Blog: What happens when people in crisis are met by someone who has been there too?
Our Projects Coordinator Catriona McDougall reflects on learning from a recent event exploring peer leadership and relational approaches to safety in Scotland’s mental health system.
I recently joined the Personalised Risk Management Learning Collaborative to explore how peer leadership and peer practice can strengthen relational approaches to safety and clinical support for people experiencing suicidality and self-harm.
Leaders, practitioners, and people with lived and living experience from across Scotland’s suicide prevention and mental health system came together for a session built around a simple structure: hear practice → reflect on implications → explore application → identify action.
Reflections from the day
Transforming Scotland’s mental health system requires change across many fronts. Sessions like this offer an encouraging glimpse of what that change can look like. It’s a chance to see how Scotland’s NHS Boards are taking real steps to tap into lived and living experience and embed peer support for people and their close circle while they are in crisis.
The room was filled with a sense of what’s possible. Professor Christine Goodall, Director and Founder of Medics against Violence, spoke about Navigators in Emergency Departments. Roles that provide support, hope, connection, and a path forward for people in crisis, while also addressing a broader spectrum of social and health-related issues.
We connected people across Scottish policy, practice, and lived experience with learning from three individual perspectives on developing and implementing personalised risk formulation within NHS mental health services in England. Each speaker contributed in an individual capacity, drawing on their own experience and expertise.
Claire Williams, Consultant Clinical Psychologist NHS Ayrshire & Arran, reflected on her experience of developing and embedding the approach across adult mental health services, including the clinical and organisational work required to sustain it. Adam Digby, Specialist Consultant in Mental Health & Systemic Practitioner, shared his experience of mobilising, delivering and adapting the approach across a large CAMHS service within a wider NHS trust, including working across the complex systems surrounding children and young people.
Nadia Ahmed, Lived Experience Strategy and Co-production Specialist, while hosting and presenting, weaved in her lived and living experience and professional experience of co-production across adult and children and young people’s mental health services. She reflected on how lived experience shaped the work from its early design and co-delivery through to large-scale implementation.
Some of the key takeaways from their presentation were the value and impact of embedding peer leadership expertise from the very beginning of the work, and the importance of making co-delivery of personalised risk formulation training by a clinician and a lived and living experience expert a mandatory requirement.
Discussions were open, and people showed a genuine willingness to explore different approaches and engage with people with lived and living experience. There was an honest acknowledgement that the development and spread of personalised risk management in Scotland is important for both people accessing services and clinicians. And while that understanding is shared, it doesn’t necessarily mean change will be welcome or easy.
Hopes for the future
With greater understanding and recognition of the value of peer support, we can see a shift in attitudes and culture across our mental health system. Already in the room, clinicians, policy makers, and people with lived and living experience were recognising that peer support isn’t ”a nice to have”, it’s a must. That it needs proper, relevant remuneration, training, development, and career opportunities for peer workers in services.
Consistent, quality involvement of lived and living experience in decision making, service design, and delivery can change practice, as the presentation on implementing risk formulation large-scale in NHS England demonstrated. People in the room moved from reflecting on what had been achieved in London to asking how it could be replicated in Scotland. Making sure that our strategic intention and policies are aligned to support sustainable changes in day-to-day practice.
With support and commitment, it is possible to establish peer worker and lived and living experience roles across bands within Scottish NHS services and teams. But the greater outcome is achieving a mental health system in Scotland that meets the needs of our communities and the people who are most vulnerable.
The way forward
Events like this show that the appetite for change is real and growing. The question now isn’t whether peer support and lived and living experience belong in our mental health system, it’s how quickly we can embed them properly, with the investment, training, and career pathways they deserve.
We’ll continue to work alongside partners across Scotland to turn the energy in that room into lasting change.
– Catriona
