Compassionate Mental Health conference, Hereford, November 2019

by Sue Newham

Health & Wellbeing Engagement Officer, PAVO

I went along to this conference with only a vague idea of the content, but being told by my colleagues at Powys Association of Voluntary Organisations that it would introduce me to some new ideas and give me plenty to think about. They were right!

I was asked on arrival if I’d come to do the yoga. I hadn’t, but it was certainly a novel start to the day!

Novelty continued with an opportunity to engage in “Compassion Circles”. Andy Bradley encouraged us to get into threes and listen to each other “with a quiet mind and an awake heart.” Andy’s concern is that our systems, with time pressures and outcomes, can make people feel as if they don’t really matter. Really listening to people can change their feeling of being valued for who they are.

The keynote speaker was Robert Whitaker, author of books about mental health treatment called “The anatomy of an epidemic” and “Mad in America.”

Robert outlined the history of dealing with mental health issues in the USA. He explained that, in the 18th century, the prevailing view and practice was to treat people experiencing mental breakdown as having lost their humanity. Sufferers were treated like animals and subjected to barbaric treatments. At the end of the 18th century, the Quakers set up homes where sufferers were seen as “children of God” and treated with compassion in pleasant surroundings. Records of the day suggest that there was a good rate of recovery following this treatment. In the 1980s, the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders 3 became the standard handbook of psychiatric diagnosis. It heralded a shift towards the disease model of mental health. Whitaker sees this as creating a line between “normal” people and “abnormal” people, where stresses associated with life become illnesses to be treated.

I found myself pondering the role of the American Psychiatric Association and the drugs companies. Is it likely that companies that have seen a 50 fold increase in income from mental health drugs would be open to other ways of treating people without drugs? If drug companies fund the American Psychiatric Association, which apparently they do, is it possible for that organisation to embrace different treatment models?

Early disease models of mental illness seemed to be based on the theory that chemical imbalances within the brain lead to symptoms of illness that can be corrected by medication. Although the theory had been found as inadequate as early as the mid 1980s, it has still continued as an urban myth. This was a shock to me, as before this conference, I too would have said that mental illness was to do with chemical imbalances in the brain.

Robert Whitaker challenged the prevailing disease model as an effective means of treating mental distress. He said that, if the model was correct, overall recovery rates should now be going up as medication successfully treats people’s illnesses. On the contrary, statistics record that 1.1 million people were on long term disability in the USA due to mental illness in 1987. That number is currently around 5 million. There is also evidence that full recovery is more likely amongst unmedicated groups than medicated groups.

Whitaker’s overall message is that the medication model has not achieved the outcomes expected and has failed to produce scientific evidence that it is improving the mental health of the American public. He mentioned several projects that had shown success in non-medical treatment of mental distress: the Soteria project; the Norway Medication Free Inititative; the Open Dialogue's model developed in Finland.

He suggested that we need to change the script, seeing struggles as a part of being human, rather than a sign of illness which may see sufferers relying on medication for the rest of their lives. He advocated social support, listening and giving people a sense of hope. Psychological therapies also have a role to play in helping people work through traumas and distress. 

During another session, I heard from Margaret Jordan about the benefits and practice of Sensorimotor Psychotherapy, which treats people holistically rather than focusing on the brain. A phrase which Margaret used seems to me to be important and worthy of more thought. She said, “Trauma is an action that needs to be completed in order for the symptoms to reduce.”

I observed an Open Dialogue session in which a course participant agreed to talk about a personal experience and we observed how Open Dialogue can help people to work through difficulties they were facing. The practitioners were Yasmin Ishaq and Rai Waddingham. This was an extremely interesting, but in many ways simple intervention, involving taking time with people and those close to them and listening to them. Yasmin is a social worker and psychotherapist and Open Dialogue lead for NHS Kent. This seems like a very positive way that people can be given time, listened to and enabled to process and work through their difficulties.

