Divide, rule, exclude

    Some of the most joyous, creative and exciting times of my life
    have been spent doing things with other service users. I’ve never
    doubted that I did the right thing getting involved in service
    user-controlled organisations and being open about who I am as a
    long-term user of mental health services. But pain, disillusion,
    conflict and stomach-churning emotions also go with “getting
    involved”. The other day I learned something new when I did an
    audit of my week.

    First, there was the pleasure of a meeting to develop a research
    initiative with a group of mental health service users and
    survivors and two supportive professionals. We’ve now been at this
    task for about a year and during that time we have all, I think,
    grown and gained in mutual understanding. It is a really good group
    to work in. Everybody brings their own particular personal skills,
    history and experience. We’ve begun to get to know each other and
    that’s been a really positive process.

    Second, though, were two other meetings that highlighted the
    problem I have now come to recognise. Both involved initiatives in
    which the relationship between service users and professionals was
    more complex and ambiguous. In both cases most of the service users
    were less experienced in dealing with the difficulties that this
    can create. So on the one side were professionals who may have
    thought they were keen on user involvement, but were also
    determinedly holding on to control. Typical signs of this were the
    chats they had between meetings without service users to keep
    things on the course they wanted and their requests after this had
    happened, that service users “shouldn’t delay things” by trying to
    express in their own terms their feelings that they were not being
    listened to. On the other side were service users who wanted to be
    friendly, polite and supportive to professionals and who were not
    always fully aware of what was happening – not, at least, until
    later.

    The people not to be in these situations (yes, it’s the voice of
    bitter experience) are more experienced service users familiar with
    these sort of problems: the ones who know that you have to be
    assertive, business-like and often firm. So for less experienced
    service users the rest of us can seem nasty, impolite and
    aggressive. For reluctant professionals, we are a nuisance and
    “unrepresentative”. Divide and rule and exclude the experienced
    service users are their usual tactics.

    This is a real problem, because we must always be involving new
    service users. But there is a simple answer. Before people move
    into working with professionals and policy makers, they need to get
    together in their own independent organisations where they can gain
    new skills and confidence. Then, better equipped and empowered, we
    will be much better able to work together and deal with the dreary
    little tricks that anti-involvement workers use. One of those in
    question here has just gone freelance to provide consultancy on –
    you guessed it – user involvement!

    Peter Beresford is a mental health system
    survivor.

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