?A good place to be?

Faith in action

Terry Philpot

The word ‘vocation' has often been defined narrowly as those who opt for the religious life. But for many in the caring professions and the charity world, their jobs are inextricably tied up with their faith. In the first of a new series, Terry Philpot talks to Paul Farmer, head of the leading mental health charity, Mind

Is there a saint for people who have mental health problems? What might seem to be a question for a theological trivia quiz has real resonance with Paul Farmer. For not only is he chief executive of Mind, the biggest campaigning and policy charity in the mental health field, but his father is David Hugh Farmer, former professor of medieval history and author of The Oxford Dictionary of Saints. Given this paternal influence, that his mother was a teacher and that he himself attended the Oratory School, Reading, and then read history at Oxford, an academic career or school teaching might have seemed the obvious choice. However, Paul Farmer has spent all his working life in the voluntary sector, coming to Mind to take the top job just over two years ago.

But it was his first job, as assistant director with the small but now defunct Clerkenwell Heritage Centre, that he says was his best education in what the voluntary sector was all about. It taught him much that he was to need in later life. "It was a grand title - there were only two of us and the other person was the director. I didn't know much about the voluntary sector at that time but it offered everything you wanted to know - a chance to learn everything from double-entry bookkeeping to fund-raising and PR to running a shop. I realised also the fabulous ability of charities to be innovative, as well as learning all about the idiosyncrasies of the sector," he says.

Paul Farmer looks back on that time with a very obvious affection, but he began to realise that he wanted to work with people. He left the centre in 1990 to join the Samaritans as press officer and then became communications manager. It was there (as well as volunteering as a Samaritan) that he came to learn about mental health. It is not surprising, then, that seven years later he became director of public affairs at Rethink, another mental health charity. In 2000 he also became chairman of the Mental Health Alliance, a disparate grouping of 75 or so mental health charities, other organisations (like the Royal College of Psychiatrists, Caritas - Social Action, the Law Society and the British Medical Association), individual professionals and those who use mental-health services, which was set up to oppose the Government's long-delayed and much-contested Mental Health Bill.

"I wouldn't say that when I started off - or even when I joined the Samaritans - I had some grand plan, but organisations find you as well as you finding them," he explains. "The voluntary sector is a good place to be. There's definitely a part of me that wants to make change, and trying to reach out to a wide audience has always seemed to have been there. Why? Well, I suppose if your father is an academic and your mother is a teacher, then communicating is in your genes."

It's an attribute he needs for his present role because Mind is not only about lobbying government, it is also about changing public attitudes to mental illness, as well as offering information to those who are mentally ill and their friends, family and carers. Founded in 1946, Mind's central organisation has a £16 million turnover and its more than 200 locally independent associations provide services that create an additional £81 million turnover. It has 130 full-time and 1,800 part-time staff.

His Catholicism, he says, "is very much in the blood". Both his parents came from established Catholic families. "I suppose", he says, "that if I gather together the component parts of my personality, then school is very much part of me, not only in what I learnt there academically but the kind of school that it was. Both school and home were influential but I'd say that home was more so in terms of faith. However, the Oratory School said something very seriously about Cardinal Newman's values and his kind of relatively liberal view of the individual in society, especially so given the time he was writing.

"Neither of my parents was in awe of the Church as an institution and taught me to think hard about it and challenge the spiritual and structural aspects of my faith. That gave me, first, some core values which I feel very strongly about but, secondly, also the knowledge that not all institutions get things right every time but that doesn't make them simply wrong. That's something I have taken with me in other aspects of my life. I am prepared to challenge institutions if I think they are not doing the right thing."

He has never drifted away from his faith - his wife is Catholic, his two sons go to Catholic schools and all of them are regular Mass-goers. "To me it's a very personal thing. I don't judge others and everyone takes their own different journey that will or will not confirm their faith. Many things have happened to me on my journey that means that my faith is firmly rooted. The physical institution of the Church frustrates a lot of people and I'd be one of those. It presents a challenge to being a citizen of a liberal democracy in the twenty-first century but one's role then is to try to live one's faith inside, not outside. I make a distinction between a personal faith and relationship with God and the relationship one has with the institution. Our responsibility as members is to find out why a decision has been taken and to try and influence what happens within the Church. This needs doing without compromising the integrity of the theology."

Paul Farmer is a member of a working group of the Catholic Bishops' Conference of England and Wales on mental health and parish life as part of the Everybody's Welcome initiative.

"It is quite a complicated issue," he admits. "In some places there's fabulous pastoral support for people with mental health problems but in other places people with a mental illness are not always made to feel welcome. I know what the problems are; I know this is not easy. Catholics are no different from anyone else and for some there's a lot of stigma and misunderstanding about the subject, and bad experiences affect how people are able to practise their faith. I think that it is genuinely difficult for some parishioners and clergy to deal with this. You don't want the Church to be exclusive but you also have to be sensitive and understanding in how you support people."

When I ask if he ever feels that there is a clash between what the Church teaches about individuals as moral agents with free will and, in its most extreme manifestation, the determinism that can affect someone who is mentally ill, there's a theological perspective, too. He responds: "In the cases of people who, let's say, ‘lose capacity' as a result of mental health problems, there is a theological level where you wrestle with how you can square what's happening to someone.

"I think that the thing here is that there are points in someone's mental illness where they lose capacity and as a result are not aware of their actions. I think it would be difficult to say whether any actions taken were ‘the fault' of the individual, although there is often awareness of actions taken, and individuals often feel a great sense of moral responsibility afterwards."

The voluntary sector that Paul Farmer joined even 17 years ago is one that is changing vastly, with government wanting it to take over more provision of services, contracted out by local authorities. At the time same, this means that more of the income of charities comes not from corporate or individual fund- raising but from the state. Paul Farmer had not even taken over his post when he said, in a newspaper interview, that the organisation ought to contract to provide NHS clinical services so that it was "not just highlighting the problem but delivering solutions". One effect of this would be, he claims, drastically to reduce the time it takes for someone to see a therapist. He sees no threat to Mind's campaigning role in his wish for the agency to provide more services when there is an argument that taking more of the state's shillings lessens the ability to advocate. "I am clear", he says, "that voluntary bodies have a dual role - to provide help and support to people as well as campaigning for improvement. Of course, there is always a danger of being influenced by your funders, whoever they are - not just government and local government - but in Mind our core values are deeply rooted so that won't happen. I don't think that our independence would be compromised.

"We want a mixed economy of income; we don't want all our money coming from one source. When you don't get that, that's when bells start to ring. It's important that management and organisational structures are alert to what we should be doing strategically, so that you don't go for the attractive big contract with no thought for the consequences. We need to hold true to our values and remember why we are around in the first place."

When some argue that in today's voluntary sector values can too easily be set aside in the new "market" created in social care, maybe someone, like Paul Farmer, whose own values are so important to him, is the person to make others remember what their values are.

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