I enjoyed listening to Ruth Young from Jamie’s Farm talking about residential weeks for troubled young people, which involve real farm work and responsibilities, as well as group times for talking. This is how the website describes the programme, “Jamie’s Farm acts as a catalyst for change, enabling disadvantaged young people to thrive academically, socially and emotionally. We do this through a unique residential experience and rigorous follow-up programme, combining farming, family and therapy.”

So what was my overall impression of the day? As someone with only one year’s experience in the mental health field (in other words, a complete novice) I found it thought provoking! It challenged some views that I had held as facts, without really knowing why.

It shocked me to hear that people with severe mental illness have a reduced life expectancy, often dying between 10 and 25 years before their peers. The World Health Organisation suggests that some physical illness may be exacerbated by antipsychotic and related drugs.

Overall, it left me with a feeling that profits and big business set the agenda for many of the ways we tackle everyday life. I feel that society has a duty to question why things happen as they do and whether, in fact, science is being manipulated for the benefit of those making the most money.

I also feel that better listening and focusing on the whole person could help many people experiencing mental health issues. “Compassionate” sounds like a good word to describe how I’d like to be treated if I was going through trauma and distress.

Terrible things happen to other people

This week's guest post is from PC Owen Griffiths of Dyfed Powys Police. I met Owen in May during Mental Health Awareness Week, where he spoke to colleagues and partner organisations about his own experience of mental distress. He kindly agreed to share his story with a wider audience. Over to Owen.

Bad things always happened to other people - faces on the news and names in the paper - or so I thought. My life was good and right and nothing was going to change that, of that I was sure. All that changed for me on the 22 May 2004. Let me tell you about it.

My name is Owen Griffiths. I am a 43 year old serving Police officer who currently works in the training department for Dyfed Powys Police. On the 22 May 2004 I was involved in an incident whilst on duty - one which I was very lucky to leave with my life intact. I can clearly remember being quite badly injured and standing at the side of the road. I was bruised and bleeding badly and although these injuries hurt me greatly they were nothing compared to the pain that hit me in my mind.

Before this incident I always believed that “stress” was feeling a little angry or perhaps snapping at people whilst being a little rushed or busy. I could not have been more wrong. The feeling that came upon me at that moment was something far more than this - it was a distinct all prevailing physical sensation that hit me as if I had run into a brick wall. At that moment I can clearly remember thinking “everything has changed”.

The next few days I spent recovering from the physical injuries I had sustained. My body was in pieces but it was my mind that was really hurting. Even though I was told to rest, it’s the last thing I wanted to do. I spent those early days walking around in a daze, my mind a constant stream of negative and anxious thoughts. It was at this time that I realised that I was very ill. No matter how much I tried I couldn’t concentrate on anything other than my own situation and what would become of me.

Because of the nature of the incident I had been involved in there was a procedure and as a Police officer I knew all too well that there would be an investigation into the events of that night and that my colleagues and I would be involved. Looking back now with the benefits of a clear mind and the comfort of hindsight it’s easy to see that I had done nothing wrong and it was just an unfortunate set of circumstances that would have to be looked into. Sadly this new me, a me tortured with racing thoughts, had thoughts that led to catastrophic conclusions with no possible endings other than my own imprisonment for the rest of my days. Again, looking back it seems silly that I even contemplated this happening, but what I didn’t realise is that I was now deep in the troughs of a severe episode of anxiety, one which would not leave me for over a year.

Days turned into weeks, and weeks into months, and all this time was spent in a haze of catastrophic thoughts. Sleep became almost non existent and I staggered from one horrendous fantasy of what my future was to another. I went to my GP on an almost weekly basis begging to be sectioned or given something that would relieve me of the torture that my life had become. Pills made me worse and I started to self harm and even contemplated ending it all but I kept going, unable to talk about anything other than my own problems or think about anything other than my own situation. There would on occasion be small windows of hope, perhaps I would get some good news or be cheered by the friendly words of family and friends. These moments of non worry became an incredible phenomena, a brief time when I felt for just a few moments like the “old me.” This feeling was more than just a lift of mood, more than a feeling of a weight lifted from my shoulder, it was like peering out of a cave on a summer's day. 

