Shut Up or Complain: A Terrifyingly Flawed Mental Health System

Time and again I come across the same rhetoric in mental health care: if you have any queries, concerns, ideas or wishes other than what is presented to you exactly as is, you are told to complain. Notions of personalised, patient-centred care – though frequently promoted – are often nowhere to be seen in reality, leaving patients with usually a single, standardised care model with little to no discussion, adaptation or deviation allowed. 

Discussions with those who actually make the decisions (whether individual team members, leaders or managers) are often either discouraged in favour of complainng or fruitless because ‘their hands are tied’…leading to recommendations of complaint. Even when things go horribly, life-threateningly wrong or immediate change/help is required in emergency situations, patients and their families are usually told “if you’re not happy, make a complaint”. Not only does this come from within teams across the country – who, in certain situations, one might argue are constrained by ‘higher ups’ – I have recently been stuck in situations where the line managers of team managers, other teams, and directors of the trust have advised me to make complaints because otherwise they may not be able to make the team in question comply and give me the care that they agree that I need, and that should be being provided to me. 

How can that be? 

How can a system be so flawed that those in positions of power within mental health trusts cannot reason with individual teams to persuade them that they aren’t providing care that is appropriate, safe and required of them unless the patient themself (who is, in these circumstances, unlikely to be well enough to deal with such stress) complains officially? Especially when said complaint would then be handled by those aforementioned people. 

How can a system built to care for vulnerable people function with complaints being the only path to the care required of services, or even discussion of appropriate care in many cases, when everyone but the small bubble of that part of the service itself can see that it is desperately needed? 
We would accept this attitude in no other area of life. 
We should not accept it here, either. 

But what can we do to change this within a system so apparently averse to input from its service users? Oh, that’s right… complain. 
People are falling further in to ill-health and dying because of this unfair and nonsensical system where morals and duty of care fall aside in favour of widespread attitudes of ‘shut up or complain’. All I can do is plead that those working within mental healthcare or with any influence consider how and why this attitude exists and continues, assess the impact on those in need, and think about how we can together create change. 

As a patient I feel powerless, demoralised and terrified that such inexplicable flaws leave us alone and without help even when widespread professional assessment identifies that it is vital.