The politics of Mental Health – Should people who use services commission them?

I recently attended an event at York University; run by the Social Research Council.  I went as a Blogger and as someone with an interest in Mental Health policy.  This interest has been borne out of my personal experience of using Mental Health services and wishing that this experience had been different and seeing the flaws in the system.

The event was concerned with  ‘Co-production and commissioning services.’

Co-production is the fancy term for involving people ( who have used or use services ) in producing mental health services. People may be involved in delivering or designing services.   This event was concerned with true Co-production which means involvement from the start which includes the commissioning of services.  

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Traditionally it has been Health Care Professionals who produce, deliver and shape these services.  Commissioners currently decide which services are needed and where the money should be spent.  But should people who use services also commission them?

There is currently a move towards people with lived experience becoming more involved in delivering services. Employing people with lived experience is logical as there is huge value in this lived experience at the same time it helps to dismantle the ‘Us’ and ‘Them’ culture.  However cynics see Co-production as being a response to austerity and say that it is a way of making people responsible for their own health as though it is a personal achievement.   Organisations often involve people who have used services but this is often as unpaid volunteers and then what happens to people in the long run?

We discussed the imbalance of power between professionals and people who use services.  People agreed that more authentic relationships need to be developed and that  “Professionals need to take off the protective mask and engage. ”  For a service to be more effective it needs to be human.

Pamela Fisher of Leeds Beckett University saw Mental Health Services as political areas which cannot be left to professionals alone.   So therefore does it makes sense that people be involved in commissioning?

Anne Rogers (University of Southampton)  criticised the NHS for largely commissioning and creating a culture which depicts mental ill-health as a biomedical diagnosis which is to be treated with either medication or  IAPT services or both. She talked about the importance of a person having diverse support networks and having ‘Weak tie relationships’  which may include a regular ‘hello’ to a  fellow dog walker in the park.   She explained that weak ties are particularly important as too invasive support such as an overbearing family could actually block people off from getting involved in other things. Diversity of support is important.

Commissioners do get things wrong.   A table of people from Liverpool informed the room how their local Library was closed in order to be turned into a recovery college.  A recovery college may sound great, but people actually wanted their local library. This resulted in a recovery service wasn’t used very much and no library. They wanted to know who decided this?  Co-production can open these decisions up to scrutiny.

Currently if people who use services are involved in commissioning,  it is often towards the end of the commissioning cycle when a lot of the decisions have already been made.  We discussed how true Co-production needs to take place at the beginning of the commissioning cycle.  When the public work alongside commissioners,  questions are framed differently,  and a different agenda emerges.

The event was one of a series of events by the social research council on Co-production.  In attendance were a  mixture of academics, people who work in the health services and people who have used services.   They have their own blog which you can view here if you’d like more information or to be involved.

Please feel free to comment on our blog or on our Facebook page or Twitter!

Thanks for reading.

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Nodding acquaintances

On the value of having nodding acquaintances.

If you’ve lived in a neighbourhood any length of time it’s likely you will be on nodding acquaintance terms with many people. This type of recognition can be an aid to your wellbeing as it places you in a context, of the time and spaces you inhabit…..you belong!

In an age where many report feeling they don’t belong, that they are isolated or lonely, nodding acquaintances can be a reassuring acknowledgement that you are not alone…..we are known.

If over time you’ve been on nodding acquaintance with someone, you might have progressed to stopping and ‘passing the time of day’ with the them. You might chat about what’s trending in local, national or International news. These kind of conversations are valuable, even if the chit-chat remains only that, about …….’the price of fish’ or the weather.

Often when I’m about my daily chores in LS13, I see an elderly lady standing inside her house and looking through the window, as yet we only wave, but it’s a connection, I hope we get to talk some time.

Other people who see me sit awhile to catch my breath when carrying shopping, or simply if I’ve stopped to enjoy good weather, or just ‘people watch’…. may smile…..

‘Hills….you can’t avoid hills in Bramley love, can you?’……

It is said that Leeds is one of the friendliest cities in UK and certainly its rare if I stand at a bus stop not to start up a conversation with someone.

