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

Thursday, 22 October 2015

Harts and Craft - Diane's story


Diane Hart, volunteer and member at Ponthafren Association, a mental health charity in North Powys, writes our guest blog post this week. 

Hi! My name is Diane and I have been a member of Ponthafren for five years now.

When I first attended I was in a very bad place in my head, I couldn't see the point in anything. It has only been recently that I have been able to see a future. My Community Psychiatric Nurse thought it would give me something to do and a reason to carry on.

For a very, very long time I was very shy. At first I just hid behind the laptop, which as a member I had use of, and I only spoke to people when I was spoken to. I still hide behind it sometimes but it is more of a safety blanket rather than a protective shield.

Slowly over time I joined in some art and craft classes which gave me a reason to attend Ponthafren. Back then they were not accredited so the number of people who attended didn't matter, which was a good thing because there were not many who were interested in learning how to make felt, or silk painting. Gradually I joined in other classes like sugar craft where I learnt to make edible flowers. The classes eventually became accredited and I now have three certificates for sugar craft.



Around that time I also joined an adult literacy class. Not that I had a problem reading or writing, but the tutor said he would help with interview skills and confidence building. Well, it did some good because my tutor asked me to give a ten minute talk to the other members on how my art and craft classes were helping me, which I did, and this became the first of many.

Because of my talk a very special lady, who became my friend, saw me and asked me to join the committee of Powys Mental Health Alliance. I did this for a couple of years before other commitments and ill health stopped me from carrying on.

Then, because of changes going on at Welshpool Ponthafren, classes stopped for a while and I found things very hard to cope with. I was having a bad time when someone from Newtown Ponthafren called me and asked if would I like to join a class they had there. I thought they said Arts and Crafts, but what they actually said was Art and Design. I was told that if they couldn't get the numbers up the class would have to stop. I knew how important classes were to me and I felt for the people in the group so I immediately said yes. 


Needless to say I had a very big shock when I realised my mistake. I was not only nervous attending a new place and meeting new people but to find out the course I had agreed to was a Level Two BTEC in Art and Design and they were already six weeks into it. I thought it wouldn't be too much of a problem as there were only a few weeks left. The other courses I attended only lasted ten weeks. I was reassured that I would be OK - I had an advantage over the other girls as I had a painting portfolio under my belt so I could use this as part of my work. I told my teacher at the time that I knew nothing about art but again I was reassured and I decided to stay.

Perhaps if I had known then it was going to take 18 months I might have thought differently. I am glad I didn't know as it was a challenge but one I am pleased I met.

After a few weeks the teacher left and the new lady did things differently which at the time I found difficult but over time I warmed to her. Esther Thorpe opened my eyes to appreciate art. Even if I didn't like the style, I learnt to understand and appreciate it. With Esther's encouragement I have experimented in different techniques of painting and drawing. Recently I have dabbled in sculpture which I not only found therapeutic but I found I wasn't bad at it. So, over the last couple of years, I have mounted up thirty four certificates so far.

Apart from the BTEC the others were ten week courses of card making, calligraphy, pottery, sculpture, painting, drawing, paper flower making, and jewellery making with recycled paper. I also attended computer classes to refresh my skill and learn new skills like digital photography and playing with my pictures on the computer.

A couple of years ago I also started my own class where I teach others arts and crafts in Welshpool Ponthafren, putting to good use what I have learnt. 

I have also had the pleasure of working with an artist painting a mural celebrating 60 years since the last commercial steam train went through Welshpool. This is up for posterity and although not many know I had a big hand in it my friends know and I now have the confidence to point it out to people at the side of Welshpool Library.

Last year I attended a 4 day course which, apart from my BTEC, was one of the hardest courses I attended. It was not that the work was hard but I wasn't sure of myself. However, now I am a volunteer support worker at Welshpool Ponthafren and I know it was the right thing to do, for not only is it giving me the confidence to socialise I am attending more courses to help me become a better support worker.

