‘Welfare Reforms and Mental Health – Resisting Sanctions, Assessments and Psychological Coercion’. Conference Report – Part Three

In the final part of our report from the conference, Jay Watts and Nicola Saunders share their reflections on the day.

Jay Watts

I’ve slightly volunteered myself to write something about the ‘Welfare Reforms and Mental Health – Resisting Sanctions, Assessments and Psychological Coercion’ conference because it was, I think, the most exciting event I have been to in a twenty-year history as a mental health professional. Why?

First of all, thinking and planing the conference was a real collaboration, led by Paul Atkinson and Roy Bard. Some of us were lucky enough to hear reports back as they ventured off to territories unknown to find a space that would capture the ethos of the event – a place embedded in the community and activism, as Wade Hall turned out to be. I remember an email from Paul after one such trip, telling me of his delight at finding a local pub to use for small groups called ‘The Winnicott’, so named as the publican had done the one year introduction course to group analysis in the 1970s and been inspired! Here, the kind of embedding of therapy ideas in the community we really need!

“professionals lagging hopelessly behind”

When I arrived on the day, I was greeted with a hug by the marvellous Paula Peters, the kind of touching relations the day, I believe, fostered between those on the front line of disability activism, and us professionals lagging hopelessly behind. Hopelessly? Well, certainly not after the mutual feeding, planned actions, and passion of the day. The opening speeches by Paula, Denise, and Paul were inspiring – as others have written about. But perhaps the banter and respect between the three was as important as a model of what collaborative work might look like.

At 11:00, Rob Stearn and I set off to run our workshop on ‘psychocompulsion’ with about thirty survivors, professionals, and the undefinable. This was both an honour, and a bit of a blow as it meant missing out on other workshops being run at the same time. One of our group – Liz Hughes – has written beautifully about the themes of our conversations so I won’t repeat this. But let me add that I was most taken by the emotional honesty of our grouping, many of whom were suffering that very day with insistent forms and letters from the DWP who just won’t let go of the persecution.

One of the main feedbacks of the day was how nice it was to have a warm lunch ready, so we could talk together and not splinter off to find local amendments. Steaming plate of soup in hand, we settled in to share stories, greet new friends, make new connections. It was especially nice to meet in person many of the twitter activists – we who have shared so many passions, disappointments and hope whilst missing the embodied experience of one another.

“There is a moment in all this, a moment we are in, a moment of potential profound change in how we work together, and the social power we can thus wield”

Afternoon now, I found myself in Roy Bard’s workshop on ‘Mental Wealth’, after the now normal flurry of wondering how I could be in four separate workshops at one time. Roy proposed a new consortium of organisations – survivor, professional, academic, activist – to fight together to challenge the current organisational structures that exist, so deeply in the pocket of the establishment, desperate for crumbs of prestige and funding at the cost of a true ethics. As a group, we held vastly different ideas of what was going wrong, what needs to be done. But out of our dialogue, a tapestry began to be sewn of what the next stage of our activism might look like. And lo and behold, even in the weeks since the conference, the new ‘Mental Wealth’ consortium has bought together very diverse organisations in our first action – a statement to the professional organisations piercing through the ‘reassurance’ of a recent professionals’ press statement saying any link between therapy, job centres and benefits will be ethical.

There is a moment in all this, a moment we are in, a moment of potential profound change in how we work together, and the social power we can thus wield. The conference inspired me most, I believe, because it was one of the first spaces I have been in where the personal, professional and political were taken equally seriously with survivors, professionals and activists present in equal numbers as equals. As someone who has been under psychiatric services in my day, been on disability, but got to get out, this is the only way of being that makes sense to me, that brings it all together.

“We felt mobilised, emboldened, fierce”

After this nourishment, it was with hearts lifted that we reconnected as a larger group for workshop feedbacks, final comments and questions. We felt mobilised, emboldened, fierce. But dotted in amongst this spirit were comments reminding us again and again of the lost lives, anguished realities, and impossible-to-bear poverties the welfare state has inflicted upon us. These comments bought tears to me eyes.

As the formal parts of the day closed – to make way for dance, poetry and music – all of us professionals – I feel – were left with both a renewed horror in what our theories have been used to legitimise, and a profound sense that this event gave us a glimmer that something different was, is, possible. That a different way of being together, supporting each other, fighting for each other is not only conceivable, but the only ethical way to go forward as individuals, professionals and friends.

In solidarity – Jay.

Nicola Saunders

I was late after getting lost but fortunately bumped into Andy, a colleague from the Free Psychotherapy Network, and others talking about how good the opening speakers were, whilst walking to the Winnicott pub for the psy-compulsion workshop – I joined them. We were a mix of survivors, service users, students, psychotherapy trainees and psy professionals. The workshop began with an introduction from Jay and Rob from Boycott Workfare.

After a short silence the group discussion was started by a person who had been forced to stop work because of ill health.   After being told they couldn’t work again and coming to terms with the impact of that on their life, they were told they were ‘fit to work’ at a medical assessment. Looking for work and not being employed because of their illness, they had met Rob and joined Boycott Workfare and the campaign to inform and influence charities from joining workfare.

“The person sitting next to me spoke about not wanting this to be like other meetings where ‘we just talk’.”

A ‘mental health advocate’ had travelled from outside London, spoke next, wanting to be at the conference but frustrated at finding themselves on the waiting list, decided to take the risk after speaking to Paul and ‘came anyway’. Much of their job is now supporting people to engage with the benefits system in order that they receive the benefits they are entitled to. They were very pleased to be there and be with people who want to do something about what is happening.

The person sitting next to me spoke about their not wanting this to be like the other meetings they have been to where ‘we just talk’. Following a discussion on how do psy-professionals engage with other professionals who take up jobs in job centres, they suggested we ask to speak on their training courses and explain to them what happens to the people they see when they do these jobs.

