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let’s end mental health discrimination

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Mental Health?

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© Leicester Time to Change 2014

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General personal observations about mental health offered by Jan Wild-Grant

There are many different kinds of poor mental health, and for each of us our lived experience of it will be different from others. Equally there are a variety of different reasons for poor mental health. Some, such as Bipolar Disorder, can come from a genetic predisposition: this affects an estimated 10% of people who are bipolar. Some kinds of poor mental health are directly linked to neurological problems: where there neurons or connectors in our brains seem to be wired up strangely. For others it can develop very early in life, and may be a result of environmental factors such as family life, problems at school such as bullying or being isolated. Many teenagers are affected at a time when they are under increasing stress trying to come to terms with how they will cope in the adult world and this may result in eating disorders provoked by media image of 'the perfect body', or in self harm as a cry for help or an attempt to try to ease their mental pain. Bullying at school and increasingly online through social networking sites is a very worrying area where this is increasing hugely.

In adult life stress of leaving home and within education affects many students, especially in the light of vast sums of money borrowed and family expectations that 'you will do well because you always have done' whereas students suddenly find themselves struggling to keep up whilst everyone else seems to be coping well, and there is a lot of isolation in leaving behind your family and school friends and living in a strange city where you know no one and have few ways to make new groups of fellow minded friends - the old fashioned Halls Of Residence fulfilled a valuable social networking tool.

New mums often find the demands of a new baby and no sleep contribute to post-natal depression, but there are also chemical and hormonal changes responsible for this and there is nothing worse than feeling you are a 'bad' mum and 'letting your baby down', especially when everyone else seems to be coping so well. Remember, people often put on a bright face to hide what they are really feeling, but finding people you can talk openly with about this can be very difficult, especially if you become worried that talking to Health Visitors or your GP will mean the involvement of Social Services, the last people you want poking round when you really do need help and support.

For those who don't go into higher education, having no job or one on minimal wages brings its own stresses and anxieties. Coping with the demands of a difficult boss and the 'joshing' of older colleagues can remove your self-confidence. Older parents may begin to feel the need for care, even occasionally, and others may find themselves, as young parents, without the money or skills to fill this role confidently. Then there is peer pressure to join groups and get involved in activity that might be unwelcome but is hard to avoid.

Within the wider work place stress and increasingly heavy demands lead to anxiety and depression: every year over one in six employees is off ill because of poor mental health. Some employers, in recognition of this, are getting their human resources departments to offer counselling, but when people return to work this is not helped if they return to the job that caused the problems in the first place (targets, pressure from the boss). And returning to work is itself stressful, worrying about colleagues and how to talk to them and how they will treat you. We need more employers to become more aware about mental health, and this is where the work of Time to Change can help to change their attitudes. Has your employer signed up to be a 'Champion' for Time to Change, and if so, how has this changed the culture in your workplace? Can we help with this?

For some the roots of poor mental health can go back many years: many service officers can suffer post traumatic stress disorder (PTSD) years after leaving the forces, and this also applies to stressful episodes such as attacks or car accidents. Survivors of domestic abuse or sexual assault can suffer similarly. We also all know that bereavement can often last for a very long time, and when others around us are saying things like, "you should be getting over this by now" this is exceptionally unhelpful. What you need is people to listen and sympathise. But bereavement can also cause a whole range of poor mental health conditions about which it is good to seek proper support. (Source - google bereavement Mind). Interestingly, listening to a programme on Radio 4 the other day about J.S Bach, it was mentioned how bereavement in childhood can have long lasting effects of mental health in adulthood.

And finally, as carers for people with poor mental health or our own older relatives, the stresses of caring themselves can cause poor mental health. It is important to seek out and take adequate respite before you yourself go under. This is increasingly a problem as dementia affects many more in our ageing population, and those who have brought up families, worked hard all their lives and were looking forward to putting their feet up in retirement find themselves caught in the trap of sick older parents, children with poor mental health or being called on to look after grandchildren as the economy prevents their parents paying for alternatives. There is lots of support if you go out and look for it, and when we organise our list of support groups it will be easy to pick out!

A starting point if you are concerned about your mental health these days might be to go on line and we aim to offer some links to the best of these in this website - each one individually viewed and assessed for you. I read today an email from an American site I regularly get emails from about sleep difficulties, and many of us find insomnia is a recurrent problem. I find most of these very useful and interesting, although I was a bit perturbed when I went to a Nottinghamshire NHS Trust Conference about mental health a few months ago and an enthusiatic psychiatrist who had spent a week as an 'on-line' doctor on Ruby Wax's 'Blackdog Tribe' Newsletter was describing the vision of a site where you log in, get greeted by an avatar receptionist who signposts you to an avatar psychiatrist according to the symptoms you describe. I prefer the personal approach myself, but reading other people's blogs and on-line sharing (especially at 3.12a.m., the lowest point of the night) helps reduce the sense of isolation that can overwhelm you at this low ebb.

So the next or best starting point is to visit your GP, and if they aren't very good at listening or being very supportive try a different GP. Usually they will try just listening for a while, and then maybe add in some medication. If they consider your needs are serious or urgent they will (hopefully) refer you to a specialist psychiatrist in the Mental Health Service who again (hopefully) should be helpful and supportive but not all of them are, so don't be afraid to say if this is the case: we can help you with this in stating your desire to see someone else.

