Category Archives: Mental health

Radio raises awareness: The Archers mental health storyline

I recall listening to Radio 4’s The Archers as a teenager on long hot summer afternoons; the “heatwave” summer of 1976 springs to mind. As with listening to cricket, the radio soap helped me to relax and I warmed to its quaint and easy listening style. I would not have envisaged all these years later that I would be involved with the programme – and with such a controversial storyline.

I’ve been advising The Archers on the storyline about the depression experienced by the character Darrell Makepeace. The Archers is moving with the times. It remains a quintessentially English portrayal of village life, but also has to echo the modern age and remain current. Just yesterday, new figures were published on use of the Mental Health Act in England, showing that the number of detentions, which has increased by 12 per cent in the last five years, exceeded 50,000 in 2012/13.

Controversial, contemporary plotlines will appeal to the listeners, but Radio 4 must get the balance right by keeping its traditional support base whilst acquiring a younger audience. The Archers is the world’s longest running radio soap opera and the station’s most popular non-news show with more than 5 million listeners.

With this in mind, I began offering advice on the character Darrell and his spiralling fall into depression about three months ago. As part of the Time To Change media advisory service, my role was to try to add as much realism and sensitivity to his presentation. This differed so much from my previous advisory role for the character Zak Dingle in the soap Emmerdale. Why is this so?

Well, Darrell is a character who has hit rock bottom and, in doing this, has not only caused much pain to himself but also to those around him. Chaotic and unpredictable would be just two words to describe this. He is also very manipulative. The Archers’ listeners appear divided in their opinions about this. I remain very enthused that we have highlighted the devastation of depression, its indiscriminate nature, and the “loose cannon” impact.

Emmerdale’s Zak endeared himself to the viewers as he was deemed a “loveable rogue” The fans empathised with his plight. But Darrell is not so endearing and his manipulative behaviour has only served to isolate him from most fans.

Therein lies the challenge for me, and the producers themselves – to promote more understanding and acceptance of mental illhealth, and its indiscriminate nature. I received praise and criticism – in equal measure – from listeners, and that’s fine. I no longer lose sleep at night worrying about criticism; it opens up a debate and encourages more dialogue around mental health that so far there is a reluctance to do.

This work is challenging because, by my very nature, I am a sensitive person. I have had to grow a thicker skin since to take the blows but the praising comments helps to ease the pain. The criticism at times to my role and advice taken has been quite personal, but I can only give advice from my own perspective.

I have a passion to promote more understanding of mental health and eradicate stigma from society. I hope The Archers’ storyline will help transform people’s attitudes to mental health.

* The first national Time to Talk Day takes place on 6 February, aiming to spark a million conversations about mental health. Part of Time to Change, it highlights how little things – sending a text, a chat over a cup of tea- can make a big difference to someone with mental health problems.

We need to prepare for the next global pandemic

It is a disease one in three of us will develop – 135 million people will have it by 2050 and its worldwide health and social-care cost in 2010 was estimated at £400bn…yet no one is ready for the worldwide pandemic that is dementia.

My Guardian interview with leading microbiologist Peter Piot today, coinciding with the G8 Summit on dementia, underlines why international action is vital. Piot, who spent four decades investigating the world’s deadliest diseases and whose pioneering work made HIV/Aids a global priority, is in no doubt that dementia is now the world’s greatest social, economic and moral challenge.

“There’s not enough awareness of how bad the problem is,” warns Piot, a global health expert and director of the London School of Hygiene and Tropical Medicine. Like most of us who know someone who has had or is living with dementia (my grandfather had it), Piot’s father-in-law had the illness, so he knows first hand of the denial and stigma it brings: “It is the most neglected of all the neglected health problems and it’s a hidden problem because people are at home – they’re already written off by society”.You can read the rest of my piece is here.

When Piot argues that the discrimination faced by people with dementia is tantamount to a “human rights violation” and more than just a medical problem, I couldn’t agree more.

Funding and focus on research is essential, but this has to be accompanied by a change in attitudes – and the latter will be an uphill struggle for a society fails to have older people on its radar, regardless of whether or not they have dementia.

Hope, health and happiness: new show at arts charity

Aaron WJ Pilgrim , Martika
Aaron WJ Pilgrim , Martika

Hope is the focus of a new exhibition by artists from the CoolTan arts and mental health charity.

