Developing Community Mental Health in South London: Are We on the Same Page?   

Last week, Social Interest Group participated in South London and Maudsley Foundation Trust’s (SLaM) workshop for Lewisham Community Mental Health Development. With over 70 people present, we heard from Sir Norman Lamb the chair of the trust, as well as other directors about their vision for delivery of mental health support in community settings, and their understanding of the importance of addressing the fact that black people are disproportionally represented on acute mental health wards.

Many people contributing to the workshop had lived experience, many more were carers and we were able to hear from them about the impact of racial prejudice on them and their loved ones at their most vulnerable times, sometimes at the hands of those trusted to help them in institutional settings.

We were privileged to hear from Ajibola Lewis, whose son, Seni, was fatally restrained by 11 officers at a psychiatric hospital in South London. Ajibola spoke of the betrayal in trust that her son’s death exemplifies and the incomprehensible hurt caused. It was Ajibola’s courage in campaigning for change that resulted in Seni’s Law (Mental Health Units (Use of Force) Act 2018) being enacted to end the use of excessive force against mental health patients.

Another carer and advocate, Karen, spoke of her experience of being judged as an angry, demanding and difficult black woman and how confusing it is trying to understand why, when she has tried to respectfully advocate for her son, she is faced with a wall of indifference, and accusation.

A particular word that Karen used to describe the way she has been made to feel as a result of the belittling treatment she has received as a carer, is an irritant. Words of accusation can become markers of shame that we accept as part of our identity and when we discuss stigma, it is important we address the disfiguring effect of prejudice and racism.

Another term that stands out from the workshop and featured in its title, is community. Used frequently as a key point of discussion by both SLaM professionals, and those who have lived experience, there was some dissonance between the two groups. This was exemplified by the community speaking of how well supported they were by a one stop community hub, that was closed down because the commissioning body could not see the value for it and withdrew funding. Ideas about what community service provision is, are culturally informed and any measurement metrics for value, must reflect the values of the specific community being served.

As diverse communities share what community means to us and how its structure supports our view of ourselves and society, we need to ensure that statutory mental health providers who design and commission service provision and funding, facilitate services that reflect the integrated and inclusive understanding of community that Global Majority people share.

We are looking forward to continuing our contribution to community mental health provision dialogue as SLaM develops culturally appropriate methods of engagement with community networks and providers. The outcome we hope this facilitates is authentic co-production for culturally informed service design.