The best nurse I ever had walked beside me and never got in my way. She would appear unobtrusively by my side and gently encourage me to get off my bed and go for walks with her. She hardly said a thing to me, but I could feel her calmness and acceptance through all the static of my distress. Other nurses got in my way; they tore off my blankets, threatened me, berated me for being inappropriate or for not facing the world, or gave me strange looks when I expressed my pain.

In their training and professional development, nurses learn many things – much of it is irrelevant to the experience of the person using the service. I do not remember any of the nurses I encountered for their professional skills. But I do remember them for their human qualities. Above all, I remember the nurses who were kind and compassionate.

Compassion is hard to teach and impossible to enforce, but it is the single most important attribute any mental health professional needs to develop. Compassion means being able to stand in the shoes of the other and be with the person in her or his distress. It allows the helper to stand on the ledge between deflecting the other person’s pain and losing herself or himself in it. Compassion takes a strong sense of self, patience and an acceptance of difference.

Unfortunately, compassion cannot thrive in services that control people and pathologise their experience. A recovery-based service promotes people’s autonomy and respects their subjectivity; this is the best setting for compassion to grow. Wherever we work in the mental health system we have a responsibility to foster compassion, not only in our one-to-one relationships with the people who use the service and our colleagues, but in creating a service environment that encourages empowering and respectful relationships at all levels.

Earlier this year I was waiting to turn right at the traffic lights when I suddenly became aware of a young man standing at the pedestrian crossing on the opposite side of the road. I looked again at the handsome face. The blonde hair cut in a style I remember so well. He was wearing blue jeans and a denim jacket. My heart skipped a beat. Once again, the universe had found a way to bring him back to me for a few moments. My son, Nicholas. My son who, in November 2000, had died in the psychiatric ward of a public hospital in Adelaide. He was 26 years old.

I’d visited Nicholas in hospital shortly before he died. We went for a walk in the grounds of the hospital that day, and I noticed one of the other patients, an elderly woman, was following us. We sat down on a bench and the woman came and stood close by. After a while Nicholas got up and walked over to the woman. He put his hand on her arm very gently and in a quiet voice I heard him say, ‘My mother and I are having some time together, would you mind very much moving further away?’ The woman nodded and without speaking moved away a little. We started to talk but we were interrupted again; this time the woman had started to sing. Looking over at Nicholas she sang to him. The words of the song were: ‘A certain smile, a certain place can lead an unsuspecting heart on a merry chase.’ It was an unlikely serenade but he listened attentively to her until she finished singing, then he turned back to me, and we continued our conversation.

Introduction

By now readers of this book would have been thinking quite deeply about the topic of mental health and the practical ways in which they might collaborate with and support people with a mental illness, their families and carers. The preceding chapters have given considerable emphasis to a narrative approach. This final chapter is orientated towards a discussion of leadership – particularly for new entrants into mental health settings.

Effective clinical care requires consideration being given to the lives and needs of consumers, carers and families, and having all of this richness combined with evidence-based practice. At the heart of the decision to take this approach in this book has been the fundamental belief in human connectedness. Each of the chapters contained within this book has set about encouraging discovery and learning by making sensitive revisions regarding the ways in which nursing, health and human services practices can be made more meaningful in the lives of those who need them.

By working through each of the chapters, readers will have been challenged to think about how and when to move in new ways when working with resilient and vulnerable people, which might be helpful across a range of practice settings when seeking to make a difference in the lives of people experiencing a mental illness. And while this is important in providing a theoretical and practical basis for care, it is at the point of care that effective leadership is required.