Wednesday, 16 December 2015

Havin' a Comedy Christmas 2015



"Tis the season to be jolly....." 

Yes, it's that time of year again. It's unbelievable how quickly it turns up each December.  In 2014 we posted Top 10 Tips to Survive Christmas, as we recognise that the festive season is not everyone's favourite period.

For Christmas 2015 our team have been inspired by local comedian Owen Griffkin's new comedy workshops to think how laughter has kept us going over Christmases past.

Each of the team has come up with a book, or film, or memory that has made them laugh in Christmases gone by whilst wondering whether to embrace the holly (ouch) and mince pies with family, friends or even complete strangers, or just run and hide.

"Fa la la la la, la la la la...."


Angharad

Many things remind me of Christmas and the laughs I’ve had, such as watching classic 1990 Christmas film ‘Home Alone’ with Macaulay Culkin. But the highlight of any recent Christmas was watching my dog, Bella (a fluffy white bichon frise) open my mum’s Christmas presents for her. As the centre of our little family, she is without a doubt put on the highest pedestal, treated like a human and the focus of me and my mum’s lives. I’ve had the blessing of owning Bella since my last year in primary school, which makes Bella around 14 years old (an old lady!) yet she still has the personality of a puppy and hasn’t lost any of her diva like qualities yet. She is spoiled, and rightly so!



Last Christmas, the buzz and excitement of smelling her Christmas dinner and her presents under the tree were too much to bear, and she began like a puppy, tearing the corners of the wrapping paper off. We normally get her to help open a small section of our presents, but last year, she came into her own! Without any warning she took centre stage and started unwrapping presents in the middle of the living room, swinging the paper around with her mouth as best she could, determined to find out what was inside! After some playful growling, swinging wrapping paper and presents and holding them down with her paws, she had unbelievably managed to open two well wrapped presents! This memory always makes me laugh at how loving and funny animals can be, who enjoy Christmas as much as anyone else! It also made me and my mum hysterically laugh, along with us clapping and cheering her along!

‘Animals are such agreeable friends - they ask no questions; they pass no criticisms.’ George Eliot


Anne

When Jackie suggested this topic for a blog, my heart sank slightly. Call me Scrooge but Christmas isn’t one of my favourite times of year. 

But then I remembered my favourite scene from "The Wrong Trousers", an Aardman Animations film starring Wallace & Gromit that was first shown on Boxing Day in 1993, and will be forever associated with Christmas for me. It’s the train set chase scene where Gromit is attempting to stop criminal penguin Feathers McGraw escaping after a diamond heist. When Gromit grabs the box marked spare track and frenetically starts to lay track to keep the toy train on the rails, I was in hysterics. It’s well worth watching the clip on YouTube. I defy anyone not to smile whilst watching it.


Jackie

Way, way back in 1982 I ripped open a Christmas present whilst on holiday in Dorset. It was a copy of the now legendary Adrian Mole book by Sue Townsend - “The Secret Diary of Adrian Mole aged 13 ¾”. I started reading, was hooked after two pages, and didn’t stop until I’d finished a few hours later. The Christmas pudding was long since cold, the mince pies just crumbs swimming in spilled alcohol, and my elbows had turned black and blue from lying still for so long. It was the funniest book I’d read in ages by a classic writer of comedy fiction. Who hasn’t heard of Adrian Mole?

Sue Townsend went on to write a total of 8 books about Adrian Mole, taking him from angst-ridden teenager in the Thatcherite years of the 1980s to the brink of middle age in the The Prostrate Years and Gordon Brown’s New Labour era of the late noughties. I haven’t read the later volumes - so there is more laughter to look forward to yet.

Here are a few of my favourite quotes from the original classic:

“I must say that I take my hat off to Sainsbury's, they seem to attract a better class of person. I saw a vicar choosing toilet paper; he chose a four-roll pack of purple three-ply. He must have money to burn! He could have bought some shiny white and given the difference to the poor. What a hypocrite!”

“It is the first day of spring. The council have chopped all the elms down in Elm Tree Avenue.” 


“I have never seen a dead body or a female nipple. This is what comes from living in a cul-de-sac.”


Jane

Some years ago my mother came for Christmas. She was (she died this year) a very difficult person and there was always a fair amount of tension with her around. During Christmas Eve she snapped at one of my teenage children for not doing, in her eyes, sufficient washing up. A general shouting match ensued with my mother shouting at said child and ripping up the Christmas present she was going to give to this offspring - who obviously shouted back that no-one had wanted Granny to come anyway and me shouting at my mother in defence of my children. 

Meanwhile my husband was at his work’s Christmas booze-up - which was legendary. My daughter rang the most likely pub, found him and summoned him back. Eventually he wove his way home and into this maelstrom, lay on the floor and declared “I love you all!”. I can’t actually remember what happened next - but I found a mention of this in some notes after my mother moved out of her house into a nursing home - she had written “Christmas with Jane and children, least said”. For us this is now a traditional family Christmas story, and I guess it goes to show that Christmas can be difficult and tense and also, at least in retrospective, hilarious too.


