World Mental Health Day 2018 - students, young people & mental health

Earlier this month we celebrated World Mental Health Day on Wednesday 10 October. The World Federation for Mental Health is the driver behind this important awareness day.

The theme this year was “young people and mental health in a changing world.” So what better place to raise awareness about caring for the emotional health and wellbeing of young people than the two college bases in Powys – Newtown in the North, and Brecon in the South. We worked closely with colleagues at NPTC Group of Colleges, which is one of the largest Further Education providers in Wales, to run an information event at each campus.

Brecon High School pupils on a visit to the Brecon college campus

The day was a great success. Rather than write a long blog post, I am posting photographs and feedback from some of those who attended to capture a flavour of what happened on the day.

Julia Gorman (Ponthafren Association), Claire Powell (Community Connector),
Jen Hawkins (PAVO), Sarah Dale (Individual Rep), and a student from the Newtown college campus

Jen Hawkins, Health & Social Care Information Officer, PAVO

It’s good to talk, especially when it comes to mental health. Emojis and cake provided the perfect way to start conversations around mental health at Newtown College as part of PAVO’s World Mental Health Day event.

Cake was definitely an added advantage with lots of people initially attracted by free cake to start their day but it soon proved a perfect way to begin to talk about feelings.

An Emoji wall of fame provided a great backdrop for students and staff to identify how they were feeling in a supportive, open way. Before long the wall was soon covered with a colourful range of post it notes that covered a whole spectrum of emotions. It was great to read all the positive comments, where people were feeling great, happy and excited but poignant to have people share that they felt broken, numb and worried or anxious. This was a good opportunity to point people in the right direction of supportive services such as the college counsellor and third sector organisations like Ponthafren Association.

Comments were also received in Arabic and Spanish, which just goes to show that no matter what language we may speak it’s good to talk about mental health.

Claire Powell, Community Connector - Newtown, Llanfair Caereinion, Montgomery

I was surprised at how well some of the students were able to express how they felt using just one word and it gets you thinking - do they have enough opportunity to express their true feelings in a safe and supportive environment..?? I work with adults over the age of 18 but the event really opened my eyes to the daily challenges faced by younger students, and also how important it is for them to know where to go for support.

It was fantastic to hear that so many students are already volunteering and are looking for more opportunities to do this to give back to the community. 

Lisa Harding & Debbie Rees, Children & Adolescent Mental Health Services

Lisa Harding, Team Leader North Powys, and Debbie Rees, Support Worker - Children & Adolescent Mental Health Services (CAMHS)

We felt the day was fantastic in relation to networking with other agencies, putting faces to names! So that we can communicate on a regular basis.

It was great to make contact with the young people of north Powys from the age of 16+. What we felt went well was the connection with the lecturers asking questions about the young people they support day-to-day in relation to their mental health, offering advice and support.

One of our service users came to see us while there, to say ‘thank you’ for all the help and support from CAMHS.

The day was positive and productive in nature.

Hazel Osborne, College Counselling Service, Newtown campus

Hazel Osborne, College Counselling Service, NPTC Newtown

It was great to see a presence of many local mental health services at this event.

Our students very much enjoyed the cake and engaged with the mood board. It felt an important chance to continue developing a normalisation of accessing these sorts of services and an opportunity for us to further deepen the students’ awareness of the counselling and support services available on site.

Danielle Lewis & Neil Rees, Detached Youth Work team, Powys County Council

Rosemary Denham, Student Services Manager, NPTC Group of Colleges

The day was really positive for our students. PAVO had invited the professional organisations, and our own Health and Social Care students decided to be involved as well. Having these young people taking part meant that it was easier for other students to engage in the event and speak with the outside organisations without feeling embarrassed. It was a very good mix.

Spin-offs included:

• The Newtown Health & Social Care students gave an on-the-spot donation to Ponthafren – this was money that had been proffered for the lovely cakes which they had provided themselves and were giving away at no cost.
• Our Enterprise Officer is running a project near to Christmas and the funds raised there will be given to a mental health charity.
• Our college subject tutors had the opportunity to network with professionals working in the mental health field, and arrangements have been made for talks to be given by the organisations to specific student groups in the coming weeks. 
• Our college counsellors were also able to discuss their work and referral pathways to outside agencies. 
• Our student welfare staff re-established a working relationship with the Powys Teaching Health Board C-card organisers and ensured a renewed supply of condoms.
   

