Area 43 – Powys schools & community-based counselling services

Lisa Head is the Communications & Engagement Manager, she has been at the charity Area 43 since 2017. She joined the organisation as a Senior Youth Support Worker, then moved to Centre Manager, Services Manager and Operations Manager, before commencing her current role. Area 43 provides safe spaces, information, support, counselling and training to young people aged 11 – 25 at their flagship Youth Café, Depot in Cardigan in West Wales. Their counselling services span the whole of the mid and west Wales area supporting children and young people aged 3 – 30.

In October 2023 Area 43 became the new provider of Independent School and Community Based Counselling Services for Powys.

I recently met up with Lisa to find out more about the work of Area 43.

What drew you to your role at Area 43?

It’s a long story. I am a single parent of 2 girls, one of which was particularly challenging when she was younger. They are both in their 20s now, but when they were little, I was so disillusioned by the lack of support available to children, young people and their families that I embarked on an Open University degree to learn how to support my children better. It began as something I was doing for my own personal interest, but the more I learned, the more I realised I could do to help others in my community.

In 2011, I set up a youth club in the village where I lived, the young people wanted to launch the club with a mini music festival, so they worked with me to plan, coordinate and manage the event. I had a background in Arts Marketing, so I had the marketing and events management knowledge and plenty of contacts who were happy to perform. We attracted over 1000 visitors and the youth club went from strength to strength. I ran the club for about 8 years and over that time we expanded on the music festival idea to re-establish a village carnival, with young people in the lead. We ran that event 3 times.

I had known about the work of Area 43 for a long time, but at that time they only worked with 16 – 25 year olds and my children were much younger. However, when I saw the Senior Youth Support Worker role advertised early in 2017, I jumped at the opportunity to join the team and put all my learning and experience into practice.

During the lockdowns of the Covid pandemic, Area 43 took the opportunity to conduct a large-scale consultation with young people in the Ceredigion area to ask them what they felt they needed in Cardigan. They overwhelmingly told us that they needed safe spaces and an affordable café, where they could hang out and socialise without the pressure of having to spend money or feeling that they are not welcome… And so, Depot was the result.

Tell us briefly how Area 43 came about

Area 43 was born out of a community needs-led project in 1996. Back then there were 30 odd pubs in Cardigan and all the young people were hanging around playing pool and there were issues with them not going to school or college. It was identified that they really needed a place to go to that was not alcohol-fuelled or potentially putting them at risk. A group came together to put in a lottery bid to establish Cardigan Youth Project. They were successful in receiving lottery money and it snowballed from there.

From the early days, we had volunteers and eventually staff – including counsellors and support workers. We were quite early in offering counselling to young disadvantaged people in this area. When it became statutory law in Wales to offer counselling in schools in 2008 we were successful in tendering for a couple of those contracts because of this experience, and have held on to most of those ever since.

We now deliver services throughout Powys, Carmarthenshire, Pembrokeshire and Ceredigion and will see in the region of 5000+ individuals this year.

There are a total of 30 counsellors and therapists in Powys and another 28 covering West Wales. When Area 43 recently took over the contract from Kooth, most of the staff transferred over, so they all have plenty of experience with young people in the Powys area.

How can counselling help children and young people who may be struggling with their mental health?

Area 43’s counselling service is delivered by highly trained professionals and managed by people who fully understand the values, aims and limitations of counselling.

Counselling can allow a space for children and young people where they feel they are not judged and offers the opportunity to increase self-awareness, develop personal resources and understand their problems. It is a skilled way of helping those with personal, emotional and developmental issues or difficulties that takes place in a safe and confidential environment. This allows them to explore, discover and embed strategies to cope with change and live in a more satisfying, resourceful way.

By helping children and young people to share their worries and concerns with a counsellor or therapist, the young person can gain a better understanding of themselves, making sense of what they are experiencing, which helps them gain clarity and build resilience within themselves.

How is the school counselling going in Powys and what do you offer?

Thanks to the great team that Area 43 inherited from the previous provider, our service is running seamlessly. Area 43 will continue to provide counselling services for all eligible young people to the age of 25. The Powys model works slightly differently from the west Wales model, but essentially there are counsellors and therapists in all the secondary school settings and selected primaries.

Counselling is predominantly delivered face to face with the flexibility for online provision for those aged 10 – 19 (year 6 to Year 13) in education settings, but there is also an option for up to 25 year-olds to access counselling support either online or in the community.

All young people in Powys up to age 25 are eligible to access the counselling service.

We have 20 counsellors and therapists available for 37 days per week in secondary schools, 11 counsellors and therapists based in 15 of the primary school settings and we provide at least 3 days per week of online or community counselling sessions.

How are children and young people in Powys referred for counselling support?

Whilst parents and professionals can use our referral forms, any young person can register in exactly the same way and we encourage self-referral. It helps young people to feel ownership of the counselling support and let’s be honest, counselling or therapy isn’t something that can be done to somebody, it’s a meaningful, emotional process that takes a lot of commitment and vulnerability.

Referral forms, support resources and counselling information to help children, young people, parents and education staff to have discussions about counselling and decide whether it is suitable for them can be accessed through the Area 43 website page Powys Counselling.

