Mental health chaplaincy in a time of crisis

Roadmap to Delivery

I wrote this article for ‘The College of Healthcare Chaplains’ (my professional body). Writing it was cathartic for me.

What is mental health chaplaincy like in this crisis? The answer depends largely on your Trust although there are some common themes of being (largely) stood down to work from home, the loss of chaplaincy volunteers,  being pulled more into staff support and discovering the delights of Zoom/MS teams etc. There is a sense of waiting for the mental health crisis to come, coupled with personal feelings of uncertainty and disconnection.

My experience is perhaps untypical with many in the College of Healthcare Chaplains: the ‘patch’ I cover is around a hundred miles wide and 5O deep, covers two national parks and there are several smaller units but I reckon I work around 60% of my time in community settings. I don’t have a base or office as such: this is an advantage in normal working life- I get to mix with an incredibly wide range of people & have no horizontal surfaces on which to stack superfluous paper. In this crisis, however, it means that I am a risk as I travel to so many settings, so our whole team is largely working from home. On occasion, if a request is supported by a modern matron or ward manager, team members have been able to go on a ward, but in full PPE.

Covid 19 has hit a couple of wards where I work and the death rate has been high in those wards. I knew everyone who died by name, but the option to go in and support staff is not there as it was. Phone calls are good, but you have to be aware of your own need to be needed and what would actually help- to answer the phone when a ward is working at an intensity like never before can be intrusive. Whilst a personalised email can add to the tsunami of electronic communications, it can be read when the staff member choses to do so.

Our teams have worked at a variety of ways to keep in touch:  emails to locality managers/ward managers detailing our availability, heavy use of the Trust’s internal communications, extending  times that we are available outside of our normal on call system and the setting up of one phone number to cover the whole of our (8am-8pm on call service). However some people struggle with any kind of contact via phone: they just have to know that we are available if they want to access us. In general, I find phone calls more draining than face to face contact.

We’ve also started to use more of our Trust’s software to enable virtual contacts. This is hard in a rural area where bandwith is an issue  and tech savviness is as well. I live in a rural area and have had to work from different rooms to try and get the best modem signal: not easy when my wife works from home and I have two teenage children!

Like many mental health chaplaincy teams, we’ve produced resources- freely borrowing and adapting from other teams across the country. Some has been for our online recovery college, some for staff support and more poignantly other stuff for staff to support those nearing the end of life and those affected by it.

We are being pulled more into staff support. More often than not, this is informal and reflects an existing long term relationship: I’ve had phone calls from staff on their day off. However, we are going to be pulled into this more formally which is good: it is codifying the existing and long term informal relationship that we have with employee support.

For me, this has also been a time of disconnection and soul searching: I have lost many of the parts of the role that I love and give me life. Some will return, but I’ve a feeling that the new normal will mean that the world has forever changed and I (and chaplaincy in mental health settings will have to adapt) Now seems to be a time to do the job under these new constraints, dig deep into my own spiritual tradition, rest as far as possible, reflect and wait for the coming mental health crisis that will inevitably follow as people become tired after the first flush of intense activity, lockdown continues and then- when it is lifted- the things that have been carried can no longer be carried.

You are dust

Tracing the Rainbow: Ash Wednesday - Dust

 

I don’t often go to an Ash Wednesday service: it isn’t part of my tradition, so the first few times I went I felt out of place. The bit I struggled to cope with was where the minister leading the worship marks people’s foreheads with ash and intones the words ‘You are dust, and to dust you shall return’. It felt alien- the first time I went I was in my 30s- I had an awareness that death would happen but it was so far from my ken & besides, the world and all that is in it was pretty permanent, wasn’t it?

…and then came the virus: at first a far off rumour, but closer to us- my older son was in China at the time – than others until it involved all of us. and then something that happened to other people and finally here. New words came into the lexicon: ‘social distancing’ and ‘lockdown’ (which I loathe as the word seems to have been lifted without reflection from American ‘movies’) and sometimes, a passive aggressive judging of the other as they didn’t follow ‘the rules’.

Now ‘You are dust and to dust you shall return’ seems to be more true than ever: patients I worked with have died, one friend my age was seriously ill, others who had been slowly declining have increased their decline and the world I knew has been radically altered. I do not think things will be the same again.

