In conversation: Mayday Trust and Relationships Project

I had worked with lots of different groups on lots of different issues over the years but, whatever the presenting problems, broken or non-existent relationships were almost always part of the mix

It was also a new relationship with services that the people most excluded from them were asking for: They wanted support from people that saw them as people first and were willing to be led by them as towards the goals that they found meaningful. This approach has become the PTS Response, in which coaches go out and find people who are being let down by services the most, and form trusting relationships with them, as the basis for coproducing support which is led by them and which looks beyond services into the community. Those coproduced support models are then fed back into local service planning to develop into new more relational support pathways.

I think that society in general, and public services in particular, do relationships less and less well. Of course, we network and transact in ways that would have been unimaginable at the start of my working life but being well connected is not the same as connecting well.

Every service is a relationship, of some kind. The longer the person will be in touch with a service, the deeper the impact of that relationship, so it’s vital that it’s healthy. We aim to work with people who experience the deepest inequalities in services: they have lost trust, and the cumulative cost to them of unhealthy interactions with services means that service systems are harming rather than helping them

As I was seen to be progressing, there was a delayed effect of the trauma of what had happened to me, which only really hit home afterwards – I could see later that I didn’t know how unwell I was at the time it was all happening. All my confidence had gone, and I couldn’t express myself clearly. You get so far away from society, that bringing you back in from the cold is not simple – it’s not just practical help. So services got frustrated with me. They couldn’t see that I was experiencing new trauma as a result of my progression, but the progression also meant I no longer qualified for the support. So ‘progression’ for them, was frightening for me. I needed services which would build a system with me, that worked for me, and where I felt more in control.

Relationships came to be a recurring theme in my work, as both problem and solution. Whether we were developing a practical project on the ground or a policy response with the government, repairing relationships or building new ones was invariably at the heart of our work. I began to wonder how would the world change if we thought of good relationships not as a frilly bonus on the fringes of a service or organisation but as the central organising principle – not the extra mile for the effective practitioner, but the first mile.

I think that’s what connects our work. We want to see a new public service system, but it’s not ‘system change’ at an abstract level – a new form of organisation or bureaucracy. It all boils down to a new relationship being possible and expected, whenever someone offering help meets someone who is looking for it. The challenge for public services is to create organisations, contracts, and partnerships which enable people to behave in that very human way and to do that at scale. We believe that’s possible, because although it takes time to understand what someone really wants and needs from you, if you can then offer them what works, and minimise what harms, we could save countless hours, days, and years of people’s lives spent stuck in or circling around the same ineffectual systems.

Relationship-centred practice is characterised by empathetic behaviours such as positive listening, active collaboration, a commitment to continuity, kindness and mutual trust. There is a shared sense of purpose and also of agency – “we can do this together”, capacity for challenge, for holding tensions alongside compassion and forgiveness, a focus on assets rather than deficits and sufficient versatility to adapt the practice to the individual rather than fit the individual to the programme. It is informed by experience, but not scripted. The most effective relational practice is not enforced from without. It is compelled from within, willing and dynamic.

Relationship-first practice is the key to making good on promises to ‘tackle inequalities’. How can any organisation claim to be serious about inequalities, if it is not willing to invest the time, care and energy needed to get to know the diverse group of people it is in touch with? We see this work leading to initiatives which are as much about building inclusive communities as inclusive services. One woman that we work with in London has worked with us to codesign more holistic mental health support, and has now attracted the support of NHS commissioners, working with our Systems Convenor who builds relationships between people and across sector boundaries.

RCP unlocks potential and meets need by positioning meaningful and effective relationships as the first order goal, both an end in itself and the means by which other goals will be achieved (like better health, stronger communities, greater job satisfaction) It is the principle on which we build successful services, as well as a favourable and equitable economy, fair and effective government, flourishing business, safe, happy, healthy communities.