Healthy disagreement can help broken systems

Maff: At the Association of Camerados we are thinking about the things that help people live a richer life, not necessarily things like a job or a home or a hostel. We believe it is friends and purpose that make a difference in this life. How do you create friends and purpose? Here is the newsflash: instead of asking people how you can help them, you ask them to help you. The technical term is ‘mutual aid’. To me it’s friends and purpose.

Charlie: I work across a number of organisations, initiatives, and government departments illustrating what can happen if you build solutions with people instead of for them. We say we involve service users in service design, but too often that means consulting them on what we have already decided to do. I want to build things with people. That is what I have tried to do at MAC-UK, Owls and in our testing of the Problem Solving Booths. And it is what I see, Maff, in your experiments with Public Living Rooms in Blackpool, Oxford, Sheffield, Camden, Brooklyn and so on.

My kind of innovation forces me, forces people, forces the system to work in a new way.

I suppose a difference between you and I is that I am working with ‘the system’. People come to work in public systems for the right reasons. People with mental health difficulties come to the NHS. It is a behemoth. You cannot ignore it, you cannot work outside of it. My kind of innovation forces me, forces people with mental health difficulties and forces the system to work in a new way. Failure for me is people saying ‘Charlie Howard did this’. I want them to say ‘the NHS did this’.

Maff: I admire that. It’s brave to try and change a system like the NHS. I have tried it too. If I look back I see 22 years of being mired in treacle working with people who are constrained into always finding a reason why something isn’t possible. Plus systems are always changing. So when you do manage to get something off the ground, when something looks like it will happen, it gets stymied. A new Minister or a new CEO comes in and reinstates the status quo. So there is a bit of me that wants to clean off the treacle, free up the arms and throw bombs. I now work outside of the system, doing things before saying to them ‘catch up or not, it’s up to you’.

I now work outside of the system, doing things before saying to them “catch up or not, it’s up to you.

So I don’t want to hurt systems. But I don’t like what systems do to innovation. Here in Camden we have just set up our fifth Public Living Room a space for people to live, a space that gives them half a chance to be a Camerado, a space to find friends and purpose. If it gets commissioned by a system it will become a Health and Well-Being Centre and instead of walking in off the street you will be referred via the Camden Gateway, which to many people is another name for a waiting room without an exit.

Charlie: I have had my frustrations as well. Of course I have. But it doesn’t sound altogether right to me what you’re saying about the system damaging a model. Recently I was working with a major health Trust here in London testing out our Problem Solving Booths. These booths are a couple of chairs with a cardboard label saying ‘Helper’ over one and another topped with the ‘Helped’ label. People sit in the chairs and talk about their problems. In many respects it’s another form of mutual aid like the Camerados Living Room. Except this one was run by the health trust. I found it gave the trust permission to do things quickly and overnight. One of their targets was ‘community engagement’ and I said ‘wouldn’t this help you meet that target?’. And off they went.

They adapted it. It was helping people in the community talk about their problems. But it was also helping the people in system recognise the stress they are under, and how this stress undermines their work. When I tried the model with the police recently I found it got them talking to young offenders in a different way, which got them to think about crime prevention in a different way. You never know which way this stuff is going to go.

You’re not allowed to disagree with people anymore. Yet disagreement seems to me to be at the heart of great innovation.

Maff: I like you saying ‘that doesn’t sound altogether right to me’. Why are we expected to agree with each other? We probably do agree on 90% of what needs to be done. But often when we meet we are like a couple of crocodiles snapping at each other. You’re not allowed to disagree with people anymore. Yet disagreement seems to me to be at the heart of great innovation.

Charlie: It is a paradox that modern systems foster huge amounts of competitiveness between NGOs, in other words another form of ‘crocodile’ behaviour, but in that context it tends to stifle ideas and innovation. It doesn’t create any real space for co-production for example. If I had a magic wand I would reward co-production every time, even when it didn’t lead to anything systems would recognise as concrete. The best thing we did at MAC-UK was to design a football team that never happened. The design process was as good a response to mental ill-health as the proposed innovation.

If I had a magic wand I would reward co-production every time, even when it didn’t lead to anything systems would recognise as concrete.

Maff: I have certainly learned a lot from you on co-production. I guess the thing that people tend to forget is the ‘co’ in co-production. It’s not a matter of leaving it to the users. If we left the living rooms to local users we might end up with something that looks like a conventional community centre. We are looking to inject a ‘wow’ factor. And we are trying to hold a line about how members of society support each other, that the best way we can help someone is to ask them to help us.

Charlie: Yes, I think that is the right way to think about co-production. We can think about ‘co’ in lots of ways. We have a duty to build ideas and solutions together, pooling our respective knowledge and expertise. I also think the ‘co’ goes beyond community. It has to do with services too. What are your thoughts Michael? Is there any sense to this?

Michael: I think the conversation captures a lot of the dilemmas we face in this work; harnessing the power of the system without being swallowed up by it; using the know how of people looking for help without being reduced to clichéd responses; being prepared to disagree strongly without that being taken personally.

You’re not intervening, you are changing a space so that people encounter each other in a different way, producing different results.

I also see in this conversation themes that are likely to dominate innovation in the next decade. Mutual aid you have mentioned, that is what you are both working on. But I also see innovation without intervention. Neither Owls nor the Association of Camerados is intervening with their respective innovations. Instead you are changing the context in which people live with each other. You have to let that sentence marinade a little to let its radical potential infuse. You’re not intervening, you are changing a space so that people encounter each other in a different way, producing different results.

I also see you opening up civil society. Neither of you think in terms of the ‘Third Sector’. You think much more broadly, bringing in family, friends, neighbours, and you think beyond that again to bring in strangers. Nearly everybody coming to a Problem Solving Booth or a Public Living Room starts off as a stranger to each other. To me this is another radical departure, a setting off point to completely change what we mean by public systems and the so-called Third Sector. So carry on, crocodiles.

This essay is part of a series on transformation from the boldest voices in the sector.

About the authors

Dr Charlie Howard is a Clinical Psychologist, social entrepreneur, strategic advisor and keynote speaker. She has worked as a Clinical Psychologist in the NHS, private and community sectors for over 12 years. Charlie founded MAC-UK in 2008, was CEO until May 2014, and continues to be involved in an ambassadorial capacity. She is now director at the Owls Organisation, established to gather and test new ideas driven by people to find solutions to enable mental well-being.

Maff Potts set up Camerados in 2015 to work with and support people who the existing system have failed. He has been instrumental in creating culture change in homelessness nationally: he ran the Government’s programme to modernise homeless centres, writing the policy and committing £170m; and co-created a social enterprise competition with the Big Issue and PwC that launched 34 new social business in the homeless sector. Maff has also worked front line and ran the largest homeless services in the country for The Salvation Army as well as being CEO of award winning organisation People Can.