Suddenly ‘You are dust and to dust you shall return’ seems fresh and true to life: what we thought was permanent never was and we were misguided to believe it to be so. Of course, as soon as you realise that and do not flinch from it, the gateway opens to more positive and connected living: maybe I’ll post on that when hope arises.

 

(I started writing this post at the beginning of Lent, but I couldn’t finish it- what has happened initially robbed me of my ability to write and reflect in a coherent way).

Easter Day in a ward

Writing acts of worship is hard. I used to do it at least weekly. Now I don’t: I work full time as a chaplain and when I come home I feel fulfilled but also mentally drained- there is not a lot left in the tank.

Weekends (they go on for two days: even with over 5 years working as a chaplain, I still find it a novelty) are down time, house cleaning, shopping, catching our breath: there is not a lot of headspace for the soul searching and contemplation for worship preparation.

I thought I was on a winner at February half term: space and time to begin the contemplation and stillness for Easter. I nearly finished my service for Easter day and was on the verge of emailing it before I thought that it would look a mite sad to do so.

And then the virus hit and the world stopped and every way I knew of being hit ‘pause.’ I thrive on human contact in what I do for a living and I had to work from home; for a long time I was disorientated- I guess I still am. The Easter service I’d written still exists and will maybe get reworked some day: I can’t use it at work; it wouldn’t connect.

I thought my Easter was done- quietly worship at home; read the stories, let them sink in and see what came to the surface. I thought it was done and then- and I can’t remember exactly how it happened: I’d promised two people that I’d phone them on Easter Sunday and that evolved into an act of worship- I found myself leading an act of worship in a ward 40 miles away whilst I sat in our front room.

The tech took ages to work, the ward staff were wonderful- beaming me into a ward flatscreen, the internet sometimes slowed and occasionally I disappeared from view. But… it worked.

Not choreographed, not precise or tidy, but it worked. I first noticed when my halting words elicited a response: people began to respond in a way that reflected their different traditions, when the prayers came, people began to offer their own, so I gave up my script and joined in.

It  was perhaps the most meaningful act of worship I’ve ever been part of: and I say ‘part of’ for I stopped being a leader and became part of something. Facilitated by atheists/agnostics because they cared, shared in by people who came to take part and not spectate, untidy- messy even, but ‘real’. Often mental health wards feel more ‘connected’ than the outside world: there is generally less artifice and more honesty: those who are broken and know it struggle less with being real.

Sometimes it is good to lose yourself in wonder and it often happens when you don’t expect it.

Happy Easter!

 

Lament & ‘Lockdown’ (& legspin)

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‘Is he always like this?’

Someone said these words to me a week on Sunday ; cricket nets had finished, but my younger son kept going when everyone else was packing up; leg spinner, googly, topspinner, practicing, practicing and checking length, line and that his foot was behind the crease, all in anticipation of the season that was to come.

I said that he was and that he was the same academically: incredibly focussed and had been for years,  with a clarity of purpose that was distinct.

Two days later and within 24 hours, all club nets and Yorkshire Cricket Board nets had stopped and GCSEs had been cancelled: the focus of 4 years or so had (at least temporarily) gone.

In different ways, the same has happened for tens of thousands of teenagers. Although very significant to them, of incomparably greater gravity, millions have been thrown into an uncertain economic future, those on the edge who can’t post grinning selfies from well stocked and large houses will fall off that edge, thousands will die and the possibility of a worldwide recession looms.

I know that ‘we will get through this’, or in the national mythology ‘We survived the war’ (which conveniently sidesteps the fact of millions who didn’t and more whose lives were permanently affected) although it may take many months for some measure of social normality to return: years for economic stability, but just at the moment, I want to lament what is lost.

‘By the rivers of Babylon we sat and wept
    when we remembered Zion’.

Sang Boney M, borrowing from the Psalmist & continuing with

‘How can we sing the songs of the Lord
    while in a foreign land?’

I think it is only when we truly let go and lament can the scale of our loss come home- how can we sing those songs?- but also the seeds of our renewal and rebirth be effectively planted.

One day, this will be over, one day we will walk freely again, one day we will rebuild, but things will never quite be the same again. Maybe there will even be a cricket season and maybe youthful promise will not have been snuffed out by this long lay off & maybe there will be once again be the intoxicating sight of a spinning ball curving through the air, dipping, before pitching, ripping away leaving a batsman confused… maybe….I do not know, but just at the moment I want to stay with the poignancy of those last few balls delivered and lament what is gone.

