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Peer support and activism: radical roots & radical futures - NSUN Members' Event 2023

Join us for a panel discussion about how peer support has and can continue to challenge hierarchical models of “care”, and the relationship between peer support and activism. Panelists will discuss their experiences of what changes when people have the resources and support to care for each other. We’ll also discuss how we can preserve peer support’s radical potential against co-option, and how peer support can work in activist and change-making spaces. We are joined by Marc Thompson (The Love Tank CIC), Lisa Archibald (Intentional Peer Support) and Anandi Ramamurthy (CHARM).

NSUN

3 months ago

Hi everyone welcome to our first panel for the  National Survivor User Network's Members' Event this year which is about the radical roots and  radical futures of peer support so we're going to be discussing peer support's relationship  to activism and change making and exploring what happens when people are given the tools  and the resources to take care of each other. We'll be hearing from our panellists and we'll  have an opportunity at the end for questions from the audience. So my name is R
uairi, I'm the  Communities and Grants Manager at NSUN, I use he and they pronouns, I'm tuning in from Tottenham  today. My work at NSUN involves supporting our member organisations to carry out their work and  build alternative models of care and connection. Outside of NSUN I've also run peer support groups  and been involved in organizing around a variety of issues from Reproductive Rights to resisting  police brutality. I'll be one of the chairs today along with my colleague Alaina, I'll pass
over to  you Alaina. Hi everyone my name is Alaina I'm the Communities and Grants Coordinator at NSUN and  my pronouns are she and her. Similarly to Ruairi my work revolves around working with member  and hosted project organizations to support the delivery of their work. Outside of NSUN I  have been a part of grassroots groups applying for funding for Community projects and also for  my history degree I explored the importance of peer support in anti-carceral organising against  the American p
rison system so I'm really looking forward to today's panel discussion. I'll  now pass on to our panellists to introduce themselves. Lisa we'll start with you if that's  okay and then if you could volunteer the next person to introduce themselves that would  be great. Thank you so I'm Lisa Archibald, I'm in Scotland, I've been in peer support  for a long time since the late 90s so mostly in Grassroots communities and in Scotland as  well as overseas in New Zealand and Australia, and in the past
10 years I've been a trainer and  a co-director now of intentional peer support. I've just completed the Mad Studies postgraduate  certificate as well so I'll mention that because I probably have some opinions on that side of  things too. Marc do you want to go in next? Thank you good morning everybody so my name is Marc  Thompson I'm here in London today, very chilly London. I'm currently the Co-director of the love  tank which is a not for-profit Community Interest Company that works to addres
s Health inequalities  in the most marginalized communities. I've been involved in different forms of peer support  formal and informal since my own diagnosis of HIV 37 years ago so I've been involved in developing  and implementing but also receiving peer support myself and it's really lovely to be here today,  and I nominate Anandi. Hi I'm Anandi Ramamurthy, I'm in Manchester at the moment I live here, I  helped to found an organization in Manchester called Charm Communities for holistic acces
sible  rights based mental health so that we could raise questions and campaign for better systems and  also to give ourselves support, and that's both people that are holders, carers for people in  distress as well as experiences of altered states. Thanks so much everyone. All right so I guess  we can get stuck into the first question for the panel discussion, which is what does peer  support mean to you and has this changed over time? I guess I'll pick on someone so we don't  have the awkward
waiting for someone to unmute. Marc do you want to start us off? Yes sure  well first of all I mean peer support is really important to me and it means first of all  on a really individual level the opportunity to connect with people who have a similar experience  to me and that may be to do with my sexuality, my identity, or my ethnicity but more importantly  my experience has been around my health condition and it's been really important because it's made  me feel connected on a really persona
l level, less isolated but then has also provided  me with tools, information and education to manage my condition which has then led me  to having better health outcomes directly, has made me feel less isolated, and has  also motivated me in many ways to then pay that forward. I think it's changed for me over  the years as I have got older and obviously my personal needs have changed and I've become much  more comfortable with who I am, I kind of don't experience HIV stigma in in the way that m
any  people do, I have an understanding of treatment and the condition very often learned from peers of  mine so I don't lean into formal peer support as much as a I did 20/25 years ago. but I still  benefit from being part of the community of my peers because that allows me to feel less  alone and I'm able to get new information as I when I want to. But I think really importantly  peer support has enabled me to have a voice to and to be to be vocal about not only HIV but  also other issues whic
h sit alongside that so it's morphed and its changed but it's also been  really really central to to my being as a person. Thank you so much Marc. Anandi do you want to  pick up from there? So it's interesting because I suppose that one of the things I didn't mention  in my introduction is I've been an anti-racist activist since the 1980s and I suppose activism  is a sort of type of peer support because you find people that believe in the same things as you and  then you're campaigning to change