On days when the news is particularly alarming, as it was yesterday with the US election results, you might like myself only  have accessed it via the media, and without the opportunity to discuss it with anyone, the potential to feel disoriented, destabalised is real. You may doubt your own perception, or indeed the sanity of the ‘crowd’ who brought about that result. You might as a result phone a friend and commiserate along with them about ways to avert feeling hopeless. Just how can you as individual combat that?

On hearing the news, and feeling downcast I ventured out to the local greasy spoon cafe in a somewhat defensive mood. The conversation in there is often similar to the tabloids that are scattered on its tables, it is frequently sexist and racist…….usually because of that I don’t linger.

‘If someone praises that man’s success’, I was thinking ‘I’ll challenge them’.

The cafe was empty except for the staff who also seemed as dismayed at the result as myself. Fortunately other more pleasant topics were discussed and a simple personal compliment from one member of staff, cheered me on my way, my equilibrium was restored. By the end of the day I did need a ‘top up’ by discussing the days news with a friend but I still valued the earlier time of day passed.

Lily P.

 

Clocks go BACK ending British Summer Time: Memories of light

British Summer Time ends on Sunday 30th October at 02.00a.m.

We turn the clocks….. BACK one hour.

Click here to see …..why we do it!

I’ve always enjoyed the interim period as we’ve counted down to it, though not without a twinge of sadness for the diminishing light.

The nights have been drawing in naturally enough without the need of human interference. Nature in decreasing its daylight hours has alerted us that we have still had time to enjoy, what have lately been, wonderful autumnal splendor on sunlit evenings.

The words of the beautiful harvest hymn, ‘Come you thankful people come’…..are always recalled to my mind at this time of year.

…….”All is safely gathered in”

Humans and animals alike start to ‘gather in’, or replenish their store of winter ‘comforters’.

My comforters this year include a fleecy hoodie, and in keeping with the mantra of my mum….. ‘layers’ of thermals which keep me snug, these enable me to enjoy the fresher weather of the season.

It’s a time when memories of how comforting the coal fire’s warmth and light of my childhood days were.

October, the ‘season of mists”, when the ‘feint blue land’ prior to adjusting our clocks, still has sufficient light in the morning to wake me naturally, and in the early evenings to feel unrestricted by the ever increasing darkening streets.

It’s a time of year where festivals involving light abound,

Diwali almost upon us. diwali

Even Halloween and Bonfire night with their ‘darker’ side involve colour and light in one form or other.

During the last few year the newer festival of light,….. ‘Light Night’ has become a must see festival.

This year’s Light Night outing included for me and my fellow Light Nighters, a jaunt to China courtesy of the Nankai University choir.

Nankai Uni choir by Sue

Nankai Uni choir by Sue M,

The colorful costumes I photographed here, (and there were more) represented each of the different Chinese ethnic groups and their traditional dress.

The audience were treated to a variety of Chinese folk songs, one, Mo Li Hau,  we learned a verse of in Mandarin Chinese, and sang along to it with the choir.

Apparently the folk song is very revered in China. Many in the audience were Chinese and sang it with such depth of feeling, that it moved me to tears. A sudden ‘catch’ in the throat, I was uncertain from where it came,…

was it just the power of music and lyric that  tugged at my ‘heart’ and memory? though I don’t remember having heard it before, or perhaps the tender way those beside me sang it?..I can’t be sure.

The Light Night concert also revealed that the Chinese performers alongside their very disciplined, and polished classical and folk performance could also appeal, with comedic effect, to a Western audience.

The somewhat stern facial expression, and composed body posture of the choir mistress gave little hint of her sense of well timed humour.

….although she did later revert to a warrior like role as well as sing in fearsome tones

During her initial entrance, and as she paused to gain the attention and composure of her troupe and audience, her body language indicated , ‘I’m in charge’….except that is to a young child in the front row who let out a yell…or two!

