Thursday, 7 January 2021

New Eating Disorders' Services for Powys


A Happy New Year to all our readers! 

Just over a year ago one of our Powys citizen reps, Helen Missen, (pictured above) a passionate advocate for improved Eating Disorders' services, wrote about the Eating Disorders’ Service review in Wales which had just taken place.

Roll on twelve months, and so much has developed in Powys as a result of this review (you can read the Executive Summary). At our mental health partnership board meeting just before Christmas we were very pleased to find out more about the new services from our colleagues at Powys Teaching Health Board along with Dr Jacinta Tan (Consultant Child & Adolescent Psychiatrist at Aneurin Bevan Health Board) who led the Review Team, Menna Jones (newly appointed National Clinical Lead for Eating Disorders) and Helen.


The underlying principles which people wanted
  • Early detection and intervention. Helping people, like teachers and parents, to identify people who might have an eating disorder to have access to support and help.
  • Inclusivity. Never turn people away. Anyone in distress who thinks they are, or a loved one who might have an eating disorder, deserves a response.
  • To be person-centred. To have prompt expert help for those who might have eating disorders. Giving people what they need and trying as far as possible to deliver it to them where they are. To provide person-centred and holistic care for the person and the whole family.
  • Relationship based.
  • Recovery focussed
  • Trauma informed.
In total there were 22 recommendations made by Jacinta which the government took on board. 



Where we go from here

Eating Disorders’ services were highlighted, as one of five key areas, for additional funding from the Welsh Government’s Mental Health Improvement Fund. There was a specific focus on Early Intervention as an area which the government wanted to prioritise. The first funding stream came through in Summer 2019 and coincided with a large consultation with clinicians across Wales looking at the response to the recommendations as well as some of the barriers that might come up.

In January 2019 it was announced that there would be a dedicated post created to take some of this work forward – a National Eating Disorders’ Lead in NHS Wales. Menna Jones officially started in this full-time role, the first of its kind for Eating Disorders, on 1 January this year, with the placement due to continue until March 2022. Menna’s role will be to work with clinicians, and those using services, to set up an Implementation Plan which sets long-term goals for improving services based on the Review’s recommendations and also facilitating changes to happen.

Some of the key areas include: early intervention, moving to increased delivery of eating disorder services by specialist teams, creation of physical health clinics within Community Mental Health teams, and to join up Child & Adolescent Mental Health Services (CAMHS) and adult services – looking at transitions but also at what can be learned from each of these services around models used and approaches to work.

The vision of the service review


Jacinta emphasized that the plan will focus on equity of access to specialist and high quality care across Wales, including in rurally isolated areas of large parts of Mid Wales such as Powys. There will also be joined-up working with other teams – patients are complex, they have many needs, they have comorbidities (the presence of one or more conditions at once) and it is important to interface with other services such as Autism services. In promoting specialism Eating Disorders Services will not be pulling away from the rest of the system.

The lived experience view from Helen

"From all mental health conditions eating disorders still have the highest mortality rate of any and that needs to be at the forefront of people’s thinking. I started advocating for families because I just didn’t want them to go through what we went through 11 years ago. I now sit on the Executive Committee for the Royal College of Psychiatrists’ Eating Disorders faculty and the European Board for the Academy of Eating Disorders. I really believe in change. I believe we can get it right in Powys. And I know (from my daughter’s experience) that recovery is possible." 



Plans for Powys 

Sam Shore – Head of CAMHS

Currently CAMHS has an eating disorder element to the service already, including specialist practitioner support and our own CAMHS dietician as well as support from psychology. Each CMHT does have a link eating disorder worker who will give advice to anyone open to adult mental health services and support any new referrals into the service.

Practitioners link with GPs for support in the first instance if someone’s physical health is deteriorating.

Following receipt of additional funds, however, we now are going to develop a specialist Eating Disorder Service, which is going to be an age-less service. We want to address issues such as transition and early intervention. We will be working more closely with GPs in Powys, and looking at our referrals into the service.

Following receipt of funding the following new posts have been created and we will be recruiting very soon:
  • Team leader.
  • Specialist practitioner.
  • Dietician.
  • Occupational therapist technician.



We’ve been working closely with Helen too and listened particularly to her tips and hints on moving forward. So we have an idea of what the new service will look like in terms of family intervention and family work. Menna has also offered to support us in the development of the service.

Whilst normally we would have 4 – 5 on our caseload we are actually working with 20 children and young people at the moment (mid December 2020). Covid has had a massive impact on the referrals and they are very complex – there are significant physical health issues, family dynamic issues and cases of anxiety as well as eating disorders.

Joy Garfitt – Assistant Director Mental Health & Learning Disabilities' Services

The model we’re going for is a small dedicated team of specialists who can link to the national Eating Disorder team. Within our five CMHTs and our CAMHS teams we have a small nucleus of specialism, whilst others practice as general mental health practitioners, so we’re creating a staff team which has a general mental health practice element to their role and a special interest element to their role. The special interest might be eating disorders, or perinatal, or trauma-informed services. This means that community psychiatric nurses, and social workers in the field, can also access that specialist support locally in Powys. We can’t provide an eating disorder service in every CMHT as might happen in a big city, so that’s why we’re looking at a different model. 