Support over Christmas

Wellness and Recovery Learning Centres around Powys are open at some point over Christmas and the New Year and would welcome your visit. Click here to find their contact details and links to their own websites.You can link to national helplines here.

If you need help urgently find information here.


Have a Happy Comedy Christmas and we look forward to hearing from you in 2016!

Tuesday, 8 December 2015

Making Sense of Mad Studies

by Anne Woods 
Participation Officer, PAVO mental health team

Illustration by Grietje Keller
I recently attended a two day conference at Durham University entitled Making Sense of Mad Studies organised by the North East Mad Studies Forum. Before attending, I wasn’t too sure about what to expect. Mad Studies wasn’t something that I had come across before and I felt slightly uneasy about using the word mad in this context, a theme that came up in the conference and on Twitter. 

The term Mad Studies has been credited to Richard Ingram, one of the speakers, who was inspired by the creation of Deaf Studies as an academic discipline distinct from Disability Studies and wondered whether the same could happen for madness. In his presentation he said that finding method in the madness was not as important as preserving the madness in the method! In other words, Mad Studies is a way of looking at the world that uses and benefits from a different perspective to life and need not only apply to academic research on mental health. The consensus from the conference seemed to be that Mad Studies was something done by people who identify themselves as mad and not something done to or about them.

Richard Ingram
A fuller definition is provided in the book, "Mad Matters" (2013) edited by Brenda LeFrancois (another conference speaker), Menzies and Reaume.

“An umbrella term that is used to embrace the body of knowledge that has emerged from psychiatric survivors, Mad-identified people, antipsychiatry academics and activists, critical psychiatrists, and radical therapists. This body of knowledge is wide-ranging and includes scholarship that is critical of the mental health system as well as radical and Mad activist scholarship. This field of study is informed by and generated by the perspectives of psychiatric survivors and Mad-identified researchers and academics.” 

Brenda LeFrancois
The conference included a wide range of speakers from different backgrounds: academics, some of whom identify as ‘mad’, early career researchers, activists, artists, people with lived experience of various types, sometimes presenters falling into several categories. Presenters shared some intimate and honest accounts of their own life experiences within the psychiatric system and how that had informed their work.

The agenda was jam-packed but some highlights for me included hearing about Mad Studies reading groups in Amsterdam from Grietje Keller. The groups give a space for reading and discussing critical texts that challenge the dominant medical psychiatric model and are mostly attended by people who have been users of mental health services. The groups are popular and give attendees a different perspective on their experiences.

There was discussion around ‘doing’ (teaching/ learning about) Mad Studies with a presentation from participants and tutors of a course at Queen Margaret University in Edinburgh for people with lived experience of mental ill health, and tutors of a course for approved mental health professionals (AMHPs) describing how important it is for professionals to be trained by people with experience of being on the receiving end. Dr Dina Poursanidou talked about the challenges that this throws up, including managing the emotional toll of using traumatic personal experiences as an education tool, something of particular relevance to PAVO’s mental health team in the participation work that we do. 

Brigit McWade from Lancaster University on Recovery
This theme was also picked up later by an action group called ‘Recovery in the Bin’. They have adopted 18 key principles, one of which is, “we refuse to tell our ‘stories’, in order to be validated … We believe being made to feel like you have to tell your ‘story’ to justify your experience is a form of disempowerment, under the guise of empowerment.” This is an issue that I am well aware of from personal experience. As a team, I think we recognise this and carefully balance our desire to use powerful personal stories to facilitate change against the emotional toll on the individual and their right to control how much and when they disclose.

The Recovery in the Bin presentation gave food for thought on the concept of recovery and the group’s contention that it has been appropriated by mainstream mental health services and is less focussed on what’s best for each individual and is more concerned with what’s best for a capitalist society, ie: getting people into employment and off benefits as quickly as possible. The group talk about the validity of remaining ‘unrecovered’ by this measure, finding ways to live with distress that does not necessarily neatly fit into a recovery star model, also recognising that some life experiences have to be tolerated rather than recovered from.

"You told me I'm my own worst enemy. So I got a restraining order against myself!"
The conference had a breadth of views and opinions and there were some challenging discussions, about racism in psychiatry and academia for example, as well as humorous moments such as why art made by service users can actually be good art. It introduced me to several views and topics that I hadn’t come into contact with before and had a good mix of people sharing their personal experience and academic theory. It will be interesting to see how the discipline develops and whether, in future, universities will have departments of Mad Studies and full-time degree courses or whether it becomes a movement developed by grass roots activists – or both!




You can find more Mad Studies resources on a website run by Brigit McWade.

Tuesday, 1 December 2015

Re-Live Theatre @ Dementia Supportive Communities event


Last Thursday I attended a Dementia Supportive Communities network event in Brecon organised by Ageing Well in Wales and Brecon and Hay Dementia Supportive Community with support from Alzheimer's Society, Powys Association of Voluntary Organisations, Powys County Council and Powys teaching Health Board. The event was extremely well-attended, with representatives from the statutory, voluntary and private sectors.

The aim of the event was "to build and develop Dementia Supportive Communities across Powys by:
  • Sharing examples of practical ways to support people with a dementia.
  • Identifying best practice and sources of information.
  • Exploring ways of working together in the future."
It was an absolutely packed day, and all I can do here is focus on some highlights, whilst giving links to further information where appropriate.

