PTSD in the Armed Forces: The Bomb Disposal Officer’s Tale

Chris Hunter Operating in Iraq in 2020

by guest author Major Chris Hunter QGM

Lord Moran, the much-celebrated physician of Winston Churchill’s, talked of soldiers having a stock of courage. Essentially, his theory was that people can be subjected to stress and trauma for a certain amount of time, but that each of us has a set ‘level’ of tolerance; and, crucially, once that level runs down to a dangerous level, if we are withdrawn from the stressful environment immediately we can replenish it, but if we fail to do so in time, it reaches a critical level after which permanent damage sets in.

Throughout my career I’ve witnessed countless traumatic incidents but, in 1995, as a young officer serving in Bosnia, I reached that critical level. Ten thousand Muslims were massacred during our tour and my troop and I experienced genocide at first hand.

Within months of returning home I found myself suffering from post traumatic stress disorder. I’d begun to fall off the rails and was really starting to lose my way and question whether I was really making a difference and if I was worthy of leading soldiers at all.

Chris neutralising a mock-up of a Remote Controlled Improvised Explosive Device

Brummie, my Troop Sergeant, gave me some amazing advice; he was a tough man who was no stranger to hardship. He’d spent time in both a young offenders’ institute and the elite French Foreign Legion before joining the British Army’s Pioneers but, despite his tough exterior, I soon realised that he was an extremely sensitive man who showed compassion and humility in abundance.

He sat and calmly listened to me as I struggled to articulate my anxieties and then, having listened and taken in every word, he gave me some advice that has sustained me through every challenge I’ve ever faced since. He told me that I’d never be able to solve all the world’s problems in one go, but that didn’t mean I couldn’t try to solve them one at a time. ‘A lot of good men fail because they try too hard to be perfect,’ he said, ‘and you know what? It’s all right just to be good. You can be a good enough husband, father, soldier, and still be a success.’

I’ll never forget those inspirational moments with him as he tried to shape me into a leader. Moreover, he taught all of us that worked with him that even in the macho culture of the Army that it’s OK to be scared. Through him we learned the true meaning of courage; namely that courage isn’t about never being scared, it’s about having the ability to muster up the inner strength to overcome your fears when you are. He was a very wise man, and pretty soon I learned, amongst other things, to rationalise the traumatic experiences I’d witnessed and, in doing so, I learned to overcome fear and stress.

Chris is also a motivational speaker

Six months after my Bosnia tour ended, I was driving into the British Army’s headquarters in Northern Ireland and witnessed two deadly IRA car bombs explode in a packed car park inside the barracks. It was rush hour, so as you can imagine, the first bomb caused numerous injuries; the second exploded a few minutes later, this time outside the medical centre. It had been placed there deliberately to target the wounded. I was truly sickened by the callousness of the attacks, but hugely inspired by the bravery of the bomb disposal operators who searched the remaining hundreds of parked cars by hand while those at risk were busy being evacuated. That was the moment I decided I was going to be a bomb technician. That moment was my calling.

Walking up to a terrorist bomb and neutralising it is one of the most terrifying yet gratifying experiences imaginable. When you and your team witness the truly terrible effects of a terrorist bomb and the devastating effect it has on people’s lives it really is heart-breaking. But when one is found and you are able to make it safe, and prevent that scene of carnage from re-occurring, there’s no feeling like it. It’s also one of the most exciting and adrenalin fuelled ‘rushes’ I’ve ever experienced, and those two aspects combined make it a potent and very addictive vocation.

Chris operating as an Army Bomb Disposal Operator in Iraq in 2004

On May 8th, 2004 we’d neutralised three bombs in Southern Iraq over the course of the day and had been out on the ground for over 16 hours without a break. Just as we were entering the City, looking forward to climbing into our beds, my team and I were ambushed in one of the most terrifying incidents I’d ever experienced. But as the bullets and grenades exploded into life around us, and in spite of our natural instinct to want to curl up in the foot-wells of our vehicles, we realised that the only way we’d stand any chance of survival was to overcome the paralysing fear and take the fight back to the enemy. I was convinced that my team and I would probably all be killed, but when you’re staring death in the face, it’s amazing how natural the body’s desire to survive really is. We took a deep breath, summed up a deep dark fury from the pits of our stomachs and violently fought fire with fire. 

Miraculously, we all managed to come out of it alive. But the next morning we had to go straight back out to deal with more bombs - and had to drive through the ambush site again. There wasn’t time to get over the shock; it was truly unsettling. On reflection, not only did I realize that life is finite, I also realised the true importance of staying focused and keeping your sense of humour when things go pear-shaped.

