NHS 111 Press 2 - mental health support in Powys

We recently welcomed Marielle Restall, NHS 111 Press 2 Team Lead for Powys Teaching Health Board, to our Health & Wellbeing team meeting to give us an update about this relatively new service in Powys.

What is 111 Press 2?

111 Press 2 is a mental health service available 24 hours a day, 7 days a week, for all ages. People can use the number if they have an urgent mental health concern for themselves or someone they know. It provides access to a mental health professional without the need for a GP referral. It can help people to support mental health crisis and in many cases be an alternative to attending emergency departments or calling the police.

The service can be accessed by calling NHS 111 and selecting option 2. Callers are then transferred to a dedicated member of the mental health team in their locality. The call includes an assessment of needs and a telephone based intervention to reduce stress. Where appropriate individuals can be referred to mental health services, given self-care advice or signposted to other support.

Why do we have 111 Press 2?

It came about following the publication of a report called Beyond the Call. This took a snapshot in Wales of where people presented in mental health crisis. People presented to 17 different places in total, including the police, Welsh Ambulance service, C.A.L.L. Helpline, Psychiatric Liaison Teams and others, which shows that it was not clear how to access mental health services appropriately.

The idea was to provide one number across Wales that’s easily accessible and people know they can rely on to access mental health support. This would then also reduce pressure on police, ambulance and other emergency services.

Beyond the call report, 2020

Who can call 111 Press 2?

Anyone, any age, registered with a Powys GP or visitors to Powys, can call 111 Press 2. If you are calling about someone else the staff can only give advice, they need to speak to the person directly concerned to make referrals to other services.

We take calls from any person registered with a GP in Powys, or visitors to Powys, whether they are known or not to mental health services. 111 Press 2 can refer on to any of the services within mental health. They are encouraging people to call 111 Press 2 as an alternative to attending their GP. People are triaged by a mental health practitioner and onward referral is made if required. Some GPs are actually redirecting people who call in to surgeries to access support. It’s important that the general public know that if they call 111 Press 2 they can be referred anywhere and receive any support. An exception would be if it is a medication query, for example, the person may have commenced medication and want to discuss this further with the GP.

We are working with the Powys Child & Adolescent Mental Health Support (CAMHS) Schools In-Reach team to help spread the word in schools about the service, and CAMHS teams are also promoting it.

There is a separate dedicated Professionals’ Line which is prioritised in the call queue. So far in Powys it is available to GPs, the police and the ambulance service. Currently an average of 2 calls a day are received by this line, so further promotional work is required to spread the word.

The call handlers are using an interpreting service called LanguageLine to provide support to people who speak a language other than English or Welsh. The issue is whether there is a translator available at the time of the call.

There are two Welsh speakers in the team. People can request a Welsh language speaker when they call which would take them directly to a Welsh-speaking call handler.

What can 111 Press 2 do?

• Conduct a mental health triage to assess a person’s needs.
• Provide a therapeutic conversation.
• De-escalate crisis situations (and reduce pressures of A&E and emergency services).
• Give advice on how to improve and maintain your mental wellbeing.
• Signpost to Third Sector services.
• Refer directly into mental health services for a mental health assessment, eg: Local Primary Mental Health team, Community Mental Health team, Crisis Resolution Home Treatment team, Perinatal team, Early Intervention Psychosis, Eating Disorder Services, Child & Adolescent Mental Health Services single point of access.

What 111 Press 2 cannot do

There is no face-to-face or video calling service available. Staff cannot prescribe medication - a referral would be made to mental health services or advice to attend the GP surgery or call ShropDoc out of hours.

111 Press 2 does not call people back at others’ request - the person must call themselves.

Is 111 Press 2 a listening service?

The service is different to CALL Helpline or other listening services. It is a mental health triage service so you would expect a person to ring with a mental health need.

The practitioners will always listen to the person calling and seek to support them with their mental health need whether that be through de-escalation or onward referral to an appropriate service. Callers who are not presenting with a mental health need will be advised to call another helpline or listening service if they wish to.

111 Press 2 seeks to reduce the distress felt by the caller - practitioners use a measure called the Subjective Unit of Distress Scale. It is used as a reflective tool at the end of a call to find out if there has been a change in how people feel from the beginning to the end of the call. If nothing has changed it could be that this highlights areas that have been missed. It gives control over to the person. Nobody’s distress has gone up since the Powys service began. It is about a 50/50 split on - stay the same or decreased. However, not all callers want to engage with this scale, and it is not appropriate for third party callers.

Who’s in the 111 Press 2 team?

7 x Band 5 Wellbeing Practitioners (Support Workers, Psychology graduates, therapists & social care staff).

1 x Band 5 Service Coordinator (administrative).

