Nowadays in the modern world western world more and more people are affected by mental health problems. In the UK for example 4.7 in 100 people suffered from some form of anxiety in 2009 according to mind.org.uk. Apart from anxiety the most common mental health problems include post traumatic stress disorder, depression, phobias, eating disorders, OCD and panic disorder. There is considerable variation in the severity of these problems.
Depression is the most common disorder that contributes to suicide. As people are still worried about being stigmatised probably there are cases that are undiagnosed. In addition, people might experience some other mental health problems during their lifetime, including self-harm, personality disorders, bipolar disorder and schizophrenia.
There might be a range of explanations for the incidence of mental health problems. It is very probable that a combination of factors cause them. Genetic factors can be one of these e.g. in case of schizophrenia. Certain life events might also trigger mental illness such as losing one's job, long term illnesses or social isolation. Coping with current traumatic situations can also trigger mental health problems such as getting divorced. Past traumatic experiences can also influence one's mental state e.g. being abused as a child.
The features of positive mental health include being able to control life's challenges and stresses, being able to focus at work and contributing to the community or as Freud puts it “the capacity to work and love.” Another definition could be the ability to enjoy life and finding the balance between different life areas e.g. work, family, the wider community, leisure and spirituality. Feeling generally optimistic and energetic, and having a sense of purpose in life also refers to positive mental health. Positive mental health also leads to better outcomes regarding resilience, employability, educational performance and earnings.
Counselling can contribute to one's emotional well-being in a number of ways. Clients may become more self-reliant, more independent and confident. They are likely to have more assertive attitudes and as a result they will be more capable of dealing with life challenges and will have healthier relationships. The relationship with the counsellor can be therapeutic, in person-centred counselling for example if the counsellor provides the right conditions the client will activate inner resources and personal development and self-actualisation will occur.
However, there might be some clients who require other forms of support. Counsellors must be aware of the limits of their own capability. This is also outlined in the BACP Ethical Framework: “....working within one's limits of competence and providing service on adequate training and experience.” Working outside the limits of one's ability would pose a risk on the client and also it would be unethical. According to the CPCAB model at service level A counsellors can provide support with common life problems through a formal relationship. At service level B counsellors can provide more in-depth support for people who suffer from mild to moderate mental health problems such as anxiety or depression to enable change in themselves. It may involve work with explicit and implicit aspects of the self too. (level B1, B2)
If there is a client with severe depression and the counsellor is not specially trained to deal with this issue, he should refer the client to a qualified professional to receive appropriate help especially if risk of suicide is involved. Risk assessment is crucial with suicidal clients. The best course of action for clients needs to be provided. The counsellor should inform the client about the available services and the client can accept or decline. Another reason for referral can be that another theoretical approach might be more beneficial for that individual client's needs and presenting issue. In case of financial constraints the counsellor can refer the client to a low cost agency or to a free service.
Bibliography:
https://www.nhs.uk/conditions/stress-anxiety-depression/mood-self-assessment/
https://www.mind.org.uk/information-support/types-of-mental-health-problems/
https://patient.info/doctor/patient-health-questionnaire-phq-9
https://patient.info/doctor/generalised-anxiety-disorder-assessment-gad-7https://www.coresystemtrust.org.uk/wp-content/uploads/2020/07/CORE-10-English.pdf
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