Thursday, 13 December 2012

reciprocity in principle and Millan report user voices from 2001

The 4th principle in the Scottish Mental Health Act - "Reciprocity - Where society imposes an obligation on an individual to comply with a programme of treatment of care, it should impose a parallel obligation on the health and social care authorities to provide safe and appropriate services, including ongoing care following discharge from compulsion.".

Yet another principle that was non-existent in recent experiences of Fife psychiatric inpatient treatment. Where parallel obligations obviously carry no weight, unlike the compulsion which is all-consuming.  A mental health act on paper but not in practice.  So much for NHS Fife 'experts' in the theory of the Act which doesn't play out in the wards.  Any dissenting voices are silenced by intimidation or drugs.

A colleague had reminded me today of this principle, one of ten borne out of the Millan report.  In the  summary of the user consultation on Millan report, from 2001, it is like time has stood still.  The concerns about force used, like "legalised torture".  No change there then.  "better access to non-drug treatments"  That hasn't happened.  "independent assessor to monitor the quality of advocacy services"  Nothing happening there either.  "separate advocacy for carers"  Not as far as I'm aware.

And to top it all the final sentence says "it has also paved the way for more meaningful involvement of service users and carers in the future.".  Not in my experience, which continues to be a tokenistic exercise, ticking a box to say that we were consulted.  Critical voices aren't welcome at the table and this is demonstrated in a variety of ways.  Being left out of the notes, being excluded from meetings, being patronised and various attempts made to separate out from the crowd.

I've seen it happen to others in the short time that I've been 'involved'.  Funny thing is, for me the resistance strengthens my resolve, to be included and heard, and to be part of the mix, in my own way.  I really don't like to see people picked off or picked on.  For these are usually the voices of reason and should be listened to.  Otherwise another decade will pass without any change or principles being put into practice.


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