As has been said,
I'm Graham Morgan and I work with the Highland Users Group.
Some time ago
I was asked whether I was going to speak at this conference and because
I hadn't been keeping up with Modernizing Community Care and because
in HUG we are beginning to think that we have really done the speaking,
that we know what we want, and now it's a question of getting the
real changes that might make a difference, I glibly said that I would
talk about turning the words into reality, to turn the meetings into
real action and results.
like setting yourself impossible targets. If I had the answer to something
like this I would be ever so famous and ever so rich so what I will
do instead is tell you an old story all about myself.
ago I was admitted to a psychiatric hospital in England for the first
time and I would like to tell you four things that I remember from
One day when I
was on the ward an old man was admitted because his mother had died
and he couldn't cope. He was very thin and very sad and confused and
he had trousers that were way too big for him and no belt to keep
them up and for some days he walked around with one hand holding up
his trousers. Sometimes he couldn't manage it and his trousers would
fall down in public. I can't remember the reason for it, but it ended
up with us patients providing a belt and helping him with his appearance.
He died a few weeks after I was discharged from hospital.
The second thing
that I remember is that the walls on our ward often had holes punched
in them by patients. The repairs consisted of taping patients art
therapy pictures over them and piling up any broken furniture in the
least used of the rooms where the windows were already smashed.
The last two things
I was told by a nurse I became close to. Within the nursing residence
there was thriving drug culture to the extent that sometimes the nurses
on duty were considerably more drugged up than us patients.
The last thing
was that the staff had a series of codes for the notes they were keeping.
I can't remember what they were, but they were a way of conveying
how silly they thought some of the interviews that they had with us
patients were. The code for me in sanitized form stood for "talks
a load of rubbish".
These sort of
experiences inspired other ex-patients and myself to set up a group
called Mcmurphy's, which would now be known as a self advocacy group.
We wanted the world to become a better place, and the thing that we
thought would do this best would be to create a crisis center. Somewhere
that would be open whenever we wanted it to be; a place we could go
to when things were bad and we needed a bed to stay. We wanted it
to be a place without workers and with people our own age.
We wanted disabled access and women only days and so on. It was great
dream. We planned and talked and talked until talking became a burden
and we didn't get a crisis center or anything like it, but we did
get a user run drop in center which I visited once before moving house,
and which I remember as being somewhere with gleaming varnish, food
cooking on the balcony and somewhere someone playing pool.
I moved from England
to Edinburgh and there we produced a report seven years ago calling
for the need for crisis services and safe houses and when I last looked
at the notes of their meetings they were still talking of the same
In the years since
then every user group that I have been a member of, or worked with,
has also put a huge priority on crisis and out of hour's services
accessible in the way and in the time that we need it.
In the Highland
Users Group we repeated the same mantra. We wrote the words, we did
the talks, but this time it seemed that were being listened to seriously.
We were told that an out of hours service was going to be funded in
Inverness that would be attached to Nessdoc, the out of hours service
for GP's. This seemed brilliant. At last we were getting what we wanted.
We may not have been very involved, but we were being listened to.
We even thought
that we would be at the beginning of a blueprint for future services
across Highland. The service was up and running in the autumn of last
year and towards Christmas we began hearing rumors that it might close,
which were confirmed this year when a member phoned up in crisis for
help only to be told that the service no longer existed.
And that, to me,
is hard to cope with; when for years you have been asking for something,
when the right phrases are coming from the government and policy documents,
you begin to feel tired to your soul and to wonder what the point
of all this is when you are given what you want, only to see it taken
But let us pause
for a little bit. When we talk about change, we talk about change
in both culture and large, perhaps conservative institutions, and
our words may be demanding quick changes, but these sort of changes
require a ground swell of opinion. I am sure we will get our out of
hours and crisis services in time.
People are beginning
to join together in agreement on this just as they did on the culture
of the old hospitals that originally prompted people like me to speak
out. The hospital culture and environment that I spoke of at the beginning
is now close to becoming an aspect of memory rather than an everyday
reality. That change has happened.
To turn the words
into reality is the drip, drip, drip of reasoned argument that operates
at as many levels as possible. It is the communication that strips
away our stereotypes and prejudices. It has been comforting for me
to sometimes see the barriers to change being a collection of nameless
suited obstructive "them" concerned only with money and
Over time I have found out that most people would be only to happy
to provide what we needed if it weren't for there own nameless people
preventing change in their turn, and sometimes I think that we should
go on a treasure hunt for the people who will not give us what we
need, and sometimes I think that ultimately we would end up looking
everywhere and nowhere, and looking to our own actions. When we see
us all as people working to common ends, then we have room for change
That doesn't answer
the fact that most of us cannot wait for year after year for change.
We will get impatient and angry and fed up with the talking, and for
this I think we need to build on days like this, and to take the different
services to the people who are doing the talking, in the environment
that they are in.
We need to make
our services and our officials human and approachable in the perception
of the communities that they serve. We need to look to the possibility
that groups like HUG, which have traditionally felt on the outside,
can actually feel like owners and allies in the development of the
services that help them.
Make it human
and real so that if we get fed up with waiting it is not due to misconceptions
and accumulated resentment, but for justifiable reasons.