my brilliant career - mental health services director

Published: 16/09/2004, Volume II4, No. 5923 Page 28 29

A good mental health service director will ensure that service users get more than basic support - namely people who believe in their aspirations.

Philip Howe talks to Nick Edwards

Name: Philip Howe

Job title: director of adult community mental health services, South Essex Partnership trust

Age: 52

Salary: about£70,000

How did your career start?

I moved to London from Liverpool in 1976, training as a social worker with the London borough of Newham, staying for seven years. Then I worked for the Hertfordshire branch of the National Association for the Care and Resettlement of Offenders. Two years later I moved to Essex county council as team leader of a juvenile justice team before moving in 1988 to become team manager of the intake team, primarily working on child protection.

What was your first job in mental health?

My next job was as principal officer for older people, mental health and disabilities. I needed to move into the mainstream and youth justice wasn't seen as hard-edged. A restructuring moved me to county hall with policy overview of mental health, learning disability, substance abuse and HIV, although in the end it was split so I focused just on mental health.

One of the things I was proudest of was organising a service user conference, which was a forerunner of the kind of involvement common today.

What was your first real experience in the NHS?

In 1996 I was seconded as community services manager to Southend Community Care trust, bringing together community teams from the local authority and NHS under a unified management.

It was a very different environment, the trust was having huge financial difficulties, and compared to a county council it was a very small organisation - with a small organisation's politics. And one becomes quickly aware of the pernicious effect of working in long-stay institutions: staff not working with each other for reasons that went back many years.

Then the county council restructured and I became a commissioning manager for two years.

How did you get to your current position?

North Essex Mental Health Partnership trust had been set up and I was given a remit to help set up a similar trust in the south, merging two community care trusts and the council function. South Essex Partnership trust came into being in April 2002 and I applied and got the job as director of forensic and drug and alcohol services. I was also social care adviser to the trust board.

So that was the first time I was unequivocally working for the NHS. The teams under me are the community mental health, early intervention, assertive outreach, crisis resolution home treatment, psychology services, child and adolescent mental health services and community drug and alcohol.

What are your main objectives at the moment?

The crisis resolution home treatment team's target for December is very tough. With other targets we were more able to recruit from within - we can't keep doing that. Recruitment across the board is the single largest risk to us meeting our objectives. And we are looking at international recruitment to help us.

Another priority is developing employment strategies for service users.

We need to better understand people's aspirations, vocationally and in other ways. Too often people who work in mental health do not believe those they work with are capable of achieving their vocational goals, and that flies in the face of much research. It involves asking some pretty robust questions of local trusts and local authorities - the major employers in Essex - about their own employment policies.

What is the main change in the way mental health teams see themselves?

The vast majority of people with a mental illness are dealt with in primary care and there is huge pressure on general practice. We are trying to develop a sharper focus with our primary care liaison teams, planning the patient pathway through the secondary services and different forms of therapy - and then back out again. Creating those liaison teams from the existing community mental health teams is one of the main things we will be doing.

What skills gaps should aspiring mental health managers address?

My advice for people training in social work is to train in a therapeutic intervention as well. There is a strong future for social workers coming into mental health, particularly with a growing interest in social exclusion. I do not believe in a generic mental health worker. It is good to have a diverse workforce.

What's the biggest issue you face in the next few years?

Community mental health teams were set up to focus on people with severe enduring mental illness. But now there is the issue of delivering services to what are inappropriately called the 'worried well'. We need to look at how we meet the expectations of people with problems which, whatever a service planner might think, they do not see as being 'minor'. l