Blog – Sarah Long – Mental Health & Wellbeing

Five things you need to know about Mental Health First Aid – Whoever you are.

Looking out there on the internet you see lots of different thought about Mental Health First Aid, positive and negative. Here’s a few things I think you need to know, based on 13 years as an instructor, and MHFAider. I’ve seen it done well, and I’ve seen it done poorly. It’s often how it’s implemented by individuals and organisations which dictates how helpful it will be.

What you need to know:

As an individual
As an employer
As someone needing help
As someone thinking about becoming an MHFAider

As an individual

It can help you.

Whether you are the person seeking help or the MHFAider, Mental Health First Aid can help us improve our mental health in many ways. It helps us understand this vague term “Mental Health”, how we can look after it, recognise when we ourself or others are not doing well, and learn some ways in which we can help.

It isn’t counselling

Two days can’t teach anyone to provide in depth counselling support. But sometimes a simple conversation and being heard, seen and not judged is enormously helpful. Especially if you’ve had a lifetime of people telling you to get over yourself, it’s not that bad etc. Or maybe we feel like we don’t want to “burden” our closest loved ones – so someone neutral to talk to have be a release.

It is confidential – to a point

Sometimes people worry that a MHFAider will gossip about what they have been told, or run to tell HR or management. That shouldn’t happen. Of course we can’t account for people who don’t live up to the expectations of the role, but the core principle of MHFA is that conversations should be confidential unless there is a risk to safety of the person, our self or others. There may also be specific safeguarding or safety procedures that would require reporting of particular issues if you work in certain sectors – so make sure to look at any appropriate policies if you are concerned. Even if you don’t want to talk details with the MHFAider, they can point you towards other help.

It is for anyone

Even if you don’t feel able to support others in a formal context, Mental Health First Aid teaches you knowledge and skills for your whole life. Looking after yourself and informing every conversation and relationship you have. If you are living with poor mental health or mental illness, you may find the basic approach could give you some useful ways of thinking about your experience and the importance of self care, and seeking help when you need it. If you are thinking about this for supporting your colleagues – there is no industry or profession which doesn’t have its own challenges. And the more different types / demographics / roles your MHFAiders have, the more likely there will be someone everyone can relate to and feel comfortable talking with

It can help share the load.

We all know that our health services are overstretched, and people can find themselves waiting a long time for help. Mental Health First Aid can help this in time, by ensuring people who have access to other supports, for example through a workplace Employee Assistance Programme – know about it and are able to access it. It also will mean more people understand themselves and the people around them, and hopefully catch issues at an early stage when they may still respond to self care and peer support, meaning less suffering, but also less demand on the health system, freeing up care for those with needs which do not respond to other approaches.

As an employer

It is a good start – whatever your business / organisation

Employees are human beings too. As much as we might like to leave our home problems at the door it doesn’t work like that. We have a duty of care, under the law, to look after the health, safety and wellbeing of staff. Having someone to talk to, informally, who won’t judge, and can help us think about and access more support if we need it is a helpful resource. Different industries and professions present different challenges which can impact our mental health – showing that you understand that and want to help your people to manage the stresses of life will help them feel valued and be able to thrive and perform to the best of their ability.

It won’t solve all your problems – especially if you treat it as a tick box exercise.

It’s a good start, but it won’t mean none of your staff ever face challenges, or need more help. If you train some MHFAiders but then don’t facilitate them to be able to help people, or if your other policies are not supportive of people. If your culture makes it unsafe to talk about mental health, rewards bad behaviours, or people see other staff being discriminated against or managed out when they go through difficult times, then they won’t speak to anyone.

MHFAiders need support, so do your staff.

If you are expecting MHFAiders to support staff, they will have some challenging conversations, maybe even support people in crisis. Even though our role is not to be a counsellor, initial conversations and guiding people on to more professional assistance can still be stressful. They may need some support to make sure their supporting role doesn’t have a negative impact on their own mental health. Setting up a network of your MHFAiders and other wellbeing champions to meet regularly and support each other is a good start, but ideally access to other support is a good idea too. Having an Employee Assistance Programme or similar to give access to counselling and other services will help them, but also be somewhere they can signpost all staff to when they are in need. If you are not in a position to fund such services, giving time and information about other local services or looking into industry linked charity support may be an option for you instead.

Mental Health and work are interlinked

Work is good for mental health. Sometimes. To a point… A well paid job which is interesting and challenges us, with a reasonable workload and social connections can bring many benefits to us. However, if we are overworked, underpaid, underappreciated, bullied, taken advantage of, or working unhealthy shifts with insufficient breaks – it’s not going to be good for us. Similarly if our work adds to our stress levels with uncertainty, discrimination, lack of training or support, poor environment or faulty equipment – it’s inevitably going to do us harm. Supporting staff wellbeing is good for business, happy, healthy staff work better. They have better relationships with each other, communicate well and are focused, energised and interested. The human reasons should be enough – but if you need a business case, it’s certainly there.

It works best as part of a systemic approach to wellbeing

For best results:

Train everyone in basic Mental Health Awareness
Have a good number of MHFAiders which reflect every department, function, level of your business, with a diverse array of people to reflect the demographics of your workforce
Set up support for your MHFAiders
Have good HR policies which are consistent: Mental Health First Aid, Mental Health, Stress, Sickness Absence, Carers Leave, Parental Leave, Compassionate Leave, Menopause Support.
Have self-directed groups where people can raise issues relevant to them, support each other and work with management for change.
Provide support to all staff eg. Employee Assistance Programme, Occupational Health, Private Medical Insurance, Benefits etc.
Have a good and varied Health and Wellbeing programme to support positive wellbeing.
Encourage social events and community within your teams.
Have Mental Health Champions at senior levels, to make sure Mental Health is considered in decision making, and impacts are mitigated.
Actually deal with the problems that staff raise which are causing them stress.
Design your roles with wellbeing in mind. Variety, stretch, training, realistic expectations and sufficient breaks – and either opportunities for advancement or support to find different roles when necessary.

