forgiveness

Beaten. But not broken

 

The Chattri, near Brighton

The Chattri, near Brighton

Dear Everyone

There are five stages to grief, as explained by Kubler Ross.

  • denial
  • anger
  • bargaining
  • depression
  • acceptance (sometimes called accommodation)

We do not progress through the stages in a linear fashion. Some may have to be repeated. If we are not careful, we can get stuck at any of the first four, and never fully achieve the final one, of acceptance.

Today, those of us who voted Remain are feeling some or all of the first four stages. Only a few have reached the fifth by now. Some never will.

We have a right to feel angry. The referendum was unnecessary. Some time ago, David Cameron made a promise to appease certain members of his own party. He probably never expected to have to keep it.

After the result, the only honourable thing he could do was resign. As he did so, he was trying hard to appear to have achieved acceptance. But the catch in his voice gave the game away.

And he may never achieve it. Political careers in high office almost always end in failure. But this is failure of a most awful kind. Perhaps we can be kinder if our current Prime Minister shows statesmanship over the coming weeks and begins to chart the way through unprecedented choppy waters.

The reason many voted Leave was not about immigration or perceived European bureaucracy. It was a protest vote against the greed of big business, the banking crisis which has affected poor and vulnerable people much more than those who caused it, and a political ruling class that seems dangerously out of touch.

Can we listen really carefully to those who feel this way? We need to heed their voices, as well as the cries of anguish from those who voted Remain. And listen to both groups above the triumphal clamour of the minority who believe we have “got our country back”.

It is going to be very hard. Once hatred has been unleashed, it is hard to put it back in its cage. The rise of far right politicians and alliances are real and present dangers.

The size of turnout demonstrates that when people feel their vote will count, they are more likely to use it. So maybe we have to rethink our position on our current electoral system that disenfranchises so many.

And perhaps those towards the centre or on the left politically, if indeed such definitions are even valid in this context, can stop fighting one another and think about what matters? And who our real enemies are?

In the early stages of grief, it is important not to make momentous decisions. Words or acts of anger, hatred and blame will not help us.

So let’s hold on. Let’s be kind, to ourselves and to others. We are beaten. But we are not broken.

Yours, in solidarity with the human race

 

Ten reasons we are #StrongerIn. But whatever the result, we must take care on Friday

On the eve of the EU referendum, some thoughts:

  1. In 2012, the EU was awarded the Nobel Peace Prize for promoting peace + protecting human rights
  2. Voting out is not a protest vote against big business. It’s a whimsical vote against future generations
  3. If the economy tanks, as experts predict, it will be the poor + vulnerable who will suffer
  4. We are part of Europe and part of humanity
  5. The EU is run by politicians we elect. And they appoint officials. Because bureaucracy is good for civilisation
  6. David Beckham says we are stronger in. So do Billy Bragg + Paloma Faith. And John Barnes, who was so angry about being misrepresented by Michael Gove that he phoned national newspapers and wrote this stirring piece on immigration and racism for the Guardian  
  7. Vote Leave have Boris Johnson, Nigel Farage + Michael Gove. have  
  8. Leaving the EU would cause havoc to the NHS. We would lose vital staff + face massive cuts because of recession
  9. Not all who vote Leave are racists. But all racists are voting Leave, according to . And I agree
  10. The British public are fighters. We are not quitters. We must stay in + fight to make the EU even better  

One final thought. Things have been said that are hurtful, even threatening. People have been told they are stupid, that they don’t know what they are doing. One politician has lost her life. Millions have been made to feel unwanted and unwelcome. Whatever the result on Friday, a great deal of damage has been done. It will take a long time, kindness,, compassion and forgiveness to enable us all to heal.

So let us have no triumphalism. No crowing. And no blame. And let us remember that the majority of public servants are good hardworking people. They do not gamble our pensions, live offshore in tax havens, or pay their staff below the living wage. This includes the politicians who are elected by us, the people, to make decisions on our behalves.

We live in a democracy. And that is a wonderful thing.

 

 

Please join my social media experiment

I haven’t done a blog like this before. I’m trying what I hope will be a relatively simple experiment to help me run some seminars on Thursday 3 March 2016 for the East Midlands NHS Leadership Academy.

And you can help me!

