Category Archives: Wellbeing

How arts therapy can support people with dementia

Working with memory triggers in a reminiscence arts session (photograph: Age Exchange)
Working with memory triggers in a reminiscence arts session (photograph: Age Exchange)

By 2025 there will be one million people with dementia in the UK, according to the Alzheimer’s Society; a project I reported on today for the Guardian online is proving the impact of arts-based therapy on people with the condition.

Take Eddie (not his real name). When he first met arts practitioner Jill, from London-based arts group Age Exchange, he was withdrawn and uncommunicative.

Eyes downcast, head bowed, hands clasped and legs crossed; Eddie, an introverted wheelchair user, had been in a dementia care home for a decade when he began sessions Jill.

Over six weekly reminiscence arts sessions – work that explores memories using creative activity – Jill noticed how Eddie became “awake, sitting upright in his wheelchair, trying to talk, being better at regulating his mood and behaviour … He felt safe enough to allow himself to express some of these stored up energies and feelings through movement and making sounds which freed him and allowed him to start opening up and connecting with people.”

A simple gesture after the final session – previously unimaginable – reflected the transformation. Jill recalls: “I was very touched as we said goodbye; he extended his right hand towards me, I took it and we shook hands.”

My piece today highlights the specialist practice of reminiscence arts; Eddie was among 200 older people involved in research into the method in Lambeth and Southwark, evaluated by experts at Royal Holloway, University of London. You can read the rest of the piece on the Guardian’s social care network.

Employers’ public health role

Working-age ill-health costs the UK economy an annual £100bn, and in a piece for the Guardian online, I give a snapshot of what some employers are doing to improve the health of their staff.

It might be easy to dismiss lunchtime yoga sessions or in-house physio clinics as optional extras (or a “perk”) but the stats on workplace illness suggests a focus on wellbeing makes economic sense. More days are lost through staff sickness in the NHS than elsewhere in the public sector (according to the government’s 2009 Boorman Report) and sick leave costs the health service £1.7bn a year.

Employers are starting to recognise their public health role; almost 400 organisations have, according to latest figures, pledged support for the Department of Health’s public health “responsibility deal”.

You can read the full piece, part of a supplement on physiotherapy, here.

Art show celebrates diversity

Painting by Chantelle Bellinger, from the Nexus art group, Surrey.
Painting by Chantelle Bellinger, from the Nexus art group, Surrey.

The graceful depiction of birds, above, is among the art works on display in a new exhibition celebrating diversity.

I’m sharing some of the pieces here because I was taken by the broad range of subjects and contrasting styles of the artists. Most of the pieces are inspired by nature and natural landscapes.

The paintings were created by participants in the Nexus project, run by care organisation Surrey Choices, and are being exhibited at the Sunbury Embroidery Gallery until March 1 (entry is free). Nexus provides specialist support and activities for adults with physical disabilities and mild learning disabilities.

Work by Bryan Aldridge
Work by Bryan Aldridge
By Chantelle Bellinger
By Chantelle Bellinger
Painting by Marc Leosing
Painting by Marc Leosing
Artwork by Michael Somers
Artwork by Michael Somers
By Terry Prosser
By Terry Prosser

For information, see the gallery website.

Innovative project redistributes surplus food to needy

Food donated to FoodHub, for distribution to charities and food banks (pic: FoodHub)
Food donated to FoodHub, for distribution to charities and food banks (pic: FoodHub)

Christmas – for some a time of year to overindulge, for others a desperate effort to feed the family.

With a huge rise in the number of people in the UK relying on food banks, a new London project that is making good use of food left behind when people moving house by collecting it and donating it to food banks and charities.

The organisers, a company specialising in overseas moves, explains: “MoveHub and their partners noticed that families were forced to just throw large volumes of food when they moved abroad – due to customs restrictions – and decided that instead, this food should find its way to people who really needed it.”

The project estimates that the food thrown away during moves across the UK could fill 160 supermarket delivery vans each week. While it acknowledges it “can’t reverse food poverty in the UK”, the scheme is an attempt to “contribute to the organisations helping people get back on their feet”.

Among the charities benefitting from FoodHub is homeless charity Centrepoint.