those things, but it wasn't a term that I really used or was  particularly kind of familiar with until I got more involved in sort of the areas of kind of  mental health, and so when I first heard about it I thought of it as something that was about people  that had experienced altered states supporting each other but now I kind of understand it in  a in a broader way and I've had lots of support and I'm part of different support groups for you  know for family members and and others and so I t
hink of it as yeah just supporting each other,  learning from each other, sharing information in order to navigate systems, giving each other  emotional support, all of those things really. Thanks Anandi. Lisa? I suppose just adding  to what Anandi was saying, my experience of peer support has probably changed as things have  changed, like when I first was involved with peer support it was very much about facilitating  a space in which peer support happened, people came together and support happ
ened  naturally through mutual relationships and through this kind of shared understanding of  like maybe we're not crazy but the world is, so I think thinking about more the socio-political  aspect is it kind of it wasn't about individual illness or individual problems it was about you  know people, were recovering from not being loved, having damaging relationships, racism,  homophobia, classism all of that, that was what I saw and what I experienced  in those spaces was this coming together o
f, you know why is this not fair? Why is the world  unjust and what can we find in this space to to come together? And that I think for me was where  it kind of linked to the activism and and thinking about you know how does collective advocacy  fit within that? And what I'm seeing as time goes on is something that's uncomfortable for me  is it's becoming more about individualistic peer support which is like come and have a spoonful of  peer support and this will make you feel better, which is n
ot really what I connect to and so it  it's been an uncomfortable realization for me as I see it more and more integrated and embedded  in systems and services that's quite disconnected from my own experience and understanding of  what pure support was and what drew it to me in the first place and where I felt like I  found something that I hadn't had in my life. Thank you so much everyone that was really  interesting that you all kind of spoke to the connection between peer support and  this li
ke wider socio-political context, which leads us really nicely into our next  question which is could you share with us a story or example of where peer support and activism  meet? Lisa you kind of started to to talk about this in the last question so do you want to start  us off? Sure yeah so I can think about, I mean one example that I can think about was a time where  it worked really well was when, this was when we were part of a Grassroots rural collective of peer  support and advocacy here
in the Scottish borders, and this was around the time of the welfare reform  bill so like 10/12 years ago and so it was the first time I really saw this community that I  was part of stepping up into another space and actually saying' okay not just the world's unjust  and this is unfair' because people were really experiencing hardship and adversity, and having  their value being measured on whether or not they could work which was like sitting in this really  uncomfortable neoliberalism space
and actually you know 'how high can you reach how far can you walk'  which was just so disconnected from what people were experiencing, and so as a collective we did  come together and and campaign against the welfare reform Bill. It was brought in by Westminster but  in Scotland we wanted to implement it differently and we had some control over that with with being  in Scotland having a government here so we were able to advocate for it, it was small things but  they felt big to people things,
like having their doctor's information, being allowed to be included  because they knew their doctor rather than it just being an anonymous person deciding whether or not  they were entitled to benefits which is just again in the whole space of crazy-making. So that's just  one time I can think about where I really saw peer support move into activism and collective advocacy  and really thinking about beyond ourselves is actually what do we need to do for our people,  our community so that things
feel less unfair. Thank you for that Lisa. Marc can I pass over  to you? Sure thank you for that Lisa. I'm going to give two really quick examples if I may,  one is historical and one is much more recent and if I think I look back to the early days  of the HIV epidemic where there was a lot of informal and peer support happening in  LGBTQ communities to support those who were ill and dying who were being ignored  by mainstream healthcare and services and those people became activists inadverten
tly  by fighting for rights and for treatment, so I think if we look at the example of Act Up,  the AIDS coalition to unleash power in New York in the 1980s and early 90s, is a really strong  example of peers coming together, but I think more recently in this country my mind turned to  peer support again for people living with HIV, that there were a number of community-based  peer support interventions and activities happening across the country but those are only  community- based and not being
taken on by the health care service which I'll know we'll talk  about later. But those Community peer supporters came together and started to lobby government,  the NHS to ensure that peer support became an integral part of primary healthcare so I think  again this is a a different way of working with the system to try to ensure that what we see works  in community can be replicated within the system. Thank you so much Marc, and Anandi? Well in a  way I suppose the foundation or you know the se
