Our comedy workshop @ Celf

Yesterday as a team we explored how comedy could inform our work around participation - specifically around engaging with people who have been in contact with mental health services or those close to them - and learned new ways to tell stories or describe experiences.

Who better to enlist to help us than Owen Griffkin of Havin' A Laugh fame. And what better premises for our workshop than the Celf Centre run by the art charity Celf O Gwympas in Llandrindod Wells. The place is stuffed full of weird and wonderful and very inspiring artwork. You only have to look at some of it to find yourself smiling. And, they even have red noses of their very own! Perfect for those of us working on a Comic Relief funded project called Standing up for emotional health and wellbeing (that would be Anne then, far right in the photo).

Artwork at Celf by Dean Warburton

In our very own bespoke Havin' A Laugh workshop Owen took us through a series of games over the course of a couple of hours. We were amazed to discover that there was much humour to be found in our own everyday lives and stories.

Owen Griffkin - the comedy master - and Jane Cooke, our Senior Officer Mental Health

In the first session some of us had travelled billions of miles (think Universe, speed of light, Star Wars kind of community transport) to put the most important question imaginable to The Oracle. Two of us had the slightly challenging task of answering the questions (as a sort of bizarre two-headed Oracle), one word at a time, each after the other... talk about throwing us in at the deep end. 

Questions ranged from the fairly predictable "What is the meaning of life?" to the intriguing "Why is there a colour purple?" to a rather random travel enquiry: "How do I get to Atlantis?" The answer to the latter being, quite obviously: "Atlantis relies upon your soul being attuned to many places including the underneath of your feet exactly." So.... now we know...

Artwork at Celf by Dean Warburton

Next up: Truth and Lies.... Each of us had to tell three facts about ourselves to the others in the group. Simple enough, surely? But, there was a catch. (Of course). One of the facts had to be a lie, and the others had to guess which one... Blimey, we never knew this could be so hard... our colleagues turn out to be masterful liars!

Here are the three facts Jane told us about herself.... which one do you think is the lie...?

1. All of my three children were born on a Thursday.
2. I did not start speaking properly until the age of 4.
3. My childhood ambition was to be a show jumper and a hairdresser.

One of my truths involved attending a Star Trek convention many many light years ago, but perhaps the less said about that the better....

Anne Woods - Participation Officer, and Philip Moisson - Powys Patients' Council facilitator

Further games followed, far too many to mention here, but you get a feel for the state of comedy affairs by this stage of the afternoon...

One of my favourite games was The Interview. We took it in turns to interview each other for a number of job vacancies, including Waste Recycling Operative and Koala Bear Midwife. We were either super-confident or extremely nervous, Owen explained to us. One of the funniest sessions was Anne being interviewed, as a nervous potential Rocket Scientist, by Phil. Here is how it went:

Phil: How are you?
Anne: A bit nervous.
Phil: There's no room for nerves in rocket science.
Anne: Oh. Sorry.
Phil: So, what would you bring to our next expedition?
Anne: Not much. But I'd give it a go.
Phil: What do you know about Rocket Science exactly?
Anne: Just a little. But I could go to the library and read up on it.
Phil: Right....
Anne: The main thing is... well, let's just hope we come back from the expedition.
Phil: D'you think you're confident enough for this type of role?
Anne: I am a worrier. But I do double and triple check things. I might have to restart the countdown... Once we got down to 7 I'd have to go back up to 10...

Anyone out there looking to employ a nervous Rocket Scientist then...?

By the end of the afternoon we were absolutely exhausted we'd all laughed so hard. So we sat down and had a much-earned rest for half an hour. At the same time ('cause we're so good at multi-tasking) we ate a few biscuits, drank coffee and/or water, and chatted about how we might put these techniques to use in our participation work. We started off by acknowledging that some of us had been quite apprehensive about the session, and even a little nervous going into some of the games, but ultimately had found them extremely enjoyable and very rewarding.

We also decided that using funny and engaging ways of looking at life could be a great way of showing the realities of life for people in contact with mental health services. For example, for exploring day-to-day life on a mental health ward, or what it's like waiting to access talking therapies. At the very least some of the games could be used to break the ice at meetings and we all agreed they created a very levelling experience where we are all people together sharing some small details of our lives.

What do you think? Would you like to have a laugh? Find out more about the Havin' A Laugh workshops running at Mid Powys Mind. Or let us know your thoughts in the comments box below.

