Leaving the battlefield

Three years ago I wrote A letter from the battlefield in response to the journalist Simon Jenkins’ criticism of therapies and therapists:“Therapists wander the scene like surgeons on a medieval battlefield, at a loss for what to do…Research is paltry. Therapies are half-hearted”.  My reply was a defence of NHS mental health workers and a plea for mental health services to be better funded.

The time has now come for me to retreat from the battlefield. This week, I will leave my job in the NHS after spending 23 of the last 26 years working in *shire.

Some readers will already know that there is a “good” reason for this departure. In September, I will be returning to Southern Africa to work as a volunteer in the children’s centre where I lived 10 years ago.

But despite this good reason for leaving, the fact remains that I am weary of the battlefield of NHS mental health provision. I am not alone in my disenchantment. I recently shared “A letter from the battlefield” with a Facebook group for psychologists who work independently. In a few days, the post had over 800 views across 23 countries and I was deluged with comments from others who felt angry, passionate and desperate about working in the NHS.

I thought I should not leave without an update.

Three years on from that last post, “Greenfields”, (a once-bustling, all-purpose mental health unit), is now scheduled for imminent closure. This is purely a cost-saving exercise. We have been relocated to “Centrepoint”: a cramped set of offices in a different part of the county. I now have a much longer commute.

Despite a lot of money being spent on refurbishing Centrepoint, most rooms are not sound-proofed, so that confidential clinical conversations can be overheard,  word for word. Eventually, managers listened to our concerns and agreed that we should just use soundproofed rooms. But there are only three such rooms in Centrepoint and so, despite being under pressure to see large numbers of clients, we can’t, because there is simply no space.

Hot-desking – especially on days when we are all present – means that we play a game of musical chairs, grabbing a seat and not budging in case someone else takes it. I get to work as early as I can, to ensure not only a parking space but also a desk, chair and computer. If I can get four out of four, it’s a successful day! Meanwhile, the Trust sends out bulletins stating that they care about our welfare and want to ensure that our “designated workstations” are individualised and set up to minimise the risks to our health (back strain, eye strain etc). Yet none of us has a “designated workstation”, so the bulletins are meaningless.

Many former Greenfields patients are unable to travel to Centrepoint. Managers agree that we still need a base near Greenfields, but they have struggled to find a suitable, cheap alternative. So while we wait for them to find another building, we have been allowed occasional access to three rooms in Greenfields. We compete with a number of other staff teams for these rooms.  The surrounding corridor is full of empty offices but we are not allowed to use them as the Trust is now only renting part of the corridor. Our patients are as mystified and annoyed as we are by all these changes, which seem unlikely to be cost-effective in the long run.

In symbolic contrast to the frenetic, cramped environment of Centrepoint, Greenfields has become a sort of mausoleum; a place of echoing corridors, haunted by the “ghosts” of former friends, colleagues and patients. My own history – my various younger selves and all the seasons of my career – are enmeshed with it.

I have become Greenfields’ unofficial historian and curator of memories. If you should want a guided tour, for any one office I could give you the names of at least three previous clinicians to whom it belonged, all of whom have moved on.

I could also show you one of the offices I use when I visit Greenfields, and ask you whether you think it is a suitable environment for the baring of your soul. It is small and stifling. A radiator pumps out costly heat day and night all through the summer; it can’t be turned off so a window is wedged open to let in some cool air. The room has been neglected since we officially moved out. Dead moths and spiders litter the window sill. Pictures have been torn from the walls and the paintwork is scuffed. Three ill-matched chairs are squashed in beside a desk and a rarely-emptied rubbish bin. The room is dark, with little natural light, so we use the harsh overhead strip light. The overgrown courtyard below is carpeted with weeds and pigeon-poo. As bad as all this sounds, I would point out to you that it is better than most rooms at Centrepoint, for at least this room is sound-proofed. I would also concede that if costs are to be cut, better to lose rooms than jobs.