6 x Band 6 Senior Mental Health Practitioners (with a professional registration in Mental Health Nursing, Social Work or Occupational Therapy).

1 x Band 7 Team Lead (Mental Health nurse).

1 x Band 8 Service Manager (Mental Health nurse).

In a normal shift one of the senior practitioners will be supporting two of the wellbeing practitioners.

Triage scale

Practitioners use a triage scale as a guide to decide how quickly a person needs support.

The majority of the calls (over 60% May 2023 - January 2024) are for advice and information, or advice to contact alternative providers. Emergency responses made up 11% of the calls.

Live Data (May 2023 - January 2024)

We have gathered information about the number and type of calls the team have been receiving since the service started in Powys:

• 3421 calls received in total.
• Calls equally distributed across Powys
• Averaging 19 calls a day.
• On average calls are answered in less than 2 minutes.
• Calls are evenly spread throughout the week, with peak times - 6 - 8pm.
• Age range of callers - 11 years to 95 years.
• Average caller is male, 44 - 65.
• 53% callers active to mental health services, 24% closed to mental health services, and 23% no mental health history.

Highlighting gaps in service provision

The new service has already highlighted the need to the health board of certain gaps in current mental health services, for example out-of-hours crisis care. The Crisis Care team is not available after 9.30pm so by default 111 Press 2 are taking many crisis calls during the night time, as the only out of hours contact for Powys Teaching Health Board.

The team is working closely with other services to identify where the service gaps are so that they can really focus on developing those areas. It’s finding what is working for individuals and what isn’t. 111 Press 2 is in the early stages at the moment but has amazing potential to do great things. In fact, 111 Press 2 is at the forefront of transforming how services are operating!

In summary

111 Press 2 is a single point of access into mental health services for the general public.

111 Press 2 is for everybody.

111 Press 2 provides quick access to a mental health professional 

for advice, support and / or a referral.

Many thanks to Marielle for telling us more about the NHS 111 Press 2 service.

You can find out more about 111 Press 2 on this Welsh Government website.

Llandrindod Lakers: An Invitation to Play.

by guest author Jimi

I would like to invite you to play basketball with us. You’re probably thinking “don’t you need to be 7ft tall?” and the truth is no, you really don’t.

My name is Jimi and I run a social basketball group in Llandrindod Wells. As an adult on the autism spectrum, access to sports, especially competitive sports, has always been challenging. After what was a dark, difficult and strayed 24 years of my life, I was eventually diagnosed with autism less than a year ago and I remember how unhelpful and overwhelming the post-diagnosis support thrown at me was. I was also in a pit of depression and constant anxiety at the time and my bipolar was running free and naked in the boggy marsh of my mind.

Through many other coarse experiences with mental health services, I have found that they can be congested with inflexible bureaucratic principles, galactic waiting times, a lack of resources as well as education and empathy, mountainous referrals and far too clinical to make a real and natural connection with an individual. There is also an addict-like reliance on prescribing pharmaceuticals: the irony.

The signposting on signposting on signposting played out like Dr Seuss’ Green Eggs & Ham, except my ending left Sam-I-Am to his rare refreshment and I decided to go it alone to start writing a new book to break the cycle (neither literary nor literally, just to make that clear).

I’d been in this state too many times for too long, repeating the same patterns that I knew could lead to a fifth suicide attempt. I’d had enough and it was up to me to do something about it or rot. I set off with my figurative notepad and pen to discover what positivity and wellbeing meant to me. Now I must mention here that I didn’t start playing basketball again and my mental health problems disappeared overnight, I don’t want to say it would be impossible but (reluctantly) this would be impossible.

“Know thyself.”

After a men’s process work retreat facilitated by a very dear friend of mine, Scott McGregor, and his counterpart, Laurence Johns, I decided to completely unmask. Simply put ‘masking’ is a strategy many neurodivergent, especially autistic, people do to appear neurotypical in front of others and, in terms of energy and wellbeing, it is decimating.

For me, unmasking has been arduous yet rewarding and I’m still working through it. The retreat itself was at the height of last year’s summer set in the gorgeous hills of Llanafan Fawr, disconnected from the noise of modern life and totally wholesome. This part of my life was a major turning point and with the support of other vulnerable and beautiful men, it showed me that the answers and contentment I’ve been desperately trying to latch on to were actually within myself, not out to the exterior world or with material objects or romantic relationships. I’d been unwittingly running away from that truth my entire adult life.

Enter basketball.

I’ve always enjoyed playing since my friend introduced it to me in primary school. It was different to the other mainstream sports on the playground; the play was faster, more intense, more tactile and we didn’t need to face rejection, we could just pick up our ball and play. It was at the height of the Michael Jordan/Chicago Bulls fever that was gripping the globe and a popular interest in basketball was gaining traction here in the UK. Other kids soon took notice and, of course, we let them all join us.

