Mental Health and Rights Everyones Business by Graham Morgan
Hello everyone, thank you so much for inviting me to speak today, I won’t speak for that long but I hope what I say makes sense.
My name is Graham Morgan; I work for the Mental Welfare Commission which is all about rights and I have spent most of my working life working with advocacy groups that, even more perhaps, have rights as the centre of the work they do.
In some ways I have a small problem with rights. I think it is the conflict it implies; – we the goodies will stand up for our rights against the baddies. We will set the world straight and ensure that no one suffers because of the way the bad people treat the vulnerable people. But to divide the world and services into goodies and baddies seems pretty crass to me, to reduce how we deal with the sadness of our souls to statements of law seems almost irrelevant and yet at the same time vital in a world where, increasingly, marginalised people have less and less voice and and less and less dignity.
In the world of mental illness there is a history and justification to that mantra about human rights: that ‘let’s eliminate the abuse’ mantra, that let us ensure we are treated with respect; that we always do have that dignity, however difficult or complicated our lives have become.
After all it was also mentally ill people who were subject to the worst of the holocaust that made the United Nations Declaration for Human Rights so important so many years ago. And the history of the asylums in this country hardly makes for comfortable memories and, nowadays, the fact people like me die, on average, twenty years earlier, that travesty of compassion that our UK benefits system represents, the difficulty of getting treatment or a hospital bed when desperate, the continuing judgement about people with a diagnosis of personality disorder, the overwhelming loneliness and isolation people experience as a daily reality that stretches for month after month after month. The fact that almost no one with my diagnosis is working, the austerity agenda where for some reason we are expected to say things will, of course get better, despite greatly increased demand and fewer staff and resources. These are all rights issues, compulsory treatment is, restraint is, seclusion is, even the unrelenting boredom of a hospital ward where there is nothing to do all day except watch tele and try not to smoke too publicly. These are all rights issues and there are so many more.
They burn keenly in the heart of all good people, how can you fail to be indignant at the person who has, at last, plucked up the courage to seek help, who is trembling inside with tiredness and fear; who has that white unhappy sweat about them; who feels there is nothing left for them but who, when they seek help and sanctuary, are turned away; told to see the GP in the morning and yet who are found a few hours later at the same hospital, but this time accompanied by the police and sectioned, or worse; are found later but they are no longer speaking; no longer able to get help.
And how can you not be dismayed when you hear of a person who tries and tries to speak about their concerns and is not listened to, is labelled as manipulative or over bearing; a part of the problem, while they watch their child fade to nothing.
Or the patient who begs the nurses not to let anyone know they are in hospital, still, after all these years, consumed with the shame that being in a mental hospital embodies.
Or the homeless person; worn ragged by their voices, who is so abandoned by the system that they would never dream of getting help, feels alienated and abused by nearly every other passer by.
It is a long never ending list. I have worked in mental health for nearly thirty years, I have been diagnosed with a mental illness for 35 years. I know what it is like to be in one of the old asylums, with the crowded beds, the holes in the walls, the noise; and in later years have known what it is like to have to go to the toilet in front of people, to have the light on 24 hours a day for week after week; am very familiar with the never ending succession of tribunals around my community treatment order, know what it is to have people avoid me because of my illness. Even know what it is like to have the closest of family members say that while most mental illness is acceptable that mine puts me beyond the pale.
In fact as an unashamed plug you can read all about it in my book START that was published a few weeks ago.
It is a very simple and easy job to find someone else to blame for the injustice, the inequality, the sheer horror that life with a mental illness can represent. It is exceptionally easy to blame the people who are there in our lives to try to help us.
And that of course is not surprising, we all know that there are no simple cures to mental illness, that there are no magic words or hugs or pills, no occupation or state of mind that would, in an instant, free people of suffering if only we would open our hearts to it. But it is easy to see how, when we are desperate and turn to someone for help and they cannot find a solution for us that we can grow bitter and sad and it is easy when in the anxiety and fear that comes when we summon up the courage to get help, that we can become angry and upset when the person, who has seen it all before, says that the appointment is over, and that from now on we will need to set up a contract for when and where we can speak to our helpers about our fears and our unutterable loneliness.
But I worry about this, the easy targets to blame for the utter sadness we go through. Because however much I want to see malice around me and to demonise my helpers or the world I cannot really do this any longer.
My CPN is lovely; encouraging and warm and enthusiastic and very perceptive. My psychiatrist; who I am angry at because he is a locum and I don’t approve of locums, is giving me the treatment I need, is keeping me safe and, much as I find it confusing, keeping me alive. Even though I am not too sure I would ever want to share a coffee with him or go on a walk with him, I am glad he is there.
