Christmas comes but once a year

One of the things that came out loud and clear in the Participation Report that my colleagues worked on in the Autumn was the value of the voluntary sector resource centres across the county. Particularly at Christmas, when so much else is closed, they play a vital role in supporting people through what can be a difficult time.

I'm based at an office in Ponthafren Association's centre in Newtown, which covers much of North Powys. Even now as I type I can hear staff and volunteers welcoming new members into the Centre, just a handful of days before Christmas Day itself. In the Pine Room they will find a roaring log fire, an open box of chocolates on the table, tea and coffee by the gallonful, but above all, friendly faces and a chance to chat about whatever they want. 

So... as Christmas looms around the corner... I just wanted to add some website links here to those centres around Powys which plug such a big gap in so many people's lives. All year, yes. And Christmas too!

From North to South:

• Ponthafren Association in Newtown and Welshpool. 
• Mid Powys Mind in Llandrindod Wells and surrounding areas.
• Brecon and District Contact Association in Brecon and surrounding areas. Website being updated, but I'm told open every day, 12 - 4.30pm, except New Year's Eve, open 12 - 3pm.
• Ystradgynlais Mind in Ystradgynlais, who are open Christmas Eve and New Year's Eve, 10am - 2pm.

If the opening times are not listed in detail here they are on the organisations' websites - links above.

You can also find links to other organisations that provide help and support on our website here.

Finally, I was looking back through an old Christmas issue of the Powys Mental Health Alliance magazine.... where there is a section called "Tips to stay well at Christmas."  There are loads listed, (and you can find more if you link to this page and look at December newsletters) but here are three of my favourites:

• Use the time to do something practical. You may get a sense of achievement for having accomplished something.
• If you are feeling low, try and explain how you feel to those close to you. Unless you explain how you feel, people will not understand what is wrong. Those close to you will want to help, and a sympathetic listening ear is an important treatment for depression.
• Look after yourself. Put yourself first and treat yourself to something that you will enjoy.

So, a big bag of vegetable crisps - carrot, beetroot and parsnip lightly fried and salted -  for me then!

Take care, and see you in the New Year!

Photos taken at the Ponthafren Centre, 20 December 2012

A black dog story

Many years ago a long-term relationship I was in at the time broke down. The house we had been buying together was sold, and we went our separate ways. About a year later, perhaps rather foolishly, I went back to look at the house, and it was in the process of being demolished. The site was due to be cleared, along with others in the street, for the building of flats. The roof was gone and internally the house had been gutted. All that remained was an empty shell. It looked just as if a bomb had hit it.

Suddenly, out of a gaping hole that had previously been our front door, an immaculate white cat emerged. It was like the ghost of all the much-loved cats (four) which had previously shared the house with us. For a while that cat came to symbolise for me a period of mental distress that I had gone through at the time.

But for many, it is the black dog of depression which follows them through periods of their lives. At the end of the Mental Health First Aid course which I attended in 2009, I was given a short book called “I had a black dog” by Matthew Johnstone. It is a beautifully illustrated picture book, which, as Stephen Fry comments: “… says with wit, insight, economy and complete understanding what other books take 300 pages to say. Brilliant and indispensable.” There is a link to it here.

But also, I find (thanks to my colleague Glynis), there is a short video, uploaded recently, about this black dog. We decided to share it here:

Can I have some Cognitive Behavioural Therapy please?

I heard a true story last week, about someone going to a GP surgery and specifically asking for CBT (Cognitive Behavioural Therapy). The person was feeling down because of something that had happened in their life, and decided they didn't want to take medication, but they would like to give CBT a go. But no CBT counsellors were available, only online CBT sessions (I'm not quite sure what these would involve). Anyway, online therapy was not what this particular patient wanted. She went away disappointed and still depressed.

We know there are plans and good intentions to increase the number of talking therapies made available to people via their GPs...it says so in the new law, the Mental Health (Wales) Measure. The problem seems to be that currently the supply just doesn't meet the demand.  So people are left feeling a little bit cheated and frustrated (alongside the original mental distress they went to their GP with). When you're feeling depressed, you want help now, not six months or a year later. 

The fact is that CBT does work for some people, according to a recent study in The Lancet.   You can find out more on this BBC webpage. 

I can't help wondering, what are the issues with providing CBT counsellors? Is it about... money to pay for them? Or finding suitably qualified people? Or... just that this is one of a thousand tasks the NHS in Wales have to sort out, and so far it's only at 579 on the list.... (so that comes down to money again....) 

If you've tried to access CBT through your GP surgery - we'd be interested to know how you got on.

Meanwhile, you can find out more and watch a video about CBT here, and read a CBT flyer on The Royal College of Psychiatrists webpage.

For the full report from The Lancet, click here.