All in all it was great to hear the enthusiasm and commitment to reshaping Eating Disorder Services, not just in Powys, but across Wales, and we look forward to receiving further updates as the new team settles in and starts work.

Thursday, 17 December 2020

The new normal for our Powys mental health charities

 


Back in July we had a really helpful roundup from our mental health charities in Powys, to find out how they had been innovating to ensure continued service provision for their members since the start of the Covid-19 pandemic.

We recently met with them again, and decided this would be perfect opportunity to do a further update to share more information about their services in this strange and challenging year.

Here is what they had to tell us about what’s been happening for them lately. 

Please note that this update was made earlier in December, before the Welsh Government's latest announcements about new Covid-19 restrictions were announced for Wales.

Ystradgynlais Mind

Ystradgynlais Mind has migrated the majority of its service to online platforms and telephone support. We have increased our social media presence. The result of expanding our social media presence has been the ability to engage with and support many more people, particularly young people. 

Gareth James & Iwan Evans raised £2000 for Ystradgynlais Mind on a running challenge

The impact of digital exclusion has become more apparent to us since the onset of Covid 19. We have attempted to overcome the impact of digital exclusion by the provision of some IT equipment via purchases made through ‘Computer Recyclers’ plus issuing repurposed mobile phones etc. We have also increased our one to one telephone support to those who are digitally excluded and provided pre-arranged ‘welfare checks’ for those who are not receiving the same level of support previously delivered via statutory services. 

Perinatal support is now being delivered via webinar alongside one to one counselling support and peer support groups. We have also extended perinatal support to partners. Counselling provision has been increased by 75% to address the increasing demand for counselling. Referrals to blended online SilverCloud CBT have increased, the practitioner is currently holding a waiting list. Active Monitoring has been able to fill the gaps left by blended counselling through the provision of printed supporting materials and telephone support - this service is operating at capacity. 

After receiving Zoom training a member is able to access online counselling

Yoga and Mindful meditation has all been migrated to remote delivery. These sessions are proving popular and participation has increased by 150%. Peer supporters are now facilitating twice weekly online/phone support sessions. This group is growing in size and service users involved are supporting one another to form their own social support networks, reducing social isolation and increasing their own personal resilience.

Brecon & District Mind

Some of the issues that have come up for Brecon & District Mind recently include employment, children with anxiety around school or Covid itself, and a lot of people are keen for the drop-in to restart, so we are doing that now ensuring people making appointments to attend. Also a lot of people are becoming agoraphobic because of the rules and regulations. And there is some worry about Christmas and issues around that.

We have returned to face to face meetings outside and walk & talk sessions, but had taken the decision not to open the centre before the firebreak lockdown. We are going back to 1:1 sessions (as well as the drop-in) by appointment only. We will continue our schools work with children and young people, ensuring that this is done safely. We are doing a lot of family work and safeguarding and are looking into extra/crisis support in the evenings. 
A recent survey has shown that people have appreciated the support they have received from us in the last year with comments like: “Don’t know what I would have done without (Brecon) Mind’s support”, “excellent service”, brilliant counselling."



Unfortunately as we speak the guidelines and regulations around Covid have changed yet again so we are now having to revert to remote services until the New Year when the Welsh Government will be reviewing the situation. There will be staff available over the Christmas period to offer support by phone should anyone need this. Our centre is now closed and staff mostly working from home.

The Green Minds project is continuing and Brecon Cathedral is funding this for 1 day a week. Our Mums Matter project is also continuing with a new Zoom course starting in January. Our blended work in partnership with the online SilverCloud CBT is quieter. However, we are doing more wellbeing calls by phone and having more referrals into that. A survey we did shows that people prefer 1:1/ face-to-face support and so we are busy with that.

We have been fortunate in securing funding to employ our first Digital Technical Officer who is helping us develop our digital service offering and upskilling staff and service users where needed.

Mid and North Powys Mind

Here at Mid and North Powys Mind we are seeing very high levels of demand overall across all of our services, including more complex cases requiring more time for our support workers. We expect this trend to continue through to Spring 2021.

An episode of THRIVE on Facebook

The team is providing a blended service of both online work, including blended online SilverCloud CBT, counselling and support work, as well as still providing face-to-face meetings as and when needed. This blended approach means we can still meet the high level of demand as phone sessions are usually shorter and do not require time for travel, whereas the face-to-face sessions are there for those clients who struggle with the remote support.

We had our first day back working in Builth and Llandrindod High Schools to offer support to students aged 16 and over - this support had been halted in January. We’re going in with a really open mind as obviously things have changed since the last time we were there. It’s a very different environment now and we are taking it slowly, working with the schools and students to co-produce the support for the greatest impact. We still have 2 weekly online youth group sessions that are well attended.

We were lucky to secure some space in the Armoury, thanks to Ponthafren Association, and have started to run our first face-to-face Mums Matter course in Welshpool. Seven mums attended, which is our highest number since lockdown started. Two more face-to-face Mums Matter courses will be running in January/February.

Our Outreach group in Knighton used to meet every week on a Friday, but has been operating via telephone support with help from dedicated volunteers since the first lockdown. Now with the help of Impelo (a local charity using dance to transform people's lives) we are hoping to run one face-to-face dance session a month in Knighton, giving group members a chance to meet in a safe and supportive environment.