These were difficult times for my family. Having always been a big character I think it was difficult for them to accept this new me.  They gave their all to help me and I will be forever grateful. Like the pills that could not cast a spell and make me better I became frustrated and could not see any future for myself. Things looked really bleak. They had to change.

During the early days of my illness I had been referred by the GP to the local psychiatric services. Time had gone by and I had heard nothing (I would eventually get my first appointment almost two years to the day that I was referred). Seeking help but finding little I started to try different ways of helping myself. Of course getting myself out of the gloom and into helping myself was actually the last thing I wanted to do but little did I know it was actually the best thing for me.

Exercise was something I was sort of doing without realising it. Unable to sit and relax I was in the habit of walking miles, usually round in circles in my garden totally preoccupied. But when I started to give myself small goals like walking my dog to the old ruin a few miles from home, or cycling to Tesco to buy a chocolate bar or anything else that I may need, something started.  I would suddenly go, first seconds then minutes and then maybe ten minutes, without thinking of my problems. These little breaks from the pain became a lifesaver. Now I run regularly taking part in my local Parkrun every Saturday morning and being a regular runner in local 10k races. Exercise above any medication became a lifesaver.

Meditation and Body scanning. Helped by the force's occupational health department and counsellor I was steered in the direction of mindfulness and body scanning. This again became and has become an essential part of my day. I found it difficult at first to stop the swirling voices of doom but slowly over time I managed to shut them down for a few seconds at a time. This was priceless in the long run. 

My road to recovery was rocky and long and has taken a few detours along the way. I will be forever grateful to the Police rehabilitation centre in Flint House. The meagre amount deducted from my monthly pay could never hope to pay them back for the help they gave me. Even now I get my moments but it gives me great pleasure to talk to people who are going through a similar thing and sometimes can’t see that there is a way out. I can honestly say that at its worst it was the darkest time of my life. It affected me more than I could possibly imagine but I refuse to let it define who I am. From it I grew, I started to find my love for performing again and lost a lot of the inhibitions that were holding me back in life. Now under the name Owen Staton I can often be found performing and storytelling or acting all over the country. It’s not easy sometimes but Life isn’t a bed of roses and sometimes it's better for it I feel.

Mental illness can sometimes be a gift. It makes you appreciate being well, it helps you realise the battles that people are fighting and makes your victories ever sweeter. Do I wish I had never been ill? Yes I do, but I don’t for one minute regret being the person it made me. I am better and stronger and you can be too.

God Bless

Owen

You can follow Owen on Twitter @owenstaton

Many thanks to Owen for sharing his story. We love to hear from our readers, and welcome any comments in the box below.

Positive Action for Change in Mental Health Services - Part 1

In November last year I attended this one day conference organised by PCCS Books in Nottingham. Two of the keynote speakers – Lucy Johnstone and Sami Timimi – had previously travelled to Powys to speak at a conference organised by our team in March 2014 - Finding Meaning in Psychosis: Early Intervention Services. This conference had highlighted the debate that challenges the validity of ‘mental illness’ diagnosis and raised questions about whether the idea of ‘mental illness’ is useful in driving innovation. However, due to leave I had been unable to attend. So, I was really keen to make the trip across country now to find out more about implementing innovative approaches to mental health distress. And the conference promised not just two but several inspirational speakers.

PCCS Books is an independent mental health publisher dedicated to the demedicalisation of distress, and person-centred, recovery-focused mental health services. The name developed out of a training organisation called ‘Person-Centred Couselling Services’, and at the conference (I think they organise one every couple of years) Director Heather Allan welcomed everyone and set the scene for the day:

“The case for demedicalising mental health services is well rehearsed. The research has been done, the conferences have been held and the intellectual argument all but won. Yet on a day-to-day basis, services continue to operate within the medicalised status quo. One of the aims of this conference will be to look at how we can implement realistic, practical changes in our mental health practice, education and lives, in order to continue the progression from rhetoric to reality.”

Due to limited space I can only touch briefly on the speakers’ presentations with a focus on their practical suggestions for bringing about change in working practice. (Full presentations are available here however).