 

54 and the wild places.

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I fell into a habit a few years back of taking my birthday as a day off. I went from ‘I couldn’t possibly’ to ‘Why on earth not; we are not around here for long?’

Today I’ll be doing what I like doing: walking. It costs no money apart from a decent waterproof coat, good boots and trousers. Most of the kit I have is over 15 years old: it is battered, but still useful. It is hard to resist the siren lure of consumerism, you don’t need labels to define you or bring you contentment, plus there is something profound about well loved and worn items that have aged with me.

Mostly I do this on my own; walking in wild places, sometimes getting lost, frequently getting so tired so that conscious thought fades and being totally at the mercy of the elements is powerful. I like the isolated and random conversations with strangers as our stories intersect, often over a ruminative pint and I love the luxury of a slow soak in the bath when I get home.

Today I will mostly be off grid.

I cannot go back…

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There are significant moments of our life that we revisit over and over again. Each time we retell to ourselves that the story of that moment, it changes slightly until that moment becomes mythic and begins to tell us who we are now: I think the children of Israel did that with the stories they retold in Exile.

I realise that that leap I\we took over 5 years ago was life changing and significant and still affects the ‘now’. Also; the things that hurt then no longer hurt now.

When something changes radically, we often imagine that the way ahead will be relate to how it was in the past: it rarely is.

I’m not sure whether I would call this a poem, a prayer or a reflection, but here it is:-

 

I cannot go back,

No matter how smooth the way seems

(Or tempting).

It is closed now,

and although there are no maps

Or blinding flashes of light

In this ‘now’;

This grace and place,

This ‘now’ is enough.

 

Remember with thanks

every day,

for what has been

and know that the way ahead

Is not like the past.

5 and a bit years on.

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I have loads of thoughts and reflections from the last 5 years, but 4  more and I’ll stop.

1: No pattern. I have no pattern to being involved in a church in the way I understood ‘pattern’ six years ago. I still go, but sometimes through life circumstances, sporadically. I still use a spiritual director, still go once a year on a wilderness retreat, but many of the things I thought were a pattern and had been for years have gone, and ‘I still haven’t found what I’m looking for’…

2: Freedom. The feeling of being ‘free’ is still glorious- knowing that weekends are 2 days long and that there are 7 evenings in a week that I have to account for to no one: ‘ought’ and ‘should’ have largely disappeared from my lexicon. Being able to support my children playing cricket over the last 5 years has been lovely without it being somehow ‘squeezed in’. I do not feel ‘hunted’ any more. Whilst I hesitate to say ‘never’, I never want to go back that way again.

3: I think I have ‘evening meetings PTSD’. I’ve been to one church related evening meeting in 5 years and I have no plans to go to another in the near future.  Over 15 years of evening meetings & tumbling home at past 10pm with a pile of things to do somehow burned me out. It was not sleeping after a particular traumatic meeting back over six years ago that was like a ‘road to Damascus’ moment for me- I knew, whatever the cost, that I could not continue to live my life in this way if I wanted to stay mentally healthy. I’m still involved in things in my local community, but I tend to want to leave a meeting in the evening after it lasts more than an hour: I invariably do.

4: Living…. I knew that the move would not be financially advantageous- moving out of a Manse at 49 with no assets isn’t easy. Someone at church spoke about someone still paying a mortgage at 60 as evidence that someone was less well off : I resisted saying ‘I wish I was that wealthy!’. Sometimes the feeling of dislocation , if used well is powerful: how can I minister to people who feel dislocated and that things are a struggle if I am comfortable? ‘You can’t smell it if you don’t smoke it’ is a good quote, but it is still hard though…

Here’s a 9th reason…

9: Are you happy you left and do you love what you do? Yes. I am in a rare and fortunate position of doing something I love, where the values of my work line up with my own values and where I feel supported and ‘psychologically safe’. I realise that not many in employment can say that.

5 years on

It was around five years ago that I had my farewell service as a church minister. Five years on the 2nd of March, I started my new role.

Some things that have become clearer over the 5 years:-

1: People are unutterably beautiful. When my world was church and church was almost everything, as much as I tried, I still think I defined people largely by their church involvement. It still concerns me when I hear ministers in a church refer to ‘key’ people. I know why they are saying it, but if people are indeed made in the image of God, then everyone is ‘key’.

I think I see people as more ’rounded’ now. I’m grateful for that change.

