Last week’s Mental Health and Transport Summit was a tipping point, moving the issue from the margins to the mainstream

 

hiddendisabilityFlash cards which passengers with particular needs can show to staff in a way that means they do not need to draw attention to themselves

 

There are plenty of transport conferences every year and most come and go without leaving much of a trace. But I doubt whether there were many people at last week’s Mental Health and Transport Summit who will be forgetting it any time soon. Very well put together with thoughtful and affecting presentations it did what it set out to do which is to ensure that all those who attended have a greater understanding of the issue and know that it needs to be taken seriously and acted on. Not least because there’s some big numbers involved. One in four people experience mental health problems in any given year. People with mental health issues are the largest group of people with disabilities.

It’s not a problem that is out there somewhere for somebody else to deal with. Given the numbers it’s people on your buses and trains. It’s in your workforce. One in six British workers are affected by conditions like anxiety, depression and stress every year. It may well be the largest cause of long term sickness in your company. If not it will be in the top three.

What came across at the conference too – from personal testimonies – was how transport can be a trigger for anxiety and spiralling mental conditions. The tense, sweaty silence when a crowded tube train stops in a tunnel. A humiliating encounter with a rude bus driver – with the rest of the bus the audience. Rushing for a flight. All means stress.

The brain is a wonderful and strange thing but also partially ancient and reptilian. The reptile brain is poor at delineating real existential threats from other stressful situations but the fight or flight response when faced with what it’s marked down as a threat can be all consuming. It shuts everything else down. A state of overwhelming panic. We want to avoid triggering this again. The rest of the brain may be saying this is a ridiculous over-reaction but the reptile part of the brain can’t hear. The mode is avoided because it’s a panic attack waiting to happen. One less customer. At its worst people spiralling into isolation with all the misery and wider costs to society that entails.

What to do about transport and mental health is the harder task. Overcrowded trains, tubes and trams are unlikely to be eliminated anytime soon. There was a sense from the conference that before getting to the solutions stage the first step is to acknowledge the scale of the issue (including in the workplace) and then to de-stigmatise it.

Alistair Campbell, who spoke very well at the start of the event, talked of how not so long ago cancer was the ‘Big C’ that nobody talked about because there was no language for doing so. Not so now. Mental health is where cancer was then – submerged in fear, taboo and stigma. The frankness of Alistair Campbell and other speakers on their own experience of mental health problems was partly to bring the issue to life but also to say it’s OK to talk about this stuff.

The ‘Time to Change’ campaign is all about reducing the stigma around mental health and providing organisations and individuals with a way of doing something about it. As well as individuals, employers can sign up to the ‘Time to Change’ pledge – an aspirational statement backed up by an organisation-specific action plan. More than 350 employers have signed up already, including Network Rail, Transport for London and the Department for Transport – and there’s a sense that the issue is starting to snowball.

But still, what does the transport sector actually do in a practical way to address this not always visible problem, with its many dimensions from anxiety to autism, and from dementia to agoraphobia. Conditions that can fluctuate in those affected and manifest in relation to different modes and situations.

From the conference it doesn’t appear to be an easy set of solutions but clearly staff skills and attitudes must be key. It can only take one experience of rude or inconsiderate behaviour from public transport staff to trigger or reinforce someone’s worst fears. But at the same time kindness and common sense consideration from staff when someone is struggling can move the dial for that person in the right direction. Sometimes all it takes to begin with is three little words: “Are you okay?”

One initiative that came up more than once was mental health first aiders – staff who are trained to identify understand and help a person who may be developing a mental health issue in the same way as there are physical first aiders. As well as providing immediate help and support they can also effectively guide people to further professional help.

Another initiative that was frequently name checked was flash cards which passengers with particular needs can show to staff in a way that means they do not need to draw attention to themselves. There’s some laudable single operator initiatives in this area but it would surely make sense to roll this out nationally – if this is indeed a sound way forward. Otherwise passengers are going to need a rollerdex of flash cards to choose from to cover the operators they may encounter. Virgin Trains were also mentioned in dispatches for their work on dementia friendly stations.

There was a strong show of support for the event with transport minister Andrew Jones, DfT permanent secretary Philip Rutnam and Justin Tomlinson, minister for disabled people. There were also pledges that this event wasn’t a tick box one day wonder but would flow through into a deepening commitment from government to find and support ways forward in this complex and challenging area. The forthcoming DfT accessibility action plan will be a sign of whether this will indeed be the case.

However, there was certainly a sense at the conference that mental health has opened up a new dimension and frontier on the disabilities and transport debate which could breathe some new life into an issue that feels like it’s lost some momentum since the glory days when DPTAC and disability campaigners made a reluctant industry take physical accessibility measures seriously. That’s not to say that there hasn’t been terrific progress on improving the physical accessibility of public transport. While there has been terrific progress, your jaw can still drop at how on even otherwise exemplary public transport systems abroad, one feels like grappling irons might come in handy to scale the gaps and staircases.

But welcome as the UK’s progress has been it also feels like the issue has been reduced to an engineering challenge dictated by lawyerly interpretations and dominated by the wheelchair symbol. To the extent that we’ve almost forgotten why we are doing it in the first place – which is to open up opportunities to more people to do more with their lives. Real people with all their vulnerabilities and quirks – physical and mental. We may have installed the kit to make more of public transport physically accessible but have we forgotten the softer measures to give people the confidence to use the kit? Which also plays back into the wider no nonsense focus we have in the transport sector on journey times and punctuality. By doing so are we missing out on a larger subterranean psychological landscape around the transport choices we make and why?

But that’s for another column. For now it’s enough to say that a tipping point has been reached on transport and mental health with a conference that for the transport sector has moved the issue from the margins to the mainstream. And if you don’t know where to start on this one – try the websites of Time to Change, Mind and Anxiety UK. There’s supporting materials plus also ways into specific guidance for organisations and companies.

 

About the author: Jonathan Bray is the director of the Urban Transport Group. Throughout his career in policy and lobbying roles he has been at the frontline in bringing about more effective, sustainable and equitable transport policies.

 

This article appears inside the latest issue of Passenger Transport.

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