Obviously, being ambushed and shot at was extremely traumatic but every bomb I walked up to was also highly stressful. As you take that long walk up to the Improvised Explosive Device (IED), often carrying in excess of 150 lbs of equipment, your pulse is racing and every sense is on full alert. You clear your mind of all the day to day nonsense like what you’re going to have for dinner that night; what bills have to be paid; and how your team is doing in the league, and instead you focus solely on the bomb. Where it is, how it might be constructed, and what the bomb-maker who designed that attack is trying to achieve. Is he trying to kill innocent civilians; is he trying to kill the police or members of the security forces; or is he trying to kill me?! The device might just be an obvious come-on that’s been placed to lure me into the area so that I can be killed by something more sinister. In essence, you’re playing a game of extreme chess with the bomber every time you take that long walk. But while you never fixate on death or failure – ever – in the back of your mind you have to maintain a healthy measure of paranoia... because at any moment you know that your time or luck could run out.

Total failure or complete success... 

Chris cuts the detonator out of an Improvised Explosive Device in Iraq in February 2020

People often ask why we do it; I know some do it for the ­ adrenalin rush, others to seek atonement for darker episodes in their lives. But I think most do it out of a good old-fashioned sense of duty – just because they want to make a difference. For me, I guess it was a bit of all three.

I suppose the real question is what makes us stay? There’s something immensely gratifying about neutralising a weapon designed to kill and maim large numbers of people. Everybody I know who does it is absolutely hooked. It has to be one of the most interesting jobs on the planet. It didn’t just challenge and motivate me mentally; the fact that we got to save the lives of thousands of people we didn’t know and would more than likely never meet, was massively inspiring on a ­ spiritual level too. Not a single day goes by now when somebody isn’t killed by an IED. Every device I could neutralise took me one step closer to tracing and bringing down the groups responsible.

But I guess that, if I put my hand on my heart, the biggest, most powerful incentive is the buzz. Rendering safe a terrorist bomb is probably the most exciting thing I’ve ever done without getting arrested. The rush I get from dealing with a device is fearsome. Like all aspects of soldiering, it’s truly elemental; a world where everything is often black and white; a world of straightforward choices. Life and death... both yours and the people you’re trying to save.

It comes at a cost, of course. One minute you’re standing at the cliff’s edge, just you and the bomb, pushing it to the max; the next you’re at home with your wife and kids, trying to come down and be normal again. And if you’re living on the edge, eventually you’re going to go all the way over. If you’re lucky, you see the signs and decide it’s time to pull back and step away. But maybe by then it’s already too late.

Major Chris Hunter the author

It’s worth noting that the number of soldiers who died through suicide, or who received open verdicts after returning home from the Falklands, is more than a third of the 237 who were lost there in action. An investigation by the BBC's ‘Panorama’ also revealed that 21 serving soldiers and 29 veterans were thought to have committed suicide in 2012, a number that exceeds the 40 soldiers who died fighting over in Afghanistan during the same period. And in the final year of the Afghan conflict there were more ex-military in prison, on parole or serving community sentences than were deployed in the country. Post-traumatic stress disorder is a very real phenomenon.

But on the plus side our servicemen also become more resilient in time. The more we are exposed to stress and trauma, the more resilience we build up, and the higher our tolerance – or stock of courage – to it, becomes. That is what happened with me, I believe. I definitely witnessed far more traumatic experiences after Bosnia, in places such as Iraq, Afghanistan and during the 7/7 bombings. But, by recognising my critical levels of tolerance to stress, and by learning to rationalise what I witnessed and experienced, I seem to have learned to cope with virtually any traumatic experience that has come my way so far.

When I watch the news, return from a war-zone or indeed speak with other friends who’ve recently returned from conflict, I realize that little changes. The world continues to be dangerous and un­predictable and, for the members of our armed forces still operating, the switch continues to flick rapidly and repeatedly from full-off to full-on. And yet despite the risks and the trauma, they love what they do. It’s a vocation, a way of life. And if you asked a veteran if he or she would do it all over again, you’d get the same answer every time:

“…in a heartbeat!”

Chris Hunter is a broadcaster, motivational speaker and former British Army bomb disposal operator. He is the best-selling author of the non-fiction titles: Eight Lives Down and Extreme Risk and is a regular contributor to television & radio news and current affairs programmes. For his actions during his Iraq tour Chris was awarded the Queen’s Gallantry Medal by HM Queen Elizabeth II.

This Saturday 27 June is Armed Forces Day, a chance to show support for the men and women who make up the Armed Forces community.

There are many organisations providing support to the Armed Forces community. 