tting up of charm is is an example of the way  in which a peer support group decided that they needed to do a lot more, so Paul Baker who has  also founded Charm with me and others set up a a family support group and there were just a half a  dozen of us there, still are half a dozen of us in this group and we meet fairly regularly to talk  about all kinds of things and I suppose because of the people that we were we weren't just kind  of talking about our individual situations but inevitably we
're thinking more widely about the  stuff that was going on in in Manchester, so it was in the middle of the pandemic and we had heard  that there was a new hospital going to be built, a new psychiatric hospital going to be built in  North Manchester and we thought we needed to make it clear that we felt that this wasn't the best  use of funds and that we wanted to see changes in community services, so a couple of us wrote  quite an extended you know letter explaining why this was not the best c
ourse of action and that we  wanted Manchester to kind of think again about the the way forward and then of course as activists  we circulated that letter far and wide and I can't remember how many people we got to sign it, sent  it to Andy Burnham and had a meeting with him, tried to meet with the trust - it was all a bit  all over the place at the at the beginning - just to to raise our concerns about the fact that we  needed a different kind of system and then having garnered support for this
letter, I don't  know maybe we got about a hundred people or something like that to sign it, we thought well  we ought to try and you know set up a group so that we can keep raising these issues and so  that's in a sense how how Charm got born so in a sense it was taking what you might see  as a slightly more traditional kind of peer support and then pushing it further and, I mean  I have to say as someone who's been involved in a lot of activism that if I hadn't been an  activist, if I hadn't
been speaking out my mental health would be in in an appalling state  and I would probably be on you know medications, and so it's coming together and speaking  out, raising all the you know the concerns, that's the thing in a sense that's enabled me to  carry on because you know that you're not alone and you know that you're not mad, that actually  it's the system that we're living in that is. And so you know we've raised all sorts of things  and then because we had this group then after the Pa
norama program came out you know we were able  to raise issues around human rights and we had a meeting on human rights and we then decided to  collect stories - I mean I really believe in the power of stories and of speaking out and everybody  having a story to tell and and being able to to speak that story - so we've started to, it's a  bit kind of minimal but we've started to collect people stories of experiences both in inpatient  care and community care in Manchester and we did share some o
f those with Oliver Shanley who was  doing the report which will come out in January about GMMH and we've, we've done a lot to we have,  we do liaise with the trust and are trying to work with the trust to push it forward to move It  from what is a heavily kind of medical model, so yeah so in a sense the story of Charm is  this is the story of the link between activism and peer support. Yeah absolutely, thank you so  much everyone. Yeah it was really interesting to hear you all talk about this s
ort of organic  relationship between peer support and activism. Yeah thank you so much. So I'm going to pass on  to Ruairi to ask the next couple of questions. Thanks Alaina, excuse me. I think it's really  interesting, I've heard a couple of you say kind of like, you know Lucy you said 'maybe we're  not crazy but the the world is' right, I think I've heard that echoed in terms of these spaces  being spaces where you get to kind of challenge what are the dominant ideas and perspectives of  the w
orld around you which might be unfriendly to you for various reasons, so I guess my question  is how can peer support shift those power dynamics and challenge oppressive systems? Anandi would  you like to jump in first? Well I suppose it's when we're speaking out collectively that we  have a way better chance of having an impact, and I suppose that is the kind of connection in a  sense that I you know, I've been talking about in terms of Charm and it relates though in every  single area of cours
e. You know at the moment, I'm sure lots of us have been involved in raising  the voice about you know about Palestine and you know for all and the whole situation has affected  so many people's you know, mental health and it's, there's lots of people people that had never  been on a - my neighbour would never have been on a Palestinian demo you know until a couple  of weeks ago and she said 'oh I just didn't realize how powerful it was you know coming on a  demonstration how much better it make
s you feel', and I think that's the thing is that I don't  know if I've got anything else to say it's just that the speaking out is to me probably the  most important part of peer support, because yeah I don't just want to change things for my  own family I want to change it for everybody. There's a sense of connection  and I guess with that it's not just connection with like you say  family or very close local concerns, it might be a a kind of global thing as  well. Lisa or Marc feel free to to
jump in. Well I mean I'll jump in if you want you ready  Lisa? Yeah go for it okay I mean I think for me it's, I tried to look at it from a slightly  different angle and I think about the people that are most likely to engage with, want or  need peer supporters sometimes in our lives and those are usually people who have an illness,  a disability, come from a marginalized Community or the condition that we have is exacerbated  because we come from a marginalized community, and I think that the
