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Reflections from the Royal College of Nursing PSI Alumni Conference 2025 – A Carer’s Perspective

Arriving and Opening Reflections

Walking into the RCN PSI Alumni Conference at Cowdray Hall on that crisp November morning, I felt a mix of pride, gratitude, and curiosity. It’s been many years since I first began speaking at RCN events like this, yet every time feels new because each gathering brings together nurses, carers, service users, and leaders who continue to shape the future of mental health care.

Before I continue to describe the event, let me sum up the Royal College of Nursing PSI programme. Basically the Psychosocial Interventions (PSI) programme is a nationally recognised training initiative designed to strengthen therapeutic skills of mental health professionals and embed recovery-focused, relationship-based care across services.

The PSI program is rooted in the principles of collaboration, reflection, co-production and empowerment, PSI equips practitioners with practical tools to support individuals experiencing mental distress, while also valuing the insight of carers and families.

I think what makes PSI stand out is its emphasis on seeing people beyond their diagnosis and fostering empathy, curiosity, and shared understanding between nurses, service users, and carers.

At the start of the conference and during it, I spoke to a few nurses over coffee, each reflecting on how PSI had shaped their practice one mental health nurse told me it had helped her “find her voice again.” For me, as a carer with lived experience, it was great to witness this sense of renewal. It reminded me why collaboration between professionals and lived experience communities is so essential.

Around 10 a.m., Catherine Gamble formally opened the event, setting a tone of gratitude and shared learning. Her introduction reminded us how much the alumni network had grown and how lived experience was now firmly part of the PSI culture.

As someone with lived experience of caring for my mum, who lived with schizophrenia, I approached the events not just as an observer but as someone deeply invested in the stories and struggles that bring us together as a triangle.

When I was invited to open the event and share my reflections as a carer, I knew I wanted to do more than talk about carers, I wanted to speak for them, and with them.


My Opening Talk – “The Nurses Who Walk With Us”

Standing at the podium, looking out at rows of passionate mental health nurses and lived experience, I began with gratitude. My words were simple but heartfelt:

“This is really about the nurses who walk with us, the ones who move beyond the labels, beyond the charts, and see the person, not the problem.”

I read a poem I had written to honour the compassion and resilience of those in the room a piece I called The Nurses Who Walk With Us.

The poem spoke about presence, about listening, and about the small acts of care that ripple into great change.

After my talk, I was moved by the warmth of the response. Many came up to share how my words mirrored their experiences or reminded them of why they came into nursing. That moment of connection that shared understanding set the tone for the day.


The Locksmiths Animation and Alumni Showcase

Following our opening session, Ellie Gordon and Stephen Jones launched the new animation “We Are the Locksmiths.” The film poetically portrayed mental health nurses as key-cutters shaping, adapting, and helping people find the right fit for recovery.

Watching it, I was struck by how accurately it captured the emotional labour of care, the balancing of vulnerability, patience, and professionalism

Next we had the Mentimeter session that morning, which was led by Professor Sally Hardy. She guided participants through reflective wellbeing questions using the interactive Mentimeter tool, encouraging everyone to think about how to sustain personal and professional wellbeing in mental health practice. Sally’s session wasn’t just about gathering feedback

Afterwards, the Alumni and Facilitators’ “Show and Tell Time” began. Groups from Sheffield NHS Trust, Sussex Mental Health Partnership, Lancashire Mental Health NHS trust, and Hereford NHS Trust sharing creative projects and reflections from their PSI practice. There were posters, poems, and community initiatives that had grown directly from the training. I wandered around the tables, speaking with participants who described how PSI had changed their teams. I think One mental health nurse told me, “We stopped seeing interventions as techniques and started seeing them as relationships.” It was inspiring


Workshop One – Working Together in Risk and Safety

After refreshments, we broke into workshops. I joined Workshop One: Lived Experience and Co-Production – Utilising Our Expertise, led by Hannah Cadogan and colleagues. It was energising to see lived experienced and mental health nurses working side by side.

I spoke about what co-production really means from a carer’s point of view. I shared my journey as someone who has cared for a family member living with schizophrenia and another with autism, and how those experiences taught me the importance of being included as an equal partner in care.

I explained that carers often hold a deep understanding of the person they support insights that can make a real difference if professionals take the time to listen and involve us from the start, not as an afterthought. Drawing on my work with Carers UK, the Carers Trust, and the Triangle of Care as many nurses from the mental health trusts were members of triangle of care programme., I spoke about how true co-production is built on trust, openness, and shared learning.

