After the event we invited participants to share any feedback of thoughts they had after the event. The HVN trustees would like to thank everyone who took part, and especially those who took the time to share their feedback with us.
Ruth Forrest: Personal reflection on the day:
I always find these days challenging as it makes me think about my experiences of using & working in mental health services over the years. I love having the space to talk & think & share ideas about this, and try to take positives from the often sad stories that are shared, along with my own memories.
I want people who experience emotional distress to have their voices heard in future & not to be telling the same sad stories we often hear about mental health treatment today.
On today, I feel that compared to some similar events I have been to I the past, there is more positive energy & less helpless anger & despair. Thank-you for helping us to direct our understandable anger & energy towards positive change, for anger is a positive emotion & we need to share it and use it to make a positive difference 🙂
A thought: how do we get people who haven’t ever had contact with mental services to care about (or even believe) the things that are happening in the system?
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Rachel Freeth: A letter
As a psychiatrist attending this event my impression was that I was in a very small minority, which was an interesting and also at times uncomfortable experience. Nevertheless, I am very glad to have attended and would like to thank you for organising this very important opportunity to share a vision for change. It is a pity that there weren’t more psychiatrists attending to hear the depth of yearning for a different way of thinking and helping people with distressing mental experiences – things we are not necessarily going to all that often hear from service users in our clinical environments.
As a Critical Psychiatrist with broadly humanistic values, I am in the position of feeling profoundly
dislocated having to work within a culture and system that is often oppressive and lacking in sensitivity and thoughtful responses that respond to people as individuals with unique experiences. Your event enabled me to sit with my discomfort in a way that was helpful. I think it is important that service users and mental health professionals do have a space to articulate their at times hostile feelings towards the psychiatric profession (feelings which are often entirely understandable). Whilst there was a little hostility expressed on the day, I did appreciate the attitudes and general ‘way of being’ of Jacqui and Rae that helped me to feel broadly welcomed. That said, I did notice a little reticence in myself to stick my hand up and make myself more known. But I think that is my problem!
So finally, many thanks again. Be assured that I will continue to do what I can to work towards more humane and holistic approaches (although I think I do more of this from the outside than the inside).
With best wishes,
Dr Rachel Freeth, Specialty Doctor in Mental Health
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Nicky Forsythe: Thoughts after Time for Real Change event
Here are my thoughts on the event, speaking from many angles: as member of a family of Psychiatry survivors, Psychotherapist, mental health researcher, founder of a mental health social enterprise that provides to the NHS, and former member of the Time to Change advisory board (yes, in my opinion it didn’t do the right things in the right way).
To me, the event demonstrated the commitment and passion of a broad range of people to come together and act for proper change.
I hope HVN continues to take a key role in hearing and co-ordinating this range of people both from outside the status quo and within it.
Having been through the TTC experience, I do not think a movement for change can be led by professionals or people with a vested interest in the current status quo. Unfortunately they/we are too influenced, evenat an unconscious level, by their/our position, context, training and current mainstream beliefs.
On the other hand, HVN has a great track record of hearing and embracing conflicting voices both inside and between people, and leading change. You also have a track record of dealing with wide range of stakeholders, over vast reach, in a very effective way and on a low budget.
I see that a ‘Time for (real) change’ campaign co-ordinated by HVN should have two arms
- a civil rights arm – service user led – members of public to be galvanised. We would need to find a cause that has the potential to inspire all – to focus on no more abuse of human rights through use of coercive, ineffective and harmful treatments.
- a professional arm – bringing together critical professionals to sign up to a simple behavioural charter for non-abusive treatment. E.g:
- We will never be complicit in coercion and abuse of human rights (this would need to be clearly defined)
- We will always give full information about meds and treatments (including e.g. information that questions the effectiveness, and explains the downsides, of medications)
- We will be informed about, and inform service users about, effective alternatives for help beyond the bio-medical paradigm
- Where these are not available in-borough we will point to ways of campaigning for them (e.g. Soteria, Open Dialogue, HVN, SCN).
Professionals should have a way they can display to each other and to service users the fact that they are signed up to this charter.
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This event really challenged my own belief system and brought me away from my fixed ideas about the Mental Health system, which I have become embroiled in as a patient. I am currently working my way out of it and this event has helped me deal with my anger and fury about the way the system has ‘treated’ me. Gaining perspectives from an array of organisations and individuals really helps to get a different perspective on the difficulties of supporting people in mental distress within the current MH system. It helped me see we are all in this together and we all want improvement. It seems the recognition of the current limitations is the starting point for bringing about change through forming a body of people to work towards finding the best ways to implement change. Count me in to the discussions and planning please.
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Ruth Forrest: Some ‘garbled unedited notes from the day!’
Notes from Double Agents workshop… Steven Coles
- How to make change from within – is it possible? What are the barriers?