Fast forward to 2023. I mentioned in passing to a then work colleague, now teammate, how I wished to play again: serendipity rides shotgun. He invited me to come along to play with a group down the road, the Builth Bulls, and after that first session back my fire was reignited.

Once a week could not sate my appetite for hitting those sweet buckets so a few of us ‘Llandodites’ decided to set something up closer to home and more regular throughout the week. Within a month I was finding a direct correlation between the progress I was making during practice and the progress in the rest of my life.

As more players were stepping onto our court, I kept thinking about all the other people in similar situations to me who perhaps felt that the system was letting them down, especially in a rural area such as ours. I feel obligated to do more to let them know that all their eccentricities, fears and insecurities are so welcome on our court. Basketball can take you through a lot of emotions and feelings; frustration and elation, fatigue and determination, inflation and deflation, anger and humour. It’s good to recognise them and work through them in a safe way. You work a lot with action and reaction which are very valuable tools you can then use out in the world beyond the court.

So this is what I’m offering my fellow neurodivergent peers; the opportunity to play in a space where it doesn’t matter who you are or what’s going on off the court, for an hour only basketball matters. A supportive environment to compliment whatever care or health journey you find yourself on. If you don’t relate to any of the issues I’ve spoken about, that truly is wonderful and of course you are welcome to play with us.

Psychologists and teachers say that children learn through play, but I find that to only be a half-truth: people best learn through play. I’ve learnt more about myself through sharing experiences where my sense of humour and curiosity can move freely and being inspired through connecting with others, Llandrindod Lakers has been a huge part of that and I hope anyone reading this will find their power within to do something new. Play.

Helping Mental Health With A Ball - a member's testimony

Becoming a resident to Powys in 2021 I had reached out to several sports and social clubs. Dishearteningly, most of which never got back to me. I re-attempted late 2023, predominantly from a physical health viewpoint and came across a post on a local group solution page regarding basketball. I’ve always been an admirer of the sport from afar but was typically pushed towards either football or individual workouts, for which I had no affinity.

Since joining, I’ve been taken aback of how much the group has helped mentally, from the initial welcome and the encouragement thereafter. I’ve found myself eager and excited for not only the session but week ahead. Which has translated to each aspect of my life. I’m proud to have found great friends here and an outlet for stress, anxiety and healthy competition.

Combining a welcoming group of local people with a sport that has a rich, diverse and inclusive history has surely been a winning experience for me.

Llandrindod Lakers have open basketball sessions on Mondays 6 – 7pm and 

Fridays 6.30 – 7.30pm at Llandrindod Wells Sports Centre.

Find out more on the Llandrindod Lakers' Facebook page.

The value of play to children's emotional wellbeing

by Rachel Maflin, Manager, Play Radnor

“Children need the freedom and the time to play;

play is not a luxury, play is a necessity.”

Kay Redfield Jamison

We know that allowing children time to play brings enormous benefits to children’s development. Play helps children to make sense of the world, through exploration, imagination and experience. It helps children to express themselves, regulate their emotions and cope with their feelings. Playing with others enables them to learn how their behaviour affects others and develop empathy.

Play is vital for a child’s emotional development in so many ways….

• Emotional resilience.
• Self-esteem.
• Self-confidence.
• Reduced anxiety.
• Self-worth.
• Understanding winning and losing.
• Exploring feelings.
• Self-expression.
• Empathy.
• Understanding the world they live in.
• Dealing with fear in a safe environment.
• Problem solving.

The benefits of play can be found in a wide range of play opportunities, such as:

• Playing outside e.g. swinging, climbing trees, running, jumping.
• Pretend play e.g. dressing up or den building.
• Adventurous play e.g. climbing, balancing, rope swinging.
• Group activities - playing with other people helps children express and control their emotions with others e.g. creating their own play ideas.

Activities don’t need to be expensive, the simplest stuff is often the best. We have a low cost / no cost approach using wherever possible loose parts – a variety of objects both natural and man made which can be used in a variety of ways. Loose parts play uses a range of resources that can be found both in nature and around the house, such as ….

• Cardboard boxes, paper, shredded paper.
• Materials – old sheets, duvet covers, shower curtain, wool, ribbons, old clothes for dressing up, bandages for role play.
• Buckets, tubs, tubes, pipes, containers of all shapes and sizes, funnels, plastic bottles, guttering.
• Kitchen equipment – mashers, whisks, pots, pans, sieves – mud kitchens.
• Sand, water, mud.
• Old phones, computer keyboards for role play.
• Crates, tarps, rope / string.
• Great outdoors for sticks, leaves, seeds, moss, shells, stones, pine cones, conkers, flowers, herbs e.g. potion making.
• Chalk, pens, pencils, etc.

