Monthly Archives: July 2009

Guest post SCEPrE Fellowship : Trevor Adams

This is a guest post from Trevor Adams from the University of Surrey. Trevor is very well known for his work in the area of Dementia care and has been widely published. As ever, we are delighted to feature guest posters – so if you think you have something you want to say then please get in touch.

I have recently received a SCEPrE Fellowship (see from my own University, the University of Surrey. The award offers funding to undertake a project that will ‘promote excellence in Professional Training (placement learning) and enhance students’ experiences through enquiry-rich approaches to learning’. Over the last few years I have developed with others, the idea that there are three agencies involved in dementia care, people with dementia, family carers, and care staff. This is often called ‘relationship centred care’. This work has not just focused on ideas and theories associated with working alongside people with dementia and their carers, but has also described various strategies and skills that may be used to promote their well-being.  

My main aim within the Fellowship is to develop four films, each about 20 minutes long for publication on YouTube. This will make the films accessible to all and will hopefully, help nurses and other care staff develop worthwhile and effective skills in promoting the well-being of people with dementia and their family carers. The films will draw on relationship centred approaches, but will also include positive person-work that was developed by Tom Kitwood.  One of the films will concern the experience of care staff and will draw on the idea of emotional labour.

At the moment you can buy various teaching packages on dementia care, and I am sure they are very good. But they often cost a lot and I suspect, frequently lie unused on office shelves. I want to develop a package that was freely available and open to all. One reason for this is that teaching is changing. When I first became a nurse teacher I used to spend hours and hours preparing acetates. Now it is different and I have increasingly used films from YouTube in my teaching.  It is really good to hear Dr Niles Crane from Channel 4’s ‘Frasier’ talk about how Alzheimer’s disease affects the brain (sorry if you are not a Frasier fan! ):

These films offer students a really great learning experience and are a easy way of listening to experts, whether they are staff, carers, or patients.  I now want to use YouTube to help nursing students and others learn skills associated with dementia care.

As part of the Fellowship, I will be completing a wiki. As the Fellowship continues, I will be adding to this and sharing more about its progress. If you want to keep in touch, the wiki will be available here.

Photos Flickr creative commons

1. University of Surrey by Kai Hendry

2. Hand by Pamelaadam

Let me tell you a story : the Reading for Recovery project

This is another guest post from Julie Cresswell, one of our ex BCU mental health nursing students who is now a qualified staff nurse. (This is Julie’s second guest post – see her earlier post here)

Following a comment from a member of staff regarding the lack of reading material on our acute ward, I decided to raise funds by running the Birmingham half marathon in 2008.  We raised around £200 in sponsorship and also held a ‘Reading for Recovery’ party where friends were asked to ‘bring a book’ to donate to the ward.  100 books of all genres from classic novels to biographies were donated.  I also approached celebrities who have some connection to mental health awareness and received around a dozen donations.

A local blind gentleman who heard about the initiative donated a large amount of talking books for client’s who had difficulties reading or concentrating on the written word.  We were also able to purchase books to be used with clients to encourage them to share their experience of mental illness and material to further staff’s personal development and broaden their knowledge of areas such as substance abuse, managing diabetes and cognitive behavioural therapy.

We now have an in-patient Reading Group.  The aim of this group is to hold regular sessions where the written word (sometimes short stories, sometimes poetry) provides service users with the opportunity to read aloud, listen to others, interpret themes and more often than not, participate in lively debate!  I have found that the groups can be cathartic for some clients, tears are not uncommon and can reignite an interest in reading or the discovery of their own talents in story-telling or creative writing.

Clients often make special requests for further sessions to explore a particular poet/poem or writer.  I have also learnt so much in researching such information and the lively debate that it often invokes..…one that comes to mind is the theory that Shakespeare’s sonnets were focussed around a man, rather than a woman.  This session raised issues of sexuality, religion and how words can be interpreted at one point in history and reinterpreted in today’s world.  A contemporary story by Michael Faber about a ‘safe haven’ where the people that stayed there had their life histories printed on their shirts, prompted a lively debate about stereotyping. The most popular books that client’s read away from the group are autobiographies and special interest books such as militaria or sport.   

Research tells us that service users are not satisfied with the level of interaction with staff on acute wards.  In addition, boredom is often cited as a primary concern.  Our Reading group tackles both issues.  The Group has read texts as diverse as Chekov, Rudyard Kipling, Wordsworth to Benjamin Zephaniah.  My hope is that the service users who enjoy the group benefit in some way, whether they are empowered by the words they read, distracted for a short time from their difficulties, comforted or indeed grow in their confidence when mixing with others.

Images from Flickr creative commons

1. Books by Faryan

2. Leamos/ Let’s read by annais

3. Benjamin Zephaniah by jessallen823

Counselling directory – connecting people that need help with the people that provide it

This is a guest post from Catriona Boyle who is trying to raise awareness about this resource.

As it says on the ‘about us’ page, we are keen to encourage comment from as many people as possible – if you think that you have something to say then please get in touch with me.

A few years ago, a friend of ours found herself in a very daunting situation. After struggling with a number of issues and problems, she decided that counselling was a good option for her to help get her life back track. Her initial decision to go for counselling was undoubtedly one of the hardest parts of her entire therapy process, and a very brave one.

However, once she’d decided this, a whole new set of questions arose, and it became apparent that choosing the right counsellor, whilst perhaps not the hardest part of counselling, is undoubtedly one of the most important parts.

