The Community Family Centres (CFC)
Working within our communities, we often find that, for some people who do not or cannot be with their original family, they sometimes have a friend family rather than their own family. Maybe they don’t have a family as we usually think of it and their friend family is all they have; and what about the rest of the people, are we all ok?
By the number heading to A&E each week for non physical assistance, it appears that our nations psychological health isn’t at its best. Our emotional health, our psychological state is a good indication of the emotional state of our environment. This rise in poor emotional health has been evolving for so long that its is not about the recent times political parties but goes farther back than our recent governments but of course therefore also includes them. The reason for the request for the introduction of Community Family Centres (CFC) are neither about political nor monitory issues but based on community and the needs of people and the environment around them.
There are certain things that people need to survive and indeed flourish; one of the largest of these things is connection. Connection involves relationship (Erskine, Moursund & Trautman 2014), this not just romantic relationship but human relationship.
Our connections are our happiness and the lack of connections bring great hurt and heartache to humans as we are made for connection and when we don’t have connections we can become isolated and unhappy.
We need people around us; people who will be around, because they just are. People who are in the same place as you because they are in the same community as you, know the families that are in your community and as it used to be, no-one is actually alone. Community Family Centres aren’t community centres as we knew them; they were for the people then, for how it was then. We need to have something for todays needs and use them for todays people.
We have evolved over the past few decades to be more isolated than we used to. Community isn’t about ‘living in each other’s pockets’, its about being there, actually being there. This is what we felt in the lock-down. Its a feeling, its healthy, its emotionally important
Over the time of the first lock-down of the pandemic (2020), we began to notice something that many people had never felt before; a sense of community, some of the older population of course know that feeling, the feeling that they have observed a loss of, in more recent years, from when they were small.
Isolation, as we know (even when we don’t realise we know) is the ultimate hurt for humans. We function in a different way when we are isolated. Isolation has always been the punishment for humans, yet millions of people live in isolation through no fault of their own, that is difficult to even imagine, that people live in the same solitary confinement as many do for a punishment for a crime (which is also something we’ll get onto later). Some people live on their own day after day after day; older people yes, but not only that part of our population; there are many people being or feeling alone, feeling that they live life on their own, unhappy and distressed.
As older people have come into the reading of the project, we will turn next to them, and come back to connection afterwards…
We reach an age where we can be the most useful to other members of the community. We’ve been there, done that, and bought the T shirt; we’ve reached a time when our children are grown and we finally have the time, the experience and the patience to slow down and be able to share the knowledge we’ve finally learned is of some importance. When we were younger, running around, as we all do with young and growing children, new to it all.
Social Care
This is the biggest cause of upset and the biggest change that the proposal wishes to address is social care.
It’s not surprising to me that the social care system is constantly struggling and doesn’t work as it could. It comprises many parts, no parts touch each other and therefore it’s something that looks like a system but is not. It appears to be lots of cogs trying to spin on their own, make it no singular system that is efficient enough to deal with the bigger picture, in fact it makes it no efficient system at all; its getting better as technology binds systems together but it mainly still sees the problems at surface value and does what it can to solve that particular problem. Any institution of this size is going to struggle and is going to try and categorise problems when in fact each individual has their own unique situation. (Actually, we only have to look at their clinical coding system to see how complicated situations and people’s circumstances really are). For example, a useful thing to put into a category is broken bones; an obvious issue that can be seen and has a solution that although a need for flexibility for the fix in the singular instance is generally put the bones back together within the situation of simple process or very complicated, its still the same; see the problem, know what to do with the problem, fix the problem. There are issues however, that are no as straight forward as bones.
Here are some examples of independently spinning cogs that could be the base of an integral system:
The Samaritans are an immediate service for those in psychological need and they are trying to recruit as many people as fast as they can. The service that they provide has no information regarding the person on the line as they are an independent body, but are available 24 hours a day.
Social Services have information on known vulnerable people, but an immediate service is not known to the public to use other than crisis team for which there is no knowledge for most people as to how they are accessed eg. nothing equal to 999. For those who don’t fall into that category, there is no service that can deal with the numbers who require service in real time. Some of these people call upon the services of The Samaritans etc. There are crisis teams within the A&Es of hospitals, but they for those who are at a top level of distress only. These services are running on empty and are not equipped for all situations other than that of (a perceived) high-level distress; in other words, fire-fighting at best. What does everyone else do, do they have to live in the state they are in, until they go into the perceived high risk category? Thousands of people are living in distress but are not in a category of high risk. The poor emotional state of any person is a reason for compassion and care.
Note: For those with physical things there is 999, for those with psychological things there is….nothing. That’s why 999 is called upon; there are no alternatives. If the psychological need has a physical consequence to it, then of course the ambulance team can actually help, but most times it is simply horrible for an ambulance member to be expected to deal with a psychological issue. Most become experienced in having to deal with all of this but it shouldn’t be the case and is not fair on that team. And, while that is going on, someone is waiting for an ambulance; not for a more important reason, but with something that the team is trained to deal with. Are we going to say that ambulance staff should be trained in psychological issues? We wouldn’t go to the doctors to have our teeth fixed and then say that the doctor should be trained in dentistry if he can’t solve the issue. To extend the analogy, at present people are going to the doctor as there is no dentist so what are they supposed to do!
I would hope that whoever holds the purse strings doesn’t think about it as ‘oh no, more money’ but instead to think about what to do with the money and why; how it would relieve the other services and what the knock on effect would be financially for those services. This is all social care in the wider sense.
NHS
The social care system has a knock-on effect for the NHS. For example, the older people who are sitting in hospitals, waiting for somewhere to go, could be out of the hospitals and into somewhere within their community, and only within their community. The different socio-economical differences would denote how many local community homes should be set out for the older population.