We discussed barriers time, fear, power differences but also solutions, like embedding co-production in supervision and reflective practice.

In this session, the discussion turned to how we can meaningfully involve carers and service users in planning safety not as tick-box exercises, but as genuine collaborations. I found myself reflecting on my own experiences of sitting in meetings where decisions were made about my mum rather than with us.

Hearing the nurses speak so openly about their challenges about time pressures, fear of getting it wrong, and the emotional toll of risk reminded me that we’re all human in this process. True co-production means sharing not only responsibility but also vulnerability.

One participant spoke about the importance of patience: “We’re not here to fix; we’re here to find a way in.” That line stayed with me. It echoed my own philosophy that care starts with listening, not solving.

By the end of the workshop, we agreed that co-produced safety isn’t about removing risk; it’s about building trust so we can face risk together.


Workshop Two – Co-Production and Carer Involvement

Lunch provided another opportunity for networking. The Mental Health Forum stand and MHP stall displayed resources on psychosocial practice.

I met others who had recently completed the course.

Conversations were open, curious, and full of mutual respect the kind of professional empathy that sustains hope in challenging work.

After lunch we heard from Professor Nicola Ranger, RCN General Secretary, who welcomed everyone back, commending the alumni for sustaining PSI’s legacy. Her words “you are the custodians of compassion” perfectly captured the spirit of the day.


The evaluation session of the RCN PSI Alumni Conference was presented in partnership with London South Bank University (LSBU), who have been key academic collaborators in examining the outcomes and long-term impact of the Psychosocial Interventions (PSI) programme. This section was introduced by Stephen Jones, and Professor Chris Flood, a leading figure in mental health nursing and research at LSBU.

Together, they outlined how LSBU’s evaluation seeks to capture not just the quantitative outcomes of PSI such as improved confidence and competence among practitioners but also the qualitative stories of change, growth, and compassion that the alumni community embodies.

There will be several teams at LSBU, but I was impressed on the make up of the Advisory and Supervisory Team provides academic oversight and strategic direction.

  • Professor Patrick Callaghan, Professor of Mental Health Science at LSBU, offers extensive expertise in psychosocial interventions and nursing research leadership.
  • Professor Chris Flood, a leading mental health and adult nurse researcher, specialises in health economics, survey design, and qualitative inquiry.
  • Professor Neil Brimblecombe, Professor of Mental Health and Learning Disability, contributes his expertise in workforce development, nurse prescribing, and policy analysis linking the PSI evaluation to broader NHS workforce strategies.
  • Professor Eddie Chaplin, an expert in intellectual disabilities and psychosocial interventions, supports the development of inclusive frameworks for peer support, guided self-help, and service co-production.

Afternoon workshop

In the afternoon, I attended Workshop Three: Working Together in Risk – Co-Production, Suicide and Personalised Safety. It was deeply emotional. We discussed how carers can be crucial in early warning and safety planning, but only if professionals create safe spaces for them to speak. The workshop was presented by Berkshire Healthcare NHS Foundation Trus

During the workshop, we took part in reflective exercises that encouraged us to consider what “shared safety” truly means. We were asked to think of times when communication broke down between families, patients and professionals, and how different outcomes might have been possible if trust and collaboration had been stronger.

Celebrating Archievements

Those who finished the RCN PSI programm were presented with a RCN PSI alumni badge, which i felt was a small but powerful symbol of commitment, compassion, and continued learning. For many, receiving that badge wasn’t just about completing a programme; it represented belonging to a network that values empathy, partnership, and the courage to keep improving mental health care together.

Reflections and Looking Ahead

As the day drew to a close, we took a quiet moment to reflect. Conferences like this are not just about learning they are about belonging. They remind me that, while the caring role can often feel isolating, there is a wider network of understanding and solidarity.

I missed out a lot more that took place at the alumni event, but watch out for more exciting news from the RCN in future.

To find out more about the RCN PSI Progamme, click link below.

https://www.rcn.org.uk/Professional-Development/Educational-programmes-and-services/Psychosocial-Intervention-Programme

Ethnic mental health Carer Forum : October Update 2025

By Matthew McKenzie, Facilitator, National Ethnic Mental Health Carer Forum

Introduction: A Forum that Connects and Challenges

As the facilitator of the National Ethnic Mental Health Carer Forum, I never take for granted how special these sessions are. Each month, carers, professionals, and researchers from all over the UK log in to share knowledge, raise awareness, and push for change in how mental health services understand and support ethnic minority communities.

