Mark Brown Profile picture
Mental health/tech stuff. Former writer in residence @centreforMH. Ask me to write MH things. Director Social Spider CIC. DMs open. Podcast @BBCOuch (he/they)
9 Jun
I've been live tweeting all day for #beyondtheroom from #quality2021 (…). In the thread below are links to the threads of my tweets from each of the talks and workshops on quality improvement I attended if you want to read back at your leisure (1/5)
Read 5 tweets
9 Jun
Welcome back to my live tweeting from #quality2021! The final session I'm covering today is "The Role of Leadership in People Wellbeing: Addressing Front Line Burnout Through Culture and a Systems Approach". It runs up to 17.30 (18.30CEST). I'll be tweeting throughout
Our speakers for this session on burnout and how to avoid it are Ingrid Gerbino, Virginia Mason Franciscan Health; USA and Wendy Korthuis-Smith, Virginia Mason Institute; USA #quality2021
And we're off! Gerbino and Korthuis-Smith are explaining the approach that the Virginia Mason Institute method takes to people management and to prevention of burnout. Korthuis-Smith is asking the audience about factors they recognise in burnout #quality2021
Read 33 tweets
9 Jun
Welcome to the next session at #quality2021 ( "Optimising the medication pathway: Meeting the WHO 2022 target of 50% fewer medication errors and clearing patient backlogs through automation". It runs through to 14.15GMT. Thanks for joining me
This is the abstract for the session. Basic summary: using automation to reduce medication errors… #quality2021
Kirran Walsh of BMJ is introducing our session. First up: Rachel A. Elliott, Professor of Health Economics at the Manchester Centre for Health Economics; United Kingdom. Elliot is setting the scene in terms of economic impact of medication errors #quality2021
Read 50 tweets
9 Jun
Hello! The next session I'm live tweeting for you from #quality2021 ( is "Creativity as core in QI - using the Arts to empower and build co-production". It will run until 13.00GMT. We're hearing from Polly Bowler and Leanne Sedin about work at @NHS_ELFT
Amy Price is introducing the session. Says we'll be hearing about the East London Foundation Trust's #ELFTin1Voice projects. Polly Bowler is Head of Arts Therapies for ELFT’s Bedfordshire & Luton. Says improving lives is the aim of what they do. #quality2021
Bowler is talking about the 1Voice choir project, which is run in partnership with Sing Tower Hamlets community Choir. She stresses that the project is open to all, and helps to bring together people and provides a way to discuss difficult things #quality2021
Read 24 tweets
9 Jun
Right, first session of today at #quality2021: Quality Improvement at National Scale: The theory and results of two national collaboratives using QI to address human rights issues and safety in mental health. Amar Shah is welcoming us to the session.
We're being joined for this session at #quality2021 by Ajibola (Aji) Lewis, Sal Smith and Kate Lorrimer. Shah says patients in hospital for mental health reasons experience same risks as other hospital patients, but with other risks to their safety related to their mental health
Shah says that there is relatively little work that's been done about patient safety in mental health settings. Says there is a tension between autonomy and reducing risk which is often present in mental health situations #quality2021
Read 28 tweets
9 Jun
I'm live tweeting for next three days from #Quality2021, International Forum on Quality and Safety in Healthcare Europe 2021 ofr #beyondtheroom. I start at 11GMT with "Quality Improvement at National Scale: using QI to address human rights issues and safety in mental health"
For wondering what QI is, it's not the smug telly programme about telling people they're wrong about stuff. QI stands for Quality Improvement. Here's a good intro to the whole approach in health… #quality2021
Other sessions I've got for you today are

12.15GMT Creativity as core in QI - using Arts to empower and build co-production

13.15GMT Optimising the medication pathway: Meeting the WHO 2022 target of 50% fewer medication errors and clearing patient backlogs through automation...
Read 4 tweets
8 Jun
Sitting outside in the dark. The fox cubs have been and gone. There is a cat on the roof. The silhouette of a cat sitting on a flat roof
The fox cubs are back. They move on tip toes. The vixen is grumbling to herself. She looked at me through the gate and we nodded at each other in a most neighbourly fashion.
Last week I stayed in a youth hostel on the South Downs and, honestly, I've seen more wildlife and stars since I got back. The world can be quite remarkable, really. Even during all of this horror.