Tell us more about the Youth Café you run in Cardigan

It’s about driving young people’s dreams forward, allowing their voice, hearing them and acting upon their needs. We utilised the lockdown scenario to do some online consultation and canvassed young people in the whole of our area as well as external services, to see what they would like from Area 43. Young people told us overwhelmingly that they needed safe spaces to hang out and socialise with friends where caring professionals could offer alternative views and provide additional support.

They also explained that they didn’t feel welcome in the town centre cafés - they felt stigmatised walking in as a group. The result of the consultation is Depot, which is led by young people for young people - it is their space, we just facilitate it and keep it safe.

In the youth café, young people don’t need to buy anything, they can just come in to keep warm and see other people. We heavily subsidise the cost of food and drink. We have managed to access some food poverty grants to keep costs as low as we can, and we work with Neighbourly and Fareshare for surplus foods, so we are often able to offer free meals.

Our Cardigan building is open 6 days a week up to 7pm for 14 – 25 year olds, we also hold transition sessions on Saturday mornings for 11 – 13 year olds. There are young people out there essentially living independently at the age of 14 – 16 including homeless young people, sofa surfing or sleeping rough. They come to Area 43 to stay warm, have human contact, receive support from our team, and link up with existing specialist services - drugs and alcohol, or housing options, and we facilitate this.

We also offer supported paid work placements for young people who are not in education, employment or training (NEET) to help them develop the skills to progress into the workplace from a safe, supportive environment where they can make mistakes and learn from them without dire consequences.

Do you have plans to develop and expand your offer in Powys?

We are working closely with Powys County Council, watch this space…

What are the main challenges working in this field?

I guess the main issue is securing consistent funding to provide these essential services. There is no doubt that the need for mental health support is very real. Whilst talking about mental health difficulties more openly has decreased the stigma, it has also opened the floodgates, and the need for support and counselling services means the demand is great and waiting lists across the sector are growing.

Contracts for counselling services go through a competitive tendering process and although we support the campaign by Young Minds and Dr Alex George (UK Youth Mental Health Ambassador) to obtain statutory funding for early intervention mental health hubs, we are still heavily reliant upon grant funders like the National Lottery.

Tell us about some of the most rewarding work you have done at Area 43

Seeing the Youth Café come to fruition is a proud achievement, we see over 200 young people every week, and last year had over 1600 visitors, it’s amazing and proves how much the safe space is needed by young people.

The most rewarding work is the direct work with young people, slowly building trust, and learning about them, their needs, background and challenges. Then having the honour of being permitted to walk with them on their journey and see them grow as they navigate the obstacles, dramas and emotions that fall in their way. I have seen some young people come from the most distressing situations where they have a lack of supportive adults at home, a tough time in education (if they attend), and substance misuse, bullying or other abuse in their lives, manage to find themselves and their strength because they learned that they had someone they could trust, who believed them and wanted the best for them. It’s amazing what young people can achieve with the right support if they want to.

How do you like spending your time when you’re not working?

I like peace and quiet and the opportunity to rejuvenate when I’m not working. I love a spa day! I also like to curl up in a cosy armchair with a book or to get out in nature, walk with my dogs on the beach or through the woods.

Feedback from children & young people who have been supported by Area 43 

About counselling and therapy

"Helped me release all me feeling and emotions."

"It has been helpful to be able to talk to someone. It has helped all the negative energy and thoughts to disappear."

"It helped me by boosting my self-esteem and giving me more confidence in making the right choices for myself, it also really helped with my family and friends relationships which i am thankful for."

"It was good to have someone to talk when my anxiety was a problem. I was able to work out how to control my anxiety and now have way to stop it."

About the Youth Café

“The first time I went to the Youth Café I was an upset teenager determined not to speak to anyone. But after a Youth Support Worker coming up to chat with me I opened up more than I had in a while. I felt a lot lighter when I left.”

“Coming here (Depot) for the past 3 years has done more for my confidence than almost a decade of support groups.”

“I feel that Depot youth café is a treasure to the community for young people, as a mental health sufferer this place has helped me get out of a dark place, the support I have received from the youth workers has changed me massively in ways I didn't think was possible. I've made new friends, I've learned to accept myself for my self with my mental illness and I don't feel like I'm figuring it out anymore. I have started to come out the house more as I'm less anxious of the outside world."

Many thanks to Lisa for telling us about the work of Area 43. 

If you want to find out more you can contact Lisa by emailing lisa@area43.co.uk

There is also further information on the Area 43 website including an online referral form.

The NEST / NYTH Framework – supporting babies, children, young people & families

by Sharon Titley

Children’s Commissioning & Transformation Team

Powys County Council

NEST is a planning tool for Regional Partnership Boards across Wales, to support the development of a whole system approach to mental health and wellbeing support services who work with babies, children, young people, and families. The NEST Framework was created in collaboration with children, young people and families, alongside other professionals throughout Wales, ensuring that their voices are at the heart of what we do, and inform us how best to support them.

This video introduces the NEST framework:

Children, young people, and families that worked together to create the Framework adopted the term NEST. This is based on the notion that a NEST has a caring quality and contains many different levels. They liked the notion that all support services adhered to this theme, making sure that they all felt nurturing, empowering, safe, and trustworthy.

Some of the main aims of NEST are to:

• Broaden the conversation around mental health and move away from thinking that only specialist services can provide help.
• Provide access to expertise and advice more quickly and easily.
• Make sure that trusted adults closest to the child understand what they can do to help and give them the skills and confidence to do so.
• A ‘No Wrong Door’ approach to those who might need extra support.
• Giving babies, children, young people, and families the right help, at the right time, in the right way.

