Discussions with a Project Lead – Slotting In

Slotting In.

Why is it so difficult for people in services to get their heads around the trauma of discharge? If what they are searching for is a sense of belonging underlying the issues they present with then a service not set up to foster a sense of belonging is not going to work successfully. The criticism is that families remain dependent. Families would say they don’t want to be dependent, they want to belong. There is a difference. Belonging doesn’t mean being tied to the services pin straps, “Helen hasn’t been in for nearly a year but she hasn’t been discharged. She telephones if she has an issue and because we know each other we can tackle the issue together. We get straight to the point with a purposeful one to one. No referral form necessary. Yes, families come back for help but they still have their children at home. Once children are removed, implications for resources become catastrophic”.

How can you be expected to build a relationship and come to understand each other if it’s already geared up for termination? The person will know that you’re not truly present and not connected to them. Professionals don’t like words such as ‘relationship’ or ‘connection’. They don’t want to be connected to what they see. You can watch professionals trying to hide their own disgust. They become immobile and take on the appearance of someone who has found themselves in the wrong room. They subtly, without the individual knowing, try and find the room that they should be in. And it doesn’t work. The quieter they try to do it, the louder it becomes. They can’t get past their own history and history is never quiet. Just because it isn’t spoken doesn’t mean it isn’t heard. People create systems for this reason until the systems become fluent enough to manage their own anomalies. Rules are issued. Specialised people are brought in to root out values. Values are for walls, front doors and funders. They’re not for the people who desperately need the service. Organisations don’t want you to belong. They want you for your vital statistics. They want you when the humans come to look at the animals in the zoo. Questionnaires, scales of one to ten. Ticks in boxes and tallied at the bottom. Tables consulted. You are this, you are that. People will look for a diagnosis and willingly take anything. It’s what they want and services give it to them. Then they can go out into the world and say,” I am this”. And the world says,” so what, it’s meaningless”. If you’re set up to only look for the symptoms then that is all you will treat. And they will be back because the central issue hasn’t been addressed. Belonging is clouded by issues in orbit. Services target the issues and not the belonging.

Slotting in allows the family” to carve their own niche; creating their own unique space within the service where they and we fit to each other.” Slotting in is no barrier to independence. In fact it grows dependency to independence and can solve the generational problem of dependency on services in the long term. “Discharge isn’t relevant to families here. It’s a paper exercise really. It’s easier to not have them because they’re pointless. It doesn’t enter their mind that they can’t come in. In other services there would be that barrier.”

A lot of parents have done Adult Attachment Interviews so there is a shared understanding already in place. The whole story is told through one tool of assessment so it is unnecessary to keep repeating the same story. Services get stories in fragments but the “translation of the AAI into every aspect of someone’s life is fundamental. It saves the bigger problems from happening,” for example:

Helen→Doctors→Medication→Self- Harm→Mental Health→Crisis Centre→Schools→Police

What is the impact on someone knowing that they can simply ring up or walk in to Love Barrow Families? “We didn’t know the sense of belonging would be such a massive issue. I started as a social worker in an office and going out to families. I didn’t know that people wanted to belong but that is what they said”. Families are reassured not just by the relationship but by the place also. “One child told me he just wants us to be here. He doesn’t need us to do more because his mum is okay. Children know that we help their families because we talk about it and treat the family as whole and not as individual parts. Professionals usurp the parent(s) to help the kids; they like to do that thing- work-sheet, drawings etc when it’s not the issue”. Being able to slot in becomes bigger than the service. It links into the neighbourhood and community and removes people from the hamster wheel. People may present with an issue but they won’t be presenting with the same issues each time they come in. Speaking to a solicitor recently he said he sees “the same people presenting themselves again and again with the same issues again and again. But what can he do”?

What can we do? Maybe start to grasp the psychological impact of being discharged and how it is approached. One service user was discharged via a computer screen. The doctor spoke facing the computer. The words were bounced off the computer screen to the individual who was sat behind the doctor. The system makes the decision and not the individual but the system won’t understand the experience of discharge. The experience has to go somewhere and if it hasn’t been captured sufficiently it’s easier to go back into familiar territory, familiar behaviour. ” Families will keep popping up. Possibly okay for a year or two at best”. Maybe services don’t see that as an issue, think short-term for the short-term statistic to get the short-term result published. Either way, on the ground families are not moving on. ”The idea of services moving people on so that they’re not taking up the space and resources from other families hasn’t materialised. Love Barrow Families had in mind the same families that keep popping up and it was better we captured them rather than other services”. These are families that live in gaps and ‘gap living’ is the definition of suffering and is progressive.