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All being well

Updated: Jul 25, 2020

What will it mean to be well in the next few months? And what will it take to maintain that state of wellbeing?


Those are big questions that are far from easy to answer, but what we can say with some degree of certainty is that being well won’t just be about a lack of illness.


We're well-versed in the World Health Organization’s 1946 definition of health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”[1]. That’s a big ask at any time but, in a post-COVID world, it’s huge.


In the last few weeks, we’ve seen extraordinary demonstrations of humanity and skill in the face of crisis and emergency. In the coming weeks, we're likely to observe some sort of a regression, as we realise just how uncertain the future is, and we lose some of the sense of purpose and energy that has characterised the response to date. And in the coming months, the full effect of the virus will hit home.


We’ll see evidence of #COVID19 on other urgent and emergency conditions, which people may have put off addressing for fear of drowning the system. We’ll understand more about the impact of turning down the attention on long-term conditions. Above all, we’ll realise the lasting social, economic, and emotional impact of the virus and the lockdown.


Mental health impact of COVID-19

The mental health impacts of the pandemic will likely endure far beyond the physical[2]. The link between economic hardship and mental health is well-evidenced, and the Institute for Fiscal Studies agrees with estimations that the number of people of working age suffering from poor mental health following this crisis could rise by half a million[3].


WHO’s original definition proved too innovative, Utopian, broad and immeasurable for some so, in 1984, they embraced a new concept of health, not as a state, but in dynamic terms of resiliency - as “a resource for living”, to change or cope with the environment in which people find themselves.


Mental, intellectual, emotional, and social health relate to one’s ability to handle anxiety, to acquire skills, and to maintain relationships, as resources for survival and independent living. Access to and use of health care services are vital to the health of individuals and communities. But just as important are where we live, the state of our environment[4], our income and education level, and our relationships with friends and family.


The role of civil society

#CivilSociety has a unique role to play in meeting some of society’s unmet needs. NCVO’s civil society almanac[5] reinforces the sheer scale and scope of the sector. In 2016/17, there were approximately 196,000 voluntary organisations in the UK, 167,000 of them in England and Wales. Nine in ten UK households have accessed services provided by voluntary organisations at some point.


But the well is running dry and no amount of wishing will make things magically better.


Things were bad enough before COVID-19. Charitable organisations working in health and care, for instance, had been expected to do more in response to demand, need and limited finances in public services, but often with the backdrop of diminishing resources for themselves. Charities were becoming paralysed by the sheer number of demands on them. The traditional boundaries between core service (public sector) and value-adding (charities) were blurred or non-existent.


In the last few weeks, that situation has reached a critical tipping point. In mid-March, @NCVO led a coalition of organisations to assess the impact of COVID-19 on the sector. Sector bodies estimated that charities would miss out on at least £4.3bn of income over the following 12 weeks. On 8 April, Chancellor Rishi Sunak announced that the government would be providing £750 million.


Seeking the brightest light in the darkest hour

That funding gap means that the sector will struggle to meet the demand for their services, just at a time when people need them more than ever. People seek the brightest lights in their darkest hours. Through care and advocacy, people can find relief and a sense of belonging; through the arts, culture and sport, people’s spiritual and emotional needs can be sated; and in housing associations and educational trusts, people’s basic human rights can be addressed. At its most elevated, the collective state of ‘charity’ reflects the fundamental status of community and nation[6].


Civil society can have a major part to play in society’s post-traumatic growth (PTG), by enhancing natural optimism and providing activities and services that facilitate coping. Research shows that PTG can occur after a traumatic event in five possible ways – relating to others, new possibilities, personal strength, spiritual change, and appreciation of life[7] – and civil society can offer those in abundance.


The Civil Society Strategy[8] grants charities formal permission to speak in public debate and promotes the sector’s role in shaping policy. That’s fine and dandy but it only means something if the sector’s survival is assured – and the reality is that for many charities, the struggle to keep going and to remain afloat has been forced to the front and centre of their thinking.


In the last 24 hours, @GemmaPeters has shared how Blood Cancer UK needs to contract and @EmilyPBurt has described how reporting the impact on COVID-19 on charities has been like "watching a slow-motion car crash that is just now starting to hit the wall". As a trustee of both national and regional charities, and a close observer of the sector through my work, I can confirm that charities everywhere are facing the consequences of the pandemic, taking decisions that would have been incomprehensible only a few weeks ago.


It is not good enough simply to hope that things will be okay. "All being well" is not a plan. Now we know, we must act not just react. Now is when we must support our charities, before we sleep walk into a future without them. We will lose the third sector at our peril.


ANHH Consulting can help charities as they face uncertainty - as a partner in governance reviews, strategy refresh, and merger planning - but the existential crisis needs all our action. Find a cause that speaks to you, then please give what you can: a whole load of next-to-nothings can soon add up to the kind of something that will make a real difference.


As Ernest Hemingway wrote in "For Whom the Bell Tolls":


Today is only one day in all the days that will ever be. But what will happen in all the other days that ever come can depend on what you do today.


 

[1] Adopted by the International Health Conference held in New York from 19 June to 22 July 1946, signed on 22 July 1946 by the representatives of the 61 States, and entered into force on 7 April 1948. [2] Pringle-Nelson, C. (18 May 2020) A time for ‘tragic optimism’? The Psychologist. The British Psychological Society. [3] Cited in Mental Health Foundation (May 2020) The COVID-19 Pandemic, Financial Inequality and Mental Health: A briefing from the “Coronavirus: Mental Health in the Pandemic” Study. Mental Health Foundation. [4] Place Alliance (May 2020) Delivering Urban Quality. Time To Get Serious. The case for a design quality unit for England. Place Alliance. [5] NCVO (2019) UK Civil Society Almanac 2019. Data. Trends. Insights. [6] Populus, Charity Commission for England and Wales (July 2018) How the public views charities, what this means for the sector, and how trust can be increased [7] Calhoun, L. G. and Tedeschi, R. G. (Eds.) (2006) Handbook of Posttraumatic Growth: Research and Practice. Lawrence Erlbaum, Publishers. [8] HM Government (August 2018) Civil Society Strategy: Building a Future that Works for Everyone. Crown Copyright.

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