The day was introduced by Gweneira Raw-Rees (below left), the Project Lead for Ageing Well in Wales, which has the challenging remit of "ensuring Wales is a good place to grow old for everyone". Gweneira explained that one of AWW's roles is to share good practice through events. "The formula is simple. To try to inspire people to take action."  

Our facilitator for the day was Trish Richardson (below right) of Brecon and Hay Dementia Supportive Community. Trish explained the concept behind dementia friendly communities (interchangeable with dementia supportive communities), emphasising that "it is about enabling people with dementia, working with them as opposed to doing for them."


First up, and certainly the highlight of the day for me, was a performance from Re-Live Theatre Company, working alongside people with dementia. The company is passionate about the role creativity plays in removing stigma, and aims to put the real stories and experiences of people with dementia out there. The short performance was made by two members of the company alongside real people (not actors) sharing their real experiences. These included features around the importance of singing for some, and the humiliation of being bid for as a 68 year old male in "not too bad condition.... not too challenging... no immediate family... if you know what I mean...." Number NL2810 was then sold to the highest bidder for £500 - securing his place at an Elderly Infirm Unit.

And Jill Grey read her powerful poem with support from other members of the group.


They meet in the appointed room.
Laptops, briefcases, suits.
Meet bi-monthly,
Promptly, religiously,
Unless, of course, it's cancelled
And nothing happens.

They bring their minutes
Their memos
Their own agendas,
Protect their kingdoms
Cover their backsides
And nothing happens.


They have a bright idea.
It's brilliant, workable
Inexpensive.
Then it's - 'Maternity Leave',
Or - 'Change of Post'
And nothing happens.

'Care in the Community' means
'Keep them at home'.
Poorly trained care-workers; different each day
With eyes on the clock, pens on the paperwork
And minimum pay.
Promises of improvement
But nothing happens.


A brand new ward! An Assessment Ward!
Retitled - 'Assessment and Continuing Care'.
Queues grow deeper, waiting lists longer.
Does it really matter?
The outcomes are the same.
So nothing happens.

They close a ward; its soul has flown.
A dementia ward now filled with ghosts.
In general wards they cannot sleep.
"Those damned dementia patients!
Why can't they just shut up!"
But nothing happens.

Tories blame the Socialists.
Socialists the Tories.
Lib Dem, UKIP, Plaid add their two-penneth too.
Oh where is the one who can wield Excaliber or hold aloft good Merlin's Wand?
A bold magician who would override us all
And make it happen!

L-R: Gloria Jones Powell (Chair, PAVO Board), Joy Garfitt (Head of Adult Social Care, PCC),
Rhiannon Jones (Executive Director of Nursing, PtHB)
How to follow that? Well, that was the task of the next three speakers. They all made comprehensive presentations from their individual organisations' perspectives about work being done to encourage dementia supportive activities across Powys. All three acknowledged that there is still a lot to be done, but the ambition is clearly there. Again, I can only give a flavour here due to lack of space, but there is a link to the presentations at the end of the post.

Rhiannon Jones, Executive Director of Nursing, Powys teaching Health Board
Rhiannon clarified that dementia currently falls into the mental health strategy for Powys - Hearts & Minds. Her role as Chair of the steering group overseeing the Joint Dementia Action Plan is to work more with people in contact with services, and the community, to get it right.

Joy Garfitt, Head of Adult Social Care, Powys County Council
Joy spoke of the journey currently being travelled to make the council a person-centred organisation. "It is about support, not necessarily services. It is not about fitting people into a box." She explained that from April 2016 the new Social Services & Wellbeing (Wales) Act will change everything.

Gloria Jones Powell, Chair of Trustees, Powys Association of Voluntary Organisations
After introducing the audience to PAVO's general role in supporting the Third Sector, Gloria highlighted three very relevant services - Powys Befrienders and the Third Sector Brokers are hosted by PAVO, whilst the new role for Powys of a Dementia Supportive Communities Coordinator is managed by Alzheimer's Society.


In one of the breaks I managed to catch up briefly with Karen Rodenburg (above), who has recently taken on this role. Karen is based in Newtown and covers Montgomeryshire & Radnorshire. Her colleague in South Powys is Ian Thomas, who is based in Talgarth.


A couple of really interesting workshops later ("Experiencing dementia - how does it feel?" with Re-Live Theatre Company, and "Setting up voluntary and community-led dementia friendly initiatives" with Brecon & Hay Dementia Supportive Community) and it was time to hear PtHB's Dementia Lead - Harold Proctor - speak.

After a little bit of history relating to person-centred care, Harold described how practically we can help people with dementia who are in a hospital environment. He touched on everything from the Butterfly Scheme, to colour and tonal contrast in the physical environment, with references to liaison nurses, specialised training, digital technology and dementia pathways along the way.