The PAVO mental health team has pulled together a list:

Support for Service Personnel & their families

Cefnogaeth i Bersonel y Gwasanaeth a'u teuluoedd

How playing Pokémon Go helps my mental health

by Mark Evans aka wildfairyboi 

As a sufferer of anxiety and depression, and suspected Post Traumatic Stress Disorder (PTSD), I spend a lot of time alone in my room. I find it extremely hard to start a conversation and when people begin to talk to me I get dizzy. My heart begins to race and I find it hard to catch a breath so I kinda shut off to the world. To some I might seem extremely ignorant. But this is not the case. I would love to be able to just walk up to someone random, introduce myself, and have a good old chat...

However, since I can remember I have always freaked out at the prospect of meeting someone new .. Some days I even find it hard to talk to people I know very well including my own family so I'm always looking for reasons to give me confidence to leave my room... 

As a 90s baby I grew up watching Pokémon and I loved it throughout my childhood…. And, not gonna lie, I still watch it to date… So when Niantic released Pokémon Go I was really excited to give it a go to the point I ordered a new contract mobile specifically to play... I was so taken in to the game catching all my favourite Pokémon I started going out all night when there was nobody around to play the game. I started to go out nearly every night. I walked around town and the lake every day for nearly a year.

Then I got ill and also had to look after one of my mates so I stopped playing so much. I actually didn't pick up the game for nearly 9 months as I was with my friend every day trying to fix her life up. Or I was really sick myself, and in and out of hospital. So I stopped my evening walks and began to spend all my time either at hers or hiding in my room again as I slowly got more sick. This made my depression and anxiety worse to the point I stopped going out again at all.

In the last 4 months I have picked up my fone and begun to get out walking again as I convinced my mate to do the same. She also got a fone to come and play Pokémon with me. So we began walking round in the evening, then we decided to start doing some of the daytime tasks on the game including meeting other players. I noticed my anxiety was still there but having Pokémon to talk about distracted me enough to get into conversations about it.

We met more people to share Pokémon info and tips with and began to get invites to X raids for a chance to catch legendary Pokémon ... So I started to go and meet random groups to play Pokémon although still feeling anxious .. Playing Pokémon Go gave me a reason to meet up with these random people and a reason to talk, so I slowly gained confidence to the point I'm now out most of my day playing... I’m either walking round town or the lake several times hatching eggs or walking Pokémon or even just chasing cool Pokémon on the near by. 

I'm even trying to get groups of people to come and meet me to help at some of the Pokémon raids and awaiting any one asking for help on the chat. If anyone asks for help I'll try to get wherever the raid is. 

So I've gone from having no confidence and staying indoors all the time to walking round the town for hours on end not wanting to go home some days. I’m meeting lots of new people and re-meeting old ones - all out playing Pokémon. I noticed there's quite a few really anxious players but all eager to come play when they can. 

S is another regular Pokémon Go player locally who has been 

struggling with her mental health. She says: 

“Playing Pokémon Go has literally changed my life.”

Big thanks to Anne Woods who is a Participation Officer in our team but also a very keen player of Pokémon Go. Anne has been playing since the day it started in the UK. She very kindly created the infographics with the Pokémon Go basics for the newbies amongst us...

Veterans NHS Wales – on military mental health

Victoria Williams, Veterans' Lead, Abertawe Bro Morgannwg University Health Board (left)
and Vanessa Bailey, Veterans' Lead Therapist Aneurin Bevan University Health Board (right) 

This week’s guest post is from Victoria Williams, the Lead Veteran Therapist at Veterans' NHS Wales service (VNHSW) based in Swansea's health board - Abertawe Bro Morgannwg University Health Board. The team also covers the Ystradgynlais area of South Powys.

Veterans are defined by Public Health Wales as “anyone who has served for at least one day in HM Armed Forces (Regular or Reserve) or Merchant Navy Seafarers and Fishermen who served in a vessel at a time it was operated to facilitate military operation by HM Armed Forces”.

Veterans' NHS Wales service is there to help ex-service personnel living with service related mental health problems. I caught up with Victoria to find out more about provision of this invaluable service in Powys. 

Tell us more about your role as a Lead Veterans' Therapist and what drew you to the work

I’ve been working for Veterans’ NHS Wales since 2011 for the ABMU health board. Having worked in mental health for over 20 years I recognised that I wanted to work in a service that specialised in working with military veterans and this was an ideal opportunity.

What kind of support is available to veterans in Powys?

Powys enjoys the same level of service from Veterans’ NHS Wales as anywhere in Wales. You can download a map showing the 3 out-patient clinics, based in Welshpool, Neath and Bronllys.

Why might veterans require this service?