‘When children interact with loose parts, they enter a world of “what if” that promotes the type of thinking that leads to problem solving and theoretical reasoning. Loose parts enhance children’s ability to think imaginatively and see solutions, and they bring a sense of adventure and excitement to children’s play.’    (Daly and Beloglovsky, 2015)

Loose parts create richer environments for children to play. As they are flexible, they can be used in a variety of ways, providing limitless opportunities. These play experiences promote imagination and curiosity, problem solving and independence, with children being able to choose their own direction of play.

With Christmas just around the corner, make a little space for play. Like your grandma used to say, they’ll leave the present and play with the cardboard box. It’s often the cardboard box that has the greatest amount of play value.

Play Radnor/Chwarae Maesyfed is a rural children’s charity that provides play, leisure and recreational opportunities for children and young people in Powys. We run a number of projects for children, young people and families both at our dedicated centre in Llandrindod Wells and through our outreach work. These include:

Play Rangers project: Delivering open access outreach play sessions on green spaces within local communities during school holidays.

Thumbs UP! Club: A project for families who have a child with a disability or additional need and their siblings. We run weekly sessions for children aged 5-11 and 12+.

Mud and Sticks: A Children in Need funded outdoor parent and toddler group (0-5) that meets in the woods for regular play sessions. Our aim is to inspire greater confidence in getting outdoors more as a family and develop strong relationships.

Toy Library: a low cost service enabling families to borrow toys and resources that encourage children's educational and social development. These include a wide range of physical, imaginative and multisensory resources.

Wildcraft: A twice weekly group for children aged 5-7 and 8-11 that offers opportunities for a variety of outdoor play. This could include campfire cooking, nature crafts, simple wood working, den making etc. We also run a monthly weekend session for parents and children to attend which offers low cost / no cost ideas for outdoor play.

Cooking Club: Sessions delivered in our community kitchen for a range of ages. Learning important life skills, cooking healthy and tasty food.

Stay and Play / Fun Fridays: Two hour play sessions for children aged 0-5 yrs and their parent/carer to have fun, play and socialise with others. Facilitated by volunteers.

Messy Play – Occasional sessions for parents and children aged 0-5 during school holidays and term time.

It’s Welsh Charities Week - let's celebrate our Powys mental health charities

This week, 13 – 17 November 2023, is Welsh Charities Week! It’s a chance to recognise and share the good work of charities, social enterprises, voluntary organisations and community and volunteer groups in Powys.

According to WCVA, which hosts Welsh Charities Week: “The last few years have seen the sector and country as a whole endure a series of challenges and difficult circumstances. Welsh Charities Week is a chance to recognise and celebrate all the work that people and organisations across the voluntary sector in Wales do to shine a bit of light in the dark. It’s an opportunity to come together and show appreciation, to remind people that what they do makes a difference.”

To celebrate the wonderful work of our Powys mental health charities for Welsh Charities Week we decided to showcase one of the current activities or services available from each organisation. There is so much support out there for people who need help to boost their emotional wellbeing, we need to shout loud and make sure everyone, absolutely everyone, knows about it. We never know when any one of us - you, me, our family and friends, may find ourselves struggling with our mental health and need that support.

So support these local charities, because they support us. Show them some love, because they are lifesavers, literally in some cases. You could help spread the word about their services, you could join in their fundraising activities, you could volunteer at their centres. There are so many ways to celebrate and support their essential work.

Let’s hear more about them. From South to North up through our magnificent and large county of Powys:

Ystradgynlais Mind - In-work support service

The In-Work Support Service is a new, Welsh Government funded service being delivered by Minds in Powys. It is a 2 years’ project focussed on reducing the impact of health issues in the workplace. It is aimed at individuals and businesses, providing therapeutic support for employees and training and advice to businesses throughout Powys.

The new 'In Work Support Service' at Ystradgynlais Mind can help those who are struggling with their mental health whilst working.

The free service provides therapeutic support to help people who are absent from work, or at risk of becoming absent, due to their ill-health.

Head over to the Ystradgynlais Mind website to find out more!

Brecon & District Mind - Mums Matter

Mums Matter is a National Mind programme that was created by Mums for Mums with babies up to two years old to help them to adjust to motherhood. Brecon and District Mind have been delivering it for nearly five years now. The six-week face to face course runs for groups of Mums for two hours each week; childcare is also provided.

There is a strong emphasis on peer support and being able to have honest conversations about the inevitable challenges that come with being a mum – tiredness, perhaps a loss of identity, anxiety, guilt and loneliness.

