
Are we all more or less the same, or each uniquely different? Are each of us easy to sum up in a few words, or the complex result of our backgrounds and upbringing, our experiences and dreams, our inner and outer lives?
This is usually the stuff that philosophers (and writers) sit in darkened rooms and grapple with, but every now and then they can suddenly seem like questions that are very relevant to our daily lives – even in the everyday world of `welfare to work` services.
The psychoanalyst Darian Leader has a new book out this week. It`s called `What is Madness?` Its proposition is that it is unhelpful, and sometimes dangerous, to separate the human world out into `mad` and `not mad`, to reduce and simplify the causes of `madness` and, as a result, to simplify its remedies.
Darian argues that we`re all on a continuum, that madness is a part of each of us and that `everyone is trying to cobble their lives together as best they can`. He hopes that, above all else, a recognition of this could help to take away some of the remaining stigma around mental ill health. It feels like an affecting, plausible and very human philosophy.
I met Darian in August at the Edinburgh Festival when I appeared on stage alongside his partner, Mary Horlock. Darian was relaxed, thoughtful, easy-going. There was no obvious sign that he spends each and every day working with a series of individuals who are in deep psychological distress.
One of the targets Darian takes aim at in his new book is the current fashion for industrial-scale CBT (Cognitive Behavioural Therapy), especially when it`s seen as a quick fix to get people fit for work. `Six sessions and you`ll be cured` sounds to him too simplistic and reductive. And of course this kind of approach could only be uniformly effective for everyone if we were all similarly hard-wired – if we really were all the same, easily summed up in the same way, all easily mended with the same few taps to the head.
Last week I was in Sheffield on behalf of Pluss attending a DWP event. Its aim was to brief organisations about Stage 2 of the tender process for its Innovation Fund which wants to trial what are (hopefully) innovative programmes for young people not in employment, education or training (or who are in danger of ending up in that NEET category).
The original specification encouraged projects targeted at, amongst others, young people with learning disabilities. In response, Pluss put together a genuinely imaginative pilot involving a consortium of several special and mainstream Devon schools which won through to the shortlisted second stage. At last week`s event, however, DWP revealed a payment model for the Innovation Fund which is to be based on a restricted number of outcomes based largely on qualifications which are beyond the reach of most people with a learning disability (whose trajectory to work is clearly going to be different to the one prescribed by the Innovation Fund).
The model assumes that anyone with aspirations to work will need those qualifications, and isn`t flexible enough in this instance to acknowledge the very different support needs of people with learning disabilities. With regret, we`ve had to withdraw our bid; our attempts to do things differently simply won`t fit into the commissioning framework on offer.
It has left me reflecting on the merits of the supported employment model when it`s delivered really well by a skilled practitioner working one to one with someone who wants to work. It aspires to be a personalised service. It sees the customer holistically as an individual. Like the approach which Darian Leader advocates in his new book, it doesn`t try to put people in boxes. It recognises each person as a unique and complex individual who might need something different from his or her neighbour in order to recover, or move on, or realise their aspirations.
There is a simple mantra knocking around the supported employment world which says `Equal Opportunities` means treating everybody differently. It`s a slogan based on the notion that people are wonderfully different from each other, and that what works for one person may not work for another. It`s a belief that demands that we listen to the customer, client or patient and hear what they say. And it requires each person`s package of support precisely to fit their unique set of needs. If personalisation means anything, it`s surely this. I`d like to think that, at this point, Darian would say `Here here`.
Written by Paul Wilson, Pluss Marketing Communications