There are numerous issues to consider – practical and otherwise. What about, for example, location? Despite counsellors’ assured complete confidentiality people may prefer to see a counsellor that is perhaps outside their local area, but still in surroundings they are comfortable in. Our friend certainly didn’t want to run into anyone she knew, but at the same time needed to know where she was going.

As we were students at the time, money was a paramount issue. There are counsellors that offer reduced rates for students, and the unemployed or those seeking benefits, but how do you find them? No one wants to end up bartering with a counsellor over the price of their mental well being.

And what guarantees that the counsellor is the real deal? There are no laws in the UK that govern counselling, so what’s to stop anyone setting up shop to listen to people’s problems? There are qualifications and professional bodies, but these can often be confusing and over-whelming.

Counselling can take many different approaches – from person-based to psychoanalytic, and it’s important to choose a counsellor with an approach the person will be comfortable with and respond to well.

A daunting situation indeed, and it made us think. What if there was a website that collected all this information, so you could search for your where you live and the surrounding area and find a list of counsellors, with all their information, qualifications, and what areas they cover? Of course, a website like this didn’t exist. So we made one.

Counselling Directory was set up to provide a simple, easy, and most importantly un-daunting way of connecting people that need help with the people that provide it. A comprehensive searching tool, the site allows postcode, town and country searches, and produces a list of counsellors registered in this area. Each counsellor has a profile, listing a bit about themselves, their approaches, what areas they deal with, and all their training, qualification and experience and fees.

The site shows which counsellors are registered/accredited with a professional body, and full profiles are only displayed after insurance and qualification documents are checked or membership with a professional body has been verified.

We hope the site can solve the situation like our friend had. It’s hard enough deciding to undertake counselling, and who wants extra hassle of trying to find a counsellor? The site has also become a huge information bank – there are articles written by the counsellors, as well as comprehensive information on all kinds of distress – from depression to eating disorders to abuse, to help people identify their problems and become informed, not scared.

We’ve heard from many people who have found the site invaluable, reducing the amount of stress and worrying that can contribute to an already difficult enough process.

All Photos from Flickr  Creative Commons – click below to see photographers

1. Bhernandez

2. Silviad

3 OndraSoukup

'Secret smoking'

No Smoking?
No Smoking?

The Mental Health Foundation has this month published the results of a survey which suggests the ban on smoking in inpatient units has been highly problematic, and has lead to ‘secret smoking’. You can read the full report here on the Mental Health Foundation website.


I began working as a CPN when the ban was introduced – and, certainly initially, I felt very sorry for the colleagues I had left on the PICU of a Regional Secure unit who had to tell patients with very limited access to outside that they were forbidden to smoke. I am not a smoker, however I can imagine that if I smoked and found myself in very distressing circumstances, and in an unfamiliar environment, I would find smoking a source of comfort and reassurance.


Unhappy Staff:

The Mental Health Foundation report suggests that attempts to ban smoking are simply driving the habit underground. They found that only a minority of wards in England have introduced the ban successfully. 85% of 109 respondents to the survey said the ban, which came into effect in July 2008, had not been implemented effectively. The rise of “secret smoking” has lead to safety concerns: the risk of fire, and also the risk that patients who are very unwell may become aggressive to staff when told they may not smoke.


Members of staff are reportedly unhappy to take on an additional policing role, when they are already faced with the problems of holding people against their will and persuading them to take medication. Some staff members said they felt they had no choice but to break the law and ‘turn a blind eye’ to smoking, especially when patients were acutely unwell, and in units which lack an appropriate outdoor space to allow people to smoke. The ban was also felt to be a drain on resources as staff members were needed to escort patients off the unit to smoke.


Unhappy Patients:

There are questions that need to be asked about the effect the ban has had on the wellbeing of patients. Whilst it may be the case that a smoke-free environment is a healthier one in terms of the physical effects of smoke, Vicki Nash, of the mental health charity Mind, said: “Forcing people to stop smoking abruptly on admission to hospital when they are already likely to be distressed is inappropriate and could heighten anxiety”. According to Mind, people with mental health problems are twice as likely to smoke as the general population – which means that this ban is very difficult for a high proportion of patients.


Happy Tsar:

Despite all of this the government’s mental health tsar said he had visited many trusts where a ban had been smoothly implemented. Louis Appleby, the National Director for Mental Health, said other research had shown that although implementing the smoking ban had posed challenges, most trusts believed it had been done successfully. Professor Appleby said: “I have visited many trusts who have implemented the ban with little or no difficulty. Mental health wards are being transformed for the better and going smoke-free is part of this. We believe that mental health staff and patients deserve the same healthier, smoke free environment as the rest of the NHS and there are no plans to change the policy.”


Hospital or Prison?

Prison inmates are allowed to smoke in their cells, as prison is classed as a ‘home’. Does it seems odd that there is greater freedom in prison that in a mental health setting? May be not! Prison inmates also have the right to refuse medication.

On July 28th 2008 there was a nine hour rooftop protest at Ashworth Hospital in response to the smoking ban. The Liverpool Echo reported that an Ashworth source said: “It just went cold turkey on July 1. After that it was no smoking for anyone anywhere on the premises. We’ve got lags coming in who are used to prison life and have that prison mentality, and now they have lighters and cigarettes confiscated when they come through these doors. They don’t like it and you could see trouble had been brewing because they didn’t take kindly to it. We’ve been waiting for something like this to happen.”

I’m not sure I would take kindly to the smoking ban either if I had been admitted to hospital from my own home. Even if I wanted to give up smoking I am not sure that the day of my admission to a psychiatric hospital would be the best time!


What do you think?

Pictures from Flickr (click images to see more from these photographers)

1.  by get down

2.  by Penseri

3. by Mot