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

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

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

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

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

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

Ystradgynlais Mind - In-work support service

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

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

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

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

Brecon & District Mind - Mums Matter

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

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

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

Find out more on the Brecon & District Mind website.

Mid & North Powys Mind - Bereavement Cafe

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

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

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

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

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

Ponthafren - the Gym

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

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

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

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

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

All you need to know is on the Ponthafren website.

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

Long may they continue to support our communities.

Compassionate Communities

Dr Julian Abel and Dr Helen Kingston

Last month I attended a seminar with colleagues from Powys Teaching Health Board, PAVO’s Community Connectors and our Health & Wellbeing team at Bronllys Hospital in South Powys. It was to learn about a new model of Primary Care working to provide health services. Compassionate Communities is its name and it has been operating in Frome in Somerset successfully for the past 3 years.

Dr Helen Kingston, a Senior Partner at Frome Medical Practice, and Dr Julian Abel, Director of Compassionate Communities UK, were travelling throughout Wales to spread the word. 

In brief, the three key messages, which I took away from the session

1. People – you, and me, our families and friends (the actual or potential patients or users of the health service), benefit hugely from this way of working. 
2. People – the ones working to provide the health service, from GPs, nurses and pharmacists – right the way through primary care services – are enthused, reinvigorated and actually enjoying jobs where their actions make much bigger differences to people’s lives. 
3. Money – is saved. Emergency hospital admissions drop drastically. 

The Compassionate Communities' approach is about joined up or “integrated” working. The focus is on people. The community in Frome appears to have been transformed. It looks like a genuinely supportive network. We all hope (but don’t necessarily expect) that people would rally round if we were struggling to deal with not just our health, the unexpected curve ball life had thrown, or even the mundane challenges of day-to-day life. In Frome it appears to actually happen. People help each other within this system. And, as a result, their health and wellbeing improves. 

Maggie Sims (Regional Partnership Board public representative) and
Andrew Evans (Assistant Director of Primary Care, Powys Teaching Health Board) listening to Julian

The original motivation – Julian tells us more

“We asked - how can we do what’s best for people? It’s common sense that if they are lonely they need support. Friendship. Love. Companionship. That’s what’s needed. Not a tablet.”

Julian described the essentials that are required for this kind of approach – specialist care, generalist care, compassionate communities and civic actions – and how these can affect health and wellbeing in local populations. It was all these components, working together, that led to the dramatic impact in Frome.

It is a whole population intervention – equally as valid to a teenager as a frail elderly person. The teenager might be bullied at school, cyberbullied at home, become depressed and have poor educational outcomes. Drug and alcohol misuse could establish leading to life-long problems. The solution in the context of Compassionate Communities is at school – the civic community, and at home – the community.

It is the union of the new model of primary care and the Compassionate Communities approach which brings about change. But, how you implement change is as important as the change itself. We are used to the permissions effect of top down change. This approach requires the people who do the work to implement change in a systematic way, determined by ground up change.

It is also about looking at people rather than the medical conditions they may have. “If someone is suicidal because of loneliness then their chronic lung disease might not matter to them,” said Julian.

It is about not having treatment rather than having treatment. It is about networks of support. Fifty years ago people would rally round to give extra support – but this response has been lost to some extent in local communities. Yet the resources at our fingertips are enormous, and our natural networks can extend up to five hundred people. So much is going on in communities that may be untapped. It makes sense to use that, to have a profound impact on people’s health and wellbeing, and because this is the focus, almost the unintended consequence is that emergency admissions drop. 

Dr Mary Hughes and Dr Sean O'Reilly from Haygarth Doctors' Practice

The Compassionate Communities approach in a little more detail – Helen tells us more

There are three main components to the model:

1. Clinical team and GPs. 
2. Community workers. 
3. Integration across the Health & Social Care sector. 

Previously staff in Frome worked in separate silos depending on the disease they were treating. They wanted to get back to basing care around what the individual needed – to improve care, and also their working lives. Helen described the anguish staff experience sometimes. A human being in need sits in front of them but they can only focus on just one small part of the story and have to ignore the rest. It is about recognising firstly that life is complicated – separating self-esteem from physical issues is not possible; and secondly that human relationships are powerful and in many instances, the most beneficial in maintaining and achieving health and wellbeing.