After lunch I went to the Mental Wealth workshop where there was a wide and diverse range of views and critiques of neo-liberalism. It felt to me at times that that there was such a wide a range of views being expressed, that it might prove too difficult to find a consensus, and a big enough campaigning umbrella for all to come together under. I wondered if it might have been helpful for the Mental Wealth and Direct Action workshops to have come together at this point!

Gradually though the campaign to save mental health day services in Liverpool was spoken about. Service users, social workers and academics coming together to defend day support from local authority cuts – and winning. Local defend council housing campaigns were mentioned – 1 in 4 people living on the street have a mental health problem (St Mungo’s: 2016). There was a suggestion for a way of collecting details of the many campaign groups in order that learning and resources can be shared.   And on the Monday after the conference the beginning of the writing of the joint public statement on psychocompulsion under the Mental Wealth umbrella began. I’m sure all in the workshop would have approved.


Go back to part one and part two of our report.

Alliance Meets the Shadow Minister for Mental Health

Report of the meeting between Luciana Berger, the Shadow Minister for Mental Health, and representatives of the Alliance for Counselling and Psychotherapy, 8th December 2015

Andrew Samuels, Jay Watts and Jeremy Weinstein met with Shadow Minister for Mental Health Luciana Berger MP on behalf of the Alliance for Counselling and Psychotherapy. This is the second time we have met with Luciana, and we congratulated her on her appointment and work in mental health. We then raised four areas of discussion.


We asked if Labour would consider an urgent review of the Improving Access for Psychological Therapies (IAPT) scheme. We discussed the need for increased service user choice, given its effect on engagement and recovery. We proceeded to raise concerns about the planned roll-out of IAPT-SMI (IAPT for those with psychosis and so-called Personality Disorders), fearing that it will take precious resources away from already decimated secondary mental health services. Psychosis services in the NHS and voluntary sector already struggle to get financing to offer the long term services needed for those with the most chaotic lives; moulding services into an IAPT outcome-obsessed shape will work against these clients who demand heavy investment of time and patience. This is because winning an Any Qualified Provider (AQP) contract demands showing quick, efficient treatment with good outcomes creating a desire to cherry pick cases which look good on paper. This would leave those most in need of society’s help without services.

Lastly, we provided a rereading of the figures on IAPT, showing the hundreds of thousands who are referred but who never experience a reliable recovery. We emphasised how being referred is not a neutral act, but brings a disappointment if no help is then available. Most importantly, we emphasised that IAPT has had an effect on the widespread closure of other services – especially for long-term psychotherapy – with organisations like MIND working increasingly from an IAPT model, leaving those with the most distress alone. Luciana shared her concerns about the effects of IAPT on wider mental health provision, and mentioned her recent visits to innovative crisis and day centres in precarious financial straits. She noted that she had asked a Parliamentary Question on the numbers who get referred but never actually receive a therapy, and registered our demand for an urgent review of IAPT.

Alternative Sources of Funding for Talking Therapies

We spoke to Luciana about the erosion of long-term and in-depth counselling and psychotherapy of a relational nature, both in the NHS and voluntary services, giving examples of innovative service provision which we can ill afford to lose. Of particular note, we emphasised that a two-tier system is emerging whereby the poor and disenfranchised have access to a very brief, highly manualized form of treatment (at best) – whilst the middle-classes who have resources continue to access and benefit from traditional counselling and psychotherapy. We were glad to note that Luciana agreed this is highly problematic, socially divisive and against Labour Party principles. The Alliance suggested various ways of tackling the problem with minimal cost including the provision of a small budget to inject into existing and new services for counselling and psychotherapy.

Social Work Action Network Mental Health Charter

We presented the Charter, explaining its identification of key problems such as the crisis facing service users, the role of the market, and the preoccupation with negative risk. We told Luciana about the support the Charter has received from a number of campaigning organisations such as Disabled People Against the Cuts (DPAC) and other service user led organisations, as well as practitioners involved in the Critical Mental Nursing Health Nurses Network and Psychologists against Austerity and, of course, the Alliance. Most importantly, we emphasised the positive steps of redress suggested in the Charter, including a renewed emphasis on User-run services, and the importance of hope. We hoped that the Charter’s vision might be incorporated into Labour policy on mental health.

A National Debate on Mental Health

The Alliance argued that the UK desperately needs Labour to initiate a new debate on the causes of ‘mental health’ and ‘mental illness’ based on the considerable evidence that there is no biogenetic cause of mental distress. There is a need to challenge all that might be depicted as ‘the medical model’. We argued that evidence shows us that human suffering is shaped by the society we live within, impacted by factors such as austerity measures, the breakdown of community and increased individualization at the expense of social cohesion. Luciana agreed that there is a fundamental problem with the language around ‘mental health’ and ‘mental illness’ and herself used the example of changes in the language in which suicide is discussed.

The Alliance suggested categories such as ‘anxiety’ and ‘depression’ are deeply problematic, and presented evidence that the public prefers stigma-busting campaigns based on psychosocial understandings of distress as opposed to illness models. We suggested that reshaping the narrative to include the importance of community, helping one another, listening and a relational  understanding of the self and soul fits with core Labour values.

We then all discussed how innovative projects based on community models of mental suffering could not only save money, but inspire different ways of viewing the self away from the national purse. Luciana informed us of details of the Opposition Debate on Mental Heath the following day. She stated that she appreciated our time and input, and welcomed on-going contact between the Alliance and the Shadow Ministry.

Report by Professor Andrew Samuels, Dr Jay Watts and Jeremy Weinstein (on behalf of the Alliance for Counselling and Psychotherapy)

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