There’s something wrong with how safeguarding works in the mental health world. What are we going to do to fix it?
These unfinished thoughts are informed by a couple of years of talking about and carrying out work which aims to reimagine safety through NSUN’s Community Constellations programme, which seeks to build the capacity and collective power of user-led groups. I’ve been fortunate to collaborate with a number of individuals and groups, including but not limited to Taraki, Black People Talk, Make Space and Voice Collective, and have learned from their innovative approaches to promoting safety within their communities.
Recent abolitionist and radical interventions into safeguarding practice have inspired and challenged my thinking. Much of this analysis is built upon Maslaha’s Radical Safeguarding Workbook, written by Alex Johnston and Latifa Akay, which envisions liberatory and anti-racist safeguarding practice in schools. I was also inspired by members of the Wildflower Alliance speaking about their Alternatives to Suicide approach, which emphasises staying alongside people thinking about suicide instead of jumping into risk assessments.
A common feeling from these discussions, publications, and the conversations I’ve had with individuals throughout the sector, is that there is a moment for most people with lived experience of distress where we feel ourselves being perceived no longer as a person but as a ‘risk’ or ‘at risk’. Maslaha describe the impact of this in schools, and we see the same process in other institutions: “Identifying individuals as ‘risks’ means that steps to safety require ‘correcting’ those individuals, an approach which is pathologizing and can lead to criminalisation.”
The current safety cultures of statutory and voluntary sector settings fail people with lived experience of mental ill-health, distress and trauma, in complex and varied ways. Sometimes people are harmed by having their care and support removed without their consent. At other times, people are forced to accept ‘care’ that is in fact violent and traumatising. Sometimes, people who know that sharing the details of their feelings and experiences will lead to them being punished, excluded, or viewed as dangerous choose not to disclose. Some people fight to have their lives viewed as worthy of protection; some people fight to never be coercively ‘protected’ ever again. These experiences are inflected by race, gender, and other experiences of oppression – other people’s perceptions of your identity and background shape whether they think you’re dangerous or in danger. The connection between these varied experiences of failure, exclusion and violence is a clear need for people with lived experience to have the final say in how our safety is defined and achieved.
Safeguarding as it is practiced now is a poor answer to this lack of agency. In practice, safeguarding often responds more to the fear of service providers than the needs of service users. It provides a framework for service providers to be unafraid of legal challenge, reassured that they’re doing the right thing, and able to pass responsibility onwards. In user-led organisations where ‘service provider’ and ‘service user’ aren’t always such distinct roles, there’s more possibility of real agency for people with lived experience of mental ill-health and distress. The way that risk and harm are perceived is different in user-led groups. And yet often, those of us who carry out user-led work – people with lived experience creating networks of mutual aid, peer support and community – struggle to find resources and support to think through our safety practices. In order to access funding or legitimacy we might adopt the safeguarding practices and protocols used by bigger, non-user-led voluntary sector organisations, which don’t work for our context. Or we might find ourselves making it up as we go along – often with great intuition and care, but with a lot of stress too.
At NSUN, we want to enable user-led groups to practice effective, confident and radical ways of keeping their communities safe, going above and beyond legal duties and into the realm of liberation. This means not tolerating harms which are often considered ‘acceptable’ to people with lived experience of mental ill-health, distress and trauma. It means identifying and acknowledging the threats that policing, social work and systems of coercive mental health treatment can pose to people with lived experience of mental ill-health. And it means envisaging better alternatives.
Maslaha’s Radical Safeguarding Workbook explains that some safeguarding strategies create and define types of harm which are tolerated – either they’re viewed as ‘not real harm’, or they’re welcomed as a strategy of correcting behaviour. As an example of the tolerated harms created and perpetuated by the Prevent strategy, they describe ‘a young person learning that they should be careful about what they share at school’. The harms here are the isolation and censorship of a young person’s feelings and experiences, and the singling out of their experiences because of their Muslim background and beliefs. And it’s not an accidental harm – it’s the system working as designed.
