What I offer here is a starting process to think constructively about mental health and mediation. Having practised as a mediator for some years, I am a great believer in attempting to apply the mediation process in as many situations as possible. Having been part of mediations in school, youth clubs, prisons and family court, it would seem equitable to think about applying the process to people with mental health problems. However, I feel there are genuine concerns, particularly for mediators. We cannot expect mediators to be expert in mental health assessment, or in understanding the cognitive, emotional and behavioural impact of mental health conditions on the mediation process.
To make matters even harder, every person I come across with a challenging mental health problem will have their own particular habits, behaviour and reactions to their mental ill health. Whether it’s anxiety, depression, psychosis or phobias, it will show itself in different ways with different people.
Is mediation a helpful process?
So with such variety of responses, reactions and needs, how we can we ensure that the mediation process will be helpful for someone with mental health issues? Well maybe we can turn the question around slightly and instead of assessing the person and their condition (which as I’ve said varies enormously from person to person) we think about assessing their ability to use the process.
My thinking is that rather than have a fixed assessment about mental capacity per se, I believe that first, we have to decide what mental capacities and capabilities are required by participants in order to have the chance for successful mediation. Once we start thinking about this, it may not be people with mental ill health who will struggle to work with the process, but many angry, raging and stubborn people too!
The mental capacities required for mediation
These are my suggestions – please agree or disagree with me!
- The ability to visualise a different future to the one that is predicted now.
- The ability to hold two different views in mind at the same time.
- The ability to be empathic
- The ability to understand that the mediator is a facilitator, not a judge or police officer.
- The ability to be aware when they are not understanding the process.
- The ability to ask for help, without seeing it as a negative vulnerability
- The ability to to articulate their situation and stay focussed on one topic at a time.
- The ability to decide on a way forward and see themselves staying with that decision
- The ability to understand the consequences of the decisions they make.
How might we assess this?
My thinking is that we offer these capabilities as information, prior to mediation, and invite participants to think about “mediation readiness”. This could be something that participants discuss with their clinicians, or managers, or supporters, and feedback to mediators prior to the mediation starting. So, for example, if I have a diagnosis of depression, I may have many of the above capabilities, but not have the ability to visualise a different future. Hence, I will need help with that either prior to the mediation starting, or during the mediation.
The desire to be helpful
The more I work in the area of mental health the more in turns into an art rather than a science. The one thing that remains constant about mental health is that there are no real certainties. Apart from personal and professional safety, there are no fixed rules when attempting to be empathetic with someone who is experiencing a psychotic delusion, or to help a suicidal person to stay alive, or to explore the obsessions of a highly anxious person.
Often, when I think I’ve found a formula that works in one situation, I’ve found myself sounding patronising when applying it in another situation. The only philosophy that works for me is having the desire to be helpful, to be part of a nourishing environment for a person who is struggling, rather than part of an austere, rigid environment. A philosophy of empowerment rather than directives, and a belief that people can be enabled, with good support, to develop the capability to manage their own conflicts and difficulties in a constructive manner.
Mandy Rutter, Senior Clinical Business Manager at The Validium Group Ltd
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