As someone needing help

It’s good to talk

Sometimes we go over and over things in our head so many times we stop seeing things clearly. We only see things from one perspective and someone else may help us to think differently. If we’re unwell, our thinking becomes distorted and another person might be able to point that out to us. We might want to talk to our partner, family or friends – but not want to be “a burden” to them. We shouldn’t think that way but we sometimes do. Someone who isn’t personally connected to you is sometimes easier to talk to.

Your MHFAider should be able to help you find more support if needed

If your issues are really causing problems in your life, your work, your relationships – and have been for a while, then you may need more support than an MHFAider is qualified to give. But they can help you to look into the options that are available to you, and support you in preparing to seek help when you are ready for it.

It can’t solve all your problems

Sadly. We’re not there to fix things necessarily. Sometimes there might be some things we can sort out, depending on our other knowledge and roles – but more often it’s trying to find someone else who can help more directly. Or help you to overcome things yourself. And of course some problems or issues can’t be fixed. But it’s better to go through them with support, rather than feeling alone.

It’s not just about going to the doctor’s

Yes, if you need to, you should go and talk to the doctor about any physical or mental health symptoms which are worrying you. And they can refer on to other help too. However there are a great many other things you can do yourself, other avenues and types of support which can have a great impact on your mental health. And your MHFAider can perhaps help you explore these options too. Work on different coping mechanisms, and manage your stress, find wellbeing activities and support in your community which can transform your life.

It shouldn’t just be a tick box

Every organisation is different – and we can’t deny that some out there do treat it a little bit like a tick box. But these days a lot of employers are seeing the importance of supporting staff mental health, recognising their legal obligation to support wellbeing, and also understanding the genuine benefits to their business of looking after their people. It’s not just about you – it’s good for them too. If you have MHFAiders, Mental Health Awareness training, or Health and Wellbeing activities in your workplace, it’s an indicator that at least one person up there in management cares and is trying to create change. The more you engage with what is being offered, the more they will be able to do.

As someone thinking about becoming a Mental Health First Aider

It can help you too – individually, at home and at work

Everything you learn on the course applies to you too, and you can also apply to family, friends – anyone in your life. Understanding stress, knowing the signs of different mental health conditions, developing our empathy and understanding what can help. Mental Health First Aid gives skills for life that can be used in any setting.

You need to look after yourself

Your number one priority has to be your own wellbeing. Generally – you should be looking after yourself physically and practicing good self care to make sure you are getting out of life what you deserve. But sometimes you might need to seek extra support, or do a bit more to relax and look after yourself because you’ve had a difficult conversation as a MHFAider – maybe supported someone through crisis. Don’t underestimate the impact it could have. Sometimes self care looks like saying “No.” – If you aren’t in the right place physically or mentally, or if the issue at hand is something you don’t feel comfortable with – sometimes the best thing we can do is refer someone on to another MHFAider, or a service which is appropriate to their needs.

You aren’t expected to be a counsellor

We provide a listening ear, emotional support – but we shouldn’t be digging into someone’s trauma, which we may not be equipped to deal with personally, or know how to help them to deal with it. Boundaries are important all round to protect ourselves and the people we support. If something feels too much then we need to make it clear we are not qualified to help in that in depth way, and encourage the person towards professional help which will give people the skills to overcome their challenges.

It’s not right for everyone, and that’s ok.

We all have varied strength and weaknesses. Some of us are great listeners, some like the sound of our own voice too much. Some of us are empathetic, some more judgemental and critical. Some of us have the patience of a saint, some of us get annoyed if the person in front of us walks too slowly. Some of us will take a secret to the grave, others will have broadcast it all over facebook by 10am. Self awareness is a valuable thing. If you don’t feel like you have the right personality or attributes to support people, or if your own mental health and experiences might mean it would be too upsetting for you to be helping others right now – or even if you’re just really busy and don’t think you have the time, it is better to acknowledge that it’s not for you, than to take on the role and not be able to fulfil it.

It is very rewarding

If you do decide to become a MHFAider, it can be very, very rewarding. People really value having someone to talk to, and we can make a real difference to people. Even save lives. We learn more about people, make great connections, and become more understanding and empathetic towards the world at large. You realise that so many of us are struggling in silence, going through all sorts of difficulties – and that can make us much more compassionate towards people we may have otherwise viewed with judgement.

New Mental Health First Aid Course from MHFA England

Mental Health First Aid has been around for over 20 years now, and MHFA England is part of an international community of organisations delivering the training across the globe.

The course is periodically reviewed and updated to make sure it is meeting the expectations of learners. The latest update to the course launches today – and brings a fresh approach, and also a new offer including ongoing support and community to Mental Health First Aiders (or MHFAiders®).

The course centres more solidly on the role of the MHFAider®, giving opportunities to practice offering support using the Mental Health First Aid Action Plan to guide conversations through empathetic active listening to signposting and self care. It also give space to consider the boundaries which are essential to the MHFAider® role, for purposes of safeguarding and self protection.

Recognising signs that someone might be experiencing poor mental health is still a key skill for MHFAiders®, so there is discussion of a range of mental health conditions, and also a good grounding in understanding mental health and the importance of self care for all to maintain positive wellbeing.

The course is now structured so it can be delivered in the same format whether face to face or online. There are four sessions – which can be delivered over a period of from two days to four weeks – however the recommended optimal learning experience is that online course sessions should be on different days, and all sessions be completed within two weeks.

I will be continuing to focus my open courses on online delivery for the time being – however I can offer both online and face to face training if you are looking to book a course for your workplace or organisation.

Once you complete the course you get a digital MHFAider® certificate, and badge to use on your emails etc. Your certification still lasts three years, at which point you are required to undertake a half day refresher course. However in the mean time, you now also have additional support available to you.

