The Curse of Meetings

I have a week of meetings about Julie lined up for next week, and as you can guess from my title I am not much looking forward to them.  It will be a festival of talking, but there may not be much to show for it.  There are meetings about our transition from child to adult services, regular meetings to discuss progress, and meetings about returning to school.

The problem I have with meetings is too much talking and not enough listening.  Meetings can become dominated by the loudest voice, and quieter voices or more complicated or unpopular points of view get ignored.  Underlying this is the deeper problem that all the participants come from different services - they belong to separate tribes specialising in education or social work or hospital or outreach services.  They speak different languages, have different constraints on them, and are shocked or amused by different things.  It is the United Nations all over again, and about as effective.  The most successful meetings are those which just aim to introduce the members of different tribes to one another or exchange information.  But the least successful are where there is a problem to be solved jointly.  Sometimes when you look round the room at one of Julie's mammoth monthly planning meetings, you can start to understand why the world is failing to solve global warming.

The biggest problem facing us right now is whether or not Julie can make yet another attempt to return to school.  The different tribes have widely different views on this: the education people are defensive and anxious to point out that they have no budget for supporting her; the hospital people are keen to point out that she cannot stay attached to the ward indefinitely; the outreach people are in the middle of a massive restructuring which means that they have no idea what they could or should be offering.  What tends to happen amongst all these tensions is that everyone is faultlessly polite to everyone else, but no one actually tackles the real problem.  The goal of the meeting becomes avoiding conflict while not making concessions to the other services.  The real problem is that Julie needs very high levels of support to be safe at school, and this will cost someone some money.  As each professional comes out with their solution to a (different) problem that they can solve, all the others applaud their hard work and professionalism, but nobody wants to admit that it hasn't addressed Julie's problem.  So it's thank you to the school staff who have offered a quiet place for her to go to between lessons, and thanks to the outreach team who have offered to pop in at lunchtime, and before you know it everyone is packing up, swapping phone numbers and declaring the meeting a great success.  But hang on a minute, we haven't solved the problem at all: this is a young person who can't be left on her own even for short periods of time, who rapidly becomes distressed by noise or changes of plan and who has a (very recent) record of serious self-harm.  She needs more than a quiet space and a lunchtime chat, she needs someone checking up that she has got to the next lesson in one piece, someone getting her to a place of safety if she hasn't, someone helping her negotiate the noise of the dining-room.  No one seems to have the remit of looking at what Julie's problems actually are and what she needs: everyone just has the responsibility of telling us what their service can provide.

The reality, time and again, is that what they provide isn't enough: Julie self-harms, the school won't have her on site, she ends up back in the hospital.  The family pick up the pieces, transport her to and from school, respond to emergencies, care for her when she is neither in school nor hospital.  The ability of the family to soak all this up is never examined too carefully, if at all.  Some bright spark proposes some new scheme - Julie will stop going to hospital and go to school for one hour a day, say - and not one of the collected professionals asks the simple question, what will she do for the rest of that day?  She can't stay on her own at home safely; she isn't getting an education; she's missing out on social interaction.  I am the only person filling in the gap, trying somehow to work from home while juggling care for her, and trying to support her unaided while her mood spirals downwards.  Is this stressful?  You bet!  I'll let you into that secret for free.

I do say all this - sometimes - in meetings, but only if I am feeling thick-skinned that day.  They all bat it away individually: it isn't the responsibility of the education people to find out what happens out of school, it isn't the responsibility of the hospital people once Julie is discharged, the outreach people are not sure yet what their responsibility is. Other responses: I am over-reacting, we mustn't over-protect Julie, maybe I should consider giving up work.

 

But if I loathe the meetings, the alternative must be worse: when there have been no meetings, or I have not been invited to them, I admit I have been the first to complain.  Meetings may not be a good way to make decisions about Julie's future, but at least the decisions made in a meeting are transparent.  I may hate the fact that resources are tight or non-existent, but I would rather know that, than have to guess at the reasons behind a bad decision.  I may hate the things that are said to me in these meetings, but I would rather hear them there than guess where I stand.  Even the confusion and inefficiency of trying to make decisions across so many different services is probably better than delegating all the decisions to one service with one fixed and unmovable point of view.  So I will carry on attending meetings, I will carry on trying to remain calm, patient and dignified, and I will carry on trying to remind everyone that Julie is a real person with a real family and a real future.