First on left: Freda Lacey, Senior Officer Health & Wellbeing Team at PAVO

Setting up a hub in Frome

The hub is the single point of access in the community. Staff - the primary care team (GPs and nurses), work alongside the new Health Connectors (akin to our Community Connectors). Volunteer Community Connectors (akin to Community Champions) are out in the community, they can be post people, the hairdresser, local shop keeper, milk person, taxi drivers, sixth form students, but have a route into liaising with primary care staff at the hub, if this is needed.

So, when people call, it’s not just about discussing medical matters, but also other things that are important to them. “We have turned life’s difficulties into a disease and medicalised everything and then use the medical model to manage it,” explained Helen.

There may be a window of opportunity in a crisis situation. It is about empowering staff to take a different approach. But, also, about meeting people where they are. “There’s no point telling someone about community groups if they have to work up courage to go and buy milk”.

Mentors work with staff to help them change their approach. Stories at team meetings can turn hearts and minds and people begin changing their way of working. Helen suggested finding key people in practices who are enthusiastic to work with initially, so the energy goes with the flow.

Mistakes will be made, but we can learn from them. It is about being creative in our approach.

Suzanne Iuppa, PAVO Community Connector, contributing to the discussion

The voluntary sector

In Frome, the paid Health Connectors (now mainstream, funded for three years) work very closely with an “amazing voluntary sector”. Health Connectors offer one-to-one appointments and do care planning (“they are the glue, but not necessarily the experts”). They recognise that 95% of the support that people need is around them in the community, and link them in. Some people may not be ready to accept help immediately, but Helen’s advice is “have courage and be persistent. They will come back when the time is right for them.” Many of people’s problems are solved outside the medical practice in this model.

Over 400 groups and services are listed in Frome’s electronic healthcare recording system so social prescribing is at their fingertips. When patients are signposted this is coded on to the system. The nature of the conversation changes with this website directory immediately to hand. (In Powys we have the online service directory infoengine, and although it is not currently linked in to the GP electronic system here, we are in discussions about this with a provider of this type of technical service).

Then there are over 600 trained volunteer Community Connectors (Community Champions). These are interested members of the public, whose role is not 1:1 work but to raise awareness of the service. In an ideal world, everyone would be a Community Connector or Champion! Each person signposts on average twenty times a year.

Building community resilience

Other options for people:

• Talking Cafés – drop-in sessions run by the Health Connectors. Anyone welcome. Signposting to other resources and places to make friends. 
• Health Connectors’ groups – peer support groups following 1:1 work. 
• Self-sustaining groups – leg ulcer, diabetes, macular degeneration, stroke support… and many more. 

Helen finished the session with a couple of detailed case studies which brought the Compassionate Community approach to life.

“Most small acts of kindness happen with individuals. It’s building that capacity. It’s about face-to-face relationships, and people caring for each other. About having that conversation that might not have happened.”

What do you think about the Compassionate Communities approach? Here in Powys we already have a lot of the elements of this model in place – we have our Community Connectors’ team, an equally amazing voluntary sector, and the online service directory infoengine. And work is well underway to further integrate systems and teams to do what’s best for people here too.

Once we know how this work progresses we’ll update you in another blog post. Watch this space!

What do people ask the Powys Mental Health Information Service?

Recently I was tasked with looking at our stats to identify some of the most common enquiries we receive at our Mental Health Information Service. I thought it would be interesting to share my findings with a wider audience. I’ll also provide some typical responses to the queries and who knows, there may actually be an answer to a question that a reader has wanted to ask for ages!

Enquiries come in to our service via telephone, email or in person – and from absolutely anybody with an interest in mental health in Powys. We also receive a lot of enquiries from people outside Powys surprisingly, but these usually relate to services available within Powys, and are made because Powys residents are currently living away from home, for whatever reason, but still have links with providers of the health services in Powys or family and friends here.

Sometimes we are asked a question which totally throws us – and then in our team we have to don our private eye deerstalker caps and do a little bit of investigative work. But those unusual and often intriguing topics are really probably the subject of another post!

So, without further ado, here are some of our most common enquiries:

I’m concerned about the mental health of a close family member. What should I do?

Whether a mother, sister, son or nephew – or any other relative for that matter – spotting that a close family member is struggling can be upsetting and hard. What can you do to help? The person concerned may not be ready to accept help. They may have received support in the past, recovered and now relapsed. They may already have put mechanisms in place to help themselves, or they may be really struggling and crying out for help in all kinds of ways.

