When I was asked a few months ago to chair a conference on personality disorder and doing an opening talk, I thought it might be worth doing - and agreed. The first draft of the programme they sent me looked quite interesting - not the normal decontextualised and competitive datafest - and I had a few email conversations with a person I didn't know, called Romy, to bring a bit more of a policy / systems / 'relational' angle to it. It was being run by a commercial conference company called Forums and Events, who were a new outfit to me. With the venue overlooking Lord's cricket ground, and its expensive delegate fee, my expectation was that it would be fairly low key and probably mostly appeal to people in grey suits from private hospital groups, who were wanting to set up slick and profitable PD services for their shareholders. In a way, although that's not a milieu that I enjoy, I didn't mind the idea too much - as my intention for the conference was to show that a purely evidence-based and commercial approach misses more than half the point. And maybe the faceless corporates would start to understand that...
But, in fact, I was altogether wrong - and the delegates included a wide range of people from all sorts of organisations, professions and sectors. I counted about 90 of them, including an actor who introduced herself to me afterwards, to wonder how a highly articulate and intelligent friend of hers - who had been badly let down by the NHS system - could 'help the cause'.
But even more than the mixed, enthusiastic and appreciative audience, the almost randomly thrown-together speaker list - with five half hour presentations in the morning and another five in the afternoon - worked like a dream. The morning started with a short explanation of my usual 20-year project timeline for 'PD World' - ending with an exhortation that 'the golden thread' to make it all hang together is 'relational practice'. Here's the prezi: https://tinyurl.com/DanubiusPD. The rest of the morning included four presentations, and discussion slots, all of which made different cases for relational ways of thinking and working. The high point for me was when somebody, during the final discussion panel, so powerfully said "this isn't really just about PD, is it"...
The afternoon - chaired by a good friend and former warden of the PD movement, Conor Duggan - was similarly collaborative and inspiring. I chatted to the person next to me at tea time - and was surprised by how unreservedly positive they were about the whole experience. But this is what normal conferences (in the PD and TC and EE worlds) are like - though they were expecting it to be more like a 'boring old psychiatry one', as they were used to.
The most interesting bit of discussion - which might be a bit arcane for those who don't know the history of people and problems involved - was how the newly appointed commissioner for the NHSE specialist 'Severe Tier 4 PD services', Sarah Skett, is determined to get things done differently. She will be working with Steve Pearce (clinical chair of the reference group) who seems to have been banging his head against a brick wall for several years now. Under her commissioning of NHS England's half of the Offender PD Pathway, following Nick Benefield's diversion of the DSPD funding in that direction, great things have already happened in the criminal justice sector. The recognition of the importance of relational practice - and the underlying principles and values from Enabling Environments - has made over 200 prison and probation units less violent, with prison officers finding meaning in their work and prisoners being recognised as human. They have set up effective and progressive pathways, with research backing, that are lauded by Michael Storr, the head of English Prisons and Probation. Now that Sarah has the brief to look at non-forensic severe PD services which are commissioned in the NHS, let's hope that we can expect to see a similar light-bulb moment in those policy circles. She will have plenty of support from those who have been trying to do the same, with varying levels of learned helplessness, in our various fortresses of locally industrialised and walled-off health services. It could even fit very well with the aspirations for STPs, ACSs and the 5YFV - if we could get rid of the almost meaningless six-tier system.
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