Rachael Beech, PAVO's Powys Befrienders' Coordinator, was the final keynote speaker of the day. Her topic: Establishing a Powys Dementia Network. She put into words what I had been thinking increasingly throughout the day - there is a lot going on around dementia in Powys. How do we pull it all together? Care homes. Memory clinics. Singing groups. Hospitals. Memory cafes. Carers' respite. Neighbours' support.... Who is doing what, where and when? PAVO has already started work on a mapping and gapping project, and now proposes initiating a dementia alliance, forum or network - Rachael asked people to suggest names. She also posed the questions - who would be invited? How often would it meet? Would a virtual network be an option?

The new network could be facilitated by PAVO, and would be aimed at people using services and their carers in the first instance. The idea is to launch it next April after further dementia events have been held and information gathered. What do you think? Would you find a dementia network useful? Have you got a good idea for a name? Let us know in the comments section below.

All told everyone seemed to find this dementia networking event extremely valuable. A similar event is planned in North Powys for the New Year. Watch this space for further updates. Here's hoping they manage to book Re-Live Theatre Company for another inspiring session.
_________

Dementia Supportive Community Coordinators in Powys
Montgomeryshire & Radnorshire: 
Karen Rodenburg, email: karen.rodenburg@alzheimers.org.uk
South Powys: 
Ian Thomas, email: ian.thomas@alzheimers.org.uk

Presentations from the day can be found on the Powys Mental Health website 
under the Powys Mental Health dementia blog section.

Jill Grey has written a book which is available online - 
After the Rehearsal - Living with Dementia, a Carer's Story

Friday, 27 November 2015

We are all in it together

This week's guest post is from Philip Moody, who is an Adult Carer Outreach Worker and Carers' Advocate in North Powys for Powys Carers Service.

I was visiting the PAVO offices at Plas Dolerw just to get my post and Jackie Newey, Project Officer PAVO's Powys Mental Health Information Service, waylaid me and asked me if I would write this blog post. Seriously Jackie, thanks for asking me. So here is some information about Powys Carers Services and a few rambled thoughts.

I have worked with Powys Carers Service for 13 years as an Outreach Worker/Advocate in the Montgomeryshire area and support adult carers. I work from home (just outside Newtown) and we have an office in Llandrindod Wells. As a service we endeavour to support unpaid carers, adults, young adults and children alike.

We try to empower these carers and give them support, information, one to one support, advocacy and a lot more. We do believe it is important that everyone’s voice is heard and “carers” voices should be heard as well. Their views should not be lost because we live in a noisy world.

So why did I chose the title for this blog “We are all in it together”? It sounds a bit like a socialist catch phrase. I have had lots of different jobs including Baptist Minister and Trade Union rep! However the reason for the phrase - “We are all in it together” is because of what I experience day in, day out.

I support people who care for folks who may have poor mental health. I also support carers who have mental health issues themselves and care for someone who is physically ill. I work alongside other professionals who struggle sometimes with their own poor mental health and at stressful times in my life have battled with a few “dark days” myself. (Life can be complicated and not fit neatly into a box!) So whether its physical or mental health issues “We are all into together”.

Poor mental health can knock on anyone’s door and often does. When I visit a carer for the first time, they tell me their “story”. I still find it a privilege to be let into their lives. Some carers I visited told me their experiences - they were a couple whose child had gone to university, had returned home and was seriously ill with depression. As I listened they told me about their hopes, fears and challenges both now and in future.

That’s a story I have listened to on more than one occasion with slightly different twists and turns. Stories differ but we try to be there for carers. Powys Carer Service never closes a case until folks are no longer caring or someone asks us to. We will also continue to support people for a few months after they have stopped being carers.

While I do not have a magic wand, Powys Carers Service does seek to make a difference, whether it’s filling in Personal Independent Payments (PIPs) applications, supporting someone in a medical assessment, assisting you to make a complaint/compliment or “just” listening to your story.

We will visit you in your own home or meet you in a cafĂ© near your home, the choice is yours. Powys Carers Service also works alongside other organisations and values the services they provide - because “We are all in it together”. Together we can provide a better service to carers. We seek to listen to the goals and needs of carers and support them in any way we can.

In addition, the carers I know give so much back to me - it’s a real privilege to know them.

Powys Carers Service has support workers throughout Powys and office staff who have lots of information. If you are a carer, or just want to know a bit more about the work we do - give us a call on 01597 823800 or check out our website.


Good mental health is important for everyone and like it or not “We are all in it together”. 


Many thanks to Philip for telling us about his role at Powys Carers Service. If you have experience as a carer in relation to mental health which you would like to share, we would love to hear from you. Comment below or contact us by email - pamhinfo@pavo.org.uk, tel - 01686 628300 or twitter - @PAVOMH.

Wednesday, 18 November 2015

Young Adult Peer Support workshop @ PAVO AGM

L-R: Julia Gorman (YAPS co-ordinator), Robin Green (YAPS Assistant Co-ordinator)
 - both with Ponthafren Association, and Sarah Harmon
Just last week I joined colleagues to help at our annual PAVO AGM which took place at the Royal Welsh Showground near Builth Wells. In the Chair's invitation to the AGM, Gloria Jones Powell wrote: "Welsh Government's White Paper, Reforming Local Government: Power to Local People, states that we need to be: 'Putting people at the centre and involving service users in prioritising, commissioning, designing, delivering and accessing services'. Unlike the usual approach to consultation and engagement, the projects within PAVO's One Powys - Connecting Voices portfolio invite commissioners, service providers and others to listen to what's important to them".



