Mike Cooke on mental health

The massed ranks of mental health trusts lined up in June to learn about the practicalities, benefits and preparation required to achieve foundation trust status.

It was a pleasure to see such commitment, enthusiasm and talent in one room. Much is rightly expected of mental health trusts on engagement, participation and social enterprise as we move towards foundation trust status.

I often reflect on what the best ways are of engaging with service users and communities of mental health interest, who are often vulnerable, lack support and need tailored responses based on choice. We have combined our membership council constituency for the public, service users and carers in an attempt to reduce stigma.

I am delighted that 11 service users and full-time carers are on our 38-strong council. If you count me in - I attend to support and energise, and to help facilitate contributions - that makes 12.

Yes, I am a service user as well as a chief executive. I am in recovery. I have experienced depression, and view this as a strength.

It is why I moved into the mental health sector, to try to make a difference. It drives me to seek improvements and keeps my feet very firmly on the ground as a chief executive.

Depression, I hope, allows me insight into planning, developing and challenging services and, at times, justifiably challenges my well-formed irrational prejudices.

On several occasions this has inspired service users and carers to get involved in service solutions. One in four people (some claim higher) and one in 10 young people experience some form of significant mental health problem. It is very common, but stigma still exists.

One of the chief executive's key roles, more and more in concert with the board of directors, is to set the tone of an organisation, keeping connected so that the board's tone supports the preferred culture of the whole organisation, to support 'the way we do things around here'.

I strongly believe that being able to talk about my own mental health ups and downs and listening to service users and carers enables the use of personal insight and influence in key situations, such as service user engagement, appointment of key clinicians, developing supported employment schemes and opening a new learning centre.

Occasionally, situations demand that positional power is used, sometimes through reminding individuals who put you there, and in more formal situations.

Personal influence works best and requires empathy, consistency, flair, resilience and adaptability. It is not about wearing the service user tattoo on all parts of the body (what a sight that would be) to intimidate those who are fortunate not to have experienced a mental health problem. Nor is it about creating anxiety or sympathy when, as a senior leader, you talk about your own mental health issues. They are my vulnerabilities, which I hope are turned into strengths when we are trying to transform services, when we need to reach foundation status and when we need creative ideas on the problems we all face.

A fundamentally important aspect of healthcare is the meaningful involvement of service users and carers in the design and development of mental health services. Listening to their feedback, hearing them tell it like it is and then trying and promising to do something about it is tough. This is a ticket I signed up to as a chief executive with 15 years' board experience and, more importantly, 25 years as a service user.

Mike Cooke is chief executive of South Staffordshire Healthcare foundation trust.