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Why some complaints pack a greater punch than others

firemonkey

firemonkey

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The NHS is failing to deal adequately with complaints about its services, according to a recent report by the Healthcare Commission, the watchdog responsible for reviewing complaints that cannot be resolved at a local NHS trust level. The report reveals that the proportion of complaints upheld rose last year by 50% - and in less than a fifth of the 9,000 cases it looked at, the watchdog sided with the trust.

Most worrying for those who believe in the importance of listening to user feedback as a means of improving services, the main issue raised by complainants was the way in which the NHS handles complaints. In other words, what bugs people most is not the issue that led them to complain, but the way in which the NHS responded when they did so. Complaints, it appears, breed complaints about complaints.

What the figures cannot show is how many people wanted to complain but failed to do so because they believed there wasn't any point. It's only a hunch, but I'd hazard a guess that users of psychiatric services are not exactly under-represented in this category. It's not that we don't moan. The psychiatric service user without at least one burgeoning grievance is a very rare being indeed. But while moaning is the province of the disempowered, a complaint requires at the very least a hope that one might be heard.

A complaint is more than a moan; it is a call to action. The action called for may range from a simple apology to compensation to a full-scale inquiry and reform of the service in question, but whatever the specifics, the complainant wants something back. And the more they have to barter with, the more likely they are to get it. Regrettably, the success of complaints has more to do with the power of the complainant than with the merits of their particular case, as anyone who has tried complaining about social security benefits, for example, can readily attest. And few positions, if indeed any, can be quite as powerless when it comes to complaining as that of the mental health patient.

A typical letter of commercial complaint comprises the following elements, the proportions of which may vary: a compliment designed to flatter the reader and impress on them the sound judgment of the complainant, along the lines of: "I've been a loyal customer for the last 10 years and have always been tremendously impressed both by your products and your exceptional standards of service"; an expression of shock at being let down, culminating in "I was therefore extremely disappointed..."; empathy with the predicament of those responsible for the failure, such as "Naturally, I understand that a car is a complicated piece of equipment..."; or a request for some form of restitution and a threat of forever withdrawing custom if this is not forthcoming.

With this model in mind, it's not hard to see why psychiatric service users may struggle to get their complaints taken seriously. The fact that they have mental health problems automatically calls into question the soundness of their judgment why else are they barred from jury service? And the longevity and loyalty of their custom, far from aiding their cause, is likely to be held against them. Any shock or anger at the way they have been treated is easily dismissed as a symptom of their condition, and a threat of withdrawing custom can always be answered with a section.

The complaints of psychiatric patients are, in short, so instantly dismissible that they are seldom worth making at all. Time and again, it proves too tempting for recipients of service users complaints to exploit the credibility gap, rather than confronting the awkward process of self-examination.

There are, of course, complaints procedures for mental health services, like anything else, but unless we are prepared to address the stigma that lies at the heart of the problem, these are likely to constitute little more than box-ticking cosmetics. Which is a shame, as the genuine feedback of service users, both positive and negative, might be seen as something well worth bartering for.
http://www.guardian.co.uk/society/2009/mar/04/nhs-complaints-mental-health
 
keepsafe

keepsafe

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Scary, I for one know complaining only gets you in a worse predicament - well that has been my experience.

I.E - So section it is then - its a mighty powerful dissuasion tactic :eek:

Yes I think it is true - no voice.
 
nickh

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Many thanks for this firemonkey - very useful.

And yes sadly keepsafe that is something that I hear time and time again; people don't complain because they fear that services will be withdrawn or that they will be sectioned.

It all goes to show why service users need to have strong, INDEPENDENT, collective voices. But that is a long and diffiuclt struggle.

Nick.
 
KP1

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I don't think you should ever allow the system to put you off complaining.

When I was in psychiatric hospital for a week last year I complained to the ward manager in writing about restrictions on where we could go during the day eg from our rooms and other areas. She saw me on the day I was discharged and discussed the reasons why they did. I put my point of view across about the effect that had on me as a patient. She then asked did I want my complaint put through officially my answer and my advice to anyone else was yes then the complaint is logged and formally responded to. It didn't personally change the conditions for me but at least it was registered. With a good complaints procedure organisations should use them to review and improve their sytems.

This is more effective than "moaning" at the time or worse being disruptive.
I also used the same tactic with wanting to go home which probably the majority of in patients want as they are not the most desirable of places to be in. I put my reasons in writing for why I needed to be discharge, the psychiatrist read it and acknowleged it when he saw me so I wasn't ignored.
 
nickh

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Definitely kp and its really good that you did complain. I would certainly encourage everyone to do the same :). I was just saying that in practise I think may people are intimidated, or scared, or cynical about the whole process.

Nick.
 
keepsafe

keepsafe

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Ok then I have to add - when making complaints I have been, lets say not too well and in very highly emotional states and kicking off to put it bluntly. So I can see why they do not get considered and that why sometimes we do ourselves no favours.

I do on the other hand think now that some of my complaints were justified, but lack the push to even persue them now, it's just another complication and that I wouldn't be able to handle.

KS

P.S I was trying to remember - yes thats what I was disruptive - but I didn't mean to be.
 
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R

ramboghettouk

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it's not just psychiatric services, it's even more common in housing, if you've been housed in social housing theres some reason, the housing assoc will know if it's mental health

With the benefit system your either mentally ill in which case your complaint is suspect or your sane in which case your not in need of services, difficult if your complaining about lack of services, same with social services
 
Q

quality factor

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An interesting piece.

When I've had cause to complain as a user I've tried to do it face to face and taken a witness with me.
When I had cause to make a more serious complaint a few years ago I put pen to paper and importantly kept a copy of what I'd said.
It has been my experience as a user, that the 'powers that be', always managed to close ranks and cover for each other, when I complained.
I agree with the others, because we have mental health difficulties, it is used against us....and a section is dangled in front of us.
I have been made to feel that I am lacking in some way which doesn't make any complaint I make viable in any way.
I agree if a person with mental health problems has cause to complain then they should have access to an independent advocacy service for support.
There's also the problem of those people who complain on a regular basis. No matter how earnest they in believing they have cause to complain, once you have a reputation for making continual complaints, I feel you are automatically met with a brick wall.
 
R

ramboghettouk

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In brent mind it's part of the office politics to encourage a loony to complain about an enemy, if that goes on elsewhere it is hard to take complaints seriously
 
KP1

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On the other hand. Since being diagnosed with a mental illness I am very sensitive to what I perceive to be other people's perceptions of me. For example I didn't make a formal complaint at the GPs surgery about a rude phelbotomist because I was worried that they will think I am difficult.I have to think of myself and my family for instance when I take children I want them to take me seriously and listen to me.I'm not sure any more that the GP really does.
Having an advocacy service is a really good idea.
 
nickh

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Agree with everyone! (that's rare). Personally I have a poor record on this because when I am ill I would certainly not be in a position to complain (I am mute) and when I get better I tend to think that I can't be bothered. I know this is wrong; but again suspect that a lot of people feel like that.

I quite agree about advocacy KP. And as I said before the existence of independent user voice type places - which is what I keep working on (not to much effect so far :().

Nick.
 
Q

quality factor

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' To agree or disagree, that is the question'.

That's what forums are all about.....we are not all tarred with the same brush, and that's got to be a good thing hasn't it??

I also feel that we have to speak with an INDEPENDANT collective voice, in the pursuit of the improvement of mental health services.
 
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