This is the NEST framework; the acronym is around the outside of the circle and then the stakeholders in the second circle. The white segments of the circle give us the 6 core principles of NEST. The inner circle contains the underpinning values of NEST which show the expectation of services and their strategic context being psychologically informed, adopting a children’s right based approach in accordance with the United Nations Convention on the Rights of the Child, respecting equality, and inclusion, being values led and being led by a child’s development rather than their age or predetermined stage.

Powys Regional Partnership Board recognises and welcomes the introduction of the NYTH NEST Framework:

“It emphasises that every relationship and every service need to work together to prioritise what is needed most if we are to build the foundations for positive mental health and wellbeing. These qualities are even more important for those who are struggling most, which is why it is about prevention AND intervention. The NEST Framework helps us keep an overview on how everything and everyone works together to achieve the best outcome.”

The RPB's Start Well Partnership is responsible for taking forward the Regional Partnership Board’s work to strengthen and transform services for children and young people in Powys as set out in Powys’ Health and Care Strategy and will therefore be leading on the implementation of NEST in Powys. Partners of the Start Well Board have developed a multi-agency model to respond to and support the emotional health and wellbeing needs of children and young people in Powys.

The Powys model recognises the importance of the community where a child lives, the schools they attend, as well as the important relationships in a child’s life which can be strengthened to support children and young people to prevent their needs from escalating into specialised mental health and statutory services. It also focusses on early intervention and prevention, a whole systems approach, which avoids duplication and allows for integrated access to service.

This model acknowledges that children and young people are more likely to communicate with adults that they know and trust. The need to focus on the adoption and embedding of early help offers has never been more important. It aims to bring about the kind of transformational change that children, young people, and their families tell us they want.

The ambition for every relationship and every environment to feel:

• Safe, nurturing base.
• Enabled to fly the nest.
• Return to the nest if need to.
• Unique to the individual.
• Builds on natural resources.
• Multi-layered.
• Same basic need for every child – but some need additional layers.
• Every interaction is an intervention.
• It is the little things that make the biggest difference.
• Culture shift away from ‘What is wrong with a child?’ towards asking ‘What is a child’s NEST like?’
  
  

How NEST is being implemented nationally

• Community of Practice.
• National Training Programme.
• A Self-Assessment and Implementation Tool.
• Aligning cross policy work.
• Regional Partnership Board Leads' meetings.
• Built into Regional Integration Fund.

How NEST is being implemented in Powys

Start Well Partnership met in October 2022 to develop a Powys Implementation Plan, which includes some of the following actions -

• Coordinating an initial NEST self-assessment across services working with babies, children, young people, and families.
• Supporting a culture change through developing a suite of training opportunities, as well as offering accessible training on values that enhance the framework e.g. Dr Treisman training.
• Defining areas of development e.g. improving coproduction and community engagement.
• A NEST Steering Group has been established to develop a collaborative approach to embedding the NEST Framework in Powys, bringing stakeholders together to develop a shared understanding of the sustainable long-term change that is required.

If you would like to learn more about the NEST Framework in Powys, or would like to discuss any training requirements, then please contact Sharon Titley – sharon.titley@powys.gov.uk

You can read about case studies, including the Development of the Team Around the Cluster Model in Powys, in the recent Welsh Government publication: 

“NYTH / NEST in action - Good Practice Examples of the implementation 

of the NYTH / NEST framework 2023.”

Black and white photographs by Myléne from Pixabay.

Warm Spaces for Wellbeing

The Hanging Gardens, Llanidloes

Is getting cold getting you down this Winter?

Powys County Council has created a directory of Warm Spaces. It is made up of libraries, community centres, churches and other places, including mental health charities, that are opening their doors to anyone who needs them. This network of Warm Spaces offers support to anyone struggling with the cost of living this winter. Each Warm Space has its own opening hours and facilities. The one thing each has in common - a warm big welcome to all!

We asked some of the people generously sharing their Warm Space with their community to tell us more about how it’s working in their area, and a few PAVO colleagues gave feedback from their visits also.

CARAD - Community Arts Rhayader & District

At CARAD in Rhayader, we decided to run a weekly warm spaces activity day to support those who needed to cut down on their energy costs and risked being in a cold house over winter. We employ a facilitator, funded by Comic Relief, and have a volunteer present so that we can welcome people, have a chat, make a them a cuppa and biscuits or toast and guide activities. We have general activities in the morning and a more organised free workshop in the afternoon. This latter preferably needs booking as we need to make sure we
have enough materials to cover those who come. We chose a day when the library was closed and have also produced a flyer about other warm spaces in Rhayader.

Simply coming down to somewhere with nothing to do isn’t an option as, if you can’t put the heating on, you may not be feeling too good about life. Sitting in a warm room but feeling in the way, lonely or depressed won’t improve that.

Being welcomed to an organised activity makes all the difference. Because any visitor is welcome, you are not signalled out as different for attending. For that reason, we stress the activities rather than the warmth!

We really didn’t know what to expect but find that many of those who come through the doors are facing challenges. These might be around caring, health or other circumstances. There have been many positive benefits. Simply having some company has made a big difference to some, enjoying new activities has very obviously impacted others with a lot of laughter coming from the space and repeat visits. The benefits of those activities - lowering stress, having time out, and feeling accepted and safe (and warm) are also really positive for staff to see.

