V – I think we’re due an update on the mental health work?

A – There have been a number of positive developments but looking at the bigger picture, I’m not sure how far it’s going.

V – OK, well let’s start with the positives.

A – The sub-group on developing a digital resource has got going and it’s making, slow but steady progress.

V – What exactly was that about again?

A – There are two bits.  One is a directory of organisations, and an existing council website is seen as the place for that.  The other is for something more general on mental health and wellbeing, such as providing advice, and which we’re doing by renovating a site started a few years ago.  It’s the latter that the sub-group are working on.

V – and it’s productive?

A – reasonably.  One thing helping it is a weekly teleconference to review and plan progress.

M – If I remember correctly, those were things you’ve mentioned in previous blogs – setting up sub-groups, more action between meetings – so you’re managing to have an influence!

A – Sadly they’ve come from others, mainly the chairman, rather than me.  I didn’t really raise the concerns I mentioned in the blogs in actual meetings.

V – Hang on a minute, have we got a bit of role reversal going on here?  Mal, you’re bigging Ade up, and Ade, you’re the one criticising yourself!

A – yeah, well, I suppose you’ve got to recognise the problems to learn from them.

V – anyway, any other positives?

A – well, there was discussion at the last meeting about being a bit more systematic on project management such as having project initiation documents for each piece of work, which would include the purpose and outputs.

M – isn’t that a bit practical for you?  Don’t you prefer the high-falutin, high-level strategy stuff?

A – well yes, I do, but I still respect the need for project management!  It’s just-

M – there had too be a just!

A – it’s just that, as I said in the meeting, I suspect that the attempt to identify the purpose may surface issues on which we haven’t yet had a full decision.  But that’s not necessarily a bad thing.

Linked with that, there was also discussion about whether the key decision makers were round the table and what discussions were happening in other forums.

V – so what do you take from all that?

A – We’re making slow but steady progress on the projects were focussing on with increasingly improved management of processes.

But …. oh, aren’t you going to say anything Mal?

M – I’ve given up.  There’s always a but, we know that now.

A – OK, well … but collectively we’re stumbling around in the dark.  We don’t have a clear picture of our purpose, particularly in relation to other things going on in mental health (for instance by the provider, the mental health trust), or a clear view of what is possible (though individuals may see that detail – we just haven’t articulated and recognised it as a group).  So we’re helping tweak existing projects or setting up new, very small scale ones rather than making a big difference either through new projects or changing commissioning.

M – but you’ve got all the main players round the table, can’t they make those links and help focus on something more worthwhile?

V – and if not, why not?

A – Some links are made.  There was someone from the trust and she talked about work that had been done on physical health care for people with serious mental illness.

But there are also discussions going on outside the meeting, for instance, the new head of public health said he’d been talking to the CCG and trying to get them more engaged.  And there are some groups working on community navigation and the list of community organisations – though I only heard about those in other meetings.

V – so this isn’t the only place where partnership working on mental health goes on.

A – no.  And that was recognised as an issue in the meeting.  The other thing that struck me, though, was the imbalance of power of members of the group.

M – Really?  Who would have thought it?

A – I know, it’s obvious, but a senior officer can go off and have conversations with senior people in the CCG in a way most of the voluntary and public members couldn’t.  (There’s more to it than that: the different sorts of power, based on resources, legal powers, authority, and so on, and the extent to which different personalities draw on that power.)  And I’m not saying they should have asked for permission first, but taking unilateral action just emphasises the limits to which they need the other stakeholders.

M – but wasn’t there supposed to be a ‘co-production’ approach?  Doesn’t that mean taking everyone along with you?

A – indeed.  But I’m not sure how deep that commitment goes.  Perhaps they’re starting to think that this isn’t the best forum for getting things done.

V – so the main lessons are something to do with the importance of power in partnerships, the need to understand and work within the big picture (vision and strategy) and locating this forum within the wider network of relations between the partner bodies?

A – yes, and maybe the need for me to raise my concerns earlier and push harder for things to be done in different ways rather than just waiting for others to do it.