Survival Strategies

1) - Introduction - Trauma, Abuse, Bullying & Mental Health:

I hope that you find this site helpful & constructive. What we are setting out to do is quite a challenge and will meet with criticism from some quarters, although our purpose is wholly constructive. Much of what we will tell you may appear to go against the grain and be critical of current trends at times. We are all individuals and our perspectives will vary considerably. This is more a challenge of the 'interpretation' of modern social care ideas and practices, seen through the eyes of service users.

If we are doing an effective job I would be very surprised if there were no criticism. We positively invite them. Community Care does work & this has been demonstrated in City, Urban & Rural contexts. Therapeutic Communities can work and 'The Community' can be Therapeutic of itself, when informed & supported to be so, with greater local understanding. I want to challenge you to take some control of 'your' life and seek to construct, with institutions help, the necessary support you desire.

My personal claim, based upon many years of proactive experience, is that the most significant determinants in the progress of any Mental illness, Addiction, or any psychological & emotional distress, are 'social' & the most effective recoveries require significant 'social' intervention, in addition to any beneficial medical intervention. Our argument is that there are very few exceptions to the social causations / contributions, even in cases where there is 'proven', or 'assumed' organic conditions.

Meanwhile, our families and communities have become dispersed and fragmented; out of economic necessity and due to 'self interested' 'governmental & commercial initiatives. People have become increasingly dependent upon statutory services to meet their needs, supporting highly stressed immediate family members, who often have to work, in addition to supporting someone in distress, children, or other family members.

Most specialist, skilled services are now reserved for situations where a person's mental health problem has become critical in some way. This is often at the point where family support is also breaking down. Up to that point GP services have usually provided the limited resources they can make available, mostly centred around medication and counselling. The critical time for skilled social intervention is before the problem becomes critical. Early, skilled, preventative intervention is very limited.

Serious Mental illness is either generated, or else further aggravated by ourselves & others; from parents, siblings, teachers, social workers & clinicians, through to bosses, colleagues, competitors, friends, police & enemies. Most of this is done in relative ignorance and quite often with the best of intentions. Its main effects operates through the 'restrictive' institutions of the community. We are all influenced in some way by 'authority', even when it is misguided. There are famous examples!
(See: Social Adaptation).

Fear & Misunderstanding of Difference:

Many of our personal problems are due to our own, or other's fear & misunderstanding of 'difference' & the 'unknown', compounding the effects of violence & abuse in various forms. People are recognised as 'different' and yet we expect them to fit the same set of general moulds for education, training, right handedness, gainful employment, being husbands, wives, kids and just about everything else. Anything different is seen as 'abnormal'. This doesn't suit institution's remit in particular.

Most institutions are 'prescriptive' by their nature. Those people that don't fit our limited expectations are treated as 'miss-fits'. We no longer use that term (although some unashamedly still do), but in our ignorance we still practice in those terms. We just use more polite, clinical terms to describe them. We are more politically correct in our words, but not so much our actions. Social History and engrained attitudes are difficult to shake off. These historical interventions were 'relatively' helpful but their underlying assumptions concerning mental function were erroneous.

Diagnosis and Social Analysis are fine and are useful techniques of enquiry, but not appropriate systems for categorising people and their problems. It is not unusual for misused professional terms of diagnosis and analysis to be adopted as terms of insult by the general population. This is not just a distortion of word usage. The professional attitudes behind the terms also affect how members of communities see these problems with derision. These professional attitudes are often flawed and misinformed, by these historically inadequate theories.
(See: So What?).

These Problems are Essentially 'Social' Problems:

The 'Consequences' of violence, abuse, neglect, ignorance, injustice, misunderstanding, limited insight, and individual, family, community & institutional prejudices, may be reasonable targets for institutional help, but 'assumed' organic causes require positive social intervention, as we will prove. This is the appropriate role of Community 'Health Care & Social Work'. Not 'social control'; but 'community re-enablement'. The Law now tries to play its part in ensuring this more intelligent objective.

Institutional attitudes have to change before responsible communities can be reborn. Professionals are often forced to take on a 'social control' roles. This is in order to protect the interests of the institution and its administrators. It is a failing of an institutions core responsibilities. The consequences are that ordinary members of the community are 'protected' from their responsibilities (and their positive empowerment) and service fall short of meeting the substantial needs of people.

These same social phenomena, that I describe here and else where, gave us racial & sexual bigotry, educational inequality, cultural stereotyping, religious intolerance and just about every other negative feature of history and culture. We solve the problems piecemeal. One 'popularised' prejudice at a time. Moral, Racial, Sexual, Gender and Intelligence stereotypes have been largely removed from the institutional prejudice repertoire and psychiatric classifications. Others are to come.

We neglect to adequately recognise the underlying errors; the learned limitations in our conception of 'others'; and the serious 'mental health' consequences of all this abuse, neglect, prejudice & intolerance.

