A new Mental Health Charter for Britain

by Tom Griffiths, Manchester Mental Health Charter Alliance
We are said to be living in unprecedented times. Certainly the scale of a global pandemic touching every corner of the earth is exceptional but here in Britain and Europe we have faced deadly viruses or plagues through the centuries.  A century ago, an avian-type flu, or Spanish influenza, led to the deaths of more than 25 million people in Europe – exceeding the total numbers who had died during World War One.  Two centuries ago, the scourge of TB, smallpox and influenza devastated our cities, towns and villages in a disease-ridden landscape lacking any public sewers or sanitation.  British people were dying of starvation and infectious diseases in large numbers.   Governments were more concerned about the  conflicts on the Continent than the cost of poverty to those living in slums or on the streets.
 
So what can we learn from the distant past?  It is claimed how any nation that fails to learn from its mistakes in history is in danger of repeating them.  That’s why in Manchester, we have taken inspiration from an earlier local protest against a national injustice.  Maybe you saw a recent film ‘Peterloo’ which dramatised how one sunny day in August 1819 a crowd of peaceful protesters gathered in St Peters Square to protest about hunger and high prices  in the cost of bread only to be cut down by the sword of the Hussars – leaving 18 of them dead and 700 seriously injured.   Fewer than 2% of the population had the vote at that time.  The atrocity spurred working-class people to demand greater political rights and influence.  Out of tragedy, Chartism and the seeds of a new political Charter were born.  It pressed for   universal suffrage and equal representation in Parliament for everyone.  Out of this social movement, emerged a new public agenda for political action which resulted in the wider   provision of clean water and free education - until they eventually became available to all.
 
Fast forward 200 years to the same city.  Today we have forged a second Charter – this one specifically about Mental Health.  In a modern world where inequity is at the centre of a new plague, it’s a reminder how all health, including mental health, is inter-connected and that our own health depends on the health of others.  The Manchester Mental Health Charter was designed by service-users and carers to express their collective demands to be treated as equal citizens when it comes to being involved in decisions about their own care or mental health services in general.   It is a check list of ten basic principles that enables them to have a real influence on the delivery of local services and to know what’s happening in them.  
 
Here are 4 examples of areas in which our members criticised the local Mental Health Trust over its failure to put our Charter principles into practice. - as it is legally required to do.  
 
1.  No evidence on how it involved service-users to improve the quality of their own personal care or treatment or demonstrating a better understanding of them as whole people.
 
2.  No evidence of an independent service-user perspective being sought or undertaken.  
 
3.  There is inadequate advocacy provision in all areas, including peer advocacy - which undermines how service-users and carers are informed about services and their rights.
 
4.  No evidence of working together on an equal basis with service-users and carers in line with National Standards on Co-Production.  Financial and clinical factors always come first.
 
Our Charter galvanised our members to collectively challenge poor practice at a local level – such as the closure or re-design of community centres.  We have also campaigned strongly on behalf of service-users to prevent them from being stepped-down from secondary care and transferred to their GP or what the system calls primary care pathways.  We are both a critical voice and a vibrant alliance of members.  As a result we were able to persuade health commissioners to call for an independent investigation into this divisive policy.  The report by Manchester Mind was based on a series of service-user interviews and its findings have reinforced our long-held belief that Stepping Down is an uncaring, unjust and callous policy - motivated less for therapeutic reasons than the commercial goals of saving money.  Our members are convinced that the local NHS Health Trust is manipulating a complex system of mental health clusters (validated by NHS England) for its own ends – and the report bears out our beliefs.   Similar clusters and stepping-down are being enforced in your region too.
 
So is the Charter worth the paper it is written on? At first glance, maybe not. Some of its principles are vague – for example, about ensuring that service-users and carers are listened to, and are part of both their own care and the service. But the simplicity of these demands are its greatest strength and an alliance of its members our greatest asset.  Under the single banner of user-defined Charter standards, our Alliance is strengthening and healing people rather than leaving them to struggle on their own.  But it’s not enough in itself.  We still haven’t stopped a corporate juggernaut from casting service-users aside – leaving them to fend for themselves with little support and without receiving any answers why.  Now with the impact of covid-19, we face the prospect of Stepping-Down by stealth across Britain.  
 
In Manchester, we’ve taken one small step in the right direction.  Now we hope that with a little help from our friends at NSUN we can take our next step – or a giant leap - forward.
That’s where you come in.  We believe everyone can benefit from a Mental Health Charter.
 
So here is what we are asking of you.  Here are the next 3 steps if you would like to join in.
 
1.  Start a Conversation – chat with your friends and other service-users or carers or allies, ask them what they think about our Campaign and the benefits of having a national Charter.
 
2.  Let’s Co-Produce a National Mental Health Charter together -  if more survivors / service-user or service-user organisations sign up to it then we will be stronger in solidarity.
 
3.  Be prepared to Challenge –  combining a Mental Health Charter with a Manifesto will strengthen our hand to stand up for the rights of all service-users – locally and nationwide.
 
The injustices of a bygone age still persist and the threat of poverty and callous indifference by an uncaring state has not gone away.  In addition to being isolated or stepped-down by services as social distancing regulations take priority, the voice of many service-users who are reliant on support from family, friends or support workers is being forgotten or ignored.  We are publicising our Alliance in this bulletin in order to discover if our experiences of a crumbling system failing to deal with our expectations tally with yours – despite up-beat managerial claims to the contrary.  We want to learn whether the Charter is just about what is going on in one Northern metropolis or whether our struggle is also your struggle.  If it is then please contact us at [email protected] so that together we can secure justice with and for service-users and give you a platform to have your voice heard.