Changing Mental Health Policy and Practice for Changing Times, by Peter Beresford

This post is one we are particularly delighted to share. We have said right from the start of the Network that ‘the critical is political’ and this is a highly political piece. It is a talk given by Professor Peter Beresford at the Mersey Care conference in Liverpool last Friday. The conference was called Service User’s Voice, Change, Rights and Advocacy: What is the reality?

Peter Beresford, OBE, is Emeritus Professor of Social Policy at Brunel University London. He is Co-Chair of Shaping Our Lives, the national user controlled organisation and network of service users and disabled people. He has a background as a long-term user of mental health services and has had a longstanding involvement in issues of participation as activist, writer, researcher and educator. He is author of A Straight Talking Guide To Being A Mental Health Service User, (PCCS Books) and his next book: All Our Welfare: Towards participatory social policy is to be published by Policy Press early next year.

Peter’s talk struck a strong chord with the approximately 200 delegates. You may know him from his writing for The Guardian, from his books or if you have heard of Mad Studies, introduced in this talk and a movement with which we hope to engage further as a network. So, in introducing Peter Beresford we hope to bring more topics into our conversations and also to further the links between our network and survivor expertise, with whom so many critical mental health nurses find such resonance and – finally – the kinds of partnerships we were looking for when many of us first began. 

Peter’s talk also included two examples of people who have found themselves in impossible discriminatory hardship due to cuts to welfare. We have mutually decided to edit these out to protect their anonymity. It is Peter’s view that they are not exceptional as examples, but share an increasingly common experience.

Please feel free to comment or ask questions below, which Peter will read.

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Changing Mental Health Policy and Practice for Changing Times

Hello. It is really good to be here again. Although in one sense things could hardly be said to be getting better since I was present at the last of these terrific conferences. Exteriorly they can only be seen to be getting worse. But since I was last here with you many terrible things have been happening and here I’ll just list a few;

• The worsening situation for so many people in Syria and elsewhere leading to massive flight and seeking of asylum
• The failure of the west to respond to this in an effective and humanistic way
• The election of another far right government in the UK
• The increasing bad mouthing of disempowered groups here, from refugees and poor people, to young people, lone parents and others
• Continuing determined efforts to unravel and destroy the welfare state

Nonetheless, we can also see at the same time new conversations emerging. Things that were not being said, permissions to say such things that were denied through a frightening political consensus are being challenged – at last. So:

• We have the election to the labour leadership of Jeremy Corbyn who says things that before all major political parties insisted must not be said; that austerity is a lie and a confidence trick; that all our problems aren’t the fault of people needing benefits and refugees
• We hear Alan Bennett the respected writer supporting Jeremy Corbyn and rejecting this government as totalitarian in intent
• We have actors Benedict Cumberbatch and Samantha Morton speaking truth to power about the situation of refugees and this government’s cruel response to them
• We have the determined response and opposition of the house of lords to the planned cuts to tax credits

The neoliberal parade is beginning to look as it would have looked to the small child in the crowd when the emperor processed by naked.

And I think when we consider mental health policy and practice, we must be honest about the extremes that our politics and policy have been reduced to. But equally we must be open to and fully aware and in a position to respond to the new discussions that are beginning to take place.

So I don’t doubt that there are local managers, practitioners, service users and carers here as elsewhere committed to maintaining positive services, making savings where they can as best they can, introducing and developing new ideas, taking seriously ideas of user involvement and co-production. These determined, hard fought efforts must be applauded, they must be reinforced. They must never be devalued, talked down, belittled or denied. But at the same time we must be honest with ourselves. We must not deny the truth. These are fightbacks. These are rearguard actions, they are emergency operations. They are taking place in a politics of destruction, committed to the ending of those values which our grandparents fought for before, during and after the Second World War, that found their expression in the welfare state, social security, public housing and the National Health Service.

This government and its broader fellow travellers will only be happy when these achievements are cut, privatised, outsourced out of existence. They are in some senses even honest about this. Remember the extreme comments and the madness of the recent Conservative Party Conference. Through mouthpieces like the Daily Mail, Katie Hopkins  and the Sun, they recast us all as a scrounging detritus who want to live off hard working people, when the reality is that they and their fellow members of the one percent club are sponging off the labour, voluntary, waged, and mutual of all of us.