And I find this wherever I go, when I visit hospitals as part of my work with the Commission I often hear of times when people are dismayed at the condition of the wards, both staff and patients and carers, but when I ask the patients about the staff they do usually tend to say they are very good, very committed; if too busy. When I ask them about home they may say they live in a difficult situation but that they often have wonderful support workers who make up for the fractured families they have come from.
When I speak to managers; who the ward staff may want to see as the agents of change; I often meet people who are also struggling to make ends meet, keen to try something or anything to make a creaking system better and sometimes just plain old unable to because we are not all the geniuses who know how to make less money do so much more work.
When I meet the policy makers, I tend to see people burning to improve the system and the politicians when, occasionally I meet them, they too seem committed but sometimes unable to command the resources they would want or to instruct the organisations that have to live under the laws they create, to do the things they would want to; because by doing so, an aching hole in another budget would open up or a staff group threaten to go on strike or one of a million things I have only a sketchy knowledge of would happen.
What I am very painfully trying to say, is that there are usually no ‘them’ that are seeking to deny us rights and life. Just a complex and deeply unfair world. I have never met any worker whose mission in life is to see how miserable they can make their clients, I am sure such people do exist somewhere but I have never met them.
I think, that between us all: the goodies, the baddies the in betweens; we are all struggling painfully and with difficulty to make life better for each other and that sometimes we make mistakes and that sometimes we are arrogant in our assumption that we know what is best for people but despite the odd foul exception: those people who do indeed live with hate in their hearts; we are all, in our different and often bungling ways, trying to make a difference.
And this is where I will finish; this time with an example. In HUG, the group I used to work with in the Highlands; we carried out a lot of awareness training with professionals and the public and with young people.
Key to that training was a determination not to have the answer or the model or the way of thinking that people needed to live up to. Instead, we spoke our stories; the good and the bad of them. But we did not demonise and we did not say our treatment would have been wonderful if it wasn’t for so and so who was just like all social workers or nurses or whatever.
I think letting testimony stand and letting people make their own mind up makes a huge difference. I am optimistic in that I believe that giving people their own opportunity to think and consider rather than demanding they do as we say, think as we think, leads to much better services; much freer and more honest beliefs..
And I also think it makes people want to make a difference themselves, I think, for a time in HUG, we were very good at helping professionals, family, patients, politicians, managers and the public think that what we needed to do was to work together to make a difference and indeed to believe that we were working together: that no one was the enemy.
When we don’t spend our energy allocating blame and instead look for solutions to the injustice we experience then of course we can make a difference and who we are and what we are is irrelevant. As fellow humans witnessing distress our inclination is to lesson that distress; it’s only when other people point the finger again and again and say we are the very cause of the problem that we become angry and defensive and refuse to speak to each other, start to alienate each other.
I used to work in the Highlands, but sometimes down in the central belt; I meet young people who witnessed our training or experienced our plays in the schools many years ago in Highland and sometimes I find out that it was meeting us that made them become the psychiatric nurses that they are today.
I met one a few months ago, she now works in a secure hospital, loves it and is busy with different frameworks with rights as their basis. That is how it happens; it implies trust; it implies belief in each other.
When life is hard, it is incredibly easy to blame other people and, of course it is : we all need explanations even when there aren’t any. However when we reach out to each other and trust each other even when that trust is difficult and may be betrayed that seems to be the way to address rights, that is how we create dignity and community and belonging.
The more we feel we belong and are a part of, the more likely we are to be able to promote rights and reduce injustice.
It is incredibly difficult to oppress another person when they believe in you, when they trust you, when they smile at you, it’s possible of course and that may be why some of us ended up in the situations we are in.
And much as I hate models or ways of living it is much harder to get lost in different thoughts and realities, it is much harder to become isolated and alone when you know that however you are behaving and however sad you are, people are still there for you, still want your life to be better, still reach out to you despite it all; despite the anger we naturally feel at our situations and lives.
I suppose I really am an old hippy but I do believe in connection and community even when personally I find it hard to get to know my neighbours and I do believe that the solution to the injustices we face will occur when any professional or for that matter member of the public naturally knows that the bed rock of what we all do is about dignity and belonging and that of course is what underlies all human rights legislation. That need for community and belonging also includes us, the people with experience of mental ill health, who so often are the people abandoned and excluded, so often the people who feel they are not listened to, feel that the assumption that they have rights makes a mockery of their reality.
And in a very long winded way that is why I think incorporating rights into everyone’s practice is so important.