I am still attending classes teaching and volunteering and I am now the chair person of a small volunteer group called Meeting Point Montgomeryshire. Last month I also joined a creative writing and poetry group. I have already had some of my work published, so who knows what the future holds. I am also helping to make things for the Welshpool Carnival next year. This is not connected to Ponthafren but through Ponthafren I met people who asked me to get involved with outside interests. In a way though it has everything to do with them because it was through them and other agencies that I feel able to do what I do. Even though some days all I want to do is crawl up in my bed and stay there having responsibilities and reasons to get out of bed has been a literal life saver.

Throughout July this year I did probably the hardest thing I have ever done and that was to go to shops in Newtown and Welshpool canvassing for money for charity. I had pledged to shave my hair all off to raise money and in doing so I raised £700.00.

I still have bad days but, as my CPN says, we all have blips and if we can see them as that they don't seem so dreadful. All I know is, five years ago I wouldn't have dreamt of being able to write what I have written, never mind see myself doing what I have done, for I saw no future for myself.

So I would like to say a big thanks to Ponthafren for all the help they have given me over the years and a big thanks for not seeing my visual and physical disability as a problem to becoming a volunteer.

And to you reading this - I hope it helps you to see a more positive future, for if I can do it so can you. I think life can be like climbing a mountain. It looks impossible but if you only look at one step at a time before you know it you have reached the summit. Don't worry if you slip a few times. I did many times. It’s not the slipping that matters, it's the getting up that counts.

Blessed be - Diane.

Many thanks to Diane for sharing her story with us. If you would like to tell us your story, then please get in touch.


Photos of Diane's art and craftwork courtesy of Diane Hart.

Thursday, 8 October 2015

World Mental Health Day 2015


Saturday 10 October 2015 is World Mental Health Day, which is organised by the Mental Health Foundation in partnership with the World Federation of Mental Health and the World Health Organisation. This year’s theme is Dignity in Mental Health. The MHF states:

“We believe that effectively supporting people experiencing mental health problems is on target to become one of the greatest public health challenges of our time. Stigmatising and discriminatory treatment can be particularly distressing when a person is experiencing a health crisis.

We all have mental health, and by failing to treat people with mental health problems with dignity we make it more difficult to ensure that everyone takes steps to safeguard their wellbeing and to seek help, as it can lead to self-stigma, low confidence, low self-esteem, withdrawal and social isolation.”


The World Federation for Mental Health has published a collection of papers under the heading "Dignity in Mental Health" from "expert authors who show that dignity in the mental health context can have many meanings and can be applied to every aspect of care." There are contributions from all around the world - including for the UK - Professor Mike Pringle CBE on "Mental Health for All: Mental and physical health parity - the role of General Practice".

The definition of dignity, according to one of those handy online dictionaries, is: “being worthy of honour or respect”. In our day-to-day lives we all expect to be treated with dignity, and it follows on from that – so we would too if in contact with any services we seek in relation to our mental health.

But provision of mental health services is complex and linked in to the laws of the land. Staff are often desperately firefighting due to cuts and increased paperwork, sometimes they barely have time to even talk to their patients…. The very fact that this theme has been chosen for World Mental Health Day 2015 suggests that there are issues around being treated with dignity whilst distressed.


Mental Health Foundation Tea & Talk initiative
for World Mental Health Day
What does it feel like, not being treated with dignity? It might feel that:

I am not being listened to

My colleague Jane Cooke says: “I think the fundamental thing for me is the quality of listening - and acknowledging that I am saying what I am saying - I think my dignity is affected when people reply with something like “So it’s about…” and then telling me what I said. It means that I am not heard - I’ve been put into a box.”

I have been labelled

Perhaps I have been told I have a specific diagnosis or disorder. I might not agree, but I might need the diagnosis to access further support or other services. I have to compromise to make a step towards recovery. In North Powys young people are fighting back against being labelled – those involved in the Young Adult Peer Support project at Ponthafren Association made a video called – “I don’t let mental health define me” in which young people challenge stigma with the powerful message: “Everyone has mental health.”