Buildings that hold 40, 50, 60 etc people or more are not required in reality. Acquiring larger sized existing buildings will be all that’s required to bridge the gap that is lacking at present. Plenty and familiar is the key. Staff will be happy to work there, within their communities with people who are in their community. Families will be able to see their elders and so will everybody else. The doors will be open, they will not be locked up. They will not have lost their place within the community; in fact, they will take their place as the knowledge of the community, an up-to-date version of what has always happened. A history of a different kind, a needed part of the community. As one of the indigenous leaders said “they are the most valued in the population, without them, each generation would have to start from the beginning and learn everything all over again.” At present many of the younger parts of this generation are learning from their peers, as if their peers know more than they do. Peers may know different things but only from the same maturity as themselves. From the point of view of someone who listens to people’s troubles every day, it seems that they are concerned about how much they don’t know, how they feel about themselves and the feelings of inadequacy that comes from that. From that comes anxiety and then depression. If we are not looking at the bigger picture, then we are not looking at anything at all.
Emotional conditions would be supported at the Compassion Family Centres which will be attached next to each hospital A&E where ‘minor needs’ are now, or a department within the hospital where people can go for that need, just as much as others can go their physical needs. People who have a complex need can be seen efficiently as each physical (A&E) and emotional (CFC) place is in a location together with the other. What about the department of ‘minors’ at A&E. Speaking to doctors about the differences between A&E and walk-in centres, I believe we need to put an x-ray machine in the walk-in centres. All this costs money? It already does but apparently, we don’t change how we spend it, so we get the same outcome.
The NHS will then be able to manage the physical accidents, emergencies and conditions that come their way. The NHS doesn’t need to have good money thrown into a system that doesn’t work because its dealing with something that was never meant to be dealing with. It was intended to deal with issues that entered the building, which were then resolved, and then doctors went onto the next person.
Each Compassion Family Centre should have an addiction counsellor, a trauma counsellor, a listener, a person who is there for them. Someone to connect and have compassion for their situation. These roles could be filled by two people, the listener/counsellor/person who is there for them.
The emotional states are trying to be dealt with by physically trained doctors and therefore the situation is unmanageable as it is doing what its made for and it shows. The violence through frustration is unacceptable and yet there is nowhere else to go. My colleagues and I are very aware that a place for physical trauma or medical assistance is not made for emotional trauma or emotional assistance. Only when these states are presented as physical do they arise in the accident and emergency department of a hospital. Imagine a hospital accident and emergency department without people who are drunk or have addictions. The absence won’t be because nobody cares, but because there is a place where someone can cater for the emotional type of trauma or distress rather than physical trauma or distress.
GPs
GPs are amongst the top professions for experiencing emotional stress. Research states that this is due to the underlying training they receive to relinquish their emotions in order to do the job (Deveer 2021)
The therapy world has many doctors in all their professional capacities as surgeons, GPs, A&E specialists etc and the relinquishing of emotions is not an ideal target to aim for, when training people to heal people (Wible 2005)
GPs are at the beginning of the procedure for patients and could be referring patients very differently by starting their enquiries as to why that person made the appointment in the first place. GPs are not trained to ask the patient in the clinic “what happened to you that makes you feel like this” and yet they are the people who need to say it the most. Instead, several investigations begin which are both time consuming and costly and is solely for the purposes of finding something physical. (And actually, intense pain in a patient’s back may not have a physical cause at all).
The disconnection is very clear. If we ourselves are disconnected, our resolve will be search for the cause by the same rules. It is no wonder or no fault that the physical is not found where they didn’t need to look. Many (nearly all) of the doctors who have attended counselling or psychotherapy are listening to the physical reasons for physical disturbance. IBS, fibromyalgia, CFS, ME etc. Trauma to the human being isn’t always an event; it can be something that didn’t happen, that should have happened, or something that did happen that shouldn’t have, and the body may have a physical reaction to it, either in an immune response, or a nervous system response such as violence or anxiety (Porges 2017).
Actually, most people know ‘what happened to them’, but they don’t associate that, to what is physically happening to them now….until someone asks them. Do we really want to go through blood tests, ultrasounds and x-rays before someone says we can’t find anything, maybe counselling would be a good idea? How much have those things cost; Not only in money but in time and resources? And all the time the person is just following what they are being asked to do. Could the question be asked in the beginning. Is it as simple as that, no not really; sometimes it can be psychological and sometimes it can be physical but at present, I don’t feel that both are equal starters on the GP path to finding out what’s going on with that person?
Housing
Once we get onto housing, we can begin to see how the new systems can come together. The reclaim of houses for the people who need them comes into view and the system of humans is seen for what it’s supposed to be.
Social Care housing for our elders doesn’t have to be new housing; utilising what’s already in the area is familiar and comforting to all who are involved. Refurbishing those houses, isn’t more expensive than building from new, but building new would may be somewhere where they know no-one, when they can only see family now and again as people who can’t afford to go; people without cars must spend time, find childcare, time from work, their own resting time etc. This is all unnecessary; in my opinion, if you can’t walk it, it’s too far. Refurbishing the existing houses will keep families in the area, making it far easier for all socio-economical levels of people to see their loved ones and to take the children with them; popping in instead of having to make it an event. Strategically placed Churches and Public Houses, all empty; I say strategically placed as they were, no-one is going to place a pub were no-one is going to go. They were in the heart of the community and so were churches. Sometimes we turn a corner on what we think is a tiny road, and there is a church, huge, prominent in the community. Now more than ever, empty, some converted into flats etc, trying to find a use.
Liverpool Therapies 