It is estimated that around 3.5m tonnes of food is wasted every year in the UK and this latest drive is a welcome addition to schemes like the “community supermarket” plan, under which unwanted supermarket food is already re-distributed to needy families.

* This is the last Social Issue post for 2014 – the blog will be back in January. Thanks to everyone who has read, shared, contributed to, commented on and got in touch over the last 12 months, your support’s very much appreciated.

Mental health on TV: entertainment vs realism and sensitivity

If someone’s arm was broken on TV we would see it bandaged up. If someone had diabetes we would see them receiving insulin. If we see someone had a heart condition we would see them wired up to an ECG machine.

So why when we see people displaying symptoms of mental illness do we usually see this depicted as violent or histrionic, with a focus on the challenge and not the solution?

Christmas is next week – a time of year that can brings an unbearable pressure to people with mental health issues. We are all very familiar with seeing mental illness portrayed in cliched, negatively stereotypical ways on our TV screens. The storyline involving the character Steve McDonald’s unfolding depression in the TV ‘soap’ Coronation Street is generating much interest currently .

I am watching closely as this storyline unfolds, not least because we at Time To Change are advising on this to try to ensure as much sensitivity and realism as possible.

Although only in the early stages of the illness, Steve’s behaviour is causing both consternation and confusion for those close to him, and not so close. People are trying to make sense of it all at the moment. Classic symptoms pointing to clinical depression can often be overlooked in the early stages. The programme is cleverly highlighting this and showing the insidious nature of the illness.

I believe it is all around finding the right balance between providing drama for the viewers but also ensuring mental health is not further stigmatised through lazy, damaging scriptwriting. It is a win-win situation for everyone to have mental health storylines depicted with responsibility, authenticity and maturity:
• viewers will gain more awareness of symptoms and treatment
• the programme will receive positive publicity for the research and efforts made
• a powerful anti stigma message will be ultimately delivered.

It is critical to present as authentic a picture of mental health symptoms and treatment as possible to de stigmatise mental illness. The media plays a role that must never be underestimated. It will educate and challenge opinions, it will inform. The viewers opinions and impressions are often influenced by what they see and hear on their TV screens. In advising on the Zak Dingle depression storyline in Emmerdale, I was at pains to reinforce how the illness not only impacts on the sufferer but also the family and significant others.

This is the reality.

The person who is ill does not usually suffer alone, their families/partners have usually cared for them before they seek help and continue to provide care afterwards. I will be watching the Coronation Street storyline to see how those near to Steve are effected by his own deterioration. It must also be realistic in showing the time span of the illness. It would be ludicrous for the viewers to see a decline into severe clinical depression undermined by a miraculous recovery within weeks.

Unfortunately drama that portrays a swift recovery only serves to misinform and mislead. Realism and credibility is then left on the cutting room floor. This is why good research is the key alongside learning the lessons of the past. Lessons need to be learnt and I strongly believe this will be the case in the Coronation Street plot.

Recent research by Time To Change has shown that attitudes are changing as a consequence of responsible media portrayals of mental health. We must not become complacent though and continue to build on the good work so far.

Coronation Street is a very popular soap. Many will be watching for the drama and entertainment element, while others will be scrutinising closely to look for a positive, realistic depiction.

I want these reasons to combine.

I hope nobody is left disappointed or disillusioned. I am excited by this storyline and so should others be. Excited because the storyline will, if successful, leave a seed of hope and a motivation for change in everyone’s minds. That seed will eventually grow into a realisation that when covering the topic of mental health, it is crucial this is responsibly portrayed in the media.

My campaign to change attitudes, one event at a time

We have just ‘celebrated’ World Mental Health day (10 October). I, and many like me, hope that as each year passes so does the stigma and discrimination of mental health. Stigma impacts like a disease – if left untreated, the result is devastating.

Attitudes are certainly changing around mental health, although slowly. As pointed out by Time to Change, the mental health campaign I’m involved in, perceptions are changing. The National Attitudes to Mental Illness survey shows that since 2011, an estimated two million people – or 4.8% of the population – have improved attitudes towards people with a mental illness.
In addition, the data suggests that more people are acknowledging they know someone with a mental health problem (64% in 2013 compared with 58% in 2009). However nearly half (49%) of respondents said they would feel uncomfortable talking to an employer about their own mental health.

