Prejudice, Neglect & Abuse Causes Serious Mental Ill Health.There is a strong, proven, and theoretically explainable, link between all forms of Neglect & Abuse and Serious Mental Ill Health. Prejudice, Neglect & Interpersonal Abuse lead to Social Stigmatism, Social & Cultural Isolation, Inter Cultural Conflict and Institutional Abuses & Neglect, affecting all ages. Misunderstanding and poor management of this powerful process, is what generates and perpetuate Serious Mental Health problems, what ever assumed predispositions people may, or may not have. World Health Organisation (UN) identified, nearly 30 years ago, that these problems are greater in the Advanced World than they are in the Developing and Under Developed World. The episodes of Serious Mental Ill Health are more frequent, more enduring and more disabling in Western Cultures than in any other Cultures. All the evidence now, is that this problem is getting worse and is affecting a larger proportion of the young and the elderly ("Mental ill health epidemic"). Institutions have been negligent and incompetent at dealing with the underlying causes and the effective recovery. Many of these misunderstood causes and resolutions have been passed on to the rest of us. We have tended to trust these intellectually biased 'expert' opinions. The result is a highly prejudiced public perspective on all Mental Ill Health, Stigmatisation and low expectations of recovery, even from relatively minor difficulties, which become compounded by lack of early relief. Modern Health & Social Care Services are barely able to meet the critical demands, leaving the early 'social' stages almost totally neglected. Social Policy, which now prioritises those in 'greatest need', has had the predictable result of drawing resources away from prevention. It also neglects the earlier stages of social, psychological and emotional distress and the manifestations of ill health, which invariable affect adult life at all stages, often quite seriously. This progressively causes most serious and more exaggerated forms Mental Health crises and sociopathy. The way some people express this distress may be socially unacceptable and require sanction, but our inability, or unwillingness to recognise the mechanism, just creates more problems for us all. A physically assaulted child, or mother, is evidenced abuse, it gets attention some of the time. The pernicious psychological & emotional abuse is low priority for health & social services. It is rarely attended to. I have tried - believe me - and I have worked as a social worker. My more recent research shows that many Professional's will argue that "Its is someone else's problem", referring people on to other agencies, asking them to return if the problem gets worse (as it will, when neglected). This is a characteristic of the same cause and effect that can be seen in distressed people who eventually develop mental ill health. It is the same dynamic seen within distressed, unsupported &/or already dysfunctional nuclear families. It is the sense of powerlessness, where a person, or professional, does not have the resources, or insight, to deal with the avalanche of problems that besiege them and looks to transfer all the 'responsibilities' and 'blame' onto others. This is a well understood defensive reaction which causes the entrenched problems that we are experiencing now. Not only in our health & social services institutions, but in our commercial, industrial systems & financial institutions also. As long as Specialist Services continue to believe that the most serious Mental Health, Addiction problems and criminal behaviour, are largely due to organic and genetic dispositions, this problem is unlikely to be resolved and will continue to grow, as all the evidence is clearly indicating. How our society and its institutions currently operate is inherently abusive, and the indications are that this will continue under current social and economic policies & conditions. All evidence indicates that Managers of Institutions, and the Professionals that they Micro Manage, are unlikely to change their perspectives, unless the problems rear up and poke them in the eye. Even then, many of them are in denial of their own part in generating and maintaining the frustrations and distress. They are often 'deluded' in their rational competence and are likely to continue to 'blame' the people & communities they are charged to care and support. The sad fact is, institutions, communities and cultures can become 'sick', in the same terms that we sometimes describe individuals. Some of the strongest features of a sick institution, or a society, is the tendency to collectively 'deny' the symptoms, 'project' the causes of problems onto other individuals and groups and 'delude' themselves that they have developed the skills, competence and methods to sort thing out 'their way'. We are all susceptible to this. In fact, all the skills and competences are there, but are largely being used in a situation of 'overwhelm'. Managers of Services (or Directors of Business Units, as they now like to be called) have sequestrated the same styles of managements of the now fast failing commercial and financial institutions, with whom they have developed some affinity. It is about time that these institutions faced the fact that they are largely generating their own problems. While the more successful and increasingly socially conscious, financial and commercial systems adjust to become more entrepreneurial and socially minded (in the image of Quaker, Virgin, Intel & Microsoft), ours institutions follow 'Lehman Brothers', 'Woolworths', 'Iceland Bank', or worse still Amstrad; Showing the same arrogance, ignorance, dishonesty and lack of foresight, which drove them into progressive failure and sudden, poorly explained bankruptcy. Not that there is any shame in this, if lessons are learned and appropriate actions taken in future operations. I am afraid that this will take a bit of a push from the rest of us. We have been too slow to recognise bankruptcy already evident in these institutions, because they have always been protected by the permanent availability of public funds, allowing them to create a great public front, at the expense of the customer services. Compare websites with services provided! It may appear that my arguments and theory are simple political statements, I realise that they have this character. The fact is, this problem is evident in any political system. It is all about social attitudes and social cohesion. Anyone, like myself, standing back a little and observing the increased complexity of systems and evidence of 'Micro-management' from the 1970 through to now, would have been able to predict this state of social and economic affairs. In terms of your own local Health Trusts and Local Authorities ('Avon & Wiltshire Mental Health Partnership', Local Primary Care Trusts and the new Improved 'Wiltshire Council' in our Wiltshire instance), there are clear indications of imminent crisis and/or, serious failures of providing adequate, quality services. There are serious budget cuts and staff reductions, at a time of increasing demand, where costly reorganisations are not