Catherine Allan, Chair of Trustees, CARAD

Ceri Williams, PAVO Health Promotion Facilitator 

& (inset) Melanie Taylor of Llanidloes Library

Llanidloes Library

Ceri Williams, our new Health Promotion Facilitator (North Powys) at PAVO visited the Warm Space at Llanidloes Library on 11 January. She spoke to Melanie Taylor who has worked there for about 7 years. The library staff welcome anyone who wants to use the Warm Space.

The library is located in the former town museum at the side of the Town Hall. There is a children's area and computers are available to use free of charge. Melanie said "this space is nothing new, we have been offering a warm environment for many years. We welcome new users to the library."

Hanging Gardens, Llanidloes

The following week Ceri visited the Hanging Gardens in Llanidloes (photo at top of post):

I walked in to laughter and went to talk to three adults playing board games. They told me: "It’s a fantastic environment - such a welcoming space. All the crafts and plants growing. It's what we had before everyone owned everything. Kevin and Fran (of The Wilderness Trust) had a vision and worked 12 hours a day to make it happen."

Local childminder Sammy shares an allotment plot with other childminders which enables them to feed their charges fresh veg (funded by the Co-op). She attends the Thursday singing sessions with her young charges.

Louise Evans, who works there, mentioned the Art therapy group and the Celf Able group which is a mobile art group that comes once a month.

All the activities are on the Hanging Gardens website.

Knighton & District Community Centre

At The KDCC Hub we have two sessions per week which are dedicated to offering ‘Warm Spaces & more’. The sessions are available on Tuesday 10 - 1pm & Thursday 10 - 2pm, both have access to the Cafe, our Advice from the Hub service, volunteer support, television, radio and reading material.

On a Tuesday the Cafe offers a hot drink and a piece of homemade cake at £1; on Thursday we offer hot drinks from 10 - 12pm free of charge, and from 12pm we have soup, sandwiches and homemade cake which are all free.

At the Tuesday Warm Space Cafe we also have with us staff from other organisations, such as POBL, Powys Housing and an Energy Efficient Advisor funded through Citizens Advice. The third Tuesday of the month RNID Hear to Help hold their hearing aid repair clinic at the centre 10 - 12pm (no appointment needed) and on the 4th Tuesday Credu's Leanne has a carers' support coffee morning in the Cafe.

Thursdays we welcome Hayley Lloyd, our PAVO Community Connector, to the building. Hayley has a drop-in from 10 - 12.30pm, we also have District Nurses in the Reynolds Room offering a Leg Clinic 9.30 – 12pm.

Alongside all the Community Centre Hub has to offer customers also have access to the Library and our new Digital Hub project. The Library is open on Tuesdays from 10.30 - 1pm and 2 - 5pm; Thursdays 10.30 – 1pm; 2 - 6pm. Booking is essential for the Digital Hub which is open on Tuesdays 9 - 5pm & Thursdays 1 - 6pm.

A recent customer survey highlighted that our customers very much enjoy coming to both of our Warm Space activities, and for many different reasons. Some of our older single attendees, who have limited contact with others, come so as to have the opportunity to socialise either with each other or our happy and friendly volunteers and find the human contact they engage with both uplifting and refreshing. Our younger customers come so as to have a change of scenery, and meet up with people of their age and circumstances (i.e. being mums), most come as they are finding it challenging “to make ends meet” so not having to worry about warming their home a couple of times a week takes immense pressure off them, and the welcome addition of either reduced Cafe prices or free lunch is more than an incentive in these hard times.

All customers are very positive about all of the other services/activities we offer, and really appreciate the fact that help, support and advice is available from services like The Advice from the Hub or PAVO Community Connectors. One very frequent comment is that people really value the Warm Space sessions, and are very keen for them to continue as all users find the services invaluable and of vital importance to their wellbeing.

Annie England, KDCC Hub Coordinator

Mid Wales Arts

Mid Wales Arts centre has a large Artshed that has been completely rebuilt for exhibitions and events. It is well insulated and has underfloor ground source heating, which means it's lovely and warm and not harming the environment.

We have set up an area of the shed as a 'Warm Space' with a table, chairs, books, newspapers, drawing materials and of course tea, coffee and a kettle.

It's an inspiring and uplifting place to be, you can enjoy the art on the walls and the wonderful views, garden, farm, peacocks and you never know who you might meet.

It's a good place for groups who wish to take part in an activity ...knitting, book clubs, philosophy, writing etc.

The shed has wifi and charging points. There is a cafe on site.

The space is open from 10 - 4 Thursday, Friday, Saturday and Sunday and you are most welcome. Just come along and check in at the barn cafe. Any queries: office@midwalesarts.org.uk or tel: 01686 688369.

The space is much appreciated. 'It's a space where you can enjoy the art and the warmth, it's lovely and friendly.'

Today we have had quite a few visitors and they have been inspired to start a 'Tai Chi' Weekly club starting on Wednesday 1 February, 12 - 1pm followed by a new discussion group 'Artspeak' 2 - 4pm where members can focus on selected artworks from the current exhibition.

