The SKELLERN LECTURE, Dr Julie Repper - The changing agenda in mental health: an opportunity we can not afford to miss

Introduced by Gary Winship.

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Julie Repper comes from a new generation of MHN graduates that were trained in the after glow of Skellern's influence at the Maudsley in London.  In many ways Julie's work on advocacy, voice and formal user involvement is a derivative of Eileen's vision for truly patient centred mental health nursing which emphasised the ultimate importance of relationship based approach to MHN practice.

Mental health nurses have taken a lead role in this change using a conceptual framework of Recovery and Inclusion, building on hope-inspiring relationships.  Over the past 15 years Julie has developed a programme of research (funded through local Health and Social Care Trusts, Regional Health Authority, National DoH and Charitable Trust Research Grants to a total of £1.4m) examining the experiences of people using mental health services and living with mental health problems.  This has revealed some of the unintended effects of mental health policy on marginalized groups (eg the insensitivity of national guidelines to minority and excluded groups (2006-7); the exclusion of informal carers (2003-2007); rejection of the most disturbed referrals to community care services (1989-96), marginalisation of women in services dominated by men (1990-1996); problems in the widespread implementation of evidence generated in 'model' programmes (1996-2000; 2004-6); the neglect of unpopular patients in acute settings (1997-1999), the exclusion of Gypsies and Travellers by mainstream services (2000-2003) and the extent of mental health problems in prisoners (2004-7).  These studies have increasingly reflected the priorities expressed by service users and latterly have involved them equally as researchers.  This has led to further studies into the process and impact of user involvement in training and research (2004-2006).  Drawing on this research along with clinical work and her personal experience of mental health problems Julie has co-written 3 books that have developed models for practice.  She has co-edited a further two books examining the implementation of mental health policy, contributed over 30 chapters to edited texts and published more than 100 papers in peer reviewed journals".     

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Lecture Synopsis: For the first time in the history of mental health services, service users' views   are reflected in government policy , backed by research evidence  and clearly supported in the 2006 CNO Review of Mental Health Nursing  to herald an unprecedented structural and cultural shift in the values, vision and overarching philosophy of what we do .  Mental Health services are shifting away from an altruistic 'get what you are given and be grateful' culture  to one based on 'customer service', rights and citizenship.  A culture in which the concerns and convenience of those who use services are paramount; where a guiding vision of helping people to make the most of their lives replaces a narrow focus on symptom reduction; where strengths and possibilities take precedence over deficits and dysfunctions; where fostering opportunity is paramount; and where helping people to take control over their own lives replaces professional prescriptions of what is good for them .  Mental health nurses can lead this change.  We have a conceptual framework of Recovery and Inclusion for understanding people's experiences  and we can use this to do more of what we are good at: building the hope-inspiring relationships that people need to rebuild their lives and travelling alongside them on their journey of recovery. We now need to focus on further developing our skills so that we really do enable people to access the opportunities, relationships and roles that they value .  In this paper, I will discuss the fusion of policy and research with the expertise of personal experience and consider the profound implications and unprecedented opportunities that this presents for mental health nurses.

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JPMHN Lifetime Achievement Award

Professor Phil Barker

Introduced by Dr Liam Clarke 

Professor Barker received the Inaugural Lifetime Achievement Award, sponsored by Wiley-Blackwell.  "Phil is the shining star and public face (or beard) of Mental Health Nursing".  In his address Phil listed his personal influences (family and teachers) and then his intellectual mentors including: Harry Stack Sullivan, RD Laing, Hildegard Peplau, Loren Mosher, Viktor Frankl, Shoma Morita and Thomas Szaz whom Phil described as the philosopher of psychiatry of the twentieth and twenty first century.  Phil was critical of the emphasis in the user movement whereby only some people are seen as experts; "We are all experts by experience" he contends. 

 

He finally recommended: "Being by doing, Being remembered, Being who" and added that he you are more likely to be remembered if you always wear the same outfit (in his case red clogs and a black suit: the Johhny Cash of MHN according to Liam Clarke).  Phil finished with 2 Quotes from Samuel Beckett which he thought embodied the challenge of working with great suffering (and even therapists must suffer too he said):  "Ever tried. Ever failed. No matter. Try again. Fail better" and "Where I am, I don't know, I'll never know, in the silence you don't know, you must go on, I can't go on, I'll go on."

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Prof Phil Barker - is a psychotherapist in private practice, Visiting Professor at Trinity College Dublin and Honorary Professor in the Medical School, University of Dundee. He was the UK's first Professor of Psychiatric Nursing Practice at the Medical School, University of Newcastle England from 1993-2002 and previously was the Director of Studies at the Department of Psychiatry, University of Dundee.  He has published 18 books, over fifty book chapters, over 250 academic and professional papers and articles and has delivered more than 300 conference addresses and countless workshops in Europe, Australasia, North America and the UK.  He was elected a Fellow of the Royal College of Nursing in 1995 and was awarded the Red Gate Award for Distinguished Professors at the University of Tokyo in 2000. He was awarded an honorary Doctor of the University at Oxford Brookes University in 2001 and has been Visiting Professor at several international universities including Barcelona, Tokyo, Auckland, Adelaide and Sydney. He has devoted his whole career to the psychiatric field, becoming one of the first Clinical Nurse Specialists (1981) and one of the first Clinical Nurse Consultants (1986). He maintained a clinical role throughout his nursing career, believing that his research and educational responsibilities needed to be integrated with ongoing involvement in the development and delivery of care.  Although now officially retired from nursing, he remains committed to the development of mental health nursing, through his involvement in a wide range of projects in the UK, Ireland and internationally.