Anti stigma work has taken up a large part of my life in psychiatric nursing. And, although it sometimes feels like two steps forward and one back (as the research quoted above hints), the long and winding journey is worth the taking and the rewards are for the benefit of everyone.

I have seen the impact of stigma. I have also felt it. I have seen the destruction it causes people who experience mental illness and their loved ones. This is the motivation for my work.

The recent news about the impact of isolation underlines the need for more work along these lines. Both young people and older folk are affected by severe loneliness.

These issues provided the context for a talk I organised in my childhood village in July, and which I blogged about on these pages.

My talk was about the stigma of mental health and aimed to promote Time To Change. I wanted to raise awareness of the insidious impact of stigma and its long-term damage, and explore how we can all make a difference to the lives of others through our daily interactions. I wanted my message to reach across the village and, more personally, make a mark in the place where I spent my childhood years.

For me going back to my former home, which I left almost 40 years ago, was quite an emotional occasion. It had been the culmination of a life long ambition, a seed borne in childhood that had finally flowered. In the dark corners of my mind has sat the repressed thoughts from childhood of my father’s mental health issues, and the attitudes of others at the time to this.

Assembled in the room of around 50 people were faces from my childhood, alongside faces of the present. An eclectic range of people and experiences, young and old. Friends and family sat beside strangers. I will always be very grateful for the efforts they made to attend and help me to achieve my ambition.

Social contact and interaction is a powerful weapon in challenging ignorance and the myths surrounding mental health. Breaking down the invisible barriers we put up and accepting people as people, rather than defining them by their mental health condition is critical. The two-hour event was informal and interactive thereby providing the ‘safe’ space for those who wished to be open and share their personal experiences, or the experiences of others they hold close.

I started with a mythbusting quiz about mental health to highlight the misconceptions that exist, then spoke about my work in mental health nursing, my anti-stigma initiatives, and also my own experience of depression. I covered my work in the media with the TV soap Emmerdale, advising on the award winning depression storyline of one of the main characters, Zak Dingle.

I stressed it was my hope to encourage the viewers to empathise with Zak’s plight, to see him as being vulnerable and a victim of his circumstances rather than a danger to others, and criminalized

To contrast with this I also explained my advisory role with the character Darrell Makepeace in BBC Radio 4 The Archers. This character had not been received positively by listeners because the producer had decided to criminalise this character. Despite this, I stressed this at the very least ensured people were talking about mental health.

It was a success. I was at pains to ensure it went well because it meant so much to me. I have delivered many talks and presentations previously to large and small audiences but this one was more personal.

Since that summer’s evening I have spoken to people to gauge how things went. Did it make a difference? Has it changed their views? Inspired them? Where do we go from here? The responses have enthused me.

I intend to arrange a follow up event to build on this and plant another seed for the future. A seed for the young people, some who, sadly, will inevitably grow up with the same experiences I had.

Hopefully there will be some changes in attitudes resulting from that evening. It might seem to many just a single, small event, but if it can change just a handful of attitudes and encourage people to talk about mental health, it will be a success. Change drips slowly, but it will come all the same. One day.

Campaigning in my community for mental health

Each time I return to my childhood village the memories come flooding back.

Memories of football in the street and endless walks along rugged cliffs that are some of the highest in the country. A sense of innocence from another era now gone forever.

My native town is Staithes, a small fishing village nestling beneath cliffs on the north Yorkshire coast. A tourist attraction in summer, Staithes is synonymous with Captain James Cook who worked and lived there prior to setting sail to discover Australia.

My childhood growing up in the village was mostly uneventful but rocked by my parents’ separation and my father’s mental health issues. Mental illness was very much misunderstood in the village and this was no different to any other village in England at that time.

Over 50 years later, and nearer to the grave than the cradle, I now want to return to my roots to try to bring about change, however small, around attitudes to mental health. I want to raise awareness in the village of the stigma of mental health and how it impacts on the sufferer and their families. A stigma as dangerous as the high cliffs I would climb as a child and the raging sea that batters the village in winter.

