Dramatis Personae:

A = me
V = Val, my mentor
M = Malcolm, another player in the system, (perhaps more typical of others than I am)

V – so how’s the mental health strategy progressing?

A – Inching forward – I keep adding bits to the ‘joint document’ though I’m not sure anyone else much is aware of it – but essentially caught up in the random whirlpools of ordinary life.

V – the messy practicalities of reality?  What does that look like?

A – There have been three disparate meetings that I’ve been involved in, plus other meetings I’m aware of and presumably others I don’t know about.  All fairly normal, but I don’t think we’ve got a coherent, co-ordinated approach from it all.

M – actually, I don’t agree.  I think we’re starting to see a sense of direction – and action at last.  We’re finally moving towards some specific priority areas of activity for the next few years and an action group to take it forward.

V – OK, but can we first just hear from A about his three meetings (it’s his blog, after all).

A – the first one came from the little strategy group I’ve been working with and was to focus on one aspect of the strategy, mental health literacy.  It didn’t have enough of the relevant people there and there was a bit of a meandering discussion, but it wasn’t too bad.  There was in fact an agenda and we did stick reasonably well to it.  The relevant bits of the draft strategy were circulated in advance, so we were able to build on the work that had already been done.

V – and what proposals did it come up with?

A – things like:

• social prescribing;
• produce mental health awareness raising videos including people you wouldn’t normally associate with talking about mental health;
• link with the LEP on what workforces can do to support employee wellbeing;
• pilot appraisal 1:1s which look at the individual’s health and wellbeing and try to develop a plan for them.
• Also, to measure progress, we talked about having mental health awareness surveys for the general public and for particular populations such as council staff.

V – OK, so what about the second meeting?

A – it was a follow up to an event I hadn’t been to, and it was also trying to get agreement to a series of propositions to take to the third meeting.

V – and did it go well?

A – well, like the first meeting, it was a bit digressive and largely consisted of specific proposals.

V – I’m sensing you weren’t impressed.

A – it maybe didn’t take a coherent approach but I actually found it quite useful for hearing practical solutions from people with lived experience.  It provided valuable material to add to the strategy.

V – so not every meeting needs to achieve everything.  And what were the proposals coming out of that second meeting?

A – I haven’t seen any official notes, but I think it was:

• a peer support scheme (where people with lived experience act as mentors and supporters to people experiencing mental health problems);
• a crisis café, where people can go for mutual support (rather than, say, rocking up at A&E); and
• support to help people into work and improving employment conditions to make them more conducive to positive mental health.
• Then there was stuff about governance and modifying the existing groups so as to be more focussed and effective and with accountability for delivery.  And a plea for adequate funding.

V – so nowhere in this did all the key players come together to agree a way forward, building on what had already been done?

M – I think you’re actually missing the main point.  The ‘powers that be’ (aka the senior officer in the local authority who effectively drives the HWB) was trying to move to some more immediate priorities-

A – I was getting to that-

M – mm, yes, getting to it.  A perennial issue with you, if you don’t mind me saying.   Anyway, what we’re trying to get to is a few, key priority actions for the next couple of years, with clear indicators of success and accountability allocated to some individual, group or organisation for delivering them.

V – that doesn’t sound unreasonable.  A, what’s wrong with that?

A – nothing, I’m happy to move to action planning-

M – I sense a ‘but’ coming on …

A – I just think that the action should be decided in the light of a coherent, strategic approach; one that considers the interrelationships between the various actions and projects – how they can support each other to be more than the sum of their parts.  How doing one thing, like information and communications for mental health literacy, could support other objectives, like social prescribing.  How, by having the right combination of things, at the right time, you could get a critical mass and produce massive rather than incremental change.

V – and you’ve got that all mapped out from your work on the strategy so far have you?

A – well … nearly …. there’s some diagrams that are nearly there-

M – see what I mean?

A – but it can’t just be me, it needs all the stakeholders to input-

V – it sounds to me that to meet what both of you are saying is required, you need to get all the key players in a room and thrash it out.

M – which is exactly what happened.  The third meeting.

V – pray tell more

M – It was a roundtable designed to identify key priorities for the next couple of years and allocate accountability for delivery.

V – Sounds good.  How was it organised?

M – It included all the key players (including statutory organisations, voluntary and community sector and a service user).  It was facilitated by a senior officer.  It started with an overview of where we were at, a mapping exercise of current activities, discussion of options at tables and selection of priorities in plenary.

V – and it was a success?

M – a great success yes.  It went through that process, identified some priorities and identified two co-chairs to lead an action group to take it forward.

V – and what were the priorities?

M – well again, we haven’t had any official minutes yet, but from the notes I took, it was:

• mental health coaching / peer support;
• activity to support employment (getting people into work and better employment conditions);
• social prescribing where people are allocated to community navigators to help them find appropriate support;
• engagement with service users and with employers;
• mental health literacy and Mental Health First Aid;
• co-production;
• signposting and mapping community assets.

V – so A, that sounds like job sorted.  Do you agree?

A – not entirely.  I think it took us backwards rather than forwards because-

M – how can you say that?  It was-

V – M, just let him have his say.  A, what was wrong with it?

A – I think it was a tough job and it was never likely to have achieved what it aimed to-

M – but it did, it identified-

V – Let’s hear from A, please.

A – it didn’t build on the evidence already collected.  It didn’t take the sort of coherent, strategic approach I talked about earlier.  There were no new proposals.  Selecting options in plenary did not draw on the full knowledge and experience of the people there, never mind those who weren’t.  It proposed a group to take things forward, when one already exists, with the right membership and appropriate remit.

M – but that group isn’t delivering.

A – then work out why and reform it.  Starting a new group from scratch doesn’t guarantee any better a result.

V – so you don’t think this was the best way to co-ordinate action locally.  What do you think is going wrong generally?

A – The typical difficulties in co-ordination.  Not getting some of the basics right in terms of managing meetings and facilitation.  Too little time.  Too much information for everyone to be able to access.  Not recognising what the problems were – not addressing the ‘meta-issues’ of what we are trying to achieve and what’s the best process to achieve it – or at least not addressing them with all the players.  Not having the techniques to aid co-ordination.

V – I’m sure you’ve got ideas for dealing with those problems, but I’m afraid we’re running out of time.  Any last thoughts?  Something a bit more positive to finish with?

A – well actually, I think some sense might have been pulled from the rubble of that meeting.  In discussions after it, we agreed we’d do some briefing on the work done so far.  There was also to be more discussion about the nature of the ‘action group’ which is to take things further.

V – So, as so often, despite the official process, we manage to muddle our way through.  Thank you both for your time and contributions.  I look forward to hearing an update next time.