I am just a number, an entry on a list, without individuality or identity

It is all-too-common anywhere in Wales, not just in Powys, to be on a waiting list for psychological or talking therapies if support of this kind is considered appropriate. People in this situation can feel isolated, forgotten, and helpless. They don’t know where to turn. But just communicating with people can be helpful, as Jane found out at an event she helped organise earlier this year specifically to look at issues relating to the waiting lists.

I might lose my freedom

I no longer have control over my life – perhaps I am forced to take medication against my wishes or engage in activities which don’t interest me. Ultimately I may lose my freedom if I am detained under the Mental Health Act. Derek Turner and Jan Rogers wrote about the value of Advance Statements for crisis planning recently, whereby people are able to make their wishes clear in a written statement which could be referred to in times of mental health crisis. In this way someone experiencing mental distress in a public place could be supported with dignity rather than arrested and perhaps “bundled into a police van.”

I am not valued – by family, friends or staff with whom I come into contact… My self-esteem has hit rock bottom…

On Maple Ward at the Longley Centre, Sheffield Health & Social Care NHS Foundation Trust has developed ‘Dignity Steps’ which translate the views of people using the service into actions for improvement. It’s a lot like the approach taken by Powys Patients Council here, where mental health inpatients meet with experienced volunteers to talk about improvements they would like to see on Felindre Ward at Bronllys Hospital in South Powys. Rhydian Parry, who is a rep on the National Mental Health Partnership Board, wrote about his experience of volunteering on Powys Patients’ Council.

Together for Mental Health is the Welsh Government strategy for improving mental health and a vision for mental health services across Wales. Objective 13 of the national outcomes states:

“Service user experience is improved, and safety, protection and dignity are ensured and embedded in sustainable services.”

The ambition is there, but what is the reality actually like? Identifying the problem, in some ways, is easy. Much harder is thinking of solutions… but there are lots of ideas on the Social Care Institute for Excellence website – take a look and see what you think.

If you have been in contact with mental health services, do you feel you were treated with dignity? If yes, great, tell us about it and we can spread the news of some good practice! If not… why do you think this was so, and what could be done to improve things?


Brecon & District Mind is hosting a Mental Health Awareness Morning to mark World Mental Health Day this Saturday 10 October, 10am - 2pm at Brecon Guildhall. Tea and coffee available. All welcome.

Thursday, 1 October 2015

More Harm Than Good

A couple of weeks ago our guest blogger, Anne Watmough, went along to this London conference - More Harm Than Good: Confronting the Psychiatric Medication Epidemic, organised by the Council for Evidence Based Psychiatry (CEP). The CEP website reports: "Global leaders in the critical psychiatry movement met for a one-day conference to address an urgent public health issue: the iatrogenic harm caused by the over-prescription of psychiatric medications." Anne kindly sent in a review of her experience of the day - read on.

I set out on Thursday the day before the conference at 9 o'clock in the morning and boarded the bus direct to London. My journey took five and a half hours. But I didn't mind as the coach was very comfortable.

I arrived at my small hotel to find my room cosy and spotlessly clean. I had a nice meal that evening at a Moroccan restaurant on King Street.

The next morning I rose early and went out to have a full English breakfast at a nice cafe. Where the chips were delicious. I allowed myself to eat this food because I was a traveller.

Then I took a taxi to Whiteland College, part of Roehampton University, over Hampstead Bridge.

I arrived to an empty auditorium - one of the very first people to get there. Then two women came to sit down beside me. These remarkable women both had sons like myself affected by psychiatry and psychiatric medications.

Amy, a most young looking natural blonde lady despite all of the transgressions her life has held, explained she was prescribed psychiatric medications whilst she was pregnant with her son. He was born handicapped and she has had his lifetime to regret what happened to her when she was most vulnerable and carrying him inside her.

She has devoted her life to caring for him.

