For #SHW24 we’re exploring the links between mental health and sexual health. Rachel Gambling is a Health Promotion Specialist for Brook Southend. Outside of her work for Brook, she writes film reviews on her website, girlblog!. Here, she combines her two passions to explain how films can be used to aid professionals in applying trauma-informed practice in their community outreach work.
In my three years of working for Brook Southend, I’ve met people from all walks of life — from the mayor to the rough sleepers along the high street. There are many in my hometown who are struggling financially and, consequently, are facing health inequalities.
Southend City Council reported in their Health and Wellbeing Strategy for 2021-24 that “life expectancy is 10.5 years lower for men and 9.4 years lower for women in the most disadvantaged areas of Southend-on-Sea than in the least disadvantaged areas. This is significantly worse than the England average.”
To address these inequalities, it’s essential to take a trauma-informed approach.
Gov.UK describes a trauma-informed practice as:
“[increasing] practitioners’ awareness of how trauma can negatively impact on individuals and communities, and their ability to feel safe or develop trusting relationships with health and care services and their staff.
It aims to improve the accessibility and quality of services by creating culturally sensitive, safe services that people trust and want to use. It seeks to prepare practitioners to work in collaboration and partnership with people and empower them to make choices about their health and wellbeing.”
Trauma-informed practice goes hand-in-hand with effective safeguarding.
To have this, we need to understand the behaviours of the clients we’re working with. In my opinion, films that draw from real-life experiences can be powerful tools in helping us to develop the emotional intelligence required to assess and support the people under our care.
For example, Fish Tank (2009) follows the perspective of Mia (Katie Jarvis), a 15-year-old girl living on a council estate. Her mother (Kierston Wareing) is more interested in her new boyfriend Connor (Michael Fassbender) than Mia’s increasing social isolation since being excluded from school. Connor, however, takes note of Mia’s passion for dance. He shows her more attention than her mother does, giving her money to buy alcohol when she asks, providing her with the music and video camera to film her audition for an exotic dance club. As an audience we don’t necessarily perceive his actions as grooming – he’s handsome and charismatic, providing encouragement to a girl who has frequently been overlooked. So, when they eventually do have sex, and he breaks up with her mother the next day, we might think he’s taken accountability for his wrongdoing. Perhaps he never meant it to become sexual. But if we look more closely at his actions, we can see how Mia’s vulnerabilities and lack of protective factors made her a target for Connor’s cunningly nefarious intentions. As the film reaches its conclusion, the reality of Connor’s background is laid bare for us to critique.
Fish Tank is rooted in the authenticity of the lead’s performance – Jarvis had no prior acting experience before this role; she was scouted at Tilbury Town train station by a casting assistant during an argument with her boyfriend. The rawness of this film depicts how a lack of protective factors in a young person’s life can increase their vulnerability to sexual abuse by trusted figures in their lives.
Thirteen (2003) centres on Tracy (Evan Rachel Wood) as she begins seventh grade. Her mother, Mel (Holly Hunter), is a recovering alcoholic who struggles to make ends meet as a hairdresser. On a surface level, their mother-daughter relationship appears open and affectionate; but when Mel gets back together with her ex-boyfriend Brady (Jeremy Sisto) after Tracy witnessed him relapse into his drug addiction, her mood becomes more aggressive and turbulent. Tracy becomes fast friends with Evie (Nikki Reed), who introduces her to sex, drugs, and crime. Mel tries to intervene with Brady’s help, but Tracy and Evie find new ways to hide their exploits. They find themselves in a downwards spiral as Tracy’s substance abuse and self-harm leads to her academic decline and social isolation.
Thirteen is co-written by Reed and the film’s director, Catherine Hardwicke; it’s based on Reed’s own experiences as a 13-year-old. This autobiographical element emphasises the crucial need for early intervention with young people like Tracy/Reed. As rumours about Tracy’s sexual activity and drug abuse circulate her school, professionals within this environment could investigate ways to build trust with her and discuss with her mother potential support to sustain a suitable recovery pathway.
As professionals, we can use the portrayal of trauma in these films as case studies to improve our practice, looking beyond the surface-level behaviours and acknowledging how these characters’ backgrounds increase their vulnerability to poorer sexual and mental health outcomes.
Seeing the bigger picture portrayed in film forces us to recognise that what may be labelled ‘behavioural problems’ do not exist in a vacuum.
They are symptoms of difficulties young people may have been experiencing from their early years, and of the lack of accessibility into support services due to social isolation stemming from financial deprivation. All these factors are intertwined, meaning that they must all be addressed.
It’s important to acknowledge that it’s not because of their disadvantaged backgrounds that they then choose to engage in risky activities; it’s because of how society treats disadvantaged people, which then limits their options into more fulfilling lives. Gov.UK states that:
“This does not mean that every child experiencing trauma and adversity will experience poorer outcomes. Multiple factors influence outcomes – the presence of protective factors such as a supportive family will also be key influences”
If we, as frontline workers, can build trust with individuals like Mia and Tracy, we can then challenge their health inequalities by listening to their needs and advocating for the wider changes that are needed to improve the social conditions of their lives.