Sophie Jones, PCSO, Brecon Neighbourhood Policing team

Emojiis on a blank wall prompted students to comment on their feelings – 62% said they were happy, 8% were hungry – and 32% expressed negative emotions (including being stressed, anxious, tired, paranoid, depressed, worried) – this highlighted the need for the college to do all we can to help with mental health awareness.

PAVO offered the opportunity to work with our Health and Social Care students on volunteering, and also mentioned the possibility of a work placement in Llandrindod Wells.

I was invited to feed back on the day to Louisa Kerr from Powys Teaching Health Board, Vanessa Young from the NHS Confederation, PAVO and staff from mental health services in Mid Wales .It was a great opportunity to reinforce the need for improved mental health services for young people.

Thanks again to PAVO, I also attended the NHS Wales/Powys Teaching Health Board workshop in Builth Wells to contribute to the Powys Sexual Health Improvement Plan about services available / needed for our young people.

Louisa Kerr (PTHB), Vanessa Young (Welsh Confederation), Owen Griffkin (PAVO), Rosemary Denham (NPTC Group), Melanie Davies (PTHB), Lucy Taylor (PAVO), Jolene Duggan (PTHB)

Gateway/Foundation students at Brecon College

• Good information given.
• Excellent day.
• Seeking awareness for students with mental health issues.
• Excellent advice on the stalls.
• Good advice given.
• Fun.
• Interesting.
• Helpful advice.
• Fun activities.
• Informative.
  
  

Kemal Keeble from Rekindle chatting to some of the students in Newtown

Kemal Keeble, Recovery Practitioner, Small Steps Project, Rekindle

It was really great to be a part of the World Mental Health Day at NPTC. It opened the door to many conversations about "what positive mental health means to many of the students" and insight into the work we carry out at Rekindle's The Small Steps Project. It was lovely to see so many young people getting involved and gaining a greater understanding about what services are available to them within the community they study and live in.

Suzanne Fairclough (R) and colleague from Sexual Health Services, Powys Teaching Health Board

Suzy Fairclough, Development Officer for Sexual Health & Support to Perinatal Mental Health, Powys Teaching Health Board

It was a pleasure to attend World Mental Health Day on the 10th October with information boards on Sexual Health Services and to have the opportunity to speak and hand out information to the young people on this subject and explain how Sexual Health links in with mental health, health and wellbeing. 

Abby Sims & Lorna Jones, Mid Powys Mind

Lorna Jones, Youth Worker, Mid Powys Mind

It was a good day with great networking and a privilege to meet young people who wish to make a difference with the outlook and positive attitude toward mental health. 

Lucy Taylor, Senior Officer Children & Young People, PAVO

Thank you to all the students and organisations that joined PAVO in making our World Mental Health Day celebrations with NPTC Colleges in Brecon and Newtown a success. It was so good to see everyone chatting about wellbeing, mental health and just how they were feeling that day. Our Emoji walls captured an image of "How are you feeling today?" 

We would be really pleased to know how you felt the day went and whether you would like to partner with PAVO on future events/ collaborative working? Comment in the box below, or contact us by emailing mentalhealth@pavo.org.uk or ringing 01597 822191.

Self-harm research project - SHARE UK - can you help?

by guest author Amanda Marchant

I'm Amanda, a PhD student and research assistant at Swansea University. I run the SHARE UK webpage, Facebook and Twitter accounts. I also work on other research projects looking at childhood and adolescent mental health, self-harm and suicide prevention. As a team we want our research to help improve mental health support. 

Reports out in the summer suggest that 1 in 4 fourteen year old girls and 1 in 10 boys have harmed themselves in the past year. Self-harm is very common but research suggests that up to half of young people who self-harm don’t receive help from anyone. 

We want this to change and for this we need your help! SHARE UK is a ground breaking study looking to learn more about self-harm from people who have experienced it themselves. We want to make a real change but we need you to help us learn about what would make a difference to you. This could be better support in hospitals, schools, anti-bullying policies, help online or maybe even some new ideas! 