In statutory and voluntary settings, and in our wider society in the UK, many harms to people experiencing distress, illness and/or trauma are accepted and sometimes welcomed. We see the examples of this in the ‘neoliberal co-option of positive risk-taking’, the ‘[weaponisation of] mental health concerns to draw racialised people into a pre-criminal setting’ and the use of Community Protection Notices to criminalise mental distress – to name just a few.
There are two rhetorical moves that are sometimes made in relation to these harms. The first is gesturing to over-policing and lack of access to care and saying, ‘This could be avoided if we funded mental health workers instead of police and made more care available.’ This argument suggests that mental health care in the UK is fundamentally liberatory instead of a site of frequent violence for many.
The second move that gets made acknowledges the violence in our mental health care systems but then appeals to innocence: it says, ‘We’re innocent people, why are we being treated like criminals?’ This move suggests that there are ‘good people’ and ‘criminals’ in the world, and that the way to get treated right is to prove you’re part of the former group – but where does that leave people who, because of their race or other characteristic, are profiled as inherently criminal? Or people who are criminalised, convicted, and subjected to violence through the criminal justice system?
These two moves compound, making it harder to practice solidarity around ideas of safety. The alternative is to say: no one should be treated with such violence or disregard for their safety. Assumptions of sanity or lack thereof, innocence or lack thereof, are built on whiteness, ableism, patriarchy and other oppressive norms. So if we can’t count on those as ways to assess and respond to harm, we need to count on each other instead.
User-led safety cultures
‘Safety culture’ means an organisation or group’s approach to the safety of the people who are involved with it, in any capacity. The term was coined by people trying to figure out how to stop industrial disasters happening through bad management that prioritised profit over safety. In mental health, the stakes are no less serious, but when we think about safety, our imagination often snaps to safeguarding policies and doesn’t go any further. This stops us from considering things like the relationships that exist within organisations or the ways that safety and harm are defined and perceived.
Plenty of user-led groups struggle to articulate their safeguarding processes. This isn’t because they don’t safeguard; it’s because their safety culture is broad, embedded, and tailored to their work. Some examples of safety practices used in user-led groups include:
- Interrogating hierarchies and naming power dynamics
- Building deep trust and working relationally – escaping ‘one size fits all’ solutions
- Being closely connected with other groups and resources in their communities
- Collecting minimal information – protecting people’s privacy and ensuring it’s a person’s choice to divulge details about themselves
None of these characteristics are specific processes triggered when someone is perceived to be ‘risky’ or ‘at risk’; they’re consistent built-in ways of working which help to create spaces where there are no punishments for being unhappy, afraid or suicidal, or for perceiving the world differently to others. One example of building in proactive safety practices is Taraki’s safeguarding matrix, which they created in a collaborative space with NSUN and Black People Talk. The matrix promotes collective responsibility and care, accountability without blame: “In developing this policy, it is acknowledged that safeguarding should not perpetuate a blame culture but emphasises the importance of shared responsibility, as steps are taken towards more collective and emancipatory infrastructure which is rooted in people rather than solely process.”
What about emergencies?
When radical ways of moving beyond the harms of current safeguarding processes are suggested, the response is often, “Okay, but what about when stuff gets really serious?” In fact, “when stuff gets really serious” is exactly the moment that liberatory and emancipatory practices are most needed, especially in relation to suicidality. Most safeguarding models operate in the opposite direction: the higher the perceived risk, the less agency or authority a person is permitted to have over their own safety. What if we responded to crisis as a cry for more choice?
As part of their safety practices, Voice Collective, a youth-led hearing voices group based in Mind in Camden, asks young people in the group to give the details of a ‘trusted contact’ instead of an ‘emergency contact’ in a bid to prioritise the young person’s agency and assessment of their own safety. It also challenges unhelpful and sometimes stigmatising assumptions about ‘emergency’: it offers the possibility of support and safety before, during and after crisis, based on young people’s existing trusted relationships.
Let’s do it together!
There’s more work to be done on all of this – a lot more. But it is possible to build a safety culture which focuses not on isolating and punishing people who are ‘risky’ or ‘at risk’, and instead creates opportunities for meaningful connection and choice. We’ll be publishing some more pieces on approaches to safety, and continuing our exploration of the topic. If you’re involved in user-led work and have ideas to share or questions to ask, please share them with me at firstname.lastname@example.org