Prejudice can exist without overt abuse. Ignorance, as I use the term here, is our inability, or refusal, to comprehend the experiences, perceptions and conceptions of others. The child, or adolescent, who commits suicide because of bullying, abuse, emotional put-downs, a requirement to 'fit the mould', or 'achieve in the adults terms', is first an abused child, however unintentional. Community institutions are culpable. They are not an 'inadequate' child. 'People have effect'.

The child who survives this self destructive urge (not unusual in today's cultures), feels increasingly powerless, because they were put in a state of 'overwhelm', they are robbed of 'actualising' their unique disposition as a child' forced to take on a submissive role. Their natural inclination to please adults (where it exists) works against them and they are steered down a path that is not natural for 'them'. They become the frustrated product of an institutionalising system, meeting institutional needs.

We do the same with Adolescents, Adults and Elders, who have had significantly different expectations and experiences from ourselves. We are often intolerant in understanding differences, based upon their experiences. Early childhood experiences, poorly recognised and appreciated, are compounded by ignorant, judgmental & intellectualised attitudes of those who manage institutions and services and also some of the practitioners.

Justified fear & anger is frequently poorly appreciated by institutions and professionals, even when they have generated it. You have to approach the 'system' from the point of view of the potential service user, to understand why there is reluctance and resistance to taking up these services, until substantial damage has been done. This is assuming the service is made known, available and easily accessible in the first place.

Given the general lack of dignity and respect shown to people with mental health problems and the tendency, even for professionals and institutions, to be defensive and judgmental, it is little wonder that people in trouble in this way put things off and go into denial. The process is often a 'victimising' process, where treatments still often assume an underlying weakness, or personal flaw of some kind (it is the social circumstances are the real flaws).

Eventually people go along with this unjust, 'qualifying' system, just to get some help, or else resist out of reasonable fear, until they are unable to contain the risks to themselves and others. The suppression of symptoms and reduction of risks often comes at a very heavy price; the loss of the person's confidence, personal autonomy and self respect. Most of us have seen these mostly unnecessary and avoidable effects.

I have spent most of my career digging people out of their toxic and institutionalised states and getting them re-diagnosed & assessed. Intervening in cases where Mental Health Act interventions were being used prematurely and inappropriately. Showing how good social interventions can enable substantial and sometimes complete recovery from 'apparent' serious mental illness.

There is little community education concerning positive attitudes towards mental health. I have done some myself, when I have had time, since the later 1970's. It goes down well. There is little open discussion of mental health and learning problems in schools, or employment. There is little preventative and early specialist & skilled intervention to avoid crisis. Most interventions are late, intrusive and often misguided. Assertive Outreach is a nicety. a politically correct 'hit squad' approach.

There is also little real revision of psychiatric text book theory in the last 100 years, although psychiatric practice has improved immensely, mostly the result of the intelligent and insightful initiatives of individual psychiatrists. Unfortunately, the general trend is to assume that all the problems that befall a person with a classified diagnosis of mental illness are due to that classified illness, as if they stop being 'normal' emotional and psychological human beings, outside of their diagnosis.

Personal & Cultural Insecurity Plays a Part in the Process:

Insecurity breeds this state of affairs. It potentially makes emotional & intellectual bullies of us. We measure our progress and status, relative to those we see as 'inferior' in some way (in the best possible taste of course). Such standards for measuring ourselves are demeaning to others and can actually give us an 'underestimated', or 'overestimated' view of ourselves. There are unavoidable consequences that will affect us all. Some are more aggressive at this than others, but we all pay a price.

We need to judge ourselves against our own 'progress', respecting 'others' and expect the same in return. That is the nature of 'Human Rights'. Rights, like 'power' have responsibilities attached. It is actually beneficial to our self interest to be aware of this. If our natural, or acknowledged human rights are infringed, if we are treated without appropriate dignity, we can naturally feel resentful of the communities that do this. The Law is only the final, crude mechanism for mediation.

There are Always Social Consequences:

By restricting people's channels for expressing natural skills and competences, we restrict the expressions of those special qualities & insights that people can 'constructively' have. There have been famous examples that appear to be exceptions to this. We assume these are the only 'smart' exceptions. They are not. There are many others that we misunderstand, undervalue and inadvertently neglect from childhood, through adulthood. We all pay a price & moan about consequences.

There are sad, negative consequences for us all! This is because of our lack of perception & inability to consider other ways conceiving and the social context of other's negative experiences. We misunderstand the part that our collective (institutional) ignorance plays in the generation of poor mental health and antisocial actions. Like in all other cases of prejudice and intolerance, this is a feature of our fear and ignorance concerning individual 'differences'.

Difference and change, tend to make us feel insecure, especially when we have some doubts about ourselves, our perceptions and our own culture. Our ignorance & fear has 'consequences' for ourselves as well as for others. Sadly, any frustrated competence that a person (we) may have, when undervalued and abused in these ways, will often show itself in negative and destructive forms, for both the individual and for the community. Fact. All individuals and cultures do this in some measure.