The Young Adult Peer Support (YAPS) project, which is one of the One Powys - Connecting Voices projects funded by the Big Lottery Fund, held a workshop at the AGM. It was attended by representatives from Powys teaching Health Board, Powys County Council, and numerous voluntary organisations and individuals, all of whom had an interest in mental health. My role was to support the project facilitators on the day, and so it was I joined Julia Gorman, Robin Green, and Sarah Harmon - one of the young people involved with the project - to capture feedback about mental health services from those attending. 

The YAPS project is delivered by Ponthafren Association, and offers peer support mentoring to young people (16-25 years old) who experience mental health issues, by helping to give them a voice of their own in the development of services. A project volunteer wrote about her experience for us last year, and we featured the project video "I don't let mental health define me" earlier this year.


The YAPS team had devised an intriguing game to carry out for the first half of their workshop. They had raided all the Ponthafren board games for dice! The aim of the game was to try and access mental health services as young people would do in the real world if they were experiencing mental distress. Starting at home, a simple throw of the dice would see the workshop participants on their way to the various services on offer in Powys. How hard could it be!

Martin Nosworthy, PAVO trustee, at the start of the YAPS game
Depending on the throw of the dice participants would be directed to one of various stages around the main hall at the AGM venue. They might be sent to College, a Friend's house, the GP, Ponthafren Association, the Police, or Child & Adolescent Mental Health Services (CAMHS) for example. On the way to their next "station" in the game, they had to negotiate chairs, tables, and numerous other players of the game, all competing to reach their own stage and win the support they so very much needed.


Those lucky enough to reach College/University then had to throw again. 1 = too anxious to go - return home, 2 = bad day - get a Crisis Card, 3 - 5 = good day = go to friends, 6 = pass an exam - take a chocolate and go home. 



The Crisis Card was particularly bad news. It stated: Stop taking your medication, lose a chocolate and go to the GP...


The pile of sweets did go down slowly, but most people, whilst glad to pick up an occasional reward, were starting to feel increasingly frustrated about how often that they had to return home....


Many participants made it to the GP surgery, including Kate van den Ende, one of the reps on the Mental Health National Forum, (who wrote for us very recently about Dual Diagnosis).


However, over at Child & Adolescent Mental Health Services there were very few arrivals...


And at the Police Station whatever the throw of the dice, the news was not good. 1 - 2 = get fined, go home and return a chocolate. 3 - 6 = cautioned, and go home.

After 30 minutes the game was stopped and we gathered the participants together to get their feedback. Everyone expressed frustration at not being able to access the support they needed. They kept "getting caught" or "having to return home". Their frustration escalated significantly when they learnt that one dice roll was equivalent to one whole day! They said that the situation was totally unpredictable and completely out of their control!

Only two players of the game acquired the elusive Mentor Card and were less likely to be trapped at home. They quickly realised that they: 
  • Would no longer be sent home.
  • Had increased confidence.
  • Felt more comfortable. 
  • Could do things and get results. 
As Robin explained: "That is what peer support does. This is what YAPS does."

It was a brilliant game. And both a brilliant and fun way to convey to people the increasing frustrations of a young person trying to access services and being passed from one to another without ever getting to the root of their problem.

Barbara Perkins (centre), PAVO One Powys Connecting Voices Officer
with Sarah and Robin
The workshop continued for another half an hour with an animated discussion around the value of the YAPS Project and the many barriers to young people accessing relevant services in Powys. Watch this space for further updates as the One Powys - Connecting Voices Project continues to make a difference to the way in which public services are planned and delivered. Over at YAPS they are listening hard and looking to suggest some very innovative solutions.

The YAPS Project runs its own blog called VOX. Check it out here.

Thursday, 12 November 2015

Dual diagnosis - changing times

Dual diagnosis - co-occurrence of a mental health problem with a substance misuse problem.

This week’s post is from our guest author Kate van den Ende. 

Kate is one of three representatives on the National Mental Health Forum in Powys. There are ten such networks across Wales, feeding in to the National Partnership Board – where those using services, carers, professional groups, the statutory and voluntary sector and government departments across Wales meet three times a year to oversee the delivery and implementation of "Together for Mental Health – A Strategy for Mental Health and Wellbeing in Wales".


The bad news

If you live with a mental health problem, you are more likely than the rest of the population to have to manage a problem with substance misuse as well......and vice versa.

The most commonly used 'substance' is alcohol, but, in the world of addiction, the understanding is that, at different times, we use different 'substances' to support us, to self-medicate - a horrible term used by professionals! So alcohol can be interchanged with food, drugs, relationships and/or gambling as the 'substance of choice' at different stages of our lives, depending on which is available or which fills the need at that time.

The double whammy of co-occurrence used to be considered a rarity but, as any of us could have told the professionals, statistics show that it is more like the norm..... and if you have a severe and enduring mental illness like schizophrenia or bipolar disorder, your chances of having to cope with both is considerably increased again.