Lucy Johnstone – Challenging, compromising or colluding? Some thoughts on trying to bring about change in mental health systems

Lucy made regular reference to her own personal situation working as a Consultant Clinical Psychologist at the Royal Glamorgan Hospital for Cwm Taf University Health Board in South Wales. This is the most socially deprived area in the whole of Wales, where 13% of the population are in contact with mental health services. It was a very medicalised service when Lucy arrived.

Lucy has since introduced an approach called “team formulation”. Regular meetings take place involving services in contact with an individual experiencing distress, within Community Mental Health teams, Assertive Outreach teams, rehab services and inpatient wards, to develop an in-depth understanding of that person’s particular difficulties. Staff will then work together to tailor any support to the needs of the individual rather than applying a one-size-fits-all approach. Using a case study of a 17 year old girl hearing hostile voices, Lucy contrasted the medical approach, which resulted in a diagnosis of psychosis/schizophrenia, to the way team formulation drew out the young woman’s story of abuse and bullying over a period of years. The latter approach acknowledges that responses such as hearing voices are survival strategies – “a normal reaction to abnormal circumstances.” 

In Cwm Taf team formulation has spread organically and not aroused much resistance. Lucy explained that her colleagues may not always agree with her approach but they take her stance on board, and some people are shifting away from using diagnostic approaches. The team formulation approach had led to “a change in thinking” and become “part of the culture as a word and a concept.”

“Instead of giving a diagnosis, we need to listen to people’s stories.”

Peter Beresford – From mental health to mad studies: making involvement real

Peter Beresford was introduced as the first “out” mental health service user to become a professor (Professor of Social Policy at Brunel University in London in fact). He spoke knowledgeably about the political background to current mental health service provision, noting politics’ powerful alliance with traditional psychiatry at the expense of those living with mental distress. He believes that “lived experience” is devalued by government, and rather than trying to influence politicians we would be better advised to take the initiative ourselves. Peter’s recommendations included:

• Resisting forced employment and impoverishment.
• Holding on to good participative practice.
• Listening to service users.
• Encouraging service user input in professional training, which has a real impact on service culture.
• Focusing on changing the future for mental health and service users by innovating, by developing our ideas for change and our practice.

Peter also spoke about the value of Mad Studies, and referenced the recent conference Making Sense of Mad Studies which my colleague Anne attended in early October.

“We have to be courageous and rigorous and stop hoping that powerful big voluntary organisations will speak for us.”

Look out for Part 2 of this conference report next week, when I feature the talks of keynote speakers Sami Timimi and Pete Sanders. You can also find out more about the Soteria Network and the British Association for Person-Centred Approach, along with other organisations who attended. Thanks for reading, and let us know your thoughts on these ideas and approaches in the comments box below.

Making Sense of Mad Studies

by Anne Woods 

Participation Officer, PAVO mental health team

Illustration by Grietje Keller

I recently attended a two day conference at Durham University entitled Making Sense of Mad Studies organised by the North East Mad Studies Forum. Before attending, I wasn’t too sure about what to expect. Mad Studies wasn’t something that I had come across before and I felt slightly uneasy about using the word mad in this context, a theme that came up in the conference and on Twitter. 

The term Mad Studies has been credited to Richard Ingram, one of the speakers, who was inspired by the creation of Deaf Studies as an academic discipline distinct from Disability Studies and wondered whether the same could happen for madness. In his presentation he said that finding method in the madness was not as important as preserving the madness in the method! In other words, Mad Studies is a way of looking at the world that uses and benefits from a different perspective to life and need not only apply to academic research on mental health. The consensus from the conference seemed to be that Mad Studies was something done by people who identify themselves as mad and not something done to or about them.

Richard Ingram

A fuller definition is provided in the book, "Mad Matters" (2013) edited by Brenda LeFrancois (another conference speaker), Menzies and Reaume.