Cathy Knapp, Creative Director

Councillors Carol Robinson and Julie Arnold with Rotarian, Tony Harvey, waiting to 'warmly' welcome members of
Welshpool Community to join them at the Welshpool Winter Warm Hub

Welshpool Town Hall Assembly Rooms

Pauline Chapman-Young, the PAVO Community Connector covering Welshpool and Llanfair Caereinion, called in to this Warm Space in Welshpool recently, and provided the following feedback:

The Warm Space has much more footfall now as its offers of free 'light lunches' have increased the interest from attendees. It is hard to judge the numbers as the hall is huge and people seem to drop in rather than stay all day.

Local Town Councillors are very supportive and are actually cooking some of the food and collecting donated food themselves. The councillors, including Nick Howells, are also working hard to bring in funding to enable them to keep the Warm Space going and have a 'healthy float' for additional supplies.

Printed material (leaflets) is available to offer help and support from many organisations including Community Connectors’ support. Volunteers from the community are visible and engaging with visitors. Overall there is a good vibe.

We hope you are keeping warm this winter. Let us know what you think about the Warm Spaces scheme in Powys in the comments below - we love to hear from you!

Stress Awareness Week 2022 & Powys Cost of Living Hub

This week, 7 - 11 November, is International Stress Awareness Week which is organised by the International Stress Management Association (ISMA).

Stress is defined by the Mental Health Foundation as “the degree to which you feel overwhelmed or unable to cope as a result of pressures that are unmanageable”.

The theme of Stress Awareness Week this year is “Working Together to Build Resilience & Reduce Stress”. Organisations throughout Powys are currently working very closely together to help support people through the Cost of Living Crisis - there is further information in the second half of this blog post.

Meanwhile, to start us off with some top tips about how to relieve stress, we spoke to one of our Powys Mental Health Individual Representatives*, John Lilley. He told us what has worked for him when dealing with stresses in his day-to-day life.

*The Individual Representatives are people who have either used, or care for somebody who has used, mental health services. These unpaid volunteers sit on regional and national partnership boards, alongside professionals who are involved in the delivery of services. 

The reps are there to make sure user / carer voice is included in the planning of services and they are always on hand to listen to your experiences and issues so that they can feed this back to the partnership groups. You can contact the reps by emailing the Participation Officer Owen Griffkin on owen.griffkin@pavo.org.uk or calling 01597 822191.

John Lilley - Powys Individual Representative Mental Health

I found the 8 week Mindfulness course I took with Mid & North Powys Mind very helpful. There is a new online course currently on offer - An Introduction to Quantum Consciousness Therapy which starts on 14 November and runs for 4 weeks with John Paul.

There is also a half-day session on the Five Ways to Wellbeing - which includes reflection and creating personal goals to put the Five Ways into practice in your own life. You can also find out more about the Five Ways to Wellbeing on the Powys Mental Health website.

Previously I benefited from taking exercise classes in Rhayader as part of the Welsh National Exercise Referral Scheme. Clients of the Community Mental Health team can be referred for safe and effective community-based exercise opportunities. This includes:

• Healthy lifestyle advice as appropriate in partnership with the CMHT.
• Promoting and improving the mental and physical well-being of clients.
• Increasing clients’ physical activity on a long-term basis.

I also want to raise awareness of the excellent work that is being done to support 

children and young people with positive mental health in Powys. 

Here are three initiatives I want to highlight:

Thinking about options for younger age groups, Mindfulness is now offered to children and young people in Powys schools. You can find out more about this from Linda Gutierrez, Emotional Health & Wellbeing Lead in the Powys County Council Pupil Referral Service, by watching this short video.

Ysgol Calon Cymru - the school at the heart of Wales - has two campuses - in Builth Wells and Llandrindod Wells. Earlier this year the school won a Wellbeing Award for achieving A National Standard for Positive Mental Health & Emotional Wellbeing for their wellbeing support and helpful resources for both pupils and parents / carers.

Kooth, the online mental wellbeing community for children and young people, offers a lot of good online support, with a mental wellbeing community.

Children and young people across the whole of Mid and West Wales can now access Kooth’s service as both Powys Teaching Health Board and Hywel Dda University Health Board work with Kooth to provide an online counselling and emotional wellbeing service for this age group. Kooth provides a blended approach of online counselling, support, and advice to young people, which is free, safe, and anonymous by friendly counsellors.

Finally, I also like this edited list of tips from Peter Beresford’s* book "Being a Mental Health Service User”:

• One thing at a time.
• Try to live day by day, one step at a time.
• Don't anticipate troubles and problems (living in the moment).
• Give yourself the same advice you'd give others.
• All things pass - including the bad things.
• No one is less than me. I am not less than them.
• We can get real help and support from others. But the people we can feel closest to, and who offer the most natural understanding and mutual aid, are people who have 'been there' like us.

* Peter Beresford OBE is a long-term user of mental health services and Co-Chair of Shaping our Lives, the national independent service user-controlled organisation and network. He is also Professor Emeritus of Social Policy at Brunel University London and Visiting Professor at Edge Hill University and the University of East Anglia.

Cost of living crisis and your mental health

Here are some links to other services / online resources that could be of help at this difficult time.

Mental Health & Money Advice

Mental Health & Money Advice is a UK-wide online advice service designed to help you understand, manage and improve your financial and mental health. Difficulties in resolving financial matters can exacerbate mental health distress leading to a vicious cycle of increased stress and worry. Find online support, expert advice, tools and calculators, template letters, real life stories and much more on the website.

