We need to urgently change the narratives of "you are not suitable for / in need of our service" in mental health and social care. When the reality is actually "our services/staff are not adequately resourced/skilled/supported to provide what you need".

The reframing is not just a misrepresentation; it is not just a way of maintaining the status quo or keeping our heads down, of not upsetting the 'big bosses'. It is actively harmful to people. It gaslights, it denies, it blames, it neglects, it stigmatises, it marginalises.

The honesty is important. It's hard, and yet it's real. There are services and clinicians that exist with the skills and support to offer. There aren't enough who have enough of what's needed. Many people are doing their best and yet it's not enough, with what we have.

This applies to many particular groups; families with MH and social care needs, young people with educational needs, people with eating difficulties and complex trauma and substance use problems. And many many others.

Of course there are individual, hopefully collaborative decisions to be made about readiness, safety, particular approaches + techniques. This is the crux of person-centred care. And that's not the same as denial of service based on lack of service (in terms of skill or resource)

We have to be honest with ourselves and each other and those who fund and organise us.
It's the only way to facilitate real change.