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

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

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