By the way, the next Stand up for emotional health and wellbeing meeting takes place this coming Monday 29 February in Llandrindod Wells. It will be at the Resource Centre, Mid Powys Mind between 3 - 5pm. If you have been in contact with mental health services, or are close to someone who has, and would like to speak with mental health professionals or give some feedback about your experiences, we would love to see you there. And if you would like to find out more about the project please contact Anne by emailing: anne.woods@pavo.org.uk or ring 01597 822191.

The Cash Cow at Celf - even she has a red nose!

Ymddygiad gwrth-gymdeithasol a iechyd meddwl – beth mae gwasanaethau angen ei ystyried? Anti-social behaviour and mental health – what do services need to consider?

Meddyliau o brosiect ymchwil gan Philip Moisson

Thoughts from a research project by Philip Moisson

Gall ymddygiad a dargedir gan y ddeddfwriaeth ar ymddygiad gwrthgymdeithasol fod yn arwydd o broblemau iechyd meddwl (fel yr ysgrifennwyd amdano yma - efallai y bydd y cynnwys yn peri gofid i rai darllenwyr). Mae'r blog hwn yn ymwneud â phroject ymchwil yr ydym newydd ei gwblhau a oedd yn canolbwyntio ar 'bobl fregus ac ymddygiad gwrthgymdeithasol'. Bu i ni edrych sut yr oedd ymarfer cyfredol yn edrych i bobl â phroblemau iechyd meddwl y mae ymddygiad gwrthgymdeithasol yn effeithio arnynt, naill ai fel dioddefwyr, tramgwyddwyr neu dystion.

Behaviours targeted by the anti-social behaviour legislation can be a sign of mental health problems (as written about here - some readers may find the content upsetting). This blog is about a research project we have just completed that focused on ‘vulnerable people and anti-social behaviour’. We explored what current practice looked like for people with mental health issues who are affected by anti-social behaviour, either as victims, perpetrators or witnesses.

Roedd fy rhan fy hun yn y project hwn fel hwylusydd grŵp ffocws, ac roeddwn i'n un o'r bobl a hyfforddwyd gan academyddion o Brifysgol Bangor i wneud hyn ochr yn ochr â phobl eraill mewn cysylltiad â PAVO ac Unllais yng ngogledd Cymru. Mae'n hynod o bwysig i bobl â phrofiad o hyn fod yn rhan o'r broses o gasglu a mireinio gwybodaeth am y materion hyn, a chwarae rhan wrth ffurfio argymhellion ar gyfer arfer da.

My own involvement in this project was as a focus group facilitator, and I was one of the people trained by academics from Bangor University to do this alongside other people in contact with PAVO and Unllais in North Wales. It is incredibly important for people with lived experience to form part of the process of gathering and refining knowledge on these issues, and in playing a part in forming recommendations for good practice.

Yn ein cyfarfod cyntaf cawsom roi cynnig ar gymryd rhan mewn grŵp ffocws, lle bu i ni drafod un o'r senarios a baratowyd yn ofalus, a oedd yn troi adroddiadau heddlu go iawn ar ffurf hanes ffuglennol bywyd cymeriad. Ar ôl hyn, fe wnaeth ein hyfforddiant ein harwain at gyflwyno'r grwpiau ffocws a chawsom ein gwahodd yn ôl hefyd i drafod y canfyddiadau o'r ymchwil cyn cadarnhau a chyhoeddi pethau. I rywun fel fi sydd ag amser sbâr, mae bod yn rhan o broject fel hwn yn arbennig o ysgogol.

At our first meeting we had a go at taking part in a focus group, where we discussed one of the carefully prepared scenarios which turned real life police reports into the form of a fictional account of a character’s life. After this our training led us onto delivering the focus groups and we were also invited back to discuss the findings from the research before things were finalised and published. For a person like me who has spare time, being involved in a project like this is incredibly stimulating.

Yr hyn yr oeddem ni'n ei wybod o'r cychwyn yw bod yr heddlu'n aml yn cael eu rhoi mewn sefyllfaoedd amhosib wrth ddelio ag ymddygiad gwrthgymdeithasol yn y ffordd fwyaf effeithiol. Er enghraifft, efallai nad ydi'n briodol bob amser gorfodi sancsiynau sifil neu droseddol, a bydd llawer o sefyllfaoedd lle mae dyletswydd gofal yn bodoli yng nghyswllt unigolyn bregus. Hefyd, mae trefnu cydweithio rhwng amrywiaeth o wasanaethau yn aml yn anodd yn yr amgylchiadau hyn.