Mental Health & Money Advice has been developed by Mental Health UK, a UK-wide charity that represents its four member charities; Rethink Mental Illness in England, Adferiad Recovery in Wales, Support in Mind in Scotland and MindWise in Northern Ireland.

Welsh Government

On the Welsh Government website Get help with the cost of living you can find out more about living costs, housing, financial help, benefits entitlement, school and childcare expenses, and health & wellbeing.

Powys County Council - Cost of living hub

Powys County Council has launched a campaign to help support residents and businesses with the rising cost of living.

The council has worked closely with local partner organisations to pull together a wide range of information in one place to ensure people know what help is already available and how to access it.

The online hub, which can be found at www.powys.gov.uk/costofliving, has been created to offer as much advice as possible to those in Powys who may need it during this time.

The #CostOfLiving campaign aims to provide information and advice on:

• Household energy advice.
• Money, benefits and debt advice.
• Powys foodbanks.
• Support with household utility bill.
• Support for businesses.
• Support for families with children.

Powys Family Information Service

The Powys Youth and Family Information Service is a one-stop shop where parents, carers, young people and professionals can obtain a range of information for children and young people aged 0-25 years and their families. The team recently produced an excellent guide to support available to people on a range of issues in relation to the cost of living crisis.

Citizens Advice

Citizens Advice, the independent information and advice service, has extensive information on its website relating to the cost of living crisis.

If you have any tips and ideas about how to deal with stress and the current cost of living crisis then please let us know in the comments section below.

Creative writing workshops on Felindre Ward

Emma Beynon is a writer and creative facilitator based in Mid Wales. Since the pandemic she has “led creative writing workshops on Zoom and face-to-face. Every workshop is carefully planned to guide participants through a series of exercises designed to fire up their creativity and strengthen their writing skills.”

Late last year Emma began facilitating creative writing workshops on Felindre Ward, the mental health inpatient ward in South Powys.

This week I caught up with Emma to find out more about more about the workshops and her creative writing work in general.

Tell us more about your role on Felindre Ward

Millie, the Occupational Therapist, invited me to attend to run creative writing workshops to compliment the work she already does on the ward. I’d already been running creative writing workshops online during Covid, working with Mid & North Powys Mind, and had a tremendous response.

Creative writing was part of the choice of activities people have during their stay on the ward.

What happened at the workshops

I came in for an hour every Wednesday for 11 weeks in total until the end of March 2022. There is an amazing creative room on Felindre Ward where they do pottery. I brought in a table cloth and objects such as flowers, feathers, rocks and postcards to soften the room and set up the table as if we were in a cafe.

I always start with a short warm up. It could be a playful question such as: If you were a packet of crisps what flavour would you be today? This would be followed by a ‘free write’. This technique is used by many professional writers to limber up.

Free writing invites participants to write without stopping, letting their thoughts flow onto paper. There is no wrong answer. The emphasis is upon catching ideas rather than worrying about spelling or punctuation. I find it is really useful to use a prompt when free writing, a starting point such as a shell, a feather -  something to hold and look at.

I might also let everyone choose a postcard of a painting and ask them to free write in response to that. If I can sense participants are stuck I ask questions about the painting. What do you see or hear? What do you smell, what textures might you sense? I invite them to draw upon memory. If people get stuck I encourage them to not let your pen stop moving! Just write “I don’t know what to write” until the stuckness stops. If people can look at me very grumpily – that’s fine – I smile and invite them to continue. I try and shift the parameters until they feel safe enough and ready to give it a go.

Free writing is a great way of focusing on the five senses and noticing too. Millie (OT) was the first to notice the link between creative writing and mindfulness, but during the course of the project many of the participants enjoyed making that link too.

I would then share a selection of poems: poems about nature, weather, working on building sites, even a ping pong ball. I wanted everyone to understand that poetry is a broad church, it can be about anything, not just flowers and feelings. We then read the poems aloud, line by line. This is often a wonderful moment of group performance where we all rely upon each other. Everyone’s voice brings a new meaning to the lines. After reading the poem a number of times we’d talk about about how the poem makes us feel, what we enjoy, what we don’t like.

I was very keen that everyone could be honest about what they felt about the poems, you do not have to like them, they were there to be discussed. I was really impressed by everyone’s response, it was always so detailed, evocative and yet always so true. I learnt so much from the group.

I will never forget the day we read The Door by Miroslav Holub, it is one of my favourite poems, I have read it so many times and always loved it. But this time when we read it, one of the participants just looked up, smiled and said ‘It’s about change’. I had never thought of that, to me it was about risk and opportunity. But they were right, it was great to witness everyone bring their own view of the world to strengthen our understanding. Inspired by the poem, the discussion or maybe just a line or image, everyone would be given the chance to write and they did!

How did the project come about?

As part of the HORIZON project led by Powys Teaching Health Board in partnership with Powys County Council. “HORIZON aims to strategically embed person-centred creativity at the heart of mental health and wellbeing practice.”

One of the aims of the HORIZON project is to learn about patient experiences through involvement in the arts.

Other creative interventions are being planned in Powys, including somatic experiencing and dance with people engaged in the Improving Cancer Journey, and clay modelling, sculpture making and printing workshops for young people at risk of substance misuse at the Mid Wales Arts Centre.

How do you support someone who says they can’t write?

