Rethinking Secondary Mental Healthcare

‘Rethinking Secondary Mental Healthcare: A Perceptual Control Theory Perspective provides a comprehensive deconstruction of the limitations of current mental healthcare design and delivery. Whilst the critiques in this book are stark, I don’t think any of the observations of current provision will be received as a blindside by practitioners. An achievement of the authors is that they have been able to synthesise, using the theoretical lens of Perceptual Control Theory, and write about, their collective experiences as clinicians and users of mental health services, without the undertone of blame or ressentiment that often (perhaps, understandably) characterises critiques of psychiatry. This should enable the radical yet practicable ideas and solutions to be confronted without moral injury to any individual or group who have a stake in the quality and safety of mental health services. The deficiencies in care and compassion that are outlined in the book are, after all, a product of systemic rather than individual failings (i.e., conceptualisations of mental distress that are impersonal and of questionable validity, the pervasive experience of being ‘too ill’ or ‘not ill enough’ to receive any or certain types of support, and arbitrary limits set on the duration and intensity of the support that is offered). The book’s fundamental proposition is that mental service design and delivery should be transformed via radical shifts in the ways that behaviour and distress are conceptualised. Namely, that behaviour is a product of efforts to control perceptual input, distress is a consequence of conflicting goals in the attainment of desired perceptual states, and that effective support should be characterised by the facilitated reorganisation of goal conflicts to reduce distress. It is, fundamentally, a profoundly optimistic text that everyone working in mental health should read.’

Owen Price, Senior Lecturer in Mental Health Nursing, University of Manchester.

‘This text will – I suspect – force professional readers to question many assumptions they hold about the nature of psychological distress and its alleviation, whilst simultaneously striking service users as common sense. Rooted in PCT, the text has wide-ranging implications for the way services are designed and delivered, advocating for the allocation of control to service users wherever possible. Time will tell whether the proposals stand up to empirical testing and deliver on the promise of more effective and efficient care. Irrespective, the over-arching aims of the text are I believe commendable and much needed in the context of over-stretched services.’

Marc Tibber, Lecturer in Clinical Psychology, University College London.

‘A shroud of pessimism has long stymied secondary care mental health services. The people who use them have been viewed as passive recipients of their own care. In this brilliant book, Robert Griffiths and colleagues draw from Perceptual Control Theory to reimagine services that place people as central agents in their own recovery. People are driven by individual goals and are seen as controllers of their own perceptions. Given the right environment, people are capable of solving the inevitable conflicts that emerge when dealing with the complexity of their lives. The challenge then, is to create environments that allow people and families to creatively address these conflicts, in order to find their own solutions. This book provides a blueprint for services to do just that, and in doing so, moves secondary mental health care to a place of hope and optimism.’

James Kelly, Lecturer in Clinical Psychology, Lancaster University; and Consultant Clinical Psychologist, Greater Manchester Mental NHS Foundation Trust.

‘This original and insightful text offers a fresh perspective on the organisation of mental health care and support. The recognition that control over aspects of one’s life, or lack of it, might be the most crucial consideration regarding disturbances to mental health is the pivotal touchstone for examining identified shortcomings of mental health services and pointing to solutions. The proposed remedies appear to have great promise in tackling the alienating features of contemporary services, offering a route to more democratic, relational, person-centred responses. Even if the suggested approach to redesign is not to be adopted wholesale, this book offers clear food for thought for practitioners, service users and families who are rightly concerned about the lack of choice within services overly reliant upon coercion rather than consent.’

Mick McKeown, Professor of Democratic Mental Health, University of Central Lancashire.

'Radical, practical and humane. This work deserves to be a seminal text in the field of secondary mental healthcare and required reading for students, practitioners and managers who wish to be a part of the solution, rather than the problem.'

Nathan Filer, author of This Book Will Change Your Mind About Mental Health and The Shock of the Fall

‘As many mental health services seek to redefine how care is provided, this book gives a theoretically sound framework for coherent patient-perspective-care. Perceptual control theory is offered as a guiding model for mental health services and potentially for shaping communities and society. As a service model and an approach to psychological therapy, PCT gives us something properly new and inviting as an alternative. As a psychological therapy, Method of Levels is truly oriented to patients’ priorities, from the timing and duration of sessions to the moment-by-moment content. The book itself is a collaboration between those who have used mental health services and those who work in them. The superb writing in this book is made richer with the views and stories of patients.’

Christopher Whiteley, Chief Psychologist, Central and North West London NHS Foundation Trust.

‘This book succeeds in that all too rare a feat of being both an enjoyable read, alongside explaining some important ideas in easily digestible form. As a clinical psychologist within the NHS who, in addition to delivering psychological therapy, is also involved in service evaluation, design, and management, there are many lessons contained within these pages for me to consider. As a parent of two feisty children, the lessons the book has taught me about control, conflict and reorganisation have also contributed towards me upping my game on the parenting front. So, if you want to improve your standard of therapy, or survive and thrive within services, which we all know have a long way to go, or if you want a solid strategy to remain present and compassionate alongside feisty family or friends of your own, then give yourself the chance to enjoy this book like I did.’

John Mulligan, Lead Clinical Psychologist, Manchester Early Intervention Service, Greater Manchester Mental Health NHS Foundation Trust.

“This is the most important and exciting book I’ve read in a long time. It explains in everyday language recent developments in psychological science which have profound implications, and the potential completely to transform mental health services. The principles it sets out are revolutionary, but also simple – and liberating for both clinicians and those experiencing mental health problems. The book is supremely practical too, and full of stories that inspire.”

Anne Cooke, Consultant Clinical Psychologist, Clinical Director, Doctoral Programme in Clinical Psychology, Canterbury Christ Church University.