People Power

In 2012 patients and former patients set up the People’s Network, a group working to give voice to issues related to mental health services in Hackney. Recently I’ve been working with the group as they review the last few years, clocking all they’ve achieved. There is ambition for the next five years, work that ‘needs to be done’, which will need funding. It’s an impressive venture not least because users of mental health services in Hackney lead it. They know the reality.

“We’ve lost services. Things have gone. There wasn’t much there in the first place, that’s the truth. Now there’s not much left.”

I arrive at the group’s weekly drop in, as another member navigates the intercom and carefully ascends the stairs. We find the space and the bulky frame in front reaches his destination, collapsing into a sofa. The group assembles, distracted, chatty. I’m plied with tea and digestives as the conversation starts. I listen, typing notes as we go. The sofa stirs, its occupier now asleep. I’m buoyed by the welcome and friendliness.

“You can wake up and be confronted with an issue and that can make you feel suicidal. It’s help with money, budget with everyday life. I want help with education, and training and employment. Just advice about how to get on.”

It’s a lively unpredictable group defined and led by users of mental health services, all with experience of mental health ‘issues’. The ‘issues’ word is banded about a bit here, clumsy but necessary, papering over long stories, complex trauma and huge challenge. Despite contrasting appearances everyone in the group has or continues to face mental health issues. Amongst the banter and debate there are knowing looks. I’m hit by the profound solidarity.

“Changes have made me very anxious. No key worker anymore. I’m anxious. That’s not good anymore. I don’t have a mobile phone, so I show up here at the People’s Network. My GP is not there for me, that’s what they say. It’s help with the every day.”

Mental health need is high in Hackney compared with the rest of England. Income deprivation is high and linked to higher than average levels of mental health problems in the population. Locally there are significantly higher proportions of Black people with Serious Mental Illness, compared to White, Asian or other ethnic groups. Deprivation has a huge impact with research showing higher than average numbers of people claiming the old incapacity benefit for mental illness in Hackney. With huge need is the perfect storm of cuts to services alongside the impact of welfare reform and changes to housing benefit. In Hackney there is the rising cost of housing.

“We want to go to speak to someone who can help us and have someone to listen. That feels good. Even if you let it all pile up within you, all the anxiety and stuff, you explode. You end up stressed and you talk gibberish. You end up getting sectioned. Talking with someone one to one, and it just brings release. You’re available – we can talk. I want some time with you. We want empathy and friendship. It just helps.”

I listen to people talk freely about complex mental health need. Shortly, a well documented tension between clinical, medical responses and softer talk therapies surfaces. An uneasy balance is struck. A recognition that medication is necessary alongside ambition to break free, to find space for talking and recovery fuelled by the patient, seemingly frustrated by the professional. Nods of support and murmuring of encouragement.

“Professionals are not covering the final outcome, which is recovery – they are covering their tracks. It’s about on-going medication not recovery. They are not looking at the system. The stuff that gets us here – all we have to face and work through.”

One of the members has made everyone lunch and we finish up talking over food. Surprise at what’s been said and encouragement follow, alongside deeper reflection on the insights shared. Then we leave. Things to do back in the realities we’ve left behind. I listen. Some of the obstacles confronting group members feel impossible, instantly generating work for the People’s Network – which they aren’t funded to do. I leave inspired by the solidarity and a sense that the group is making all the difference.

“I get made homeless in April. My landlord wants me out… I got a possession order asking me to be out in March. I said, “You can’t do that!” I spoke to the landlord and he said he’d put it back till April, but that I’d have to be out because he’s selling the place. I have to be at Hackney Council. The landlord will send the bailiff round. I rang Family Mosaic they said there will have to have a referral from your psychiatrist. So I’ve got to arrange an appointment. I’m anxious, but I’m OK”.

People’s Network is supported by Social Action for Health

Eating as a subversive activity | 2.

We host a weekly meal open to anyone. Attendance is ‘random’, which is tricky.

How many will appear? How many are we cooking for? How much should we prepare for? You don’t know. And that’s the point. There is no way around it. The meal deal is an act of faith, that people will show up and somehow, there will be enough food for everyone. Some weeks we’ll host 15 or 16… other weeks it will be more.

It isn’t simply the numbers – its also combinations of people that are outside control.

A mix of people emerge to welcome, talk to, catch up with. But how? And what about the dynamics? You’ll be aware of the dangers in a random blend of people. To help sometimes we’ve identified regulars – a core group of 2 or 3 people – who host, keeping an eye out for those on the edge of conversation, inadvertently excluded, the collective body language of the group leaving them out. Some times the whole group functions as host – this is best.

Some of the people we invite became friends. Some of the people invited – or who show up – have quirky behaviour. Others have difficult, challenging behaviour. This is critical. Eating as a subversive activity is not a meal with mates. The meal is partly about eating with strangers or strange people.

You may need to think through your own boundaries – whats acceptable and not. And safeguarding if you think its needed. There are complexities and paradoxes about hosting community work in a domestic space – your own home. You need to work these through.

We’ll invite all sorts – including the peculiar, perplexed, stressed or homeless. Occasionally the person you think, you really cannot invite. If they make it, if they show up, if they share food, if they are drawn into conversation the meal becomes subversive. You, me or others may be changed in some way by it.

In the vulnerability, insecurity and unease of an open table there is grace, development, growth – and fun.

We could talk about BP.

BP would shuffle in with plastic bags, eat for a week, then turn and talk at whoever he happened to be sat next to, spraying people with words for hours, without interruption or escape. People felt trapped, looking around for escape. Brian, who seemed oblivious to this, persisted, leaning in. This wasn’t babble – this was a coherent and knowledgeable monologue – from Greek mythology, ancient monuments, obscure world war 2 battles to Mahler, Wagner, the Labour party. It was also unrelenting. People tried to manage Brian by interrupting, shifting topics. However, BP new his stuff, made connections – and went with it. People tried moving. Getting up, shifting seats. BP would follow.

Brilliantly, some people took a lead with Brian, welcoming him and pursuing conversation – actively engaging and listening. Within a week or two, the whole group was compensating. It was like friendly tag wrestling, taking turns, welcoming Brian and sharing our responsibility too him across the group, watching out for each other, like a peculiar dance.

When BP died in October 2012 the eulogies from those at thE Meal clocked how much he had impacted on them. Irritating, difficult, offensive, yet people listened, persisted with him, asked him about his life and got to know him for who he was – this obstinate, fragile human. Babble from Brian turned in to conversation and then,  listening to one other, with Brian asking questions, tuning in to others around him.

So food becomes an opportunity for an encounter with someone different, a moment to share story and be listened too. For BP it was a moment of grace. “I’d wish I’d known about this before…”