P is for Post Natal Depression

Recently several readers of this blog have said that they would like to post about their own experiences of mental distress. So, here we have the first guest blog, on the subject of Post Natal Depression, from a friend living in Mid Powys:

"The 'baby blues' arrived, but they never left.  I can only describe this as soul destroying; it was like a physical ache in my chest.  I was living on auto-pilot caring for this baby just as I should, under a suffocating black cloud. The fact that this baby was my responsibility 24 hours a day, 7 days a week was completely overwhelming, and an enormous shock.   There was this beautiful baby that everybody else worshipped and adored, but I felt nothing towards it.  At my worst, I left the baby with my husband, got in the car on my own and drove. I didn’t know where I was heading, I didn’t care if I had an accident, I just wanted to stop hurting.  I battled on in denial for 6 months, before I broke down with my health visitor, who made an appointment for me at the doctor's.  Going to the doctor’s was the easy bit.  I was prescribed anti-depressants and referred for counselling.  The medication took effect quite quickly and I started to feel the cloud lift.  Going for counselling was really hard.  I was sat in the waiting room, thinking I didn’t need to be there, and was just about to bolt, when the counsellor came to get me.  Counselling turned out to be the best thing I could have had.  She helped me to understand that I had undergone some major life changes in a very short space of time, and that sometimes it can be just too much to deal with, and something has to give.  I had about 5 sessions with the counsellor, and stayed on the medication for about a year and a half, coming off it when we were thinking about having another baby. 

Fortunately I didn’t suffer after our second child was born.  I saw the consultant shortly before the baby was due because they thought it was breech.  The baby wasn’t breech; the consultant was more concerned that I had suffered from post natal depression previously.  I found this really reassuring.  I was watched closely by the health visitor and doctors to make sure that I didn’t suffer again. The ‘baby blues’ were just a blip, and went as soon as they came.

I battled with guilt for a long time, as I felt sure that my baby could pick up on how I felt.  This of course was not the case.  We are now bonded for life.  We have our ups and downs as any healthy family does.

I know now that depression is my ‘achilles heel’ and I have been on medication intermittently since, as I know that it will help me.  I also know when I don’t need to take it anymore.

I would urge anyone who finds themselves in the same position to go and get help.  You deserve not to feel this way, and there are people out there who can help you.  Don’t suffer in silence."

There is some really useful information about Post Natal Depression, along with links to other support groups, on the Mind website here.

You can read other people's stories on the Post Natal Illness website here.

And there is an online Welsh support group for men whose wives or partners are experiencing post natal depression called Fathers Reaching Out.

Do we have a right to our mobile phone?

OK, so you’re in hospital and you want to ring your Mum, or your brother or your best mate… but you can’t, because the staff have confiscated your mobile phone. And you can’t borrow another person’s mobile phone on the ward, because everyone’s mobile phones have been taken away and locked in the office.

It doesn’t seem likely in 2012 that this situation could arise, but on a mental health ward at Bronllys Hospital in South Powys, this is the reality. There is a free phone available in a private room for patients, but this is a 12 bed unit, and queuing for a chance to use the phone is hardly spontaneous… Besides, how can you possibly predict when someone might want to ring or text you?

For two years now staff, patients, carers and others have bounced two conflicting rights backwards and forwards:

1. The right to access your own mobile phone when you wish to make and receive calls and texts.
2. The right of others on the ward to privacy (did you ever come across a mobile without a camera these days…?)

But so far no balance or compromise has been reached. And every month at the Patients’ Council meetings patients ask for their phones to be returned, but nothing changes.

The relevant law around this is contained in The Code of Practice to the Mental Health Act 1983, and states in Section 16, Privacy & Safety:

“Given that mobile phones provide a readily available means of communication with family and friends and are in widespread use, most detained patients are likely to have one. It is unlikely to be appropriate to impose a blanket ban on their use except in units specifically designed to provide enhanced levels of security in order to protect the public.”

You can read and download the Code of Practice here.

There is also a useful NHS document called Using mobile phones in NHS hospitals which you can read and download here. This states early on:

“The Department wishes to reflect the rapidly developing principles of patient choice in the matter of mobile phone usage. It therefore considers that the working presumption should be that patients will be allowed the widest possible use of mobile phones in hospitals, including on wards, where the local risk assessment indicates that such use would not represent a threat to:

• patients’ own safety or that of others, 
• the operation of electrically sensitive medical devices in critical care situations,
• the levels of privacy and dignity that must be the hallmark of all NHS care.”

The Stronger in Partnership Network in Powys is working to change the approach to mobile phone usage at Bronllys Hospital. In gathering feedback about the Aneurin Bevan Health Board mobile phone policy which covers the mental health ward at Bronllys, a patient who had previously attended another unit said about using her mobile phone:

“….this was a vital form of contact and normality for them (my children) and me, allowing some control over the situation on the home front whilst also decreasing that sensation of loneliness and isolation.”

A mother of someone who had been on a ward at Bronllys Hospital said:

“…This is a step back into the dark ages - when mobile phones are part of most people's life style with music, photos…. and an important means of contacting friends and family. Patients at Bronllys are denied that right presumably because they don't have the same needs as other people!!!”

In other areas of the UK patients are allowed mobile phones on mental health wards if they promise not to take photographs or videos without seeking permission first. If they break the rules, their mobile phone can be removed. Fair enough -  life is full of rules. And we all pay the consequences for breaking them. But we aren’t punished before we break them.

Why is it so different on a mental health ward? Let us know what you think.