Our October 2025 session was a powerful one. Falling on the last day of Black History Month, it brought together crucial themes on race equality, co-production, research, and carer visibility.

We heard from two key areas shaping mental health equity right now:

  • The OSMOSIS Project, led by Dr. Jacqueline Sin and Sharon Galliford, focusing on developing social care-based support for carers of people with psychosis.
  • The Patient and Carer Race Equality Framework (PCREF), presented by Aboobaker Bhana, Equality and Involvement Manager for South West Yorkshire Partnership NHS Foundation Trust.
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What Makes for Meaningful Carer Involvement?

By Matthew McKenzie FRSA BEM, Chair, Triangle of Care Community Group

This week’s Triangle of Care Member Webinar, hosted by Carers Trust, which focused on a vital question: What makes for meaningful carer involvement?

We heard from across the Triangle of Care network, these being carers, professionals, and trust representatives coming together to share what genuine involvement looks like in practice.

I spoke about my own lived experience as a carer, supporting two non-verbal brothers with autism and my late mother with mental health challenges and how this journey has shaped my advocacy for stronger partnerships between carers and professionals.

Over the years, through the Triangle of Care, I’ve seen how much difference early and equal involvement can make.

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Ethnic mental health Carer Forum Update June 2025

By Matthew McKenzie – Carer activist, poet and author

Welcome to a brief update of my ethnic mental health carer group, held monthly.

The meeting began with introductions and technical discussions on connecting to zoom, followed by presentations on research related to mental health care and carer support, particularly focusing on minority communities and paranoia. The group discussed various initiatives including a community intervention study, a carer experience questionnaire, and progress updates on Patient Carer Race Equality Framework reporting across different NHS regions. The conversation ended with discussions on challenges faced by minority carers, including access to mental health services and the need for better support systems, with calls for national collaboration and improved respite services.

Summary

Carer Support Network Expansion Discussion

The meeting began with Matthew introducing the session and addressing technical issues faced by some participants, including a participants video problems, which were resolved. Matthew explained his recent laptop issues and mentioned his involvement with Carers Trust regarding Triangle of Care. The group discussed the expansion of their focus with minority carers and the importance of connecting and networking across the UK. Juliana, a researcher, provided an overview of her work, and participants introduced themselves, sharing their roles and experiences related to mental health care and carer support. The conversation ended with a brief overview of upcoming presentations and discussions.

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Cygnet National Carers Event – Carers Week 2025

By Matthew McKenzie, Carer Ambassador, Cygnet Health Care

On Friday 13th June 2025, I had the privilege of attending and speaking at Cygnet Health Care’s National Carers Event, hosted at Cygnet Churchill in Lambeth, London. The event brought together carers, staff, professionals, and advocates to reflect on the vital role of unpaid carers who step up daily out of love, resilience, and responsibility, often with little recognition.

Carers Week is always a powerful reminder that caring touches us all – and Cygnet’s event this year was especially moving and informative. It offered a platform for carers to share their lived experience, influence policy, and strengthen our collective voice.

Agenda Highlights

The day opened with a warm welcome from Laura Sheridan & Shane Mills, setting the tone for a day grounded in empathy and collaboration. We heard from a range of speakers including:

  • Susan Hartnell-Beavis, sharing practical tools for supporting carers.
  • Kate Mercer and Carly Ellicott, who both championed carer involvement in care planning and research.
  • John Bangs OBE, who brought a national perspective on carer rights and policy.
  • Dr Angela Misra, who tackled the health implications of caregiving.
  • Julian de Takats and Matthew McKenzie (myself), focusing on empowering carers’ voices.
  • We also had insights from Dr Henk Swanepoel & Sophie Borg, who presented on collaborative approaches with carers in mental health services.
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Challenges of Carer Over involvement in Mental Health Caregiving

Understanding Over-Involvement as a Mental Health Carer

Welcome to another lecture taken off my YouTube channel. If you want to watch the lecture please see the video below.

Caring for a loved one with long-term mental ill health is a profound act of compassion, resilience, and often necessity. For countless unpaid carers, the daily reality involves advocating, supporting, and filling in the ever-widening gaps left by under-resourced mental health systems. But amid this dedication, a challenging reality emerges: what happens when you become “too involved” as a mental health carer?