A lot of people think creative writing is like the writing you did at school. But creative writing is completely different. I make this explicit at the start of the workshops when I introduce free writing. I explain that everyone has an individual voice which develops from what they notice. Creative writing is about capturing what you notice in words so there is no wrong answer. Creative writing, in its early stages,  is always messy, misspelt, and the punctuation can be wrong – but it doesn’t matter!

It’s a bit like a sport - you need to practice to get match fit. So I support people from the start to feel they can give it a go. During the project sometimes participants got stuck or did not want to write a particular poem so I would offer them an alternative. That’s the great thing about creative writing - it is very adaptable. Often when I find I get stuck with my own writing I just make myself write a list of questions or objects or thoughts or feelings and somehow this helps get over the ‘stuckness’.

What are the benefits of the creative arts, and specifically creative writing, for mental health inpatients?

A chance to relax

‘It was really relaxing because it does not matter what you write, there is no fear of judgement. If you hate it, so what? You don’t have to share it or go back to it if you don’t want to. Next time you will have a chance to develop different skills. It develops a resilience. It’s just about the person who is writing, the participants lead it, they can write what they like, they have control, they can share their views on a poem and then do what they like.’ Feedback from Occupational Therapist, Bronllys Secure Mental Health Unit.

Confidence

‘I feel as if my confidence in my own creative abilities has grown’. Mind Participant.

‘Creative writing gives me confidence, a voice and certainly an outlet to escape the daily pressures of life.’  Mind Participant.

‘They've made me feel about fitting in, and confidence to maybe not fit in, but still be a part of things?’  Mind Participant.

Companionship

‘You could see that they wanted each other to be good, they really listened. Sometimes out on the ward this does not happen.’  Feedback from Occupational Therapist, Bronllys Secure Mental Health Unit.

‘I love sharing our creations, I feel like I'm getting to know everyone a little better through the sharing of our work. It's beginning to feel like a family in a way’. Mind Participant

New skills and hobby

‘I have gained so much knowledge and confidence as well as interest to definitely try and find more courses to learn more skills in writing.’  Mind Participant.

‘I learnt how to have more structure to writing. I learnt how to write in a time frame without pondering too much and without over thinking. I learnt how to believe that what I write is worth more than to be lost on random bits of paper and thrown away when it's clear up time.’  Mind Participant.

‘I cannot thank you enough for connecting, engaging and inspiring me to write. I ask myself questions about what I am writing as you would at times. I enjoy stripping away words and using the magic of simple language. I will carry it on and what you have taught us I will carry with me always’. Mind Participant.

Participants on one of Emma's creative writing workshops in Newtown

What are the benefits to the providers of health services?

• Millie remarked positively on the way the workshop provided an escape from the ‘enclosed hospital environment of the ward’. Everyone shared all or part of their writing so we could imaginatively join them in Anglesey or out in the field in a valley somewhere in Mid Wales.
• The patient feels in control in an environment where they cannot control much as they control what they write about. If they like the poem and if they want to discuss/share it – it’s up to them.
• Patients are out of their room so can be assessed more easily.
• Concentration, motivation can be assessed as to whether they can concentrate throughout the duration of the group and then this can be monitored and compared to other weeks.
• Patients often feel a change in mood following the sessions as they have been off the ward (in the pottery room) which is a change of environment and so feel happier and brighter in mood.
• They can express themselves in a different means which they are comfortable about and say what they feel.
• It’s so good they get a chance to see the patient in a different and very positive light.

What happens to the creative work that the workshop participants produce?

My practice is all about process - those moments in the workshop rather than the outcome.

I bought notebooks for everyone, plus copies of poems to slip in. They all took their notebooks away and wrote in them in the evenings. They would often show me what they had written at the next session.

Those poems stayed in the notebooks and kick-started private writing and journaling.

Tell us about some of the more unusual places where you have held workshops over the years?

I once led writing workshops for the opening of a new Sustrans bicycle track in Paddington – it was a one-day celebration. Michael Bond, the author of ‘Paddington’, was there. It was difficult to start a workshop as people were milling around so I just went up to them and asked them to read ‘What If This Road,’ a poem by Sheenagh Pugh. Everyone loved the poem and they were keen to respond to it with a story or memory of hope for a road which I then scribed into a poem.

I do a lot of sailing and was sailing from Iceland to Greenland and got terribly seasick so they dropped me back in Iceland. There I was in NW Iceland when I was supposed to be in Greenland. I was feeling quite lonely and abandoned when I came across a tiny 1950s shoe shop which had been turned into a Museum of the Everyday. I went in there and talked to the girls who had started the Museum and within a week I was running writing workshops which developed into a residency every February in the town.

Do you have any other workshops coming up in Powys?

I have some new creative writing Workshops for Wellness starting on 21 April in Newtown in North Powys working in partnership with the Oriel Davies gallery.

We will try and capture the hidden beauty of Newtown’s parkland in words - noticing the changing seasons, the weather and wildlife. It’s about feeling good in body and mind and connecting us to the bigger picture.

Readings and reflections will also be shared to inspire participants to write as we explore Dolerw Park.

No previous experience is required, just curiosity and two hours of time on Thursday afternoons. Workshops are free of charge, funded through Welsh Government.

Workshop dates: April 21, 28 and May 5, 12, 19 & 26, 2 – 4pm.

Feedback from workshop participants

'I like it – poetry is a little like mindfulness.'