Violence, Bullying, Abuse, Humiliation & Prejudice are key mechanisms in this undermining of a person's general mental health. These are themselves, usually a features of someone just being different in some way. Condescending & disempowering treatments then compound the problems. This is a feature of social psychology, it requires no moral or ethical code. The cause and effects are obvious and evident. There is no 'bad' gene, there never was. It was a typical, convenient, institutional distortion of knowledge in the late 1800's (See: Genetics Unplugged).

There is Sound Reasoning for all 'Reactions' to Circumstances:

Also, many early features of 'mental ill-health' are 'healthy' defensive responses to unacceptable, or intolerable levels of distress, but we do not adequately recognise and appreciate them for this. We react and try to 'cure' them, to get people back to work, or seek to quickly get them to resume normal responsibilities, or otherwise see them as 'failing'. We are made to feel uncomfortable with this natural, 'protective' phase.

Sometimes we are best to 'go with' and accept our feelings of distress. Clinical intervention should be for emergencies only, for when we have become trapped in 'emergency mode', as a way of life. Too often we feel we can not express our problems in terms of temporary psychological and emotional incapacity. This is often seen as a weakness, as pathetic, in contrast with other's dishonest tendency to be in 'denial' of such things, through intellectualising problems away, perhaps projection them onto others & making feeble 'physical' excuses to cover their insecurity.

Even those that have experience these 'reactions' to distress and overwhelm, often learn to accept these as a 'negative' experiences. They are socially 'taught' to believe so. Because of this, they 'are' negative experiences, often compounded into more problematic conditions that we call Serious Mental Illness, or 'Dependencies' The further reactions of others, once more, further compounds the problem. The person becomes increasingly defensive and often further alienated. This is the classic 'victimising' process. It is a chain reaction that needs stopping

So. Where Does This Lead Us:

As trauma, violence, abuse, bullying, humiliation and prejudice, are key contributors to poor mental health, we will be dealing with these negative forces as a priority. Not just the 'gross' forms of abuse but the subtle, misdirected sympathy, neglect and misrepresentation of a person's particular, unique experiences. I will, perhaps a little unfairly, coin the term: 'Killing with kindness and condescension', for this effect. The primitive, 'pecking order' type behaviour will also be challenged.

There is a simple rule that I feel sums this up. My own recent personal experience really confirmed it for me. If you treat people like children, or in any way as less than ourselves, you will get negative reaction. Either you will create resentment, anger, indignation & non-cooperation (including violence,) or, you will get high dependency & low responsibility. None of which are beneficial to cooperative, inter-dependent, re-enablement and recovery from any trauma, or social distress.

Well, that set the scene on what we are seeking to do. There is a need to 'repair' the relationship between Service Users, Professionals and the Local Community. It sounds like a tall order and a bit idealistic. Well, its not. I have done this on a number of projects over the last 30 years. Others have done the same when community crises arise. There is never perfection but we don't need it, just a better mutual understanding and a sharing of 'responsibilities' and 'power', as well as 'rights'.

Professionals don't know it all, Institutions are not the ultimate 'authority' and Communities & individuals can't afford to pay enough professionals to do it all for you/us (even if that was appropriate). Volunteers enjoy doing it for the kick but that does not remove civic responsibility upon us all. If you don't like the consequences of your collective ignorance (society), find out more, listen to the person with the problem and do your little bit to stop abuse (your own and others). Take some more responsibility; it can be empowering and satisfying.

Institutions and professionals of the past happily took away some of your responsibilities and created a problem of increasing dependence (institutionalisation). It gave them inappropriate power and status. That is not good for anyone. It is now our job to give you back self respect, dignity, appreciation of your own perspective on your life and problems, and empower you to take control over any 'recovery', or any re-enablement that you may need, hopefully before it becomes critical.

You should be in the driving seat with us providing support and advice, where and when asked. You should have choice but this must be 'informed choice'. One of the best ways to do this is in loose, or organised support groups, within the community. At your initiative and with the cooperation of others, it is possible to provide your own support services and there is funding available to do this. By this 'collective action' each compensates for the lack of a skill in others of the group.

We will advise you how this can be done. A group can be as few as two or three people. Sometimes groups can even grow too big and become institutions in themselves. There are initial difficulties getting started, especially in Rural Areas but you can get help if you organise and seek it. We will guide you in this and refer you to others who can help. This is the primary objective of this web site. To empower you in your own support and put you in the centre of the 'community care' you need.

Some Basic Advice:

My first, and most important bit of advice is; 'don't allow yourself, or others, see your problems as embarrassing, abnormal, or entirely 'your' fault. We are all products of our inheritance and our experiences, supposedly 'good' and 'bad'. People 'react' to us and that also has consequences for us. It is what we and others allow us to do with these dispositions and experiences that determines our success in life.

