Time to talk?
This month the mental health team is giving its support to the new campaign hoping to end discrimination against mental health.
It’s time to talk, it’s time to change.
The statistics show that 1 in 4 of us will need help from Mental Health services during our adult lives. However, we also notice that if we break a leg we celebrate it with our friends, signing the cast and showing us care, but if we have a mental health problem we keep it to ourselves and our friends may even avoid us. This campaign wishes us all to address this imbalance.
As someone who has suffered depression I welcome this initiative. I have always believed that I have the right to talk about my experience and be accepted for who I am. The response I get when telling people about my mental health issues is varied. I have met incredulity, one student’s reply on hearing I was a service user was “no you’re not”.
I was not believed because I did not fit their idea of how the mentally ill present. I have also met with a lot of kindness and a wish to know more. Talking about mental health also empowers those students who have issues themselves. I have found that those who have felt alone with their problems, and there are more than you think, welcome this approach
So now it’s up to you. Get involved in this campaign, end the silence and misconceptions about mental health issues and be a friend. Hopefully a little bit of kindness and care will help someone return to a healthy happy life.
The following addresses will take you to the websites where there is a lot of information for you to read
Time to change campaign website Facebook page & Twitter
Shrek theatre asks autistic boy to leave – what do you think?
The mother of an autistic boy said she was “ashamed of society” after her eight-year-old son was asked to leave a performance of Shrek the Musical.
James Geater, from Worthing, West Sussex, was taken to the Theatre Royal Drury Lane in London with another autistic boy by four carers.
They were asked to leave the auditorium because they were too noisy. James’s mother Karen said it was unacceptable.
The theatre said the party was asked to sit outside until James calmed down.
©BBC News 31st August 2011 (Link to full article here)
James’s mother is ashamed of society, but I would like to pose the question “Should poor behaviours be acceptable if they are the result of an illness”. In a recent blog Tony mentioned road rage. Is it the fault of this condition that people assault one another or do they still have choices? For many years I have told young men who have schizophrenia that assaults on others are not acceptable. Is it really unreasonable to ask that having paid to see a show I should be allowed to do so without distraction?
I remember travelling from New York to Baltimore on a bus with a very noisy child, who threw high pitched tantrums at any opportunity. His mother was asked to either control the child or leave the bus. What sort of society would strand a mother and small child because of its behaviour?
The phrase “For the greater good” has been used to allow some terrible acts in mankind’s history and maybe James should never be allowed to go to the theatre again so the rest of us can watch in peace or maybe the theatre should put on special shows for people with problems?
Photo of Shrek on Wikimedia Commons click here for information re author
Learning Disability nurse vacancies?
This post is by Fiona Rich, senior Lecturer in Learning Disability Nursing at Birmingham City University.
I am disappointed to learn that our first year student nurses are yet again being told that there are no jobs available for learning disability nurses, because in fact there are many vacancies for learning disability nurses – just Google ‘Learning Disability Nursing Vacancies’ and see for yourself.
The NMC have recently re-written competencies for entry into Learning Disability Nursing… they would not have done so if the role was going to be obsolete. In addition, this university alone was commissioned for 35 Learning Disability Degree students by the Strategic Health Authority for our next intake… again, they would not spend money training student nurses if they intended to make the role obsolete. The Strategic Health Authority only commission student places for the jobs available within the NHS, but only 45% of learning disability nurses work in the NHS – the other 55% work in the private, voluntary and independent sector. This means that there is actually a shortfall of 55% of learning disability nurses to meet the demands throughout the UK.
All of our students get jobs when they qualify – whether it is in the NHS or other sectors is irrelevant as they still provide the skills needed to support this vulnerable group of people which is growing in demand not decreasing. Many people with learning disabilities are living to an older age and therefore have very specific needs. In addition, people with LD tend to acquire the problems associated with older adults (eg Alzheimer’s, Dementia, physical disorders and diseases such as sensory defects, cancer, diabetes, respiratory and cardiovascular illnesses) at a much earlier age than the general population so there is a growing need for very specialist learning disability nurses.