If you miss a course, there are always new courses coming up. The latest course starts in Brecon this week at the Subud Centre, and there is also a Mums' Social group during term time which is open to expectant Mums too. It's a great place to chit chat and get to know the Family Team at Brecon & District Mind. 

Find out more on the Brecon & District Mind website.

Mid & North Powys Mind - Bereavement Cafe

If you are experiencing grief and loss and would like to connect with others who have, or who are undergoing, a similar experience, why not consider going along to Mid & North Powys Mind’s Bereavement Cafe.

It takes place on the first Friday of every month at All Saints’ Church in Newtown at 6.30pm.

The cafe is part of a Bereavement Support service offered by the organisation. You can be matched with a Bereavement Supporter who will work alongside you, listening and helping you work through your grief in your own way, on a one to one basis. Your Bereavement Supporter is a volunteer who has undergone extensive training.

Each session will last about an hour and will continue for an average of 6 sessions. Support can be face to face and/or telephone/Zoom, depending on what works for you. Anything you say is kept in the strictest confidence, unless someone’s safety is at risk. 

Check out the Mid & North Powys Mind website to find out more.

Ponthafren - the Gym

Ponthafren recently announced the opening of the new Ponthafren Gym at the Armoury in Welshpool.

It has been shown that doing physical activity can help improve your mental health. Physical activity can help with:

• Sleeping better.
• Feeling happier.
• Managing stress.
• Managing anxiety or intrusive thoughts.
• Improving self image.

Ponthafren Gym is a great place to get healthier in a relaxed non-judgmental atmosphere.

Come along and join for a Healthy Mind & Body with Ponthafren. Membership is just £15 per month. You must complete a compulsory induction before using the equipment. 

All you need to know is on the Ponthafren website.

We wish our local mental health charities all the best for Welsh Charities Week 2023! 

Long may they continue to support our communities.

New In-Work Support Service launched at Mid & North Powys Mind

 by Anna Poulton 

In-Work Support Service Coordinator, Mid & North Powys Mind

The In-Work Support Service is a new, Welsh Government funded service being delivered by Minds in Powys. It is a 2 years’ project focussed on reducing the impact of health issues in the workplace. It is aimed at individuals and businesses, providing therapeutic support for employees and training and advice to businesses throughout Powys.

Namrata Bhardwa (Nami) and I (Anna Poulton) are the manager and coordinator for the service respectively and we have recently been employed by Mid and North Powys Mind who are facilitating the service. The In-Work support service will be using therapies offered by regional Minds in Powys to deliver the Mental Health individual therapies and the wellbeing and training aspects of business support.

Anna and Nami

Why are we needed?

The service has been available in other areas of Wales for a while now, and our service now means that all local authorities in Wales have an In-Work Support Service. The Welsh Government is developing a new strategy for Mental Health 2023 and this service, which is also part of Healthy Working Wales, will help to deliver this.

Who can use the service?

Anyone 16 or over who is in employment or off sick from their job, an apprentice or self-employed who lives in Powys can access our support. Referrals can come from anyone, yourself, your GP, your employer, etc. You can contact via the website, email or a phone call to Nami or Anna is all that’s needed. The same applies to businesses, and small/medium enterprises based in Powys are eligible for support.

What support can we offer?

We can offer rapid access to high quality mental health and physical therapies, training and specialist support delivered by Mid & North Powys Mind, Brecon & District Mind, Mind Ystradgynlais and a range of external partners.

We can currently offer:

• Counselling.
• One to One support.
• Supported Self Help.
• EMDR (Eye Movement Desensitisation and Reprocessing) and Hypnotherapy.
• Physiotherapy.
• Osteopathy.
• Employee training.
• Wellbeing advice & support.
• Employment law specialist support.
  
  

The therapeutic support is set out across up to 6 free sessions, and the business support is delivered in a tailored package by either Nami, Mind’s training staff, or Rradar-our specialist law firm – depending on their needs. 

As an example, we could provide advice around employee policies such as creating, updating or overhauling a family friendly policy. We could provide legal advice around HR issues. We could help with implementing wellbeing tools into the workplace such as a Wellbeing Hour. Staff training could be provided to some or all staff; examples of this training are: 5 Ways to Wellbeing, Mental Health Awareness, Tai Chi and other relaxation techniques, Assertiveness Skills and Stress & Anxiety Management and many more which can be adapted to suit a business’s needs.

At the moment Nami and I are meeting and getting to know other services available to the people we will be supporting. This will help us to signpost to further support, provide a continuation of support for people who are receiving support elsewhere and to make sure that we can signpost people to the appropriate support if they don’t match our criteria.

It has been great to meet so many like-minded people and learn about all of the other great support providers in Powys. We have already made some really valuable connections and are continuing to make more and more as time goes on.