Stigma and discrimination of mental illness exists in all villages and towns. Time To Change, England’s largest mental health anti-stigma programme seeks to change all that. I volunteer for Time To Change and use my qualified psychiatric nurse knowledge and and personal ‘lived experience’ to try to bring about more awareness, understanding and tolerance of mental health.

I feel confident that the event next Thursday (24 July) will be successful. Why? A sense of community exists to this day in Staithes, which I believe is part of being from North Yorkshire and who we are as a people. A down to earth friendliness, community spirit, and willingness to help others in time of need.

What I have organised is an informal evening in the village hall to raise awareness, educate, and de- mystify some of the negative and damaging misconceptions of mental health; SOS Staithes Opposes Stigma of mental health (the title “SOS” reflects the international distress signal ‘Save Our Souls’ which the village, a once thriving port, uses so I thought that would be an apt title).

I will also talk about my advisory work with Steve Halliwell, who played the character Zak Dingle in the television soap Emmerdale , to help craft the award winning depression storyline. This was done with the aim of making mental health depictions on TV more realistic and sensitive. People here in identify with Zak Dingle as the programme is Yorkshire-based.

So far the response to my evening event has been very positive. I have visited the village and left posters everywhere. I have spoken to some people I already knew and strangers who I can now call friends. They have been very open and honest about their own mental health issues or spoke of people they know and care for. This has enthused me all the more. I appreciate their being so open and trusting very much.

I wish I had possessed the same feelings of acceptance, understanding, and trust all those years ago as a child around my fathers illness. Small rural communities such as this are more isolated than the larger towns and cities and as a consequence people are often left feeling more alienated and lacking support. I often say as a child I did not understand the word stigma but I certainly knew how it felt.

My aim is simple. I would like the people in the village to be more aware of mental health issues and how mental illness it is indiscriminate. How it effects one in four of the population and that nobody is immune.

I would like the young people to see me as a positive role model and for them to be influenced to try to bring about change themselves in whatever way they can. I would like everyone to understand that Time To Change is a social movement for change and they can all play a part, no matter how small, in this ground breaking campaign.

The young people are the future of the village. They can all make a difference to the villagers of tomorrow as well as today by their words and their actions.

• SOS: STAITHES OPPOSES STIGMA of mental health. Thursday 24th July 7 – 9pm held in Staithes village hall – An informal evening of interaction and discussion around mental health. Free entry by ticket. Refreshments available and free promotional Time To Change materials. Tickets from Lol Butterfield on 07958064025, Veronica Foster on 07891607786 or members of the village hall committee.

Older people power: society and product design need to wise up

Gordon Morris, Age UK Enterprises
Gordon Morris, Age UK Enterprises

Society often fails to realise that people aged 65 and over currently represent a sixth of the UK population responsible for £120 billion worth of spending power a year – over 18% of total spending in the UK. And the number of people aged 65 and over is projected to rise by nearly 50% in the next 20 years to over 16 million (figures from the Office for National Statistics).

As Britain adapts to an ageing population, the marketplace for assisted living aids and adaptions such as stairlifts, adapted bathrooms, wheelchairs, mobility scooters and pendant alarms will become a dominant area of spending. Market forces will encourage producers and distributors to sharpen up their communications to older people but it would be a very positive development if we were to address this now rather than later.

The government’s 3 million lives initiative, announced last year with the aim of improving access to telecare and telehealth, is an important step towards transforming service delivery for people with long term conditions, and/or social care needs, by utilising telehealth and telecare within health and social care services. Telecare and telehealth relate to the use of technology-related devices, from high-tech equipment to simple sensors, that help people maintain their independence and boost their safety. And during a recent debate on the Care Bill in the House of Lords the government announced that it intends to maintain existing entitlements for older people regarding aids, minor adaptations and intermediate care.

These developments are warmly welcomed. However recent research by Age UK Enterprises, the commercial arm of the charity, found that there is still a way to go in ensuring that knowledge about these developments is passed to those who most need them. The survey revealed that 20% of over 65s feel there is a lack of information available about independence aids for the home.

