From surviving to thriving: how does that happen
| DOI | https://doi.org/10.1108/JMHTEP-06-2015-0027 |
| Date | 02 November 2015 |
| Pages | 337-348 |
| Published date | 02 November 2015 |
| Author | Mark Bertram,Sarah McDonald |
| Subject Matter | Health & social care,Mental health,Mental health education |
From surviving to thriving: how does
that happen
Mark Bertram and Sarah McDonald
Mark Bertram is Service
Manager and Sarah McDonald
is Project Development
Manager, both at the
Vocational Services, South
London and Maudsley NHS
Foundation Trust, London, UK.
Abstract
Purpose –The purposeof this paper is to explore what helpedseven people in contact with secondarymental
health services achieve their vocational goals,such as: employment, education, trainingand volunteering.
Design/methodology/approach –The authors used the practice of co-operative inquiry –staff and peer
supporters co-designed an evaluation of vocational and peer support work with service users.
Findings –Service users experienced invalidating living conditions that caused serious distress. These life
struggles included: isolation, trauma events and stigma. The impact involved distressing emotions such as:
despair, fear, pain and confusion. In contrast, when service users experienced supportive validating
conditions (trusting relationships, engaging in valued activity and peer support) they reported being able to
learn, change and grow –finding their own way forward, to improve well-being and quality of life.
Research limitations/implications –Qualitative analysis from in-depth interviews revealed a range
of consistent themes that enabled the authors to visually represent these and “begin”developing a model of
change –grounded in lived experience. Further research is required to develop this model.
Originality/value –The development of a model of change grounded in an invalidation/validation framework
offers a different approach –in terms of how people are perceived and treated. This has relevance for
Government policy development, clinical commissioning groups and practitioners.
Keywords Social inclusion, Mental health services, Vocational services, Peer support, Recovery,
Employment support
Paper type Case study
Introduction
Our vocational service forms part of a large NHS mental health trust that operates in a densely
populated inner London borough. The population is extremely culturally and ethnically diverse
and it is one of the most deprived boroughs in the UK with high levels of social inequality, crime
rates and acute admissions.
The drivers that initiated our vocational service developments stemmed from extensive service
user consultations –some user-led –audits and service evaluations. Service users were asking
for a better deal, a broader range of support and better opportunities to achieve personal goals
and make progress. “Replace the fear with real possibilities”(Bertram, 2008, p. 27). We also
keep a baselineof how many service users on CPA areemployed. Over the last decade thisfigure
has remained between 3.4 and 4.9 per cent. Collectively, this evidence created a compelling
argument that a fundamental change was needed, towards prioritising social inclusion.
With the support of our local progressive service director and commissioners we started to grow
a range of innovative initiatives in a centre located on the ground floor of a block of council flats,
opposite a primary school. These consist of a user run information and support service, a work
training project that won a contract with the local council to carpet clean all of its libraries and
Received 18 June 2015
Revised 11 August 2015
Accepted 11 August 2015
The authors thank the people
who voted with their feet and
courageously undertook these
profound journeys, telling the
authors what it was like. The
co-operative inquiry group and
peer supporters: Shaun Williams,
Manju Rajput, Lucas Teague,
Rob Harrison, Kate Reaney, Ed
McFadden and Kevin Poulton.
Graphic design (Trees) Sophie
Walker. For helpful guidance
during the write up: Thurstine
Basset.
DOI 10.1108/JMHTEP-06-2015-0027 VOL. 10 NO. 5 2015, pp. 337-348, © Emerald Group Publishing Limited, ISSN 1755-6228
j
THE JOURNAL OF MENTALHEALTH TRAINING, EDUCATION AND PRACTICE
j
PAGE337
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