We held a launch day at PAVO in Llandrindod Wells on the 4th of September. Nami and I presented an overview of the service to the audience including: local businesses, Mind employees, Welsh Government representatives, colleagues from other support providers such as Department for Work & Pensions and members of the public. 

The launch went really well; I had never presented to a room full of people before so I was very nervous! We started off with a short quiz as an icebreaker which also helped to settle my nerves. The room at Powys Association of Voluntary Organisations was really well set out. It was bright, the technology all worked and we had plenty of space. We had a warm welcome and everybody enjoyed the lunch at the end which was supplied by The Herb Garden. I’d like to thank PAVO in Llandrindod Wells for all of their help.

Who am I?

I’m Anna, I have recently begun working for Mid and North Powys Mind in Llandrindod Wells and have 20 years’ experience of previously working in the adult health care and support sector. My job as Service Coordinator is doing the admin for the service, I run the social media and I meet clients to see if they are eligible. I have also spent some of my time out in the community promoting the service at events such as the Cost of Living Fair in the Pavilion in Llandrindod Wells and in some supermarket foyers across Powys. 

In my spare time I am an animal lover, I have 3 dogs and 2 cats who take up a lot of my time! I am a volunteer for Many Tears Animal Rescue, I check that people’s homes are suitable for the pet that they would like to adopt. I also enjoy craft, especially knitting and making Christmas decorations.

For more information about the service and how to refer yourself, please visit our dedicated In-Work Support Service Powys website. 

‘A place to just be’ - Forest Bathing for everyone

Lucy McQuillan is a Forest Bathing Guide (Mindfulness in Nature) based in West Wales and has been guiding a wide range of groups since 2021. She has a background of 25 years working for National Parks and Wellbeing Projects in community engagement, health and wellbeing in the Inner Hebrides of Scotland, the Lake District National Park, and Exmoor National Park. 

Lucy’s final move has been to the beautiful Cardigan Bay, at Aberystwyth, her partner Dave’s childhood home. She started as an Activity Leader with Tir Coed (a charity that connects people with land and woods (tir, coed) by delivering outdoor training, learning and wellbeing programmes across Mid Wales) last year and was asked to run a forest bathing session at Y Plas Garden at Machynlleth this March. We heard about the event and decided to find out more about forest bathing from Lucy.

What being out in nature means to me

Being out in nature is my favourite place. It grounds me, reminds me of what is important in life and generally maintains my sense of wellbeing, for both my mind and physical body. Recognising the massive benefits of Forest Bathing, and loving being in nature, I decided to train as a guide with Nature and Therapy UK in 2020, gaining my diploma in 2021.

What is Forest Bathing?

Shinrin-Yoku, translated as Forest Bathing, is a practice that originated in Japan in the 1980s as part of a national health programme designed to reduce population stress levels. Shinrin-Yoku literally means ‘bathing’ all the senses whilst immersing yourself in the forest atmosphere.

What happens during a session?

During a Forest Bathing session I take you through a number of invitations between 3 minutes to 20 minutes long (simple mindfulness activities). We follow a framework - a beginning, middle and ending - that makes forest bathing 'a practice' and not a general walk in the woods (which of course is lovely too!). 

As with any practice, repetition helps to build a deeper understanding and ability to 'drop in' to your inner self and connect with nature. I intuitively shape the session to reflect the needs of the individuals in the group and the nature setting we are in. No two sessions are the same. An introductory session can be up to 90 minutes long with longer sessions being 2 to 4 hours.

What are the benefits of Forest Bathing - to you and to our natural environment?

You will experience the health and wellbeing benefits from simply 'just being' in amongst the trees and nature. Benefits of this scientifically proven practice include: reducing blood pressure; lowering stress; lowering blood-sugar levels; improving concentration and memory; lifting depression; increasing anti-cancer protein production; improving pain thresholds; improving energy levels; and boosting the immune system with an increase in the count of the body’s natural killer (NK) cells.

…………And leave us with a deep sense of calm that follows us home…..

By experiencing the ‘awe & wonder’ of being in nature this can lead us to an appreciation of the natural world, and our place within it. And this in turn leads us to have a desire to protect and nurture nature.

Machynlleth Forest Bathing 23rd March at Y Plas

5 people were booked onto this session at Y Plas Gardens, Machynlleth. Fresh April showers, interspersed with sunshine and blue sky, set the scene! My helper Carys and I wondered if the weather would put people off…. We waited at the main entrance. People can tell it’s you waiting for them and one person, two and another two soon turned up and introduced themselves. All were new to forest bathing and all were not bothered by the weather one bit and were intrigued to find out what we’d be doing.