Stayin’ Alive, which opens today, includes works in different media including oil on canvas, acrylic, printmaking and sculpture. The stigma-breaking south London-based organisation is run by and for people with mental health issues and encourages the idea that mental wellbeing is inspired by creativity. The recent World Mental Health Day was the impetus for the artworks.

Aaron Pilgrim has four pictures in the exhibition and has been involved in CoolTan for five years. His Warhol-like Music (Martika) (above) is about the impact of music on mental health (“and I love listening to the 80’s pop star Martika”). Aaron’s last picture, Drawing futureristic cars (Michael), reflects how he helped to frame the exhibition and taught two volunteers how to mount, cut and frame pictures in the exhibition.

He says of The Globe Theatre & The Tate Modern “the arts help keep me well, especially painting, and these two places represent the arts. This picture is in the style of Turner.

Another of Aaron’s picture, My beautiful daughter Grace is about “being a good dad & my family help keep me well”.

Liz Innes, who has been attending art classes at CoolTan for around seven years, shows piece depicting a Lake District landscape. Liz adds: “I wanted to submit my landscape painting which was inspired by a photograph I took 20 years ago. I enjoyed painting this as it reminds me of my younger, more lively days when I often went walking with friends. I have really enjoyed my work in pen and ink recently and feel it is developing well. I have received a lot of encouragement from the staff and tutors at CoolTan.”

Marjorie Mclean, who has been involved with CoolTan for eight years, is showing her watercolour My Allotment. “For me going to the allotment, being in the sunshine and seeing things grow, producing food, makes me feel hopeful and happy”, she says.

Marjorie McLean, My Allotment
Marjorie McLean, My Allotment
Ese Imonioro, Gotcha
Ese Imonioro, Gotcha

Ese Imonioro’s work in collage and felt-tip was done about a difficult time in her life” “At that moment I felt quite persecuted, but I could not convince anyone of what was happening. The painting is of a doctor who helped me during this period and made everyone see the truth. I will always be eternally grateful to him for that and for giving me my freedom.”

Lynn Hughes, Kingfisher
Lynn Hughes, Kingfisher

* The CoolTan exhibition runs until 26th November, Monday to Thursday 10-5:45, Fridays 10-5 at CoolTan Arts, third Floor, 224-236 Walworth Road, SE17 1JE

Puck, peppermint and posh frocks (again)

As it’s Fragile X Awareness Day, I wanted to re-post this poem about my sister, Raana. I wrote it for Mencap’s blog and as a hearty nod to the fantastic film Mission to Lars which I also wrote about for the Guardian.

Fragile X is the most common cause of inherited learning disability in the world – but my sister’s a rare character, as you’ll read here.

My sister, Raana
My sister, Raana

The Fabulous Raana Salman

What does “puck off” mean, you asked,
When a playground jibe you misheard,
It’s an insult, we said, with a bittersweet laugh,
And “puck” is quite a rude word.

You’re older now, and more in the know,
And you’re still just brilliantly funny,
We love how you call my other half “bro”,
And our mother is always called “mummies!”

You constantly amaze us with all that you do,
You garden, you cook and you bake,
You’re a music fan who likes her tunes loud,
Full volume – bloody early – at dawn break.

You love Chinese food and movie nights in,
And sometimes the pub if it’s near,
Remember your fury when we ordered you juice,
And you indignantly cried: “I want beer!”

“You’re fried!” you shout, knowingly wrong,
After watching The Apprentice on telly,
You say it when angry or to make us smile,
And it shows you’ve fire in your belly.

You’re creative and busy and do stuff we can’t,
You’ve woven and painted and grown,
I love having you stay so you’re able to see
How your art brightens up my home.

You’re thoughtful with gifts, matching present to person,
(You know I like peppermint tea)
We joke how “mummies” foots the bill sometimes,
And you say of your gifts: “They’re for free!”

You love baggy sweatshirts, they comfort and cloak,
You categorically refuse a posh frock,
You know your own mind, you’re fabulous and kind,
And basically Raans, you rock.

Follow the hashtag #FragileXAwarenessDay on Twitter to find out more about the syndrome, or try the Fragile X Society and Mission to Lars.

Artists re-imagine iconic Star Wars design to launch new search for missing man

David Bailey with his capped stormtrooper helmet for the Art Wars exhibition
David Bailey with his stormtrooper helmet for Art Wars, an exhibition to raise awareness about the disappearance of Tom Moore, brother of Art Wars creator Ben
.

