Around 90% of mental ill health stems from anxiety and depression. In any given year, 40% of us will experience symptoms related to those conditions – and in any given month, we at Samaritans receive a quarter of a million contacts. It’s important to consider what it says about society that so many people are in such distress that they feel compelled to call us.
My mother suffered from serious mental illness for most of her life, and I myself suffer from anxiety and depression – so, mental health has always been a significant topic for me.
In my career, I’ve held senior roles at businesses that could be described as icons of capitalism, such as McKinsey and Deloitte. What stood out from working at those firms is that my clients were based mainly in government, including the NHS. So, that gave me a firm grounding in how certain, key public services are delivered.
I went on to chair Build Africa and the Mental Health Foundation, the latter of which led me to my current post as chair of Samaritans – and it’s important to note here that while all previous Samaritans chairs were selected from the charity’s pool of volunteers, I was appointed from the outside.
At Samaritans, our work is based around two, fundamental tenets:
- All mental ill health is preventable – and mental wellbeing is a goal to which we all can, and should, aspire.
- People who are suffering from mental ill health, but have the support of people around them, have a radically different experience to those who don’t have that kind of support.
If we look at those tenets together and examine their practical implications for society, a couple of things become immediately clear:
- We can’t look to the NHS for answers. Indeed, I would argue that we have a ‘National Illness Service’: one that’s so heavily entrenched in treatment that it no longer has the resources for prevention.
- We must therefore reframe the challenge. You don’t have a personal policeman who follows you around every day to make sure you obey the law – abiding by the law is something we do as a community. And in my assessment, we must think of mental health in much the same way.
On an everyday basis, the Samaritans model of one individual listening to another under voluntary, non-clinical conditions is something we can take into any community context. So, leaving aside the family, which other communities can play a key role, here?
One is the educational community. Schools, colleges and universities are fantastically important, because the foundations of good mental wellbeing – or its reverse, mental ill health – are laid in the early decades. Some 80% of serious mental ill health is diagnosed in people before the age of 24. So, in that respect, the educational context matters hugely.
Another, equally important context is the workplace. Just over a year ago, I published a book called A Question of Leadership – proceeds from which go to Samaritans. It’s about leading change in organisations, and a quarter of the book focuses on how you can hardwire belonging, inclusion and mental health into people’s experience of work.
As someone from a corporate background, I do lots of talks with companies explaining why you should pay serious attention to promoting mental health in the workplace. Firstly, there is a strong moral imperative. But secondly, there’s a commercial one: my former colleagues at Deloitte published an analysis showing that for every pound a business invests in mental health at work, it will earn five back in the same year. That makes it about the best investment you could possibly imagine.
But apart from education and work, there’s one community domain where we’ve made much less progress than I think we should have, and that’s the spectrum of older age groups – particularly in relation to loneliness. And this plays right into our core mission at Samaritans of helping to reduce the number of people who take their own lives.
Data matters, here – and it’s stunning how many of the talks I give to parliamentarians, civil servants and NHS leaders finish with people coming up to me saying something like, “This has been so interesting – it’s told me so much about suicide that I never knew.” Often, the spotlight falls upon young people: the fastest-growing risk group. But the most at risk is middle-aged men – typically as a result of disappointments such as relationship breakups or loss of work. And middle-aged men are very hard to reach. So, we we’re not going to solve the problems of suicide and mental ill health by either government, or indeed Samaritans, action alone. It will require all of our social resources as communities.
For our part, Samaritans is one of the biggest organisations of its type, with 22,000 volunteers in 200 branches across the UK and Ireland. Each branch is overseen by a shift leader and branch director and, in addition to those who take calls, has other volunteers who look after functional jobs such as training, outreach and managing branch premises. So, our volunteers are surrounded by people who are unlike them in terms of background – and yet like them, too, because they all want to help people in distress.
Our stakeholders demand a high level of professionalism from us, which may seem paradoxical for a voluntary organisation. But our volunteers are highly trained, and the nature of our work requires us to put quality at the top of how we handle phone calls and web chats, and how we conduct our relationship with local and national government.
To manage our branch network, we have a central staff of about 250 people. One interesting exercise we’ve been doing for the past year-and-a-half is interleaving volunteers with staff. This process – which we are planning to do much more of – is stimulating cross-pollination, with staff reporting to volunteers and vice versa. Our aim is that this will help us think more creatively about how to correctly position each management role.
In line with our constitution, the volunteer view is represented at senior governance level in more than 50% of our board posts. We find that senior staff who get involved with us from outside the organisation eventually become volunteers, and then some volunteers take on full-time, paid roles and become members of staff as well as volunteers. So, there’s a lot of merging going on, enhanced by how we function as an organisational community.
Voices from our community: Keith Leslie is chair of Samaritans and author of A Question of Leadership (Bloomsbury, 2021)