Three minutes talk by Mark Brown (@markoneinfour) on the future of mental health to the Dublin Dialogues: Discussing the future of mental health event, 16 June 2014
I’m the director of a social enterprise. I’m a person who does mental health stuff. I’m also a person who experiences mental health difficulties. I spend a lot of time thinking about the future of mental health.
Many of the mental health systems we have were designed before we even had the idea that people with mental health difficulties had any sort of views about what we wanted out of the future. Many of us find ourselves campaigning to try to save services that, if we’re honest with ourselves, we don’t actually find that useful. Younger people with mental health difficulties don’t take on the political identity of a ‘service user’ now. That doesn’t mean that they don’t care about others with mental health difficulties. It’s just that they want to be the change rather than asking someone else to make the change.
The aspirations of people with mental health difficulties have grown more quickly than the ability of existing services to respond to them. Each generation defines its struggle based upon where it finds itself now. What was once new is now old. Everything has its time and everything dies, as the ninth Doctor said in Doctor Who. Unless we’re talking about a mental health service which, of course, is designed to last forever. Services themselves don’t spot how out of date they are.
Maybe we should stamp them all with a best before date so we know when to chuck them in the bin.
A generation is growing up that has had a different experience of mental health difficulty precisely because of the gains made by previous generations. We’re closer to the future, because we’re living it and increasingly we want to be making it.
In little pockets, often with people working in isolation from each other, we’re seeing a new approach. What someone who is nineteen needs to help them get through life hearing voices isn’t the same as what someone who is forty nine needs to help them get through life hearing voices. While people may have the same symptoms, they don’t have the same lives. People with mental health difficulties are saying ‘hang on, what if I didn’t spend all of my time trying to fix a system or service that I don’t have control over? What if I expended my effort in producing something for people like me?’ That’s the moment where what I’ve called The New Mental Health comes into being.
It’s people with mental health difficulties trying to fill the gap between what is needed and what is currently available. These plucky outsiders are pragmatic people with mental health difficulties making stuff happen ourselves, outside of state or large providers, because that’s the only place where really different things can happen without being smothered at birth. It might be a business. It might be a small charity. It might be a group of people around someone’s kitchen table.
This New Mental Health tends to start small and to meet the needs it finds directly. It grows from identifying a particular problem that a particular group of people have rather than attempting to find an answer that will work for everybody. The answer might be digital, but more often it’s about people.
In mental health scarcity means the most arguments are about how we meet basic needs. This means mental health as a whole only thinks about its next meal because it has been starved too long. If there is more money secured, the temptation is always for the big providers to keep it to serve their hunger first. Doing that is ignoring the organisations and people with direct experience of mental health difficulties building the kinds of things and the kinds of communities big providers will need in the future.
If there’s two things that the New Mental Health needs it’s for larger providers to learn to ‘get money out the door’ and for those of us with mental health difficulties who are already making things happen to offer the opportunity for those who come after us to learn from our example, mine us for our knowledge and skills, and then look us in the eye and say ‘sod you, I’m going to something completely different, better and closer to what we need now.’
The New Mental Health happens, and will happen more, when people stop asking politely to be included in the planning of existing services to draw attention to the gap between what is being provided and what people need and start asking: ‘what do we need to solve this problem ourselves?’ People with mental health difficulties are asking questions that no one in services has even thought of, never mind answered.
And that’s one of the places you need to be looking to for your laboratory of the future.