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:
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Predisposing factors
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Precipitating Factors
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Perpetuating factors
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Biological factors
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Psychological factors
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Social factors
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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!
