The bridge builder's role

Bridge building is a strategy developed in the late 1990s and early 2000s. Designed to promote social inclusion for groups that might otherwise be marginalised, bridge building has been used to immense effect in the mental health field. Bridge building is particularly useful for people who suffer or who are in recovery from severe and enduring mental health conditions.

The role of the bridge builder is very simple. It is to help facilitate access to mainstream environments for individuals, based entirely on their own personal choices. The original social inclusion think-tanks were set up by the (then) office of the deputy prime minister. Nine key social domains were identified as key to individual development. However, it is not expected that every individual would be expected to access every single domain, nor would they wish to. The key areas include employment, arts & culture, faith and cultural communities, education & training, volunteering, befriending, sports and wellbeing. There are other domains as well, such as friends and family and statutory services.

Within these contexts, a bridge building team can be set up, working in mainstream with referrals from other agencies particularly NHS and social services. It is crucial that the organisation that is commissioned to carry out mainstream is itself embedded in a mainstream environment or conducts its interactions with clients in the big wide world, rather than in a clinical setting. It is the only way that a conversation with a client about their hopes and aspirations can be realistic and genuine. These approaches are entirely in line with the way mainstream was envisaged as a key part of the care pathway and an alternative to what Dr. Pat Deegan has aptly described as 'a career in mental health'.

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How mental health can enrich the work environment

People with mental health conditions who are returning to employment or even accessing it for the first time can often make exceptional contributions to the workplace.

Their previous experience can be considerable and many individuals returning to mainstream carry high levels of skills and expertise.  It may also be the case that the previous workplace was a contributory factor and there is no desire to return to 'the scene of the crime'.

Individuals returning to mainstream often do so with care and caution.  The pathway back to employment may begin with voluntary work or a part-time position.  Often it provides an opportunity to discover an area of interest the individual has always wanted to take up but never had the chance.  A part-time post in a related field can help to prepare the way for a full-time salaried position.  The returning employee makes his or her way back into the workplace with new skills, new experiences and new life encounters.

An art tutor who understands mental illness from first-hand experience will apply non-discriminatory and more inclusive practice alongside his or her skills.  An individual in recovery might discover through accessing a mainstream service that he or she has gifts that can be developed and extended.

The way back into mainstream for people who may have never worked due to illness needs to happen through gradual re-skilling and training.  With good bridge building, clients can identify the kind of special gifts they may have never identified previously.  Person-centred planning is designed to help clients discover genuine aspirations and goals.  It is not designed to force individuals to  fit  into a particular job role nor to be assigned to sheltered employment outside mainstream, except where the individual feels this may be appropriate.

Identifying a suppressed aspiration as the cause of stress at work can lead to formidable achievement when previously hidden dreams are pursued and developed in the appropriate mainstream setting.  This too creates employment or self-employment alongside increased cashflow and profits for the service providers and employers who are helping individual dreams to become reality.