About

The radical road to better mental health services and better mental health – possibly

Introduction

If you are thoughtful, conscientious, experienced, perceptive and attentive (in whatever role you may have at the moment in or around the field of mental health) and at the same time puzzled, frustrated or fed up, where do you go with your ideas, enthusiasm and possible solutions?

If you provide a service or support, your employer or professional body controls what you say externally, perhaps as a preliminary to controlling what you think. You might have gone to work for a charity, believing this would give you a freedom of expression which isn’t possible in the statutory/State sector. But increasingly charities have become co-opted and locked into the government project, which perpetuates and shores up authoritarian control from the centre by enlisting them as providers or tying funding to campaigns which have a radical coating but an unchallenging and essentially conservative centre.

This unhealthy homeostasis is buttressed largely by fear: that is, of loss of employment, or of an inability to get employment, or of disapproval or sanctions from professional bodies, or of simply becoming conspicuous. The established view, and the models, concepts and language that derive from it, now have such currency and weight that to question it is to demonstrate unfitness or even instability. This is no different if you are a recipient of a service or support: a failure to echo or to be in step with the established view casts doubt on your capacity not on the validity of the view.

The subliminal message of the marketised quasi-religious monolith that mental health services have become is that, if you don’t subscribe to it, there is no place for you in it: if you don’t believe, you don’t belong.

ShrinkTank will cast its gaze – always penetrating but mostly benevolent – over (for want of a better expression for now) the territory of mental health. It is for those who rove along its byways or across its clearings, or who get snagged in its undergrowth or sucked down by the undertow of hidden currents. It will serve as the logbook to return to and record hypotheses, observations, comments – cries for help, even.

ShrinkTank is for givers and receivers – of help, treatment, advice, finance and all the other currencies of exchange. It is for doers and the done to, for those who run the show and for those who either choose or are compelled by law to watch it. Above all, it is for the disenfranchised rather than the disillusioned. That is to say, it is for those who don’t belong to any movement, vested interest, pressure group or professional cadre and for those who instinctively prefer to propose an alternative rather than carp at the status quo.

ShrinkTank will always be radical and contrary. It will unpick received wisdoms and tease out the inherent flaws and absurdities in new ideologies. Just as every organisation or movement contains the seeds of its eventual destruction (a truism which good managers and good leaders will not just grasp but happily embrace), so the models and so-called new ways of thinking which spark that concerning gleam in the eye of mental health’s front-bench gurus will contain fatal contradictions and, with them, the certainty that they will cause unintended harm.

This is the territory which ShrinkTank’s radar will sweep and scan. But its mission statement, if you like, is that there must be no mission statement. Its approach carries a contradiction which is not difficult to spot. Should its ideas or observations begin to have some influence or currency, it will become the thing it has set out to challenge: success will be a kind of failure.

ShrinkTank, therefore, has no overarching vision. Instead, it has the shifting perspective, not of the sniper but of the fifth-columnist who blends in, observes and reports back. It will obsessively resist jargon of all kinds at all times, jargon being the Trojan virus which infiltrates and later controls thinking. It will offer strong opinions, weakly held – unlike Bush, Blair and other dangerous ideologues who have bamboozled us with weak opinions strongly held.

The importance of doubt is the only certainty that ShrinkTank will countenance. What may sometimes look like an attack is intended as a plea – to see that there is another view or another way. What may seem like negativity is a polite inquiry about whether the Emperor is actually clothed at all or, if there is unanimity that he is, about whether his clothes are quite as new or impressive as both he and his followers assert them to be. Its target is always the thought, not the thinker – the premise underlying a construct, rather than those who develop or implement the construct. And should the reader navigate his or her way to the end of this manifesto, it will already have been superseded. It will already be out of date.

London 2010