way that this can challenge  oppressive systems is because the aspiration of peer support is it is putting the power and the  tools in the hands of those who are marginalized and oppressed so I think that what we need to  do when we're providing or engaging people with peer support and I've done it in in my work  particularly with people with HIV is it's not just about managing your condition, it isn't  just about managing your isolation or connecting with communities and I think as an Anandi ha
s  said it's about giving you voice and when you feel connected to something to a community  to others that are going through something so similar to yourself you become empowered.  So I think that the the trick for us is to try to ensure that all of us who are engaging  or delivering or experiencing peer support, it's just not a one thing you know so we have  the power to to push back so we can lobby, we can advocate for ourselves and for others but then  also to look at whatever is impacting u
s which has brought us into peer support sits in society, so  all of those other things which may impact on our lives and our well-being, whatever that oppression  may be, we see our condition or experience in that lens which just allows us to then challenge the  oppression or the system or to make a difference. Thanks Marc so yeah there's that that kind  of it changes how you view marginalisation or oppression and it's focused on giving people  power rather than I guess taking it away which we
often experience that in like healthcare settings  and things like that Lisa I'd love to hear your thoughts. I mean I love the two answers that  have already gone I'm not sure I have much to add other than you know for a long time I just  was so frustrated with conversations talking about what's not working and how power is misused  and abused and it became such a heavy space to be and then just thinking about activism as another  kind of power but a power that can be used for good has felt quit
e energizing and it's probably  kept me in this world I think I was starting to feel like I was in the vortex of negativity  for a long time where it was just like how on Earth do we do anything here everything is so -  trying to think of a word that's not swearing - messed up and thinking about well what can we  do what can we do collectively and thinking about activism as still a for a form of power  and a new power and I've been reading some, a book recently about new power and how you  know
even just you know if we can do something that feels like we can have a voice like Marc  was saying you know that is still powerful and you know for a long time I just thought power is  bad power is always misused and it harms people and now having this new relationship with even  the word or the concept of power feels kind of refreshing. That's really interesting yeah in  terms of yeah just shifting that that kind of notion and thinking about yeah how people can  impact change or can affect cha
nge for good so we've spoken a bit I think Lisa you you  brought this up about kind of the co-option of peer support and how you've seen it change and  uh I think that's I think I've seen some comments in the chat as well that that that feels quite  present for people so in your opinion how is peer support being co-opted and how can we push  back against this Lisa I might go to you first as you've already spoken about it a little. I mean  what worries me is that there's there's there's versions
of pure support now that don't feel  like they are what we would call peer support and there's there's not really a connection  to the history and the fact that peer support was embedded in social movements, people are for  are forgetting or not being taught that part you know I'm older so I'm kind of fortunate that I've  kind of known some of the activists and the lead -movement leaders and being kind of educated  about some of the history but then I'll meet people who are working in peer suppo
rt who think  peer support was brought in to make the systems better it was about jobs and it was about the peer  workforce and more and more we're having this kind of grow in pure Workforce one of my worries  is they're employing us they're employing the activists and there's not many people that can  have an independent autonomous voice to actually advocate against the systems that are harming  people if they're being paid and employed by the same system so we're kind of losing some  activisms
through that route and activists and you know I there's there's not so much kind of  even activism happening about the harm towards the system you know I think about the history of  mad pride and around some of the social movements that really you know and Judy Chamberlain and  some of these leaders that did some amazing work and there's there's people who are now working in  peer support who don't know about some of those histories and so what what I think is lacking  is a connection to that k
ind of fidelity piece around what peer support was was actually about  you know it wasn't about making systems better it was about relationships and conversations and and  the connections that come with that and the kind of mutuality piece and then people are working in  peer roles where they're told well you can't talk about this or if someone says this you're now a  mandatory reporter or you have to do a medication run or you're there to provide care that's not  peer support it's just a word a
nd a job title so I do see it being diluted co-opted whatever  words we want to use and that kind of hurts my soul a little bit I'm still plodding on but  wondering when I can retire but it's still a while off. It's interesting I kind of see a  parallel with with with activism and and the and saying this obviously as  somebody who's employed by a charity but the the the relationship between uh activism  and social movements and charities is really interesting in terms of like you say obviously 