What we knew from the outset is that the police are often put in impossible situations in dealing with anti-social behaviour in the most effective way – for example it may not always be appropriate to enforce criminal or civil sanctions and there will be many situations in which a duty of care exists to a vulnerable person. Also, organising collaboration between a range of services is often difficult in these circumstances.

Prif amcanion y project yn gyffredinol yw deall y set o broblemau uchod o safbwynt gwasanaethau, ac o safbwyntiau defnyddwyr gwasanaeth a gofalwyr. Roedd y project hefyd yn ceisio tynnu sylw at ffyrdd y gall gwasanaethau gydweithio, a chydnabod yr hyn a allai fod yn rhwystro hyn ar hyn o bryd.

The main aims of the overall project were to understand the above set of problems from the perspectives of services, and from the perspectives of service users and carers. The project also sought to highlight the ways in which services can work together and to acknowledge what might be preventing this at present.

Drwy gyfweld ag amrywiaeth o weithwyr proffesiynol a sgwrsio efo defnyddwyr gwasanaethau a chynrychiolwyr gofalwyr yn ein grwpiau ffocws, mi gasglwyd llawer iawn o ddata i'w dadansoddi. Mae ymddygiad gwrthgymdeithasol ei hun wedi cael ei ddiffinio gan ddeddf seneddol 2014 fel “Ymddygiad sydd wedi achosi, neu sy'n debygol o achosi, aflonyddwch, braw neu ofid i unrhyw un.” 

By interviewing a range of professionals and talking to service user and carer representatives in our focus groups, a large amount of data was gathered for analysis. Anti-social behaviour itself has been defined by a 2014 act of parliament as “Conduct that has caused, or is likely to cause, harassment, alarm or distress to any person.”

Roedd gan lawer o'r rhai a gymerodd ran yn y project wahanol safbwyntiau ar hyn, ac roeddent yn pwysleisio nad oedd pethau bob amser mor glir wrth siarad am bobl fregus. Mae'r heddlu felly'n aml mewn sefyllfa annifyr wrth benderfynu sut i ymdrin efo pobl sy'n achosi problemau heb fod o'u gwirfodd.

Many participants in the project had different views to this, and emphasised that things were not always so clear cut when talking about vulnerable people. The police are therefore often in an awkward position in deciding how to deal with people who are not wilfully causing problems.

Daeth llawer o argymhellion gan ddefnyddwyr gwasanaeth a gofalwyr allan o'r project, a dyma rai ohonynt:

• Mae ar sefydliadau statudol angen gwybod mwy am waith da'r sector gwirfoddol.
• Mae ar asiantau angen cydweithio i helpu'r unigolyn mewn angen, yn hytrach na chael ateb wedi'i ddiffinio ymlaen llaw wedi'i seilio ar label, h.y. ‘sgitsoffrenig- angen meddyginiaeth.’
• Dylai'r heddlu a thimau iechyd meddwl gydweithio mewn timau blaenoriaethu (neu triage) a dysgu swyddogaethau'r naill a'r llall.
• Mae Eiriolaeth Iechyd Meddwl yn hanfodol.
• Mae angen cryfhau hyfforddiant i heddlu yng nghyswllt gofid a gwrando.
• Dylid defnyddio gofalwyr ac aelodau'r teulu bob amser gan fod ganddynt lawer o wybodaeth. Dylai defnyddwyr gwasanaeth a gofalwyr bob amser fod yn rhan o'r cynllunio a gwneud penderfyniadau.
• Mae cydymdeimlad, parch ac urddas wrth ddelio â phobl i gyd yn hollbwysig
• Mae tai a ffactorau cymdeithasol eraill yn bwysig iawn.
• Mae'r system cyfiawnder troseddol yn amhriodol i bobl mewn gofid difrifol
• Dylid ceisio cael atebion tymor hir yn hytrach na mesurau sy'n datrys pethau'n gyflym ond dros dro.