Assuming that co-occurrence was a rarity meant that the two sides to the problem tended to be treated separately, as if they were symptoms of two completely different, unrelated conditions. People were shunted between the separate services and, surprise, surprise, they fell through the gaps!

Our experience was just that.

An appointment would be made to see the mental health team or psychiatrist. Nervousness and self doubt resulted in large quantities of vodka. The professionals refused to see a drunk patient. An appointment was made to see the drug and alcohol service. Nervousness and self doubt resulted in large quantities of vodka and a failure to attend the appointment. This in turn fed into the 'I'm rubbish, just see how rubbish I am....I can't get help even when it's offered.' Vodka again, with pills this time. A&E admission and a couple of days to check liver function before discharge either directly home to exhausted and lost carers or mental health ward, with or without Section. Medication, escapes to buy vodka, discharge to the even more exhausted and despairing carers.

An appointment would then be made to see the mental health team....vodka.....no change in mental distress......appointment with drugs and alcohol service....vodka......further reason to beat herself up.....vodka and pills.....A&E.....Section.....revolving doors, escalation of the problems.....further desperation for carers....

And so we went on, for 18 months, with the reliance on vodka and the self harming reaching ever higher, dangerous levels. Neither service looking beyond their particular remit. Nobody was looking at the whole distressed person, with all her complexity of problems.

The good news 


Changes are being made to the way help and treatment are offered to people battling with co-occurrence. Indeed, changes are being required by the Welsh Government. If you talk to service providers in Powys, they will tell you that they have already started on a new, joined-up approach. Drug and Alcohol services are provided in Powys by Kaleidoscope and CAIS. They have started to work out ways of joining forces with the local mental health services, to deliver 'seamless' provision.

But the new legislation demands far far more. Seamless delivery is just a start.

It includes:

"It must not be left to the service user to navigate between substance misuse, mental health and other related support services themselves." They and their family will have a nominated, responsible key worker to help them find their way.

There must be "absolute clarity on which agency is leading and coordinating care."

An integrated approach, with clear treatment protocols and care pathways will provide "holistic, person-centred care."

To deliver these improved services, the Welsh Government recognises that:

Professionals on both sides will need considerable training "to overcome institutional and cultural assumptions."

So, from December this year, when Powys teaching Health Board resumes complete control over, and responsibility for, the commissioning and delivery of services to those in mental distress in this area, they have been offered a fine example of the kind of services we want, whether or not we have a co-occurring substance misuse problem.

Integrated, holistic, person-centred and individually tailored to our needs, delivered by teams of well trained professionals who work together and who listen!

That’s the kind of support we need to recover control over our lives.

Thursday, 5 November 2015

Bev Clarke - award-winning volunteer counsellor Ystradgynlais Mind

Bev receiving her Outstanding Contribution Award from the
High Sheriff of Powys, Lieutenant Colonel Mike Lewis DL
Bev Clarke has been volunteering at Ystradgynlais Mind for the past 4 years as a Level 6 counsellor / supervisor, enabling the mental health charity to provide a free counselling service to the community. She volunteers 3 days a week. She has enabled the recruitment of 7 further student counsellors, who benefit from her supervision and guidance. Her input both into clients and students is life changing.

In October 2015 Bev was winner of an Outstanding Contribution Award at the Powys Volunteer of the Year Awards. Her nominator said: “Bev has experienced her own difficulties throughout her life and she demonstrates you can overcome anything and give so much to the community despite those difficulties. She inspires all at Ystradgynlais and is loved and respected.”

Carol Stephens, Chief Executive at Ystradgynlais Mind, said: “We are thrilled about Bev's award, it is so well deserved. She's a diamond.”

We talked to Bev to find out more about her invaluable contribution at Ystradgynlais Mind.


What originally motivated you to start volunteering at Ystradgynlais Mind?


I graduated from the University of South Wales at Pontypridd in 2009 (Bachelor of Science (BSc) Hons, Systemic Counselling) and was looking for a counselling placement. I needed 450 hours of supervised counselling for my accreditation. I have 1050 now, 800 of these from counselling sessions at Ystradgynlais Mind.

I first came over to Ystradgynlais looking for plants and saw that there was a Mind centre here. I set up my own counselling practice in Port Talbot with a friend from university and volunteered my services to Ystrad Mind. Carol interviewed me and it went really well. She said – can you start next Wednesday?!

I have bipolar and Carol said “we’re looking for people like you”. It’s been a wonderful experience. I didn’t have to hide my mental health issues, it was like the start of a new beginning.

Carol and I share the same vision – which is to do the best for our clients and also to provide good packages for our student counsellors.

Tell us more about your role as a counsellor at Ystradgynlais Mind

A lot of men come to us for counselling which is unusual. It stands out at about 55%. They have moderate issues as they almost leave it too late to seek help. Women are not afraid to access the service, so their issues are often mild to moderate.

Most of our clients are middle-aged – in their 40s and 50s, with various issues. Often they might be waiting for treatment from the statutory mental health teams so they seek support from the voluntary sector instead. They usually have about 7 – 8 one hour counselling sessions, weekly or fortnightly depending on the complexity of the issues.

How does counselling make people’s lives better?

It is a forum where people can be heard. They take their issues away from their families and share them with someone else who is prepared to listen. They have more clarity with the help of a counsellor and so see things that they couldn’t before.

