By Courtney Buckler
Senior Policy & Campaigns Manager at NSUN
A few months ago, I was invited to the House of Commons to give evidence to the Health and Social Care Select Committee’s Inquiry into Community Mental Health Services (CMHS). I wrote about the inquiry when it was first launched: that article includes information on what the inquiry is, who it is led by, and what it is for.
In this brief piece, I want to reflect on the experience of going to Parliament, including taking up the role of “expert”, the limits of lived experience, and how my big day out confirmed everything I already knew about power and knowledge.
Becoming an expert
It was only when I found myself in the House of Commons, sat shakily beside esteemed colleagues in the mental health sector, that I realised I had become an “expert”. Immediately in front of me was my own name — “Dr Courtney Buckler” — on a slip of paper. In front of that was a panel of Members of Parliament, who were themselves sitting in front of numerous colonial style paintings in a grand and gilded room. They smiled at me eagerly, ready to hear what I had to say.
It was a bizarre sensation. People like me are not expected to end up in places like this. But somehow, there I was. I was fuelled by the responsibility I feel to the many, many hundreds of Mad and Disabled people I have the honour to work and organise alongside. Being there felt simultaneously like the most and least important thing I had ever done. Afterwards, people told me that I didn’t seem nervous, but I was.
Giving evidence
The first panel of the day was made up of people who had accessed (or at least sought) care through Community Mental Health Services. Their stories had a striking congruence; they spoke of gaps in care, impossibly long waiting lists, and a catalogue of related failures caused by underfunding and bad attitudes within mental health services. We too had submitted our own written evidence which showed the same. When panellists spoke of what “good care” is, the features were the same: time, respect, patience, care. These seem like things we should take as a given from a mental health system, but unfortunately they are rare.
I was on the second panel. On it, I was joined by others who held similar roles at some of England’s largest mental health charities. We were called on as “experts” to back up the claims of the first panel, showing how their experiences were not isolated accounts but instead reflective of bigger, system-wide failures.
For the most part, my answers drew on the “bigger picture”; pointing to increased demonisation of the so-called mentally ill and decades of austerity as responsible for a failing mental health system. I shared many examples — “high intensity” programmes, creeping privatisation in the NHS, inadequate reforms of the Mental Health Act — and proposed cuts to welfare support for Disabled people. I articulated, multiple times, how we will never “solve” CMHS (or mental health services more broadly) if we could not also challenge increasingly hostile rhetoric toward the so-called mentally ill.
Where’s the evidence?
In each of my answers I spoke about our membership, those on the first panel, and drew on the expertise of those who I have spent a career working with. I also drew on my own experiences of being someone who lives with mental ill-health and has been through the mental health system. Still, towards the end of our session, the inevitable question got asked: something to the effect of, “and, do you have the evidence to back this up?”.
I should have known that this question would come — not least because my PhD explored the imperative of being “evidence-based” — but still, I was surprised. What was this whole day? How was this, in itself, not evidence?
I may be an “expert”, but I was also naive. No amount of goodwill and convincing arguments are going to overturn the juggernaut of “evidence”; certainly not in a 45-minute session in the Houses of Parliament, of all places.
I walked out of those gates with yet another example of how lived experiences are so often framed as a nice (or not so nice) add-on to the “hard facts” of a situation. Our expertise is used to contextualise “data”, rather than being considered sufficient to be considered “data” in itself. We are called on as experts and then, in the same breath, told that this expertise is not enough.
Ill will alone is not enough to account for the wholesale relegation of lived experience wisdom. It is something far bigger than that, which could not be overridden by the genuine concern and interest I felt from the MPs before me. This was something far bigger; bound up in the post-Enlightenment, colonial-era approach to knowledge that pedestals objectivity, lack of bias, and some mystical “Science”. In speaking from our own experiences, perhaps we will always be on the back foot.
Engagement and complicity
I have mixed feelings about the experience. On one hand, it is impressive that NSUN — as a relatively small, survivor-led organisation — was invited to speak in this kind of venue. While we may not see much tangible change, it is a powerful thing to bring survivor knowledges to the table. We never really know what seeds we are planting.
On the other hand, there is a question of complicity. By engaging with the powers that be on their own terms, we risk endorsing the very things we are trying to challenge, irrespective of what we say when we are there. What am I endorsing when I show up as an “expert”? Is it worth the risk? The tensions of “playing the game” is something that I have written about before, and has been long-contemplated by my predecessors in this role, as well as fellow colleagues at NSUN.
Overall, I am not sure how much we “achieved”. Our words were still contorted into what was recognisable, constrained by the limits of questions asked and invariably translated into the language that best suits the style of an inquiry report. That report is not yet published. Only then, when we see the report and its recommendations, will we see the impact our being there might have had.
Even so, perhaps we can never know the true consequences of our engagement. Things are never quite as straightforward as they seem. Instead of branding each opportunity as “good” or “bad”, we must commit to this kind of reflection; sitting in the ambivalence, and hoping that together, we might possibly find a way through.