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Yes, I pretty much agree. My experience is more in so-called social care / long term support but supervision is another thing that you need 'slack resources'' for (in health and social support/care). I'm maybe a bit more sceptical about the value of professionalised psy-services (can afford to be with a nice pension from years of doing just that) but am very clear that narrow managerialist (that is to say 'dirigiste') approaches will make the situation worse. ___________________ Mark Burton Scholar Activist; Visiting Professor: Manchester Metropolitan University http://steadystatemanchester.net http://libpsy.org http://www.compsy.org.uk http://greendealmanchester.wordpress.com http://uncommontater.net 37 Chandos Rd South, Chorlton, Manchester, M21 0TH, UK Telephones: +44 (0)161 881 6887 landline +44 (0)777 594 9479 mobile skype name: markburton52 -----Original Message----- From: Jane Mitchell <[log in to unmask]> To: [log in to unmask] Sent: Sun, 04 Aug 2013 5:03 PM Subject: Re: [COMMUNITYPSYCHUK] Lean in mental health care Some useful advice here to consider. Not sure that protecting my sectional interests at the expense of labelled people was the cause of my objections to lean, (consciously anyway), but more have been concerned that the effects of it in mental health care has been to demonstrate the unimpeded flow of a labelled person into and through a system supposedly to meet their needs. In practice this appears to be to get staff seeing as many people as possible in a day, to extract information from them to put on to the time consuming electronic recording system (thus to show productivity)to indicate by ticking electronic boxes that risk has been assessed, and that they are getting supposedly the right "interventions" for their assigned cluster in line with payment by results. Not included is the consideration that staff need supportive supervision rather than performance monitoring and management to be able to contain and manage difficult feelIngs in them evoked by being in touch with the distress of labelled people, in order to be able to interact with them compassionately and view them as humans in need of compassion. Staff also need some space and time to think about these people and plan how they can be helpful, (I know of the arguments that mental Heath care is never helpful). Lean is eroding working conditions to enable the above to occur, and one of the consequences I fear is that the consequent stress experienced by staff leads them to cope by emotionally cutting off and treating labelled people as objects, annoyances, diagnoses to an even greater degree than before, or by going off sick, or at worst losing their jobs, or positions in the organisation if they object. If mental health services were bad enough to warrant justified criticism before, this just seems to make a bad situation worse. Sent from my iPad On 3 Aug 2013, at 16:09, Mark Burton <[log in to unmask]> wrote: > I think the things to emphasise in any struggle about this are, > 1) We do not endorse waste in human service systems. > 2) But our services have been subject to (annual cuts usually called something ideologically appealing such as) efficiency savings. > 3) There is positive value in having some 'slack resources' in a system - so in social care (where I've seen Lean tried) it allows adequate time for staff handovers, training, team working - and no doubt similar in mental health care. i.e. efficiency isn't necessarily a good thing. > 4) Emphasise things like co-production of interventions, support by labelled people and staff - how do you model that in Lean? > 5) Expose what this is really about - cutting people's jobs and rationalising support to a minimalist level. > 6) So be careful not to accept the terms of the imposition of this kind of managerialism and rationalisation - wherever possible define the terms of the debate - go outside the imposed framing, frame of reference. > 7) But try not to appear just defensive because then they say you are just protecting your sectional interests at the expense of the labelled people. (And you aren't are you?) > > > ___________________ > Mark Burton > Scholar Activist; > Visiting Professor: Manchester Metropolitan University > http://steadystatemanchester.net > http://libpsy.org > http://www.compsy.org.uk > http://greendealmanchester.wordpress.com > http://uncommontater.net > > 37 Chandos Rd South, Chorlton, Manchester, M21 0TH, UK > > Telephones: +44 (0)161 881 6887 landline > +44 (0)777 594 9479 mobile > skype name: markburton52 > > -----Original Message----- > From: Jane Mitchell <[log in to unmask]> > To: [log in to unmask] > Sent: Fri, 02 Aug 2013 10:15 PM > Subject: Re: [COMMUNITYPSYCHUK] Lean in mental health care > > I'd love to see an article in clinical psychology forum on this issue, again I think the absence of such writing in such a publication is significant, given the huge impact such management practices are having on all aspects of delivery of psychological services. If I wrote one under my name, I think I would be targeted though by my employer. > > Sent from my iPad > > On 2 Aug 2013, at 17:19, Penny Priest <[log in to unmask]> wrote: > >> Yes, I think the business model has trumped the medical model in healthcare for years now, although some models, like the medical model, fit more naturally with business models. >> ----- Original Message ----- >> From: Jane Mitchell >> To: [log in to unmask] >> Sent: Friday, August 02, 2013 5:12 PM >> Subject: Re: [COMMUNITYPSYCHUK] Lean in mental health care >> >> The medical director of the trust said it to service leads when the model was being introduced to the trust to which you referred. I agree with the lack of critical writing on this issue. I work as an inpatient psychologist and amusingly found myself reflecting with the consultant psychiatrist with whom I work that rather than the usual arguments between psychiatry and psychology about how to view distress, both professions now are struggling more with models of new public management of which lean is one, which tries to standardise and reduce everything to set protocols and procedures. This is coming to dominate the workplace so much now that there is little space left to have the old arguments that used to occur! Whilst critical and community thinkers continue to tackle the usual old problematic psychological and psychiatric discourses, are they ignoring or not addressing the impact of this new discourse which is becoming extremely powerful and which in it's own way may have extremely adverse effects on how those who are distressed and powerless, are viewed, constructed and treated? I wonder if the absence of such a critical and community commentary is significant in itself. >> >> Sent from my iPad >> >> On 2 Aug 2013, at 10:32, Penny Priest <[log in to unmask]> ___________________________________ There is a twitter feed: http://twitter.com/CommPsychUK (to post contact Grant [log in to unmask] To unsubscribe or to change your details on this COMMUNITYPSYCHUK list, visit the website: http://www.jiscmail.ac.uk/cgi-bin/webadmin?A0=COMMUNITYPSYCHUK ___________________________________ There is a twitter feed: http://twitter.com/CommPsychUK (to post contact Grant [log in to unmask] To unsubscribe or to change your details on this COMMUNITYPSYCHUK list, visit the website: http://www.jiscmail.ac.uk/cgi-bin/webadmin?A0=COMMUNITYPSYCHUK ___________________________________ There is a twitter feed: http://twitter.com/CommPsychUK (to post contact Grant [log in to unmask] To unsubscribe or to change your details on this COMMUNITYPSYCHUK list, visit the website: http://www.jiscmail.ac.uk/cgi-bin/webadmin?A0=COMMUNITYPSYCHUK