What I've been working on is what's being called a broader framework for understanding inequalities in health status and our passage through the health system and in public health.
So the frameworks I've been using are what's being called syndemic frameworks and eco-social frameworks. Essentially all they mean is that there are multiple adverse webs of causation in the environment, including place and geography. They all interact with personal dispositions and lead to poor health, and we've got to be able to intervene at all those levels.
All of my projects are deep dives into one or other of these particular paradigms.
So I’ll offer two potential projects, one is the Mental Health Act project that I've described. The other project I'm working on at the moment is understanding adverse childhood experiences of diverse communities, different ethnic backgrounds, ages, genders, LGBTQ plus, neurodiversity; and properly understanding the range of experiences they have that are traumatic and how it affects their lives and how they develop illnesses, physical illness, or mental illness, and how they may actually be supported to not develop mental illness.
And we're doing that through a very nurturing, supportive process involving creative arts methodologies and artists working with young people to gather their experiences either through theatre, through dance or performance, or through photography. It's a gentler way to gather their experience than asking them questions which can traumatize them.
And it's a way of informing policymakers about things they’re not listening to, practitioners about things they're not listening to. And these young people are then going to co-design interventions for public health prevention; for schools, for teachers, for employers, and also, we hope there'll be a ‘serious game’ being developed which will embed some principles of narrative exposure therapy in order to help people who've had serious traumatic experiences, for them to realize what's happened to them and begin to seek help.
That's the biggest project now linked to that, we know that adverse childhood experiences also lead to physical health problems and shorten your life expectancy by up to 20 years if you have had lots of them.
So some of my projects are also looking at physical health and multi-morbidity, and coming in the reverse direction, seeing how adverse childhood experiences affect that outcome and having a better understanding of how we can provide care in the health system and in the social care system for people with these complex problems. At the moment they are complex, and they don't fit our existing systems. We don't have the systems to properly support them.
So what I'd like to see is change in the entire health service to cater for people with complex mental health problems, with complex identities, and we can more appropriately then provide better support and care and improve quality of life in the long term.