Sadly, I have been hearing this misinformed argument about the future of learning disability nursing for decades but there is still a demand for such a role and it grieves me to see genuinely dedicated learning disability nurses dissuaded from qualifying in this branch. I would urge all first year learning disability nursing students to think carefully about who will support this vulnerable group of people if there were no learning disability nurses in the future because the very specific needs of individuals with learning disabilities are not going away.
A Tough Question
“So, what is madness?”
This was the question posed to me by a friend. Obvious and easy answer I thought, seeing as this is part of the job I do day in and day out.
“Well, its…” and then I stopped. I couldn’t answer it. Not if I wanted to produce an accurate and true answer. What is madness? Is it simply when people are not acting in their normal fashion? If that is the case, then we are all mad as when we are angry or upset then we do not act in our normal manner. ‘Road rage’ means many people are mad if the ‘normal’ fashion definition is accepted as well as love.
Is madness not conforming to the norms of society? Well, many people I know have speeding tickets so either they are mad because they have broken the law of the society or they are the sane ones because speeding tickets appear to be the norm! And what exactly are the norms of society anyhow?
So, is madness an illness? If it is then rates of this illness would be fairly consistent across the globe but we know that depending on where you live defines your illness. For example – schizophrenia. If schizophrenia is an illness then why are there different diagnostic criteria in countries around the world? Why do immigrants show higher levels of this illness but not in their own countries?
Do medics define madness? Insight appears to be on the diagnostic criteria for most illnesses (or the lack of it to be precise). I once read (Ron Coleman) that a patients level of insight simply depends on the extent to which a person agrees with their doctor – disagree with your doctor and you are obviously lacking in insight and are therefore mentally ill. Or agree with the doctor that you are ill and you are again obviously ill. So madness cannot be defined by doctors (as any reader of Thomas Szasz will understand).
Perhaps madness is the system we live in, where budget cuts mean people are unable to access basic and fundamental needs/services yet some people are paid millions to kick a ball around a pitch.
Perhaps madness is trying to define madness.
I still cannot answer this question satisfactorily.
Do you have an answer?
(NB we have a temporary fault blocking comments – hopefully this will be resolved soon)
Image above from Wikimedia commons:
“English: 1857 lithograph by Armand Gautier, showing personifications of dementia, megalomania, acute mania, melancholia, idiocy, hallucination, erotic mania and paralysis in the gardens of the Hospice de la Salpêtrière. Reprinted in Madness: A Brief History (ISBN 978-0192802668), from which this version is taken.”
Child and Adolescent Mental Health – Every child matters!
The recent dept of Health document “No health without mental health” emphasises the need to prioritise preventative and early intervention services when responding to the mental health needs of young people.
Yet, I believe that people are unaware of the numbers of young people suffering with serious mental health problems. Mental health promotion for young people is vital, in my opinion; failure to intervene early enough contributes to a life of distress, barriers, and problems for too many young people. I am aware of many children struggling with the challenges of education, learning and growing up whilst also experiencing low mood, depression, self harm and suicidal thoughts.
More young people are being referred to CAMHS services. It is worrying that at least 1 in 4 young people are likely to be referred to CAMHS during their childhood or adolescence. Within the West Midlands CAMHS community and in-patient services for young people have been developed in response to this growing need.
As a CAMHS nurse and a senior lecturer at BCU I believe passionately that the comprehensive health care needs of young people and their families must be integral to our courses. We must ensure all pre-registration student nurses have opportunities to consider child and adolescent development issues, the importance of attachments and supportive relationships, risk and resilience factors which impact on health, the incidence and nature of mental health and related challenges, the structure, and how to access CAMHS.
Child and adolescent mental health is “everybody’s business” whether we are engaged directly or indirectly with children and their families. We have a timely opportunity to integrate this perspective within our student population: tomorrow’s registered nurses.
I hope we do not miss this opportunity.
We also offer a Learning beyond Registration CAMHS pathway as part of our BSc(Hons) Mental Health Studies programme for registered nurses, allied professionals, and other people interested in the health and wellbeing of young people. Please contact me if you are interested in hearing more about our learning beyond registration BSC(Hons) CAMHS pathway. We are currently planning the two double modules which will be offered during the 2011/12 academic year which is scheduled to commence in October this year.
