Powys Mental Health Alliance Open Day 2013

Last Thursday I made a scenic detour around the Royal Welsh Showground at Builth to attend the Powys Mental Health Alliance (PMHA) Open Day at  Bishop Bevan Hall in a beautiful sunny Brecon. The day was attended by individuals and also staff working for the following organisations - Aneurin Bevan Health Board, Brecon & District Contact Association, Hafal, Powys Association of Voluntary Organisations (DIY Futures project, Powys Befrienders' project, and me - the Powys Mental Health Information Service), and Ponthafren Association. People had travelled from further afield than me - including some from Welshpool and also Ystradgynlais.

The first session was an update from the PMHA trustees about recent developments within the organisation. A new logo was presented, and Chair Bryan Douglas-Matthews explained that the charity had gone through a radical overhaul of late. The eight trustees running the charity have recently developed a new vision - "We believe the collective voice of individuals has the power to improve the world of mental health." 

Trustee Lee Watmough was joined by magazine editor Carla Rosenthal to talk about the revamp and relaunch of the PMHA magazine - now called Headspace. The first issue (1,000 copies have been circulated throughout Powys, and an online version is available) has been extremely well-received, and plans are now under way for an Autumn issue. The magazine is more colourful, vibrant and light-hearted than the previous incarnation, and Lee said that he hopes it draws together the collective voices of not just individuals, professionals and carers, but everybody - "everyone is touched in some way by mental health or emotional difficulties." Carla encouraged people to submit articles, poems, photographs and artwork - the deadline is 30 August. "We want to give a platform to your voice. We want to let people who create services change the way they offer them by listening to people who use them."

Lee and Carla also explained that a brand new website is currently being developed - it is viewed as an opportunity to talk about mental health issues in Powys and break down stigma - watch this space for the launch date!

Lee then described some of the future projects the charity hopes to focus on, including Powys Patients' Council in the Community, teaching others how to lobby effectively, reaching out to the rural community including farmers, helping people deliver a message through innovative drama and fundraising with a difference. Events featuring inspirational speakers and debating topics such as medication are also part of the proposed mix.

Before lunch, and our chance to sample trustee Diane Hart's amazing artwork, there was also a long discussion about the disparity between mental health services available in the North and South of the county, with a focus on crisis teams. Whilst there was acknowledgement of the important developments in both areas (we have written previously about the Home Treatment Teams in the North and South), it was clear that there are still gaps in provision out-of-hours which need to be addressed.

Following lunch the main speaker of the day, Reverend Dr Melanie Santorini, outlined the Time to Change Wales campaign - "don't be afraid to talk about mental health." The campaign is jointly run by three mental health charities - Gofal, Hafal and Mind Cymru, and funded by the Big Lottery Fund, Comic Relief and Welsh Government. So far about 150 Welsh champions have been recruited by the campaign to challenge stigma, perhaps by writing a blog post, or talking to the media, or volunteering at events. Locally there is an event on 3 October in Llandrindod Wells to coincide with World Mental Health week and the aim is to boost the number of champions to 200 by the end of the project.

Melanie also spoke about the importance of talking about mental health with family, friends and colleagues, and politely challenging those who stigmatise people experiencing mental distress. The campaign regularly refers to the 1 in 4 people who supposedly experience a "mental health problem" (we posted about this here). However, it was good to hear challenges from the audience at this event - "it's not 1 in 4 it's everyone!" and Melanie herself referred to people who "think they don't have the experience." She told us a personal story of explaining to someone she knew recently - "I have a mental health diagnosis". The man nearly fell off his chair. He then said - "but you look normal!"

The day was rounded off for me by a question and answer session with two Community Psychiatric Nurses (CPNs) from the Brecon area - Andrew Stephenson (Team Leader) and Dawn Carey. They talked about a variety of issues, including:

• Working alongside the Home Treatment Team in the South to ensure people have a supported transition from hospital to home, and also to reduce admissions.
• Outlining the referral process and distinguishing between Primary Care Services (GPs, nurses and counsellors based at health centres) and Secondary Care Services (CPNs, psychiatrists and support staff in Community Mental Health Teams).
• The impact of the Mental Health Measure on the ability of an individual to self-refer back to a Community Mental Health Team for further treatment.
• The new Care Treatment Plans which were launched in June 2012 and the role of a Care Co-ordinator (nurse, doctor or social worker for example) in developing them with an individual. Paper and electronic copies are available - and Shropdoc can access these via the Home Treatment Team staff as appropriate.
• Out-of-hours support as provided by Shropdoc and possible referral to out-of-county 24 hour assessment units.
• The pros and cons of having three different health boards providing mental health services throughout Powys.
• The involvement of advocacy services to support inpatients at Bronllys Hospital.