- What is a Double Agent? Working for a dominant profession or organisation but have a conflict with the status quo – trying to alter a system you are a part of – critically minded
- “Questioning Professional”
- Mental health & distress is about what has happened to someone, whereas the system sees it as a problem within the person to be pathologised & medicated
- Layard & Clark (IAPT) minimise impact of social inequality & social factors in emotional distress – access for BME men hasn’t improved, and other marginalised groups
- How do you manage the power imbalance? Our livelihood depends on the existence of the psychiatric system, but we’re conflicted about how the system treats people
- (Personal note: I often feel good about my job & the work that I do, then I come to events like this & feel as if my job is pure evil !!!)
- Suggestion from the back row – some people pretend to be double agents but they are co-opters in disguise (triple agents ??!!) – giving lip service to alternative models of mental health whilst really holding onto the medical model (doing this unconsciously or manipulatively..?)
- Discussion about co-option… Before you used to campaign against something (psychiatry, CTOs, forced medication, seclusion, ECT etc) then enter the system with plan to change it from the inside but realise in the end that the system has changed you :-/
Question to discuss:
- What needs to change in my system? What should be the focus of the double agent? What is their mission?
- Main change: get rid of diagnostic system, focus on social factors & inequality (is this a bigger
- question about social justice rather than mental health? mental health strongly associated with social justice)
- Is diagnosis the problem or is it medication? If it was a medication free NHS would there be a problem with diagnosis?
- Is part of the problem that we lack confidence in our ability to tolerate other people’s distress? (So it’s easier to medicate than manage the distress) This seems to be a perceived inability within professionals – we sit with distress in our personal lives but not at work… We don’t try to medicate our friends & family at times of distress, we talk to them
- What should we do? Ask questions without being afraid of being shot down!
- How do you try & bring about change? Try to help people to develop skills to prepare them to leave services & enable them to communicate this & convince whoever they need to convince that they are ready to leave!
- Providing space for discourse
- What power and/or influence do you have to bring about change?
- Very little! Small changes at individual / team level.
- Teaching, research
- What strategies do you use? Critical mass of like minded people, never give up!
Sharing ideas (things from other people in the room)
- prosecution against psychiatry suing them for corporate manslaughter of everyone who has died prematurely from taking anti-psychotic medication
- kidnap psychiatrists & lock them up, tell them they’re not really psychiatrists & they’re suffering from delusions of grandeur (ha!)
- better access to evidence that doesn’t support the dominant paradigm
- use lived experience to bring about change
- service users to educate services – user led not co-produced
- how come the multi-disciplinary team doesn’t always include the person ??!!
- encourage & support people to challenge the dominant paradigm
- social change towards mutual support & away from competitivism/individualism
- allowing a framework for people who have had their agency removed to get their agency back so that we are not the only agents for change (there are agents not just double agents!)
- capacity based rather than diagnosis based approach
- risk of double agency… we need to make sure that we’re not trying to “save” people
- system of moles & invisible double agents within the NHS
- need visible movement within staff so we know who it is safe to talk to
- wear a badge, drop the secret handshake! Come out!
- less secrecy & subversion, openly challenge the system & share ideas
- How do we overcome barriers TOGETHER?
- And how do we look after ourselves? It is draining & demoralising to work in a system you feel
- conflicted about… It is very exhausting to live in conflict / dissonance
- Are we actually doing what we think we’re doing or are we actually propping up the system?
Change the World workshop with Jacqui Dillon
- Legal challenges on individual cases (e.g. deaths caused by meds / treatment)
- Polls of opinion (survey the public – also raises awareness, e.g. should people ever be detained against their will when they have committed no crime?)
- Eye-catching powerful emotive images (restraint, seclusion, forced medication)
- Direct action & protest (Houses of Parliament when bills being passed, e.g. CTOs)
- Stimulate social action
- Demonstrate in the right place at the right time
- Collaborate with other organisations (like today – also Amnesty since UN report about torture under the Mental Health Act)
- Flash mob protests
- People in public image & media speaking out (but in a different way to Time To Change – people talking about being detained & more voices for people diagnosed with psychosis, schizophrenia & BPD)
- Desperation/pushing back is a GOOD SIGN – there is only a backlash if the campaign has enough momentum
- Change on multiple levels – what can I do at my level?
- What can I Do with my knowledge & resources to create change?
- I feel helpless 🙁
Small group campaign – embed true informed choice in mental health support
- Allies from the inside, not just inside mh services but from all big institutions
- How to make this campaign appeal to people who have no contact with mental health services… what are their assumptions about mental health problems & treatment
- Write to or phone your local representatives, they need public to back up change
- Educating the public about medications
- Trip advisor for mh services
Group campaigning about chemical imbalance theory is a fallacy
- How to make this campaign appeal to people who have no contact with mental health services… what are their assumptions about- link with allies, include in curriculum of training for mhps
- Slogan badge from signing pledge to support cause
- If you start challenging you get diagnosed with BPD – still true
Group campaigning for psychosis as a sane reaction…
- People in public image & media 3min video clip, education at schools, preview at cinemas