One thing is sure. Families are all different and relationships within any of them can be complex. No two enquiries about families will ever be the same, but there are many common themes:

• How do we get help from statutory health services (the NHS)? The first port of call is the GP. After that – there are various options which are outlined on Getting help & support in Powys.
• Where can my relative go to meet people going through similar experiences? There are mental health orientated voluntary groups all around Powys running all kinds of activities and training sessions – find the one nearest to you. They welcome new members.
• I really want to help, but I’m exhausted myself. Family members who provide an informal caring role can find support in Powys at Credu Connecting Carers.

Where can I find counselling in Powys?

That there are long waiting lists for talking therapies in all parts of Wales is generally well known, but people still need to talk and will go to great lengths to investigate all the options. One of our guest authors wrote Finally receiving treatment – a personal view which documents one journey. We were being asked so often about alternative options that we decided to set up a webpage dedicated just to this – How to find talking therapy or counselling in Powys. Here you can find links to the charities locally offering counselling, plus an extensive list of counselling directories – everything from the Buddhists’ Therapy Database to the Hynotherapy Directory.

I think I need a mental health advocate – what do they do and how do I find one?

If an individual in contact with mental health services feels they’re receiving the wrong treatment, or wants someone to support them at a meeting or tribunal, for example, then they may be eligible for free support from an independent mental health advocate.

Advocacy is all about taking action to help people say what they want, secure their rights and obtain the services that they need. Mental health advocacy in Powys is available to:

• Those residents who are currently inpatients on a mental health hospital ward. That could be within Powys (Felindre Ward at Bronllys Hospital) or in another county (for example, North Powys residents may be at the Redwoods Centre in Shrewsbury in England). This service is provided by Conwy & Denbighshire Mental Health Advocacy Service. Don’t be put off by their service name – CADMHAS do cover Powys!
• People in contact with what are known as “secondary” mental health services, so they live in their community but receive support from, for example, a community psychiatric nurse or psychiatrist. There are advocates in the North and South of the county provided by the Powys Independent Mental Health Advocacy Service who can support them.

I’m moving to Powys soon and need mental health support (or my family member does)

Moving is one of the most stressful things we do, so combine that with pre-existing mental distress and understandably people are keen to find out what they can do to make the move easier.

• If someone is already receiving support from a Community Mental Health Team in another part of the United Kingdom, then it’s a really good idea to liaise with that team well before the move takes place. That way the old CMHT can link up with the new team and the transfer will work so much more seamlessly.
• Otherwise, the route for a newcomer to Powys into mental health services is pretty much the same as it would be for anyone already resident in the county – a visit to the GP will be top of the list. However, there is an exception to this – which is available for people moving to Powys from another part of Wales. The mental health law in Wales (Mental Health (Wales) Measure) states that if people have been discharged by secondary mental health services during the past three years then they can go straight back to the mental health service which was looking after them before and ask them to check whether they need any further help or treatment. 

Can you tell me the contact details for the Powys Community Mental Health Team

And to round off this post, one of our all-time top asks! How do you find your local CMHT? Especially when there are five different teams covering this enormous county which is Powys, not just one?

If you didn’t already know, the five teams are based in Welshpool, Newtown, Llandrindod Wells, Brecon and Ystradgynlais.

And the best way to find each CMHT’s contact details is by checking out our webpage Getting help and support in Powys.

And that's the end of this round up of some of our top questions! If you have a question for our Information Service which isn't answered in this blog post, then please get in touch by ringing 01686 628300 or 01597 822191 or email: mailto:mentalhealth@pavo.org.uk 

PS: We have our deerstalker caps at the ready!

Mental Health & Missing Person Support Officer - Dyfed-Powys Police

Carina Giannuzzi is the Mental Health & Missing Person Support Officer for Dyfed-Powys Police. 

We recently worked with Carina, and colleagues at West Wales Action for Mental Health, to produce some mental health information cards for use by police officers who come into contact with people experiencing mental distress.

We caught up with Carina recently to find out more about this project and other vital work she is doing in Powys and Ceredigion.

Tell us more about the work you do

I started in my current role as Dyfed-Powys Police’s Mental Health & Missing Person Support Officer on the 1st September 2014, and from the start have been involved in two major projects which are ongoing.

One is the Mental Health Triage Team run in conjunction with Hywel Dda University Health Board and although the project does not cover the county of Powys, it does cover Ceredigion, Pembrokeshire and Carmarthenshire. The other is the Time to Change Wales anti-stigma campaign to tackle the discrimination surrounding mental health where I assisted Hywel Dda with a week of events they held last October.

I am a member of various mental health related groups, both internally and externally, and attend regular meetings relative to these.

I am also responsible for collating data and providing reports; receiving and identifying areas of work that require improvement to deliver change and am involved in multi-agency and partnership working.