All reactions to life experiences are 'normal' and 'rational' in some way. Exceptions are rare; perhaps the most extreme cases of psychopathic, sociopathic disorders, or the most severe of brain damage (where there is no appreciation of a relationship with 'others'). All psychological and emotional trauma is susceptible to substantial recovery, re-enablement and adjustment. If you can appreciate the needs, feelings and wishes of others, you can recover your own empowered position in life.

We need to have a genuine will to do so, 'for our own sakes' (not just to please others) and then seek that help for ourselves, largely in our own terms, but in mutually respectful negotiation with others. In taking this fresh approach, it is important to let go the resentments towards people from the past and in general. Sift through until you find those that have half an understanding where you are coming from and respect your particular slant on things, as the basis for progressing further.

It takes honesty and courage towards ourselves and with those who we choose to trust to help us. Not so much in the terms that we are 'told' we need to do, but in terms of recognising, for ourselves, that there is a personal problems to solve; In a way that is least punishing & restricting on ourselves and also lest detrimental to others in our support network. Those who would convince you otherwise are ignorant and abusive.

We can start by getting the past abuses and prejudices stated and accepted, then progress to see how we can negotiate a more balanced, equitable and just relationship with our families and community (including professionals and institutions). A relationship that acknowledges the responsibly we have for each other. That is the only way 'Communities' are ever able to work, 'warts & all'. To do this we must lay our anger to rest where we can, or confidently express this more constructively.

If it is any consolation to you. It is those who are most in denial of personal trauma, life events and 'getting older'; believing there will be no 'mental heath' effect; who suffer the most when they do have this kind of experience. We all do this to some degree, it is natural. Our first inclining of mental & emotional 'distress' should make us more appreciative of how susceptible we each can be to breakdown and potentially disabling mental health reactions to trauma.

Take these experiences and mental health reactions, as 'safety valves' and preparation for future life events. Politely demand what you need for your recovery, including recognition of the part others (including institutions) have played in producing your problems. Feel no shame or weakness in acknowledging such problems (they make you 'human') and seek help without becoming a 'victim'. Confidently state as much.

If you are a Visitor seeking immediate help in dealing with Assault, Abuse, Humiliation, Indignity, or Bullying of any kind, anywhere: Please go to: Violence & Abuse, or 'Emergency Page'

If you want Guidence on how to get referred to Community Care services, or Specialist Health Care, you can visit: Surviving Systems. If you simply looking for general information on Mental Health, Learning Difficulties, Alcohol & Drug problems, or Health & Social Care Services and issues, you may wish to go straight to Section 3.

On this website you will get the conventional picture, but will also get this 'alternative' perspective on metal health, along with advice about how to stay 'empowered' in obtaining 'institutional' services. These services are geared to 'average', so they only ideally meet a small proportion of the needs of people. If you are not middle of the road, middle class, average, you may need to request service adjustments to suit you.

We look at the realities of access to services next. You may have to wait until your problem has reaches a significant level. Your GP will help best he can and you may have to do some research and find help for yourself. Ironically, the current services are often geared to meet the needs of people who have have been 'neglected' in their support & have reached a critical stage. The service provided is often quite prescriptive.

1a) The Reality of Accessibility of Service to People in Distress:

Most Professionals & Managers have a genuine commitment to providing appropriate support to people in need. It can be almost as frustrating for those providing the service as those trying to obtain it. There is an obligation to assess, 'but not to provide', is the institutional argument.

That is the bottom line for the 'Institutions'. Actually there is an obligation to provide a service 'assessed' as needed. Assessment is a skilled part of the work. A good practitioner will 'translate' your felt & expressed needs into a professionally identifiable requirement for support.

Professional assessments look at the 'immediate', or 'imminent' risks & the 'potential' risks and then seeks ways to bring these to an acceptable 'normal' level. Life always involves some risks & if the professional (OR the Institution) is too 'anxious' about legal 'consequences', then the support can become restrictive and even abusive.

When services are organised by institutions, 'by committee', if you like, they usually become 'all-or-nothing'. Inadequate resources, used badly, with heavy & costly 'administrations', little initiative & very little flexibility. Government initiative to free them up usually makes it all the worse. Professions tend to react defensively and pull into their shell.

The impact on yourself is that services are restrictive, have inadequate choices and come too late to stop the problem getting to a crisis. This is because Institutions are not very creative, even when they try to be. They often just create another 'layer' of bureaucratic red tape, Quangos & Committees.

Every now and then (in fact quite often) the institutions need waking up to what they are supposed to be providing, and for who. There is a great deal of waste and misdirected good intentions. The rules end up protecting the institution & the professional, rather than you. You then have fewer resources to call upon. Here is our Wake Up Call.

