
One of the most important areas of research has been around the use of Mindfulness within the treatment of long-term physical health conditions. A review of 114 studies (Carlson L., “Mindfulness-Based Interventions for physical conditions: A narrative review evaluating levels of evidence”, International Scholarly Research Notices, 2012) found, in the context of poor physical health, consistent improvements in mental health and wellbeing, particularly reduced stress, anxiety and depression where a mindfulness-based intervention is used.
Mindfulness has proven to be effective for children and young people, with school-based interventions having positive outcomes on wellbeing: reducing anxiety and distress as well as improving behaviour, among other areas (K Weare “Developing mindfulness with children and young people: a review of the evidence and policy context”, Journal of Children’s Services, 2013). Evidence also suggests that children who used mindfulness practices more frequently reported higher wellbeing and lower stress scores (W Kuyken et al, “Effectiveness of the Mindfulness in Schools Programme: non-randomised controlled feasibility study”, The British Journal of Psychiatry, 2013). A successful Mindfulness in Schools project was set up in 2007 and is now being taught in 12 different countries. This nine-week course is especially designed for school students, whether they are dealing with exam stress, bullying, or seeking to enhance study skills. It’s being used to improve students’ wellbeing as well as helping them to learn and concentrate better.
What are the obstacles to teaching mindfulness in the community to individuals with SMI?
Mindfulness requires a regular practice for individuals to gain a noticeable benefit. Individuals therefore have to invest some lengthy periods to get a benefit. Although the research does not specifically say how much is enough (this is an area of active research) the 8 week MBSR course which was used to develop some of the depression research includes homework which requires practice of 45 minutes per day, as well as a 3 hour directed weekly session. Individuals with chaotic lifestyles may struggle without good quality ongoing support, and a personal investment in the process.
Mindfulness requires space to practice within a group setting. Individuals with severe mental illness (SMI) have issues with physically getting themselves to such groups at the right time. These individuals are very rarely drivers (due to the medication they take) and are therefore reliant on having the funds, skills and confidence to make use of public transport.
Although mindfulness is well known within the profession of mental health, it is not widely known within the general public yet. Therefore there are issues with convincing individuals to invest time and energy into something which appears to sit outside mainstream medicine.
Training for trainers is a further issue. Currently in order to officially teach the MBSR programme, an individual would needed to have a Masters Degree at one of 4 universities across the country. There are other programmes including the mindfulness in schools programme which requires a history of personal practice, as well as completion of the MBSR programme as a student. It can therefore takes years for even the most dedicated person before they are in a position to teach mindfulness.
Although there are obvious obstacles to teaching mindfulness techniques they are not insurmountable. Firstly, having mindfulness coached within a recovery college program, helps the individuals to contextualise the process as a learning opportunity. Mindfulness is like a training session. It is also helpful if the recovery worker (support worker) they have a relationship with, also practice mindfulness, so as to show that it is something that everyone can engage in. Having staff who make mindfulness a regular practice means that it is easier for them to personal explain the benefits and therefore support the individuals to invest in the process. The issue of time and travel are age old issues which can be mitigated against by good quality support.
Avondalecare has been teaching mindfulness techniques to scores of individuals for the last 2 years, with great reported benefit. We hope to expand this programme in 2017 to offer it more regularly and give more opportunity in order to provide more benefit for both staff and service users.
Thomas Jeffs - BSc Health and Social Care
Director @ Avondalecare