Mental health and the hunger for innovation

Clare Allan was interested to see what new ideas people might have for improving the experience of those affected by mental distress.

I was excited to receive a letter from NESTA inviting me to take part in the judging process for Innovations in Mental Health. As a service-user, who has spent the past decade in the psychiatric system, I was interested to see what new ideas people might have for improving the experience of those affected by mental distress.

That proposals should be innovative was central to NESTA's objectives. This would probably mean new or improved services but we were also considering technologies and products, where these had a role to play.

What we were looking for were local ideas, and germs of ideas, that had the potential to grow and replicate across the UK. Projects that ultimately could have an impact on mental health nationally.

This was a wonderful process to be involved in. After months spent sitting idly on wards, discussing how things could be improved, here was a concrete call for proposals, and an opportunity to play a part in seeing ideas transformed into reality

Treasure or junk?

When the box of proposals arrived at my flat, I sat and stared at it for a while, like an unopened chest whose contents I could only guess at. Would it be filled with treasure or junk? It was huge, which seemed promising, if slightly alarming. Clearly a lot of people had a great many ideas and to consider each one properly was going to take a very long time.

There wasn't any junk. If not entirely filled with treasure, I can honestly say that the box contained not a single proposal that could be dismissed out of hand. The quality of the proposals was impressive as was their range, both in terms of the variety and location.

There were proposals addressing the mental health needs of children, older people, the homeless, carers and those in residential settings. There were proposals responding to the varied needs of people across the UK. There were proposals from service-users as well as frontline workers and carers, and from groups and individuals, reflecting a hugely diverse range of cultures and social backgrounds.

There was so much need bursting out of that box and so many and such varied ideas, I wondered where to begin? I looked up 'innovation' in the dictionary: 'innovation n something newly introduced, such as a new method or device'¹ This, I decided, must be my starting point.

The best ideas come from the front line

The field of mental health is badly in need of new ideas. With limited resources available, service providers have a tendency to stick to the tried and tested.

But to continue my metaphor, fields soon become infertile if you simply keep growing the same crops in them. New nutrients are needed, new crops, new ideas and bringing these in and nurturing them properly can transform the health, not just of the field, but of the entire ecosystem.

When I published my novel, Poppy Shakespeare, a satire of mental health services, a number of reviewers compared it to Ken Keysey's 1962 classic, One Flew Over the Cuckoo's Nest. The irony is that when I wrote Poppy Shakespeare, I had never read Ken Keysey's novel. I wrote, as he did, from what I knew, from my experience of the system. That the worlds we portray, 40 years apart, are so recognisably similar says little for levels of innovation in psychiatric care.

The best ideas come from those on the front line. Whether service-users, workers or carers; these are the people best placed to judge what helps and what doesn't. These are also the people who too often go unheard, forced instead to cope with the impact of changes dictated from above. The NESTA call was in itself innovative, in asking these people for their ideas and offering support and guidance to help develop them.

What about innovation?

If the quantity and quality of proposals were impressive, the levels of innovation they represented were sometimes disappointing. Perhaps this should not be surprising.

For one thing there are a great many worthwhile and important projects, meeting a real and obvious need, which must nonetheless struggle for funding. Many arts projects fall into this group, for example. To say that they are not innovative is not to suggest that they don't deserve to be funded. The fact that so many applied to NESTA raises worrying questions about levels of funding elsewhere.

Making an impact on people's lives

Meeting the other judges for a lengthy day of discussions was an enjoyable and enlightening, experience. As a service-user my knowledge is deep but not broad. I have never lived in Northern Ireland, for example, nor experienced services in a remote rural area.

The varied panel of judges was helpful in this respect and we learned a lot from each other. I had worried that the proposals I supported might be dismissed by the others. But true innovation stands out a mile, such is the hunger for it, and there was little disagreement.

By the end of the day I felt tired but exhilarated. The proposals we'd selected had real potential to impact on the lives of thousands of people struggling with mental ill health. And that's very exciting.

References

1. Collins English Dictionary, Fourth Edition, Harper Collins, 1998.