In Llandrindod our Tai-Chi group is meeting again in Celf after not meeting for a time and briefly being held in the Rock Park. This group is going well and is supported by volunteers and a trained tutor.




Since March we have supported over 500 people through face to face or phone meetings. Live broadcasts have continued to be very popular. Our digital content on Facebook and Youtube has been well received and we have been producing videos on Mindfulness, Tai Chi, THRIVE tips and other wellbeing activities. On Facebook we have had over 68,000 minutes of our videos watched since March and have now reached over 30,000 people.

We continue to offer remote training via Zoom, this has been a huge success, with many people previously unable to attend due to travel now being able to access the support.

Ponthafren Association

At Ponthafren Association we have been continuing to provide our services. Face-to-face this is appointment-based only to reduce our numbers in the buildings. Zoom has become the go-to for most things which has been really positive. Two Zoom groups, crochet and afternoon tea, have been very popular. Plus the videos on how to make Christmas decorations. Life skills courses have been popular and there has been strong demand for anger management courses. We continue to see an increase for all our services whilst working in partnership with others such as the Newtown Network.

Lockdown has created the opportunity for some people to reflect and explore their gender and we are currently supporting a number of people around this.

The Armoury, our new building in Welshpool, is preparing to open which is great. The construction company Paveways provided free labour and materials to refurbish the building through their charity’s arm, and they have been fantastic. You can watch a video of the work here




It’s been truly magical how the community has supported Ponthafren to support others. Rory raised over £800 as Santa on a bike and Cathy Beech released a record to raise funds for us.

You can find out more about the services these organisations are offering on their websites (linked above) or Facebook pages where you will also see details of their Christmas and New Year opening times.

Wishing everyone a relaxing Christmas and a peaceful New Year, 
and hoping for brighter times in 2021!

Monday, 14 December 2020

Harnessing the power of music - a dementia project


Steff Griffiths is the Local Coordinator in Mid Wales for the music and dementia charity Playlist for Life.

The charity was founded in 2013 by writer and broadcaster Sally Magnusson after the death of her mother, Mamie, who had dementia. The charity’s vision is that everyone living with dementia has a unique, personal playlist and everyone who loves or cares for them knows how to use it.

I caught up with Steff on Zoom recently to find out more about this amazing work.


What is your role with Playlist for Life and which area do you cover?


My role as a local coordinator for Playlist is basically to get out and about in the community and tell everybody how helpful music is in the lives of people living with dementia. So before Covid I would go and visit dementia cafes, dementia groups, carers organisations – basically any organisation that deals with people either directly living with dementia or their carers, their families, and people who support them. And I talk to them about the way music affects the brain and the way music brings back memories and then show them how to build personal music playlists.

I cover the whole of Wales north of Cardiff and the Valleys. I've a colleague in Cardiff but otherwise I'm everywhere!

What brought you to work in this field?

I’ve always found it very interesting and I have experience in my family of people living with dementia and had already realised how much music helps. So when I saw this lottery-funded post I thought I've got to do this job. It's a simple tool that really helps people. We've been based in Wales about a year now. The charity started originally in Scotland and it’s spread to London, the Southwest of England and now Wales. 




How does Playlist for Life work in brief?

Basically we give organisations and groups step by step help so that they you can choose songs that have memories attached to them and put them into a playlist for people living with dementia to listen to. You can create playlists in a number of ways, for example on YouTube, and then email them to people if they've got a phone or laptop or an iPad. It's free. When a song is played the memory comes back and you can talk with people about when they were children, when they married, when they used to go to gigs, and all the songs that remind them of Christmas, holidays or celebrations from their past.

We have lots of case studies of people living with dementia who are very withdrawn. But then when certain songs with memories attached are played, they get up and sing and dance. They play the piano, they will remember seeing Pink Floyd in concert or perhaps the Rolling Stones. And I think – wow, that's cool. But it's just the power of music that's personal to you which really does bring people back to the present and it helps people connect.

If you're caring for people who can communicate with you it's very easy to build a playlist because you can have a chat about the songs from the past. If they're not able to communicate those memories to you we also provide training called Music Detectives. It's all the tips and the tricks about how to build a playlist for somebody who has difficulty communicating and remembering their special songs. There’s also a Mini Music Detectives for children to help as well so they can work with their grandparents or go with their school into a care home (although not at the moment obviously).

Why is music such a powerful force for people living with dementia?

It's the memory. When you listen to music, you're hearing some of the melody, the words, the tone and the pitch and this connects parts of the brain that don't normally connect together for people living with dementia. It can fire off a lot of the neurons in the brain. You don't have to listen to professional music you can just sing the song. I spend a lot of time singing (I can't sing very well!) on the phone to people. Over the summer, when I was working with the Alzheimer’s Society creating personal playlist for people, Neil Diamond’s bank balance must have grown exponentially because everybody liked Sweet Caroline and it was on a lot of Playlists!

The Playlist for Life website is open to everyone and there are loads of downloadable resources on there. Create the Soundtrack to your Life is a popular one. It's a little booklet and it's where you write the song and the associated memory and then the booklet goes with the person if they go into respite for example. So staff know that the song “Sweet Caroline” has this memory associated with it, then the conversation starts and it builds that trust and bit of rapport. We have case studies on the website but you have to get your tissues ready to watch some of the video stories because it can be quite emotional, even though it’s a happy story.