  • If you read the blog before Thursday, I would love to have your comments at the bottom of this blog to help me help the people in the seminar groups think about the use of social media in the NHS.
  • And if you read it afterwards, you can help me to think about it some more. Comments would be really welcome from seminar participants and others. Because like all of you, I am a lifelong learner.
  • I intend to use this blog as my main audio-visual aid for the seminars. It is therefore shorter than usual and presented mainly as
    • Bullet points!
  • As well as seeking your comments in bold, I will be encouraging comments and discussion from the attendees.
  • I plan to start by asking people where they are on scale of 1 – 10
    • 1 = a social media virgin
    • And 10 = social media savvy warrior
    • I am pitching the seminars and the blog towards the people who place themselves towards the lower end of this scale, but I will try to engage the more informed attendees by inviting their comments, as I am inviting yours.
  • How does that sound to you?
  • I will then introduce social media as a form of media where the control lies with the individual.
  • I will illustrate my point with a newspaper story that ran about me recently (two blogs down from this one if you haven’t heard about it) and how I was able to redress the balance myself via Twitter, Facebook and my blog.
  • Is the above example too self-indulgent, do you think? And if it is, can you think of a better one?

I will then list the different forms of social media thus:

Social media products:

  • Facebook: An early product. I use it to stay in touch with family + friends. But people use it very successfully for work, even instead of a website
  • Instagram – good for sharing photos, I am told.
  • Linked-In: For keeping in touch with people at work, finding jobs, making connections. Again an early product. I don’t like the interface. But I’ve missed some important messages from people who have tried to contact me that way, so be warned!
  • Skype: Free video calls. Can be erratic. But great for interviews or meetings with people far away. Much cheaper than video conferencing
  • Twitter: Admission time – my favourite. I love the discipline of the character limit.
  • Viber: Similar to WhatsApp. Also free calls
  • YouTube: used by President Obama, Justin Beiber and me!

  • WhatsApp: Great for staying in touch with individuals and groups. And free phone calls!

Does that sound overwhelming? Any glaring omissions? And does expressing my preferences help or hinder?

Benefits of using any/all of the above:

  • Control
  • Thrift
  • Contacts and connections
  • Equality

Things to look out for:

  • No such thing as a free lunch – you are the product for the companies providing these “free” services
  • Warning: social media can be addictive
  • Loss of privacy with some formats (see my blog On Forgiveness)
  • Trolls and other monsters (see my blog Please Take Care, Twitter can be Cruel)

Again, your thoughts please?

Blogging

  • Why do it? (see my blog called Why do you Blog?)
  • And why not do it? (hint: there are lots of good reasons)

This is where I hope we will have the richest discussion.

I’d really welcome your comments here too please.

Some NHS-inspired bloggers that I think are worth following:

  • Zoe Bojelian Wonderful mother of a brilliant boy who we will never forget
  • Annie Cooper Senior nurse + social media genius – she will be at the conference
  • Andy Cowper The most original writer on health policy I know. Also v funny
  • David Gilbert Writes in a brilliant, challenging way about patient leadership
  • Paul Jenkins Ex CE of Rethink, now runs a mental health trust. Deep thinker
  • Liz O’Riordan A breast surgeon with breast cancer. Stunning
  • Charlotte Walker A mental health patient (like me). Writes in real time. Gutty, startling insights
  • John Walsh My personal compassion guru
  • Rob Webster A brave, wise leader who shares generously

The list is of course not exhaustive, but I’d love your thoughts – who would you add?

My plan is to share this blog via the seminars, including all comments received, to stimulate discussion. And I will invite those who take longer to decide what they want to say, to add their comments after the event.

My final question to readers of the blog is this:

  • Would you find a seminar structured in this way useful?
  • And if not, and I really want your honest answers, please tell me how you would improve it.

I promise to incorporate your ideas. And I will also let you know how it goes.

Thank you very much indeed for joining my social media experiment!

 

 

 

 

 

 

 

 

A mixed week: updated Sunday 21 Feb 2016

It’s a good thing we don’t know what the future holds. Otherwise we might never get out of bed.

On Monday, the long-awaited Mental Health Taskforce Report was published. And it made grim reading. Behind the awful stories about people being let down or receiving no treatment at all is the spectre of stigma. How else can it be that government ministers have spouted forth about No Health without Mental Health and Parity of Esteem whilst at the same time services have seen real terms reductions to funding far greater than other parts of the NHS. And despite referral rates continuing to rise? The suicide rate is rising again too, even among groups not previously considered to be at high risk.