Veterans’ NHS Wales is a psychological therapy out-patient service offering therapy for veterans with service related mental health difficulties. This means that anyone who's finding it difficult to cope after they have left the military, if they think their issues might be ‘service related’, are able to self refer to us. We will then offer an initial assessment of their needs and from there a management plan will be put in place.

Mark Birkill, Veterans' Therapist in North Powys

How can Powys veterans access the service? Who can refer a veteran for the service?

VNHSW is the Welsh Government funded NHS mental health service offering therapy for issues related to military service. It’s important to note that ANYONE can refer into the service. We offer an open access policy meaning that people are able to self-refer via the website. We do find a lot of people think they have to go via the GP but this isn’t necessary.

Once referred an opt-in form is sent asking the veteran for extra details and proof of identity. When we have this information we aim to offer an assessment within 4 weeks. The assessment will look at all aspects of the current situation and look at how we can best support you.

The Powys Veterans' service is delivered by neighbouring health boards. How does this work?

VNHSW is a ‘hub and spoke model’. This means we are one service centrally based in Cardiff with our ‘spokes’ throughout the other 6 health boards in Wales. Powys is covered by 3 health boards but because we are ‘one service’ it therefore has no impact on the service a veteran will receive. If there are any doubts as to where your clinic is based then individuals can contact us (see details on the map or go to our website) and we can point the individual in the right direction. For example, if the veteran's GP surgery is based in the Abertawe Bro Morgannwg health board, then the veteran would be seen in our out-patient clinic in Neath.

A Veterans' service is very specialist. What training do Veterans' Therapists undertake?

All veterans' therapists are trained psychotherapists with training in Cognitive Behavioural Therapy (CBT) and Eye Movement Desensitisation and Reprocessing (EMDR). Both therapies are what we call ‘evidenced based therapies’ for treatment of a variety of mental health difficulties. In addition we receive additional specialist training in military mental health difficulties.

Oxana Jones, Veterans' Therapist in South Powys

Are there other agencies Powys veterans can contact for support with their mental health or other issues such as debt management or armed forces compensation?

Veterans’ NHS Wales has a network of agencies working throughout Wales offering support for many different issues. We currently have a peer mentor support worker who is able to help veterans link in with the most appropriate agency to help with their needs.

What has been the most challenging aspect of running the Veterans' NHS Wales service?

One of the most challenging but rewarding aspects of the role is the increasing number of referrals we’ve received since we started 10 years ago. Initially this led to an increase in the time veterans were waiting to be seen for therapy. However, with the support of Welsh Government, which has recently increased our funding, this has meant that we’ve been able to extend the input of psychiatrists and administrators can give to the service. We’ve also been very lucky to receive additional funding from the charity Help for Heroes over the next 3 years and this has led to an increase in the number of therapists in the service leading to shorter waiting times.

Tell us about some of the most rewarding work you have done with the Veterans' NHS Wales service so far

Being able to speak to someone who isn’t aware that there is help for the problems they are presenting with. Also helping someone to make sense of why they feel the way they do, and offering an evidenced based psychological therapy to reduce their symptoms and improve their general daily functioning, is pretty rewarding stuff.

When you are not working, how do you enjoy spending your time?

As a mother to two teenage boys and two dogs I tend to be very busy but you can often find me on the beach with my dogs or eating cake, I’m a big fan of cake.

Many thanks to Victoria for telling us about the Veterans' NHS Wales service in Powys. If you would like to contact her, please email: victoria.williams4@wales.nhs.uk

Change Step - led by veterans for veterans

Stephen Jones has recently taken on a new role with the charity Kaleidoscope. 

He works to support veterans and their families in Powys, particularly in respect of any problems associated with military service and the transition to civilian life. 

A lot has been written about the mental health of service and ex-service personnel, such as this 2013 report from the Mental Health Foundation.

We asked Stephen to tell us more about his new role and why it is needed in Powys.

You seem to have two separate but linked roles - tell us more

I have recently become the Listen In Project Co-ordinator for Change Step – this role sees me supporting families, friends and carers of veterans to aid in promoting recovery from problems associated with military service and the transition to civilian life.

I am also currently a Change Step peer mentor aiding the veterans themselves, providing a unique peer-led service.

What led you to these particular roles?

As a veteran myself, and a volunteer for Kaleidoscope (the substance misuse service in Powys), my personal journey is and can be seen to be very similar to those who I support.

Steve at Ystradgynlais Welfare Club

How do you define the term “veteran”?

A veteran is anyone who has served one day's service with the Armed Forces, whether it be as a reservist or full time member.

Tell us more about why veterans in Powys need the kind of support you offer?