The MHFAider Support App® offers mental health information, a secure place to log reflections about conversations – reminders to check back with people we are supporting and so on. There is also a dedicated support service offered for MHFAiders by the SHOUT Crisis text line service.

You will have ongoing access to your digital manual on the online learning hub – where you can connect with the wider community of MHFAiders® in England – and access ongoing learning opportunities from MHFA England.

I’m excited to be delivering my first new course from next week – I’ll come back to tell you how I find it. We have all been working very hard to familiarise ourselves with the new content, and the development work has been ongoing for well over a year.

I’m in the process of listing open course dates – I’m trying to offer a mix of short and long stretch courses as I know people have different requirements. However if you don’t find something to suit you, please get in touch and I will see what I can do – or signpost you to another instructor who can help.

Costings for the course have changed slightly – to reflect the enhanced support offer. MHFA England value the course at £325 per person.

As ever* I will try to make the course as accessible as possible by offering discounts to those on reduced budgets, eg. charities, non-profits, people in receipt of benefits or on low income. Please contact me to discuss if you are eligible. If you are not eligible, then I still offer the option of Early Booking incentives – as this helps me to plan and manage workload – so look for courses more than one month in advance. On the other hand I encourage you to pay the highest rate you are able, as this enables me to offer the other rates to those who need them. I subsidise this myself – rather than through any funding.

If you have any questions, please get in touch. We can discuss your requirements, and see whether this course, or another, best suits your needs.

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Unconditional Love – Pets and Mental Health

I am not doing too well at the moment. If you asked me over the past couple of decades what helps my mental health – high up there on the list, if not at the top – would have been my cats. Brother and Sister, Ixxy and Poppy. They have been my world. I don’t have children. They have been with me through thick and thin. Until now.

Some days ago we had to say goodnight to Ixxy. A very rapid decline, weightloss, lack of interest in food, lethargy, fast breathing – revealled a cancer which had clearly been hidden for a while, and maybe explained some other changes we had put down to ageing. He was 18 years old. Somewhere around 18 years and four or five months. Up until this recent deterioration he had been quite a young cat for his years. Healthy. Happy. Beautiful. No doubt I will write about him more elsewhere. But as I grieve I wanted to write a little about the joys and woes of pet ownership (or having a companion animal, – not our property but our friend), and its relation with mental health.

A lot is said about the benefits. They are many. Pets can give us companionship, company, love, solace, laughter. They give us a focus for our attention, someone to care for, structure, responsibility. They teach us about life, and death. Pet ownership is linked to less depression, lower blood pressure, triglycerides and cholesterol, longer survival of heart attacks, better overall health. They have a positive impact on those pesky brain chemicals which are associated with anxiety and depression. They give us emotional attachment, they improve our ability to relate to other creatures including other humans.

It cannot be underestimated the joy and positivity that animals can bring to our lives if we allow them, if we take the honour of caring for them seriously and enjoy the gift of love this new family member can bring us. Because they are – they can be, a beloved family member. I don’t have children, I don’t have siblings. But I have / had my cats. I had my dog when I was young. I can’t say if I would feel something greater for a human – I will never know. But my animals have never let me down the way some humans have.

Of course – this all has a price. The potential positive impact must always be weighed against the negatives, and potential costs, financial and emotional. Love has a price, and I am paying it right now. Losing a pet – especially after a long time with them, can be utterly devastating. You know it is going to happen – unless something goes wrong, or you are very old when you get them, your pet’s life is going to be shorter than yours. But that doesn’t mean you are ever ready for it. Sometimes – you have to make the choice to end their suffering, a kindness we mostly cannot offer our human family. You know it is probably the right, the compassionate thing to do – but it comes with awful guilt and sorrow. And echoes of the moment if you stay to comfort them in their last moments – which for me, was a necessity. It hasn’t been a week yet. No heart that large and loving can be forgotten or got over so quickly.

But there is another cat in my life to care for too – his sister. Equal in age – her own health worries, and now I am observing to see how she is dealing with his absence. They didn’t get on really, they mostly kept to themselves. But they have been together their entire lives. She has never been without him this long. She seems a little more needy. More sad. She made a weird noise the other night. Loving is worrying. Keeping an eye on them. Monitoring their food and water intake, toileting, energy and behaviour. Finding a balance between safety and freedom. Keeping them entertained while not annoying them too much. Tell me again how they are not my children?

Pets cost money too of course. More depending on how fastidious you are going to be about caring for them properly. Some require more equipment or set up than others. All require food, some form of bedding or litter. Toys maybe. And medical care – vaccinations, boosters, flea and worm treatment, spay/neutering. And that’s if they don’t get ill. Maybe you get insurance to guard against that. My biggest anger in this whole process has been the fact that I paid for insurance for about 15 years of their lives, at which time the premiums became too much. At exactly the point when they are more likely to need care – they price you out so they don’t have to pay. I know it’s the way insurance works, how they make money. But when it’s life and health it seems unethical. Like Health Insurers in America refusing to cover certain illnesses or treatments because they cost too much. How difficult would it be to offer a lifetime cover – guaranteed to cover the whole of an animal’s life, with an averaged out premium from the word go. So you can make sure that you can treat illnesses that come up later in life, to give longer lives (hence more premiums) – and also, crucially, that animals are not left to suffer unnecessarily, or put to sleep without confirmation that there is no other option. It has cost me over £1000 to find out my boy was dying, to say goodbye and the consequent arrangements. When I took him in, it could have been a stomach bug putting him off his food and causing weight loss. It took £700 to find out it was not. If I hadn’t had access to that £700 in credit or cash – what then? Sorry baby, you come home and we keep our fingers crossed? And potentially horrible suffering. I mention all of this – because for all the pain and worry I have had, I at least know I did what I could for him. The torture of not being able to do right by him because of money would have been worse. And that worry comes right through their lives. Money worries weigh heavier on you when you know they also impact your ability to care for your dependents – human or otherwise.

