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'Here in
Bradford psychiatrists have made the remarkable step of giving some
of their power away to users'
November 14,
2001
Adam James
profiles Peter Relton who works for Bradford's Home Treatment
Service. Relton is the first UK service user who can help make clinical
decisions about patients catered for by an NHS psychiatric service
.....
Long have users
demanded a say in how mental health services are run.
Ever since the
Bedlam riots in the middle ages patients have called for more respect
and humanity in how they are treated.
How familiar
we now are with users' collective call for psychiatry to be less
reliant on medication, and to place more emphasis on psychosocial
therapies.
It was with
high hopes, therefore, that Bradford's Home Treatment Service (HTS)
arrived on the mental health scene five years ago.
Setting itself
up as an alternative to hospital-based psychiatric treatment, it
rejected the medical model. And as well as becoming the first NHS
mental health service to not label clients with a psychiatric diagnoses
it became the first to invest a user, Peter Relton, with power to
make clinical decisions about patients.
As the user
development worker Relton sits alongside the team's psychiatrists,
GP, nurses, support workers and social worker at the review meetings
when clients are discussed. He has equal say on all matters - whether
it be the progress of a client or how to spend the service's budget.
"My position
means I can make a direct impact on professionals' attitudes and
the team's philosophy," explains Relton.
"Most power
in mental health services lies in the hands of psychiatrists. But
here in Bradford psychiatrists have made the remarkable step of
giving some of their power away to users."
Relton's professional
status is a far cry from the lowly days of 1980 when his "break
down" meant he had to pull out of his librarianship course
at Manchester Metropolitan University.
He was suffering what he calls an "existential crisis"
and "was close to a paranoid state"
"I was
avoiding people and not turning up to lectures," he remembers.
"I was convinced that I had schizophrenia - largely because
I was reading work by the American fantasy and horror writer H.
P. Lovecraft.
"He had
a reputation of being a recluse, and he felt alienated from the
20th century. The 18th century was the era that he wanted to live
in.
"His biography
referred to him having a schizoid personality -this was how I came
to understand my experience."
Relton was in such distress he had no choice but to seek refuge
at his mother's home in Bradford.
His GP diagnosed
him with depression and anxiety, and referred him to a psychologist
and mental health day centre.
"This was
a very important time for me because I started to come out of my
shell, and I discovered that I could actually get along with all
sorts of people," recollects Relton.
But when the
centre closed, it left a still vulnerable young man without the
support he needed. Nevertheless, he struck up a good relationship
with a member of staff at Lynfield Mount Psychiatric Hospital who
encouraged Relton to join a creative writing group for service users.
Together they published a number of booklets.
"For years
I had wanted to write fiction, and now I discovered that I was able
to do it," Relton enthuses.
With this boost
to his confidence Relton got involved with Bradford Mental Health
Advocacy Group.
"I soon
discovered that I could interact with mental health professionals
as an equal, and not as a patient," says Relton.
"Gradually I switched from being a passive recipient of mental
health services to an activist."
After working
for the Bradford and District Coalition of Disabled People Relton
landed his present job with Bradford HTS.
Such is its
reputation that the Department of Health awarded it with a "beacon
status" for good practice and handed it £50,000 to promote
its work to other mental health services.
Relton, who remains as enthusiastic as anyone about Bradford HTS's
treatment philosophy, explains that it is the service's day-to-day
innovative approach that stands it out.
"An example
of how we work was when one woman referred to the team with a diagnosis
of schizophrenia and "delusions" of being attacked,"
he explains.
"But, when
the team's workers visited her home, they discovered her husband
was regularly beating her up.
"It was this violent domestic environment which was the biggest
problem in the woman's life.
"Yet up
to this point other services had taken her husband's version of
events that his wife was mad.
"I belief
bizarre behaviour can always be made meaningful if attention is
paid to what is going on in an individual's life."
Relton's main input to the team is to portray a user's point of
view.
His position
means he can make a direct impact on professionals' attitudes and
the team's philosophy.
"I certainly think there has been a shift in philosophy within
our trust where it is more accepted to employ former service users.
"But we are a drop in the ocean. If mental health services
want to gain more credit from users, it has to give us more say
in how things are run."
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