It can be a very daunting process, leaving the military to joining civilian life, with there being many changes to day to day life. Sometimes it can appear to be a lonely process and there are many new challenges ahead for those leaving the forces. In particular some veterans may be experiencing Post Traumatic Stress Disorder (PTSD), or issues surrounding family life, housing, and also substance/alcohol misuse. I feel that anyone leaving the military may benefit from a quick chat with someone who has been in their shoes and understands these unique issues.

Do you know how many veterans there are in Powys? What barriers might prevent them seeking support and how do you work to overcome those?

I would imagine that there are many veterans in Powys, and we also have a large Gurkha population in the county. Powys is a very rural area, which could present as a barrier within itself. I work Powys-wide, so can travel to see those who cannot travel to see me, helping those in remote areas.

Trust is also a barrier, which is where Change Step and Listen In assist greatly as we are veterans supporting veterans.

Are there particular issues which arise in rural areas for veterans experiencing mental distress?

I think it is hard for anyone suffering mental distress, and I think the main issue is being heard, supported and knowing where to go for that support.

Steve at Dering Lines Army Camp 

Drink Drive Awareness Day

What kinds of activities are available to support veterans in Powys, and in your experience which are found to be the most appreciated and/or useful?

There are various support groups in Wales such as Combat Stress, Veterans Wales, Royal British Legion (RBL), SSAFA (Soldiers Sailors Airmen & Families Association) and many more. I am having meetings with the RBL and hope to open drop in centres in some of the major towns in Powys, where veterans can pop in for a cuppa and a chat.

What support is needed by the families of veterans who struggle to make the transition to civilian life? What is your role here? 

It can be hard for veterans to adjust, however it is also hard for the families to adjust – they may have lived apart for some time and be used to a different lifestyle, maybe in military accommodation in this country or abroad.

They will also potentially see their family member 24/7 for the first time, and also experience issues surrounding witnessing their family member suffering with PTSD. They could feel isolated and not sure where or who to turn to.

What is the most challenging aspect of the job?

I think that the main challenge with my role is making sure that I can reach all those who need our support – there are a lot of veterans and families who may need support however have not yet heard of Change Step or Listen In, something which we are working hard on changing.

Can veterans sign up to volunteer with the project? If so, what are the criteria for people who are interested, and what kind of roles are available?

Yes, and we would like to see veterans signing up as this in itself can help alleviate some issues surrounding isolation or boredom, and also help those who have not yet referred into the service. Contact us for further information.

When you are not working for Kaleidoscope, how do you enjoy spending your time?

I am a keen fisherman and spend a lot of my spare time at the coast. I also enjoy camping in the summer months.
 

Many thanks to Stephen for taking time out to update us about his new role. You can contact him at Kaleidoscope: 9 Castle Street, Brecon, LD3 9DD, tel: 01874 622333, mobile: 07738 320 390, or email stephen.jones@kaleidoscopeproject.org.uk

Mental Health Act 1983 – Code of Practice: the review (in England)

Jan Rogers, who recently wrote for us about Volunteering whilst getting benefits, has been playing a key role over the last few months in the review of the Mental Health Act 1983 Code of Practice in England. This work is being led by the Department of Health and backed by the Minister for Health, Norman Lamb, you can read more about PAVO’s role in this work here. 

Jan was recently asked to speak about her experiences, as someone in contact with mental health services, at the Expert Reference Group reviewing the Code. With her permission we are publishing Jan’s talk as a guest blog post.

Hello, my name is Jan Rogers, I live in a small village not far from Newtown, Powys, Mid Wales. I am married and have been for nearly 36 years. I have 10 children although I did cheat a bit as my husband, Mike, had 4 children when I met and married him. Pre-1988 I lead a happy healthy “NORMAL” life. I used to do a lot of running, competitive and for fun, and also competed in a lot of different sports.

In 1988 a life changing traumatic event happened. Without going into detail, for a few years I pretended it never happened and it seemed to work but in 1992 “hell opened its trap door” and I fell in the most darkest place I had ever been.

I was diagnosed and labelled with "Post Traumatic Stress Syndrome” and depression. The reality of it all and the issues I have had to deal with, and still do, day to day – are guilt, lack of self worth, failure to family and friends and society in general (although after I was labelled I didn’t seem to have as many friends), flashbacks, voices, hallucinations (even to the extent I can’t always tell if the people I am talking to are real or not).

When I an unwell I tend to pace backwards and forwards with my fist clenched usually talking to the people that others may not see. I feel that this is the only way to keep control and to stop them taking over. In the past people, police, doctors and other professionals, have perceived me as on drugs or alcohol and mistaken my pacing and keeping control as lack of control and a possibility of turning violent. Those that know me know I am not, and never have been, violent towards anybody.