'I really enjoyed it.'

'I like it – it's random.'

Feedback from staff

‘It was really relaxing.’

‘I liked it, I enjoyed it. M enjoyed it and engaged much more than I thought he would be. I was surprised when he shared his first poem. It was good.’

A big thank you to Emma for telling us all about the creative writing workshops on Felindre Ward and other aspects of her writing life.

If you want to find out more about Emma Beynon’s work check out her website. You can contact Emma here and find her on Instagram here.

HORIZON is strategic, action-based pilot project designed to inform the production of the Creative Arts, Health & Wellbeing Strategy (led by Powys Teaching Health Board in partnership with Powys County Council) by providing arts interventions for people experiencing mental ill health across a whole range of areas. HORIZON aims to capture the patient voice / service user story around their creative experiences. The project is funded and supported by the Powys Teaching Health Board Charitable Fund and Powys County Council.

Reading your way to recovery

 

By guest author Janet Mulready
Health & Well-being Librarian, Powys

My work as a Branch Librarian in the early 1980s confirmed my philosophy that libraries can and should be central in offering support to the more vulnerable members of our communities. Libraries offer a safe and welcoming environment, and to paraphrase the author Matt Haig – whose books often reflect his own experiences of dealing with mental health issues – where else can you spend time where you are welcomed as an individual, with no mention of the contents of your wallet?

Janet Mulready, Health & Well-being Librarian in Powys

After more than two decades as a primary teacher, I was delighted to return to my library roots and I was very excited to be seconded recently as Health and Well-being Librarian for Powys. The role is funded thanks to the Welsh Government's Integrated Care Fund, through the Age Well Partnership in Powys; it is part of the project which is focused on scoping and development of community hubs, for these will be a source of early interventions to improve access to health-related information and advice. ​Being appointed to such a stimulating job in my 60s certainly shows that you can age well in Powys!

My job is excitingly diverse and has already involved building strong working relationships with other organisations seeking to improve well-being within the community. The provision of services to people living with dementia and their carers is important to Powys Libraries, and the development and dissemination of resources to support this is a significant part of my role. I am currently working closely with museum staff and library colleagues to devise a system of lending memory boxes and reminiscence hampers to care homes. We also supply resources from the dementia charity Playlist for Life via the collection service at branches to those who request them.

Another important role is to promote the Reading Well scheme (Darllen yn Well). The Reading Agency and Welsh Government have provided Reading Well resources in both Welsh and English, to support living with dementia, adult mental health and children’s mental health. All titles are recommended by health professionals and people with experience of the conditions covered.

I work with a colleague in disseminating this important service, which is linked to public libraries’ ever-expanding work around community health and well-being. The books can be referred via a Book Prescription, and are also available for self-referral via the Powys library catalogue, for collection from the local branch; some are also available as e-books or audio books. The system supports a self-management model, to encourage patients to take an active role in the decisions made around their health and well-being.

The Reading Well for mental health collection provides general information on mental health and well-being, and offers condition-specific titles, support for those difficult experiences which affect us all, such as bereavement and loss, and personal stories. To ensure the collection is accessible to a wide range of audiences, it includes a range of different formats and reading levels. Topics include therapies and approaches, common feelings and experiences, self-help books to support mental health and personal stories. The scheme supports living well and self-care and self-management models. As a community intervention, it also allows for public services to work together to support the health and well-being of their communities.

As well as signposting to sources of professional help and support, it recommends other well-being activities such as reading groups and volunteering opportunities. And of course, libraries are a vital source for the comfort of fiction. To quote Matt Haig again, “There is something about absorbing yourself in a story that can make you feel comforted. One thing about depression is that it is plotless, there is no shape. Stories have shape – and books became my antidepressants.”

A further remit I have is to help library staff to become confident with services that are available in Powys to support residents, so I prepare and disseminate regular ”How to Help with …” resources. The pandemic has meant that part of my work focus is working with colleagues to develop digital access to supportive services. We have initiated an “Ask a Librarian” enquiry service via the website and the loan of blood pressure monitors; many people are concerned about the physical health effects of lockdown and a more sedentary lifestyle due to home working, yet are understandably reluctant to “bother” a health professional, so they can borrow a blood monitor for free and have it delivered to their local branch for them to collect. As lockdown eases, we are looking to provide rooms in selected branches for individuals to have privacy for online medical consultations.

The importance of digital services and new means of communicating has become important for all of us, so my role also involves supporting colleagues in providing health and well-being information and services digitally. A large number of people are experiencing anxiety due to the restrictions on social interaction, and so we are working on producing well-being videos and resources such as adult literature hours, to play a part in reducing isolation.

A typical working day for me at the moment can involve giving a zoom talk on the Reading Well Scheme, applying for funding for well-being projects, making a video, and writing a Help sheet. Every day brings something new and involves me collaborating with some inspiring, committed people. I have a wonderful job and I am very grateful to have the opportunity, in a small way, to make a positive difference to people!

Many thanks to Janet for telling us about her new role as Health & Well-being Librarian for Powys. 

Find out more about the Powys library services on the English & Welsh websites below:

Powys Libraries' Services

Llyfrygelloedd Powys

If you have any queries then please drop them in the comments section below. Alternatively you can contact Janet directly by emailing: janet.mulready@powys.gov.uk or ringing: 01639 845353.