expected to 'widen' services. I could present you with my own evidence to demonstrate this process. It is available on the website, but the best evidence is already available to you. It simply needs viewing and considering, without the rationalisation of the 'experts'. In order to help this, I would invite you to ask the Chief Executives of the local, social institutions you are particularly interested in, to give you a breakdown of the source, amounts and use of the funds that are made available to them. I suggest that you insist that the breakdown should illustrate the amount spent on general administrative overheads of that section of the organisation; the average amount spent on the local service administrative overheads; the amount spent on purchasing services from the private and charitable sectors (separately), and the amount spent employing professionals to provide direct services (including assessment and information) to the public. Having done that, I would also suggest that you ask for a breakdown of: Professional time spent on purely administrative duties, like completing forms and entering data on computers; The proportion of professional time spent on 'face to face' contact with people like yourselves and at necessary meetings; The average time spent travelling, and time in necessary training, etc. If you do not get an answer, ask your MP, or Local Counsellor to get this information. The overall costs, and the way they are allocated, will surprise you. How budget information is normally presented does not reflect the funds that are made available to the direct provision of services. Of course there are always overhead costs and the direct administrative services are very important in providing an efficient and reliable service. With these figures, you will be able to make up your own mind if the proportion of time and costs is good value for money. Click here: Example Chief Executive Letter Most professionals, like in any occupation, are excellent, good, bad and indifferent. There are solvable reasons for the discrepancies. Like in commerce, industry and banking (on which modern social & health care services are now being modelled) there are competent, productive ways of motivating and getting the best out of people, within constraining budgets. Unfortunately, there are also incompetent, defensive, punitive ways, that reducing productivity and motivation. In circumstances where we have little say in how services are generally run, and little real opportunity to get our complaints and suggestions heard and implemented, these institutions have to be judged in the context of their own declared objectives and demonstrable failures to meet those objectives. In business operations, the buck is passed up the management line, through Executive Officers, to the Chief Executive. That is where the buck stops. If our health and social care services are now being run like businesses, then it is time we got down to business and took a critical look at the services provided, customer satisfaction (in customer terms) and how those shareholder assets (collectively our money) are being used. What is the investment in?. What are the productive outcomes, Who holds Corporate Authority? Who is culpable for the persistent failures. Its time we had as Shareholders Meeting. I have been a manager myself. I have run businesses; mostly successfully, sometimes dramatically failing. I have considerable sympathy for the plight of Executive Officers and Line Mangers. These are very difficult tasks, under highly pressured conditions. Decisions have to be made and sometimes these work, sometimes they fail. It requires competence, of course, but mostly it requires integrity, foresight, vision and knowing when to accept failures. There comes a time when good Managers have to take responsibility for disclosing the failings - Bad Managers never will. Chief Executives have to take responsibility for taking wrong decisions, sometimes in employing the wrong managers, sometimes in not keeping an adequate eye on them and perhaps inadequately guiding, or chastising them. There is a need now for more transparency and honesty. It would be seen as courageous and well respected. The most important requirement is to remain creative and adventurous. Life doesn't stand still and our society is in constant change. Any business, or social service, has to be able to respond to change and emergencies. Copy existing examples of success doesn't work, or we would have dozens of Virgins and Microsofts. Each enterprise has to be unique and meeting the needs of unique a niche, and a unique set of customers. It is good to pick up on good ideas but it is also necessary to make then 'native'.
| Standard Letter to Chief Executive of Services,
Enquiring How Services
are Funded and Allocated:Chief Executive Letter Notes:
This Document is still at some stage of development. You are invited to respond and comment on its content and its logic. If you return to the document at a future date, you will be able to see its continued development, hopefully reflecting your own and others commentary. I thank you, in advance, for any contribution that you make. Please also feel free to visit and contribute, in any valid way, to these and other social issues, through our Forums. There is also a Chat Room and protected Chat Space for more serious group discussions and individual counselling. Please feel free o use this space for your legitimate activities. Copyright: Although you will see very few reference to other formal writings in this document, I acknowledge general recognition to the discussions and debates that I have had with students, practitioners and clients over the years. Most of the ideas and theory has evolved through this rather pragmatic process (operational research), rather than any formal reading. If any content of this document describes concepts, theory, or ideas that have been established else where, (prior to my writing, either here or else where - in part or in full), I acknowledge their entitlement to claim them as their intellectual property for financial purposes, if they can evidence this. I also reserve the right to retain them as my intellectual property, with due recognition to those who have made direct contributions, including other writers, should I identify such a past influences. Other than this, I invite you to share and copy any content, to the benefit of intellectual debate and the benefit of individuals and groups, without restriction, other than it be used for constructive purpose, in the wider context of my writing. Should you wish to use any material presented here 'as is', I ask that you then make reference to myself and the web site. The 'Reading Date' would be a useful 'publishing date' for the Current Edition. 1980 is the core publishing date for most of the basic ideas and theory (unless stated otherwise). This 'Reading Date' may be an important part of this 'reference', as the document (by its 'internet fluid' nature) will be constantly changing and this may affect meaning and interpretation, for those following up on such a reference at a later date. Thank you for your cooperation. TRC. eMail: terry.couchman@visitweb.org |