“An umbrella term that is used to embrace the body of knowledge that has emerged from psychiatric survivors, Mad-identified people, antipsychiatry academics and activists, critical psychiatrists, and radical therapists. This body of knowledge is wide-ranging and includes scholarship that is critical of the mental health system as well as radical and Mad activist scholarship. This field of study is informed by and generated by the perspectives of psychiatric survivors and Mad-identified researchers and academics.” 

Brenda LeFrancois

The conference included a wide range of speakers from different backgrounds: academics, some of whom identify as ‘mad’, early career researchers, activists, artists, people with lived experience of various types, sometimes presenters falling into several categories. Presenters shared some intimate and honest accounts of their own life experiences within the psychiatric system and how that had informed their work.

The agenda was jam-packed but some highlights for me included hearing about Mad Studies reading groups in Amsterdam from Grietje Keller. The groups give a space for reading and discussing critical texts that challenge the dominant medical psychiatric model and are mostly attended by people who have been users of mental health services. The groups are popular and give attendees a different perspective on their experiences.

There was discussion around ‘doing’ (teaching/ learning about) Mad Studies with a presentation from participants and tutors of a course at Queen Margaret University in Edinburgh for people with lived experience of mental ill health, and tutors of a course for approved mental health professionals (AMHPs) describing how important it is for professionals to be trained by people with experience of being on the receiving end. Dr Dina Poursanidou talked about the challenges that this throws up, including managing the emotional toll of using traumatic personal experiences as an education tool, something of particular relevance to PAVO’s mental health team in the participation work that we do. 

Brigit McWade from Lancaster University on Recovery

This theme was also picked up later by an action group called ‘Recovery in the Bin’. They have adopted 18 key principles, one of which is, “we refuse to tell our ‘stories’, in order to be validated … We believe being made to feel like you have to tell your ‘story’ to justify your experience is a form of disempowerment, under the guise of empowerment.” This is an issue that I am well aware of from personal experience. As a team, I think we recognise this and carefully balance our desire to use powerful personal stories to facilitate change against the emotional toll on the individual and their right to control how much and when they disclose.

The Recovery in the Bin presentation gave food for thought on the concept of recovery and the group’s contention that it has been appropriated by mainstream mental health services and is less focussed on what’s best for each individual and is more concerned with what’s best for a capitalist society, ie: getting people into employment and off benefits as quickly as possible. The group talk about the validity of remaining ‘unrecovered’ by this measure, finding ways to live with distress that does not necessarily neatly fit into a recovery star model, also recognising that some life experiences have to be tolerated rather than recovered from.

"You told me I'm my own worst enemy. So I got a restraining order against myself!"

The conference had a breadth of views and opinions and there were some challenging discussions, about racism in psychiatry and academia for example, as well as humorous moments such as why art made by service users can actually be good art. It introduced me to several views and topics that I hadn’t come into contact with before and had a good mix of people sharing their personal experience and academic theory. It will be interesting to see how the discipline develops and whether, in future, universities will have departments of Mad Studies and full-time degree courses or whether it becomes a movement developed by grass roots activists – or both!

The conference is on Storify on Twitter.

Mad Studies is on Twitter.

You can find more Mad Studies resources on a website run by Brigit McWade.

Exploring Mental Health and Trauma: Books To Get Us Thinking ....

Guest Blog by Jane Cooke.

There has been a focus on trauma-oriented work and ‘treatment’ in recent Powys conferences.  You can watch Jacqui Dillon at the Powys Stronger in Partnership conference last year here and you can watch Sami Timimi at the Finding Meaning in Psychosis conference in March 2014 here.

One of my roles in life (when I’m not working within PAVO’s mental health team) is as a counsellor/psychotherapist. I have a trauma-oriented approach which has been reinforced by listening to these speakers and by reading around the subject.

A trauma-oriented approach, as advocated by Sami Timimi, is a gentle way of beginning work that enables a person to feel safe and able to gradually build up a personal sense of control over their own boundaries and in time over responses to events or reminders that can lead to upsetting and overwhelming reactions. Even if a person doesn’t identify trauma as being relevant to them and why they come for therapy, this approach is empowering and helpful anyway. (It is not about forcefully inducing ‘catharsis’, re-living the situation, ‘facing up to it’ or any other similar techniques which can be re-traumatising or even abusive in themselves.)