Who is eligible to receive the counselling service, and for how long can they access support?

The service is available to people 17 +. They can self-refer – some people walk in off the street - or they are referred by the GPs in the Abertawe Bro Morgannwg University Health Board cluster area.

If your role didn’t exist, what would happen to people who needed support with their mental health in Ystradgynlais and district?

I’ve seen mental health care decrease unbelievably in the past 4 – 5 years. There is no help there for people. Mental health isn’t a “sexy” health condition, so there is no investment or focus as with other ailments. It feels as if mental health is the poor relation. This is really obvious when working in the Third Sector.

Tell us more about your work supporting 7 student counsellors

I provide support for them, which includes 1½ hour supervision once a month where we’ll talk about the issues that have been raised with clients and signposting options for people. I also make sure that the counsellors are safe, and don’t take home any issues that could impact on their lives.

We source new student counsellors when we need them from the universities. The students are supposed to complete 100 hours of supervised counselling here, but some have already done 300. We give them an excellent level of support, their insurance is covered and they enjoy the experience here so they stay.

I believe you also provide counselling for GP patients in a neighbouring health board?

Our counselling services have now been taken on by GPs in the Ponterdawe and Neath Valley area so it has been well worth it.

Tell us some of the hardest things about being a volunteer counsellor

Watching how hard it is for those working and volunteering in the Third Sector to apply for grants and funding just to make ends meet. I’m here 2 – 3 days a week, but Carol is here for 5. I know how hard she works and how little she takes. I’ve got a bigger picture as a volunteer.

What is the most rewarding aspect of volunteering at Ystradgynlais Mind?

To see how the clients improve. And most of them give back – for example they give talks on their own mental health which is so enlightening for the student counsellors. It’s great the way that they find it good to say what they’ve been through. Clients also feedback to counsellors in supervision sessions.

What was it like winning the Outstanding Contribution Award at the Powys Volunteer of the Awards ceremony?

Well, at the end when I knew it was me who had won – my first thought was – don’t fall down the steps! There were fifty to get down!

I’m so proud of myself. My daughter was with me and she said – “you’ve set the bar even higher now!” To hear the words Carol had written when she put me forward for the award was wonderful.

The narrative of my own mental health issues was a guilty secret for so many years, it is almost a relief to talk about it now.

It was just a wonderful experience.

What would you say to encourage other people to volunteer to support people experiencing mental distress?

Don’t be afraid. We seek help from a psychiatrist in the same way as someone who is diabetic would go to a medical ward. It’s not like “One Flew over the Cuckoo’s Nest”. We’re working with wonderful people who just have unfortunate mental health issues.

I have enjoyed every minute that I’ve given to Ystradgynlais Mind.



Many thanks to Bev for telling us about her role at Ystradgynlais Mind. You can contact the charity by emailing info@minditv.org.uk or ringing 01597 824411, or visit the Ystradgynlais Mind website.

You can read more about the Powys Volunteer of the Year Awards on the PAVO website.
Outstanding Contribution category: These awards are in recognition of the outstanding contribution and commitment made to voluntary activity. The volunteering undertaken is selfless, a response to local need coming out of the community and is carried out willingly.

The Judges’ Panel was made up of PAVO trustees - Gloria Jones Powell, Ian Charlesworth and Keith Rollinson. The panel felt that Bev stood out because of:

  • Her willingness to support others achieve their goals.
  • She has overcome huge personal adversity in order to help others.
  • Her unyielding commitment to the organisation she volunteers for.
  • The difference she has made to the organisation on many levels.
  • The difference she has made to the local community.
Claire Sterry, County Development Officer for PAVO, who helped organised the 2015 awards, said: “Bev is truly inspiring, it was an honour to meet her - she is a very special lady, and so unassuming!”

Thursday, 29 October 2015

Spirituality and Recovery in Mental Health

Last Monday Tim Teeling, the Pembrokeshire Mental Health Development Officer at West Wales Action for Mental Health, travelled up to Mid Wales to join us for our regular monthly team meeting. We had invited him to talk to us about an innovative project he set up for WWAMH on Spirituality and Recovery in Mental Health

Our team had made a trip down to Carmarthen and WWAMH HQ earlier this year to find out more about the organisation’s work generally

We discovered TONIC for surfing, watched the Recovery Wall Project and heard a veteran’s story, but the day just raced by – they have so much exciting stuff going on down there! And we ran right out of time to pick up more than a passing hint at Tim’s work. 

It was enough to whet our appetite to find out more, however, and so here is a taste of what we enjoyed on Monday.

Beginnings

Tim was originally inspired to set up the Spirituality project for WWAMH about four years ago when he became aware that whilst much had been written on the topic, very little was available about how to work with spirituality as part of an individual’s recovery. Tim did not want to set up a project that looked at faiths in particular, but rather at “how my feelings and thoughts can help me recover from mental health problems. Instead of seeing our beliefs as signs of illness, we explore them as strengths in recovery.”

Whilst the statutory mental health sector concentrates on reducing symptoms such as hallucinations, the spiritual approach focuses on hope and optimism. There is a shift away from problems to look at a person’s strengths.

