World Mental Health Day 2015

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

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

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

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

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

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

Mental Health Foundation Tea & Talk initiative
for World Mental Health Day

What does it feel like, not being treated with dignity? It might feel that:

I am not being listened to

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

I have been labelled

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

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

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

I might lose my freedom

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

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

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

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

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

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

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

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

Paid workers – a voluntary group’s “essential” or “luxury”?

Another debate that has been very much “in the air” recently, is about whether or not groups of people who come together to pursue a common goal should receive more formalised support, particularly in the early stages. This could apply to any type of voluntary group, not just those focusing on mental health issues. Just because individuals decide they want to work together to campaign, for example, for better or different services, does not necessarily mean that they have the skills required to set up, run and sustain the group.

Working at Powys Association of Voluntary Organisations for the last few years I have come across many people volunteering across all spheres – health, the arts, heritage, sport and more. The one thing which brings them together is their passion – in my own case, volunteering for The Quilt Association in Llanidloes, it is a love of quilts both old and new that is the common bond. In mental health people might want to press for new services in a particular geographical area, or provide support for a specific group such as carers, for example.

But... what all these people (including me), with their diverse range of interests and skills and goals, suddenly find they also have in common – is the need to skill-up fairly quickly on the day-to-day basics of running and maintaining a group and the implications that has for them all. This is particularly the case for those groups which decide to become charities, where legal and financial responsibilities can create a lot of work – work which has absolutely nothing to do with the original reason why the group was set up!

So, whether promoting heritage quilts or campaigning for increased mental health services... we suddenly all need chairs, treasurers, secretaries and incredibly hard-working individuals who don’t mind finding out the nitty-gritty about insurance, equal opportunities policies, expense procedures and so it goes on...

The question is, should some of these groups – in the area of health often referred to as “user-led organisations” - be provided with a paid development worker in the early stages to help them? According to the Social Care Institute for Excellence (SCIE) “strong user-led organisations help commissioners tackle inequality, build social capital, contribute to prevention, and be more responsive to the local community.” You can read some of the guidance given to people commissioning services to develop and strengthen these organisations here.

What do you think? Are you involved in a voluntary group yourself, or thinking of setting one up? (Wales Council for Voluntary Action has useful information here if you are).  And if you believe paid support is required on a regular basis – who is going to fund it?

PS: Whilst reading around the issues for this post I discovered that the Office for Disability Issues has a Strengthening Disabled People’s User-Led Organisations Programme - short-term grants to groups in the UK. “The programme is a £3 million investment over four years (until 2015) that will aim to promote growth and improve the sustainability of DPULOs.”  You can find specific advice for organisations based in Wales here.