Talking about race & racism can be difficult. For those of us working in prisons, immigration removal centres and forensic units we might be aware that rates of incarceration are higher than they should be for racialised people.

Black people make up 12% of the UK prison population but only 3% of black people reside in the UK (Lammy, 2017). Overrepresentation of black people is found in all psychiatric settings but is greatest in forensic units (McKenzie, 2004) where often the diagnosis received is psychosis.

Members of the Hearing Voices team travelled to snowy Montreal this November where we took part in the 11th World Hearing Voices Congress. Voices Unlocked piloted a workshop addressing the legacy of colonialism with global majority voice hearers.

We then went on to run a one-day training in Central London entitled ‘Opening Up Conversations – Let’s talk about Race’  thinking around how to engage with race in a meaningful way for the people we work with. We covered the structural realities that shape our awareness of racism, we unpacked what it means to be white, covert racism vs overt racism, colour-blindness and honoured how black, brown and white bodies all hold racialised trauma, especially in forensic settings.

Feedback for both the workshop and training was good and we hope to run the one-day course again in 2020.

For some of the topics raised, please follow the link to read a blog written by Jessica Pons for Mental Health Today.

In August 2019, A Place of Safety invited both Jane (Voices Unlocked) and Lucy (Voice Collective) to join them on their podcast.  During the podcast they discuss what the Hearing Voices approach is, talk about the Mind In Camden projects and explore some of the challenges in bringing the approach to specific settings.

“Episode 13 – Supporting people who hear voices, with Jane and Lucy…”

Last month we completed the training day ‘A Fresh Approach to Mental Health’ for Change for Good, a mentoring and befriending project for men leaving Wandsworth Prison.

6 users of the service and 7 volunteers attended and we enjoyed lively discussions, with participants remarking they learnt a lot of new information. Men who had been detained in HMP Wandsworth had the chance to share experiences of adversity and have these validated through a framework that accepts non-biomedical understandings of mental health difficulties.

One man fed back that the most helpful part of the day was ‘engaging in one’s truth’. At the end of the training day, people commented that the take-home message is that truly empathetic listening is vital for supporting people in distress.

In February we ran our 3-day Hearing Voices Facilitation course from Manchester for the first time. We had twenty trainees from HMP Wakefield, HMP Berwyn, HMP New Hall, St George Healthcare Group, HMP Garth, HMP Haverigg, HMP Hindley, HMP Wealstun & Arbury Court Forensic Hospital.

Staff from HMP Berwyn in Wales (which when fully operational will be the largest prison in Europe!) have been in touch to say they are progressing well with laying the foundation for their Hearing Voices Group launch.

Since the training, HMP Garth’s Beacon Unit, part of the National Offender Personality Disorder Strategy, have been in touch to organise further training.

We shall be developing the Voices Unlocked network across the North of England next year, using Manchester as our Northern base.

We’re really proud to share our ‘Philosophy of Mind’ podcast, which is based on a ‘Philosophy of Mind’ workshop series which Mind in Camden ran in October 2017. The group was open to everyone, ran once a week for six weeks, and focused on sharing and using philosophical tools and ideas to talk about mental health. Based on this, we have just launched a ‘Philosophy of Mind’ group in HMP Pentonville.

The first part of this podcast is an interview with Sophie Stammers, the creator and facilitator of the workshop series and a philosopher at the University of Birmingham – she tells us about her work and her experience of facilitating the group. The rest of the podcast (from 12.25 onwards) is a group discussion amongst several participants about their experiences of the group – what was most important, what the group felt like, and what has stayed with them… A huge thank you to Camden Community Radio who helped us produce this.

You can listen to it on various platforms:

• The CCR channel on iTunes
• canstream link on the CCR website
• ‘Podcast’ apps on Apple smartphones and iPads – search ‘Camden Community Radio’, click on the podcast and it will show up as one of the most recent episodes

All of Sophie’s materials for the workshop series are online.

In Spring 2018 Voices Unlocked project provided a one day “psychosis” awareness and support training for staff and volunteers at The Manuel Bravo Project.

The Manuel Bravo Project is a charitable organisation based in Leeds that aims to help asylum seekers who are unable to find adequate legal representation elsewhere. Senior Immigration Caseworker, Holli, reached out to Voices Unlocked for training because her team felt the need for a better understanding of mental health issues.

Many of the people that the Manuel Bravo Project works with have experienced trauma in their home countries or on their way to the UK. None of them know if they will be allowed to remain in the UK. And all are under considerable financial pressure – one of Manuel Bravo Projects’ criteria for helping people is that “they must be unable to pay for a representative – this usually means they will be destitute or receiving asylum support”.

Holli and her colleagues noticed that after going through lengthy legal interviews, many of their clients were struggling with voices and visions and seemed to have no access to support. They wanted to create a more ‘holistic service’, which, as Holli described, “would not only provide legal advice but also use client connections volunteers to provide friendly support and assist male clients to attend appointments, see the doctor/expert when they find it too difficult, and help people to relax after what can be a difficult consultation with their caseworker.”

They launched a pilot project to support clients by pairing them with volunteers (many of whom had been through the asylum application system themselves).

“The idea for the project was to have a volunteer who was mental health trained who could meet with the client after they had been in a meeting with me. Often they have to go through the traumatic event they suffered through and this had a huge impact on their mental health. The volunteer would be ready with tea and biscuits to chat about anything the client wanted to for up to an hour. I hoped that by having this conversation it would help to ground the client a little, so they wouldn’t be thinking so much about the traumatic experiences they had had to speak with me about.”

The pilot project made a great start, however, volunteers were uncertain about how to support people who were experiencing voices, visions, and other experiences commonly associated with “psychosis”. The training that VU provided explored these experiences and gave some guidance about how to support someone who is distressed by their experiences.

