The failing Mental Health System- How is Expert By Experience involvement part of the solution?

The mental health system is on its knees, vulnerable patients are experiencing abhorrent abuse in the very places that are meant to protect them. This isn't a new discovery all the major channels have produced their own documentaries where they have uncovered abuse in different hospitals up and down the country and unfortunately, there are probably going to be many more documentaries finding the same things. unless there is a genuine change to the way the system operates.

BBC Disclosure - Kids on the psychiatric ward available on BBC Iplayer

I personally was really hesitant to watch this documentary, the young people in the documentary are extremely brave to have spoken about their experiences, something that can be really difficult to do. To talk about traumatic events can take you right back to them, to relive them can be just as scary as when you originally experienced them. The voice of lived experience is such a powerful thing, something that no textbook or findings can explain in such an impactful way. It angers me that there are so many of these documentaries and no real change has happened, maybe a specific ward is shut down, or maybe one ward makes small changes but the system as a whole remains the same.

There have been many calls for wards to be closed down, which solves the issue there but doesn't really address the larger issue. The staff from these shut-down units move elsewhere, they move to other units and the cycle continues. There is a deeply ingrained culture of abusive practices within the mental health system, the people providing day-to-day care are often heavily weaved into this culture, becoming desensitized to these abusive behaviors towards service users. The majority of these staff members joined the mental health system with the hope of helping and protecting vulnerable patients, however, they become indoctrinated into this culture, told that this is how "we always do it". They don't have the time or even get offered anything above the standard training which is extremely limited. They don't get to see the long-term impacts, they don't get the space to learn from mistakes, or even at times be given the space to acknowledge there is learning to take place.

On the 14th February NHS England put out a request to have every mental health trust and Integrated Care Board (ICB's) to review the findings from the report and update their local action plans for supporting people with a Serious Mental Illness who require intensive and assertive care and treatment after the findings of the Independent mental health homicide report into the treatment of Valdo Calocane was released on the 5th of February.

The report can be found here (NHS England » Independent mental health homicide report into the treatment of Valdo Calocane)

Both mentioned sources of failings within the mental health system show that there needs to be learning for the whole system, learning that goes from right from the bottom to the top and the system irrespective of whether they are NHS or private. It's imperative that this learning is led by lived experience, it needs to be created and delivered by people with lived experience. It needs to be in a format that's personal, and that staff see the value and importance of it. It can't just be seen as extra training they are expected to do that doesn't have any real meaning, as it is pointless if the staff don't truly understand the reasoning behind it, if they aren't invested in it.

The Expert by Expieracne (EbE) movement has been growing since the 2000s, which in the history of psychiatric and health care is a blink of an eye. There are still trusts within the UK that don't have EbE involvement, with many saying they have EbE involvement but not actually including EbE in upper management positions, maybe giving them a ceremonial position on a board but not true integration across the board. EbE have been seen as vulnerable individuals without the ability to truly contribute, there are high levels of anxiety around EbE, which leads to professionals avoiding involving EbE. There are voluntary/charity organizations that say they are led by EbE, but there are a lot fewer that have genuine EbE involvement throughout their organization.

It's so important that everyone with lived experience has the space to talk about their experiences and inform change, there currently isn't the support for EbE to develop their skills, and there isn't the support for those who don't quite have the confidence in themselves to share their lived experience. O.R.A.O.K CIC has been working hard to create workshops and training for young people to empower them to share their lived experiences, in a range of ways including public speaking workshops, building confidence workshops, and self-care and boundaries workshops.

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