The coverage was wide and mainly pretty fair. (I say mainly; the Metro managed to annoy almost everyone on my Twitter feed with an offensive headline.) I was impressed by what Paul Farmer and all my other friends on the taskforce have achieved, and by the measured response of NHS England and the Secretary of State. But instead of feeling proud to have played my tiny part, and girding my loins for the sustained effort that will be needed to hold the government and the NHS to account, I noticed my mood gradually getting lower throughout Monday. By the evening, I was overwhelmed with sadness that it has taken so long for so many people to be heard, and that many lives have been lost along the way. And I was assailed with despondency and a sense of utter failure for what I hadn’t managed to achieve in all those years I was running mental health services and had so much opportunity and influence.

Things got worse on Tuesday. I woke to find myself the subject of an article in my local paper, the Brighton Argus, along with a massive photo of me with a long-forgotten hair colour. It said that 19 staff at Sussex Partnership, the trust I used to run, had received severance pay-outs totalling several millions in the past four years, and that I had received the largest sum, £275k, in 2014.

It was wrong in every respect. The highest payment was £27.5k not £275k. And I hadn’t received one at all. And I felt tearful and scared and powerless and all the other things I remember about being public property for the 13 years I was a chief executive.

I minded most because leaving the trust caused me great anguish. Anticipating it almost certainly led to my last serious depression. Going back to work after my breakdown for another 8 months was very hard. It mattered greatly to me that, having managed to do so, I should leave on my own terms.

A few phone calls later, I was reassured that the story had appeared because of a combination of cock-up and further cock-up. Thank you to everyone concerned for your honesty; mistakes are always forgivable when people tell the truth. By the afternoon, The Argus had removed mention of me from their website and agreed to publish a correction the following day. Which they did. And today they published a letter from me here (there may still be issues with this link if you are on a smartphone. Try Argus Letters in your preferred search engine and ask your browser to use the Argus desktop site. Or try this link directly with the trust website http://www.sussexpartnership.nhs.uk/whats-new/no-severance-package-former-chief-executive-note-lisa?platform=hootsuite)

As I left the house yesterday afternoon somewhat surreptitiously to do some local errands and keep an appointment to give blood, I wondered what people must be saying behind my back. And I was reminded what it felt like to have no place to hide.

However, the week wasn’t all bad.

I was asked to appear on Radio Surrey and Sussex this morning to talk about the stigma of mental illness as part of the BBC #InTheMind series. You can catch me, Danny Pike and the wonderful Sue Baker of Time to Change here 1hr 10 mins into the programme.

Our choir has been rehearsing for a charity concert on Saturday afternoon – details here https://twitter.com/slondonchoir/status/699507596353499136 All welcome.

Brighton and Hove Albion drew away on Tuesday night with Championship leaders Hull and are now third from top, and only one point away from an automatic promotion spot to the Premiership.

And I have at last finished the first draft of my book, which is about being a chief executive who occasionally experiences doubts and depression.

One day I hope you will read it.

Update: I spoke too soon, which after 21 years following the Seagulls, I’ve found it’s easy to do. We got stuffed 4-1 yesterday by Cardiff City. Have a feeling this season could go right to the wire, just like every other year!

But the choir concert was – well I don’t have enough superlatives. Life – affirming will do. And today I helped my lovely husband Steve, who supports me in all my endeavours, to raise money for The Tall Ships Trust, a youth development charity to which he is very committed, via a jumble sale of boat stuff. The two of us were up at 5.00 am. By 2.00pm, we had made just shy of £1,000 which will help kids from disadvantaged backgrounds to experience the joys and lessons that can be learned through sailing.

And I’ve heard from hundreds of people who’ve said kind things. Which for someone like me means more than I can possibly tell you. On Tuesday I was in the depths of despond. Today, on balance, I’m really happy to be me.

Thank you.

 

I’m sorry. No ifs and no buts.

Last night, I glanced through a well-written Guardian Healthcare piece about the distress experienced by a psychologist over the death by suicide of a patient. It touched a nerve deep in me, and I tweeted this:

Those who rush to judge mental health staff should read this honest piece. In my exp, every loss is as keenly felt
https://t.co/WGM0S2lALL

It got 15 retweets, 9 likes, some positive comments from people who work in mental health services but also a few more questioning ones from people who I would describe as experts by experience. And it was these, plus my initial reaction to the article, that have had me thinking rather hard over the past 24 hours.

I want to make some unequivocal apologies:

  1. I am sorry for my initial tweet. It is sadly not true that all such deaths are so keenly felt. Many are, but by no means all. I desperately wish they all were.