I found this session particularly useful as it is a real luxury to have staff providing mental health services in a specific area to be available to fill in the many gaps in our knowledge in such a complex and ever-changing area.

All in all a really interesting and useful day - and I look forward to the next one that PMHA organise! If you were there - tell us what you thought.

When was the last time you really listened?

Last week I went on an audio editing training session with StoryWorks. We learnt how to carry out 10 minute recorded interviews with people, transfer them to computer, and then edit them down to 3 minutes to provide a succinct but memorable digital story which could potentially be uploaded to a website or blog post as a podcast. The training was great – the day flew by – and at the end I left feeling really inspired – with a new skill to add to my toolkit (need to practice more though, once colleagues have bought the kit) – which could, in the future, be of real value to the team and those wishing to tell their stories.

The session also prompted me to think more about listening skills. I have had some training around this in the past, including on the Mental Health First Aid course. I shall always remember the frustration I experienced when sitting telling the amazing story of my other life as a Heritage Seed Library guardian, only to find that the so-called listener was sitting cross-legged, facing in another direction completely, and apparently staring out of the window!

Despite the training, I am incredibly bad at listening properly most of the time. Whether I'm at work, and a colleague wants to talk to me while I’m writing a long and complex email, or I’m at home and family ask me to listen about work stresses, for example, and I would rather, at that moment, just relax and chill out. 

It’s hard – this listening thing! And that’s even before we bring some serious emotional distress into the equation. When we are mentally distressed, one of the first things we often feel a great need to do is talk to someone else. The very act of talking and being genuinely listened to seems to help a great deal.

There are some excellent guidelines out there. You can read about the value of listening skills for mental health nurses in a piece called “Core communication skills in mental health nursing”:
“...many mental health nurses believe they are not doing anything when they are just listening and as a result they underestimate the value of simply listening and more importantly its therapeutic effect.”

And closer to home, the DIY Futures lottery-funded project has recently been holding Listening Skills workshops as part of its Stories Project. Individuals have volunteered to tell their stories of mental distress, whilst others have volunteered to listen. Project Manager, Jane Cook, has been telling me about the workshops which have been really well received. The project sourced useful guidelines from world-wide, including this piece about listening from the Bloemfontein Samaritans in South Africa and a useful online presentation about the Process of listening.  By October there will be a book of DIY Futures stories available – the culmination of all this storytelling and listening that is currently happening - we’ll let you know more nearer the time.

Perhaps if we all listened that little bit more carefully on a regular basis (listening rather than just hearing) then others would gain the benefits of sharing their story/distress. And even if they felt just a tiny bit less distressed as a result – what an impact that might have overall.

What do you think? Do you have any experiences of good and bad listening to share with us?

Jacqui Dillon heads to Mid Wales

I’ve just finished reading a brilliant book called – "Agnes’s Jacket" by Gail A. Hornstein, Professor of Psychology at Holyoke College in the USA. It’s about Gail’s investigation into people’s experiences of mental distress, and at times it reads more like a detective story than an academic piece as with as open a mind as it is possible to have she enters and explores “a vibrant underground network of ‘psychiatric survivor groups’ all over the world.”

Jacqui Dillon features prominently in the book as the Chair of England’s Hearing Voices Network – Gail’s enquiries take her to many of the HVN meetings and events. At one Jacqui says: “I have come to view hearing voices as an adaptive and creative strategy, an example of the persistence of the human spirit to survive in the most extreme circumstances..... My hearing voices was a perfectly natural response to the sadistic torment I experienced. Psychiatrists should stop asking, what’s wrong with you? And start asking, what’s happened to you? That’s what we do in HVN support groups.”

I’d come across Jacqui online before, as she features regularly on a favourite website of mine - Mad in America – but search online for any information about hearing voices and her name soon crops up. Jacqui is “a respected campaigner, writer, international speaker and trainer specialising in hearing voices, ‘psychosis’, dissociation, trauma, abuse, healing and recovery.” And her own website is not just an excellent resource for anyone wishing to find out more about the hearing voices movement, but tells a powerful personal story – “of surviving childhood abuse and subsequently using psychiatric services (to) inform her work.... she is an outspoken advocate and campaigner for humane, trauma-informed approaches to madness and distress.” 