1b) Your are not Powerless but may need some help:

We intend to inform Service Users and the various Institutions, Agencies, Managers and Professionals providing service, of the realty of the services available. How they are seen by the average member of the public, Service Users and Family Carers, especially when in Crisis.

We will inform & support Service Users, Family Cares & Professionals to get the best out of those services available, but in doing so will report the shortfalls, gaps, prejudices, inappropriate attitudes and practices, & seek to explain how these can happened and how to challenge this.

There needs to be greater frankness with Service Users. There is too much reliance on the good will of Family Carers & Voluntary Agencies. There is too much putting responsibility for the failures in individual lives and relationships, on the individual and the family. Professionals cost the community a lot of money. They need to be more accountable.

Institutions & professionals of all kinds, play a very potent part in effecting good and bad social consequences, depending upon their attitudes. They are set up as the modern day guardians of our communities. They need to do a more responsible, proactive and transparent job of it, if they are to gain the respect of Service Users and the communities that fund them.

For More Information, Please go to: Surviving The System:

If you are a casual visitor, or Service User, Family Carer, or Professional worker, seeking general information on dealing with Abuse, Bullying, Mental Health, Learning Difficulties, Alcohol & Drug problems, or Health & Social Care Services & issues, you may wish to go on to Section 3. However, you may find some of this other information informative of the kinds of difficulties that Service User's encounter:

2) - Experiencing Trauma, Violence, Abuse, or Bullying:

This bit of the introduction is primarily for the person who is here because of a dramatic personal experience, or series of events, that has happened to them, or someone close to them, in some way which has had a stunning & traumatic effect upon them. Initially we will be dealing with problematic relationship issues, violence & other abuses, because of their particular urgency and risks.

It is not unusual to find that one personal problem generates or magnifies other problems in your life. You may well be dealing with a number of difficulties at one time. In consideration of this we have a 'Cross Link' arrangement, which allows you to have more than one 'window' open, each on a separate subject that you may find helpful. If you get lost, any window can then take you back to the main page; 'HOME' (Here).

2a) Violence, Abuse, Harassment and Bullying:

You, or someone close to you, may have had 'distressing' experiences and now realise that they are, or have been, experiencing; sexual assault, physical assault, persistent physical abuse, harassment, bullying, psychological & emotional trauma, neglect, or overwhelm. This may be to a degree where your confidence fails and you contemplate running away, or perhaps harming yourself. Breakdown is imminent.

It is important to muster the confidence to get help as early as possible. You do deserve better. There are a number of avenues open to you but you have to decide what is best for you at the time. In these kinds of relationships there are often mixed feelings and sometimes there are children involved. Getting out of the situation is not always easy, we know that. It is still important to get backup of some kind.

If you wish to think over things a while & work out what you want to do; it may be helpful to read through our section on 'Surviving Abuse'. You may get some ideas here and get your situation into better perspective. At the end of the day, it is important to recognise that persistent abuse, of any kind, will have serious psychological & emotional consequences. In some situations your life may be in danger, even if accidentally.

Please 'click' on the following link when you are ready, feel free to come back for further advice if you have any problems. People do want to help but they may not have been there themselves, and their reaction may frustrate you is some ways. This is not unusual, as will be explained else where. Mostly though, the help you should get will make things safer for you, or the person you are concerned about:

Please follow this Link & return here later: Emergency Link

3) Further Introduction to this Web Site:

Some initial criticism of the site is already established and relates to a 'partially' legitimate complaint that much of the material is sometimes extensive, convoluted and can be difficult to follow. This will be true, in some instances, and in some respects, because of poor writing style and the fact that it is only partially completed. I apologised in advance for that and do so again, wherever this is the case.

This writing style will be improved upon, especially in response to your comments and suggestions, where this does not affect fundamental meaning and accuracy of what is being said / told you. These are 'open' documents and are therefore available for improvement and clarification. That is the purpose of the site. To establish as broad a perspective on the issues we are dealing with that will eventually satisfy everyone involved, and at some level that will satisfy, or stimulate, all readers.

In some instances, however, this criticism is not wholly appropriate and the reasons for going into great depth and sometimes taking a 'style that may be irritating for some, is unavoidable. Sometimes Detailed, Logical Accuracy & other times; Blunt Honesty are what is required. Some of the issues we are dealing with have a strong commonsense and emotional component. In these respect we can write in a very relaxed and frank style (and we will do so progressively).

If there are clear interpersonal and institutional abuses, with direct, understood, unambiguous impact upon people's mental & physical health, and the quality of peoples lives, these can be described in very simple terms, without too much in the way of ambiguous interpretation, i.e. where the causes and effect are widely understood & accepted as 'given', to most people. Increasingly this is the case, thank goodness.

4) - OK. So, why don't we just stop there?:

Well; If you do feel that 'emotional' kinds of argument and descriptions (disclosures), adequately deal with your concerns; If this adequately communicates the abusive, neglectful, or risky situation you are in; It should be relatively easy to get the Police &/or Social Services, the local Child Protection Service, or Vulnerable Adults Unit, CSCI, or other relevant community organisation too respond.

