Raising awareness of anxiety issues

As well as exposing the chronic lack of understanding that pervades at some levels of management, Whitehurst’s story also touches on two other issues that have contributed heavily to the stubborn resistance to tackling mental health accessibility head-on.

Ignoring the needs of someone in a wheelchair or with any physical disability would be visible and direct discrimination, she suggests, making it a far more blatant transgression than failing to consider a call for help from someone with a ‘hidden’ disability such as anxiety.

Whitehurst adds that those with mental health problems also have to combat the suspicion and stigmatisation of a small (but vocal) minority who feel they are less deserving of assistance if their affliction is not visible. This means that public attitudes towards mental illness must also change, to thus bring more pressure to bear on transport providers to change their ways. 

“It is something which is hidden - you can see a person and not know they’re suffering,” she says.

“At the summit we discussed the metaphor of ‘What would be our ramp?’ for helping people with a hidden disability. That could be as simple as helping someone in the midst of a panic attack.

“But if you take away the wheelchair, you take away something which shows the world you have a disability. There is a danger, sadly, that if you give assistance or let someone queue jump who doesn’t have a wheelchair, people will question it in the same way that blue badge holders with a disability that isn’t immediately obvious are the target of people’s anger in supermarket car parks. It is about public perception as much as transport providers. 

“A lot of people can be quite cynical and say ‘of course we’d all like someone to carry our bags to the train or get free water or a seat to sit down on’. But it’s so debilitating to be in that situation, and we’d much prefer not to be.”  

Despite the ‘hidden’ nature of mental illness, the solution to making rail journeys easier is not an intractable problem, explains MHAG Co-Ordinator Niki Glazier. However, any solution will require human interaction and a physical staff presence, at a time when many customer-facing activities such as ticketing are being automated. 

“It can be split into formal and informal assistance,” she says. 

“Formal assistance would be that staff have to be trained in order to feel confident to offer help, and recognise when help should be offered. The human reaction is to back off if someone is feeling anxious, so we must empower staff to act. Using flashcards that are recognised by train guards to subtly communicate individual needs is also an example of formal assistance. 

“Informal help would be to turn up at a railway station and be able to approach someone and get a sympathetic or more welcoming response. You only have to do something small to make a big difference.

“It relies on human to human contact, though, and automation can be exclusive in this case. At smaller stations staff numbers have been reducing, which is a big no-no for people who need that comfort. Nothing replaces the human touch.

“My feeling is that a line has been drawn in the sand, and we now need buy-in from senior management at the very top.” 

The calls from campaigners have not completely fallen on deaf ears, and there is clear evidence that some TOCs are being more proactive than others. 

In February 2015 First TransPennine Express became the first train operator to use the Blue Assist initiative (www.blueassist.org.uk), which helps people with a range of hidden disabilities to discreetly communicate to on-board staff what they need to make their journey more comfortable. For example, presenting a small blue card to a ticket inspector can convey the need for more patience, or that an individual suffers a condition that makes it hard to speak. 

It is hoped by Anxiety UK and MHAG that the example set by TPE is followed by other TOCs, enabling more passengers to come forward and ask for the assistance they need. 

Another initiative the organisations would like to see introduced is the presence of mental health first aiders - staff trained specifically to identify and help those with a psychological disorder, in the same way that physical first aiders operate. 

As much as it being the moral imperative of TOCs to adopt these measures, Whitehurst says that increasingly it is becoming an economic and legal one. At the summit the legal team from national mental health charity Mind gave a briefing on what constitutes direct and indirect discrimination against someone with a hidden disability, and how transport providers could fall foul of the law if more is not done to change the way they approach their needs. 

It also represents an opportunity for TOCs to increase passenger numbers - excluding up to one in four of the UK population could mean losing out on millions of pounds of revenue.  

“I think people are unaware that there could be legal implications for breaching various laws,” adds Whitehurst. 

“But it’s difficult because we don’t have any specific legislation behind us, and the Equality Act (2010) can be interpreted in a number of ways. It is easier to provide physical assistance, as what people need with mental conditions can vary a lot. 

“But mental health should be given full parity. Hopefully the direction of travel is going towards more compulsory measures, and perhaps it could start to be rolled out in franchise terms. 

“It also makes strong financial sense due to the amount of people in contact with us every day asking what assistance they can have on the trains. If we have to say that you can get on with this operator and you get this, but you will get nothing with another operator, then they will travel where the assistance is… or not at all. 

“On a personal level, when my anxiety was at its worst there was no help getting buses or trains, so I used taxis everywhere and ran up a debt of £2,346.60 in just one year. That money could have gone on public transport - and that was just one person for one year. 

“There will come a point when TOCs need to do this, because either there will be a discrimination case or other providers will lead the way and shame them.”

The rail industry has invested heavily in installing aids for physical accessibility. The time has now come for psychological accessibility to receive equal billing, and for the railways to show national leadership in bringing about change across wider society. 

For more information on the campaign to end mental health discrimination, visit: www.time-to-change.org.uk

  • This feature was published in RAIL 798 on April 13 2016.


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  • FrankH - 29/06/2016 00:57

    "You wouldn’t say that to someone with asthma or epilepsy who feared an attack, and it would be extreme discrimination to prevent someone boarding because they feared having a panic attack.” If your travelling by air and have health issues you need a note from your doctor stating you are fit to travel, otherwise they'll not let you on. The industry is spending millions on making itself accessable for all, lifts, ramps, wheelchair access and spaces on trains and stepless access into carriages. Anyone who thinks they may suffer whilst on a train should not board or at the very least have someone with them to assist.

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