One of the key messages from the training was that supporting someone experiencing voices or unusual beliefs (etc.) is in many ways the same as supporting someone who is not experiencing these things. The most important elements of support are still being present, listening non-judgementally, and believing in the person you are supporting. These are all things the Manuel Bravo Project staff and volunteers were already doing well.

The training also covered coping strategies and techniques that people with lived experience have identified as helpful, with the caveat that what is helpful for one person might not be helpful for someone else.

The last part of the training was a ‘reflective practice’ during which staff and volunteers shared their experiences of working for the Manuel Bravo Project. This was a chance to support one another and recognise challenges of the work.

In feedback, MBP staff and volunteers said that they felt more prepared to support clients who might be distressed by experiences of hearing voices, ‘unusual beliefs’ (etc). We hope that this will help them to continue the excellent work that they are doing to support a marginalised and neglected group of people.

For more information about the Manuel Bravo Project, their website is: http://www.manuelbravo.org.uk/

Last month the team attended the Hearing Voices World Congress in the Hague, Netherlands. We attended workshops and delivered some of our own. One of the workshops our development worker Jessica Pons held was called ‘Voices, Visions and Borderline Personality Disorder (BPD) – whose story counts?’.

Within our work with women in prison and forensic Hearing Voices groups, we come across many women who hear voices and have received a diagnosis of Borderline Personality Disorder/Emotionally Unstable Personality Disorder. The diagnosis is incredibly controversial for a number of reasons. Many women feel it’s invalidating, or retraumatising, and can impact how they are believed, perceived and treated by professionals. Women with this diagnosis are sometimes told that voices they hear are ‘pseudo-hallucinations’. In the workshop, we explored how this framing might affect how women understand, speak and relate to their experiences. We also thought about the effect it can have on staff, and how it might affect their ability to hear and support these women. Finally, we put to the group whether we needed to hear more about this diagnosis within the Hearing Voices Movement.

Towards the end of September, Mind in Camden hosted Flick Grey’s workshop ‘Deconstructing Borderline Personality Disorder’. She spoke about how BPD is a label applied predominantly to women, many of whom are survivors of childhood sexual assault, family violence or other overwhelmingly distressing interpersonal experiences. The workshop challenged the pathologizing, de-contextualizing and individualizing concept of “personality disorders” and explored more generative ways in which experiences labelled BPD can be understood – in terms of mis-attuned, disavowed and invalidating relational environments, as creative adaptations and/or (valuable) relational sensitivities.

Both Flick Grey’s training and Jessica’s workshop were fully attended and received positive reviews.

We now plan to talk more explicitly about the impact of a BPD diagnosis within our training and materials. Thinking back to the history of the Hearing Voices Movement, it makes sense that there has been more reflection on the impact of schizophrenia and psychosis. We now think it is now time to hear more about people’s lived experience of the diagnosis Borderline Personality Disorder in the context of hearing voices, having strong beliefs and other non-shared sensory experiences.

We are due to hold a BPD workshop later this month for female service-users on a forensic ward in Essex. We’ll then begin developing a one-day training on BPD to be delivered in February 2019.

Photograph taken at the end of the ‘Voices, Visions and Borderline Personality Disorder’ workshop at the 10th World Hearing Voices Congress. We’d noted down the DSM categories and begun to unpack, critique and think about how we might talk about the impact of this diagnosis in Hearing Voices Groups.

In February, one of our development workers presented at the Oxford Migration Studies Society about the work that Voices Unlocked does in Immigration Removal Centres. The talk gave an introduction to ‘Hearing Voices’, presenting the Hearing Voices Approach and explaining how it differs from the mainstream bio-medical approach. It then moved on to discuss Hearing Voices in spaces of detention, and Immigration Removal Centres more specifically.

In the Q&A/discussion, students expressed their curiosity about the effects of detention on mental wellbeing. They explained that because they had mainly learned about detention from more abstract political and sociological perspectives, they hadn’t thought so much about the pressures and stresses that individuals in detention are likely to experience. They reflected on how the high levels of uncertainty in Immigration Removal Centres – where, unlike prison, there is no limit to the duration of detention, or known outcome of detention – must be unbearable to live with.

We also had an interesting discussion about ‘intersectionality’ – the overlapping effects of the different categories by which a person is defined. We talked about the intersection of citizenship status (citizen vs non-citizen), race, gender, and mental health status. 

We look forward to future discussions with OMSS!

10 forensic service users have just finished our 3-day group facilitation course. One attendee had been an inpatient but is now living independently, returning to the ward employed as a peer worker. Three are living in a step-down rehabilitation service and the other attendees are inpatients of three different medium secure wards.

Material covered included language used to discuss experiences, ‘normal’ vs ‘not-normal’ beliefs, different understandings of why people hear voices, voices as messengers, the differences between a peer group and a clinical group, recovery journeys and the Eleanor Longden YouTube video. We also did facilitation skills looking at the role of a facilitator, safety within a group, opening up vs closing down conversations, debriefs and coping strategies.

We had a chance to problem-solve some issues with their current Hearing Voices Group and discussed how they want to use the training in the future. All who completed the training want to go on to co-facilitate their group.

After such a successful result, we plan to roll out group facilitation training for service-users to other organisations next year  🙂

Please get in touch if you’d like to know more!

In December we wrote about the workshops for prisoners at HMP Huntercombe, a foreign national prison in Oxfordshire. They now have launched their men’s weekly Hearing Voices Group and we’ve heard it’s going well.

Since the launch, we’ve had a member of their staff on our one-day Hearing Voices Awareness training. Hopefully, we’ll be able to train more of their staff in group facilitation in the near future.

We shall stay in contact with Huntercombe, providing support for the group’s ongoing development.