How can creating a personal playlist impact on the emotional wellbeing of someone living with dementia?

Well, we have an example of a lady who is very withdrawn. But when she plays the piano she’s very engaged with the music and her audience. She's engaging with people which ordinarily she wouldn't do if the music wasn't there. It's not a panacea. It's not going to cure people but it really works with some people and it can help people a lot.

If people living with dementia aren’t able to reminisce in ways like this, what can happen to them?

It's probably a very lonely existence. People can be very withdrawn and anxious, and can't connect with the outside world. They get very upset and they don't know why.

There's a lovely video featuring Harry and Margaret on our website showing how they connect via music. You can see on Margaret’s face - she's got her husband back. They talk about when they used to go dancing and that's when they met. He knows the words to songs from the 1950s yet ordinarily he doesn't remember things. It's that connection which the music helps with. 




How has the Covid pandemic impacted on your work?

Lots - because the job is very face-to-face. We go out and talk to organisations and show them all these resources for creating playlists. But of course nothing's face to face now. So we've been holding webinars for people to sign up to and we've been doing music detective training over Zoom.

We've also been working with the Alzheimer’s Society creating playlists for people who can't get out and about as their usual meeting places have been closed. And it's been online for the past nine months. We’re also doing whatever we can to spread the word about the charity and the resources so that hopefully, in six months’ time, when all this hopefully will go away, people will know what the charity can offer them.

One example was when we made a playlist for a lady in her 90s and her son-in-law was telling me “we know exactly what song is playing because even though she's got headphones on she's singing at the top of her voice!”

Which other organisations do you work closely with in Powys, a very rural county?

So far Dementia Matters in Powys and yourselves. It’s early days so far. The community councils are also keen to get involved as well. So if there are any organisations in the area interested in using music to help people living with dementia, please get in touch.

Tell us what a “dementia friendly Powys” looks like to you personally

It's about people having the knowledge of what dementia is and understanding the many different types of dementia. Then knowing how best we can support people living with dementia, and their carers, and their families. So it's all about knowledge. It's about using all of the tools that we've got available to help and to support people. And everyone having their own personal music playlist, of course. 

What are the main challenges of the role?

I made the mistake early on when I started the job of sending out 50 emails in one day to all these organisations to say hello. I had about 36 of them come back within a day saying yes, we want to meet you and find out more. So keeping up with demand was the biggest challenge in the early days.

But during the past few months the challenge has actually being the technology side of things. We've got some lovely organisations that I met before lockdown that are not able to use technology very well. So they’re waiting to return to face-to-face before engaging with me again. So, it's tough now getting to the grassroots’ groups.

And also the need to diet from eating all those cakes, when we were meeting up, has been a real challenge!

Tell us about some of the most rewarding work you have done at Playlist for Life so far

It's definitely been creating playlists for people. We have such a laugh! One couple were having a disco in the garden with a little MP3 player of all the personal music we gave them. The gentleman had the story of his life turned into his playlist. It was a fantastic playlist.

Another highlight was running Music Detective training courses with colleges. We trained 60 - 70 of a college’s access students in the Music Detectives’ work – it’s been great to have that opportunity.

When you are not working for Playlist for Life, how do you enjoy spending your time?

I love walking and cycling. I'm an out-and-about person. I love to travel abroad as well. During Covid I have found so many new parks and places to go locally that I never would have thought about before. That’s been great. 


If you want to find out more about Playlist for Life you can contact Steff by emailing: steff@playlistforlife.org.uk or ring 07712 273 946.

Tuesday, 24 November 2020

Farming charity launches new service for farming people



RABI – the Royal Agricultural Benevolent Institution – is farming’s oldest and largest charity, operating across Wales and England. The charity has been serving the farming community since 1860.

Though best known for offering financial support (having given out grants of more than £3m to farming people in 2019), RABI is extending its services to provide more all-round support packages. The charity recently launched an online wellbeing community and counselling service for farming people of all ages, as Communications Manager Rob Harris, below, explains.


Tell us a bit more about the new service?

We’ve launched two distinct websites - Qwell.io/rabi for adults, and Kooth.com/rabi for those aged 11-17. These are safe and confidential online platforms, which are delivered in partnership with a specialist online mental health provider. The websites include dedicated farmer friendly content and access to BACP (British Association for Counselling and Psychotherapy) recognised, qualified counsellors. It means anyone from the farming sector can talk to a counsellor, for free and in complete confidence, about anything that’s bothering them, whatever the issues might be.

Counsellors are available from 12pm - 10pm Monday to Friday and from 6pm - 10pm at weekends. Drop-in and pre-booked sessions are available.

What prompted RABI to set up these new services to support farmers’ wellbeing? 

We want to offer more support and be there for the small things as well as the big. 
We are known for helping people during the toughest of times, but we want to give assistance much earlier. We recognise that early intervention and one-to-one support are key in preventing problems from escalating.

Did you aim to launch this service in a pandemic?

No, but in many ways it’s appropriate because 2020 has been testing for so many of us. For farmers there are always uncertainties and things beyond their control, such as fluctuating prices and adverse weather, but planning ahead during a pandemic is almost impossible.