  2. I apologise to all those staff at the mental health trust I once ran who experienced the death by suicide of a patient and who didn’t get the support they needed to help them cope with such a loss or learn valuable lessons that would help them and other patients in the future. Despite my sincere wishes otherwise, I wasn’t always as consistently effective as I intended to be in this regard. I am so sorry for this.

  3. The people I was referring to who “rush to judgement” and look for people to blame after a death by suicide are NOT people who have experienced care, good or poor, or their families. In my not inconsiderable experience, such people are often the most moderate, thoughtful and compassionate towards the staff.  Those who DO rush to judgement are some, not all, of the media; some, not all, politicians; and a tiny but vociferous minority of the general public. It can nevertheless feel overwhelming to be under such an onslaught. I have experience of this. But I should have made what I tweeted clearer. I am really sorry that I didn’t,  because I upset and hurt people whose feelings matter very much to me. I may have done so inadvertently, but I was careless. And I am truly sorry.

  4. This stuff is particularly painful to me because of my own experiences many years ago when I made an attempt at suicide. What the nurse in A and E said to me, that I was selfish and a waste of space and keeping him away from patients who were really ill, had a deep and lasting impact. It took many years before I confronted my shameful secret and quite a few more before I came to accept that he had been wrong. So I am especially sorry that my tweet wasn’t well-constructed. Of all people, I should know better.

  5. It was after I returned to work in 2014 after my worst-ever depressive breakdown that I fully confronted the reality that staff who work in mental health are not all as compassionate as we might hope. There are many wonderful people, but there is still some downright cruelty, some poor attitudes and practices and some not inconsiderable compassion fatigue. I have written about this and my contribution to changing things here and about how challenging it is here. Today, we had a really good, honest project working group meeting, which I chair. This is extraordinarily difficult stuff. It cuts to the heart of things that matter deeply to me and to all the others around the table. So I am especially sorry about my tweet. As a writer, I should be more precise and thoughtful. As a chair, I have responsibilities. As a human, I should have taken more care.

I thought about just deleting the tweet. But that won’t make what happened go away. An unequivocal apology seems a better response. That, plus continuing the work with Time to Change to tackle what we know from countless surveys to be true, that stigma and discrimination are still alive and kicking within mental health services. And if we allow ourselves or anyone else to go la-la-la-la-We’re-not-listening, we, indeed I, are/am complicit in letting it continue.

You will be hearing more on this from me and others in due course. Our work will, I hope, feature in the upcoming Mental Health Taskforce report and in the future work plans for Time to Change.

The death of anyone by suicide casts a long and painful shadow. It is right and to be expected that staff should feel distressed. But they also need compassionate support so they are able, eventually, to carry on being compassionate themselves. And the ones who can’t be compassionate need to be helped to find something else to do.

One of my big lessons in life has been that I can’t be truly compassionate towards others if I am not compassionate towards myself. This means forgiving myself for making mistakes. I hope the people who I carelessly hurt by my tweet will forgive me too. Eventually.

PS In fact, within a couple of hours of posting this I had heard from all those mentioned. I feel deeply blessed to know such kind and forgiving people :):):)

Don’t be mean*

In my blog last week, I mentioned that my next one might be contentious. This is it.

Tonight, Health Service Journal (HSJ) have announced their inaugural list of Patient Leaders.

I am stunned to be on it. Plus a little bit anxious and also prouder than I have felt for a long time. Here’s why.

I’ve been on a few lists in my time. I remember the first one of influential women in the NHS. Some of us got a bit of stick for that, as did HSJ – “What about the influential men?” came the cry. Take a look at the top of the NHS, and you will see why there is a need for a list with just women on it. Even more so for Black and Minority Ethnic NHS leaders. Hats off to @NHS_Dean who has been open about changing his mind recently regarding quotas on Boards. It’s not too late to join him.

There are many other reasons why such lists can cause controversy. One is that they seem to include all the obvious people, who have reached positions of influence “just” by the nature of their jobs. Who have apparently been in the right place at the right time. Whose mistakes haven’t yet caught up with them. Or who are lucky enough to have a face that “fits”.

I’ve been there and even made such remarks. And I know that, although doing so might have made me feel better about not being on some list or another myself, it also introduced a tiny chip of meanness into my heart which I then had to work very hard to eradicate. Or it risked undermining me and any future good I might bring to bear.

To the people who are feeling mean about this latest list, I say this. Yes, some of the names on it may seem obvious to you. But only they know the personal cost of being there. And yes, there may be some, me included, who are relatively late entrants to the patient leadership world. But that doesn’t make them, even me, unworthy, nor does it in any way diminish the extraordinary contribution of those who have been doing this labour of love for much longer than the rest of us.

