Category Archives: Mental health

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 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.

Why I always had time for George: older people and mental health

I’m walking across the grounds of the psychiatric hospital on a very wet winter evening and a patient, let’s call him George, steps out from behind a bush to talk to me. He needs to tell me something that he feels is important and can’t wait.

We both stand for quite a while talking (he’s a staunch socialist and wants to talk politics) and both get soaked to the skin. I think to myself that it’s more respectful to hear what he wants to say then hurry on and seek shelter. As we eventually walk back to the ward together, he is calmer, seemingly content to have got his feelings off his chest.

This scene took place more than 20 years ago (I mention it in my book, Sticks and Stones) but I believe now what I thought then, that my exchange with George is what real empathy is all about. It’s what being non-judgmental is about, what being human is about, what being a nurse is about.

I have nursed enough people during my time as a mental health nurse to understand that life is a bit of a lottery. I have seen the elderly lose their dignity in nursing homes and in hospitals. This is not always through dementia. This could be depression or psychosis, or other debilitating illnesses depriving them of their confidence, self worth, and esteem.

But as the recent figures about suicide rates rising among the elderly show, mental health issues may be overlooked in older people as society mistakenly presumes dementia is the only condition older people experience. Another assumption is that depression is a normal part of ageing, because the elderly have more of a sense of their own mortality.

I hope that whatever befalls me in my old age I am shown the same respect and compassion as I believe I have shown others. There’s often a failure of respect not just because of deliberate neglect or a lack of compassion, but through ignorance – through not treating people as individuals or not meeting their emotional needs.

So how do we prevent this? Essentially it is around searching for the person behind the illness and stepping back for a second and thinking “how would I like to be treated if this was me?” or “would I like to be looked after in this environment?”

Of course I’m not arguing against the completion of care plans, but I do worry that the increasing onus on form-filling and box-ticking can deny care staff more time to spend with those they support. A care professional might be spending hours on admin, or typing up a care plan – but how does the person in their care know this is part of them being cared for? They’d rather have our face-to-face time I’m sure.

Person-centred care, as the name suggests, is meant to put the client at the heart of the care planning process. This care is collaborative and negotiated with the client (theoretically). However, often when someone is acutely psychotic and lacks all insight, nurses then become the advocate and the care must be planned depending on what is required to get the person well again. As for personalisation and personal budgets, the take up is sadly not as high as it should be; people worry about risk management and general funding pressures that can put people off.

Compared to when I was in a clinical setting, today’s care world involves a far more litigation and risk-averse culture which takes staff away from the client. At the time I knew George, I could spend longer in one to one sessions with clients, so could my colleagues, but more often than not, today’s staff are only allocated a set amount of time each shift to spend in one to one, face to face therapeutic sessions on the wards.

Staff cutbacks on the wards and in the community will also reduce the time staff can spend with clients in face to face interventions. However staff should still show empathy and be non judgmental in all approaches, because this is the essence of their roles.

Clearly, organisations promoting older people’s issues have a role to play in raising awareness and educating. We stigmatise the elderly as much as we stigmatise the young people, so we need more positive promotion of what the elderly can offer society. Countries like China and Japan, for example, revere the elderly and yet in this country I think some people view them as an afterthought, a burden.

The hospital where I met George has long since been converted into a block of expensive flats while the man himself, already in his 80s when we had that long rainy chat, will have passed away many years ago. But the memory of that evening stays with me as a reminder of the underlying principle of care as I see it; listening to, respecting and having the individual – not “the system” – as your main focus.

Art fights social taboos

Living with chronic health problems and facing social taboos are issues at the heart of an international artistic collaboration about HIV/AIDS as part of the Cultural Olympiad.

Portrait by Rachel Gadsen © Rachel Gadsden

© Rachel Gadsden

The powerful images here are part of the Unlimited Global Alchemy project
which launches today as part of the London 2012 Festival. After today’s launch at the Museum of Archaeology & Anthropology in Cambridge, the exhibition culminates at the Southbank Centre during the Paralympic Games.

The project has been produced by Artsadmin and commissioned by the Unlimited programme launched to celebrate arts, culture and sport by deaf and disabled people.

© Rachel Gadsden

Artist Rachel Gadsden, who has lived with disability all her life and whose inspiring work I came across last year, began the project after seeing the work of South African artist Nondumiso Hlwele at the museum in Cambridge – Body Map, below, reflects Hlwele’s experience of living with HIV.