This is a government that seeks constantly to divide and rule us; to make one group hate another; to set us at each other’s throats. This is a government which majors on what it calls competition, making us fight each other for ever diminishing pots of money, while making the wealth we create available for the profit-making of big corporations. This is a government which seeks to destabilise us by increasing our uncertainty, fear and anxiety, whether it is about the threats they identify to security, from different generations – the young versus the baby boomers, from different faiths and cultures, from us as strivers from those it damns as skivers. This is a government that let alone supporting social justice, has undermined the prospects of justice in our society, slashing legal aid, even charging people for pleading not guilty. This is a government that seems determined to encourage hate crime by attacking with its media allies disabled people, mental health service users, people with learning difficulties as self socialised into dependence. This is a government that wants to make us deny who we are, not see ourselves as the people it puts upon, but instead for us to be aspirational; to fantasise that we are someone else; on a par with the tiny band of super rich that alone they help prosper. We have a government committed to denying who we are and wanting us to deny ourselves too. That is its justification for reducing policies to help people when they need help which any of us might need at any time.

I believe therefore that this is a government committed to the generation of mental ill health, to mental distress. This is a government whose welfare reform policy has undoubtedly driven many people to contemplate killing themselves and some to do so –only the numbers are not clear.

So we can hardly look to this as a politics that will take seriously mental health policy and practice, when it is a politics that is essentially distressing and maddening, except for its top dogs and fat cats. A politics that seeks to make you deny who you are and hate everyone else by othering them, is I would argue a politics of madness. Its appalling record on and dismantling of mental health policy is of course just a part of this bigger denial.

What has it done, this government, like its predecessor, is instead of supporting good policy and practice for mental health is to sell rhetorical positives while whittling away at and destroying the actual infrastructure of help and support and understanding. It is using policy to oppress people. So it talks up recovery and mindfulness, while it makes them the handmaidens of policy to try and force people off benefits into jobs, however inappropriate they may be, whatever difficulties people are facing; whatever barriers there are in the way of such jobs for them.

We have to accept that we cannot expect to see understanding, sympathy or a grasp of good mental health policy from this government. The problems it poses because of the nature of its politics and ideology are much more profound. One simple expression of this is its approach to welfare reform as it calls it and the implications this has for people’s mental health and for mental health service users.

Service users like me have highlighted the importance of policy and practice giving equal value to experiential knowledge, the knowledge that comes from lived experience, service users’ realities, as well as traditional expert knowledge, generated by research, by professionals, by experiment. Governments like this however have made clear that they devalue and ignore both expert and experiential knowledge. That is why I argue that they are themselves irrational and themselves advancing and responsible for a form of madness.

Last year when I also had the privilege to contribute to this wonderful event, I talked about Mad Studies, a new international development. I referred to a new Canadian book that had really helped this take off. This is Mad Matters. I said that this book was living proof that people with direct experience, supportive professionals, academics, educators and researchers can together take forward something better, different that offers hope. This is mad studies and mad action. And here we can see the value, the strength and the possibilities of such a new direction building on such alliances. Suddenly it feels like a struggle that can be won. Since then much has happened here in England and the UK to take forward this alternative way of coming at our mental and emotional distress, with more events, publications, social networking and social media spreading the word.

Lucy Costa, the Canadian survivor/worker/activist’s has offered a helpful definition of mad studies on the Mad Studies Network Website. She says it is:

…an area of education, scholarship, and analysis about the experiences, history, culture, political organising, narratives, writings and most importantly, the PEOPLE who identify as: Mad; psychiatric survivors; consumers; service users; mentally ill; patients, neuro-diverse; inmates; disabled – to name a few of the “identity labels” our community may choose to use. …Mad Studies, right here, right now is breaking new ground. Together, we can cultivate our own theories/ models/ concepts/ principles/ hypotheses and values about how we understand ourselves, or our experiences in relationship to mental health system(s), research and politics. No one person, or school, or group owns Mad Studies or defines its borders.

As explained in the book, Mad Matters, Mad Studies is a, “project of inquiry, knowledge production and political action”. Presently…we need more action. She makes clear that she sees Mad Studies as a cooperative venture, but one led by the experience, ideas and knowledges of ‘mad-identified’ people. I believe that this is a wonderful hopeful new development. And I think it is particularly timely.

I believe that this is our golden time, a time when the supposed certainties of neoliberal dogma are being to be questioned; beginning to come unstuck. This makes it the time to develop our ideas, our plans, our proposals, our initiatives to start building them and to challenge right wing received wisdom – specifically in relation to mental health policy and practice, and also more generally from our standpoints as service users, workers and carers. We now have a powerful new narrative to tell and to share and spread. A counter to the over medicalised, over drugging psychiatric model in daily operation. Now is not the time just to try and respond and just make the most of the cracks this government leaves, but to prepare for the time that is afterwards and which increasingly clearly and strongly beckons. This government wants to take us back to a poor law past where people were driven mad by the deprivation and disadvantage that was made routine and left unsupported by the absence of any real system of support. We must have the courage and confidence of our convictions and fight for a very different holistic, social and humanistic model of help which involves us all as service users, workers, family and friends.

Thank you.