Bullying in Mental Health Care: Misuse of Authority and Power Can Trump Wellness
You can’t open a newspaper or turn on the radio without hearing about bullying in kids. It’s a form of violence that degrades the self, disconnects children from social networks, and often paralyzes their ability emotionally regulate. No physical violence needs to occur to create these drastic consequences. The emotional injury is enough. What we see in the media is often the tragic end results: suicide or murder in an effort to stop the pain or get others to stop hurting you. People do incredible things in an effort to “be” instead of being erased by meanness. They either give up or get even. A few have the good sense to leave and start over somewhere else—when they have the power, authority, and access to do so. But what about the longer term effects of bullying on kids who are now adults, or bullying that takes place between adults?
Because the dangers of bullying have only been recognized somewhat recently, much of the research on the subject is new instead of “longitudinal” which is required to show how bullying effects people over time. In fact, the first longitudinal study about the impact of bullying was published just last month. Researchers at Boston Children’s Hospital studied the effects of bullying from elementary through high school on over 4,000 children. Predictably, the kids who experienced bullying the whole time had the worst mental and physical health. The study showed that “bullying, especially when chronic, resulted in greater depression, anger and anxiety, and lower self-worth.” And, predictably, kids who were different in origin, physiology or character (e.g. extreme height or weight, visible or known disabilities or medical conditions, learning or emotional differences) were the ones most often bullied.
Let’s fast forward from these results that confirm what you probably already know to consequences we’re just starting to understand. Any number of those children—and many others—end up as service recipients in foster care, residential care, substance use programs, and mental health facilities. Their care may continue into adulthood. Others manage and may become service providers. So what?
In many of those programs, staff who have primary responsibility for the care of these bullied folks are (mostly) young, less trained, and receive low pay. They do the very best they can. Many have big, caring hearts. But how well equipped are they in terms of skills, knowledge, and understanding of how to use authority and power? Relational skills take time to develop and hone; they require a keen awareness that sometimes the easiest way to “control” people in your care isn’t the best way. Learning the difference between authority and power takes time. Both of these usually take guidance, support, and an organizational structure that recognizes the hidden traumas that influence service recipients’ and service providers’ pasts.
In many care-giving situations, the real need is to manage the behavior of the people who receive care. The goal is a calm unit, no upheaval in behavior, no angry outbursts, no hurling of chairs across the day room, no striking out. The people there are wounded souls, some bullied, some abused, all experiencing the worst times of their life in the middle of a controlling environment that often leaves little choice or personal control. There may even be bullying between service recipients as they jockey to establish pecking order. At worst, staff responses lapse into the misuse of authority, raw use of power over others, and yes, bullying. Not because they want to—it may be their best fallback behavior when they are scared. Even the smallest kitten tries to look huge and scary when it feels cornered.
People on both sides of this situation do what they can to manage. Sometimes it’s not pretty. In the absence of higher order thinking, supportive policies, staff skills in relational process, and dogged organizational commitment to differentiating power and authority, bullying occurs. This fallback behavior can make things momentarily easier for service providers, but it’s a form of emotional violence that nixes any chance for the service recipient to discover wellness.
Healing for service recipients and growth for staff cannot occur in environments where bullying is the fallback response. Relational skills, right use of authority and power, and practice exercising these under stress are essential for healing. Elimination of the double standard in which service recipients are made powerless while service providers exercise power is critical in mental health care from the C-suite to the back units.
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Image: Flickr/BronsonABbott cc license
Power, E. (2014). Bullying in Mental Health Care: Misuse of Authority and Power Can Trump Wellness. Psych Central. Retrieved on September 4, 2015, from http://blogs.psychcentral.com/organizations/2014/03/bullying-in-mental-health-care-misuse-of-authority-and-power-can-trump-wellness/