I wonder what you would think if I told you how, in a neighbouring county, (which has always been better-resourced and where there is more money because of funding from a prestigious University), an award-winning Hospital building is to be built, with a superb glass atrium costing millions of pounds.

Yes, it is time for me to leave the battlefield, though whether this is for a rest or forever remains to be seen.

Time, for now, to leave the people of *shire to whatever fate Jeremy Hunt has planned for them.

Time to leave my colleagues, who remain fighting. What a pleasure and privilege it has been to work alongside you and your predecessors. How wrong Simon Jenkins was: we and our therapies were never half-hearted!

Time to leave Greenfields to the moths, spiders, pigeons and NHS accountants.

Time to take off my armour, walk away from this particular battlefield and, with a spring in my step, set off on a different path.

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6 thoughts on “Leaving the battlefield

  1. You have many skills, a great depth and width of knowledge, and a diverse array of profound experiences – these all make you useful in many other settings. That you will be able to make a wonderful contribution in South Africa is a win for you and a win for others. And that is all that matters. The ugliness of the past employment changes must be put in the back burner of your mind, so that you are free to sparkle anew with the new opportunities. How exciting for you. I do hope there is a way we can keep in touch if you close your blog. I always thought if I came to England again I would make contact – now I can think if I travel to South Africa I could make contact. Cheers and best wishes, Helen

  2. Thank you Helen! Yes, I would definitely like to stay in touch. I might start a new blog, though in the short term will be working behind the scenes on my husband’s blog about our journey to Africa. The blog – http://www.drcosinmoz.wordpress.com is aimed at his school pupils in England but I expect it will be quite amusing/interesting for adults too so do have a look! I will also continue to enjoy reading your blog and learning about Tasmania! x

  3. Helen, you write with such a descriptive and passionate style. I was moved reading your post as you could indeed be writing about my own experience of the battlefield. We too have been moved from a “greenfield” purpose built clinic for families and children to a “centrepoint” with rooms where you can hear everything next door, nowhere for families to park and hotdesking. We too receive regular emails from our CEO regarding how they care about employees stress and wellbeing which is laughable. Our centre point crams is in fighting for space. Attempts to work therapeutically with trauma and complex emotional needs are thwarted by the noise of the corridors, the risk of people walking in. The waiting room creaks under the strain as parents sit with their child waiting for a health check trying to avert their eyes from the sultry teenager with cuts to her arms in the corner. Our receptionist keeps a watch to make sure the lively or distressed child doesn’t run out of the building and into what now is a busy main road rather than the lovely piece of grass we had before where we could sit with the troubled child and encourage them to come back in. Our organisation isn’t interested in these things, they don’t even begin to try and understand. They are just interested in targets, indicators, breaching, and trying to manage the growing 200+ waiting list.
    I’m still on the battlefield, encouraged by the fabulous team I work with, yet this too is slowly dwindling away as we all become disillusioned by the way we are treated not just as professionals but as human beings.
    The NHS may as well be a private enterprise as the Trusts are being run as such. Business speak litters the meetings and we are told to think as such. Those who are running it have little expertise in actually managing a business and money is being wasted left right and centre. The greenfield site we used to occupy had new technology points put in 3 months before we left, the building is now set for demolition.
    I wish you every success in your endeavours. Your talents, knowledge and expertise will be put to great use.
    Don’t forget to turn the lights off as you leave!

    • Hi – and thank you! (By the way I am Sally not Helen, But that’s OK!) Your description sounds horrendous. There were many other things I could have mentioned, aside from buildings, and your comment reminds me of some of them. I have absolutely loved many aspects of my job so I leave with such mixed feelings. Well done for keeping on… x

  4. As one still on the battlefield, words fail me to describe how much I love this post. It’s both hideously accurate and beautifully written. Thank you for documenting the struggle so eloquently; I’ll say hello to the pigeons for you.

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