people uh people need to live and often the people who want to make change are people who by reasons  of marginalisation can find it hard to to to get other other work or you know don't want to spend  their lives working on something that they they don't feel is important but then as you say when  that work is linked to being able to pay your rent it's really yeah there's a there's a power dynamic  there there's something there that is is really complicated I've that's a huge can of worms that 
I'm just kind of like opening up and lying on the table and then we'll solve it by approximately  half 12 that's my promise to you. Marc did you have any thoughts on uh the the co-option of peer  support I mean I just I mean thank you for that Lisa because I Echo absolutely everything that you  said there but I also feel a little bit challenged given that I've been somebody that has fought  to have peer support within the system and to have peer supporters employed but just picking up  what Ruai
ri said very often those peer supporters in my field were Black African women who were  you know just been given citizenship in the country hadn't worked for years and so there  was that really tricky balance right of do I try to make sure these women get paid and their  skills are recognized at the same time as trying to ensure that they stay authentic but I think  for me the challenge goes back to something that you said earlier Lisa as well is I think what we  lose is the individualistic- we
lose a collective nature of peer support and what that means and I  and I think again if I think about the condition of HIV or other medical conditions you you may  go to a healthcare care setting and you're given a peer support worker and that's it that's your  only connection and they just talk to you simply about what is going on for you at that time and  there is no connection to the history there is a kind of dampening down of the activism rather  than building people up I'm not sure the pu
sh back on is that or or how we do that I always  believe that my push back needs to completely be continually creating new people empowering a  new generation of people I can put a lot of energy into changing the system but I think as most of us  know that could be an uphill battle so a lot of my energy continues to be developing grassroots  peer support people and activists on the ground. That's such a yeah it's a really  insightful point that that sense of like you know we need to keep going
and keep building  this kind of momentum that it's not enough to to do it once and say okay well we've got we've got  that sorted now you know and I I think yeah that point about peer support not being a single point  of connection feels really important because yeah there's a sense of of trying to build a community  which isn't going to happen if you you just have one person and you know you see them in quite  a regimented way and Anandi I'd love to hear your thoughts well yeah know I really ap
preciate  Lisa and Marc's reflections on this on this point and it listening to Lisa talking about uh the  co-option of social movements it made me think about well in my day job I'm an academic and I  I wrote a book called Black Star Britain's Asian Youth Movements and it was about you know what it  was mainly young Asian males how they organized in the late 70s and early 80s and in part of the book  I also talked about the whole process of co-option in the early 80s with many of the activists
being  bought off with nice jobs you know in councils and education and elsewhere and so I think that those  points that Lisa's speaking about are are really important and funding is of course a crucial thing  to offer services but when you're working on an advocacy side then it becomes problematic because  you can often not even realize it but you are you you are channelling the kinds of things that  you you perhaps engage with to to fit in with what would be acceptable to to funders and and  t
hings like that so in fact this did impact on how we set up Charm because to begin with I said  I don't want us to take any funding because if we take funding we will end up not being able to  say everything that we want to say but then at the same time you do need to be able to do some  things that involve more resources than you can just you know collect by passing a hat around so  to speak so so we have now set up a Charm CIC so that we can do like research work but we've  still got the Charm
community so what we've tried to do is to kind of keep these two things  going at the same time so that we can still if you like keep our autonomy and from that point  of view that Grassroots power that you have when you're independent but also do other things which  you know involve funding I thought the point that Marc spoke about in terms of the need to always be  creative is really important because if we're not constantly being uh creative being innovative  in the way that we think in a se
nse then we we we stop really thinking critically because every  every single social and historical and political moment involves us doing things in a sense  differently so yeah those were just the things that I thought of when I was listening to to Lisa  and Marc and also the other thing I just thought about was in terms of this whole issue around  co-option yes of course we do want peer support workers within the kind of the institutions of  health care but if it's just kind of mediated and mo
derated to make the system a little better  then of course what it's doing is is taking our well it's taking control in a sense and the power  and autonomy that we invest in ourselves as if we take peer support into a more campaigning level  when it's just kind of left there so those were those were the things that I was thinking of  yeah. Thank you and Anandi and thank you so much for that example I think it's yeah in terms  of like user-led groups it's a really common thing to really have to l