As a guide my role is to slow you down and help you stay in the moment and to open the door to your senses. We started by walking to a start point under some trees, dodging another shower.

After a brief introduction of names, and what had brought people to the session, I started with an invitation to leave worries, tasks, ‘to do's’ at this threshold and to enter the woodland/nature space with no expectations, nothing to accomplish, to just lean into what was being offered and see what unfolds. After some simple breathing and sense awareness we went into the first invitation ‘Slow Walking’ taking time to look, touch and listen to what was around us.

After gathering together again, to share what we experienced, (to share is entirely optional) we moved into the second invitation, by the garden, of Human Camera, working in pairs. One partner led the other, whose eyes were shut, to different photo points. By having your eyes closed, when you do open them, to take your photo, the frame before you is intensified and the sense of awe and being in the moment are nurtured.

We then walked over to a woodland area near the garden, which had a completely different, hushed and atmospheric feel, of which all the participants commented on. Here we finished with a 15 minute ‘Sit Spot’ gently focussing on a chosen focus point – a leaf, a piece of moss, bark on a tree – gently bringing our minds back to this simple activity, when they inevitably wandered. The more you look the more reveals itself to you….

By experiencing the ‘awe & wonder’ of being in nature this can lead us to an appreciation of the natural world, and our place within it. And this in turn leads us to have a desire to protect and nurture nature.

Some feedback from the participants included:

“I enjoyed exploring the different ways to immerse yourself in nature and learnt some great new techniques to share with my children and for myself.”

“A great experience to share with others.”

“Lucy’s experience and calm nature and skill share were a real treat – thank you so much.”

The general feedback on the feedback forms was that everyone strongly agreed that they enjoyed spending time in nature and felt connected to nature, and left with a sense of wellbeing.

Many thanks to Lucy for telling us more about Forest Bathing. You can find out more on her website - Forest Bathing & Mindfulness and Facebook page.

If you have a positive experience of interacting with Nature in Mid Wales, please let us know in the comments section below. We love to hear from you!

Mamwlad - reaching out to support Powys farmers

Photo by Joseph Reeder

It was November 2020 when we first heard about a brand new project called Mamwlad which had been set up in Powys to support farmers and was run jointly by two local organisations – Care and Repair Powys and Age Cymru Powys. Mamwlad means Homeland or Motherland in English.

At the time client data from both organisations had demonstrated 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. Jointly CRP and ACP planned to 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.

The Mamwlad project has worked hard over the last couple of years, despite the challenges of the Covid pandemic in the early days, to reach out to and support the older members of the farming community. Today we hear about a client from south Powys and how the project has supported her. Lesley Price, a caseworker with Care & Repair Powys working on the Mamwlad project, tells us more.

Photo by Helen Davies

Menna lives on a farm near Llanwrtyd Wells, a small market town in south west Powys. She was referred to Care & Repair via Bronglais Hospital in Aberystwyth after a stay there following a fall in which she unfortunately broke her hip.

The farmhouse where she lives had enough rooms to move her bed downstairs as she is unable to climb stairs (she is is hoping to get back to full fitness with the help of an exercise plan she received from the hospital).

A Health Occupational Therapist had made a referral to Minor Adaptations for a stair rail to be fitted.

One of the Mamwlad caseworkers arranged to visit Menna to carry out a Healthy Homes Check. Menna had a number of concerns about other areas in the house that may cause her problems, particularly as she had lost her confidence since her fall. The caseworker took the time to listen to Menna’s concerns and make suggestions for some further minor adaptations to reduce the risk of falls. The caseworker is a Trusted Assessor for Minor Adaptations and able to make direct referrals for works to be carried out.

During the Healthy Homes Check the Mamwlad caseworker discusses support options with the client, looking at isolation and loneliness that can have an impact on a person’s mental health. It may be appropriate to refer someone to project partners such as Age Cymru Powys for other services such as befriending or to explore benefit entitlement.

We also network with other organisations such as The DPJ Foundation, who specialise in mental health within the farming communities. From our evaluations the impact of introducing minor adaptations to a home on clients’ mental health is positive. They have increased confidence and independence leading to reduced anxiety and worry when they are receiving the support they need.

In this instance the two entrance doors to the house both had small steps, so the caseworker agreed that grab rails would reduce the risk of falls. The caseworker also identified small steps leading into the utility room and the hallway as potential trip hazards and agreed to fit grab rails in these areas.

The caseworker drew up a set of recommendations, which she forwarded to the Care & Repair Minor Adaptations Team. The work was carried out by an in-house Minor Adaptations Officer within 10 working days of the referral.

Menna is extremely pleased with the finished work and tells us that the rails have increased her confidence and independence. She has also had three more grab rails fitted in the bathroom to provide support when showering and using the bath.