Despite the pain, the worry, the cost – I would hate to have lived a life without these little creatures with their enormous characters. If their impact on my mental health were to be a bank account, it would be heavily in credit – despite these recent hefty withdrawals.

Part of the problem I have is that back of the mind thing – which comes from things said by people who don’t really get it – who have never had decent connection with animals, which suggests you should somehow just shrug off the loss and move on. Which is offensive and absurd. Only you know what someone means to you, only you know what you are feeling, and why. There are all sorts of complexities to my grief at the moment, that come from the importance of Ixxy to me – from the fact I had to be the one to let him go – from his relationship with my husband – from his connection to my former partner, sadly no longer with us. Loss is not simple. So sometimes it takes time to deal with. And sometimes we need help.

I have added some resources relating to pet bereavement to the national resources section – there are useful information pages, helplines and support out there if you too are in this sad and difficult place. If you are – my love to you. I hope their memories are a blessing to you, and that you find comfort in time.

(If anyone is in a position and would like to help with Ixxy’s vet fees – there are a range of options on this Twitter thread, from buying a card or print, joining me on a mental health course, to simple donation.)

Blue Cross Pet Bereavement Service

Cats Protection – Paws to Listen Grief Support Service

EASE Animals – Pet Loss Support

Friends at the End – British Horse Society

Living with Pet Bereavement

Ixxy Long – March 2004- July 2022 – Always loved.

LGBTQ+ Mental Health – Working with Happy Valley Pride

As I gradually return to face to face work, I’m remembering the pros and cons of training to a room of real life humans. Most of the cons are to do with travel and the amount of energy it takes to get places and then train for two long days. So I was delighted to be able to do a course on home ground in Hebden Bridge – even more so that it was a group from our local LGBTQ+ organisation, Happy Valley Pride.

Perfect for Pride month of course. But I have been working with Happy Valley Pride for a while now on a number of mental health related projects, as part of their Mind Your Head Campaign in partnership with The Brunswick Centre. During the pandemic, we discussed the impact that lockdown was having on the LGBTQ+ community, I ran a pair of webinars – first on anxiety, and then depression as we approached the festive season, which isn’t always the easiest time.

Sarah was a key part of our very first Mind Your Head event back in December 2022, an online panel discussion looking at many of the issues around LGBTQ+ mental health. Since then the campaign has grown and evolved considerably and Sarah continued to play an important role.
She has hosted online sessions on both anxiety and depression. More recently she provided Mental Health First Aid training for volunteers. The feedback has been so positive.
Her style and approach is down to earth and she has an amazing ability to make what is often a complex and difficult topic so accessible. She has helped provide many people with tools and techniques to help them with their own mental health and a greater understanding of how to help others.
Malcolm Struthers – Happy Valley Pride

And now this past week we finally had the opportunity to do something in person, and we now have 9 brand spanking new Mental Health First Aiders equipped to support themselves, their friends, families and colleagues.

It was genuinely one of the nicest groups I’ve ever worked with – lovely, thoughtful and considerate people. Happy Valley Pride do wonderful work in the Calder Valley, including the week long festival which returns on 25th-31st July this year – there are always a good variety of interesting activities and events to suit all tastes.

Working with Happy Valley Pride is very important to me – I am a member of the LGBTQ+ community – people don’t always realise because I am a Bi woman in a heterosexual marriage, currently very Cis-femme presenting but that doesn’t really reflect my inner feelings of gender, which are more fluid, or non-binary. My sexual orientation has interacted with my mental health in many ways, positive and negative over the years – and I am not alone.

Statistics around the prevalence of mental ill health within the LGBTQ+ community are not happy reading. It is not being LGBTQ+ which causes mental illness, but rather our experiences of stress, discrimination and trauma. We in the UK have made great progress even since I was at school 30-40 years ago. But things are still not perfect, and the backlash and desire to push us back into the shadows can still be felt. Even where people may be accepting of Lesbian, Gay, Bi/Pan people – we see Trans and Non-Binary siblings experiencing horrendous prejudice and hate.

Hebden Bridge is a bit of an oasis in some ways – we have a higher than average LGBTQ+ population due to a large number of lesbians deciding to make the town their home since the 70s. The town’s history and demographics are fascinating. Not to say we are without tensions or homophobia – but there are many young people growing up here in families with much more progressive attitudes around identity than is the case in some other areas – and was the case when I was growing up. Hopefully they will become adults in a world where their rights and safety are secure – and where they are able to thrive. Hopefully their mental health will be better than their predecessors.

Even if we never experience any discrimination or negativity, the sad fact is, that growing up in a homophobic world, or a world where we are worried we may be rejected by those we love – increases our chance of mental ill health. Much of Mental illness is about feeling unsafe. Feeling threatened. From the moment you realise you are not the heterosexual, or Cis person the world generally assumes you to be – you start to wonder what it will mean for you. You look at the world for cues of what to expect, and the world warns you that there may be trouble ahead. The better your relationship with family and friends, the more you fear losing them by revealing your truth. So your anxiety grows. Hopefully without cause. Hopefully coming out is received with warmth and love and you live happily ever after and are able to fully express the many facets of your true self joyfully and with pride.

But we know that isn’t always the case. We know people are rejected by family and friends sometimes. Or even if not, that relationships can be strained and difficult. That we may not have the supportive network that others rely on. We may experience many different forms of prejudice from different directions. In work, in the streets, when seeking services. It is a sad fact that 1 in 4 LGBTQ+ people have witnessed healthcare workers making negative comments about LGBTQ+ people. Even worse, 1 in 20 were pressured by healthcare workers to access “conversion therapy” type services while seeking other health support. – not surprising then that 1 in 7 avoid healthcare for fear of discrimination.