ike struggle with what your  structure should be what your funding is going to be and what kind of obligations that that  puts on you what kind of resources you are able to access it's a really big issue so we've got  a final question and then we'll move to to some questions from attendees so what just just a  small one what do you think the future of peer support looks like and Anandi would you like to  go first I think that I would just say I have no idea but that as long as we maintain some l
evel of  activism continue to work collectively and voice the things that are- matter to us and empower ourselves in that way there's a a strong future. Thank you Anandi, I'll pass to Marc I  always I'm always hopeful I think as long as we are people we will always need each other  and therefore we will always need our peers I do think we have to be watchful because as  we can see there's lots of stuff going on in the world which puts many of us under attack  or at risk so we need to continue to
to stick together to come together and find really  smart ways- I'm a great believer in smart activism and sometimes smart activism means  kind of engaging with the people that we're least likely to engage with and to find ways to  share our tools and our experiences with them because sometimes when they're presented with  those they may come along on the journey with us to change that so I'm always hopeful and I'd  probably just wrap up by saying you know what I said in my last answer that we
need to continue  to build grassroots peer support and find ways to encourage and enable people who are coming through  who will always need to come on the journey with us. Thanks Marc I love that like we will  always need each other it's such like I think sometimes like needing people is thought  of like a vulnerability but it's actually this wonderful strength and kind of really cool thing  about how we can yeah how we are. Lisa would you like to to wrap up? Gosh I have so many thoughts  on th
is question I don't know what the answer is like I've got a couple of thoughts and I could  see it going in multiple directions and I don't know which way it'll go I'll probably go all of  them at once but I think we are seeing more and more peer support being integrated into systems  and services and the dilution of peer support in that space and it is being commodified it's it's  now something that says can use it has a value and so with that that's where we're seeing it  sit within some of th
ose spaces but I also see lots of amazing like Marc saying these grassroots  alternatives led by people who have set things up social enterprises that are led by people not  funders so they're looking at what do we need in our communities not what do the funders need so  they're thinking more about relational outcomes and how they want to really meet the needs of  particular communities and you know I'm all for abolishing the systems but we're not there yet  and usually when one ends another one
comes in you know we had the Witchcraft Trials and people  thought that was great for a while and now we're in the psychiatry phase there'll be something else  some other dominant power structure that would come in in place of psychiatry next I'm sure and  it's probably sitting there waiting to go for all we know but we need to kind of create alternatives  for people- accessible alternatives that don't have these kind of eligibility criteria and you  know assessments and all of these things tha
t are forcing people into particular heteronormative  existence and instead just communities where people can just be themselves and if they choose  to live in a forest and not work then let's celebrate that let's just let people be people so  the more the more alternatives we can see forming and growing and thriving the better that will  balance out at least some of the other stuff. Thank you so much Lisa we're going to move to uh  we're going to move to taking questions we've had a few in the
chat so far if you'd like to feel  free to to pop questions in chat or raise your hand using like the virtual the the virtual  thing I can't see everybody on the screen so please yeah if you use the functional Zoom to  raise your hand because otherwise I might miss it we've got a question from Rachel Rowan Olive  I'm just trying to find it. I can just ask I can just ask it is it's easier. Great yeah.  I I guess something that I struggle with and think about a lot as I've moved more into kind  of
radical activist spaces that that kind of have peer support along as part of that function  is burnout like individually and collectively and sometimes it feels to me like there's a bit of a  tension between kind of wanting to have informal horizontal spaces and guarding against actually  labour being quite unevenly distributed in a way that can end up being really painful and and  kind of when everybody's struggling creating some really really painful and difficult  dynamics and I guess I just
wondered if that's something that as a panel you recognise  and if you've kind of found ways through it? Can I answer that one? Yeah anyone. Yeah so I  I'm really glad that you raised that Rachel I think it's a really important one and certainly  it was an experience for people involved in like anti-racist activism you know it still is I have  found and this is just on a really personal level in working in mental health campaigning there's  been greater understanding that there are times when y
ou just have to step out and I think it's  something though that we should all be aware of is that you know we only have so much resource  we also have uh personal circumstances which sometimes mean that we're not able to to to put  in and to to do what we could and having having you know what you described Rachel as sort of  horizontal organizations with less structure can be can actually be oppressive I can't  remember who talk talked about the tyranny of structural-ness and but it's certainly