Hopefully you will then get the problem dealt with to your satisfaction (perhaps via some of these links). Emotional arguments can have their place and can have a powerful effect upon Service Provider, where they understand the problem and have the appropriate resource to deal with the problem to your satisfaction. The problems often arise when your felt needs do not match the criteria and resources of the institution.

The situation you are managing 'feels' risky and you, &/or the people you are concerned for, are potentially vulnerable. If you believe a vulnerable person (child or adult, possibly including yourself) is at social and physical risk and you have taken no action; then it is important that you click on the following link: Take action, Go to: Emergency Link

5) Has the System has Failed you before?

If, however, you have already done these things before & don't feel this has been helpful and you still feel that there is a serious problem that needs attention. Perhaps you feel that the way things are going will put additional pressures and risks on you &/or others. Maybe you feel that the service is not recognising the risks, or is not offering appropriate choices to help manage those risks and needs better.

Well, there may be other, more complex things we need to consider. If the service response is inadequate, or doesn't meet your own reasonable standards, you may have to present a case at a higher level. This may require you to get help to present your case. It can also be empowering to present your own, well reasoned case. In either event, this is where our literature and guidelines come in to support your own initiatives.

It may well be that you have had a very bad experience with 'Statutory Services'. Maybe a poor deal, or abuse while in 'Care'. Perhaps inadequate support when leaving 'Care'. Your family may have been 'neglected' in terms of their needs and this has affected your life since. You may feel that there was an 'overreaction' by professionals when you were going through a bad time, perhaps a breakdown, or addiction.

These experiences are not unusual and are often dismissed as griping, or lack of cooperation with the services offered. There are even highly prejudicial actions by Professionals in dealing with Child Protection issues. Lack of wider recognition of a child's family & social needs. Lack of understanding of Mental Health and Addiction problems. Poor appreciation of the root causes, progress, antagonists, risks and resolution all these kinds of psycho-social issues.

5a) Failure of Communication & Understanding

This 'inadequate expert' syndrome often leads to their tunnel vision. The conflict, anger & frustration shows on both sides but is always the Service User who looses out in these emotional conflicts. Professionals are either ignorant of their effect, or justify their effect by referring to the 'higher order' issue (Protection of a child, or Community), they rationalise away any responsibility they may have to deal with 'you' adequately.

Once we loose our 'cool', or temper (however justified), the 'system' is very good at covering itself at your / our expense. There are well established rationales for justifying being unemotional. Society places a great deal of pressure on us to 'intellectualise' our feelings and get them under control. In fact, this is often bad for our physical and mental health. You know that as well and I, I am sure. Even some professionals recognise the consequences of holding feeling in.

Often, professionals don't even recognise they are doing this. It is a common, middle class, social prejudice. A misunderstanding that getting 'angry' is a negative emotional response, a sign of not being able to express ourselves adequately. In fact, anger is a perfectly legitimate emotional expression, limited only at the point of 'physical assault'. The fact that anger 'intimidates' those who do not understand it, is their problem, but it will be used against you none-the-less.

5b) Legitimate and Illegitimate Anger.

We consider the legitimate role of 'anger' as a reasonable expression of frustration of 'others' inability &/or refusal to comprehend circumstances beyond their own experience. This is bad enough in society, where prejudice and bigotry can generate legitimate anger. In the case of any Professional's inability to comprehend 'others' circumstances and explanations, there are no excuses. It is incompetence & prejudice.

Anger can be a legitimate expression of frustration, indignation & fear; at being treated without adequate respect, understanding, or dignity. If people don't like it, just calmly remind them this is what they are doing. If you are a large person, speak loudly, swear, or think differently to them, this may be seen as 'aggressive'. This is again, pure prejudice. Point this out to them and insist that your anger is justified, but recognise your effect, even if it is unintentional.

Actual Violence, on the other hand, without physical provocation, is unacceptable. Remind those perpetrating this 'intellectual abuse', that misuse of 'power' in also intimidating and bullying. Condescension is disempowering and assumptions that one perspective, understanding, or theoretical explanations is better than another, is Prejudice. We can reject 'any' inadequate theory, or explanation that we like. Most are inadequate &/or misunderstood.

The fact is, many of the services offered are insufficient, poor quality and disempowering, especially in dispersed, rural areas. Even some professionals recognise this but are in a difficult position to acknowledge this. I refuse to be in this position and there are a few others. There needs to be a radical 're-education' of professionals and managers, in the effects that 'they' generate by their lacking in insight into 'alternative' perspectives and 'natural' reactions to insensitive conduct.

This is why it is necessary to understand better How the 'system' works. and how professionals often think. With a better understanding you will feel less intimidated by their stance and better informed in obtaining an appropriate service. You need to be patient and persistent, however. Some things are gradually improving but there is also 'back slips'. These situations are very 'political'.