Body Map © Nondumiso Hlwele

Gadsen travelled to the Khayelitsha Township, Cape Town, pictured below, to collaborate with the artist-activist collective which Hlwele leads. The works in today’s exhibition were created over a six week residency in Cape Town in October last year.

Khayelitsha township where today's works were developed

Together, the striking pieces show what it’s like to live with disabling conditions and social prejudice. “At the heart of this life-affirming and timely collaboration is a celebration of survival against the odds,” say the artists. “It is also about access to art in a very broad sense, participation, and the potential for bridges to be built across cultural, educational and geographical divides.”

You can follow the project on Twitter with the hashtag 
#UGAlchemy and the exhibition is at the Museum of Archaeology & Anthropology in Cambridge until 18 August before it transfers to the Southbank Centre, London in September as part of the Unlimited Festival. There will also be a collaborative performance work once the project transfers to the Southbank.

How I fell back in love with learning

The recent Mental Health Awareness Week made me reflect on my experience of mental health problems and how studying is helping me – hopefully – recover.

Recovery from a mental health problem is rarely easy and, in my opinion, highly subjective. Medication may form part of a person’s recovery but those little green and white capsules aren’t the magic “happy pills” you may have envisaged and sometimes the first step is simply trying to access the right help and support to manage your symptoms.

While I’m dubious as to whether I’ll ever fully recover in the medical sense – complete absence of symptoms – by understanding myself and my condition better and am slowly learning what may help alleviate the impact depression and anxiety has on my life.

Last year I began studying with the Open University (OU), a short science course on particle physics which did not require me to leave the house or interact with anybody face to face; my idea of heaven. One of my issues is severe anxiety triggered by social situations, when I’m at my worst I am unable to leave the house for fear of seeing another human being and becoming paranoid, agitated and having to run away.

I’m 23 now and left school with five GCSEs at the age of 16, since then I’ve been in and out of college and university, believing if I was strong enough I could “get over” my mental health problems and fit in with my peers. Unfortunately being in a classroom inevitably triggered my anxiety due in part to bullying in high school which I’ve struggled to recover from.

I was always reluctant to study with the Open University despite encouragement from my mum, a fellow OU student. Part of me felt I was somehow “giving up” by not facing my issues head on and forcing myself to be around people in an educational setting. But, fed up of being a drop-out and realising I’d always preferred the autodidact way of learning I signed up and haven’t looked back since. Studying with the OU allows me to continue my education despite my problems and has helped me fall back in love with learning again, something I doubted would ever happen and believing the opportunity to gain a degree and have a career was something other people had, not some anxious wreck terrified of the world.

Following the completion of some short science courses to ease me back in to studying again I’m now aiming for a degree in physics. It’s not always being easy, concentrating on differential equations for hours on end when you’re depressed and crying your eyes out can be horrific but the university has services on offer for students with disabilities which include the Disabled Students Allowance (to pay for any additional costs relating to your disability), flexibility with assignment deadlines and individual support during examinations. I have asked for extensions for a couple of assignments due to struggling to motivate myself because of my depression.

The study is also part-time which makes things less stressful and means I can study alongside receiving treatment for my mental health. The number of hours I study a day or week varies quite a bit, but on average, around two hours a day are dedicated purely to study. I’ve found when my assignments are due I become a bit obsessive with the studying and can spend days or nights on end studying.

Some people find distance learning isolating and admittedly, sometimes it’d be great to sit down and have a chat with fellow students; there are plenty of opportunities to chat online via the forums, Facebook and Twitter, which suits me.

I have used the forums available on the OU website which is part of it “virtual campus”. I have also used one set up by students on Facebook where I just chatted about the course rather than anything mental health related; it helped remind me I wasn’t on my own.

For some courses there are face-to-face or online tutorials every few months where you get to communicate with your tutor, who is always available by email and telephone. I’ve been too anxious to go to face-to-face tutorials which is why I’m so glad online ones were provided.

Studying as a way of managing a mental health problem may not be for everyone but it has managed to keep me focused and helped me realise my life doesn’t have to be defined by being unwell and a mental health service user. Recovery may be long and arduous but I’m convinced studying – and I hope to finish the degree in another four years – will be an integral part of keeping me mentally healthy.