Read 6 tweets
8 Jun
We aren't going to make it out of this pandemic without changing how society works. We aren't going to make it out of this pandemic without changing how everyday life. We aren't going to make it out of this pandemic without thinking about how to make sure we keep what's important
We won't be going back to how things were before the pandemic. We will be remaking what was there before, not returning. We can choose the best post post covid-19 world or we can let it just happen and hope for the best. The best will not be best and will not be fair, either
The last time I felt myself at a turning point in world history was in 2008 as the global financial crisis happened. This is bigger. If we don't actively work for a future we want, we're going to end up with what's left after covid-19 has closed off all the avenues of choice
Read 5 tweets
27 Feb
One thing my early zoom fatigue makes me think is we should always listen to Disabled people first. Disabled people aren't outliers to whether something is usable. Disabled people are people with fewer options and/or energy to adapt to how something works: an early warning system
The zoom fatigue thing is a literal experiment in resilience. A service or interface that works well once but requires a long recovery time on part of user is not a service that works well. Instructive to see the rest of the world understanding what that means in practice
Read 8 tweets
27 Feb
Grief hides in everyday things like a sweet in the pocket of your third best coat or jam on the knife you spread virgin butter with. Grief is like a cough, like the alarm you forgot you set, like the annual subscription to the app you used once. Grief hides in everyday things
Grieving is opening a letter to find another letter inside. Grieving is a performance forever rehearsed for an audience who never come. Grieving is sowing a garden with dead flowers in hope they'll grow again. Grieving is talking an inventory in knowledge the shop will close
Loss is carrying a piano up the stairs alone, finding the fuel to feed one heart where two once steadied the pressure, serving tennis balls to the back of an empty dusty court. Loss is knowing the thing you need to feel fully is the thing that the loss is about.
Read 6 tweets
25 Feb
You might think that the vaccination effort in the UK is a story about vaccines. It isn't. It's a story about primary care, administration, infrastructure and team work. Vaccination is one intervention that rests upon an almost infinite number of publically funded interactions
Getting vaccination to everyone is a very different thing to getting vaccination to everyone who turns up. That we can move quickly to vaccinate is not pinnacle of the NHS, it's a result of everything else the NHS is. The vaccination is a result made possible by everything else
I'm so fucking proud to be helping out making these vaccinations, even in a tiny way. I'm more proud to be part of a wider team and set of structures working together to get them to happen. I'm proud to be an unimportant person engaged in a profoundly important task
Read 7 tweets
14 Feb
Some of you will probably know I'm currently grieving. It's a month since my fantastic sister died. I've been thinking a lot about loss, progress and reckoning and coming to terms, both personally and as a society. And I've been wondering: how will we remember the pandemic dead?
The UK is filled with memorials to the dead of wars, of disasters, of lifeboat crews and atrocities. We are a landscape haunted by attempts to remember the brave and the innocent. Villages, towns, businesses, communities: all grouped together to pay for plaques, statues, gardens
I have a terror that in our desire to get 'back to normal' we will forget those lost and things lost during the current pandemic. There's not an enemy they were overcome by; not a single flashpoint of tragedy. Those lost to the pandemic are an uncomfortable reminder of failure
Read 21 tweets
12 Feb
Just doing a bit of reading, the talk of NHS reorganisation having whetted my appetite for a bit of health geekery. I'm mainly trying to get my head around the purchaser provider split in NHS and what that means. Here's @mellojonny from 2011 (Pre Lansley)…
This by Mick Timmins is great "choice and competition in health seem to work best when there is a growing rather than a shrinking market – and, despite its relative protection, health has been a shrinking market since 2010"…
*Nick, not Mick
Read 5 tweets
12 Feb
Thinking about health and social care integration. Some people think you need reorganisation to remove silos. But, thing is, people like silos. And things not working in partnership often result from one partner not wanting to, or being in a position to do, what the other wants
I think reorganisation of health and social care always tilts toward 'reorganisation of social care so the NHS works better' and very seldom 'reorganisation of NHS so social care works better'. Social care isn't just an element of local authority work that enables the NHS
I kepp thinking of the grand utopian dream of end-to-end health and social care, all together under one notional organisational roof like Toys R Us and thinking: it is a utopian dream and it's also one that people didn't really like the closer it was to reality
Read 6 tweets
8 Feb
