Positive steps

First instead of a deficit-orientated approach, take one which is function-orientated. Instead of assuming a prototypical 'norm' and assessing according to that, develop awareness of normal diversity in 'psychological types', and from that standpoint develop understanding of the problems and difficulties that can lead to, including metacognitive difficulties, self-concept etc. Then aim to assist people to get the best from their abilities - i.e. as analogy, instead of getting left handers better at being right handed and addressing that deficit, work on assisting them to be functional and successful left-handers - which they have not properly understood how to do. The scientifically bogus tacit assumption that there is a prototypical 'norm' which all 'ought' to be is like assuming left-handedness is itself a deficit. That tacit assumption gets in the way of attaining mental health. People who are of an atypical psychological type do struggle and have difficulties and often have mental health problems; these can't be resolved by efforts to make them more like a psychological type which they are not, but by learning how to become healthy as the psychological type which they are. Prof. Sternberg's 1999 work on Thinking Styles has much the same lesson: differences in thinking style meant that when all students were taught the same way there were the 'smarts' and the 'dumbs'. When the teaching style was changed, the dumbs became smarts and smarts became dumbs. Rather than remedial assistance to help 'dumbs' cope better with the normal teaching style, far more can be gained by teaching them in a way that suits them, so they can properly learn how to function and succeed. (i.e. a function-orientation rather than deficits-orientation). A great deal might be gained from using psychometric profiling (e.g. MBTI), and psychoeducation to assist understanding their cognitive style and behavioural dynamics. Once the confused prototypical sense of self is addressed, then there is an interpretative and evaluative context for current view of self. (i.e. when not longer falsely suppose one is a disordered typical 'square peg', but one's prototypical self is an atypical 'round peg', one can then see how one is a round peg with splinters, and can then address these problems). More emphasis also needs to be given to moving people down the Kaiser Pyramid towards 'supported self-care'. Self-help groups of users can be hugely beneficial, but for some mental health conditions these do not exist. Where needed, support and assistance should be provided to facilitate, organize and fund these, instead of leaving it to patient groups to do so themselves. (A classic example is with Adult ADHD - given difficulties adults with ADHD have with organisation, filling in forms etc. not suprisingly there is no properly organised user group for adults with ADHD in the UK. Though NICE state such support groups are important, and SLaM could play a key role in assisting set this up, the focus on 'professional' services means that it is left to the users to do it all by themselves - despite the obvious difficulties for them which means it doesn't happen). This need not require significant funding - there are plenty of opportunities for funding for such groups - e.g. Lottery Fund. What is needed is assistance for users to get such groups up and running: governance documents, accounts, grant applications, employing an administrator, etc. SLaM could provide a user group support service with these governance/treasury/secretarial/administrative competencies to be shared across several user groups with just 2-3 FTEs (which would become self-funding). A lot of emphasis is now placed on working with user groups, but if these don't properly exist, initiatives are needed to get these up and running. A good start would be by establishing service user groups for the various service areas SLaM deals with. Patients/users and carers could be invited to become members of the relevant group, which would be meaningfully involved in having a say in shaping the services which are provided for them. This would not only be a positive step, but I'd think it is one which is also required given SLaM's strategy.