The study can be completed all online and you can tell us as much or as little as you like. If you have any ideas or comments or if you would like to write for our blog then we’d love to hear from you too at shareuk@swansea.ac.uk

The UK's first self-harm research register – over 200 people strong so far! 

The most important part of any research with self-harm is real people. We can’t make change without you to tell us about your experience. We have created a register that gives everyone the chance to sign up to hear more about future research and studies that they might like to take part in. People can sign up online and we hope that this will give everyone a voice in research.

We have had over 200 people sign up already and this is amazing! Research is an important part of the push for services, government spending and how support is organised. If as many people as possible take part then we can make this push for change even stronger.

What you guys say

We’ve had some amazing feedback and ideas from you guys especially from our feedback survey where you get to write pretty much whatever you like! Here are some of our highlights:

‘There needs to be more work on the barriers to finding help for self-harm. Things could change to help people engage with services.’

‘There needs to be more community based mental health education classes. This could improve social skills, confidence and give people a chance to support one another.’

‘There needs to be more support for new mums.’

‘The topic of self-harm is very important to me and to so many people. Thank you so much for working in this field!’

The good? Not so good? Dark or not? Role of the internet

World Suicide Prevention Day brought about a lot of debate about the press and the internet and the way we talk about suicide, self-harm and mental health. Creators of content online can reach so many people and have an important role in starting conversations and reducing stigma. This doesn’t always happen though and there have been several high profile cases of online bullying, predators and other dangers conjuring images of a dark and precarious online world.

We want to know more about what you think. What’s good and what’s bad? This can help to make guidance for bloggers, internet service providers and anyone who makes content online for how best to talk about suicide, self-harm and mental health in a sensitive way.

By learning more about how people use the NHS we can help to make it better. Every time we use the health service data happens. This can be from a seeing a GP to visiting A&E or staying in hospital. This data has been anonymised and secured to be used for research.

Here at SHARE UK we want to take this even further. We are giving people the option of linking the information from the SHARE UK site to anonymised healthcare data. All the information is separated from personal details so even our researchers cannot identify anyone. The possibilities for research from this anonymised data are huge and it means that we can give extra meaning to the information collected from the NHS. This could help us make a real impact on healthcare.

To learn more we have created a Pinboard style dashboard where you can add anything you have viewed online to our media databank. Anything you upload will only be seen by you and our research team and you can add comments about sites or groups if you want to. We use this databank to look at things like quality, images and potential for harm or for support.   

Want to know more? 

We need your help to make a real difference. Your story can help make sure that in the future no one has to face self-harm alone. 

If you are aged 16 or over and would like to learn more or sign up visit www.share-uk.co.uk or email shareuk@swansea.ac.uk 

Introducing SilverCloud – online Cognitive Behavioural Therapy

Becka Williams, Project Manager, SilverCloud CBT

Last month I was pleased to accept an invitation to attend a Mental Health Partnership Board meeting at our Llandrindod offices, as it gave me the chance to find out more about the new online Cognitive Behavioural Therapy offering in Powys. It is called SilverCloud. 

Becka Williams, the Project Manager overseeing roll out of this new service across the county, gave us some background, an update on project progress and outlined plans for future development.

It was an interesting session to learn more about the new service, as individual representatives attend this quarterly partnership meeting. The reps are people who either have used, or care for somebody who has used, mental health services in Powys. Their role is to make sure user/carer voice is included in the planning of services, and here they were able to voice some immediate thoughts about online CBT.

Joy Garfitt, Assistant Director of Mental Health Services for Powys Teaching Health Board, began by explaining that CBT is a therapy that can help us think differently, particularly if we have unhelpful thoughts.

Background

Some regular readers may remember that we wrote about an earlier provision of online CBT in Powys, which was called Beating the Blues. This 3 year pilot scheme was spearheaded by a European funded project called Mastermind, but unfortunately engagement with this model was not brilliant. Out of 543 referrals to Beating the Blues, only 100 people completed the full course. Many disengaged with the process and some did not even start after being referred. Mastermind’s key aim, however, was to implement online therapies in rural areas across Europe, rather than to monitor the effectiveness of the actual CBT programme. But the project was invaluable in that many lessons were taken from this early work to help inform a new improved provision of online CBT in Powys.