Navigating the boundary between healthy support and over-involvement is fraught with emotional, social, and systemic complexities. For many carers, especially those without significant backup or support from services, over-involvement isn’t a deliberate choice. Rather, it’s a reaction to anxiety, lack of resources, unavailable respite, or a deep sense of responsibility, factors often compounded by the failures of the very systems meant to help.

This article explores the nuanced challenges of over-involvement, the psychological and social fallout for carers, the systemic pitfalls that fuel this cycle, and constructive pathways forward.


What Does It Mean to Be “Too Involved”?

Over-involvement as a mental health carer doesn’t refer to love or dedication, but to a state where healthy boundaries are blurred. It can look like:

  • Constantly monitoring or managing every decision or behavior: Driven by anxiety, the carer feels compelled to oversee every aspect of their loved one’s life.
  • Neglecting one’s own needs and identity: Support shifts from helping to living solely for the cared-for person, with carers sidelining their own health and well-being.
  • Becoming the sole or primary source of support with little to no backup: In the absence of adequate services, carers take on overwhelming responsibility.
  • Feeling unable to step away—even when necessary: Carers may feel there’s simply no option to rest, leading to chronic exhaustion.

While not every carer will experience all of these, most will likely encounter at least some, especially during crises or prolonged periods of under-resourcing.


The Emotional and Social Toll of Over-Involvement

Burnout and Fatigue

The most immediate impact of over-involvement is caregiver burnout. Continual vigilance, lack of sleep, and emotional strain take a heavy toll. Fatigue accumulates until carers can no longer function effectively, putting their own mental health at risk.

Guilt, Anxiety, and Isolation

Carers often wrestle with overwhelming guilt—fearful of not doing enough, or of something going wrong in their absence. Anxiety about possible crises or relapses becomes a constant presence. Over time, this anxiety, coupled with a lack of support, leads to profound isolation: friends, hobbies, and social ties erode under the relentless demands of caring.

Loss of Identity

Many carers experience a blurring, or even a loss, of their personal identity. They become “the carer,” subsuming roles as a partner, parent, sibling, or friend. The world shrinks to the immediate needs of the cared-for person, often at the expense of the carer’s own aspirations and selfhood.

Depression and Hopelessness

Without respite or validation, carers can slip into depression. Hopelessness stems from the sense that there is no help available and nobody understands the unrelenting emotional labor.

Neglect of Personal Health and Finances

Skipping one’s own medical appointments, neglecting health, and losing the ability to work full or even part-time are all too common. The financial strain can be devastating, adding yet another layer of stress.

Social Withdrawal and Relationship Strain

Over-involvement is a key driver of relationship breakdowns—not just with friends and work, but with the cared-for person. Overreliance on the carer can breed resentment on both sides, fueling conflicts, codependency, and, on the part of the cared-for person, a diminished sense of autonomy and independence.


Systemic Failures: Why Carers Become Over-Involved

Underfunded and Overstretched Services

The reality for many mental health carers is that the system simply doesn’t provide for the needs of those with mental health conditions—let alone their carers. Cuts to services, lack of staff, and waiting lists mean that carers are left to fill the gaps. They become, by necessity, the constant support, regardless of personal capacity.

Lack of Communication and Training

Poor communication from health or social services leaves carers in the dark. With no clear guidance or explanation of the cared-for person’s needs, diagnosis, or care plan, carers are left to guess, manage, and advocate alone. Often, vital training around role limitations or healthy boundaries is missing entirely.

Delayed or Insufficient Care Provision

When care is delayed or inadequate, carers are expected to step up, often without assessment or recognition. Insufficient professional support forces carers to take on roles they may not feel prepared for.

Weak Support and Community Networks

With respite care and carer centers decreasing in number and capacity, finding relief or support is increasingly difficult. Carers are isolated, unable to share experiences, access information, or receive the validation needed to carry on effectively.


The Double-Edged Sword of Professional Involvement

When Professionals Flag “Over-Involvement”

Health professionals may at times flag a carer as being “too involved” and, in some cases, limit or block their involvement in treatment or information sharing. While, in theory, this is a safeguard to protect the autonomy and recovery of the person with mental health needs, in practice it often plays out as a means of gatekeeping, especially in overburdened services.