The second woman I met was Jemima and she explained how she was fighting for her son who had had a bicycle accident when young. He was left disabled and in a wheelchair. She felt that when he was prescribed psychiatric medication his disabilities were made worse. How horrendous for a woman whose son was disabled for her to watch him become more disabled due to side effects of medication that is supposed to keep him healthy.

I listened to the wonderful speaker Peter Gotzsche and how he is fighting for the rights and care of people like myself. To keep us free!

There were several speakers who were educated renowned men.

But one of the speakers who most impressed me was the renowned American journalist Robert Whitaker. He wrote "Mad in America" and "Anatomy of an Epidemic". He has researched and investigated psychiatry and psychiatric medications. And the drug industry. He has a website - Mad in America - and his work is also on this along with that of other people. The epidemic of labelling and drugging is rife in America and also in Europe. More and more people suffering from normal emotional problems are sent to their GPs who go on to prescribe medications like anti-depresssants or refer them to a bio-psychiatrist. These medications do more harm then good. This award-winning journalist can be found also on YouTube.

The main speaker, and a man I totally am devoted to, was Dr. Peter Breggin. He came through from America on Skype. He couldn't attend because his wife Ginger was unwell and he felt he had to be by her side. He gave his talk and as I expected the audience gave him a rapturous applause.

Then he was up for some questions. I was the first to put up my hand to speak. The sound effects were an issue on that day and at first he couldn't hear me but I managed to speak loud enough and clear enough so my question could get through.

First, and this is the first time I ever had a chance to speak to him, I wanted to tell him I have read his books. "Toxic Psychiatry", "Your Drug May be Your Problem", "Withdrawing off Psychiatric Medications" are just a few of his wonderful writings. I have his latest book in front of me -  "Guilt, Shame and Anxiety" - which I think is his best book yet. My favourite being "The Psychology of Freedom" which he wrote in 1980 when my son was born. Which makes it 35 years old. Somehow my question got through to him despite the sound situation. And he answered me giving me hope about my own current brain damage.

Dr. Breggin has been a psychiatrist working in New York for 61 years. He started at the young age of 18 at Harvard University and went on to train. He never prescribes medication or sends off his patients to be incarcerated. He has never had a suicide on his books.

Which in my opinion makes the man incredibly remarkable.

After the joy of speaking to Dr. Peter the conference went on with the panel and people asking questions.

I am afraid my anger got the better of me on that day although I passionately expressed myself and did keep it in check. It is recorded on YouTube under the title of this article.

My son I feel has been damaged by psychiatric medications. And that they stirred in him mania which he may not have suffered from if given talking therapy which was suited to what ailed him emotionally at the time he was in crisis.

I have been in therapy these past two years and I feel I will never have another psychotic episode.

I became aware at the conference of the wonderful Sandra Breakspeare and her dream of starting up a farm called Chy-Sawel in St. Ives, Cornwall. Chy-Sawel is Cornish for ‘House of Health giving.' Sandra's son is incarcerated as we speak and has been in an institution over these past ten years. Which without a doubt makes this remarkable woman even more amazing.

This is an alternative to medication and is the way forward and will help millions. Anyone interested can find details online. Please do all you can to promote this.

I am also aware of Open Dialogue Therapy which is curing, with a 86% result, people who are suffering from first diagnosed psychosis. This is the way forward also. This nursing approach by psychiatrists and psychologists and trained nurses has been working in Lapland, Finland these past 20 years. It is slowly being introduced to the NHS in this country. Sandra is embodying this into her farm. Which is a non-profit making charity.

Open Dialogue UK is holding a conference next February in London. Anyone who wishes to attend can find details online.

I would say that not only has my therapy been a way forward to recovery for myself but attending this conference has also been life changing.

Simply Google Dr. Peter R Breggin psychiatrist, Robert Whitaker American journalist psychiatry, Open Dialogue Therapy Lapland Finland and Chy Sawel. And you will find these people.


Anne Watmough


Many thanks to Anne for telling us about this interesting day. If you want to find out more, you can watch videos of the event on the CEP YouTube channel.

Some names have been changed to protect the privacy of individuals.