First consider 'again' taking this advised action, following the link above, or by approaching your local Social Services Department, or calling the 'Single Point of Access' Telephone help-line (Hopefully listed in you local Telephone directory), or by speaking with your GP, or local Police Station, whichever you feel most comfortable with right now. Any of these could advise of your best coarse of action.

If, however, you feel that you can not do this, for any reason, then continue here and start dealing with the more 'tricky bits' now. This will usually mean understanding better how things work, including the normal failings of institutions and professionals. It may also mean looking at your own approach, especially if you are now angry. You may have to adjust this in order to get a service, but you do not have to play 'victim':

6) Institutional Prejudices and Distorted perspectives:

This is the start of the really 'heady' bit and there is no way of avoiding it. We have to break through extremely powerful, established ways of thinking, and behaving, that often put people at a social disadvantage, while they are seeking help, or are being 'helped'. It is 'institutional' think. It is rarely deliberate, although it can appear 'thoughtless' (as it often is).

If you have so far met a brick wall, or feel that the service being offered was demeaning, or otherwise inappropriate for you, then you have probably met one of the 'filtering' processes which are designed to ensure that only the more serious problems get through. Or, you have been offered the 'standard' service available, or referred on to a voluntary organisation, or 'support' group.

Much of this 'institutional' thinking and behaving, behind this 'referral' process, is largely 'blind' and is a feature of normal 'social learning' & indoctrination, both good & bad. Professionals have been as susceptible to this as the rest of us. The problem & skill, of 'seeing things' from the 'perspective' of the Service User has already been identified in the fields of Learning Abilities, Sensory Abilities and Physical Abilities.

I now want to guide you to a section where we deal with the mismatch between your expectations and the kinds of service being provide for you. I will assume that you have tried these services and that that they had failed for you, or you were not assessed as appropriate for them. This is very frustrating but it is not uncommon.

7) Mismatch in how You & the Institution see your needs.

This 'mismatch' needs some explaining and is not going to be sorted overnight. It requires Service Users to calmly and purposefully to make their needs and wishes known. Sometimes, at the earlier stages of a problem, you do not know what these are, at least to be able to put them into words. People are very individual and their needs vary accordingly.

One size does not fit all but Institutions often deal in a limited set of sizes. They are largely 'off the peg'. This is partly due to limited funding but is also because of poor use of resources and poor, or inconsistent, support of community ventures. The administrative cost of providing the services they elect to provide are disproportionately high and use up most of the funds. This is done to provide as many people as possible with something just good enough to cover themselves.

Although there is a genuine attempt to be 'inclusive' and 'person centred' (or focused), this largely fails because of the limited resources they make available to this end. Some of these services are 'traditional', some are 'legalistic' and some are to deal with 'crisis'. There is little room for novelty and creativity, even if the institution was committed to this. There is precious little attention to early intervention and nothing for prevention.

The expectations of many Service Users and Family Carers now largely outstrip the ability for many institutions to provide an appropriate 'person centred' service. While this is the case there are plenty more who just give in and accept what they are offered, often accepting the 'victim' , 'subservient', or 'disempowered' roles, becoming dependent as a result. You may have recognised this yourself.

If left unsupported long enough, most of us tend to end up do this. It is not deliberate, but it is the natural consequence of institutions putting off support and intervention until a problem becomes critical and more challenging. In a way, they create the bigger problems for tomorrow by ignoring the smaller problems of today.

It is for these reasons that the dissatisfied Service Users and Family Carers need to learn some of the language of institutions and how they tick. If you are up to it (perhaps with some help from friends) the process is very empowering and you will get the support you need, possible quicker than you expect. For further consideration of these issues is dealt with under: Institutions Unplugged

8) The Professional Practitioners Role in this:

Meanwhile, I want to reassure individual practitioners that this is not a criticism of them directly. There are exceptionally bad practitioner in all fields and most of us know of these cases. Where these are bad enough we have to take some responsibility for challenging, or correcting these poor practices.

Here we are concerned with the sometimes abusive, neglectful and often hidden, 'disabling' and 'disempowering' practices of individuals' and of organisation's, due to ignorance & natural prejudice. Those professionals who are unhappy with current institutional practices may well find it useful to follow the same link, to see part they can play in helping Service User's provide the service they desire & best fits their needs.

I have done this myself in a number of projects and it is very exciting and productive. The projects don't have to be 'permanent', they just need to have an objective and a focus that will attract a small group of people who will help support each other, with the backup of a professional. It is actually about using Service Users as Volunteers into their own service.

Where and how far a project goes is determined by the service Users and their circumstances that surround them, including their locality and accessibility. There can be difficulties in rural localities and this is why professional involvement is so critical, to enable the coming together of these support groups on a regular basis.