Meeting people & socialising in the LGBTQ+ community has for many been heavily dependent on alcohol based settings – and drugs of different kinds have also become widely used. This adds to the risk of mental health difficulties, and also increases the chance that people may act on urges to self harm, or suicidal thoughts. Which are common. In the wider community it is estimated that 1 in 5, or around 20% of people consider suicide at some point. Figures in the LGBTQ+ community are much higher – from 28% of Lesbian or Gay people contemplating suicide, almost half of trans people, and 70% of LGBT young people aged 18-24 thinking “life was not worth living”. One in eight of this same group had attempted to end their own life in the previous year. Rates are higher in trans and non binary people than non-trans LGB people – higher in Bisexual people than lesbian or gay. Rates also increase when we look at intersectionality – where LGBTQ+ people also have other factors of diversity – such as being Black, or People of Colour – and/or Disabled, or in less privileged socio-economic class divisions.

12% Trans
2% LGB non Trans
11% Non Binary
8% BIPOC
8% Disabled
7% C2DE social group

We see higher levels of all mental health diagnoses – I’m in the process of gathering statistics for a new data page – but here are some snippets to be going on with:

	LGBTQ+	LBT Women	GBT Men	LGB	Lesbian	Gay Men	Bi/Pan	Bi Women	Bi Men	Trans	Non-Binary
Depression	50%
Anxiety	60%				60%	53%		72%	56%
Self Harm	48%	20%	12%	14%	14%	7%		28%	18%	35%	41%
Eating Disorders	12.5%	13%	9%							30%	25%

All of the above are why I am passionate about building a world where people can grow up free to explore and express themselves without prejudice and judgement. Only when people are supported and celebrated from the word go, and protected from cruelty and discrimination, do we have a chance of escaping some of these figures. Do we ensure people grow up secure and with a strong sense of self, identity, self esteem and belonging. Able to navigate the rocky waters of life, the unavoidable difficulties and challenges, without being hampered by a trail of unnecessary and avoidable trauma.

Mental Health First Aid helped me to understand how my experiences had shaped my own mental health, and also gives me empathy to consider how the events of the world impact the mental wellbeing of others, and confidence to offer support.

A wide range of local and national LGBTQ+ support organisations can be found in my resources pages – please let me know of any others you are aware of.

Come join me on an online course over the summer – or contact me to discuss training options for your organisation, workplace or group.

Upcoming Dates:

Online Mental Health First Aid: (Four 3hr sessions)

13th, 14th, 20th, 21st July 2022
26th-29th July 2022
2nd-5th August 2022
6th-9th September 2022

Online MHFA Refresher: (Half Day)
Fri 15th July 2022
Fri 22nd July 2022
Fri 29th July 2022
Fri 5th August 2022
… (More dates available)

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What to do when hope feels lost.

CW: Suicide, Suicidal Ideation, Self Harm

I saw a raft of posts the other day from Andy’s Man Club, with the devastating news that one of their group facilitators had taken his own life. I don’t know who, or where he was, but my heart reaches out to him, his loved ones, and the whole AMC family who I know will be grieving. I hope they all band together to support each other in this truly horrible time.

It cemented something for me though – thoughts I have had for quite some time.
It is wonderful that we have these groups, self organised peer support to help people (in this case men) to have somewhere to talk and realise that to struggle is to be human, not weak. It is wonderful that we have helplines, and support available via text, email, web chat, or even the good old fashioned snail mail. Support given by volunteers.

But it is not right that this should be the main source of support for suicidal people. And that when many suicidal people reach out for professional medical support they do not get the right kind of help, or even care they need. By care I mean caring. Compassion. Understanding. Trust. Belief.

More and more I get the feeling that there is no clear idea what to do. No clear message as to why we say the things we do.

Suicide is a terrible thing. So many of us (including myself) have lost people we love to it. So many of us have felt its seductive and awful allure. I spent much of my life troubled by suicidal thoughts – “ideation”. I attempted several times when I was young – but came close many many times until turning a corner somewhere in my early thirties. Since then the thoughts come occasionally but are not as attractive or powerful.

4912 deaths by suicide were registered in England in 2020. There’s always a delay in the statistics, so these are not necessarily deaths that happened in 2020 – there is always some lag in terms of waiting for an inquest – but then the pandemic also meant these took even longer, so the figures are an indication rather than being set in stone. This is 404 fewer than the year before. This could be due to the above delay. Or it could be something else. But numbers had been going up for a few years before this. Quite steadily.

And this is the lowest the number could be. Because we know there are lots more that are really suicide that get registered otherwise due to lack of certainty in some way. Accidents, deaths by misadventure, narrative verdicts etc.

But then there are the bigger numbers.

10-25 times that amount of people are estimated to attempt suicide each year. So 49,120 to 122,800 people getting to the point of taking action to potentially end their life. Just in England.

And then there are those who don’t get to that point but maybe get close. Those of us who think about it in one way or another. Which is estimated to be 1 in 5 of the population.

It is not OK that nearly 5000 people died by their own hand – nor is it ok that 1 in 5 of us experience such hopelessness and despair that we contemplate ending it all. Maybe some degree of this is natural and understandable. The passive, fleeting feeling of not being able to go on the way we are, not having it in us to keep going, not knowing what to do about the difficulties we face. Live can be bloody hard sometimes. To acknowledge that, is to acknowledge maybe we can’t do it alone. We are not solitary creatures. If we are trying to get through without support it is maybe our mind’s way of reminding us that if we carry on trying to carry this load alone we are going to break our back.

If you’ve ever played a computer game, and it doesn’t go as you want it to, and it gets difficult and boring, and maybe you don’t know if it’s even possible to meet your objectives any more having found yourself where you are – it’s not uncommon to think – I’ve had enough of this, I’m going to quit and start again. But we lose everything we learnt or accumulated in that life. As far as we know, real life is not a game, we don’t get to reboot. Maybe it is, maybe we do – but it’s a hell of a chance to take, and it does mean we are losing everything about this life, not just the bad stuff. And the other thing we are pretty sure of is that the other characters are conscious too – and our leaving the scene affects them even if we did go on to some new iteration. So while it may be normal sometimes to get to that point of frustration or despair – I hope we can agree we want to find a way for people to be able to click “No”, when the “Are you sure you want to quit” box pops up.

