Choice and compulsion

Mental Health Nursing,  May 2000  by Faulkner, Alison

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Alison Faulkner, programme manager, Strategies for Living programme at the Mental Health Foundation spells out some hard choices over 'compliance'

Recently, the Mental Health Foundation published the report Strategies for Living. a report of user-led research into people's strategies for living with mental distress. This report takes a very different view of living with mental distress in the community, a view based on the potential for selfdetermination and respect for individual choice. The report was based on 71 interviews with people living in the community and experiencing mental health problems. The aim, as with the whole project, was to document and disseminate people's strategies for living with mental distress and promote a holistic approach towards mental health - an approach, it would seem, that is at odds with current policy

The research found that relationships with others are central to most people's survival strategies. For some, it was individuals, family or friends, while for others it meant the company of people encountered through local day centres or self-help groups. Yet for others, the important people in their lives were mental health professionals: counsellors or CPNs, support workers or social workers.

The key principle underlying this report, and the Strategies for Living project overall, is the element of individual choice and selfmanagement. The experience of service users is often overlooked or dismissed. How, in this climate of increased compulsion, do we engage in a dialogue about creating responsive services and reducing discrimination?

Copyright Community Psychiatric Nurses Association May 2000
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