Young people’s mental health care: Déjà vu, again

Last week was all about a heightened sense of déjà vu. For example, I don’t normally go to Stockport NHS FT on a Friday, but as I was chairing an interview panel for consultant anaesthetists, I swapped my days. Having got up and done the chores, I was on the road by 5.45. It was a lovely morning and as it was the school holidays, I knew that traffic would be light. Driving down the M55 I saw a plume of black smoke in the distance. I wondered what it was but didn’t think anything of it. Coming onto the M6 the gantries lit up, telling drivers to slow down as there was a vehicle on fire up ahead.

Shortly after, the traffic stopped. Half a dozen fire engines went past me and many more police cars plus a couple of ambulances. Things looked very serious. After 90 mins stationary, I found a website that showed the motorway cameras closest to the scene of the accident. I could see it was an articulated lorry that was on fire and I might well be sitting going nowhere for some time. I had a real sense of déjà vu. The same thing happened to me the previous Thursday on my way to work. On that occasion it took 90 mins to get through the accident. Last Friday it was nearly 3 hours.

However, I did get to do the interviews, and we were able to offer two candidates a consultant role. So, I was in a great mood driving home. There was the weekend to look forward to, and although I have little interest in football, I’m very much looking forward to the Lionesses’ final later on today. I have also been sampling my wine collection, a collection that goes back 30 or so years, on the basis that if I don’t start drinking it now, I may never do. I had selected a 12 year old Beaujolais for my Friday evening drink and was looking forward to a glass or two. However, the pleasure was to be delayed. As I joined the M6 for the second time that day, I joined a queue that stretched as far as I could see.

I waited and waited. Three ambulances went past me on the hard shoulder. Frustratingly I couldn’t find anything on social media to tell me what was going on. Equally frustrating was the knowledge I was only just a couple of miles away from the M55 junction which would take me home. Some 2 hours passed before I was able to start moving once more, and my whole journey took over three hours, twice as long as normal. I can’t tell you how good that first glass of Beaujolais tasted!

What wasn’t so good was hearing our new Secretary of State for Health and Social Care suggesting that the solution to the current problem of ambulance waiting times and flow in our acute hospitals was to hold a ‘hackathon’. Thanks to the Heath Service Journal for the heads up. We did hackathons, sandpits and all kinds of similar stuff when I was working at the university. They were sometimes successful, but often not. They were fun of course, and very occasionally a great idea emerged. Is this the way to solve the problems with the UK social care crisis? I don’t think so.  

And the fact that the idea came from someone who, in the recent past, has argued that nurses don’t need university degrees and actually we could train our nurses in two years not three, just adds insult to injury. This nonsense illustrates, perhaps, that right now, UK politics is in a very bad place. I have been writing about the ‘being’ and ‘doing’ of nursing for many years now. Yes, you can possibly train someone to do nursing in two years, (just as we have seen with some social work and teachers’ degree programmes), but that doesn’t mean they will be able to be a nurse after that time.

I’m with my favourite educational influencer, Paulo Freire, who so eloquently talks about the notion of praxis. Knowing how to do the job (the ‘doing’) is not the same as turning theory, knowledge, and skill into something that is enacted, embodied or realised (the ‘being’) into professional practice. And in so doing, making a positive difference to the lives of others. It was in thinking about this notion of praxis and the translation of theory into practice that I had another déjà vu moment last week. The headline that professed an approach based upon 'relentless love' caught my eye. It was a story about a group, called Oasis Restore, who were claiming to open the first school for young offenders. You can read their story here.

Now then, I thought, where have I seen that before? What brought me to Manchester all those years ago was an advertisement that promised an opportunity to ‘go where no RMN has gone before’. It was an advertisement that sought to find mental health nurses to work in the first secure forensic mental health service in the NHS for young people. The service was housed in a purpose-built secure unit set in in the grounds of what was once called Prestwich Hospital, now part of Greater Manchester Mental Health NHS FT. Today they are one of six such services across England. It had a school. Teachers, headmaster, classrooms and all. The young people had to attend it Monday to Friday. It was staffed, as was the whole service, by colleagues who universally practised ‘unconditional positive regard’ with the young people and colleagues too – I don’t know if this is the same as ‘relentless love’.

Actually, I don’t care. What I do care about is that someone is doing something positive to protect and nurture our young people’s mental health and wellbeing. Oasis Restore is part of the wonderful Oasis Charitable Trust and they are working with the Commission for Young Lives, who believe that every child and young person should be given the support, help and positive reinforcement to enable them to succeed and live their best life possible. It will cost money of course to realise their ambitions, but what an investment!