There were many recommendations from service users and carers that came out of the project, and here are some of them:

• Statutory organisations need to know more about the good work of the voluntary sector.
• Agencies need to work together to help the individual in need, rather than have a pre-defined solution based on a label, ie ‘schizophrenic- needs medication.’
• Police and mental health teams should work together in triage teams and learn one another’s roles.
• Mental Health Advocacy is crucial.
• General training for police around distress and listening needs to be bolstered.
• Carers and family members should always be utilised as they have a lot of knowledge. Service users and carers should always be involved in planning and decision making.
• Sympathy, respect and dignity in dealing with people are all paramount.
• Housing and other social factors are very important.
• The criminal justice system is inappropriate for people in severe distress.
• Long term solutions should be aimed at rather than quick-fix measures.

Mi wnes i helpu Anne Krayer wrth gyflwyno'r canfyddiadau hyn a chanfyddiadau eraill i grŵp yn cynnwys gweithwyr proffesiynol iechyd meddwl ac uwch swyddog yr heddlu'r wythnos ddiwethaf. I mi'n bersonol, os ewch chi â dim ond un peth o'r ymchwil hon, hynny fyddai ei bod yn hanfodol i'r holl bobl ac asiantau, yn cynnwys yr heddlu, grwpiau yn y sector iechyd, gofal cymdeithasol, tai a gwirfoddol, ddeall ei gilydd, a chyfathrebu'n gyson â'r naill a'r llall i ddatrys materion cymhleth iawn.

I assisted Anne Krayer in presenting these and other findings to a group consisting of mental health professionals and a senior police officer last week. For me personally, if you only take one thing from this research, it would be that it is vital for all of the people and agencies, including the police, health, social care, housing and voluntary sector groups to understand each other and to constantly communicate with one another to solve very complex issues.

Am fwy o wybodaeth, cysylltwch ag Anne Krayer ym Mhrifysgol Bangor: a.krayer@bangor.ac.uk

For further information please get in touch with Anne Krayer at Bangor University: a.krayer@bangor.ac.uk

Cyllidwyd yr ymchwil gan Lywodraeth Cymru trwy Ymchwil Iechyd a Gofal Cymru

The research was funded by the Welsh Government through Health and Care Research Wales

Positive Action for Change in Mental Health Services - Part 2

Last week I posted Part 1 of my report on this one-day conference which took place in November 2015 in Nottingham. It was organised by PCCS Books and looked at how services could try and break out of their medicalised approach to supporting people experiencing mental distress. Many of those in the packed audience worked professionally in psychology or psychiatry departments, and it was heartening to note their interest in the overriding theme and sense a real enthusiasm to drive some of these approaches forward in their own teams.

Clinical Psychologist Lucy Johnstone, and Professor Peter Beresford, had spoken passionately about their work in the morning session. This week I cover talks given by the two afternoon keynote speakers, Professor Sami Timimi and author and educator Pete Sanders. I will also touch on the work of organisations like the Soteria Network who attended to spread the word about their developing and ground-breaking work across the UK.

Sami Timimi – Beyond diagnosis: developing an outcome-orientated approach

Sami is the Visiting Professor of Child and Adolescent Psychiatry at the University of Lincoln. He began by focussing on the genuine issue that, despite the growing spend on mental health services on both sides of the Atlantic, there is a corresponding increase in the number of people classified with severe/enduring mental health illnesses.

He went on to describe the commodification of mental distress. Whilst large pharmaceutical companies are frequently attacked for profiteering from “disease” and “mental illness” through their growing sales of medications, Sami pointed out that psychotherapies are equally as vulnerable to this kind of criticism. Brands of psychotherapy compete, claiming they are the best option for a particular problem – producing associated books, courses, conferences and programmes. In this capitalist world of mental health people’s unhappiness is exploited for profit – even during a recession there is no dent in the profit margin of major pharmaceutical companies.

So, what did Sami advocate in these depressing circumstances? He spoke about differentiating between the relationship and the technique used when supporting a patient. If the relationship is primary, the technical aspects have to be slave to the relationship. So… if one patient who is depressed wants Cognitive Behavioural Therapy, the next, though reporting similar symptoms, may want to talk about what happens to them when they experience domestic violence, for example. “Treat each person on their merits – it is harder to turn (treatment) into a commodity as each person has a unique story and a unique model of change.” Sami calls this approach – Outcomes Orientated Approaches to Mental Health Services, and went on to describe in detail how it works in practice in his team’s service provision. This approach “is better at not creating chronic patients. Patients are leaving us.”

