1 September 2017

Service User Perspective: Barriers to Engagement with QI Projects

Tony Fulham

Thana Narashiman , QI Communications Assistant, interviewed Tony Fulham; service user in July 2017, about his personal journey and barriers to engaging with QI Projects at the Trust and offered his advice.

Please share with us some barriers you faced to getting involved in Quality Improvement (QI) Projects?

I believe the biggest barrier to engaging was myself. I had ‘false pride’ and was not able to manage change well. The change of personal status – from being employed full time to becoming the victim of a serious crime which caused me severe trauma.

As a result of this incident, I was medically diagnosed with Post Traumatic Stress Disorder (PTSD) arising from the trauma. I was referred to my local mental health services at East London Foundation Trust (ELFT).

My engagement with the services caused me confusion as I wasn’t sure what it was all about. I was not aware of what resources were available to me to access and meeting the criteria for treatment was itself quite confusing and alien to me as I was functioning under adverse shock.


What other personal barriers were you facing?

I felt that my identity totally changed. It was also those environmental changes – I wasn’t aware of my local community and my neighbours and became increasingly isolated, that led to change.

Once I accessed Mental Health Services there was a lot to learn and I found it hard to take it all in.

I also lived with survivor’s guilt and had to come to terms with my personal circumstances through understanding what was back then PTSD and how it had impacted me with those changes within myself for my self-understanding.

I struggled for self-awareness of me with coming to terms with my personal change of circumstance(s) once I was discharged from local Community Mental Health Team (CMHT) services.  I was left confused about state entitlements like entitlement to Department Work and Pensions (DWP) benefit allowances, housing needs etc. and to accessing these services were very fragmented I feel at the time looking back now.


What experiences did you gain from confronting the challenges?

I stumbled across the ELFT Working Together Group and became involved through tenacity as I was approached to be the new chair of a local HealthWatch Mental Health Task Group.

From all of this, I wanted to learn more about recourse to the state benefits system in order to help other people like myself. I successfully trained as a generalist  advice worker within a local advice centre. I truly enjoyed this engagement as I got to meet people in my community which helped addressed my isolation and trepidation within society.

I also learnt how to use a computer & discovered new soft skills within me which were invaluable. All this helped me to build upon my confidence.


What were your experiences of attending other ELFT meetings?

My first Tower Hamlets Working Together Group was very new – and sadly it was not a warm welcome. The group’s focus is on reintegrating people who’ve been discharged from the service. From my observation, it seemed to be very much “the old guard”, people had been in the group for years and years. It put a lot of people off from attending, I felt I was alone again.

I had a basic experience of chairing meetings with the NHS and so volunteered to become the new Chair of the Tower Hamlets Working Together as I thought it would help my recovery. I also wanted to influence positive change and felt the group needed a fresh approach.


What can you share with us regarding any other barriers that we can change?

A simple matter : meeting rooms not being very welcoming with no windows and not a dark room and also no windows can be opened due to Heating and Ventilation (H&V) system.

Since meetings were alien to me, I really did not know the “rules” of a meeting so simply felt I couldn’t leave the room when needed to.

I didn’t have any personal reference or the training to know how to behave and I felt like an actor, not truly being myself. So any training would be useful for all.


What are the opportunities moving forward?

As part of my engagement here and with the People Participation Team in general, I am now involved with the monthly ELFT QI steering group and I am going to be co-chairing the meeting with the current chair, Erayna soon.

I have also been engaged wider as part of local Metropolitan Police Safer Neighbourhoods meetings and Community Safety Board – as I wanted to give back to the community when I was within my local CHMT.


What is your passion?

“I want to make a big impression” : “6 foot manhole imprint” and “something that’s long lasting.”

I would like to witness improvements to the Mental Health service for people entering the service in the future and to use my lived expert experience to a better use.

Prior to being a victim of a serious crime where I nearly lost my life, I was a more of a taker and now I want to be a giver. It has really changed my life seeing life more positively now.

I don’t want to be a passenger anymore –  I wish to be involved in QI to acquire new skills and training and be a driver of change for both carer, service users and staff members to share back.


Tony Fulham

Service User

21 August 2017


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