Tom Moore, who went missing in 2003, his family is now renewing the search to find him.
Tom Moore, who went missing in 2003, his family is now renewing the search to find him.

July 17 2003, Ancona, northern Italy. A 31-year-old Englishman withdraws 150 Euros from a cash point. This everyday event just over a decade ago has huge significance for the Moore family because it was the last financial transaction Tom Moore is known to have made; the last sign his parents and siblings have that he was still alive. Tom has not been seen or heard or from since.

Next week, Tom’s brother Ben is renewing the search for his sibling with an art exhibition featuring high profile artists as well as rising stars of the art world. The aim is to raise both awareness and funds to mark the tenth year since Tom’s disappearance. Proceeds from Art Wars, a collection of Star Wars stormtrooper helmets transformed by internationally-renowned artists, will be auctioned for the Missing Tom fund.

A note written by Tom Moore before he went missing.
A note written by Tom Moore before he went missing.

Ben, founder of public art enterprise Art Below, has collaborated with Andrew Ainsworth, creator of the original 1976 stormtrooper helmet, to produce the show. Art Wars launches at the inaugural Strarta Art Fair at the Saatchi Gallery next Wednesday (October 9), with works showcased via a series of billboard posters at Regent’s Park underground, coinciding with Frieze London.

“Stormtrooper helmets are iconic, international, instantly recognisable and timeless,” explains Ben of the medium and the message. “I’d been working with Andrew Ainsworth since 2007 and it was always in my mind to do this show with big artists; I had access to these iconic objects and I knew that there were artists who would like to be involved because it’s something we all grew up with [the Star Wars films]. When I realized it was the 10th anniversary of Tom going missing, I needed to catapult myself into action and do something to get the search for Tom re-energized.”

Artists, all of whom were issued with a helmet cast from the original 1976 moulds, include Damien Hirst, Jake and Dinos Chapman, Paul Fryer, Mat Collishaw and David Bailey. Other participants are English multimedia street artist D*Face, Portuguese artist Joana Vasconcelos, Turner prize nominee Yinka Shonibare, street artist Inkie, Mr.BrainWash, East London’s Alphabet Street creator Ben Eine, BP Portrait Award winner Antony Micallef and upcoming star Oliver Clegg.

The money raised from Art Wars will enable the family to travel in the search and to publicise their efforts to find Tom. Ben also hopes to bring attention to the Missing People charity, which has supported his family. There is also a new website Missing Tom to help locate the now 41-year-old.

'StormOffSki': Stormtrooper head encrusted in Swarowksi crystals by Ben Moore
‘StormOffSki’: Stormtrooper head encrusted in Swarowksi crystals by Ben Moore

As Diana Brown, Ben and Tom’s older sister, writes on the Missing Tom website, the Moores were, and are, a close knit family. “Tom and I growing up, had been as close as it possible to be as brother and sister,” Diana writes. “There was a curious closeness that comes, from having a brother seven years before another two brothers arrived. We were the lucky products of a military family [the sibling’s father was a colonel in the Royal Marines]…We moved house frequently, but were always secure in the knowledge we had loving parents and family all around us.”

Tom was, by all accounts, a genial child (“Tom was blonde, small for his age, good-looking, with a quirky sense of humour, a born actor, musical…with his beaming smile and his floppy fringe. He was thoughtful, kind and never hurt a soul”, writes Diana) but he found it tough at his all-boys school.

Antony Micallef with his 'Peace Maker’ helmet,  for the Art Wars show
Antony Micallef with his ‘Peace Maker’ helmet, for the Art Wars show

After school came a gap year to India where Tom “full of hope and promise”, as Diana writes, grew “disheartened at the huge confusion that India presented to him” and was affected by the drugs he found in Goa. He returned to live with his parents before going to Lancaster University to study theology. There, as Diana found, his mental turmoil was obvious. “He played music, he studied and he went about his daily routines, but he found life very hard. I found my brother, confused and suffering from the onset of mental illness. He left university early and came to live at home.”

The following few years sound like a fragile mixture of travels, doctors and medication, with Tom’s family struggling to find the right balance between supporting their son’s desire for freedom and realising that medication might help bring some stability to his mental health, the “daily dark thoughts” which Diana describes on the website.

A few months before he went missing, Tom had travelled to a shrine in Bosnia, where Ben eventually found him in a nearby town. Ben explains: “When he went away again a few months later, I thought I could find him – but the months started turning into years.”

