The marvels of technology - the train to London only takes about 2 and a quarter hours these days. Those clever Italian engineers have perfected the the tilting mechnanism on the Pendelino, and, as the driver cheerfully announces, it reaches a top speed of 125 MPH. We were on our way to a conference on the future of mental health services.
1 in 4 is a magazine which focuses on mental health issues. It is innovative and aims to raise awareness of mental health issues and combat stigma, and it was they who organised the conference. We showed up a little late and missed the first few speakers, but what we heard was interesting and inspiring. I heard a phrase that was new to me – co-production. Co-production is the next logical step in service user involvement – service users getting more actively involved in services, and rather than merely being occasionally consulted about things. So instead of being listened to (and, it seems, often not listened to very closely), service users will be more involved in running the services they use and having a much bigger say in them. This has major implications for the mental health system, and is potentially very positive. But, as some of the delegates at the conference commented, this could merely be a sneaky way of camouflaging cut backs.
After the break, Alisdair Cameron spoke about how service user involvement is developing in the North East. It seems that service users up there are as concerned about the state of services as we are down here. Alisdair represents an organisation called Launchpad (http://launchpadncl.org.uk/) which is mainly concerned with service user involvement and improving the lives of those who have experienced mental distress. The philosophy of Launchpad is pragmatic and refreshing – egos are left at the door, and whilst some of the people involved there may work for other agencies, they are expected to focus on achieving results regardless of who pays their wages – getting things done, rather than promoting any organization or other alliegence, is the focus. A shared understanding and an alignment of protocols and processes underpins the approach.
We are currently in a period of transition when it comes to mental health services, and this fact was reflected in the discussions that followed. Everybody wants to move forward, or so it seems, but few people have definite ideas of how things should go. Everyone wants more service user involvement and for things to be user led, but how this is to be achieved remains a source of mystery to a lot of people. The idea of co-production is to get past where we are now and take it to the next level – this means us doing things for ourselves, on our terms and for our own financial, personal and social benefit. During the discussion, several themes were repeated – in an era of austerity, how would a service user get funding? How can we overcome the lack of access to the information we need? how can we motivate people to think outside the box, be they professionals or service users?
It was concluded that, in order to give people the opportunities they often want, another set of themes keep coming up – the need for service users to ‘get connected’ to what’s happening, the need to acknowledge the contribution that service users make when they are involved, the need to recognise that people were leading full and productive lives before they became unwell and often have skills to offer, the need for more service user lead research, the need to for service users to have ownership of the services they use and the need for fluidity and collective action.
To many peoples mind, Camerons idea of the ‘Big Society’ is merely a fig leaf for withdrawing funding from whatever section of the state that he can. But in mental health, this sleight of hand could actually bring benefits for service users. At the moment nobody seems to know where Cameron is going with this vague idea – he probably doesn’t know himself. So the unfortunate conclusion that we had to reach at the conference was that, with the way things are at the moment, no one can really predict where services are headed or whether user involvement will be improved, stay the same or get worse. To give it a positive spin, the cutbacks give rise to the opportunity for service users to get more involved in the nuts and bolts of delivering more effective services. The system is being shaken up, is in crisis, but crisis also creates the neccessary conditions for change and development.
To view the 1 in 4 website, click here – http://www.oneinfourmag.org/
To find out more about service user involvement in the North East, visit the Launchpad site here – http://launchpadncl.org.uk/
Claude Cookie has a personal interest in mental health issues, having experienced a considerable amount of psychological distress himself over a sustained period. He has collected several diagnoses during this period of involvement with psychiatric services, none of which he feels adequately describes his experience. His interests include music (which he both listens to and performs), reading, writing, walking, politics and spirituality. He currently volunteers on several mental health projects and would encourage other service users to get involved with the services that they use, and help direct the way in which these services develop in the future. 