This Code will better safeguard people, carers and others that could be effected by the Code’s use. With every meeting I felt more confident in myself, maybe even talked too much sometimes, and felt confident enough to reply to emails if I wished. To be honest I’m not sure if I have had any conversations with people that possibly weren't there and still don’t. But I have never felt or been made to feel uncomfortable about the issues I deal with or pitied, only ever thanked for being honest. It has been great to be accepted for who I am. I spoke earlier about feeling like a failure to society but it’s projects like this that water this feeling down. I would like to give my personal thanks to the support I have received from Freda (Lacey), Derek (Turner) and Jane (Powell) in making it possible for me to come and take part.

Can I just say before I bore everyone too much that I really appreciate being involved in this work and even though we are playing a small part in a bigger picture I feel things are moving forward for the better. As much as our lived experience view helps professionals I also feel it’s helping me on my journey to living instead of existing.

Inspector Brian Jones of Dyfed-Powys Police asked if I would go along to a meeting and talk about how I was treated by the police when I had been arrested whilst being unwell. From here I have been involved in a lot of different projects. I have not been in hospital for two years and four months and I believe a lot of this is down to my volunteering and being involved with different projects like this.

Passing on my lived experience gives me a purpose and an outlet for the HELL I live in sometimes, along with the support I have had from the staff at Ponthafren, PAVO and the Community Mental Health Team, and last but certainly not least, my “Mountain” (my hubby and family).

When Freda asked if I would like to put my name forward with a possibility of being a part of “The Expert Reference Group”, I said yes, and when she came back a short time later and explained that I had been accepted I was excited. Then panic set in. I started thinking what if I upset people by talking to people that nobody else could see? What if I couldn’t make out who was real and who wasn’t? I have in the past while doing a card making workshop spent 10 minutes showing an empty chair how to make decoupage cards and it wasn’t till I noticed the others looking rather confused that it dawned on me. Thinking quickly I said I was practicing, now I will move on to a real person, phew, my mum always said I was born in a knife drawer.

Another thing that was going through my mind….. As I said, I have been involved and gone along to quite a few different meetings and projects, but sadly there have been a few where they said they wanted input from people who use the services but I soon realised that actually it was more that they needed to tick a box to say that they had input from us. And I really felt as if I was invisible.

Between 1992 and now I have been arrested under the Mental Health Act and held on a Section 136 over 30 times. Every time I have ended up on a section and taken to hospital. I have been pepper sprayed, thrown in the back of a police van in a cage, held down in handcuffs over a wall, while the police officers spoke to their sergeant over the radio as to where they could take me (as the police have always thought that a cell is not the best place for people suffering mental health issues), stripped of my clothes in a police cell, bearing in mind to me the cell had between 15 and 25 people in it at any one time….

All this I believe was because of a lack of training and being unsure of what exactly to do with people struggling with mental health issues. Sometimes even a lack of understanding. It would have been interesting if any of the officers involved took any advice from the Mental Health Code of Practice! On the other hand when it has been officers that have known me, things were very different. They allowed me to pace instead of being forced and held down, spoke quietly and at a distance and even allowed me to have a fag.

After years of being in and out of hospital, cutting a long story short, I came into contact with Ponthafren Association, which is a resource centre for people with mental health issues or those that feel lonely or isolated. Through doing volunteering there and becoming part of the public relations group, I met Freda Lacey a lady that works for PAVO, (Powys Agency for Voluntary Organisations). Through Freda and PAVO I met Inspector Brian Jones from Dyfed-Powys Police force who chairs the Confidence and Equality Group meetings in Llandrindod Wells every quarter. There are representatives from several front line organisations.

Also maybe in some people’s eyes a serious problem, I listen constantly in one ear to 60s music as I found it’s the only way I can listen to a conversation with a real person as it quietens the voices a bit and helps me concentrate.

I remember the first time I came down to the Expert Reference Group, my stomach churning and brain spinning and the voices and extra people were worse than they had been for a while. When we all introduced ourselves and I explained the issues I deal with, voices etc, straight away I felt accepted for who I am - lock stock and barrel - and this meant so much to me it’s unexplainable in words really.

Well! From the time I got there it has been an extraordinary journey, from everyone’s attitude, explaining what it is all about, directions, travel and follow-on emails about the previous meetings, and future agendas. The meetings and discussions felt like they flowed, we all were able to give and were asked for our views. When the Minister and other professionals came along to some of the meetings, I felt it went well as we were all able to have a wider view of things. It felt so easy to put my point of view across and I personally felt very much listened to. To be able to play a small part in reviewing the Mental Health Code of Practice for England is unbelievable and a great personal journey and already leading to other things.