Wake up and smell the (decaffeinated) coffee.
So Great Britain isn’t so great after all. Perhaps this isn’t news for many but I was very surprised to read that Britain is well down the list on the WHO league table of health care
(see link and go to p18)
I always thought, in true English stiff upper lip and arrogant fashion that ‘we are the best’ and Johnny foreigner should be envious. But hold on – it turns out that Pierre, Gustav and Ricardo all enjoy a far better health system that poor John English. It turns out that we are 17th and that our partisan friends in Europe have a far better time than us.
Why is this? Well, I have the answer.
You see, England once ruled the waves and Queen Vicky dominated the world with the Commonwealth reaching all corners of the globe. England was the dominant world force and when Britannia spoke, all listened in trepidation. But all we did was speak and not act. We were so confident that we were ahead of everyone that we didn’t try as hard as the others – and try they did.
The result was the rest of the world very quietly, caught up with this country and left it behind.
Unfortunately I think that this is true of many facets of life in this country not just health. Perhaps there is some solace in the countries that we are ahead of – two countries placed in the 30’s caused me even greater surprise (and delight admittedly).
So what next? I would like to think that we are waking up and realise that arrogance does not make a world leader. Hard work, effort and a driven desire to be the best makes the leader – the question is, are we waking up to the smell of coffee or pressing the snooze button for ten more minutes sleep?
Cruel world
The events in Bristol must be a source of shame and disgust to us all. I make no attempt to condone the actions of these appalling people but it got me wondering. If you take the conditions in that “hospital” must we fear similar events in the NHS?
A national company set up for profit, where workers seldom if ever meet the bosses, work long hours and are poorly paid, is it just Castlebeck or is this the future of the NHS?
Lack of support, control and training can affect the morale of workers leaving them embittered and shattering their self esteem.
I once heard a nurse jokingly (I hope) remark that “this job would be okay if it weren’t for the patients”
When demoralised staff begin to view those in their care as “The Problem” then resentment and bitterness can take over.
I stress again I am not trying to defend these people and I hope their prison sentences are long, although Ken Clarke would probably prefer community sentences. That’s a thought now, what service could these evil people do to the community? I just think that where money is the basis for all care I hope never to get sick.
PS This is the link to the Care Quality Commission inspection reports on Winterbourne View
Rather than love, than money, than fame, give me truth : Thoreau
Consider these examples:
- One of my personal students told me that when on placement some staff told their patients that they would do things for them and then never bothered. The student was upset by the fact that staff would systematically and routinely lie to their patients.
- I did an exam with a group of students, I told them about the assessment criteria and then used something else to work out who passed or failed, ok, I lied but who cares?
The above examples are completely untrue but what would you think about health care staff or University lecturers who routinely lied to people?
Lies: Everyone’s at it?
“It is that truth that guides our action in Libya……………………………………… …………………………………….That is why we stopped a massacre in Libya. And we will not relent until the people of Libya are protected, and the shadow of tyranny is lifted.
(Barack Obama speaking in London’s Westminster Hall)
Is it just me or did the West court Gaddafi for his oil money? Are we now supporting the insurgents so we can now court them for the same?
Then I came back to the NHS. I watched a daughter talking about the death of her mother on the news. Her story reflected the lack of care given to the elderly in the NHS according to the Care Quality Commission report. Yet when we visit websites belonging to these same hospitals we are bombarded with mission statements and philosophies about “putting the patient first”
Is it possible that the public does not need to know the truth? Or is it that we don’t want to? If people in power told us the truth could we handle it? If people in power told the truth could they remain in power?
We live in a world that claims to put transparency above all else but uses smoke and lies to blind us.
What could I say to this student or the daughter? I suppose I’ll just have to say that’s the way things are?
New Perinatal mental health care course
(This is a post by Pam Morley, Senior Lecturer at Birmingham City University)
Many people are aware of possible mental health problems associated with pregnancy but do people realise how destructive these can be? Suicide in the perinatal period is the highest cause of maternal death in the UK. Also, maternal depression prior to the baby’s birth can increase the risk of birth complications and poorer birth outcomes, including higher rates of spontaneous abortion, low birth weight babies and developmental delay. Again, anxiety in the mother has been shown to be linked to poorer child health and behavioural difficulties at the age of four years.
