Access to Mental Health Care or the Jackson Pollock of It All

by Monica A. Ross, LPC

Problem-solving.  Why would the ability to problem solve be a core component of resilience? My first thought on that one is that people who are struggling just to survive, for those who face steep obstacles in life, the ability to problem solve is critical in order to figure a way out of the crisis(es). 

Take a look at this clip, for instance, from the Center on the Developing Child at Harvard University “How Resilience is Built.”  It talks about the importance of relationships and the importance for the developing child of the ability to both monitor and problem solve. 

At the time of this posting, what comes up in a google search on “How to problem solve” is this method:

1.     Identify the issues.
2.     Understand everyone's interests.
3.     List the possible solutions (options)
4.     Evaluate the options.
5.     Select an option or options.
6.     Document the agreement(s).
7.     Agree on contingencies, monitoring, and evaluation.

This is of course geared towards problem-solving in the workplace. That sounds about right, but we also know that people who find themselves in crisis at work or at home can’t even begin to complete number 1 let alone move smoothly along to 2, 3, 4, etc.  The reason for this perhaps is because those living in crisis are living life from a scarcity mindset. 

Mullainathan and Shafir in their book Scarcity: Why having too little means so much explain that the focus on what we lack, or approaching life from a scarcity mindset forces a type of preoccupation in life.  When we are preoccupied we do not have the cognitive bandwidth to begin to address other problems.  Or at the very least, addressing other problems becomes a daunting task.

The scarcity mindset as the authors point out is not about lacking the capacity to process, but it is about lacking the mental resources. With the scarcity mindset we tend to do things like incorporate tunnel vision which is good when something deserves our sole focus and concentration, but towards how many singular things in life do we have the luxury of dedicating all of our attention? 

Scarcity also affects our executive control, making it hard to have self-control.

A lack of self-control can then interfere with problem-solving.  Lack of self-control more often than not can exacerbate a problem. It is these types of psychological biases affecting those living with a scarcity mindset that fuel sometimes poor choices despite the fact that the consequences of those choices can be extreme.

This lends itself to doing impulsive things despite the fact that the stakes are higher. Not only do those who are operating at the survival level (e.g. the poor) have less room to fail because they have fewer resources, but they also have a compromised ability to make good decisions. This, in turn, increases the likelihood of failure.

As clinicians, one of the modules we are typically called upon to utilize in working with clients and in conducting psychoeducation is the module on problem-solving. Why? Because people with severe mental health issues sometimes forget to take their medication and when that happens they may stop taking medication altogether. They may act on impulse and find themselves running up gambling debts or maxing out credit cards in an impulsive spree, or making hasty major life decisions like moving cross-country.

It’s important then both to gain some level of stability as a consumer or client either on or off medication and from there to work towards maintaining that stability. Stabilizing itself takes a certain amount of problem-solving ability and that problem-solving ability may never be reached if a person finds themselves in a constant state of making both impulsive and poor decisions.

Now let’s compound the issue for the person struggling with mental health issues by making access to help in and of itself confusing. If I were to describe the process of finding a psychotherapist from the consumer or clients’ side, well it’s a bit like this:

Some Issues for Consumers

To me the current marketplace is like…..my own artistic interpretation:

scribble

 

Or

Like a Pollock Painting

Pollock Painting

Or

Like my friend Yoon Lee’s paintings

Yoon Lee

It’s like a kindergartener took a piece of paper and did this:

kindergarten

To put it metaphorically….

It’s like a city wanted to build a new roadway system and they let everyone decide where they wanted to put the pavement, stoplights, lane markers, and highway signs.

Mullainathan, S., & Shafir, E. (2013). Scarcity: Why having too little means so much. London: Allen Lane.