I feel I have learnt so much as when I first looked at the Code I was totally pickled but now I feel that, albeit a small step, the Code will be much easier for people who use the services, carers, and professionals to use and understand, as I’m sure a lot of the areas which were very grey and doubled up will be more understandable.

Many thanks to Jan for sharing her experiences of the review process with us. You might also be interested to read a blog post by Aimee Wilson about her experience of reviewing the Code of Practice. She was initially approached by a Youth Engagement Worker from Young Minds and asked to get involved.

Powys Mental Health Alliance Open Day 2014

Yesterday my colleague Freda and I went along to the latest Powys Mental Health Alliance Open Day at The Commodore Hotel in Llandrindod Wells. These days are a great opportunity to find out more about what is happening in the county around mental health, and to meet up with other members and people representing organisations to chat, catch up and have... as it happens... fun! The big yellow inflatable football in the photograph below is a bit of a clue...

L - R, top row: Debra Douglas-Matthews (PMHA trustee), Philip Bowen (High Sheriff of Powys),
Bryan Douglas-Matthews (PMHA chair)
middle row: Christine Field (PMHA trustee),  Kelvin Mills (PMHA trustee), Carla Rosenthal (PMHA magazine editor)
bottom row: Bill Fawcett (PMHA Vice Chair), Michelle Hart (Stretch & Smile)

Surprise guest this time round was Philip Bowen, the High Sheriff of Powys. "The Office of High Sheriff is an independent non-political Royal appointment for a single year". Philip has many hats it seems, as he is also Artistic Director of The Willow Globe - a scaled down, living willow theatre, based on The Globe Theatre in London. Philip enthusiastically opened the day with, appropriately enough, a reference to some of the distressed heroes of Shakespeare's plays, including Prospero and Pericles. By the end of the drama they are able to say - "this is who I am.... this is my story." Through the storytelling process they are healed.

Eddie Evans, the Regional Welfare Officer for Combat Stress, the veterans' mental health charity, kicked off as first speaker of the day. He had served in the army for 26 years, and now works with Community Psychiatric Nurses and Mental Health Practitioners to provide support to ex-servicemen and women in the community.

Eddie spoke about Post Traumatic Stress Disorder (PTSD) - "a normal reaction to an abnormal situation". Personnel often go back to their families after being in a war zone and try and start up again as if nothing has happened... but problems can quickly escalate if people need help. "It is as if the wheels fall off before some people seek help... there are failed marriages, lost jobs..." Eddie is the first point of contact for people as there "is a bond of history". Some veterans can receive support in the community, including practical support if there are money issues; others, who may be more severely distressed, enter one of three Combat Stress treatment centres - the one serving Wales is in Newport, Shropshire. "Some veterans smile for the first time as they are amongst other veterans."

Freda catches up with Eddie Evans in the coffee break

Eddie's obvious understanding and empathy for struggling veterans was picked up by several people in the audience, who responded by describing moving experiences relating to themselves and family members. "You could not believe some of the sights that they see..."
"My son went away for a week (with Combat Stress) and the difference was so remarkable that you wouldn't think it was the same person!"
"People don't realise that veterans suffer from mental health problems in a big way."

The coffee break was followed by a brilliant session of seated exercises with Michelle Hart from Stretch & Smile. Nearly everyone joined in, including the High Sheriff of Powys and Freda! 

L - R: Carla Rosenthal, Philip Bowen, Michelle Hart & two others stretching!

These were just the warm-up exercises.... but then the large inflatable balls were rolled out and the real fun began... 

Chris Coe - Am I really as tough as old boots?

How to follow that...? Well, what better choice than Chris Coe of the Farming Community Network (previously Farming Crisis Network).

Chris had been a Rural Officer with the United Reform Church when an opportunity arose for an additional part-time post - this time as Regional Director for FCN based in Llandrindod Wells. Chris explained that the charity's main role was to "walk with people" - to be there, to listen, to respond - as a friend. He can go with farmers to court, to the bank, to a doctor... shopping... even organise to have a field ploughed if that is what is needed when someone is too distressed to do the work themselves. The service is free and confidential. The hardest part is encouraging people to ask for help in the first place.

Chris works with a large team of volunteers covering Powys and SW Wales... and if the two case studies he gave us are anything to go by the work is very much needed in the county. He said "45% of the people helped suffer some form of mental illness caused through the stress and hardship of producing the food we all depend on." The farming community is currently bracing itself for changes in the Single Farm Payment from the government which so many depend on to stay afloat.