So I was delighted to discover that Laura had booked Jacqui as the keynote speaker at the Mid Wales national Stronger in Partnership event (“Shaping Services”) on 19 September in Llandrindod Wells. This event is one of three organised by our Powys Mental Health team here at PAVO and funded by Welsh Government and Public Health Wales. Individuals, carers and staff are invited to share their experiences and views about services, and find out more about what is proposed nationally. (Last year’s event was in May 2012 in Newtown - Eleanor Longden spoke inspirationally - you can read more about the day here).

Laura tells me that this year’s themes are:

• All age participation – to fit with the national and local mental health strategies.
• Children and young people feeling more confident to support each other through mental distress (for example, self harm, hearing voices, sadness, and anxiety).
• Welfare Reform – how are the changes affecting people in contact with mental health services and those close to them? What can we do to make a positive difference to improve their experiences?
• National and Local Mental Health Partnership Board Strategy, Implementation and Participation. 

You can find out more about the conference here. So many interesting issues and topics to discuss, AND Jacqui’s keynote talk….

And so, back to Jacqui… The Hearing Voices Network has joined the debate which has been active on here lately - about the medicalisation of mental distress. Jacqui writes, as Chair, that “psychiatric diagnoses are both scientifically unsound and can have damaging consequences..... People who use services are the true experts on how those services could be developed and delivered; they are the ones that know exactly what they need, what works well and what improvements need to be made. This is not just an academic or professional issue – it’s one that affects our lives.”

So, for anyone interested in pursuing this debate – make sure you book your place at the event as soon as you can - BOOKING NOW OPEN HERE – a quick reminder of the date as I can hear the rustle of paper diaries and clicking onto online calendars….., that’s Thursday 19 September, The Pavilion, Llandrindod Wells, and we really hope to see you there!

Any queries, just get back to us – as always – by commenting below or emailing: pamhinfo@pavo.org.uk, or ringing 01597 822191 or 01686 628300.

Self harm in Powys

A couple of colleagues at Powys Association of Voluntary Organisations work with organisations supporting children and young people (you can be defined as a young person up to the age of 25 these days). Last week they told me that a recent Youth Forum meeting had highlighted an increased incidence of self-harm in the county amongst young people. I don’t know all the details (if anyone reading this knows more then please get in touch), but it makes me wonder what could be done to support young people who self-harm more.

There is an excellent website called TOWIP (“the only website in Powys”), – named by the young people who helped set it up with Powys Youth & Family Information Service “to express their views, reviews and creativity”. I’ve been following the posts of Black Star – also known as Cara – who writes about her own experiences of self harm. She is a 17 year old teenager living in Powys, and comments openly, honestly and eloquently about why she self harms and her efforts to stop - “...to me it’s an automatic reaction to stress, it helps, and it’s addictive. It’s the way I turn emotional pain in to physical pain, physical pain is easier to deal with, and all I have to do is shove a bandage on it.”

Back in April Black Star asked if there should be a self harm support group in Powys, as she had looked around and been unable to find one. I’ve been doing a lot of reading about peer support groups recently and they really seem to help individuals across the whole spectrum of mental distress. It makes so much sense. “A peer has ‘been there, done that’ and can relate to others who are now in a similar situation.” After all, how would it feel to be a self harming young person, isolated in a rural county like Powys, knowing no one else who self harms to talk to? 

There are many online forums and useful websites – I’ve listed some below – but whilst young people are the most ICT savvy folk in the world even they need to meet up and talk face-to-face with peers sometimes.

I’ve also been watching the BBC 3 TV documentary Don’t Call Me Crazy for the last couple of weeks – a distressing but again honest insight into life on a teenage mental health inpatient unit in Manchester – the McGuinness Unit. It’s described by the BBC as “a place of last resort for many adolescents with eating disorders or psychosis, who self-harm or are suicidal”. It’s not an easy watch. But in amongst all the images of cut arms and legs, the screams, the tears, the physical restraints, something shines through. And that’s the sheer positivity of the relationships the young people build, the way this can increase their sense of worth, their strength to overcome their distress and move on, and their inherent deep-rooted desire not just to survive but to flourish – and I’ve found it very moving.

So, what do you think? Is Black Star’s suggestion a good one? And if it is – who can start it off and give it a go?

PS: the support sites I mentioned:

Kooth - online counselling for young people in Powys.
Harmless - a national voluntary organisation for people who self harm, their friends, families and professionals.

Recover Your Life - one of the biggest self harm support communities on the internet.