* Carrie is involved in the charity Young Minds’ VIK (Very Important Kids) project which campaigns on youth mental health. You can follow Carrie and Vik on Twitter @vikproject

The power of a poem: how reading broke David’s isolation

EleanorMcCann, TheReader project

Guest post by Eleanor McCann, The Reader project

Whenever I arrived to read with patients at the psychiatric hospital, David was always alone. I approached him a few times but the weeks went by and he seemed unreachable, saying nothing and making no eye contact. One evening, I came on to the ward to find him lying on a sofa with the lights off, his hood up and his earphones in. All the barriers were up. I handed him a poem and, to my amazement, he took his earphones out, his hood down and said: “Can you turn on the light?”

The poem I gave to David was Release, by R.S. Gwynn. It goes:

Slow for the sake of flowers as they turn
Toward sunlight, graceful as a line of sail
Coming into the wind. Slow for the mill-
Wheel’s heft and plummet, for the chug and churn
Of water as it gathers, for the frail
Half-life of spraylets as they toss and spill.

For all that lags and eases, all that shows
The winding-downward and diminished scale
Of days declining to a twilit chill,
Breathe quietly, release into repose:
Be still.

I think the poem’s stillness broke David’s silence. After that, he joined the reading group on his ward, where we enjoyed short stories, such as Saki’s The Lumber Room and Doris Lessing’s Through the Tunnel; extracts from novels including Jane Eyre and The Old Man and the Sea and poems old and new. We read Release with the group and David said he loved the last two lines, especially. He said: “Poems can move you even though you’re sat still. Probably you actually have to be still like it says there. It’s different from feeling manic.”

Weekly Get Into Reading groups bring people together to read aloud. Pic: The Reader project

David has instructed me to always approach him: “Come and knock on my door, even when I’m in the dark and I’ve got my back to you.” This is the essence of why the reading project exists: to knock on doors, bringing light and lightness through reading.

David’s group is one of about 280 Get Into Reading (GIR) groups across the UK. GIR brings people together through weekly read aloud groups, where people can choose to read and are invited to give personal responses. We have groups in locations such as care homes, libraries, prisons, mental health drop-in centres, community centres, schools, hostels, refugee centres and workplaces. Sessions are an opportunity for people of all ages, backgrounds and abilities to engage with reading for pleasure. The work aims to bring about, what we call, a Reading Revolution. This means we want to make literature available to those most in need in our society, as a way of fostering individual wellbeing and social cohesion.

Reading as part of a group can bring mental health benefits. Pic: The Reader project

I work specifically within mental health settings so my groups are in a variety of health-care environments: older people’s care homes; psychiatric units; secure hospitals and addictions services. This type of work is an innovation. The medical director of Mersey Care NHS Trust has said that “Get Into Reading is one of the biggest developments in mental health practice in the last 10 years.” We believe our model is a pioneering way of using creative partnership to deliver meaningful activity to patients. Reading should not be merely an additional intervention; I would identify it as an integral part of the care provision for mental health patients.

My grandmother was an occupational therapist in the 1960s and 70s, and she remembers reading aloud with some of the people with whom she came into contact. It’s just that we are only now really realising the full extent of the potential that literature has to help people- and that this can amount to the transformation of lives and communities.

We have recently carried out some evaluation so have statistics to substantiate this. 54 reading group attendees, both inpatients and outpatients, filled in a questionnaire. The results showed very encouraging responses to their experience of the reading groups.

There were some overwhelmingly positive results, for example, 94% of people agreed with the statement ‘The reading group has given me a chance to take part in interesting discussions’ – but the results form our research are particularly relevant in the context of mental health. In response to the statement “reading has improved my mood”, 78% agreed, 18% neither agreed nor disagreed and just 4% disagreed. And in reaction to the statement that “in the group I’m able to be myself”, 79% agreed, 19% neither agreed nor disagreed and just 2% disagreed. Our research showed 85% agreed with the comment “I’m more able to relax” while 11% neither agreed nor disagreed and 5% disagreed.

I find my work extremely rewarding, primarily because of qualitative, individualised stories like David’s, but this is verified by a growing evidence base, pointing to cost-effective, lasting benefits for our readers.

* Eleanor McCann is a project worker with Mersey Care Reads, a collaboration between The Reader Organisation and Mersey Care NHS Trust. The organisation was a runner-up in last year’s Guardian Public Service Award. Eleanor’s work involves delivering weekly reading groups in mental health settings across Merseyside. She is also studying for a masters in Reading in Practice, a course combining literature and health science, at the University of Liverpool and is co-editor of The Reader magazine. Eleanor can be contacted at