Adrian Smith: a former psychiatric in-patient, now an NHS worker

Former psychiatric in-patient Adrian Smith is carving out a career on the other side of mental health. He spoke to Simeon Brody about the importance of providers employing service users

When Adrian Smith (pictured left) is asked whether he ever imagined as a psychiatric in-patient that he would one day work for a mental health trust, he laughs: “No, never.”

Smith, an information analyst and quality manager for South West London and St George’s Mental Health NHS Trust, ended up in a psychiatric ward in 1991 after an overdose as his life “fell apart”.

There he was given what he calls his “ball and chain”, a diagnosis of paranoid schizophrenia. “When you get that diagnosis it’s just like telling someone they are terminally ill,” he says. “You become isolated, your community mental health team becomes the centre of your life almost.”

But towards the end of the decade Smith’s condition improved and three years ago he discovered the trust’s pioneering user employment programme.

The programme, introduced in 1995, has helped 145 people with mental health problems find clinical and non-clinical positions within the trust.

All posts involve a competitive recruitment process but the programme can help with applications, discuss disclosure of applicants’ conditions and provide support to people once they are in post.

A report last month by the Sainsbury Centre for Mental Health, Leading by Example, urged trusts to do more to recruit people with mental health problems, suggesting it made good business sense, given general recruitment difficulties and the insight service users have to offer (news, page 13, 20 July).

Smith, who was offered a job last November, after building up his confidence through volunteering, feels he had something to offer as well as to gain.

Although he is not a member of the clinical staff, and is involved primarily in bed management and administration, he does have daily contact with service users. “I felt that I had some experience, something that I could put back: being able to relate to them and act as encouragement, remind them there is a future and, though they might not be as productive as they were, it’s not the end of the road.”

Colleagues have reacted well to his appointment, says Smith, who feels that attitudes among staff have undergone a “big turnaround” since the early 1990s.

He says: “It’s not like they treat you with kid gloves, like you’re different, and that’s a good feeling.”

Smith says schemes such as the user employment programme should be compulsory for all trusts. “Service users tell you they want to be back in work but you have to deal with people’s attitude, with their stigma. I’m convinced that a lot of people will return to employment and work well and be less ill.”

He believes the framework offered by work has been invaluable and has experienced just one period of 10 days when he was unable to work. “When you’re ill and at home, what do you do? Just think and get more ill – it is a bit of a hole. I can do something now and that makes so much difference. You feel you can make a difference, you’re useful, you aren’t just the bottom of the pile.”

Favourite film:
Brokeback Mountain
Ideal Saturday night:
“Cooking some food and having some friends around.”
If you could be any type of animal, what would it be?
“A cat, because they are independent. Can I be a puma, please?”
Who has influenced you most?
“Rachel Perkins (a service user who is a clinical psychologist and a trust director). You have to think ‘well, she’s doing it’ and then you believe again. Things like that give you hope, it’s like having a role model.”

Additional reading
Why councils should employ more people with learning difficulties

Further information
South West London and St George’s Mental Health NHS Trust

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