2: I can’t last without church. Many chaplains are so bruised by church that they largely cease being involved: I couldn’t understand why that would be the case when I was a full time minister…. until I found myself in that same situation.

For a while I largely stopped going to church, although I found my way back, yet I’ve let go of almost all of my commitments. However, I find I can’t live a full life without being in worship (even if it isn’t every week): being forced to be with others, knowing that I am not ‘self made’ yet loved, being forced to confront failings, knowing that seeking justice & fairness even to my own cost is the right way etc etc is essential to me; and I am not alone…

3: I don’t miss the ceaseless activity. I guess that every role always has a lot to do: more than can be done in the time available and where- if you are not careful-‘busy’ is a signifier of worth. I don’t miss the aspect of being ‘busy’ 6 days a week and several nights a week, feeling responsible and being unable to stop.

4: Christians are (generally) kind. Yes I’ve seen the rank hypocrisy and abuse scandals nationally (and tragically, close at hand..), but in general, people who are part of a church/other faith community seem to give more of themselves to their area and those around them than others.

It doesn’t stop me disliking even more ‘evangelical mansplaining’ where it happens  though…

There is more, but I’ll save that until next Sunday.

 

 

3 questions:3

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https://www.youtube.com/watch?v=pHNbHn3i9S4

‘I once read a newspaper article, watched a film, a tv programme, heard something on the radio. It made me feel very…… and I decided to….. which I had never done before.’

When I saw this question written down (read back & find 1 and 2 in this series), I thought of music. I find it impossible to live without music: not music that sounds like ‘aural wallpaper’ that in my darker moments I refer to ‘music for people who don’t really like music’, but music that reaches deep into you and takes more then a cursory listen to appreciate it. I am happy to admit ‘After 30 years, I’ve become my fears; I’ve become the kind of man I always hated’ (James ‘Come Home’ , but you knew that) and I’m a musical snob.

I was maybe 9 or 10 when I bought my first proper LP: ‘Revolver’. Even now, despite owning over 600 albums, I’d still say that it was my favourite & there is a tang of nostalgia every time I play my original LP. It was hearing ‘Tomorrow never knows’, however, that made me feel differently about music.

I think that the first time I heard it, I was immediately gripped by the feeling that music could be different; it didn’t have to be immediately accessible to be good. I didn’t understand it at first, but I kept playing it- and the whole album- again and again until I began to do so. It taught be that good art often has to be worked at to fully appreciate it.

That foray led into Sgt Pepper’s and then I was off in my teens through early 70s prog rock, and as I got still older onto other musical roads less travelled.  That journey still continues; at its most positive always trying to find something new and imaginative- at its most negative, if everyone else likes something , trying to be different. It was ‘Tomorrow never knows’ that began that. Even now, although Paul McCartney’s songs in the Lennon & McCartney partnership are lovely and wondrous, it is the more off kilter Lennon songs that I keep returning to.

My first listen to that song opened my eyes to the power of music to move and to change perceptions- good music is never merely an anodyne ‘nice’-but something stranger, richer and deeper.

3 Questions:2

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‘I once went to….. where I saw……which completely changed the way I think about….’

We all have stories lodged in our brain: isolated fragments that we return to that define how we interpret the world. In one of mine, I’m in the early years of primary school & my class are all together. The teacher is asking ‘Who wants to be in the school play?’ I really wanted to be in the play, but I was painfully shy and I longed to put my hand up, but didn’t.

I regretted it, because the memory stuck with me and became a metaphor for ‘feeling the fear and letting it take you over’, so when the preacher gave us all the above question, I began to alter it…

‘I once went to’ at this, I inserted the name of someone who is active in the church and the local amdram society. ‘where I saw’ I changed this to ‘where they said’ and remembered the gist of what they’d said: ‘You can do this’. They asked me to be part of a murder mystery; that childhood memory came back, but now I heard ‘You can do this’.

‘which completely changed the way I think about’ I added ‘acting’. I could do it: I wasn’t very good at it- few are when they try something which they’ve never done- I remember completely ‘blanking’ when I did the first rehearsal without a script: the empty stage seemed massive and the lights were so bright.

But ‘You can do it’. I could; I can. I am unlikely to be brilliant, but several productions and twelve or so years later, I’m still doing it and people laugh when I do comic parts.

That childhood memory still comes back, but this time I’ve got my hand up and I’m cast and something that scares me no longer does. I’m content.