Sami closed by imploring people to go to commissioners with evidence of working in a different way – and showing that outcomes can be better. He believes that change really can be influenced at that level.

Pete Sanders – If therapy could be part of positive action for change, what sort of therapy would it be?

Pete is the co-founder of PCCS Books, and has over 30 years’ experience practising as a mental health nurse, counsellor and educator. He introduced his “unbalanced presentation” with a large dose of humour, warning the audience that he wanted it to be a “rude slap in the face for all helping professions!” If there is one thing I took from his talk, and there was no joking intended here: it is the importance of genuine human kindness – of just being nice. As he said - “do not act like an ‘expert’, be your real self as a helper; fallible, vulnerable, imperfect, not knowing any of the answers.”

He asked us what kind of therapy we would want – one “that pretends to provide a systematised treatment, but is really a placebo?” And shared three separate scenarios with mental distress at their heart and asked “what would you do?” Some of the suggestions were basically the actions of a kind-hearted friend or colleague. How many qualifications do you actually need to take someone for a drink after work? To sit and listen to them talk? Pete said that professionals had conned everyone that caring for others is more complicated than it actually is!

“There is no statutory service of natural kindness… Only a proper expert can interpret this chaos and mend the broken brain.”

In 1974, when Pete was a trainee counsellor, there were only five counselling courses in the country, yet now you can “fall over them on the way to the bus stop!” He supports a person-centred approach and is against the medical model.

Pete left us with 11 pointers for “Therapy for positive action for change…” and because I know you can read the whole presentation I shall just quote the one which particularly resonated with me on the day: “therapy that…. understands that the primary healing force is the client themselves, not the person or techniques of the therapist”.

Also attending the conference were various organisations who are working with what we call in our team the “beyond medical” approach.

Soteria Network

Margaret Turner, Secretary of the Soteria Network

The Soteria Network is: “A network of people in the UK promoting the development of drug-free and minimum medication therapeutic environments for people experiencing 'psychosis' or extreme states. We are part of an international movement of service users, survivors, activists, carers and professionals fighting for more humane, non-coercive mental health services.”

British Association for Person-Centred Approach

Bernard Mooney and Sara Callen of the
British Association for Person-Centred Approach

The British Association for the Person-Centred Approach (BAPCA) is: “An organisation that embraces and promotes the person-centred way-of-being: the striving to create relationships based in genuine acceptance and empathic understanding.”

Critical Mental Health Nursing Network

The Critical Mental Health Nursing Network is: “A network of mental health nurses and others who want to think critically about mental health nursing and related issues.”

Working to Recovery

Working to Recovery are “world renowned for their innovative Recovery based practice, training, writing and service designs, working across the world”.

You can find out more about the conference speakers and link to their presentations on the PCCS Books website.

What do you think about these ideas and approaches? Let us know in the comments 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.

Meet Mandy Pearce - Reablement Worker at Mid Powys Mind

In 2015 Mandy Pearce started as Mid Powys Mind’s new Reablement Worker, funded by the Lloyds Bank Foundation, in a new three year project to help support people in transition from hospital. 

Working originally with patients from Felindre Ward in Bronllys Hospital, South Powys (a ward offering acute inpatient mental health services) the Reablement Service offers much needed support to people coming home after a medium to long term hospital stay.

We caught up with Mandy recently at her Llandrindod base to find out more about the project has evolved since she started last summer.

What does reablement mean exactly?

The reablement approach is well known in physical health. It is newer in mental health. It is short intensive support, usually offered to people in their own homes, after a stay in hospital and during a period of ongoing recovery back in the community.

I have access to patients’ Care Plans, liaise with their Care Co-ordinators and also attend their discharge meetings. Once they have left hospital I then visit them and provide support depending on their needs. This can be very varied depending on individual situations. Two of my first clients had been long-term patients on the ward – one for 12 months. There was a lot of work to be done. People become quite institutionalised and it can be quite scary returning to the community. Even going to the corner shop can be hard.

Some people, meanwhile, are only in hospital for a couple of weeks and then quickly get back on track with their lives once they leave.

How does reablement make people’s lives better?

It provides additional support that hasn’t been there before. It’s about looking at people’s needs. Isolation is a key word really. The hospital reflects that sense of isolation back to the patients. They have been unwell at home for quite a long period, perhaps staying indoors, maybe even in bed. Then they go into hospital and are still quite isolated.

