Mad on the inside: An ally’s perspective on one organisation

Anonymous: Former employee of the mental health trust discussed on this website.

I started working in mental health before recovery and lived experience practice made their way into the zeitgeist (not long before honest). Being very familiar with the recovery movement, I was sceptical as ‘recovery’ started to appear on everything. And I was right to be. I felt, witnessed and experienced superficiality, tokenism and a need to be seen to be doing, with minimal meaningful doing.

I expressed my concerns that we were co-opting recovery, that it was something that should happen in spite of us. That’s the whole point. I was horrified to see professions jostling to ‘lead’ on recovery initiatives and was told why it was important we embrace it to advance our profession, to make us relevant to the trust’s agenda. Professions parking their tanks on the recovery lawn because it was politically expedient. Without a clue about recovery, its history and its meaning. Assuming they already ‘got it’, or not really caring, just wanting to be seen at the centre.

There was great fanfare as peer support workers (PSWs) were trained. People had their ‘stories’ featured in organisational magazines. But underneath it? There were no plans to meaningfully incorporate lived experience, and a fundamental lack of appreciation of what it offers. If they really ‘got it’, it was immediately squashed back in its box by the hierarchical power holders.

PSWs were split up and dropped into teams that had no forewarning or understanding of how to optimise the amazing resource they were handed. PSWs had no clear role or understanding management. In many cases, because teams had no clue what had happened, PSWs were left to do tasks no one else wanted. So those celebrated PSWs came in with expectations that they were welcome and potentially transformational. But the reality? They were, well, dogsbodies, ignored and forgotten. Or was it hoped that something magic would happen in spite of mental health services? I felt the tensions as a ‘professional’ staff member passing as sane but working in a system that challenged my values. What on earth would this have been like? Other bloggers here will tell you. 

There are allies though. People who, even without reading the literature, could see it was completely unacceptable that a PSW could not have keys when a member of domestic staff could. I saw them fight in vain, arguing and then trying to prove with a pilot – that it was complete bollocks to suggest a PSW couldn’t have keys. What was the risk? I don’t know if anyone dared say it explicitly – but I suppose, someone mightrun riot and open all the doors? No-one worried that I had a set. Ultimately this staff member would need to phone to be let into the building, or ask to use the toilet. I like to pursue things more aggressively, probably much to the annoyance of the powers that be, I remember leading a group fight against a policy change we thought was unacceptable. And being told, that that isn’t leadership. Apparently inspiring people to join you in a vision to make a change only counts as leadership if you go in the direction the organisation has already set. 

What’s going wrong – across many organisations, including this one? In my view, there is too much attention on being seen to be doing what is fashionable (trauma-informed care anyone?) without actually bothering to understand what it is, or conveniently ignoring that it also involves change in organisational structure and culture. Staff who point this out ‘don’t get it’ and are an irritation to be forced back into delivering what has always been done.  For me, that was the problem the activists here experienced attending the board. Organisational culture is set at the top, and this culture is one of: keep everything under control. Be strategic, be seen to be doing the trendy things. People who point out other ways, ways to genuinely change, they are pests not leaders. Why this culture? Maybe for fear they would need to acknowledge some serious work needs to be done. And it does. 

Not that anyone has asked, but I think an independent review by someone with expertise on what is good practice, is needed. I know these people and places exist, because now I work in one. It couldn’t be more different. It is expected, not a battle met with confusion, that you work with people with lived experience and pay them the maximum you can. No one has said recovery or trauma-informed to me once. It has been astounding, and this is what every mental health trust should be aiming for. But of course, there has to be a genuine desire to do the work and be better.  

Anonymous: Former employee of the mental health trust discussed on this website.