Sami Timimi is a psychiatrist and a founding member of recently established Council for Evidence-Based Psychiatry.  He believes that working in a trauma-oriented way makes sense for most people who come into contact with mental health services. Much more sense than identifying ‘pathology’, symptoms and ascribing a diagnosis; all of which generally ignore the story, the experience of the person, how it is that they are who they are.

There are two writers who I have found very helpful and their work complements each other. Both Judith Herman and Peter Levine are concerned that people (clients, patients, service users, survivors) gain/regain their own sense of personal power and agency as they recover from their trauma/s.

Peter Levine has written a number of books about trauma. One of his books “Healing Trauma” is a slim self-help book with a CD covering a programme of exercises that anyone can follow to help overcome the neurological ‘holding’ of trauma. It is, he says “for restoring the wisdom of your body”.  He does caution that professional help may still be required. An empowering way of working could be therapist and client working together with the book and exercises, keeping the client in control of the work.

‘Trauma’ is a word we use in everyday speech,  but paradoxically in relation to emotional well-being there is a limited perception that trauma has to relate to major events that are, for example, combat situations, witnessing  extreme violence, being in danger of one’s life or experiencing sexual violence or abuse in childhood or adulthood. However, as Peter Levine says “People, especially children, can be overwhelmed by what we usually think of as common everyday events …The fact is that, over time, a series of seemingly minor mishaps can have a damaging effect on a person. Trauma does not have to stem from a major catastrophe” (his italics).

There is increasing evidence for this. So, for example, bullying, repeatedly not getting your needs for love and positive attention met, feeling fear regularly such as maybe a frightening  walk to school, regular contact with a frightening , threatening teacher or relative; being regularly shamed by powerful people when you are young.  Many things can build up to create a response in the nervous system which then needs to be ‘taught’ to respond to the here and now and to recognise/feel  current sources of support and comfort, including your own capacity  to support and nurture yourself.

Jacqui Dillon (a survivor of childhood sexual abuse) told us how much she had been influenced and empowered by Judith Herman’s book “Trauma and Recovery”. Herman looks at the way in which women’s (and children’s) experiences of violence, fear, captivity (and you can be captive in all senses without the doors being locked) and powerlessness in the domestic and community realm have been seen as variously: natural, bought on by the victim themselves, exaggerated  and overcome-able by normal acts of will. She looks at the way in which their experiences are minimised and belittled.  “Social judgement of chronically traumatized people tends to be extremely harsh” .She also looks at ways of working with people who have experienced trauma. Judith Herman has a framework for recovery from trauma. There has to be in her experience, in sequence (and returned to as often as necessary) Safety, Remembrance and Mourning and Reconnection. This works very well with Peter Levine’s work which in the early stages emphasises ways of achieving an inner sense of safety, and of course actual safety in daily life is essential.

Judith Herman is very clear that therapists need good training and good support, this is work that can be complex and challenging.

There are many books about trauma; I would recommend these two. They are compassionate and well-grounded in research and experience. They are as much for the person recovering from trauma as they are for therapists and other workers.  

Judith Herman’s “Trauma and Recovery provides a radical, community oriented approach to recognising trauma in the lives of women in particular as well as a way of working that can lead to recovery.

Peter Levine’s book is a gentle, practical self-help book (although he does not minimise the need for professional support as well).

Between them they are a very good ‘starter kit’ to this subject whether you are a health professional, or someone who has experienced, is experiencing, trauma – and you could very well, of course, be both.

Trauma and Recovery. Judith Herman.  Pandora  ISBN 978-086358-430-5

Healing Trauma. Peter Levine. Sounds True ISBN 978-1-59179-658-9

Written by Jane Cooke

Member of PAVO Mental Health Team:  jane.cooke@pavo.org.uk

And when not working for PAVO....

