Friday, 31 May 2013

professional service users, more harm than good?

I was speaking to someone on the phone yesterday about mental health service user involvement, the issues around speaking out critically and being silenced by both the professionals and the service users.  It followed a meeting we had both attended locally, headed up by NHS and social work.  The person mentioned 'professional service users', a description I wasn't familiar with.

Here are quotes from a 2010 Guardian Professional article 'Does user involvement in charities bring any benefits?' by Stella Smith: 

    "There is of course, the 'professional service user', the individual who regularly acts as a service user representative on committees and is called upon for media interviews."

    "Service user involvement is important but it takes significant staff time and financial investment. To involve service users without this and often with no reward other than travel expenses and a free lunch, is patronising and ultimately reinforces the social exclusion which charities purport to challenge."  

The piece also mentions that "much user involvement is so poorly executed it does more harm than good".  Which rings true with my experiences over the last 5 years of trying to get meaningfully involved in mental health service design and delivery, and in having a voice.  The more I've spoken out the more control comes into play, resulting in silencing, straitjackets and exclusion.  From the professional service users.

But I think the system is happy with professional service users.  They don't rock the boat, challenge the status quo or speak out about human rights issues in psychiatric settings.  They support compulsory treatment, even force used against them, saying it is justified or was necessary.  I've heard folk say this and can't understand or identify with it.  I never liked being grabbed and jagged, detained and made to take the psychiatric drugs.  I wasn't grateful.

I see no justification for the use of force in psychiatry.  It demonstrates poor nursing practice and human rights abuse, in my opinion.  I now know that complaints processes in psychiatric circumstances can be unsatisfactory (in Fife) and frustrating in the longer term.  Psychiatric nurses writing what they like in the 'medical' notes, badmouthing carers, justifying poor practice and denial of basic human rights. Non-existent policies and procedures, making it up as they go along, and getting away with it.  

I want to see service user, survivor and carer participation and leadership, in mental health/psychiatric service design and delivery.  It's not happening where I live and I'm not seeing any signs of real change or of senior health and social care managers understanding what meaningful involvement is all about.  It seems they would prefer to continue with professional service users who will tell them what they want to hear and can put up with the labelling, patronising, broken promises and same old.


  1. Hi Chrys

    I was involved with a local service user organisation last year and found it frustrating. I am glad it's not just me! I have been wondering on and off whether I should have stuck it out for longer, but your piece here has made me think my instinct to jump ship was right. Thanks for keeping up your blog - I find it a great encouragement. All the best, Louise

    1. I'm still involved in a number of mental health groups from the survivor and carer perspective Louise. It's useful to have a voice in different places, it just means, I think, choosing where to persist and where to shake the dust off your feet. But I will keep on speaking out so as to make a difference.


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