Why do we get to that point? I have a fairly straightforward understanding of how and why mental ill health develops which may be wrong, but it helps me to navigate my experience. It is of course more complex than the following – but for ease of discussion: Life is stress. Stress builds. If there is too much stress, too many problems, we get anxious and feel a desperate need to act to solve or get away from those stressors. If they go on too long, if we can’t solve them, escape them, if they are out of our control, we can become depressed – because maybe the best way to keep safe is to isolate, hunker down, wait it out. But if that goes on too long, or if the problems seem absolutely overwhelming and inescapable – what then is the point?

The important word there is “seem”. Because it’s all about perception. Whether we feel there is a a solution, a way out, hope. While we have hope – we can keep going. When we lose all hope – that is when we become suicidal. But hope is perception, is relative – is chemical. When we become anxious and depressed our brain changes and that changes how we see the world. Threats become more terrifying, problems more impossible, life more painful and cruel. We can no longer see the light at the end of the tunnel. Not because it isn’t there but because our brain has blindfolded us.

The brains of suicidal people are seen to have less endorphins than average. Endorphins – happy dolphins I heard someone call them once – that swim through our blood stream and make us feel good – ease our pain. You injure yourself, your body provides this natural pain relief to help you deal with it. And our brain perceives physical and emotional pain in pretty much the same way. Perhaps this is why so many people turn to self harming behaviours – causing injury to ourselves – in response to emotional distress. If I am depressed and in despair, my mind swirling in torment – and I hurt myself in some way, not only does the shock of the pain break through the noise for me for a moment – but my body sends those endorphins which help both the physical and mental pain just a little bit.

However that is not a solution – or a particularly healthy long term coping mechanism.

Luckily there are other ways to get endorphins. And this is where a lot of the recommendations that we might receive from helplines or medical services come in – which seem patronising and trivial. Take a walk or a bath, exercise, eat something nice – do something you enjoy…. Of course these won’t solve your problems. That’s not their job.

There are different levels of suicidal ideation. I think of it like a storm. Not all suicide is linked to Depression but lets take it as an example. Depression is the gathering of dark clouds. They get darker and darker. Our perspective on life, our ability to see our way through, becomes more and more bleak. At some point it starts to rain. This rain is the emergence of suicidal thoughts – the light drizzle of possibility. It grows heavier, we start to contemplate it more and more. It takes shape as an idea, of what we would do and when, torrential downpours as our plan solidifies – and if we are at the point of thinking of taking action -that’s when the thunder and lightening are happening.

If it’s thundering and lightening we have no hope in that moment. Whatever anyone says to us feels like a nonsense, we don’t believe it – we cast around in despair and cannot see any possibility that the rain will end, the storm will pass and maybe one day the sun will even shine.

We need to get back to a place where that seems possible. We need to get through the raging depths of the storm – and part of that is trying to increase our endorphins. Trying to make this moment less terrible. Trying to distract ourselves from it for a little while – till things subside and we are able to start to even contemplate any support that is offered, or find the ability within us to seek it out or take other action.

Happy Hormones. DOSE – Dopamine, Oxytocin, Serotonin, Endorphins. How can we increase these. Especially Oxytocin and Endorphins in this circumstance. Dopamine can be a little problematic in that it makes us more motivated, so could make us more likely to act impulsively. But Oxytocin comes when we feel safe and connected, Endorphins reward us for doing things that keep us that way, that are beneficial for our survival – hence warmth, food, movement, pleasure.

There are always several sides to suicide prevention. What can the person themselves do – difficult when we are in that state of mind but not impossible – if we can come to recognise when we are feeling a given way that it is not an inescapable state. Recognise our suicidal thoughts as a call to action of a different kind – not to do what they say, but to extinguish them. A fire alarm tells some to evacuate, but others to go and find and put out the fire.

But if someone cannot do that for themselves, how can others help them? How can I as a friend, or volunteer, or colleague, or random person on the street – help them to feel better in that moment, and start to find a way through.

There are courses of course which tackle this- what can we do to help prevent suicide and support people – excellent free basic training online by the Zero Suicide Alliance https://www.zerosuicidealliance.com/training . We cover it in a little more depth in Mental Health First Aid, then there is Suicide First Aid, a one day course, and Applied Suicide Intervention Skills Training (ASIST) – a two day course.

We can learn to look out for warning signs, know risk factors, and most importantly – step in, ask the question, be there for the person, have a conversation. Listen. Be empathetic, not judgemental or angry. Build Connection. Make the person feel safe, help them to find hope. Being with someone, acknowledging their pain, how hard it feels for them, showing we care – helping them to talk, and share what is going on for them, helping them to contemplate the options, or reframe their experiences.

Show them they are not alone. Be with them. Go with them. Do things to change their immediate emotional and physical state if you can. Move to a different place, talk about something else until they are ready to talk about the issue at hand. Find common ground.

It’s vitally important that people in our mental health services get a thorough understanding of these things. I understand the difficulties presented by underfunding – lack of resources and staff etc – the inappropriateness of A&E as a mental health crisis service. But there is a fundamental lack of basic understanding of mental health across many health professionals and support staff, and more troublingly – a seeming lack of the specific knowledge I would expect to see in mental health services themselves.

The number of people who experience mistreatment and cruelty within services is unforgiveable. The punishment of people who present with suicidal ideation or having attempted to end their life – event to the point of criminalisation. It’s a disgrace. If someone is persistently suicidal, or keeps coming back – it is not because they are meaning to be bothersome, manipulative, attention seeking, a waste of time. It is because they are still in pain. Either their current circumstances are overwhelming them and they do not have the resources – physical, emotional or otherwise, to cope – or their life experiences have overloaded their emotional system so that they are unable to regulate to see through the noise to bring perspective into their understanding of what is going on for them.