Maintaining good mental wellbeing is absolutely vital, for individuals, for families and for businesses. No one should take their mental wellbeing for granted. We want to get to a point where the farming community accept that it’s OK not to be OK.

Is this a new venture for RABI?

Yes. It’s part of a five-year strategy that will extend our reach to more people. 
We want to focus on early intervention and providing one to one support that prevents people reaching crisis point.

What else are you currently involved in?

We’ve appointed the University of Exeter to conduct a survey to better understand the issues facing farmers. The research will be the largest survey ever undertaken to gain an understanding directly from farming people of the stresses they face and the impacts on their wellbeing of these challenges.

We’ve worked with a number of key stakeholders to help develop the survey including the NFU, NFU Cymru, Defra, Welsh Government, the Worshipful Company of Farmers, the National Rural Mental Health Forum, the Prince’s Countryside Fund, Farmers Weekly and Farmers Guardian. We’re hoping to achieve 26,000 responses to the survey across Wales and England. 

You can read more about the research project here.

What will you use this information for?

To shape our services going forward and ensure we remain relevant in a rapidly changing world. 

We might think we know what the issues in farming are – but the results of this survey will portray the true picture – and it might surprise us.

We’ll publish the results to provide the agricultural sector with an overview of the issues those in farming are facing. 


Many thanks to Rob Harris for telling us more about this valuable new service to support the farming community across Powys (and beyond). 

To find out what RABI can do for you go to www.rabi.org.uk, call the Freephone Helpline 0808 281 9490 or email help@rabi.org.uk

Tuesday, 17 November 2020

Reaching out to people made homeless in Powys


Two Community Connectors working at Powys Association of Voluntary Organisations, Lynda Rogers - South and Rebecca Henderson - North, have been allocated to work directly with clients presenting as homeless via Powys County Council. They will be coordinating the Third sector (voluntary) support which is required by individuals.

I caught up with Lynda and Rebecca to find out more about this important work.


Why are two from the Connectors’ team best placed to carry out this work?

Within the Connector team there is a vast knowledge and experience of the third sector homelessness support, and of working with third sector organisations to find the most appropriate support for the client. This would be after having a conversation with the individual about what really matters to them.

Will you be working closely with other agencies?

Yes, we will be working as part of a triage team of support across Powys. We will be supporting clients either virtually, within a HUB multi agency drop in session, or 1:1 as deemed most appropriate and as suitable. (Currently we are working within the restrictions of Covid-19 and we are not delivering 1:1 support face to face).

The Connectors have vast experience of arranging, hosting and delivering ‘drop in’ information support sessions across Powys. For example, pre Covid some Connectors would hold weekly drop in sessions at library or health settings.

How is somebody referred in for this support?

Referrals are made into the service via our duty system. Upon receiving a referral the duty officer will assign it to the relevant Connector via our Customer Record Management system (CRM). Our duty system operates from 9am - 4pm, Mon - Fri, with an out of hours answerphone system also in place. Referral can also be received via email to a dedicated duty email account.

We have in fact been given a large list from the outset and professionals are referring new clients to us as they add them to the temporarily accommodated clients/ homeless people list.

Tell us more about how the support works

We will work with the client addressing the ‘What Matters conversation’. On identifying the presenting issues we will coordinate the support for the client, accessing the most appropriate and timely third sector support available. We work closely with third sector organisations including POBL, the Mind groups, Ponthafren Association, Age Cymru Powys and Powys Citizens Advice bureau.

As Connectors we will work with other professionals within the partnership (see below) to support the client, address any issues, and ensure clear communication regarding the support that is being given and obtained.

Our work will ensure that support is given in a timely manner, taking into account the fact that most clients are housed in temporary housing accommodation and need to receive support in order to move into more appropriate housing.

Which other organisations are in this partnership?

We are attending the meetings of housing teams and the Homeless Cell Multi-agency group. The latter is a multi agency group formed during Covid-19 to plan support for individuals presenting as homeless. We attend the meetings to ensure that true partnership support is in place for the client. We also inform partners of the support obtained to date, the progress of the support and input into discussions regarding clients.

The added benefit of the Connectors attending a team meeting is also to inform Powys County Council Housing staff of third sector support that is available so that they can more readily support other clients they may be working with.

What experience does the Connectors’ service bring to this work?

The Connector Service has previous experience of working within other teams such as the Dementia Home Treatment Team and the Winter Pressures Co-ordination team, for example, to deliver third sector support to clients.

What can lead someone to become homeless in Powys?

Many things! Every case is different. It could be a breakdown of family relationships. Perhaps parents are not able to accommodate an older child over sixteen. Also there is an unstable private rentals sector and the cost of private rentals can be prohibitive for people.

Homelessness can have a massive negative impact on a person’s mental health.

During the first Covid lockdown in March homeless people were regarded as vulnerable and in priority need. This approach is continuing in the Phase 2 Homelessness Project.

Have you had any feedback about the project so far?

Feedback from clients:

'Hi just wanted to say thanks for your help recently with warm regards.'

'It's been really helpful talking to you, thanks.'

‘I would not have raised the issue with my manager, if you had not pointed out I am being bullied, by accepting the name calling from my colleagues.'