  I think something that is very real and there comes a point where you do have  to to initiate you know structures and systems that doesn't mean that they'll  always be the same if we take the approach that Marc was talking about is always being  creative we can change them all the time and we we always have to keep reflecting  but absolutely understanding that we only have emotionally physically mentally a  certain level of resource is essential and we should all be taking that into account an
d  nurturing each other in whatever shape we work together. Yeah and I wonder if I could just  add to that that I'm really grateful to see the quote from Audre Lorde in the chat because  you know I've been thinking more about how does radical self-care factor we don't talk about it  in peer support people talk about individualistic self-care which I always found kind of toxic it's  like oh just go and do some yoga and mindfulness and you'll be fine it's like it's not really what  what I need to
keep going and just thinking about you know some of the work of Angela Davies and  Audre Lorde in terms of kind of looking back to social movements is what do what it does radical  self-care look like in terms of staying connected to activism whilst not burning you out completely  and I think that we can get that through if we come back to relationships what do we get from  relationships and what relationships do we need to be around us and yeah and I think Anandi's right  around sometimes we ne
ed to just step back because that's what we need to do but hopefully if we're  part of a collective and the relationships in place someone else will step forward and hold that  for us where whereas in a more individualistic approach we don't have that you know. And I just adding really quickly and on the back of both of that I've learned this year that uh rest  as resistance is a really important tool I've lent into a book which I've read which I'd recommend  anybody reads called Rest as Resista
nce by the Nap Ministry which has taught me that taking naps  from my work be they literal or just breaks where they're intentional is really radical self-care so  if you can take a nap for half an hour just switch off and we are allowed to say no I think  it's very important we are allowed to say no. Thank you everybody Joy I can see a hand up  uh there we probably sorry I've just looked at the time let's uh I can take Joy's question and then  I think we probably have to wrap up but go ahead Jo
y. Uh thank you Ruairi please may I  ask the panel mental health services often assume or even plan that there will  be throughput of intentional peer support workers therefore often there is no career  structure envisaged for such people they are expected to leave to enter different  work forces or somewhere else within the NHS workforce to progress what is panel's  experience of this and how will activism for peer support be continued by these people  or the people here today for peer support
when services at least the people that within the  UK NHS system expect turnover of staff thank you. Thanks Joy does anyone want to come in  on that? I'm happy to jump in first and then maybe Marc and and Anandi can add you know  one of my frustrations and I suppose this comes back to the question around power and  how power is held is that we often see the people in leadership roles are the people with  academic and clinical knowledge and the people on the front line doing all the hard work are
  the people with the experiential knowledge and how can we actually challenge what knowledge is  valued within actually within society as much as anything else not just in systems because I think  there's almost like oh well this knowledge this this is valuable this is the proper knowledge and  that that's over there and that that's quite nice to have within a conversation you can share your  story and so I think we need to challenge that I mean this is why I really feel we need leaders  and an
d you know communities that are set up and run by people who have you know an experiential  wisdom and and not just people you know that are part of systems that are led by more kind of  clinical leaders because otherwise you do get this point which Joy's saying where it's like  oh well I'm a peer worker well where now unless there's like a clear pathway to actually I  think that services and communities should be run by people who have the experience  of whatever it is that they're connecting o
ver. Yeah I think just very briefly of  course any job within the NHS should have a progression structure and in fact uh it's  supposed to so it's possible to to you know to campaign and to to to argue for that to be  created but as Lisa mentioned if you've got a structure where a clinic the clinicians in a  sense are in the you you know well you've got a structure of a a kind of a medical model  then the peer support worker would have to be going down the road of embracing that model  of care a
nd then that's the question as whether that's what we're looking to achieve so it's a  contradictory thing I think because they've got peer support workers in a system that they don't  necessarily really want to make radical changes to. I haven't got anything to add really to either  of those I support what both of my colleagues have said. Thank you thank you all this has been uh  yeah this has been wonderful and yeah I think like really kind of challenging and eye opening  in a lot of ways as w
ell so thank you so much to panellists and to everybody who has attended  as well uh Alaina did you want to wrap up at all and come in again? Yeah I just wanted  to to reiterate what Ruairi said thank you so so much yeah to all the panellists  it's been a really really interesting and insightful discussion and there's also  been a really rich conversation happening in the chat as well so yeah thank you to everyone  for coming and contributing to the to the session and I'll yeah wrap up there. Th
anks, thank  you thank you see you at some of the other sessions. Thank you that was amazing. Really good thank you thank you thank you very much bye.

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