Where Have We Been, Where Are We Going…
| DOI | https://doi.org/10.1108/13619322200300002 |
| Date | 01 March 2003 |
| Published date | 01 March 2003 |
| Pages | 3-8 |
| Author | Edward Peck |
| Subject Matter | Health & social care |
Where Have We Been,
Where Are We Going…
Edward Peck
Director
Health Services Management Centre
Birmingham University
Personal perspective
Introduction
First of all, a few words about the influences on this
paper, my farewell contribution to the Mental Health
Review with which I have been involved since its
creation in the mid-1990s.
I first visited a psychiatric hospital, St George’s in
Morpeth, in 1970. I was 11. One of my close relatives
had just been sectioned for the first of many times. It
made a profound impression, one that I can still
remember vividly, and I had an overwhelming feeling
that ‘they’ should not be able to do that to people.
Just over 10 years later I was a management trainee
in the NHS, and as part of my induction I spent two
weeks at Roundway Hospital in Devizes. To my
layperson’s eye, nothing had changed – ‘they’ were
still doing to people what they did to my relative. I
think I decided more or less there and then to work in
mental health services, and I have done so for over 20
years. As a manager within the NHS I was involved in
setting up CMHTs, supporting the creation of
advocacy schemes and patients’ councils and
managing the retraction of two hospitals. During my
decade at King’s College London I worked in most
localities across the UK helping to create community
services and to run down the asylums. Along the way I
have been involved in some of the fora that
governments have used to shape and influence mental
health policy. I have done some academic study and a
little research.
Now, as I take a step away from active engagement
with mental health policy and practice, I want to draw
upon these varied experiences to think about my title
topic under three broad headings: our inheritance, our
context, and our future. In addressing these three
headings I want to locate mental health services
within some of the broader social trends that influence
what we do. After all, it is against the background of
these trends that our discussions about mental health
services inevitably take place. Within each of the
headings I will say:
■something about the influences on the systems
within which mental health problems are
addressed
■something about the influences on professionals
who work in and around those systems
■something about the influences on, and of the
experience of, service users in that system.
The words ‘service user’ perhaps require some
explanation. ‘Service user’ is the most common term
that people with mental health problems who engage
with services for reasons other than treatment and care
adopt to describe themselves, for instance those who
are on committees which discuss the design and
management of services. This is the meaning adopted
in this paper, although it is recognised that there are
other meanings in use – consumer, recipient, survivor
– all of which have their own connotations.
Our inheritance
Firstly, I would like to acknowledge the commitment
and contribution of many of our predecessors,
professionals and service users to the development of
decent and enlightened mental health services, decent
and enlightened at least in relation to what society
then was asking them to do with people with mental
health problems. It is perhaps inevitable that at times
we now view this inheritance rather negatively; why
else, after all, would we be seeking change? On the
other hand, I think it is important to acknowledge that
there are aspects of our future which to a greater or
lesser degree derive from the past, and that past
The Mental Health Review Volume 8 Issue 1 March 2003 ©Pavilion Publishing (Brighton) 2003 3
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