What the project does

Three monthly groups, which are open to individuals and their carers, run in Aberaeron, Haverfordwest and Llanelli. After initially experimenting with standalone groups, Tim now works closely with pre-existing organisations such as Mind which has proved more successful.

At the start of each meeting Tim introduces a theme, such as joy, courage, or forgiveness, and following a brief introduction participants then discuss. Revealing our attitudes to our own spirituality could potentially be awkward in a group setting, but ground rules such as “respect for each other” and “no preaching allowed” ensure confidence and enthusiasm to talk. The project is non-denominational and a belief in God is not necessary.

Knowing our own Minds – the starting point

In 1997 the Mental Health Foundation carried out a survey which revealed that 50% of people in contact with mental health services relied on spiritual and religious feelings to help their recovery. This is not that surprising as 60 – 70% of people believed in “something”, even though church attendance was down to 5%. Tim has worked in mental health for 27 years now and is always aware of the importance of spirituality or the non-material aspects of life for many people, particularly in relation to recovery. “It gives a meaning and purpose to life, an optimism, and a much-needed connection to others and the outside world.”


Tim Teeling meets our mental health team
L:R Jackie Newey (Info Service), Jane Cooke (Senior Officer), Anne Woods (Participation Officer)

Spirituality and themes in spiritual therapy

One of the criticisms that people in contact with mental health services sometimes make is that those delivering these services don’t understand them or what makes them tick. “The big question is – what is the most important thing for you in your life? What brings hope and purpose into your life?” The values of peace, compassion and happiness – the sense of the inner self, and the search for a meaning and purpose in life, these themes are rarely explored in any depth. Even more radical, perhaps, is the possibility that problems could be viewed as opportunities for growth.

Spiritual practices and assets

Engaging with our spiritual side does not necessarily mean (although it might – it so much depends on the individual) praying, reading scripture or taking part in a particular faith’s rituals. It could be as simple as enjoying nature, cooking, or helping others. “One guy just loves fishing down by the river. That is his spiritual practice – standing in the river and listening to the birds – not how many fish he catches”.

Once they engage with their spiritual side people start to realise that life is “not just about me – I am part of a greater whole. It gives the courage and grounding that people need, and hope in the face of distress”.

Spirituality and religion

The difference between spirituality and religion is a subject often discussed. Tim said that spirituality is usually something we do on our own and covers beliefs and practices found outside organised religion. Religion, meanwhile, whilst intrinsically spiritual, tends to be organised and communal.

Research

There is a wealth of research in the area, and evidence shows a statistically significant relationship between those who engage in spiritual practices and greater life satisfaction, including: an increase in hope and optimism, a sense of purpose and well meaning, increased self esteem, less depression, fewer suicides, less substance abuse, and less psychosis and psychotic tendencies.

Of course, negative experiences are also possible – people may feel persecuted by spirits or punished by an intolerant deity, and it would be unwise to suggest someone cut out all their medication in favour of prayer, for example.

Mental health assessments and spirituality

A particularly interesting part of Tim’s talk related to the way in which mental health nurses struggle to explore an individual’s spiritual life with them, in care and treatment planning for example. The Mental Health (Wales) Measure 2010 acknowledges the importance of spirituality in its Code of Practice:

“Spirituality can play an important role in helping people live with, or recover from, mental health problems. Spirituality is often seen as a broader concept than simply religion”.

But for the nurses it is often an awkward area to discuss. Where do they start? What questions can they ask? They may be fearful about stepping on sensibilities, but actually exploring spiritual issues with someone can be therapeutic in itself. In Tim’s workshops he looks at ways this can be done, using practical exercises and prompting questions such as:
  • Are you spiritual and religious in any way?
  • What do you really value in your life?
  • What keeps you going when things get tough?
  • Has being ill affected your thoughts about the future?
Once a conversation has been started, and if an individual is keen to pursue the subject, further questions can be asked about specific scenarios. Nurses could find out more about someone’s experience of talking to GPs, psychiatrists and nurses about their spirituality. And ask if they are worried about any conflicts between their beliefs and their care. At his sessions Tim talks through the specific skills which aid such conversations. These include attentive listening, suspending your own judgment, and accepting that spiritual pain may not be solved as a problem, but as a question to be lived.

So far Tim has met with two groups of nurses in Pembrokeshire – a Community Mental Health Team and staff on an inpatient ward. He has a third session coming up soon. It sounded to the rest of us as if his session on spirituality would be invaluable for all those working in the field of mental health!

Tim ended his talk by reminding us that “our health services are very much involved in symptom relief. Recovery is about living with hope, even with our problems.”

Thanks so much to Tim for telling us about the Spirituality and Recovery Project run by WWAMH in West Wales. What are your thoughts on spirituality and mental health? We’d love to hear from you. Let us know in the comments box below.

You can watch a video in which Tim talks about the project at the 2014 Annual International Think Tank Conference.

If you are interested in finding out more about the project please contact Tim Teeling by emailing tim@wwamh.org.uk

Read about other research on spirituality and mental health:

Taken seriously: Somerset spirituality Project 2002

The impact of spirituality on mental health 2006