'Thanks so much for helping me find financial support to pay for the vet to look after my cats.'


Feedback from officers:

‘This is great work. We can’t believe the amount of voluntary organisations in Powys who are able to help support people.’

What are the most challenging areas of this work?

The work can be emotionally draining as well as politically upsetting and frustrating.

What are the most rewarding aspects?

Being part of a team where everyone is working towards the same goals, and helping individuals gain support whilst in crisis.

When you are not working as Community Connectors how do you like to spend your spare time?

We enjoy hanging out with our families, cooking, reading novels, gardening and walking footpaths.

Many thanks to Lynda and Rebecca for telling us about their work supporting homeless people. If you would like to find out more you can contact them by emailing: community.connectors@pavo.org or tel: 01597 828649.


Tuesday, 10 November 2020

Supporting Powys farmers – the Mamwlad project

Elin Bowen (Care & Repair Powys) & Gethin Edwards (Age Cymru Powys)

This week’s guest post is from Elin Bowen, who works for Powys Care and Repair as a Mamwlad Case Worker, and her project colleague Gethin Edwards, a Mamwlad Support Officer with Age Cymru Powys. After finding out about the project at a Powys Agri Wellbeing Support meeting recently, I contacted Elin and Gethin for a more indepth look at this new project.

Powys Care and Repair works to help keep their clients safe, warm and secure in their own homes. They run a variety of programmes including the Rapid Adaptations Programme for those 50+. 

Age Cymru Powys provides essential support to people over 50 and their families in Powys. The organisation works to sustain and improve the quality of life of vulnerable older people in Powys. It believes that older people should be respected and valued as individuals in terms of their dignity, status, personal autonomy, diversity of needs, aspirations and expectations.

What is the Mamwlad project and why was it created?

Both CRP and ACP’s client data demonstrates a disproportionately low take up of their services by older farmers. The farming community are naturally independent and reluctant to seek out support, but as their needs change as they grow older their personal needs increase and both social and physical isolation makes matters worse. The national well-being outcomes are far from being achieved for older farmers. Jointly CRP and ACP will use their experience and knowledge of supporting older people to identify solutions to difficulties, working collaboratively with others in the wider agricultural community, public and voluntary sectors.

What does Mamwlad mean in English?

Homeland, which was the original English project title. In terms of this project we relate it to how the farming community connects with their home, their land and their life to stay living at home safely and independently.

FYI: it also can translate to Motherland, our native country.

So you both work on the Mamwlad project which is a partnership project. How did that evolve and how is it working now?

Both Care and Repair Powys and Age Cymru Powys are trusted sources of information, advice and support for older people across Powys. CRP bring confidence and wellbeing into the home along with technical knowledge and delivery of adaptations where ACP provide holistic information and advice, tackling poverty and social isolation. Together the two organisations combine to provide a complete service to support the farming community.

What led you both to these particular roles?


EB: My working background of 25 years is within nursing, district nursing and more recently a palliative care specialist nurse, however, I was retired from that post due to an injury. Having been out of work for a couple of years whilst having surgery, I by chance found this post advertised, and felt that coming from a farming background myself, the role was perfect. The aspect of nursing that I greatly missed was the client interaction for which this role provides.

GE: My working background has been in the financial / business sectors & renewable energy sectors. I have been an Independent Financial Adviser and a Regional Business Development Manager that has seen me travelling and advising our farming community on different topics across Wales. I have family who still farm in Ceredigion, and know with experience the difficulties that our farming community face in normal circumstances let alone under the current Covid-19 situation and the uncertainties of Brexit. Having seen the advert, I thought I would like to be a part of this exciting new project with a chance to help and make a change in terms of highlighting what benefits and help that is available for our farming community in the whole of Powys, to make life a little easier and happier going forward.

How has the Covid-19 pandemic impacted on the roll-out of the Mamwlad project?

Having taken up the posts within lockdown, the pandemic has had a significant impact on Mamwlad. It was the hope to attend rural shows, livestock markets and various other agricultural events in order to engage with the farming community and make the Mamwlad service accessible, however, this has not been achievable. We have now targeted our engagement through social media, press releases, agricultural businesses and charities, Powys Teaching Health Board and various community groups in the hope of reaching our target groups. 


Who from the farming community is eligible to receive support from the project?

Support is available for people who are over the age of 50 who are Farmers / Farmworkers currently farming or retired living in Powys.

What kind of support is available? How can you help farmers remain independent as they grow older?

EB: Care and Repair will provide options and advice on adaptations, repairs or maintenance required to the home to promote independence. By means of a healthy homes assessment we aim to help clients manage better and stay safe, warm and secure in their homes. This may be through falls, trips and slips prevention, fire safety checks, energy efficiency and home safety and security checks. We have a Minor Adaptations' team that can support with grab rails, ramps etc and we can also support the sourcing of funding through benevolent funds or grant applications. Care and Repair will support clients through finding a reliable contractor, provide technical advice and assistance through Care and Repair’s technical officers and liaise closely with the Occupational Therapist to ensure that all work carried out is appropriate to the individual needs of the client.