Being a member of an exclusive, perhaps even excluded club may feel good, especially one whose purpose has been to act as a ginger group. But patient leaders are doing work that is too important to remain on the outside looking in. One day, and I don’t think it will be all that long, we will see experts by experience appointed into paid leadership roles right across the NHS and care system, as a matter of course. We must of course protect their independence. But we must also stop seeing them as an optional, expensive, fortunate and patronised extra.

There is nothing I did throughout my 41 year NHS career that was harder than sharing my own experiences of mental illness, facing up to going back to work after my last episode of depression, and then retiring, I hope with dignity, to forge a new career as a writer and mental health campaigner. I know it will have been equally hard for others to have followed their personal, not always chosen, path.

So let us warmly thank EVERY patient and carer leader for the courage, wisdom, creativity and generosity they bring to improve our less than perfect, still beautiful, deeply precious NHS. And to all those on tonight’s list, here’s to you. I feel humbled to have joined your extraordinary ranks.

*With thanks to the extraordinary Kate Bornstein, whose philosophy on life is “Do whatever it takes to make your life more worth living. Just don’t be mean.”

 

It could be you

I’ve had a mixed week. Yesterday I was in Leeds with people who mainly work in the local NHS, voluntary sector and local authorities and share an interest in helping vulnerable people. The conference was called #puttingPeoplefirst. It was enlightening and uplifting. I observed a groundswell of support for a different way of being at work, where people bring their whole and unique selves to bear on issues that matter, where failure is seen as an opportunity for learning rather than a weakness to be vilified,  and where treating patients/clients/service users with deep and real compassion is underpinned by working with love and compassion with one another.

Sounds a bit wooly and Buddhist for you? Then listen up. There is an increasing body of evidence that staff, from cleaners to chief executives, who are encouraged to operate with integrity and openness provide better, safer, kinder care. And this stuff isn’t new. Thank you @jackielynton for reminding us of our old friend Donabedian, who wrote wisely about improving quality before anyone else had thought of it, and said that it started with love.

If you don’t already follow @johnwalsh88 on Twitter or read his Yes To Life blog, and you like the sound of the conference, I’d encourage you to do so. I cannot thank John enough for inviting me. Or to the other organisers and speakers and to everyone there who was so honest and kind, including when they challenged one another.

Meanwhile, in another part of the forest,  a senior public servant has selflessly stepped down from a job they openly loved despite having done absolutely nothing whatsoever wrong, and indeed a considerable amount right, in order to meet the political ends of people who appear simply to be throwing their weight about. And is being vilified online for it. What does that say to the thousands this person leads? Are they at similar expedient risk?

And in yet another part of the forest (I do like that saying, please tell me if I overuse it) senior people who should know better have been talking about “Never Events” as if by giving something a threatening – sounding name, it will stop it from happening. Actually, what it does is make staff very, very scared. And scared people are less creative and more likely to cover bad things up and to go off sick with stress. Or worse, come to work when they aren’t psychologically fit enough to care for themselves, never mind others.

Here’s a precis of what I said at the conference about authentic leadership:

  1. Bad things happen. Good leaders look after their people at such times. We live in a blame culture so this is very, very hard.
  2. The more rules and procedures you impose, the less creative and compassionate your people will become. Resisting the external demands to introduce even more is also very hard.
  3. We performance manage and inspect individual organisations at the expense of the good of the collective system, and the patients who struggle across the bits of the system. Moving to a more collective approach is a goal we could all agree on. But what about accountability, comes the cry. Or, who would we blame when things go wrong?
  4. There is a leader in all of us, whether we are a patient or family member, work on reception or sit at the board room table. Work hard, if needs be against the grain, to be defined by what you do best, not by what scares you most.
  5. Bring all of you to what you do. It took me far too long to learn that being all of me, including the bits I was less proud of, even ashamed of, made me a more authentic leader. Don’t try to hide your imperfections like I did. It’s an added burden when things are hard enough already.
  6. Many people are privately saying that everything now isn’t right, and some things intended to improve care are actually conspiring to make it less compassionate and safe. If you agree, find the courage to speak truth to power, which is what I am trying to do in this blog.

If you are in a leadership role and you see a colleague who is having a tough time, please don’t metaphorically cross to the other side of the road as though they had some toxic disease you might catch. And please don’t believe the shit you read online or even join in the anonymous bear – baiting that passes for acceptable comment these days. Instead, offer them your genuine support.

Because you never know, one day, it could be you.