Gestalt therapist, ecotherapist  and interpersonal skills trainer.  Jane.cooke@heartfeltwork.co.uk

www.heartfeltwork.co.uk

Unconventional Wisdom: Shaping Services Together Conference, Powys, September 2013 - Adding To The Debate?

2013 Conference Theme: Shaping Mental Health Services Participation

In September 2013, Powys Association of Voluntary Organisations  (PAVO) were involved in running a conference in Powys, one of three events across Wales (you can access all three conference reports here).  The event was funded by Public Health Wales and supported by Welsh Government.  The theme was mental health participation.

PAVO lead on the Powys Stronger in Partnership Participation Network and we are a member of Mental Health Action Wales.  You can find out more about the activities we are involved in and the difference we think we are making here.

You can read a full report (12 pages) from the 2013 Shaping Services Together Conference, Powys, on our website here.  In this blog though I wanted to explain a bit about the ideas underpinning the conference planning in 2013.  I also want to tell you about another free conference that you are invited to on Friday 7th March 2014.
 

Learning From Previous Conferences ...

We first ran an event of this kind (i.e. national participation) in 2012, you can watch a video from this event here and read the conference report here.   Eleanor Longden spoke at this event and her talk continued the debate in Powys that challenges the conventional wisdom underpinning our mental health system.  A wisdom that is founded on the idea of "mental illness". You can read more about this debate in my previous blogs here and you can watch Eleanor talk on ted.com in this link.  

Eleanor Longden is joining us again on 7th March 2014, you can find out more about this here.

 

Thanks to people's willingness to get involved in the 2012 conference and to the feedback we received we were able to learn a lot from this event. 

We used this learning to help us to underpin the  2013 conference planning on two questions:

 

“Should mental health services be shaped by the question what happened to you rather than what’s wrong with you?”  

 

"If so, how can mental health participation influence such a fundamental change to our mainstream mental health services?"

 

As well as asking us to provide more opportunities to explore the de-medicalisation of distress, you also told us that future conferences should include:

"...time for exceptional and inspirational speakers that bring to the debate their own experience of mental distress"

 

... no pressure then! 
 

So A Big Thank You To Jacqui Dillon...

 

Given this we were absolutely delighted when Jacqui Dillon agreed to come to Powys and talk at this conference.  We think that she fitted the bill and luckily you don't have to take my word for it,  you can watch her full talk here.

“Jacqui Dillon is one of the most inspirational speakers I have ever met, thank you for enabling me to be part of today"

Jacqui Dillon is a writer, campaigner, international speaker and trainer.  She is the National Chair in England of the international Hearing Voices Network.  Her talk was entitled "The Personal is Political" and you can download the slides here. 

She began by sharing something of her own story, her experiences and her survival strategies.  Survival strategies such as self-harm, hearing voices, eating "disorder", creativity and resourcefulness.  Survival strategies that are often judged by mainstream wisdom as "symptoms" of "mental illness" rather than a natural and normal response to difficult life experiences.

She then shared her own experience of mental health services which she summarised against 6 themes:

• Pathologised:  "You are ill. Everything that you say and do will be seen as a consequence of your illness."
• Denial:  ‘It never happened’ or ‘It did happen but you will never recover’.
• Medication:  ‘You are resistant and the fact that you don’t want to take medication is evidence that you are ill’ .
• Dependency & Compliance: ‘You must accept the psychiatric diagnosis and medication and we will give you benefits and a bus pass’. 
• Disempowered: ‘You will never recover. You will always have this illness. You won’t be able to work’.
• Passive:  ‘You do not know what is best for you. We know what is best for you’. her own experience of mental distress

Then she talked about finding a new paradigm, which she broke down into 4 main areas:

• 
  Trauma & Recovery
• Understanding Dissociation
• Attachment Theory
• The Personal Is Political 

She shared some of the latest research findings around childhood adversity & psychosis, for example:

• People abused as children are 9.3 times more likely to develop "psychosis"; for those suffering the severest kinds of abuse, the risk rises to 48 times (Janssen et al., 2004).
• People who have endured three kinds of abuse (e.g., sexual, physical, bullying) are at 18-fold higher risk of psychosis, whereas those experiencing five types are 193 more likely to become psychotic (Shevlin et al., 2007).
• People with "psychosis" are three times more likely to have experienced childhood sexual abuse (CSA) than those with other diagnoses, and 15 times more likely to have been abused than non-patients (Bebbington et al., 2004).