At first the choir mistress didn’t flinch, remaining composed, unruffled for a further minute while the small child still continued to break the silence. She captivated us first by casting him an annoyed glance over her shoulder,  then by proceeding towards him with mock anger, …..he shut up then!…..

rather than looking frightened he just seemed transfixed, even though subsequently he remained on the receiving end of  other choir members attention, who singled him out during the enacted war scenes. He remained quiet!

Possibly because of the swirling swords!

Nankai choir warriors - Sue M.

Nankai choir warriors – Leeds Uni

World Mental Health Day 2016

Knowing the value of good mental health after having experienced the disruptive force of losing it, is a great reason to keep the relevance of World  Mental Health Day, October 10th, in mind.

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My experience with acute distress which led to diagnosis and treatment I’m now pleased, and proud to say is well behind me.

Each year that World Mental Health Day  comes round I find time to reflect on that experience 16 years ago, and how it changed my life and also just how far, despite it’s residual effects, I’ve come.

I feel compelled annually to both reflect and contribute a written piece as witness to the value of good support, and attest to the value of  effective listeners and friends, when  one’s own emotional reserves may need ‘patching up’.

The theme of this years World Mental Health Day is two-fold,

Dignity and psychological first aid

Maintaining dignity after experiencing breakdown or trauma isn’t always easy but it’s an aspect of self-worth that’s important to strive for. It’s that inner core of being which aids us regain our sense of self when things get emotionally blurred, or practically chaotic, reminding us,

‘you do deserve to be well and have peace of mind’.

Dignity itself acts like first-aid, it can help people not to be cowed by negative or traumatic experiences.

The World Federation of Mental Health who are responsible for World Mental Health Day say that psychological first aid is primarily,

‘A humanitarian and appropriate response during times of mental health crisis’,

 

the WFMH also acknowledge that it not always situations of crisis which precipitate the need for psychological first aid.

Stress factors that occur either as a result of everyday pressures and mishaps that befall all, the more extreme aspects of mental illness that affect some, and pertinent to this years theme those global issues where major trauma , such as war displaces people from their loved ones and homes.

Some can be alleviated, their effects possibly reduced through particular interventions, the World Health Organisation have an extensive and excellent  report on proposed ways it can be addressed.

As respects individual mental trauma, professionals are the obvious first-aiders when its extreme or acute forms disrupt wellbeing, however it is also good to see WFMH acknowledge that telling our personal stories, related in informal ways, can also act as triage.

With that in mind they are encouraging people to share their own ways of coping with trauma and as an aid to manage their own incidence of trauma. They also give credit to the contribution of non-professionals who come to the aid of those who’s good mental health is disrupted.

On or around  World Mental Health Day,  people are asked to consider getting together with friends or family for ‘tea and talk’ and to use the occasion to consider making a donation to the Mental Health Foundation.

Making time for someone in distress so they can talk through it is a quick, low cost act of first-aid simply but effectively applied.

Put that kettle on! tea-and-talk-logo

Keep your conversations about ways to positive mental wellbeing fresh.

Finding effective personal strategies or accessing relevant available resouces can be a challenge, epecially if ongoing emotional/mental distress sometimes dints your dignity.

May World Mental Health Day find you with your dignity intact.

Sue Margaret

Mindfulness drop-in at Oblong, Woodhouse Community Centre

As the nights turn darker earlier and the leaves turn brown and fall from the trees, perhaps it’s a nice time to get together with others to practise Mindfulness?  And to bring ourselves into the moment. Well the good news is that there is a new mindfulness group starting in Woodhouse!

Steve Hart is an experienced Mindfulness and Meditation practitioner and will be facilitating drop-in sessions along with other facilitators from Leeds Mindfulness at Oblong, Woodhouse Community Centre The sessions start on the 19th October – on Wednesdays from 7.15pm -8.45pm. 

Steve is a friendly fellow with a gentle approach and I am sure that it will be a lovely community down there. The sessions are intended for anyone who is interested and all are more than welcome.  Steve describes the sessions as ‘ Simple meditation exercises using awareness of breath and body and self nurturing and loving kindness meditation.’