After a delicious lunch Inspector Brian Jones of Dyfed-Powys Police stepped up to take the microphone. He is stationed in Brecon and works as a Partnership Inspector - one of his key responsibilities being mental health. The two main areas of discussion which developed around this session focused on the Section 136 detentions (when people are taken to a place of safety and possibly assessed by mental health professionals before a decision is made about next steps) and police training.

Many of those in the audience were keen to relate their own experiences of contact with police officers whilst distressed, some of them quite negative, and Brian listened carefully to them all.

Brian explained that:

• Sometimes people will be taken into custody when they shouldn't be.
• Sometimes people don't know who to call when a crisis/incident develops so they call the police.
• New officers (recruited over the past 2 years and ongoing) have to spend three days in Bronllys Hospital as part of their training.
• A new training programme is being developed, in partnership with other organisations including Powys Association of Voluntary Organisations (PAVO), which will be rolled out to all officers. Individuals, including those in contact with mental health services and those close to them, will be involved in this training. Mental Health First Aid sessions are also likely to be made available.
• He is trying to bring about change and influence to the police by listening to people's experiences (which is why today was so valuable to him).

There followed a much longer discussion, including topics such as anti-social behaviour, multi-agency problem solving, mental health advocates and hate crime... if only we had the space and time here to relate it all! At the end of a really interesting session Brian rounded up by saying: "Give the officers a chance. Approach them. Speak to them. When we are called out we will say - the next time we come here, how would you like us to treat you? Tell us and the details will be linked to your address. We want to do the best we can."

Other mental health organisations were present on the day, and Freda and I enjoyed meeting up with colleagues at The Alzheimer's Society:

Kate Llewellyn (Advocate) and Pat Griffiths (Dementia Support Worker)

Pat reminded me about the Memory Cafe which runs every second Friday of the month at the Methodist Church in Newtown.

Here at Powys Mental Health Information Service we often signpost people to Journeys and the C.A.L.L. helpline, so it was great to meet everyone at their stands.

Lorraine Jones and Jackie Faichney of C.A.L.L. Helpline 

Gareth Childs, Journeys

Finally, I'll sign off with this photo of Freda joining Pat and Kate of The Alzheimer's Society for the Stretch & Smile session... The smiles on their faces say it all!

We look forward to the next PMHA Open Day. If you were there, tell us what you thought. Do you have suggestions about speakers or activities for future open days? Did you try out the Listening Table? Or listen to Diane Milberry's talk? We'd love to know, as we had to shoot off back to the office at that point...

Hearing the Voice

Saturday was a rare sunny day so it was destined to be a garden day. However, before heading out to attack some really vicious brambles overshadowing the bean poles, I caught an interesting feature on BBC Radio 4’s Saturday Live programme. A programme guest, Adam, was talking about his experience of hearing voices. (The 12 minute segment starts at about 39 minutes in).

“I have another person living inside my head," he said. "I’m not just hearing a voice I’m seeing a person..... the Captain of my universe..... He is dressed as a Second World War German U-boat captain. He looks like me. He has a scraggy beard... " Adam went on to describe the implications of living with the Captain inside his head. "He has cost me relationships, he has cost me money, he has cost me so much.... "

Adam was posted with the Royal Artillery in Iraq in 2003 – 4, but described this experience as “a walk in the park” compared to the Post Traumatic Stress Disorder he experienced stemming from the time he was bullied at school. The Captain is not the friendliest companion in the world, as Adam goes on to describe. "It’s definitely a darker side of me.... it isn’t me, but it is me...”

Adam's experience of hearing voices has led to his involvement with the project Hearing the Voice: "an interdisciplinary project led by researchers at Durham University... (which) ...  aims to help us better understand the phenomenon of hearing a voice no one else can hear (a phenomenon also referred to as auditory verbal hallucinations) its cognitive-neuroscientific mechanisms, its social, cultural and historical significance, and its therapeutic management."

Those participating in the project talk to one another about what they hear, and work with academics, clinicians, healthcare practitioners, and others with "lived experience" as part of the ongoing research. Adam describes it as  "(The Captain's) turn to pay me back." The project website hosts an active blog, newsletters and links to other sources of support, including organisations such as Intervoice and the Hearing Voices Network.

Speaking publicly helps reduce the stigma surrounding voice hearing - "just because someone says horrible things inside my head doesn't mean that I am that person." Yet, if anything, Adam is reluctant to say goodbye to the Captain anyway:  “If he was taken away who would I be then? My identity is a voice hearer - that's who I am.” The main thing he wants people to understand is that the voices will "never ever leave you but you can still have a life.... you don’t have to be a constant prisoner to your thoughts. There are people out there who understand and who will accept you."