Originally I thought the role would involve carrying out practical tasks such as looking after a pet or going shopping. But people want to talk. That’s often their main need. We have to be flexible in our approach and try and meet people’s needs.

Who is eligible to receive the service?

When I started it was just available to ex-patients of Felindre Ward who are from the Radnorshire area of Powys. However, my remit has now been extended and I work very closely with the Crisis Resolution Home Treatment Team which is based at Bronllys Hospital. Staff in this team support people to remain at home, and when people are discharged from their care they can be signposted to me for further support.

How was the need for your post identified?

Colleagues at Mid Powys Mind originally identified a need through speaking to staff at Felindre Ward and the Crisis Home Treatment Team. They then worked on a funding bid and were pleased to receive an award from the Lloyds Bank Foundation to fund a 3 year project.

Key to my role is my link with Mid Powys Mind. Mind offers a comprehensive service with many different facets, and I can help people understand the service and access the right area. People might just sign up for counselling or go to the art group once a week. It’s whatever works for them. More often than not it puts routine back in to their lives plus it gives them the opportunity to spend time with others who understand.

I can also signpost people to Tim Skelcher, our 1:1 Recovery Worker. 

You mentioned isolation, what are some other typical difficulties that people face upon leaving hospital?

Yes, isolation is a key factor as well as low confidence and, of course, stigma. Living in rural areas is not only a contributing factor to isolation but can make someone feel that all the locals have an idea of what has been going on for them and although things are improving around awareness there still is a certain amount of stigma surrounding mental health issues.

Returning home from hospital can be daunting for patients as it can be a reminder of how unwell they were before their admittance to hospital. Properties have been left and the environment can be reflective of how unwell someone was. So, practical help in sorting and organising can be really helpful. There can also be a backlog of mail that needs attending to. This can be stressful depending on what it is.

How long does your support last?

I work with people for up to eight weeks following their discharge. However, if I feel they need further support I can request an additional four weeks. It can take a long time to get there sometimes.

I visit Felindre Ward regularly so that people know who I am and generally have a chat with the patients. There is not enough talking going on. Interpersonal skills are so important to people’s recovery. When I start working with a patient I often find that they just want to have a good chat.

How do people stay safe, well and independent once the reablement support has finished?

Some clients may already be in receipt of additional support via the Community Mental Health Team and other care organisations. However, as part of my post it is important to try to engage people with the service of Mid Powys Mind and introduce/support them to access possibly outreach groups and many other activities that Mind has to offer.

Tell us how your work fits in with that of other voluntary sector groups

At Mind we have been working hard to create better working relationships with partner organisations that can offer a specialist service to cater for a client’s specific needs. For example - drug and alcohol support, housing and tenancy. Also, doing something meaningful with their time when further along on their recovery journey can play a very valuable role, so volunteering themselves could be an option.

What are some of the hardest things about working on this project?
I suppose one of the hardest things about this job is that time is limited. During my time with a client I can develop a good working relationship and in order to do this there is a certain amount of trust and understanding realised. It is hard when our time comes to an end for them and all clients so far have said they wished it could have been for longer.

The nice things about working on the project?

The nice part of this post is, of course, seeing clients develop and their confidence build and an ability to push their boundaries and try new things.

Any other recent developments at Mid Powys Mind you can update us on?

We are developing a youth peer support group (18 – 25 year olds) which meets weekly on Tuesdays, 1 – 3pm, in the Training Room at the Resource Centre. It is great to be able to put young people in touch with their peer group and signpost them to other services that can be useful to them. We’re planning to work again with Owen Griffkin later in the Spring with more Havin’ A Laugh workshops. And a professional animator will be coming in to bring people from different generations together and interpret their stories using animation, so we’re very much looking forward to that. 

Many thanks to Mandy for telling us about the Reablement Service at Mid Powys Mind. You can contact Mandy by emailing re-able@midpowysmind.org.uk or ringing 01597 824411.

Top mental health vloggers & videos

Happy New Year! Traditionally we start the New Year by recommending some of our favourite blogs. In the past we have covered mental health and also dementia. This year we’re looking at videos and vlogging.

“A vlog (or video blog) is a blog that contains video content. The small, but growing, segment of the blogosphere devoted to vlogs is sometimes referred to as the vlogosphere.”