The low consumer awareness amongst people aged 50-70 of the very products which can aid independent living at an older age can be addressed. But there are also social perceptions that we need to tackle too. A key finding from the research conducted by the Health Design & Technology Institute (HDTI) at Coventry University in partnership with Age UK and campaigning charity Grandparents Plus, is that while some in later life would benefit from independence aids, many older people do not want to be stigmatised or singled out as being in need of “assisted” products or “equipment”.

Age UK Enterprises is interested in this as we provide personal alarms (one of many aids that help older people remain independent within their own home). It is imperative that the utmost is done to prevent falls and accidents within the home and these aids are a step in the right direction to ensure the protection of this demographic (NHS figures show that around 30% of adults over 65 and living at home will experience at least one fall a year and this rises to 50% of adults over 80 who are at home or in care).

So we need to collectively tackle these issues by thinking comprehensively. From their inception and design these products need to help avoid stigmatising older people by ensuring good, attractive, non-medical design. Their availability needs to be considered too.

Out Age UK Engage Business Network aims to share knowledge and insight about what the ageing process means for business best practice. It encourages better design of mainstream products and services to meet the needs of our ageing populationThe Network is seeing more and more businesses waking up to the idea of making services and products easier to engage with and inclusive; not just subsets of their product range aimed at the older market but their entire offering. If done well, this will naturally make brands accessible to all customers, including people in later life.

We must help older people realise how much support is available to them. There are solutions available to help improve their independence, as well as their confidence in the support available to them. This support network is substantial and includes everyone from charities and businesses, through to local authorities and the government, and each element has its part to play in raising awareness of independence aids.

* Gordon Morris is managing director of Age UK Enterprises. Age UK’s ‘Adapting your home’ guide includes information about the aids that can enable older people to stay independent in their own homes for longer; for a free copy call Age UK Advice free on 0800 169 6565 or visit www.ageuk.org.uk to download a copy.

Tailor-made technology: systems and support in social care

Julie Heightley was so worried about her son Thomas suffering an epileptic fit at night that for two years she slept on a camp bed outside his room. The broken sleep and constant supervision of Thomas, who has autism and global developmental delay, was adversely affecting both Julie’s role as a carer and any prospect of independence for her son.

I came across Julie and Thomas’ story while researching a new report published today by the Voluntary Organisations Disability Group and the National Care Forum.

Now, thanks to a discrete network of wireless sensors dotted around the four-bedroom family home just outside Wolverhampton, Julie and Thomas, now five, are enjoying what Julie calls “a new lease of life”. Since the home was kitted out with the assistive technology two years ago, Thomas has been able to safely play and walk about the house independently without needing his mother’s 24-hours-a-day supervision. As well as having a slightly more hands-off approach to her five-year-old, Julie, a lone parent, has more time to spend her two older children who are in their teens.

Julie and Thomas with his older siblings
Julie and Thomas with his older siblings

Assistive – or personalised – technology includes a wide-range of supportive but unobtrusive services and equipment, from personal alarms for elderly people, to seizure monitors and more sophisticated fingerprint recognition systems that allow you to open the door without keys. It can also include computer software, hand held devices or video call systems that increase social interaction and family contact.

As fans of such services and systems point out, the traditional view of this technology is that it involves a medical and prescriptive approach (see the comments on the related VODG blogpost), but the key issue is to bring it to the consumer market, widen its use among the general public and raise awareness about its potential.

As the publication stresses, the social care sector has embraced a huge amount of innovation in assistive technology, using new methods to complement the physical work of support staff. it is transforming lives for the better. But the use of such services, systems and equipment does not enjoy the higher profile of our counterparts in the health sector, despite the fact it is entirely in line with the “person-centred” approach that care providers are working towards and encourages choice, control and independence – social care watchwords.

Today’s report, with its real life stories of how technology is transforming the lives of vulnerable people, aims to change that: “Put simply, technology is part of our modern landscape. We use it for work, leisure, at home and on the move. It makes our lives easier. People with life-long disabilities or age related conditions should share that experience, benefitting from the advantages that tailor-made technological support can bring.”

* Read more on the VODG website and download the report Using assistive technology to support personalisation in social care

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.