Ex-patients of the mental health system logically never wish to return. Some do return forcibly or willingly as patients again – victims of the revolving door of an unhealthy system. There are some people who willingly return to psychiatric wards and community mental health as workers. Lived experience workers, peer workers and ex-patients who become clinicians are important contributors to systemic change and better ways of working with people experiencing mental distress.

I was a Peer Worker and later Peer Educator across psych hospitals and community mental health teams. I experienced ‘Stockholm Syndrome’ in terms of being forced to take on the mission and approaches of the system of my former captors. I was forced into involuntary treatment multiple times and years later, worked alongside teams forcing involuntary treatment on others. I adopted the values of the peer work movement but was required to work in ways that totally undermined those values.

The Stockholm Syndrome I refer to here is the medicalised psuedo-psychology originating from a bank robbery in 1973. In a six day bank siege, it was claimed that hostages empathised with their captor and even sided with them. This mirrors situations where a psych patient, held captive in the hospital, eventually works with that hospital and takes their side against other patients. Though never the intention, this peer workers or new clinician may feel the need to adopt the system’s values and ways of working in order to retain and progress in the role.What happened in that bank in Stockholm seems more likely to have been clever hostages pretending to like their captor – not as a coping mechanism but just to bide time while they remained powerless. It was also hostages angry at the police for failing to keep them safe. I really hope the Stockholm Syndrome my former colleagues are actually experiencing is a careful mobilising of power with gradual momentum to eventually take control of a terribly unsafe situation.

Just as Stockholm Syndrome was a clinical means of victim-blaming, I am not blaming workers with lived experience. I cannot dismiss the brilliant work people with lived experienced have achieved with people experiencing mental distress. I am however dismissing the idea that systemic change can be performed by those who remain as cogs in the machine.

It is indeed possible to be “in the system, not of the system” but when policy, performance management, and paycheck all come from that system, you will forever remain a hostage.