“The last time I saw Tom, we had game of chess and although I didn’t usually beat him, on this occasion I was winning,” says Ben. “It was a particularly slow game and now I look back at it I realise he wasn’t mentally present, he was quiet and absorbed in other thoughts. I often wonder if I should have kept the pieces how they were, so we can finish the game one day.”

Ben spent the three years following his brother’s disappearance looking for him, visiting well known religious sites across Europe knowing of his brother’s interest in religion, and following various trails (like the cash point transaction). At one point, he says, he was only two weeks behind him, but the demands of work and his own young family meant he eventually had to put the search on hold.

“I still have great hope, confidence and faith that I am going to see Tom again, but we need to get out there and figure out where he is,” says Ben. He wants his brother to know that his aim is to make sure he’s okay, rather than simply dragging him back home against his will. The disappearance of Tom, says Ben, has left a gaping hole in their lives: “I used to rely on Tom for certain things – he was there for me, I wouldn’t go to my dad in a certain situation, or my sister or mother – there things that only he had the remedy for, I miss that.”

As Ben explains in a short video (above and on the Missing Tom site), life as a family of a missing person means struggling with constant uncertainty mixed with optimism: “Searching for Tom is like searching for the holy grail…I see homeless people in the street and wonder if they are on the same journey.” Although a memorial has been held for Tom since he disappeared, his brother refused to
 grieve for his missing sibling: “He is still alive, that is what I believe.”

Tom Moore, who went missing in 2003
Tom Moore, who went missing in 2003

* FInd out more on the Art Wars website and more about the Moore family’s search for Tom on the Missing Tom website.

Social networks and mental health: supportive environment or a stalking ground for cyber-bullies?

Bullying crushes a child’s self esteem and confidence. It can leave a child feeling alone, totally helpless, and with no one to turn to. In their childhood innocence and naivety some even blame themselves for their torment. Many schools now have robust anti bullying policies in the form of bullying charters.

We live in an age where teachers acknowledge widely the emotional needs of children more than ever before. Resources such as SEAL (social and emotional aspects of learning) provide increased emotional support in many schools.

As a consequence bullying has now left many classrooms, but not all. This is commendable but, not only do schools’ attitudes and actions in response to bullying vary considerably, is it enough?

And now in the age social networking sites it has insidiously entered the sanctuary of children’s bedrooms. Running away from the school environment and threatening bullies now leads straight to the bedroom, a once safe haven where a child’s computer suddenly provides no way of escape. Computers are the contemporary child’s toy and some may say the innocence of youth has died as a result. This year’s forthcoming Anti-bullying Week, for example, has a special focus on cyber-bullying.

These issues have been on my mind since the death of 14-year-old Hannah Smith who suffered relentless bullying online. Her death was not a stark reminder of how vulnerable our children are not protected from bullies even in the supposed safety of their own homes. There has been intense speculation and much knee-jerking as a result of her death, but the bottom line is that social media played a part in her suicide. Whatever happened, she was a vulnerable child.

But social networking sites can be so liberating for many providing an outlet for those who lack self confidence in face to face interactions and who might have smaller social networks than usual. Many can make friends and form relationships online that they would otherwise struggle to in school.

These sites can be very helpful, especially for those who lack social contact, or may have poor social skills, agoraphobia etc, but the flip side of the coin is the bullying issue. Reaching an acceptable compromise regarding social networking will not be easy because the genie has now been let out of the box, so to speak.

When experiencing low moods, your reality becomes alien to that of everyone else. I have always advised people to seek help at the earliest opportunity to prevent depression reaching this critical stage. And this is where social sites that support mental health can help.

There is the social site launched by comedian Ruby Wax, for example, Black Dog Tribe, “a place in which like-minded people can find their own ‘tribe’ and share experiences in a supportive online community through forums, blogs, daily news and mental health information”. Another example is Kent and Medway NHS Trust, for example, which is piloting Buddy, an online system that records mood changes. And there are a raft of support-specific online forums linked to various charities and support groups which can make all the difference to vulnerable people.

This is the positive aspect of these sites.

Yet it is too simplistic an argument that social media and networks alone can help prevent depression. An holistic approach can include talking therapies, physical exercise and medication, if appropriate. These therapies can support each other – medication, as I know from personal experience and from my nursing career, has its down side. It can also make your mood fluctuate wildly, become disinhibited and even suicidal. Having easy access to online support can, at times like this, be vital. These issues are brought into sharp focus by the news today that the number of people needing treatment for mental health issues will have increased by more than 2 million by 2030.