GE: Age Cymru Powys will offer farmers our primary service in terms of Information & Advice which includes a free confidential benefits check service, this will highlight areas that the client may need further guidance and help towards applying for various benefits shown in the results. We can offer our assistance in completing the welfare forms with them on request.

Other support is offered in the shape of various services, some provided in-house and others through introductions to relevant public & private organisations / charities and other professional bodies.

These services would include befriending services, where a volunteer is introduced and on acceptance rings the client on a regular basis to combat isolation and loneliness that is a big concern both in pre and post Covid-19 pandemic across the Welsh farming community. We work with specialist organisations & charities to aid with ‘Mental Health support’ as some farmers struggle with stress in the current climate and the future unknown.

Local support for practical help could include elements such as getting a volunteer to shop and deliver to their home, pick up prescriptions or help with chores around their home.

As part of the project, it is paramount that we offer our farmers encouragement through Advocacy and support to get their wishes heard through different channels of communication.

An important factor in our offering is to highlight the importance of preparing themselves for their own and the family farm’s future, this planning for their later life goals needs to be introduced and be planted in plenty of time for it to be harvested before each farmer’s journey into their chosen retired life and ensuring future happiness and their independence.

The other part of this program is to support older farmers with significant life events like:

  • Bereavement or death.
  • Divorce, separation or relationship breakdown.
  • Health problems.
  • Increased care needs.
  • Changes in housing needs or a change in housing circumstances.
  • Changes in financial circumstances.

Care and Repair & Age Cymru Powys will endeavour to secure our farming communities’ independence as they grow older by continuing our ongoing supporting activities, along with keeping in regular contact to gauge how each farmer’s goal of ongoing independence in later life is being achieved. 


What are some of the specific issues facing farmers as they age in Powys?

Farmers are extremely independent and work hard and long hours in challenging conditions beyond the natural retirement age. The rurality of their homes, a reticence to ask for support coupled with a lack of awareness of what services and support is available, can often lead to loneliness and isolation which Mamwlad aims to address through increasing the awareness and making services more visible and accessible to the farming community.

What is unique about this particular project to support Powys farmers?

There is no other Welsh Government funded project in Wales that combines the services offered by both Care and Repair and Age Cymru Powys to address the needs of the farming community.

How are you working alongside other agencies to support the agri community around issues such as isolation and loneliness for example?

We have identified key organisations in the agricultural community such as vets, feed merchants, accountants, NFU, FUW etc and approached them to support the Mamwlad project in raising the awareness of the service. It was the hope to attend livestock markets, rural shows and other agricultural events, however, the current climate does not allow for this, however, we have been fortunate to gain support from many agricultural organisations and charities through social media presence, press releases and the posting out of our literature.

What is the most challenging aspect of the job for each of you?

Negotiating the current climate is by far the greatest challenge. We are unable to provide all of the service through face to face contact as was originally planned at inception.

It’s early days but tell us about some of the most rewarding work you have done on the Mamwlad project so far

EB: Increasing independence and accessibility around the home, through both internal and external adaptations for an extremely independent gentleman which improved his quality of life within his home.

GE: Making an elderly farming couple, who are still farming in their 80s, aware of their eligibility for additional help through various unclaimed benefits and reductions in certain household bills, so helping to ease some financial burdens during this difficult economic climate.

What is the most valuable thing you have both learnt since starting your roles?

EB: I feel very honoured and grateful to be working with the agricultural community with such a wealth of history and character and value working with such individuals within my community.

GE: I think the farming community remains strong in terms of unity during these uncertain times, there is a lot of help out there in terms of actual business advice for the farmers. However, Mamwlad is centred more on the individual farmers’ current well-being and how we can help make life a little easier both now and in their future planning so independence remains integral in their older life.

When you are not working for the Mamwlad project, how do you enjoy spending your time?

EB: I enjoy costal walking with the family and my dog, Flori, and love reading.

GE: I enjoy spending time with my family, trying to keep up with my two year old grandson, trekking, cycling & consuming large varieties of food! 


Many thanks to Elin and Gethin for telling us all about the Mamwlad project in Powys. If you would like to find out more you can contact Elin by emailing EBowen@crpowys.co.uk or ringing 01686 620760 or Gethin by emailing Gethin.Edwards@acpowys.org.uk or ringing 01597 825908.

Thursday, 22 October 2020

Online therapy service to help with winter blues

by guest author Carol Brown
SilverCloud Project Manager, Powys Teaching Health Board

Every October, the days get shorter, the nights longer, and there’s a rise in demand for mental health services. But the SilverCloud Online Cognitive Behavioural Therapy (CBT) service remains open for business.

Powys residents have unique access to the SilverCloud Blended Online CBT service, which offers people aged 16+, who are experiencing mild to moderate anxiety, depression or stress, a 12-week course of online therapy via their smartphone, tablet, laptop or desktop computer, plus six sessions with an Online CBT practitioner.

Pre-Covid, the six sessions with an Online CBT practitioner took place face-to-face at GP surgeries in Powys, now they take place over the phone and by email.

The Online CBT practitioners review users’ progress on SilverCloud, signpost activities and tools available on the online therapy system, and offer encouragement and support.

The SilverCloud Blended Online CBT service is run by Powys Teaching Health Board in partnership with Ponthafren Association in North Powys, Mid and North Powys MindBrecon Mind and 
Ystradgynlais Mind.