There are a surprising number of people vlogging about mental health. Many of these are young people around the world who have grasped the opportunity that the video site YouTube provides to talk about their personal experiences online. Many report that they find it therapeutic to do this, and hope that their experiences will also help and support others who are struggling with mental health issues.

A high proportion of these vloggers regard their distress as an illness and their experiences are very much phrased around the medical model relating to mental health. There are, however, some videos which take the social model view, and others where the boundaries are blurred. You can read more about the debate around the medicalisation of mental health on this blog, suffice to say most (though not all) of the recommended vlogs and videos here tend towards the view that mental distress is, as campaigner, writer and speaker Jacqui Dillon states, “a normal response to abnormal stress”, as opposed to an illness. 

And so whilst we’re on the topic of Jacqui, we may as well start the list by highlighting a video of her on our very own PAVO YouTube channel. This was made at the 2013 Powys “Shaping Services” conference.

The channel Crazywise is run by photographer and film maker Phil Borges and features videos questioning how 'Western culture defines and treats severe mental disorders'. Phil is also working on a feature length documentary 'challenging the current mental health system in crisis'. Many of the Crazywise films are interviews with "experts" talking about their experiences in the field, including British psychiatrist Russell Razzaque who has a background in mindfulness meditation and is currently leading a clinical trial into Peer-Supported Open Dialogue.

Rai Waddingham hears voices and sees visions. She is an 'independent trainer specialising in innovative ways of supporting people who struggle with extreme states (including ‘psychosis’, ‘dissociation’ and post traumatic reactions).' This video from her channel focuses on her experiences of hearing voices.

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Laura Delano, an American who also features on the Crazywise channel, has her own independent channel where she vlogs regularly about her own experiences of psychiatry and the psychiatric system. She describes herself as an ‘ex-"Bipolar" patient, (and) discusses life after psychiatric labels and psychotropic drugs’.

Another Laura, Laura Nuttall, vlogs about her experiences in psychiatric hospital with real insight given to the actual experience of being on a mental health ward in the UK.

LikeKristen is a young American vlogger with a very watchable style. Her videos include all kinds of mental health topics, ranging from experiences of self harm, to stigma and practical suggestions to help recovery. Here is a link to her journaling video. 

Fixers is a UK organisation featured previously on our blog. Sarah Harmon, who lives in Powys, talked for Fixers about her experience of mental health issues and the work she does in schools to help combat stigma. Fixers is a project of the Public Service Broadcasting Trust, and uses short film and other media to enable young people have their voices heard and help make positive change. Check out the Fixers website to watch videos relating to mental health and young people in Wales.

Kati Morton is an American therapist who provides information about “conditions” and “treatments” that are very easy to follow. As the National Health Service in the UK uses much of the same terminology it can be helpful to watch these if you want to find out more about treatments such as Cognitive Behavioural Therapy (CBT) that are available to people here too.

And finally, the Spiritual Crisis Network has some excellent videos on its website, including a 5 minute animated film called "Compassion for Voices: a tale of courage and hope", produced by King’s College, London.

We hope you enjoy watching some of these videos and vlogs, and would love to hear about others that you recommend. Let us know in the comments box below.

All the best for 2016 from the mental health team at PAVO – Angharad, Anne, Glynis, Jane and Jackie.

Havin' a Comedy Christmas 2015

"Tis the season to be jolly....." 

Yes, it's that time of year again. It's unbelievable how quickly it turns up each December.  In 2014 we posted Top 10 Tips to Survive Christmas, as we recognise that the festive season is not everyone's favourite period.

For Christmas 2015 our team have been inspired by local comedian Owen Griffkin's new comedy workshops to think how laughter has kept us going over Christmases past.

Each of the team has come up with a book, or film, or memory that has made them laugh in Christmases gone by whilst wondering whether to embrace the holly (ouch) and mince pies with family, friends or even complete strangers, or just run and hide.

"Fa la la la la, la la la la...."

Angharad

Many things remind me of Christmas and the laughs I’ve had, such as watching classic 1990 Christmas film ‘Home Alone’ with Macaulay Culkin. But the highlight of any recent Christmas was watching my dog, Bella (a fluffy white bichon frise) open my mum’s Christmas presents for her. As the centre of our little family, she is without a doubt put on the highest pedestal, treated like a human and the focus of me and my mum’s lives. I’ve had the blessing of owning Bella since my last year in primary school, which makes Bella around 14 years old (an old lady!) yet she still has the personality of a puppy and hasn’t lost any of her diva like qualities yet. She is spoiled, and rightly so!

