A new campaign is exploring what gets in the way of delivering compassionate mental healthcare – and how to fix it, writes Lisa Rodrigues
Back in 2014, the team at Time to Change held a roundtable event that forced those of us who care about NHS mental health services to face an unpalatable truth. Which was that one in three people who used services experienced lack of compassion and even stigma from where you would least expect it – those working in those very same services. This finding has been repeated several times, and featured again in last week’s Mental Health Taskforce Report.
Now it’s time to pop my head above the parapet again.
We know staff value time out in a safe place to talk about attitudes and values, and to discuss why sometimes they fall short of providing care to a standard they aspire
Along with some amazing people, including four experts by experience and senior colleagues from our two pilot sites – Northumberland, Tyne and Wear Foundation Trust and 2Gether FT, we have carried out some action research directly with NHS staff to explore what gets in the way of compassionate care and the shifts in attitude that are needed.
It hasn’t all been plain sailing. But we have learned a lot, especially about what works. And this week we are launching a campaign within six volunteer mental health trusts, which include our two pilot sites plus four others. From the early work with our pilots, we know that staff value time out in a safe place to talk about attitudes and values, and to discuss why sometimes they fall short of providing care to a standard they aspire. The materials are being made available online via Time to Change across the whole NHS.
I want to make a few things clear from a personal perspective. We won’t shift attitudes by finger pointing and blame. The people at Time to Change know this. Their approach is positive, supportive and empathetic. They know what they are talking about. They have achieved measurable, sustained success in shifting public attitudes over seven years of work. Our project with NHS mental health professionals builds on the same approach, tailored to local circumstances.
We are acutely aware that staff who work in mental health services are under greater pressure than ever before. We know this from the hard-hitting findings in last week’s Mental Health Taskforce Report. Our project doesn’t deny this. But we are operating in the real world. And we have to start where we are now.
Charm and precision
Stigma is an ugly word. And the stigma of mental illness is deep-seated and far-reaching. It manifests in the way mental health services get sidelined. Two weeks ago, my old boss Lord Nigel Crisp published his report about access to mental hospital beds. With charm and precision, Lord Crisp ticked off Nick Robinson on the Today programme for trying to change the subject to the junior doctors’ dispute.
So who exactly are “these people”? They are people like you and me. And people like him think we are undeserving
Lord Crisp pointed out that it was illustrative of the very problem mental health services face: lack of sustained attention. And whilst the Mental Health Taskforce Report got top billing on the day it was published, we also know that it will disappear without trace unless we all stop talking and actually do something to turn mental health into a priority.
Not all journalists are guilty of stigma. I thank Shaun Lintern at HSJ, Andy McNicholl of Community Care and Michael Buchanan at the BBC for their sterling work uncovering swingeing cuts over the past four years, which some still deny, despite the evidence laid bare.
Stigma exists among some politicians and parts of the NHS. The rhetoric of parity of esteem has been trotted out while at the same time commissioners, faced with unpalatable choices, are allowed to disinvest in those services people are least likely to make a fuss about, ie mental health. And not just in the NHS, but also the third sector, where much vital provision has been wiped out in recent years and is at least in part the cause of the current mental health bed crisis besetting most of the country.
The unkindness I experienced many years ago from a nurse in A&E is repeated across acute hospitals and other parts of the NHS daily. I recently heard an acute trust chief executive say this: “These people don’t belong in A and E.” .
So who exactly are “these people”? They are people like you and me. And people like him think we are undeserving. And many, including him, still believe being mentally ill is somehow our own fault.
Our Time to Change project isn’t aimed at tackling everything at once. We have to eat this elephant together, in bite-size chunks. Working with Time to Change and supported by NHS England, I know we can succeed.
Lisa Rodrigues CBE is a writer, mental health campaigner “and a recovering NHS chief executive”