My knowledge, skills and most importantly confidence have grown over the two and a half years that I spent offering this service. This has enabled me to move onto the final stage and pinnacle of my journey. At the time of writing, I have been appointed as Vocational Officer and continue with the work I have done thus far. This post is a one year contract funded by South East London Strategic Health Authority and Choices in Mental Health. 

Whilst I am sure there will be challenges ahead, I believe that my main personal challenges are behind me. As the Social Exclusion Unit Report highlighted, employment rates amongst long term users of mental health services are very low. In Lambeth it seems virtually nil, so I am in a very small minority. Whilst there is currently great political emphasis on getting people with disabilities and mental health problems off benefits and into employment, I think this account shows just how difficult and time consuming it can be. I have been lucky. I am fairly intelligent, and able to adapt and learn quickly, but others may not be so. You cannot just send someone to a Job Broker and expect them to enter the world of work within a fortnight. Reaching this point has been for me a bit like playing a game of snakes and ladders. Luckily I have just managed to avoid the snakes and have had no real major setbacks, though I was close on numerous occasions. 

With this new-found employment, I am in the position whereby I will soon be debt free for the first time in eleven years. I can also tell strangers my occupation. It is amazing how often, when you meet someone new, their first question is about your job. At long last I can tell them I am living in the real world where I ‘belong’ and people look up to me. 

I firmly believe to this day that without the help I received, combined with stopping medication, I would still be ‘lost’ and soulless in a meaningless existence trapped in my own pain with only four walls as my friend and ultimately my enemy. My story shows the real problems faced in the journey back to the elusive world of work. It shows the importance of a strong supportive relationship. I believe it also shows the importance of finding work which makes you feel good about yourself and which suits you. Although the journey has taken over five years, it boils down to quite simple things; being enabled, listened to and given real choices. 

Marks Commentary

I met Shaun in my role as a vocational worker in a specialist rehabilitation team and he struck me as a very alienated man in deep emotional confusion and pain. He blamed himself for what had happened in his life, to the extent that he was burning himself and thought suicide was the best way out of his intolerable experience. 

Based on my own experience of working through similar types of emotional distress from childhood traumas, I understood that he had to tell his story safely, if he was to live and get some sense of self-confidence and possibility. Shaun told me his story and I listened carefully, validating what he was feeling. I tried to be tender because what he was working through often overwhelmed him. He needed to cry a lot for a long period before we could begin focusing on practical directions. 

From the clinical angle it was becoming increasingly difficult for me to justify seeing him on a weekly basis without a clear practical outcome. Luckily the manager was supportive of this kind of work, although at clinical meetings it always boiled down to pragmatic questions … But what is he actually ‘doing’? Does he need more medication? Deep down though, I knew Shaun was trying to gain insight, find and accept himself before he could effectively begin doing anything. Everything Shaun said to me was understandable although some of it would have been labelled psychotic. 

The path was never straight- forward but it was crucial to allow Shaun’s emotions to be registered fully. I had to keep a faith that it all could work out positively, despite my own anxieties that he might not make it. Once Shaun had courageously managed to leave his flat to meet me ‘out there’, the rest of the work was about clarifying what he wanted to try out, at a pace that suited him, and helping out with practical issues as he continued to flourish.

The important message here is that people need genuine emotional validation and support - especially during distressing experiences - if they are to get to a point of safety and eventual autonomy. This is a complex process over time that cannot be speeded up to provide a quick tick-box vocational outcome. 

Shaun Williams & Mark Bertram 

January 2006