Sunday, 24 November 2013

Possibly the best Social Care Conference in the UK? Review of Mersey Care Trust Annual Social Care Conference 22nd November 2013

I was fortunate enough to be ambushed by Emad Lilo, the conference organiser, back in March of this year, when I was appearing at a North Wales and North West AMHP Association Conference in Manchester. He booked me for the Mersey Care Trust annual conference, and I’m very glad he did, because what a memorable day it turned out to be!
The theme of this year’s conference was “Service Users’ Experience – Social and Medical Models: Exploring What Service Users Say”. Over two hundred social workers and social work students, as well as a scattering of other mental health professionals, attended. The programme was crammed with speakers of the highest calibre, including Professor Peter Beresford, Annie Hudson, the Chief Executive of The College of Social Work, and Professor Sue Bailey, Chair of the Royal College of Psychiatrists. There was even an unexpected, but very welcome, appearance at the conference of Lyn Romeo, the Chief Social Worker for adults.
So far, it might look as if I have been hired by the Mersey Care Trust to promote them, but my enthusiasm is entirely genuine, as this was certainly the most stimulating and inspiring conference I have attended. The commitment and concern to promote the needs of mental health service users was palpable from the speakers and the conference delegates.
The programme was crammed, with over a dozen speakers, not to mention an eminent panel that included Professor Michael Lavallette (oh, and The Masked AMHP, but I didn’t get to say much: there were too many others with important things to say.)
Joe Rafferty, the Chief Executive of the Trust, began by stressing that service user involvement is integral to the way the Trust works – and I believe him. He posed the question: if perfect care isn’t the right goal, then what is? He meant that “good enough” was not actually good enough, that mental health services should aim to eliminate suicide, not just to set goals for a reduction in numbers. He pointed out that a 95% perfect safety record for the Mersey ferry would mean that 4 ferries would sink each year.
He was followed by the double act of Jenny Robb, the director of social care and safeguarding in the Trust, and Iris Benson, a service user. Jenny continued the theme of the importance of service user involvement at all levels, while Iris gave the conference an articulate and truly inspirational personal story of recovery, outlining her severely abusive past and her efforts to overcome the mental health problems she experienced as a result.
Iris gave an enthralling account of her journey to recovery, and the many and varied psychiatric diagnoses, ranging from paranoid schizophrenia to depression to dissociative identity disorder, that she had received over the years. It is encouraging to hear from someone who has had positive experiences of mental health services, and is prepared to share that experience, as well as to challenge poor practice.
Neil Allen is a barrister at the legendary Thirty Nine Essex Street Chambers and a lecturer at the University of Manchester. He discussed the implications of living with mental health, including the fact that people with mental disorder have a responsibility to manage their disorder as best they can, including using any support and treatment available, not just for their own wellbeing, but for carers and others as well. He suggested that, while a social model can be usefully applied to improving attitudes to people with physical disabilities, mental disorder does not fit so well into the social model.
Peter Beresford is both Professor of Social Policy at Brunel University and a mental health service user. He continued and extended Neil’s theme of service users’ experience of mental illness, stressing the value of lived experience, and pointing out that the medical model still dominates mental health services. He was wary about the “new idea” of the Recovery Model, suggesting that this could be as potentially limiting and oppressive, and could disable rather than enable. He outlined the movement of “Mad Studies”, and promoted what sounds like a fascinating book called “Mad Matters”, a book published in Canada consisting of writing that “presents diverse critical voices that convey the lived experiences of the psychiatrized and challenges dominant understandings of mental illness."
And then it was lunchtime.
Annie Hudson, Chief Executive of The College of Social Work, started off the afternoon session, touched on the knotty problem of whether or not social workers should be integrated into Mental Health Trusts, or separate from them. My own view is that this is a Good Thing, as long as a social worker’s core role and identity is protected and maintained. She stressed that mental health should be an integral part of all social work training, as it was equally important for social workers in children’s services to have a knowledge of mental health issues. She also considered that good practice arises from a combination of knowledge, skills and research.
She was followed by the Chair of the Royal College of Psychiatrists, Professor Sue Bailey, whose presentation was both entertaining and humorous. She talked about parity of esteem between different professions working in mental health, noting a marked variability of service between different Trusts. She talked about the recovery model needing to address the quality of life for someone with mental illness within the society in which they live.
Sue raised the interesting point that clinicians and cancer pressure groups stimulated intensive research into the causes and treatment of cancer, with the result that there are now many effective treatments for cancer, and a diagnosis of cancer no longer has the stigma attached to it that it did 20 or 30 years ago. Compare that with treatments for mental illness and disorder – there has been comparatively little research into developing more effective drugs for what can be equally debilitating and life threatening illnesses.
Malcolm Jones and Roger Lewis then addressed the question: what can we do about austerity? Both Malcolm and Roger are major advocates for the rights of disabled people. Malcolm is a social worker and AMHP, as well as being a political activist and a member of the Social Work Action Network (SWAN), while Roger, who is visually impaired, is on the steering committee of DisabledPeople Against Cuts (DPAC). Between the two of them, they gave an electrifying performance, cutting through the cant and ideology of the current Coalition Government to expose the hypocrisy and double standards that is currently driving social policy and seeking to marginalise and disempower disabled people.
The afternoon concluded with presentations from two psychiatrists, Sam Vovnik, who gave a presentation on spirituality in psychiatric care, and Manoj Agarwal, who discussed ways of adopting a more holistic approach to psychiatric care. Rather than following reductive psychiatric diagnosis in the manner of the American Diagnostic Statistical Manual, Manoj preferred to use a grid, which was better able to reflect an individual’s mental health problems. I liked this so much, I will reproduce it here:
Predisposing factors
Precipitating Factors
Perpetuating factors
Biological factors
Psychological factors
Social factors

Catherine Mills, a mental health service user and one of Dr Agarwal’s patients, then gave a moving and illuminating account of her own journey through treatment and recovery.
Delegates left the conference invigorated and encouraged, while recognising that the struggle to maintain and improve services for mental health service users was going to be long and strenuous. We were also under no illusion that the professional status of social work itself is potentially under threat, and the maintenance of social work as a profession has to be fought for.
I hope I am invited to next year’s conference!

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