This chapter provides an overview of the common medicines prescribed within mental health care and explores the ways in which personal narratives and social expectations can influence the experience of taking medicines. The chapter also looks at concepts and practices that influence the management of medicines and encourage safe and high-quality use of medicines. These concepts include consumer experience, concordance, and shared decision-making. Facilitating a positive experience of medicinal use requires quality communication and team work, whereby nurses, psychologists, occupational therapists, dietitians, medical practitioners and pharmacists work in partnership with the consumer and carer.

Assessment in the mental health field is a dynamic process of learning, using experience and applying multiple sources of knowledge and evidence. This chapter presents an overview of assessment practices and processes undertaken within formal mental health care and discusses these within the context of consumer–health practitioner partnerships. We start by considering how assessment practices are a prominent feature of understanding a person’s situation and life context, and how these need to be based on the principles of person-centred, trauma-informed care and cultural safety. We discuss the importance of engagement and therapeutic relationships skills in ensuring consumers, carers and family members are meaningfully connected within a process for identifying the mental health problems the person is experiencing. Part of this awareness is reflecting on what it is like for a person to be assessed, and the power dynamics involved in naming experience, symptoms and diagnosis. The chapter then looks at the paradigm of comprehensive assessment, with specific discussions about strengths-based assessment, mental state examination and the roles of different health professionals.

Readers of this book will have thought deeply about how to collaborate with and support people with a mental illness, their families and carers. The preceding chapters have given considerable emphasis to a narrative approach. This final chapter discusses leadership, particularly for new entrants into mental health settings.Effective clinical care is person and family centred. It seeks to understand and involve consumers, carers and families in rich discussions about their needs, preferences and values. This understanding and involvement is combined with evidence-based practice to support consumers in their treatment and recovery goals.At the heart of the decision to take this approach has been the fundamental belief in human connectedness. By working through this text, readers have been challenged to think about how and when to move in new ways when working with resilient and vulnerable people, which is helpful across a range of practice settings when seeking to make a difference in the lives of people experiencing a mental illness. While this is important in providing a theoretical and practical basis for care, it is at the point of care that effective leadership is required.

This chapter introduces the concept of mental illness, how it is diagnosed, and the main diagnostic classification systems used in health practice. The experiences and symptoms of people living with mental illness – according to criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 – are reviewed. It is emphasised that diagnostic criteria can be considered within an overall framework for conversation and engagement between practitioners, consumers, and carers, with the overarching aim of exploring and understanding the best response to distress and treatment approach to promote recovery processes. Criticisms towards diagnostic classification systems are also summarised. Finally, potential effects of the COVID-19 pandemic and its implication for people’s mental health are presented.

In a still more profound way than we may think, we are in a period of crisis. Every aspect of the human condition and the social institutions we have made together are today in doubt. In the popular imagination, a crisis is a marker of something vexing that is to be overcome. It enjoys a temporal dimension, seeming to diagnose a present problem at the same time as it already imagines a future moment when the crisis will cease to be, when things will ‘return to normal’. Writing this book together during the the COVID-19 pandemic that began in 2020, that desire for a return to normal life is especially acute, currently providing the basis for a new and common hope all around the world.

And yet, the extent to which we should want to ‘return’ to what we previously understood as ‘normal’ is immediately problematic. The 21st century has already seen an unprecedented cadence of social, environmental, political and economic emergencies that have called into question the belief systems that have hitherto underpinned that normality. These emergencies have resulted in a steady decline in our trust in the value of our democratic political systems, which is seldom attributed to a globalized financial system that is too often responsible for driving these outcomes. The COVID-19 pandemic is providing humanity with an opportunity for a ‘great reset’ with the chance to ‘build back better’, but some are asking if we really want a swift return to the way things were. Instead, should we be choosing something better, a new way of organizing social life such that we can respond to the challenges of today and tomorrow, not yesterday? After all, we learn from Janet Roitman that if everything is in ‘crisis’ then perhaps nothing is. Is our state of perpetual crisis itself just the ‘new normal’? Suddenly emptied of its popular meaning then, how can we be in a period of crisis?

Reflecting on the events of 2008, when the world was first hit by those shockwaves of the global crash that still reverberate today, Sylvia Walby argues that ‘[f] inance caused the crisis.

In order to reveal how crowdfunding is different from mainstream finance, we first need to say something about the typical ways in which people understand and use their money. Since most people believe they cannot be trusted with money and so lack confidence when it comes to finance – a convenient story to tell people if you are running the financial system – it's important to begin our journey in familiar territory. After all, it is still the case that the average school leaver in the UK will have spent longer studying the mechanics of sexual reproduction than they will the workings of financial services products. Many young adults leave full-time education in the mistaken belief that a ‘credit’ card is somehow preferable to a ‘debit’ card – and who can blame them, when ‘credit’ is something that school teaches them to pursue, and ‘debit’ looks rather too much like the word ‘debt’ to be immediately reassuring. This confusion of a means of immediate payment with the idea of personal debt (actually acquired through using a credit card) does little to instil confidence.

This point is exaggerated along gender lines too. As we saw in Chapter One, women have been frequently positioned by mainstream finance as too emotional or irrational to be eligible for access to mainstream products like current and savings accounts. In a 2015 study by Abundance Investment, however, when investors were asked a question about the effects of inflation, or the risk of loss to housing equity from a drop in house prices, it was male respondents who were frequently mistaken in their calculations. Female respondents were far more likely to admit they didn't know the answer, and so only to select responses that they were relatively certain about. What this small study shows is that despite the assumptions of mainstream financial institutions, men are more likely to be ‘confidently wrong’ and women to be ‘cautiously right’, which perhaps hints that one of the main problems we face is who currently runs finance and who typically invests their money.

For the purposes of understanding where crowdfunding and P2P finance fits into our story, next we define some of the basic building blocks of the modern ‘consumer’ experience of money and finance.

Do you know where your money is? If you read ‘money’ and immediately think of cash, then there's a very fair chance that you’ve just pictured notes and coins in a purse or a wallet, or perhaps imagined a big steel vault in a heavily secured basement room in a bank. Either way, you’ve likely sought to reassure yourself that your money is safe. But if you read ‘money’ and instead thought of digital numbers on a smartphone screen, or more imaginatively still, considered your pension, savings and investments, then there's an equally good chance that you don't know exactly where your money is at all. And this suggests a far more fundamental question. If you don't know where your money is, then how do you know what your money is doing?

While most people feel supremely confident that they know precisely what money is, and what they would choose to do should they suddenly have more of it, they are equally uncertain and anxious when it comes to the seemingly more complex matters of finance. At least a part of the problem here is that we tend to use these two terms interchangeably and in different contexts, often misunderstanding their meaning because of it. This is not just a problem for everyday conversations – it creates problems for those of us who study it and who seek to make sense of the way that we think about and use money, and the ways in which financial systems are developed around money.

Throughout this book, our study investigates the stories and myths about money that have led to the creation of different systems of finance, from the eranos loans of ancient Greece to the FinTech and Crypto revolutions of the early 21st century. In so doing, we suggest that finance has not always been the preserve of the elite professional, but is rather something that develops in different ways, bound by time and cultures, and often alters as a response to crisis. The shape of finance at any given moment in history and across cultures, then, depends upon the social relations and moral values that hold those societies together