Creating a fairer Britain
Catherine Mills, a 47 year-old woman with a gentle, smiling face, came into contact with mental heath services when she suffered a serious breakdown 12 years ago. It was, she says with some restraint, "not a positive experience". "There were some bad practices around at that time," she says. "The approach seemed to be geared towards controlling the patient. I became more and more distressed, and the response was to say, if you don't co-operate we'll section you. Having that kind of threat hanging over you hardly helps your recovery."
Her traumatic experiences have, however, helped to inform Catherine's work with the Mersey Care NHS Trust, which was formed in 2001. "I saw that they wanted service users to participate, and I decided that I wanted to be a part of changing some of those practices, moving away from control and towards being sensitive to people's needs."
Through a programme run as part of the Trust's innovative human-rights-based approach, Catherine has been trained to participate fully in the running of the organisation, from taking responsibility for research and evaluation of Trust services to helping interview potential recruits. Along with other service users and carers who participate in the programme, she is paid £12 an hour by the Trust for her work. "At first I was very unwell and I wasn't sure I had the confidence to participate," she says. "But I'm so glad I did. I think we have helped to create an organisation with a totally different ethos. I don't think the kind of problems I experienced ten years ago would happen now."
Mersey Care NHS Trust provides services for people with mental health conditions and learning difficulties across Merseyside. It operates across 61 sites, which include day centres, community health teams and drug and alcohol services, as well as high-secure sites such as Ashworth Hospital. It employs around 4,700 staff and makes contact with over 200,000 service users and carers every year. And unusually for such a large and complex organisation, it involves service users in all its decisions.
"The big difference with Mersey Care is that right from the beginning in 2001 the Board were committed to a human-rights-based approach," says Lindsey Dyer, the Trust's director for service users and carers. "They took that commitment seriously, budgeting to train service users and to pay them for their contribution. It is part of showing that we value their contribution, just as we value the contribution of our staff."
Over 200 service users have been trained, and they have participated in the appointment of over half of Mersey Care's staff - including its Chief Executive. "The service users have prioritised finding staff with personal qualities of empathy and understanding, rather than simply considering an applicant's technical skills," says Dyer. Service users also help with the induction of new staff, with research and evaluation of services, and with the investigation of serious incidents. "We want to open ourselves up to scrutiny. And I think we have achieved a real cultural shift within the organisation."
A shelf in Dyer's office, which is groaning with a huge collection of industry awards for excellence testifies to the success of the approach.
It may seem surprising that people with serious mental health conditions - some of the participants have manic depression and schizophrenia - would be able to participate in such high-level decision-making. Dyer insists that it is just a matter of offering the right training and support. "We need to address some of the perceptions of people with mental health conditions. Most live fully functioning lives in their families and communities. They are citizens too, and can make a major contribution to the development of organisations like the Trust. With their help, we can build a better generation of mental health services."
For Catherine, getting involved in the Trust has not only helped the organisation - it has also been a fundamental part of her own recovery. "I'm still not well enough to return to full time paid employment," she says. "But at least I know I am doing something really fulfilling with my life. I'm proud when I wake up in the morning and I know I'm going to do something for Mersey Care that day. It's given me a reason to live, really."