Some Definitions to help:

Service Users:
Although not a universally acknowledged as an acceptable term, this is the term that is currently used to identify those of us who 'receive' services from professional groups and agencies. It is not ideal but is an attempt to resist 'objectifying' people who receive some kind of health, or social care input into their lives.

The Irony is that the term also works against 'user inclusion' in some ways. This is in the sense that you / we are also the potential, or actual provider of the services in various ways. We collectively 'own' these services and have a legal and moral right to influence the development of them. We can also help run them and determine how they are provided. In some instances, we are also the direct providers of a service.

At present 'Service User' is the best term we have available, which does not connote being 'done to'. Whether we like it or not, it was the term coined, almost unanimously, by delegate to a number of Conferences, for people with learning difficulties, some 30 years ago. This was soon after the concept & practice of 'Community Care' was beginning to evolve. An initiative that began with the Campaign to improve services to people with learning difficulties.

There are problems with all these terms; like patient, client, customer, people, citizen, etc. The concept of 'Social Inclusion' assumes (rightly) that there has been some 'exclusion' of important groups, and that society is magnanimously 'giving back' status, in our relationship with professionals & institutions. Actually it is 'Service Uses', and those professionals who appreciate themselves as 'service users', who have demanded this status of 'citizen user' of our collectively owned, public services. We seek to continue this wobbly trend and are confident the process will continue until professional managers fully understand the principles involved.

The term 'Service User' helps us re-frame this relationship, but it is the underlying attitude & ethic that determines the true character of an 'empowered' partnership. Whatever the term used, it needs to connote a potentially active & informed participation, at all stages & levels. This should be from assessment stage, through the provisioning, to review & completion.

The term, & the philosophy behind it, does not ( should not), give the impression of mere representation, or token inclusion on paperwork, or in a meeting. Informed service users and their representative, will eventually determine Policy and the acceptable Practices for the services provided to meet their needs. This philosophy will eventually be sustained for all service users, of any public service. It will be enlightened professionals that will ensure the necessary self-advocacy for this to happen.

Professionals:
By this term, we mean those trained &/or expertly experienced, ethically guided employees, involved in assessing needs & risk, and in providing appropriate services to meet these. The professional services provide support that is geared toward protecting us, maintain safety & security, ensure justice, promote recovery, or help overcome the various problems we encounter in life (which affect our health, personal & social wellbeing).

A classic definition requires that Professionals are understood to be 'paid'. In fact; the essential requirement is that they are (or can be), ethically & legally 'accountable' for their expert actions & advice. This, of course, means that they are usually 'retained' for that purpose, but this does not have to be the case.

Volunteer , or independent 'professionals' can have a similar expert status but must be willing to be 'accountable' for their actions in some way, even though they are not paid. They also have the benefit of not being so constrained from expressing criticism of institutions, although funding agencies can now be seen to try & exercise this kind of restriction.

This group of Professionals may be considered to include not only Consultants, GP's, Nurses and Social Workers but also Care Workers, Managers, Hospital Cleaners, Benefit Officers, Housing Officers. Police Officers, Court Officials and the like.

Such professionals have an obligation, collectively determined by ourselves, to assess us for the appropriate allocation of services, support, advice & sanctions. This assessment is legally required as an assessment of need, not conditional on resources available. Shortages of resources must be declared separately.

Professional Agencies / Institutions:
The services provided by these professional agencies are, ideally, determined via an informed dialogue; between interested citizens, people currently receiving services, those who have done so in the past, the professionals themselves, the overseeing agencies & representatives of service users & the professions, and our local and national political representatives.

The level of funding and general disposition of these services, evolves over time. It is influences by many things but is rarely adequate for the purpose. There is a balance between established conventions & evolving ideas. Progress is often two steps forward and one step back. Apart from the responsibility for 'assessing' our needs, they & other professionals, have a responsibility to enable and provide direct services & care to ourselves as service users.

In doing this, within the constraints imposed, they do not always honestly state the position. They are often constrained by policy in ways which contradict their professional ethics and are counter to the original governmental policy (or, at least, the original intention of it). More importantly, ways that contradict the 'spirit' in which their services are developed and offered.

Professional Agencies can become defensive and allocate too much of their time and resources covering their backs and too little time meeting the challenge of providing a good quality, comprehensive and preventative service. Ironically, it is this defensive position that causes most of the legal, ethical and media problems. Too many people remain at risk, in spite of more resources being put in.

Like the Media perspectives that they are concerned about, they become concerned with negative impacts and are therefore risk adverse. While attending to the negative possibilities they generate too few positive outcomes. The Media (& therefore the public) focus remains on the failures, delays and waiting lists.

People no longer expect a great deal from public sources and with adequate, good quality, empowering support, they can actually do a great deal to help themselves. To do so they (an we) have to take some risks. Risks that the first attempts will not work. Risks that the outcome will not be perfect but will satisfy the person adequately and reduce the consequences for others.

That is the best we can expect.