Alongside medication you may be prescribed 'talking therapies'. Many people increasingly recognise that these not only complement each other, but medication needs the neurological changes of talking therapies and counselling for it to be effective and long lasting. One of these therapies is CBT (Cognitive Behaviour Therapy) where you may learn how to recognise certain patterns of behaviour and ways to deal with these. This might be individual or in a group.

IAPTs (Improving Access to Psychological Treatments) is being introduced over the next 2 years to implement new NICE Guidelines, for people suffering from depression and anxiety disorders. From 2010 it was opened to all adults of all ages, and from 2011 its focus was broadened to meet "Talking Therapies: A Four Year Plan for Mental Health", one of a series of documents supporting the All-Party "NO HEALTH WITHOUT MENTAL HEALTH STRATEGY". The national organisation Time-to-Change is itself supported by funding from the Department of Health as part of this. It will be expanded to include children and young people and cover other long term physical conditions and medically unexplained symptoms and severe mental illness. DoH claim it will save the NHS up to £272 million per year (Source NHS IAPTs website).

Finally there is the gold standard of talking therapies: dynamic psychotherapy. There is a long waiting list for this as it lasts several (or many) years).

Mind and Reclaim Mental Illness offer daytime support telephone lines, but your local Samaritans will be there for you to ring 24 hours a day, so don't hesitate to ring them up if you are at all worried or neeed someone to talk to. It is completely confidential. The number is in your phone book or on line; in Leicester it is 0116 2700007. "The time and space to find a way through".

If things get really bad really quickly you may find a support team called the Crisis Team come to visit you following a referral from your GP or from the Urgent Care Doctor at the LRI or even from A & E. And if things are suddenly seriously badly and you need to be somewhere safe you may be taken to the Bradgate Mental Health Unit (hidden behind the Glenfield Hospital) where you will receive a higher level of care - I'm assured the rooms there are now all single en suite, as opposite to the wards when I was there 5 years ago and woke on my first night to find my neighbour rooting through my drawer to steal my drawers, one of the few items of clothing I'd been admitted at very short notice with, and having insisted on being moved found myself next to someone who I had known 20 years previously who woke me several times a night threatening to kill me. So things have improved.

Alternative Therapies

A psychiatrist I know calls these self-medication. Number 1 for anyone who has spent some time as an in-patient is likely to be nicotine. When I was detained, my daughter (studying biomedical sciences at Sheffield) told me that it is good for encouraging helpful neurological activity, and a psychiatrist whom I know has indeed confirmed recently that this is a little known medical fact which the medical profession like to keep closely guarded: cigarettes help your mental health, help slow Alzheimers and ... he'd forgotten number 3 (Motor Neurone Syndrome and similar complaints). So I offered him a cigarette and suggested he go out and smoke it and it would help bring his memory back. He laughed. That's the sort of relationship you want with a psychiatrist. Seriously, the fact that the only view of the outside world is when you are escorted out for your 4 hourly 'breath of fresh air' led to many who were not smokers queuing with us who were, to shuffle out like zombies under the beady eye of a prison warder.

Number 2 is alcohol. One or two glasses may help to lift our mood, but over use will lead to increased depression although as the sedative affect kicks in it can help with sleeping. It's probably better to try to avoid too much, but there are long standing links between poor mental health and alcoholism, just as there are with homelessness. That psychiatrist, following years of me complaining about insomnia also recommends not watching a screen, especially doing computer stuff, for 2 hours before bed, and having a warm milky drink as the tryptoline in it is a natural sedative - it's what sends babies off to sleep. And it works for me, I've weaned myself off all sorts of addictive sedatives and hypnotics.Whatever the treatment you are offered there are a wide variety of self-help and support groups around as well as voluntary sector and charity groups that can also offer help and activities you might be interested in. We have prepared a page on these here. And of course we hope our group will also act as a self-help and self-support group. Please send us more information about these.

And on the subject of this, many of these groups focus on creative, artisitic and writing work. As well as being very therapeutic, almost all of us are exceptionally creative and imaginative in all sorts of ways, so this may be a route to get published and even earn some money.

Mental and Physical Health

It goes without saying, but sadly rarely seems to be recognised, that if your physical health is poor, this will affect your mental health, and if your mental health is poor, this will affect your physical health. I understand it is now easier to get general medical treatment while on a mental health ward. There has been very worrying research recently about the much lower life expectancies of people with long term poor mental health, partly due to long term medication and its side effects, and other resultant illnesses such as diabetes. So we have to continue to push for much more thought about the medication we are given and how long we have to take this for, and this is yet again another area where we need to be recognised as 'experts by experience'. Coming together in self-help groups is an ideal way to share information about our symptoms, medication and its side effects, so we can go back armed with this information to argue our case. The people who mainly seem to benefit from the sales of these mega drugs are the giant pharmaceutical companies.


Jan Wild-Grant

We all have mental health, just like we all have physical health. For some of us at times it is poor and at other times good, just like our physical health. For some of us it can get very, very bad and for others it can be poor for a short while and we can recover quite quickly. Some of us have poor mental health all our lives, just like people do with their physical health. Some people may never have poor mental health, but they are very few and far between and they will undoubtedly have been affected by it through their families, friends, neighbours and colleagues. At one in four of us each year that makes a very large proportion of the population.

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