Menna has since referred a family member, and a farming friend, to Care & Repair for support and advice on falls prevention and fire safety.

If you know anyone in the farming community who would benefit from similar support, then please get in touch with Care & Repair:

North Powys: Amy Peter, email: amy.peter@crpowys.co.uk

South Powys: Lesley Price, email: lesley.price@crpowys.co.uk

Or telephone the Care & Repair Office at the Newtown base: 01686 620760.

Names have been changed to protect the privacy of those involved.

The Mamwlad Project is funded by the Welsh Government. The two partners are:

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.

Children’s Mental Health Week 2023 – a young person’s view from Powys

Children's Mental Health Week 2023, 6 - 12 February, is all about making a difference to the lives of children and young people across the UK. The awareness week is organised and promoted by the charity Place2Be. The theme this year is "Let's Connect." 

Today, as part of our week-long celebration of Children’s Mental Health Week, we are pleased to introduce a young guest author. Ffion is a member of the Junior Start Well Board* in Powys, and writes about her life as a young person here in Mid Wales.

Life is a cage, which constantly suffocates me. The labels have become a cage - student, carer, daughter, sister, anxiety, traumatised, sad, lonely, different. But when I read I am transported, it's like the key to my cage. I feel free. It’s my lifeline, I relate to aspects of characters and their stories so, if even for a moment, I feel less alone. Less Different. I feel valid.

“I have a theory that selflessness and bravery aren’t all that different.” 

Veronica Roth, Divergent. 

This empowers me. It reassures me that even if I’m not the bravest, I am scared of spiders and I am too scared to stand up for myself, I have to be selfless because of being a Carer. Despite never being put first or me putting myself first, it gives my life meaning and purpose. I feel less alone, more normal. I feel kind, empathetic and selfless - which makes me brave. Less alone. I feel invincible.

“As long as you can find yourself, you’ll never starve.” 

Suzanne Collins, The Hunger Games. 

This resonated with me the first time I read it. Then the second. Third. Fourth. And countless other times. Life is miserable. It's a fact of life I have experienced more than some. But in life, there's beauty in doing what you love, and in finding what you love you can find yourself. Being yourself is one of the greatest joys in life, and it gives me joy. It’s how I’ve tried to live my life for the past three years while picking my GCSEs, A Levels and I hope while going to university. It makes me feel mature. Less inferior. I feel wise.

“I told you to hide your heart once. You should have listened.”

Victoria Aveyard, Red Queen.

I've been hurt. More times than I can count. And every time a similar thought goes through my head. Then, I think back to this book and how when Mare opens up her heart to others, she finds her power. That's why I will never stop. I will cry with others, I will love others, and I will trust others with my heart. Closing off my heart would make me cold, unfeeling and I can't imagine life that way. Part of who I am is my empathy, my kindness and my generosity. By reaching out to those around me, I have stronger relationships, and I feel less lonely. I feel loved.

“It’s always the fear of looking stupid that stops you from being awesome.” 

Kiera Cass, The Selection. 

Part of my anxiety is the constant fear of everything going wrong around people and being laughed at and mocked. I lacked confidence. In high school, it meant that I feared a misstep so I stayed quiet, and didn’t speak out. I felt oppressed by my anxiety and lack of confidence. But when I went into sixth form, instead of a year group of 140 people, it was 20. And the smaller group meant that I became less scared. I gradually built up my confidence and I applied for head girl. In high school, I would never have dreamed of doing anything like that out of fear of failure. But failure is how you grow and learn. I learned to face my fear so I feel less afraid. I feel confident.

The connections I feel to these books, these characters, these storylines have helped me grow as a person. I’ve learned to respect my differences, and they are actually what makes me stronger. I've learned that fear is a tool, and using it will open doors and help me get places. I’ve learned that empathy and kindness isn't a weakness, you have to lose some things to help you find better ones. Life is a cage, which constantly suffocates me. My key was reading, it has helped me deal with the pressure and changed my life for the better.

*Junior Start Well Board is a group of young people aged 11 – 17 years of age who meet every month to talk about the issues affecting young people. The purpose of the group is to listen to the views and the opinions of their peers and provide a voice for young people in Powys, so that they can feedback and contribute to decisions that affect them. Based on these conversations, they ask to meet with the services in Powys who are best placed to listen and respond or look at setting up any new projects in response to need.

If you would like more information on how to join please contact sharon.titley@powys.gov.uk

Find out more about SilverCloud online resources for children, young people and supportive adults.

Reading Well for teens suggests recommended reading and digital resources to help you understand your feelings and boost your confidence.

Photos from unSplash - Anna Meshkov, Gaelle Marcel, Kimberley Farmer, 

Sincerely Media & Olga Tutunaru.