Last Christmas, the buzz and excitement of smelling her Christmas dinner and her presents under the tree were too much to bear, and she began like a puppy, tearing the corners of the wrapping paper off. We normally get her to help open a small section of our presents, but last year, she came into her own! Without any warning she took centre stage and started unwrapping presents in the middle of the living room, swinging the paper around with her mouth as best she could, determined to find out what was inside! After some playful growling, swinging wrapping paper and presents and holding them down with her paws, she had unbelievably managed to open two well wrapped presents! This memory always makes me laugh at how loving and funny animals can be, who enjoy Christmas as much as anyone else! It also made me and my mum hysterically laugh, along with us clapping and cheering her along!

‘Animals are such agreeable friends - they ask no questions; they pass no criticisms.’ George Eliot

Anne

When Jackie suggested this topic for a blog, my heart sank slightly. Call me Scrooge but Christmas isn’t one of my favourite times of year. 

But then I remembered my favourite scene from "The Wrong Trousers", an Aardman Animations film starring Wallace & Gromit that was first shown on Boxing Day in 1993, and will be forever associated with Christmas for me. It’s the train set chase scene where Gromit is attempting to stop criminal penguin Feathers McGraw escaping after a diamond heist. When Gromit grabs the box marked spare track and frenetically starts to lay track to keep the toy train on the rails, I was in hysterics. It’s well worth watching the clip on YouTube. I defy anyone not to smile whilst watching it.

Jackie

Way, way back in 1982 I ripped open a Christmas present whilst on holiday in Dorset. It was a copy of the now legendary Adrian Mole book by Sue Townsend - “The Secret Diary of Adrian Mole aged 13 ¾”. I started reading, was hooked after two pages, and didn’t stop until I’d finished a few hours later. The Christmas pudding was long since cold, the mince pies just crumbs swimming in spilled alcohol, and my elbows had turned black and blue from lying still for so long. It was the funniest book I’d read in ages by a classic writer of comedy fiction. Who hasn’t heard of Adrian Mole?

Sue Townsend went on to write a total of 8 books about Adrian Mole, taking him from angst-ridden teenager in the Thatcherite years of the 1980s to the brink of middle age in the The Prostrate Years and Gordon Brown’s New Labour era of the late noughties. I haven’t read the later volumes - so there is more laughter to look forward to yet.

Here are a few of my favourite quotes from the original classic:

“I must say that I take my hat off to Sainsbury's, they seem to attract a better class of person. I saw a vicar choosing toilet paper; he chose a four-roll pack of purple three-ply. He must have money to burn! He could have bought some shiny white and given the difference to the poor. What a hypocrite!”

“It is the first day of spring. The council have chopped all the elms down in Elm Tree Avenue.” 

“I have never seen a dead body or a female nipple. This is what comes from living in a cul-de-sac.”

Jane

Some years ago my mother came for Christmas. She was (she died this year) a very difficult person and there was always a fair amount of tension with her around. During Christmas Eve she snapped at one of my teenage children for not doing, in her eyes, sufficient washing up. A general shouting match ensued with my mother shouting at said child and ripping up the Christmas present she was going to give to this offspring - who obviously shouted back that no-one had wanted Granny to come anyway and me shouting at my mother in defence of my children. 

Meanwhile my husband was at his work’s Christmas booze-up - which was legendary. My daughter rang the most likely pub, found him and summoned him back. Eventually he wove his way home and into this maelstrom, lay on the floor and declared “I love you all!”. I can’t actually remember what happened next - but I found a mention of this in some notes after my mother moved out of her house into a nursing home - she had written “Christmas with Jane and children, least said”. For us this is now a traditional family Christmas story, and I guess it goes to show that Christmas can be difficult and tense and also, at least in retrospective, hilarious too.

Support over Christmas

Wellness and Recovery Learning Centres around Powys are open at some point over Christmas and the New Year and would welcome your visit. Click here to find their contact details and links to their own websites.You can link to national helplines here.

If you need help urgently find information here.

Have a Happy Comedy Christmas and we look forward to hearing from you in 2016!