We should look closely at both the negatives and positives about social media and networks in relation to mental health – and ignore them at our peril. While it is also wrong to assume that social media alone can push someone towards mental health problems, excessive use of social sites, as is often reported, can itself lead to problems.

Children sitting for hours in front of a screen removes them from the social contact of others that will improve their face to face communication skills and confidence in later life. Effective communication involves eye contact, body language, and gesturing. All ignored when lying in bed hitting a keyboard in silent and lonely surroundings.

Cyber bullies and unpoliced social media sites populated by children (or those posing as children) are not part of a civilised society. We must make it all stop. Now.

How the media must mind mental health

Stephen Fry’s recent disclosure of his attempted suicide last year highlights that mental illness does not discriminate between the “haves” and “have nots”, the famous and the “ordinary”. None of us are immune from the feelings Fry described.

The representation of mental illness in the media in recent years (you need only think of Frank Bruno’s treatment by the tabloids), in television dramas and soaps has not, over many years been empathic. People with mental health issues seem to be either suicidal or mostly violent and dangerous – the two extremes of mental health geared more towards boosting viewing figures than portraying realism and authenticity.

These exaggerated displays of mental health only perpetuate the stigma and stereotypes. In fact it would be fair to say media representation has often been ignorant, discriminatory, and at times criminalising towards the mentally ill. In fact earlier this month, the actress Glenn Close apologized for her depiction of a mentally ill woman in Fatal Attraction.

Sensationalistic storylines and stigmatising stereotyping have only served to misinform and cloud the viewers image of someone who is ill and needing help – but that someone could be any one of us at any time of our lives.

The Time To Change media advisory service, which I am involved in, was set up to change negative perceptions and offer advice and guidance to promote more realism and sensitivity when covering mental health storylines. Advising the soap Emmerdale on a storyline featuring Zak Dingle, the popular loveable rogue, felt like living a double life for a year as the programme documented how his mental ill health spiraled downwards. Emmerdale provided me with a unique test: to positively influence a popular soap storyline. It afforded me the opportunity to use my own personal experience of depression, and lifetime working as a qualified mental nurse, to bring realism and authenticity for a change. I took on the role with a gusto I had not felt for many years.

I immersed myself in the role to the point of drowning. I knew that only by doing this could I truly empathise with Zak’s plight and engage the viewing public. I read countless scripts going over each one with a fine toothcomb burning the midnight oil. I spoke for hours on the telephone with Fiona, the researcher, and my mobile phone was constantly in use for texting and talking over the scenes. I so wanted this to be right.

I felt duty bound to make a difference having been given this opportunity. I advised that showing Zak’s vulnerability and fragile emotional state, rather then the often stigmatising “Mad axeman is dangerous” image, would encourage the viewer to also empathise more. This worked well and delivered the right message to the viewers.

I was made redundant halfway through this work and understandably my self-confidence and esteem was badly dented. In fact it became non-existent. Conversely my work with Emmerdale helped me regain this. I felt I could empathise more with the Zak character as my mood plummeted. I became Zak, or at least this was how I felt at the time. We walked the same troubled path for a while.

The advisory service will continue to influence and craft storylines around mental health. We will continue to provide personal advice and information to researchers, directors, journalists and the stars themselves to make mental health depictions credible. We will provide guidelines and key tips such as to try to allow the characters storylines time to develop. And that recovery can be a long process.

We will encourage the listening of peoples personal stories, and encourage careful thinking about how the other characters in the soap will react. The use of humour is not necessarily a bad thing and bringing in some humour and warmth will challenge peoples often misinformed stereotypes of mental health.

Mental illness doesn’t make people bad so by reinforcing this we can discourage programmes using a mental health storyline to try and explain bad or strange behaviour. For far too long criminalisation of the mentally ill has existed on TV and Radio and this misperception must change.

We have a long road to walk in our media advisory work to get this right. Or as near to accurate as we can. It is crucial that we walk this long and no doubt winding road together. Through collaboration and mutual respect we will make damaging stereotyping of mental illness a distant memory in the media. It is a win-win situation for all concerned.