Practising Mindfulness can bring many benefits for everyone, especially if you are feeling stressed or fatigued and it’s also good for pain management.  It can help us to achieve a state of calm and tranquillity, a positive mental state and to have a better connection with others.

Certainly it will be a nice community down there.. pop along..  I intend to!

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Steve can be contacted on 07999 218450 if you need any more information,

ENJOY

LWW

Zine and heard!

As a part of a local library project, ‘Focus on Photography’, participants created an exhibition about ways of seeing their locality when about their daily routine

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they also made a ‘zine’.

The intention is to submit the zine which has the theme, ‘This is Me’ for the Love Arts Festival which starts TOMORROW. 5th October and continues until the 20th.

The annual Love Arts Festival, now in its 6th year has as its theme;

I AM

Not knowing, most of the time, quite what I am

….I produced the following zine which explained, at least on the afternoon I made it, …

‘This is Me’.

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I bought the tee shirt, because of its slogan, sometime ago, I was sure the right occasion for wearing it would present itself. Here it is on the zine during its first airing at the Zine Festival at the Left Bank arts centre.

Zine events have been trending on social media for sometime, not knowing quite what they were led me to attend the Festival to find out.

Lo and behold I discovered zines are in fact little different from pop art or rag mags of ‘old’,  or even older grass root publications.

Zines promote a d.i.y. ethic in the face of an array of corporate glossy magazine content, zines are not dissimilar to blogging in their  intent.

Zines and blogs put content publishing into the hands of amateur and professional alike.

Challenging the accepted norms or order of things has long held an appeal for me, though it’s never been an easy path to take, at times it has led to my state of mental wellbeing being in question.

….I will let the zine ‘say’ the rest of who I am….

At least that is, what I was one late summer afternoon in LS13! Keeping in mind that like the  British seasons and weather, I am susceptible to change.

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Colour me orange

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As the summer turns slowly into autumn, the glorious days of late summer have made up for this summers later than usual start.

A bunch of orange and yellow blooms, bought at low cost,  helped to further prolong my summer break from course timetables.

I don’t have a garden and so I have to rely on simple bunches of fresh cut flowers to bring nature indoors.This bunch, with their sunburst of colour, daily lit my north facing room.

Despite the heat of late summer days the fresher mornings and evenings, together with the early turning colours of green foliage, herald autumn with its own promise of orange and gold shades.

Orange has long been a colour that

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holds some poignant memories.

Here a fresh cut, orange rosebud worn in the hair, on a certain October day moons ago.

During the ‘flowers in the hair’ era, aka ‘the 60s’, a favourite pair of jeans were also orange, …..bright orange! …. ‘loon’ bell bottom trousers.

They were ‘bell bottoms’ in every sense, as I had sewn tiny bird bells down each outside leg seam….

..’in the jingle jangle morning,’

usually evenings, I tramped around my favourite haunts in them.

Although at that time considering myself shy, I did of course wish to be seen by that ‘certain one’.

I can’t have been too shy as the bird bells and bright orage bell bottoms ensured I was both seen and heard!

Although the lyric, ‘jingle jangle’ was more likely about the jangled, on edge nervousness of recreational substances than tinkling bells, I had in mind their ‘tambourine in time’

Not being green fingered I don’t know which flowers are late garden bloomers, but each autumn a particular type of orange rose blooms in a neighbours garden. They are often still around to greet the frosts and mists. I admire their tenacity.

This is the time of year I feel most wistful, and enjoy these late blooming roses in their inevitable fading beauty, but admire their determination to hold on, adding their own splash of colour well into the “season of mists’ and greyer frosty days.

The song ‘Misty Roses’ by Tim Hardin, a person much troubled in mind,suits them well, one dare hardly touch them, as their now frozen leaves may snap.

As my eyesight changes, bright colours have become increasingly important to me. My household  filing system is colour coded in bright luminous colours, this not only ensures I can locate them easily but also acts as a memory aid.

Shocking pink is the finance file!

Bright orange my ‘Focus on Photography’ notes.

S.M.