The manager of the assertive outreach team within whose remit I fall will claim me as one of his team’s success stories. After a disastrous mental health history, it is two years since I was last
admitted to hospital. In the past 18 months I have established gratifying working relationships with Rethink, the Mental Health Act Commission, the Loud and Clear Advocacy Service and my local Mind association. I’m also about to be passed to a community mental health team social worker.
In one sense the manager can say his team’s work with me has done the trick. However, the recovery of my independence is due entirely to chance, luck and my own insistence on being treated with respect, dignity and professionalism.
Specifically, my relationship with assertive outreach was a horror story until I secured a social worker as my care co-ordinator. I was neither consulted about my transfer to assertive
outreach nor was the reason or nature of assertive outreach explained. These factors left me feeling deprived of the right to make life choices. All this shattered my confidence and I still recall being intimidated by the term assertive.
Worse, I was allocated a nurse as my care co-ordinator. Although he may be excellent at his particular profession, when it came to assisting me to recover and regain my independence, he was abjectly deficient. He simply bullied me and even behaved appallingly in my own home. In short, he saw his brief as being restricted to policing me into being medication-compliant. He perceived no life chances for me and even – without consultation – took over control of the tenancy of my flat on the basis that I was “incapable of independent living”.
Paradoxically, it was this that gave me the chance to escape his claws. In fact, being a nurse with no training outside nursing, our relationship ended when his incompetence resulted in me being served an eviction notice. I seized on this opportunity and insisted, with the help of my family, on either being discharged from assertive outreach or having a social worker as my care coordinator. The latter happened and I have not looked back since.
My social worker has always aimed at a full recovery and perceived his brief as maximising my life chances and encouraging me to rediscover myself in terms of empowerment, opportunity and self-determination. Now I am almost fully independent and I owe him a debt I cannot possibly repay.
His holistic treatment of me rendered me willingly medication-compliant; and it was he who listened when I protested that my medication regime was characterised by severe side-effects, and it was for this reason I was often non-compliant. I hope he, along with the other non-nursing professions in the team do not suffer a gradual deskilling process. Assertive outreach team care co-ordinators are often forced to be jacks of all trades but masters of none.
Stuart Wooding is a mental health service user and independent consultant