Actually, one thing I have been doing during lockdown is really indulging in 'this looks like that' & 'that sounds like this'. What I mean is kind of grazing and burrowing into visual or auditory things. Exploring without going anywhere by jumping from book to book, song to song
Really, consciously tickling my visual and auditory palate by finding things that feel new or which belong with each other by theme, production, sound or, I dunno, shared feeling of jouissance. An example: old pre-internet photobooks on niche subjects with that kodachrome hue
It's like really spending enough time in a landscape that you can see the history of the topography, uncover the old paths, see what links things that otherwise seem unconnected. Seeing the contour lines of culture and human ideas between previously singular seeming things
Read 4 tweets
8 Feb
Things I've done for my #mentalhealth during lockdown include: having a cup of tea; making space to do things just for me; getting on with some stuff that means a lot to me; looking out of the window; not kicking my own arse for things I've not done during a national crisis
I've not written a book. Or found a new hobby. Or learned a language. I've mostly been concentrating on just having a day to day life with small pleasures and tiny doses of awe and wonder. I feel like too many people think of activity as medicine against being mental
I can't give you any tips. Why should I be able to? I don't know you. I don't know what helps you to feel like your life is going OK. Having people to talk to is important to me. It mightn't be to you. Having something interesting to think about is important to me. You may differ
Read 13 tweets
4 Feb
Another year, another time to #TimetoTalk day. This year I'd like to talk about mess and discomfort. One element of stigma is feeling like you carry a story and history that will never be understood and never be possible to integrate with the lives and stories of everyone else
If there's a #TimetoTalk day, there should also be a #timetolisten day. And listening means learning to live with stories that discomfort, stories that trail off, stories that ask questions you can't answer. Mental ill-health is a fucking mess to live with.
The experiences people share around mental ill-health will not conform to your wider narrative expectations. The job of making our stories make sense that we have who live through them is not the same job that a person listening has. #timetotalk isn't about you
Read 8 tweets
3 Feb
Worth looking at trending topic 'CAMHS' (Child and Adolescent Mental Health Services) right now. We aren't providing good service to everyone who needs it. We're often providing a weird service to people who do because CAMHS gets blown about by cultural ideas about mental health
Yes, I know people don't really share much about healthcare experiences that went well, but people's experiences of CAMHS that are being shared present CAMHS as contextless set of unexplained events where things happen for no reasons instead of a place of help and support.
With CAMHS wider cultural winds are like "We need to give children/ young people every support they need for their mental health unless we don't. We don't medicalise distress, unless we do, but we might not again, keep you on yr toes. If you don't want service, you can have it."
Read 6 tweets
2 Feb
I think there are three things we need to do if #mentalhealth is a parallel pandemic to Covid-19 (I don't think it's separate btw). The first is to do everything to remove fear: fear of hunger, fear of poverty, fear of loss of life chances, fear of being forgotten (1/3)
The second thing we need to do around the pandemic and #mentalhealth is to begin now a national conversation about loss and foreground those who have lost people and things to the pandemic in that conversation. Loss needs remembering now. It's not exceptional, it's endemic (2/3)
Final thing we need to do around #mentalhealth is to stop assuming we know what people need and actually ask in good faith, with governmental commitment to meet those needs. One size fits all hammering of this exceptional time into system designed a lifetime ago won't work (3/3)
Read 6 tweets
2 Feb
I'm doing #MWE this year. each day in February an album I've never listened to before, reviewed in a tweet. I'll thread them so you can see what nonsense I've listened to...
#MWE 1st Feb "High Fidelity (A Taste of Stereo Sound)"

1st release on Sainsburys own record label(!) attempts to catch sound feel of a hi-fi shop demonstration in 1970s. It's all about separation, tone and anti static cloths. Best song? Perhaps 'This is Tomorrow' by Bryan Ferry
#MWE 2nd Feb "Fingerbobs Original Soundtrack"

'These hands were made for making and that's what they must do'. Melancholy from crossover between bleak british folk and paper based children's programming. If you grew up before 1990 in UK, this is the craft fabric of childhood
Read 4 tweets
25 Jan
It's incredible to me that we find it easier to discuss the political implications of continuing lockdowns than the political implications of 100,000 people being dead.
But the bereaved don't have a political presence, do we? Nor do those most at risk. We're a policy issue. And policy issues are difficult to discuss.
People who have died because of covid-19 are just sands in an hour glass measuring the time until we can get back to normal. It's unacceptable to be angry for those who aren't here anymore because, somehow, to speak of that result of political decisions would be uncouth, messy
Read 12 tweets