She ended her talk by suggesting some answers to the question:  "What is to be done?".  Her ideas can be read in detail on the slides from her talk available here.

I highly recommend watching her talk (just over an hour).  So far over 1,000 people have viewed it and the feedback, not only from the conference but also from people who have watched her talk on youtube, has been incredibly positive.

 Further Information and Videos From Shaping Services Together 2013

Jo Mussen, Vice Chair of Powys Teaching Health Board and their Lead for Mental Health, Chaired the morning, as part of her conference introductions which included a thought provoking reading from the Robert Whitaker book,  Anatomy of an Epidemic.  The extract was entitled “A Modern Plague” and it can be read here

Sian Richards, Welsh Government Strategy Lead, National Mental Health Partnership Board, alongside other partnership members, and David Crepaz-Keay, Head of Empowerment and Social Inclusion, Mental Health Foundation, talked next presenting us with a presentation entitled “Together for Mental Health” that provided the latest information about: 

• The National Mental Health Partnership Board


•  Developing a National Forum for strategic participation in national and local mental health partnership boards 

You can listen to this in full (36 minutes) here.
 
Powys Youth Forum and Clwyd Theatr Cymru developed, planned, led and ran a participatory workshop on the theme: “Wisdom Across All Ages”.  This helped us to begin to explore participation for people of all ages.
 
You can find out more about the conference and read a full conference report (12 pages) here.

Unconventional Wisdom:  The Debate Continues 7th March 2014

Free Conference:  Wales Early Intervention Service Conference:  Finding Meaning in "Psychosis"?

Friday 7th March 2014.  The Pavilion, Llandrindod Wells Powys.  9.30 am for refreshments.  Finish 4.30 pm.   

 

Another chance to join us and find out more about the debate that challenges the conventional wisdom and to explore the question:  “Should mental health services be underpinned by the question what happened to you rather than the question what is wrong with you?”. 

 

Speakers Are:

 

Euan Hails - Clinical Lead Psychosis Services, Hywel Dda Health Board.  Bio to follow.  But to find out more about his work click here.

 

Eleanor Longden - an award-winning postgraduate researcher with a specialist interest in psychosis, trauma, and dissociation. She is a three times TED speaker, a trustee of Intervoice: The International Network for Training, Education, and Research into Hearing Voices and Soteria Network UK, and has lectured and published internationally on promoting creative, person-centred approaches to understanding and recovering from psychosis.  More here.

 

Dr Lucy Johnstone - consultant clinical psychologist and the author of 'Users and abusers of psychiatry' (2nd edition Routledge 2000) and co-editor of 'Formulation in psychology and psychotherapy: making sense of people's problems' (2nd edition Routledge 2013) along with a number of other publications taking a critical perspective on mental health theory and practice.   More here

 

Dr Sami Timimi - Consultant Child and Adolescent Psychiatrist and Director of Medical Education in the National Health Service in Lincolnshire and a Visiting Professor of Child and Adolescent Psychiatry at the University of Lincoln, UK. He writes from a critical psychiatry perspective on topics relating to mental health and has published over a hundred articles and tens of chapters on many subjects including childhood, psychotherapy, behavioural disorders and cross-cultural psychiatry.  More here.

 

This conference is an opportunity to explore:

• how we understand and make sense of these “psychotic” experiences
• best practice in early intervention responses that help people and those close to them cope with these experiences, learn from them and thrive
• the interactions, treatments and ideas that make a positive difference to people’s lives and how we make sure that these are offered with openness and transparency
• interventions and treatments that early intervention services could deliver and how they might continue to develop

Interested in joining us?  To find out more about this conference and to get more detail about how to book, click here or contact the team on pamhinfo@pavo.org.uk, telephone 01686 628 300.