* Read more thoughts from Lol on the Emmerdale storyline here

* Tips for storylines featuring mental health issues that create dramatic and interesting narratives without alienating audiences, resorting to stereotypes or using a mental illness to try and explain “bad behaviour”:
– to make a charactor plausible and accurate, speak to as many people who have mental health problems as possible. They are the best consultants available and most want to see accuracy on screen
– think about your camera shots. Certain mental health conditions can lead people to feel isolated or to experience altered reality. This can be reflected through close up shots, POV shots or hand held
give the storyline enough time to develop. It is common that symptoms of mental health problems will manifest over a period of time and build in intensity, rather than develop and explode in the space of one episode
think about how other characters react. Stigma and discrimination can be as bad as the mental health problem itself for many people. Can you show any empathy from others?
get expert advice from mental health charities and experts to ensure that the symptoms you are showing on screen are relevant and realistic
think of your dramatic climax carefully. Most people with mental health problems are not violent so it is unrealistic for a storyline to always end in violence or homicide

Based on information from the Time to Change media advisory service. Read more here.

On loss and learning

Lol Butterfield, mental health campaigner
Lol Butterfield, mental health campaigner
I have lost too many friends and service users through suicide over the past 30 years.

We examine our consciences to see if we could have done more to prevent such deaths, that’s a normal human reaction. It’s what empathy and compassion is about. Being a nurse, as I am, is irrelevant, it is about being human. We consider those left behind to face the future and what support they need. It becomes a tragedy that spreads a pond like ripple of despair and pain. Nobody is immune from this rippling effect.

Often in our hour of need we turn to those who we know can provide support. Those who can help us to work our way through the grieving process. Sometimes just a listening ear or supportive approach by anyone is suffice. Sometimes more professional help is required. Everyone is different. We are all unique. We all deal with the inner pain following a death in the way we know best, our resilience levels dictate our strengths and coping abilities in times like these.

Recently, the All-Party Parliamentary Group (APPG) on suicide and self-harm prevention called for councils to develop and implement suicide prevention strategies. The APPG report revealed that more than a quarter (27%) of English authorities do not have any such specific strategy. As the APPG said: “The existence of any such plan is open to chance rather than determined by any national policy.”

The APPG wants councils to be obliged to develop a suicide prevention plan led by the director of public health or senior member of the public health team: “The plan should include provision for self-harm prevention and those bereaved by suicide.” As the group stressed, more than 5,500 people die by suicide each year in the UK and for people aged 15-24 it is the second largest cause of death after road accidents.

While I support anything that raises awareness of self-harm and suicide, I strongly feel that the responsibility for suicide prevention should not just be down to the passion of area ‘champions’ who have a particular interest in this. I believe all local authorities must seriously address suicide awareness, and prevention, as a matter of urgency. This is of particular relevance with increasing self-harm and suicide rates taking into account the recession and how this impacts on peoples lives at a personal level.

Mental health promotion is now under the control of local authorities, although personally I believe we all have a responsibility if working in social or health care to positively promote mental health.

As well as the personal costs to each family of a suicide the financial costs through lost earnings etc for a lifetime run into many thousands of pounds. As a compassionate and humane society I believe we have a moral duty to have in place coordinated strategic approaches to address the issue of suicide prevention involving all stakeholders. The NHS, local authority, the Police, The Samaritans, Cruse Bereavement counselling, community mental health support groups, and so on. In fact the list could be endless because in reality so many people are potential victims of suicide, directly or indirectly.

From a personal perspective, following my redundancy last summer my mood dipped. In fact it plummeted. Voluntary work at that time ensured my self esteem and confidence would stay above the water. I experienced ‘dark’ thoughts myself brought about by feelings of worthlessness and hopelessness finding myself unemployed after a lifetime of work.

The adjustment to the situation I now found myself in did not come easy. My intensive role in advising Zak Dingle in his depression storyline in the Soap Emmerdale conversely helped lift my own mood. I felt valued because I knew I was making a difference. I knew that I was raising awareness of mental illness to a large viewing public in a sensitive and non stereotypical way. Winning the Mind Media Awards a few months ago for this storyline further boosted my self-esteem even more.

Zak’s symptoms were intended to educate, encourage empathy, and promote more understanding of depression and how people can reach the point of suicidal ideation. They were intended to highlight how mental illness not only affects the person but also the loved ones of that person. I invested much time and effort to try to get this right and confess it wasn’t perfect, but nothing is. It helped me considerably as much as it helped others I had hoped to understand more and assume less about mental health.