Anthea Jones, Mid & North Powys Mind

Anthea Jones from Mid & North Powys Mind tells us how they've adapted their service from in-person to online and how social media has helped them engage with people. 

“The winter blues is a phenomenon. There is always an increase in admissions to mental health services when the clocks go back. It really does help to make sure you get outside and get as much daylight as possible in autumn and winter. Think of it as self-care. It keeps your mood up having the light. 

“As soon as Covid hit, we moved from meeting clients face-to-face in the GP surgery to supporting people over the phone and by email.

“We also widened the referral process so that as well as GPs, other healthcare and mental health professionals can refer people to us. 

“At Mid and North Powys Mind, we responded to a demand in lockdown by recording and sharing videos to our Facebook page to support people with their mental health and wellbeing.

“We’ve made videos explaining SilverCloud and the different tools and activities it features such as how CBT can help with anxiety, the link between food and mood, gratitude, mindfulness, Tai Chi, and the importance of getting out in nature to keep your mood up. There’s lots on our Facebook page.

“The response has been really positive. We get feedback from people saying ‘thanks’ and ‘that’s really helped me’ which is good to hear. Our viewing figures are up to 2,000 per broadcast and that’s spurred us on to keep going.

Tackling overthinking

“One of the common things I’ve found with people who use the SilverCloud Blended Online CBT service is the overthinking. It’s like everyone’s living a second life in their head, thinking about things too much, dwelling on things, especially with the uncertainty that Covid has brought to our lives.

“To help with this, I walk clients through the Thoughts, Feelings, Behaviours cycle, which shows you how what you think affects how you feel and how you behave. This is explained on SilverCloud.

“Keeping a thought diary can help get thoughts out of your head and help you see patterns that you can learn from, such as thoughts that come up every day and thoughts you might need to look at more deeply.

“On a practical level, positive self-talk can help. So ‘I can’t do anything right’ becomes ‘I can do better next time’, for example. Upping your activity levels is also key. Break up the time you spend sitting and thinking and get up and out, using your hands and feet and losing yourself in physical activity. Being active can make such a difference.


How does SilverCloud Blended Online CBT work?

“When people are first referred to SilverCloud Blended Online CBT we’ll have an hour for our first session together where I help them get set up, walk them through how to use it and get the most out of it.

“The amount of time people spend using SilverCloud is flexible, because users can log-in and work through the programme in a way that fits into their lifestyles. Ideally, people log-in for around 15 minutes every day to work their way through the activities and tasks that make up their programme and they’ll complete a fortnightly review online.

“I’ll have a look at their results and use the five follow-up sessions, which are around 20 minutes each, to give them a call – or email if they prefer – to discuss their progress, give feedback and offer support. 

Who do you work with?

“I work with a real range of people on the SilverCloud Blended Online CBT service, aged 16 to 80.

“I have been working with a lady in her seventies who’s been really great with it. She’s put a lot of effort into using SilverCloud and we’ve built up a really good rapport over the 12-week programme and her mental health and wellbeing scores have vastly improved.

“Then, the fact that it’s an online programme naturally attracts younger people, men especially, who like that they can work on their mental health and wellbeing in private, so to speak, without everyone knowing about it.

“For example, I started working with a student in his early twenties during lockdown who was struggling with anxiety. He didn’t feel able to talk about this with family and friends but he started using SilverCloud and likes the conversations we have around it.

“I find the service is also popular with men in their early thirties. Again, anxiety is a common issue and being able to do the programme online with the support from an Online CBT practitioner like myself means the blended approach really works for them.

“SilverCloud gives people the chance to lead a ‘normal’ life but with backup support. Plus, being an online service, it fits around working life and I think because of lockdown, more people are looking for online solutions.

“Now, because of Covid, they don’t have to take the afternoon off for a face-to-face appointment with me at the GP surgery. They know we’ll check in with them over the phone or by email. And an online service is useful for people in rural areas like Powys where the geography can pose a challenge to accessing health services at the best of times. 



Anxiety is a common issue

“Users can choose from a range of mental health and wellbeing programmes to complete at their own pace over 12 weeks. Programme options include help with anxiety, depression, stress, sleep, and money worries.

“The programmes that help with anxiety are most popular with people I work with. I’m keen to point people towards the resilience programme as it can really help with thoughts about going into lockdown again and being down about life.”
  • Mid and North Powys Mind Facebook You can view their mental health and wellbeing videos on www.facebook.com/mnpowysmind/
  • SilverCloud Blended Online CBT service available in Powys. If you are interested in signing up for this combination of online CBT with phone call and email support sessions with an Online CBT practitioner, please contact Ponthafren Association in North PowysMid and North Powys Mind, Brecon Mind or Ystradgynlais Mind. Alternatively, please email Silver.Cloud@Wales.nhs.uk with the subject line ‘SilverCloud Blended Online CBT service’ or call 01874 712 428.
  • SilverCloud Self-Referral available across Wales If you’re aged 16+ you can now sign up directly for SilverCloud Online CBT without needing to go through your GP or other healthcare professional. Although an online self-help service, you will be allocated an Online CBT co-ordinator who will liaise with you via the SilverCloud platform in order to guide you through the programme and monitor your progress.