In fact, many benefits of online CBT were identified directly as a result of the Mastermind scheme:

• Online CBT provides care closer to home – anytime, anywhere. 
• It reduces the number of unnecessary appointments. 
• It gives almost immediate access to therapy for people. 
• It reduces the travel time of people using services, carers and healthcare professionals. 
• It supports Prudent Healthcare – an approach at the heart of A Healthier Wales, the Welsh Government's long-term plan for health and care. 

The Welsh Government is now providing funding to continue and upscale online CBT not just in Powys but across the length and breadth of Wales. Powys Teaching Health Board is leading on the roll-out of SilverCloud across the country, starting with Powys. The aim is to:

• Increase options available to people experiencing mild / moderate anxiety and / or depression. 
• Reduce waiting lists / times by improving quicker access to therapies. 
• Improve equality of access to mental health care across both urban and rural areas.

Project progress 

SilverCloud online CBT went live in Powys on 1 May 2018. There are now 8 programmes available, including Space from Anxiety & Depression, Space from Stress and Space from Chronic Pain. Since the launch about 300 people have been referred to the programme, which can be accessed on smartphones and tablets as well as computers. Referrers can be GPs, Occupational Therapists, staff in the Community Mental Health, Local Primary Care and Long Term Conditions teams. In future people will be able to refer themselves onto the programme.

At this point in the meeting the individual reps began asking questions about managing risk. What happens if someone is considering self-harming? If it’s midnight? If someone is extremely lonely and this is all they have been offered to deal with their depression or anxiety? Joy described the online CBT as “adding another tool in the box for people”. It might not be right for those wanting face-to-face talking therapy, but others may prefer to do it privately. It is not aimed at people experiencing severe and enduring mental health issues. If someone has complex needs they will be referred to a different service. They may still access SilverCloud CBT but as an additional therapy to enhance what is already being done by mental health practitioners working to provide care in primary (via GP services) and secondary (via Community Mental Health) teams.

From day one when people register on SilverCloud, they have access to all the programmes for 12 months. Staff closely monitor their engagement with the platform for 3 months, but people can provide feedback for the whole period. Risk alerts are set in place, so that if anyone expresses an intention to self-harm they are contacted straight away and referred to a health care professional as appropriate. The service is monitored between 9am – 5pm during the week, but details of support / help out-of-hours are provided. Online CBT is not designed as an emergency response service.

People can write in journals as part of the programme, and choose to share (or not) the content with the online CBT co-ordinator. Some online content, such as the Mindfulness videos, can be downloaded onto a computer for future use. If access to an online device is not available people can use computers with privacy screens at their local libraries and further options will be available at Job Centres ultimately. Regular online reviews take place with the co-ordinator, and phone conversations are also possible. The whole process is confidential unless policies around safeguarding issues and / or criminal intent are set in motion.

Future development

Work is currently underway to further develop some of the strands of the online CBT, including:

• A combination of online CBT and face-to-face counselling, known as ‘blended’ counselling. The health board will be working with third sector organisations to provide additional support to some people using SilverCloud CBT. 
• The self-referral model for those who do not see their GP or access any other help. This will be the first time in Powys that open access is given to such a service and should be available in the New Year. 

Whilst Welsh translation of relevant forms and help pages has already taken place, the platform as a whole now needs to be translated. The design and roll-out of an All-Wales SilverCloud online CBT platform is then the key next step.

And, importantly, Becka is very keen to receive feedback from people who have used SilverCloud CBT, to help inform future development of the online provision in Powys and further afield.

If you have used SilverCloud online CBT and would like to let us know what you think, you can email us at mentalhealth@pavo.org.uk Alternatively contact Becka Williams directly at becka.williams@wales.nhs.uk

And what are your thoughts on online CBT generally? Let us know in the comments box below.

Feedback about SilverCloud CBT 

I found SilverCloud very easy to use and was surprised at how well developed and researched the platform was. 

I have found SilverCloud hugely useful in teaching me ways to improve my mental health and managing stressful situations. I am excited to continue using the skills I’ve learnt. 

I have been feeling more positive since taking part in this programme. I have been able to do simple things like taking the bus and going for a walk alone a lot more easily than about a month ago.