I was also asked by a good friend to consider becoming more involved with Stamp Revisited, a wonderful, life changing for some, advocacy service on Teesside for those affected by mental illness. I had been a member for many years and applied to be on the group’s executive comittee. I was accepted.

This also boosted my self-confidence and esteem and played no small part in helping to lift my mood to a more acceptable level. Stamp Revisited is a charity and, as such, relies heavily on donations and the generosity of its volunteers. its aim is simple. To help those who struggle with mental ill health, any one of us at any time in our lives could be in this position. It would be fair to say their work has at times saved lives.

Knowing someone is there in your darkest hour can help to steer you away from the depths of despair. Specialist support can offer a more objective view on improving your personal situation that may have been lost in the spiral of depression. Insight can be lost in severe depression. Taking your own life can then become an option you would not have considered, ever. Knowing people are there to listen makes such a difference and words cannot explain how life saving this may be.

* The Samaritans’ Media Guidelines aim to promote the sensitive reporting of suicide and self-harm incidents

The season to be jolly?

Christmas isn't all it's cracked up to be. Pic: The Topé Project (see end of article for info)
Christmas isn’t all it’s cracked up to be. Pic: The Topé Project (see end of article for info)

Hooray, it’s Christmas! Yes, the season to be jolly is upon us once again. But that’s OK because everyone loves Christmas, right? Well, I’m not a fan and I know I won’t be the only one shunning the Christmas cheer, preferring instead to hide away with old Ebenezer Scrooge until the tinsel is put away and a new year begins.

This Christmas will be a difficult time for many people, even more so for those with mental health problems. Our society expects a lot from us at Christmas; shops, TV, advertisements and jolly newsreaders perpetuate the myth that we all have to be happy simply because it’s ‘that time of year’.

Being unwell at Christmas as a result of a mental health problem is rarely spoken about since the expectation is that everyone ought to be enjoying themselves; quaffing wine, eating too much and watching the Eastenders Christmas special. Knowing that people are suicidal or spending Christmas locked up in a psychiatric ward distorts this myth and exposes the reality of what Christmas is like for many of us.

Why aren’t you happy? It’s Christmas!

Telling people to ‘get a grip’ or ‘pull themselves together’ doesn’t help, ever, but especially not at Christmas when people are no doubt already chastising themselves for not being in the Christmas spirit and feeling like they are letting friends/family down. If this was possible there would be no such illness as depression, nor any other mental health problem. Making someone feel guilty over how they’re not feeling helps no one.

Having a mental health problem is a lonely experience and can make you feel like an outsider. It can be difficult to find people who ‘get it’ and are willing to listen, especially at Christmas when most people would rather be thinking about what presents they are going to buy.

It becomes less acceptable for people to speak honestly because we’re all supposed to so happy. People are more likely to keep quiet about how they are feeling at Christmas because of the pressure to be positive and have everything ‘perfect’ for the day itself. This quest for perfection can be dangerous because it is unattainable and doesn’t allow for people to let others know they are struggling.

Between Christmas and the New Year the usual support systems that people rely on aren’t available. Mental health services close during this period and on Christmas Day itself even places like coffee shops are closed. This may seem like a trivial complaint to some but when you rely on little things to help you get through the day – such as being able to go out each day and sit in the local coffee shop – not having the opportunity to do this can make it more difficult to cope with existing mental health problems and the stress of Christmas.

The disruption to regular appointments with a mental health service can make it difficult for people to know where to turn if things get tough over Christmas. Thankfully there are helplines available, such as the Samaritans, which do a fantastic job supporting people over the holidays. Generally people are told to go to A&E if they are struggling with a mental health problem in lieu of other mental health services being closed, but as you can imagine going into that environment when you’re in emotional distress can be inappropriate and frightening.

A great service in Leeds which offers face to face and telephone support for people experiencing a mental health crisis is the Leeds Survivor Led Crisis Service. Set up by people with direct experience of mental ill health they will be open Christmas Day and throughout the holiday season, providing an alternative to A&E and helping prevent hospital admissions with their helpline and crisis house.

It would be great if more of these services were available to people across the country, particularly at Christmas when many have nowhere else to turn.

* Project supports care-leavers at Christmas, writes Saba Salman
“Christmas conjures up thoughts of a big massive dinner, presents, fun… and then I think about so many young people who don’t have that. For me it’s really important that young people, especially the most vulnerable, have a good Christmas.” These are the words of youth worker Shalyce Lawrence, 24, who was in care for 10 years and who, along with several peers, has launched a project to support young care-leavers who are alone at Christmas.