Surely our job is to help them to find solutions. To provide compassionate support and understanding. To give the support – therapy, tools, medication, coping strategies – to help them to be able to begin to manage those wild emotions. We need to help them feel safe now in this moment, and believe that they will be safe in the future. We need to help them heal from past traumas and leave the echoes of past insecurity where they belong – in the past.

Shouting, judging, being critical, punishing, withdrawing care, – will not do this. It will compound any feelings of insecurity, of being unloved, unwanted, unworthy – it will confirm every bad thought the person’s mental illness has given them about themselves – and it will most of all push hope even further away.

Maybe one day there will be a pill we can take when the clouds gather, like we do when we get a headache, which will instantly clear them and restore hope and perspective. But for now it takes a little more work. And that isn’t necessarily a bad thing. Pain, whether it be physical or emotional is telling us that something is wrong. Sometime our wires get crossed and we feel more pain than the problem warrants. Ghosts in the machine telling us that our leg is dropping off, or that the world is ending. We need to find a way to remind ourselves, and to believe – that just because it’s loud doesn’t mean it’s true. And if the people around us, the people we turn to for help, can help us to see the gaps in the clouds – with kindness, with compassion, with love – with infinite empathy for another creature in such desperate pain – then hopefully we will find the strength to keep going, to find hope, to find solutions or alternatives. The possibilities are endless, as long as we don’t end them.

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All by myself

Yet again I couldn’t get myself in gear to write my piece for Mental Health Awareness Week – but here we are anyway. The theme this year was loneliness. Something many have faced over the past few years of lockdowns – but which is by no means a phenomenon reserved to pandemics.

What is loneliness? Because it is more than being alone, isn’t it?

It is possible to be alone and not lonely. Solitude, can be a blessing, a gift – something we can cultivate to make it an indulgence – living life exactly to our individual specification.

I was an only child, but I don’t really remember being a lonely child – in my home. I pottered, I occupied myself.

I was sometimes lonely at school. Because I could see what I was missing. Other children with closer, existing friendships which I perceived, rightly or wrongly, to be better than any I had with the few friends I made. Making friends, interacting with other children – was always hard. I preferred adults. Something I believe is not unusual for autistic people.

Humans are made for connection – we learn from our earliest connections, in fact we rely upon them for proper development – absent of connection and love, our brains do not develop in the way they should, and our ability to develop and maintain such relationships in later life is impaired.

Once we know what connection is, if we are able to appreciate it – then many of us miss it.

Loneliness is the lack of connection. Sometimes coupled with solitude, maybe involuntary solitude – but it is certainly possible to be surrounded by people and feel alone. It is possible to be in a loving relationship and still be lonely.

Can we connect? Can we relate? Do we understand each other? Does it feel like hard work?

In the recent incarnation of the Star Trek franchise – Picard, we are reunited with Seven of Nine – the former Borg drone who became part of the crew of Voyager. The Borg – assimilating all species they meet into their collective, all connected via the hive mind – all thinking and feeling as one.

Once separated from the collective, Seven tells us, you will always miss that connection, no matter how much you hated the violation of assimilation. No relationship ever brings you close.

Our attachment style may have a big influence on how we experience connection in our adult relationships. Understanding this helped me to unpick a lifetime of wrecked love affairs. Insecure attachment, Anxious attachment – I fall in love hard, and deep. My most profound relationships have shared the same intense beginnings – feeling like someone sees deep into my soul, understands me, like some kind of star crossed, destined to be together, inevitability. It burns with the heat of the sun. But never for long enough. Because most relationships – will reach a point where we settle down, where the rolling boil reduces to a simmer, still hot but not as excitable. If you have a secure attachment, that’s fine. We might look back on our glory days with fondness but actually we’re maybe glad things are not so intense, it was exhausting. We evolve into a new kind of connection. But with insecure, anxious attachment style – the loss of that fever dream leaves us bereft. It means you don’t love us any more, the validation we received from your obsession with us made us feel worthy, good enough – and the drifting of our connection leaves us uncertain – are we good enough? Do you love us? Will you leave us? In times gone by this danger zone would be where other attractions may form – with new loves who can give that certainty, reassurance -for a while. Understanding attachment means that when I feel that insecurity seeping in, I know i’m being silly. I maybe seek some reassurance, and I don’t run off with the milkman.

That doesn’t mean I don’t get lonely. I do miss that connection. That feeling that someone was fascinated by everything I said, and I them. That hunger, and synchronicity. Connection – like a radio signal – at one point on the same wavelength, our communication and understanding crystal clear, and then it drifts, and the crackling static starts to interfere and bring misunderstanding.

Friendships too – missing those days when I had a bevvy of friends I lived among, shared lives, shared experiences, shared understanding. There are people who the connection will never fade with, no matter how long you are apart. And others who are in your life every day who will never understand you.

I’ve come to realise a lot of the people I really connect with are maybe neurodivergent, or whatever this thing is that so many of us are recognising as we share our experiences. We think differently – our wavelengths are more similar. Sometimes trying to connect with people is like trying to fit a VGA cable in a HDMI slot. It is never going to work.

And that can be lonely.

How do we deal with loneliness? A) Seek connection by finding like minded people or B) Learn to be more comfortable with solitude. Connect with ourselves. With nature, the universe, God, whatever we feel energises us all. Meditation can help with the latter – self compassion, grieving the loss of connection (whether through bereavement, break up or simple drifting of time)

Finding opportunities to do things we love / are interested in / passionate about – in the company of others may lead to new friendships forming. It’s not always easy – I’ve sat on the sidelines of many groups and clubs, feeling more and more alone and alienated as others chat along happily. If you are an easy talker – someone gifted with friendliness and warmth – look around to see if anyone might need your help to make connections. They might be fine to watch, just absorb the hubbub, but they might also welcome someone the help them bridge the gap.