What led you to this particular role in the police?

When I read the role profile for the post it sounded so interesting, worthwhile and rewarding that I thought “I want that job!” and thankfully I was successful in my application.

I also have a personal interest in mental health which I feel benefits that side of the role due to my understanding the impact that mental ill health can have on individuals, their family, friends, colleagues and employers.

What is the most challenging aspect of the job?

I would say juggling the two sides of the role as both aspects are equally important and demanding areas of work.

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

Isolation is probably one of the biggest factors. Many people living in rural areas reside in remote locations and will not have neighbours close by that they can call upon. Their family and friends may not live close by and transport to visit them or just a trip to the shops can cause issues for some people, especially the elderly. Regular contact and communication is key for these people.

Why do you think the police are often the first point of contact for people experiencing mental distress?

When a person is in distress or at crisis point they want immediate assistance. They may not know who else to contact for help and by telephoning the police they know that they will get a response 24 hours a day. Many services are not available out of hours and this is another reason police are contacted.

What is the biggest issue for police officers trying to support people in the community who are mentally distressed?

Accessing the necessary services to provide them care and assistance they require in a timely manner. This is particularly prevalent ‘out of hours’.

Dyfed-Powys Police are working hard to provide better support for people in mental distress (see here for example). Tell us about the latest initiatives and any feedback you have had.

Our Chief Constable Mr Simon Prince has just signed an organisational pledge on behalf of Dyfed-Powys Police to show our commitment to the Time to Change Wales campaign to tackle the stigma and discrimination surrounding mental health. I will be putting plans in place to take this campaign forward.

We are also looking at a safety card for people with mental health, learning disabilities/difficulties and dementia who may come in to contact with the police for any reason, for example, if the person is in crisis, lost or wishes to report a crime. The card will provide the officer with their name and details of their condition. It will also provide the name and details of a person police can contact to assist them dealing with the individual they have come in to contact with. This will be of benefit to both the individual and the officer. Once the design and content have been agreed, we hope to have this in place in the next few months.

Dyfed-Powys Police, in conjunction with Hywel Dda University Health Board, has set up a Mental Health Triage Team to respond to mental health related calls received by police. The scheme commenced at the beginning of January 2015 and initial feedback and statistics are very positive. Although the project has only been running for a few months, it has already been nominated for and NHS award.

How will the mental health information card we worked on together recently help?

The cards will provide an extra 24 hour point of contact for people who do not know where or how to obtain help, with the mental health team at Powys Association of Voluntary Organisations (PAVO) and West Wales Action for Mental Health (WWAMH) providing another line of contact to advise people what is available in their communities. There are so many valuable services in the third sector that people do not know about and it will also help to raise their profiles and that of PAVO and WWAMH.

Which other organisations do you work closely with in Powys and Ceredigion to provide support to people?

Powys Teaching Health Board is the main organisation. I have recently met with HUTS (Help Us To Survive), Hafal and Noddfa at a Ceredigion Voluntary Group meeting and am hoping to work more closely with all three of them in the near future.

Where do you think the 3rd Sector fit into the picture? Would officers be confident about signposting or referring people to voluntary organisations?

The third sector can and does play a major part in mental health. There is wealth of fantastic work going on that people are not aware of that is assisting so many individuals and their families. Our Triage Team officers and Force Communication Centre staff are already signposting and referring people to voluntary organisations. It is a matter of making our staff aware of what is available throughout the Force area and what services these organisations offer. One of the ways this is being done is by adding these organisations to our internal Force Mental Health Information Page. Many have already been added and as I come across new ones, they are being added to the site.

Is there anything more the 3rd Sector could do to support the police in their work with people experiencing mental distress?

I believe the third sector is already supporting police in their work.

The only suggestion I have that may be useful in raising the profile of voluntary organisations within the police (if not already being done) would be for them to invite local Neighbourhood Policing Teams along to meetings or events they are holding.

What is the most valuable thing you have learnt since starting your role?

I am finding this very difficult to answer! I have learned a great deal, particularly in relation to the third sector and the fantastic work they do. I had no idea until I started in this role and I find it very inspiring.

When you are not working for Dyfed-Powys Police, how do you enjoy spending your time?

I have a wonderful family and friends who I love to spend time with.

I love to read books of all sorts and am keen on history, fashion and art. I also like to sew when I have the time and have just started exercising again to try and gain some level of fitness once more (said through gritted teeth)!

Many thanks to Carina for telling us more about her work. If you have any queries or comments we would love to hear from you.