Shalyce and a group of volunteers in their 20s have created the Topé Project, in memory of a 23-year-old care-leaver, Topé, who took his life several years ago. The scheme’s launch event, Christmas in the Crypt, is a Christmas Day celebration in London for 70 care-leavers from across the capital. Organisations supporting the scheme include the charity Crisis and five London councils, and the group has also been gathering donations to fund the drive.

The aim of the scheme is to create an “atmosphere of belonging”, positive memories and to help young people form constructive relationships. Young people in care are not supported by social services after the age of 18, unless they are in education and based on 2011 figures, as the project points out, 44% of 19-year-old care leavers in London were living in independent accommodation.

Shalyce adds: “It doesn’t mean you are going to be affected by suicidal thoughts just because you have been in care, you can be anyone and go through that. Think about how you can support the people around you, so it doesn’t have to happen to you.”

Read more about the project on The Independent website, find out more via email thetopeproject@gmail.com Twitter: @thetopeproject or on Facebook.

Self-harm: the power of talking face to face

Self-harm has always been a taboo subject and in my many years of mental health nursing probably provided more challenges than anything else for me.

It touches at the very core of who we are and how we deal with stress. Our mental strength, or resilience to cope when under pressure, will prevail in many cases but not all.

Recently, new research by the charity YoungMinds suggested that many doctors do not know how to support young people who self-harm. And today comes the news that mental health patients are to be given the right to chose their consultant. As reported today, this will help end what can be a “like it or lump it” service – unlike patients with physical health issues, mental health patients can’t currently chose which psychiatrist they see.

Back to primary care; self-harm is still very much misunderstood by many, and the wider general public. As a mental health nurse, I confess at times to having felt at a loss myself as to how to respond to repeated self harm behaviours. You question your own approach if the problem remains despite intense nursing intervention.

But given that 10 per cent of 15 to 16 year olds are thought to have self-harmed, usually by cutting themselves, if GPs are offering a lacklustre response to the issue (not referring for counselling or for more specific mental health support), this is woefully inadequate.

The mental health charity Mind, suggests that if your GP doesn’t help, you contact the Patient Advice and Liaison Services – and you have a right to change your GP. Mind has some useful practical information on where to get help.

I have worked with some excellent professionals. However, I have also seen others who are in a privileged position to help but who try to look the other way. Or dismiss this as attention seeking behaviour.

In a profession known for its primary focus on the treatment of physical diseases, being presented with a self-harming patient provides an emotional litmus test for many GPs. Why do they get this so wrong sometimes?

Although I don’t want to generalize, I believe that some view this behaviour with frustration and a sense of hopelessness. By this I mean some medical professionals might not feel confident of their own training or understanding to be in a position to deal with things effectively.

Some GPs are too dismissive or refer to mental health services in the knowledge that more specialised knowledge will be available to plan appropriate treatment. Or they automatically reach for the prescription pad to prescribe medication without really asking themselves if a psychological approach would be the more helpful first option.

And yet all too often, just a listening ear will help, to allow the person to “offload” within the surgery. This is where the therapeutic relationship between the GP and patient is pivotal to treatment and recovery.

The power of talking openly about concerns face to face cannot be underestimated. A prescription for anti-depressants may be helpful in the long term but we should not rule out even a basic “talking and listening” opportunity as a first option (given GP’s have to stick to set consultation slots, I can see why this might seem an impossible idea – but an approach that encourages people to talk is the right one).

If a person with low self esteem tells the GP they are a “bad person” or “unloved”, the GP can use a simple cognitive behavioural approach of questioning the evidence to support this there and then, of which there is usually very little. And stress to the person that a thought is just a thought, not a fact. Simple but effective initial intervention to encourage someone to question their own negative thought processes.

So what to do?

Going back to my opening thoughts, while professionally I’ve found self-harming behavior extremely challenging, one thing I’ve never doubted is my empathy to try to look beyond the physical act of self harm to try to identify its underlining cause.

A behaviour as challenging as self-harm can distract you from seeing the person behind the behavior; what is the emotional conflict driving this kind of behaviour. People can change self-harming behaviours. Being positive and maintaining hope is the starting point of any intervention – and that goes for the professional as well as the individual.