Confidentiality laws may be invoked, sometimes rightly, sometimes in a blanket manner—leaving carers excluded from vital care discussions. “Gatekeeping” behaviors can include:

  • Restricting carers from meetings, updates, or ward visits
  • Using complex jargon to confuse or minimize a carer’s role
  • Citing a carer’s emotional state as evidence they may be a hindrance, thereby weaponizing carer fatigue

The Controversy: Persistence vs. Over-Involvement

A difficult question arises: when does persistence and advocacy for a loved one become “over-involvement”? Too often, carers asking difficult questions or pushing for better care are labeled obstructive or overbearing, sometimes as a way for professionals to deflect accountability for insufficient services or to reduce pressure on their own overstretched roles.

Yet, the very qualities needed in good carers—advocacy, persistence, commitment to high standards of care—may be used against them. Without structure, dialogue, and mutual respect, the risk is that carers are shut out, leaving both carer and cared-for at greater risk.


The Vicious Cycle: Carer Fatigue as a Reason for Exclusion

Systemic failure has a way of compounding itself. Carers are forced to step in because services are lacking. This necessary over-involvement leads to fatigue, stress, and sometimes mistakes or emotional responses. Professionals then point to this fatigue as a reason to exclude the carer or question their suitability—without offering alternatives or meaningful support. The end result: everyone loses, most of all the person in crisis.


Best Practices: Constructive Solutions and Support Strategies

Respite and Connection: The Need for Rest and Support Networks

Respite care, though increasingly scarce—is essential. Time off to rest, reset, and re-engage with passions outside the caring role is not a luxury but a lifeline.

Equally vital are carer support groups and centers, whether formal (hospital, community organizations) or informal (peer-organized). These provide:

  • Connection and reduced isolation
  • Information about navigating the mental health system
  • Validation and shared experience
  • Opportunities to strengthen one’s own identity

Many carers find that meeting others, even infrequently, offers practical ideas and emotional relief.

Learning to Set Healthy Boundaries

Establishing boundaries is crucial, but incredibly hard—especially when no backup options exist. Carers benefit greatly from structured education about:

  • The scope and limits of their role
  • When to step back, and how to do so without guilt
  • How to communicate their boundaries to professionals and family

Such education is often, unfortunately, lacking. Professional services have a duty to provide training and guidance, both for the carer’s health and for the relationship with the cared-for person.

Professional Education and Constructive Inclusion

Mental health professionals need ongoing training—not just on mental health conditions, but on carer engagement and support. Constructive inclusion means:

  • Sharing appropriate (non-confidential) information with carers
  • Involving carers in care planning and discussions
  • Recognizing their unique insights, without over-relying on them
  • Actively supporting carers to take breaks or step back as needed

Shared Responsibility, Not Transferred Responsibility

Mental health systems must prioritize shared responsibility. Carers should neither be left to do everything (“just get on with it”) nor shut out completely. Effective service provision means:

  • Joint care planning that integrates professionals, patients, and carers
  • Policies that match available resources—rather than just shifting risk onto families
  • Building a culture of respect and inclusion, not suspicion or blame

Carers’ Right to Step Back

Carers should feel empowered to step back from their role, even temporarily, without fear of catastrophe or overwhelming guilt. This is only possible in systems that provide meaningful support and backup—not merely moral encouragement.


Final Reflections: Moving Forward with Awareness and Compassion

The challenges of over-involvement as a mental health carer are not a sign of personal failure. More often, they reflect the shortcomings of a fragmented, under-resourced system that expects too much while providing too little.

No approach will be perfect. Sometimes, even with the best intentions, carers will cross the line into over-involvement. What’s essential is recognizing these moments not as failures, but as signals to seek connection, education, respite, or professional guidance.

For professionals, the task is to move beyond gatekeeping and work with carers as partners, acknowledging both their knowledge and their limits. For families, building peer support networks and for carers individually, permission to step back—are keys to sustainability.

Ultimately, meaningful mental health care must be rooted in shared responsibility, communal support, and flexible, compassionate boundaries. Only then can carers continue to support their loved ones not just out of necessity, but out of a place of balance, health, and hope.


Resources for Mental Health Carers

  • Carers UK: Offers a wide range of advice and community forums for carers.
  • Mind: Provides specific support on mental health caring, advocacy, and rights.
  • Rethink Mental Illness: Campaigning and advice for families and carers.
  • Local Carer Centers: Contact your local authority or NHS Trust for groups and training.
  • Peer Support Networks: Consider informal groups or online forums for shared experience and validation.

If you are a carer, professional, or someone with lived experience: remember, caring is both a gift and a challenge. Prioritize your own well-being as part of the journey. The health of the whole community depends on supporting you too.