National Perinatal Mental Health Project
The National Perinatal Mental Health Project Report, published by the Mental Health Development Unit on 8th March 2011 examines provision of mental health care for women who are planning to have a baby, are pregnant or who have had a baby in the past year or so. In particular the report examines the current provision of care for women in the Black and Ethnic Minority groups. (http://www.nmhdu.org.uk/silo/files/national-perinatal-mental-health-project-report-.pdf)
Seamless care?
As I was reading this report one finding struck me as being very significant; namely that 27 different professional groups may be involved in the care of women with mental health difficulties who are in the perinatal period. How can all these different groups work together to provide seamless, efficient care? After all, many of them will have been trained in different ways and use various theories to underpin their practice.
So, how can care be co-ordinated and dove-tailed together? The answer is fairly straightforward, I think. It is the mental health nurse who is at the hub of the multidisciplinary ‘wheel’ together with the service user. It is the mental health nurse who spends time with the service user, who is the conduit through which messages are passed and information carried. Perhaps we should be highlighting this aspect of our role much more. Forget superconductors; just get a mental health nurse involved!
Post-graduate certificate in perinatal mental health at Birmingham City University
Seriously though, we should be promoting this aspect of our role, and giving it the value that it deserves. Without the nurse to ‘glue’ the team together, care would be a lot more fragmented. The importance of communication is a strong aspect of a new post-graduate certificate in perinatal mental health being run at Birmingham City University. This is a brand new course, designed b y academics and clinicians together and aimed at any health care professionals who work with women in the perinatal period. If you would like more information about the course, please email pam.morley@bcu.ac.uk.
(Pictures from Flickr creative commons click photos for more details re authors)
Commercial clinical trials : How do we get health professionals interested?
(This is a guest post by Gemma Borland on behalf of the Heart of England Hub of the Mental Health Research Network)
Do your patient’s receive the best possible treatment? How do you know?
Every day in clinical practice medications are used, but do you know how these medications have been developed and would you want to be involved when the products of the future are being tested?
Pharmaceutical companies sponsor clinical trials to research new medications. Potentially, these trials may lead to the development of more effective drugs.
The importance of this research cannot be underestimated, finding medications with fewer side effects, which are easier to take, impact less on someone’s life and manage someone’s condition better, can improve a service user’s quality of life dramatically. The need to continually strive towards the best treatments available in the NHS is paramount.
Equally important is the need for new medications to be tested in the NHS and on the UK’s patient populations.
Clinical research studies
Since I became involved in setting up clinical research studies 5 years ago, I have worked with dedicated clinicians and nurses, passionate about the importance of commercial research having seen the benefits that access to cutting edge treatments can bring to their patients. However, there is a real need to increase commercial trial activity within the NHS.
Industry trials are often seen as complex, with onerous Sponsor requirements and a lack of understanding as to what the work entails. For Health Professionals who have not yet been involved in commercial clinical trials, the work can seem a daunting avenue to pursue. This is the challenge facing the Mental Health Research Network, a national initiative to support mental health clinical research in the NHS. We need to identify how we get individuals involved in commercial research and look at the issues which may prevent people working on commercial trials.
Mental Health research Network
The Heart of England Hub of the Mental Health Research Network is currently piloting a project to develop and run a mentoring programme, tailored at supporting nurses, clinicians and other professionals, working on commercial studies for the first time. The programme will provide an experienced mentor with whom study teams can access for advice and guidance whilst working on a commercial trial, as well as training and information to help people better understand commercial trial work.
With this additional support, we are hoping to expand the number of clinicians, nurses and other health professionals working on commercial studies in the Midlands, with the ultimate goal of increasing the number of commercial trials running across the region.
We want your comments, i.e. what are your opinions on commercial clinicial trials, would you get involved? If not, why not?
http://www.mhrn.info/
For further information on the mentoring programme contact : gemmaborland@nhs.net