Are there people you haven’t spoken to in a while? Old friends? Family members – reach out to them, send a text or a card, you could call or drop by (though not everyone might be ok with that of course). We tell people who are lonely or depressed to reach out – but actually sometimes that is really hard – so we all need to be doing it – reach in, see if people are ok. Regular chats and check ins are good for us all. And of course especially if people are living alone, are elderly, isolated, or otherwise disconnected from the world. Mental Health First Aid training can help us understand and recognise when people around us are struggling – and gives us a framework to help.

Depression and other mental health challenges can worsen loneliness. Depression is a liar. It can fill our head with negativity, thoughts that no-one likes us, that we’re a bad person, boring, a waste of time, etc etc. It spins everything in the most negative light. If someone hasn’t called in a while, they hate us. If they don’t reply to a message, they don’t want to talk to us. It steals any energy or inclination we might have to go out and do things. Anxiety makes us catastrophise and think that things will go wrong, fear the stress and panic of travel or meeting people. Extreme emotions may make situations challenging for us, may mean people don’t always quite get where we are coming from.

Hopefully we can get help to overcome these challenges – talking to your doctor is a good start to gain access to medication or talking therapy which may make a huge difference to you. But also look out for other organisations in your area which may offer different kinds of help – peer support and wellbeing groups, walks and activities with other people who may know where you are coming from – having their own mental heath difficulties and so being more understanding about why some may find interaction harder than others. Similarly if we are autistic, have ADHD etc – sometimes groups for neurodivergent individuals may be valuable – to connect with people who may see life in a similar way to yourself.

In my local area of Calderdale, Healthy Minds have a range of excellent activities – I haven’t yet plucked up the courage to attend anything myself, but I hear great things from those who have.

However if we’re not ready to get out there for whatever reason – we might still find connection online – social media has a lot of downsides of course, but there are some lovely lovely people out there. Finding your people online can make an enormous difference. Sometimes it’s easier to be open when we feel safe in our own spaces.

Sometimes fictional characters ease our loneliness. TV shows, films, books – the phenomena of parasocial relationships is fascinating, but sometimes in the absence of all else, immersing ourselves in other worlds can fill a void we feel in our own.

But again, as I said at the beginning – solitude does not have to equal loneliness. Try to find a way to enjoy your alone time. Make your space more you – more comfortable, enjoyable. Make it somewhere you like to be. Take yourself on a date – what do you like to do? To eat? To listen to? To watch? Pamper yourself, get to know yourself. Talk to yourself. In my experience it is the best way to get a sensible conversation! It has also been the key to unlocking a lot of my emotional difficulties. Asking myself gently, with compassion – what I need, why I feel the way I do, why I did the things I did. Once upon a time I was very unhappy – with feelings of tremendous guilt and anger about certain periods of my life. Asking myself why – and truly listening, with empathy and compassion, helped me to recognise the pain, the remorse, the lack of understanding, the sorrow at the heart of these experiences – and let go of the guilt and anger, which after all could not change anything, and were only poisoning years which I should have been cherishing. It is important to feel our feelings, to give them space. But only as much as they need. There comes a time for the crying to stop, and the laughter to begin.

Upcoming Courses

Online MHFA Refresher Courses:
Friday 20th May
Friday 27th May
Wednesday 1st June
Friday 10th June
Friday 17th June

Online Mental Health First Aid
30th June, 1st, 7th, 8th July (Thurs/Fri)
13th, 14th, 20th, 21st July (Wed/Thurs)

Online Mental Health Aware
Monday 30th May

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Online vs. Face to Face

One of the reasons I don’t blog as much as I would like to is that I often don’t know where to start. Then when I do – I don’t know where to stop. For someone who used to write abstracts for a living I am surprisingly bad at concise.

Last night is a case in point – I started writing this blog, prompted by my first face to face course in two years, and four (MS Word) pages later realised i’d got lost in a ramble. Truth be told I was actually writing three, maybe four, blog posts. One on comparing online training with face to face, one reflecting on the lessons of the pandemic, or remembering the positives, one on the My Whole Self campaign, and something there on how aspects of myself, relating to autism, gender, sexuality, fatness, had been handled badly in the workplace and led unnecessarily to worsening mental health.

I doubt I will complete all four posts unless I suddenly develop an enduring focus that confounds all precedents. But lets try for one.

As mentioned – last week I did my first face to face course in two whole years. More really – for a full course. I did a small one in Feb 2020, but the last one with a full room of delegates was Hull, December 2019 in really awful circumstances.

Two years ago came the pandemic, and lockdown. Obviously we all had different experiences depending on the work we do, where we live etc. But for me – common to many, it meant cancellation of all my work, uncertainty, and staying home. There were lots of online meetings and drop ins and so on for people like me who were cast adrift, anxious about what would come next. Surprisingly for me, I stayed pretty calm. For someone who has a history of severe anxiety and especially health anxiety – I am quite good in a crisis. Perhaps because it is good to know where your enemy is. Seeing as I am usually inventing something to be anxious about – if I actually know quite clearly what is threatening me, I seem to be able to take it in my stride. I didn’t know what would happen. I did know that my reserves were very low, having had a terrible year the year before. But I also knew that I was happy to be able to stay home and be more sure of my health and not bringing something home to my husband. I put my faith in the universe that we’d cope with whatever was to come.

And in a few months time MHFA England came to the rescue with a new online course that I could upskill in and opportunities to deliver online. Later, other online courses followed, and more opportunities. So life found a new rhythm. I took my place in my spare room / office / craft space, in front of a camera, and learnt how to deliver training online.

I was nervous at first. The unknown is always unnerving. I had to get to know the different platforms we were using, figure out the technology. Luckily I am pretty competent in that department, a quick study as they say – and also have the enormous advantage of being ok with imperfection. I recognise sometimes when things are out of my hands and am happy to make do.

The online version of Mental Health First Aid is different from the face to face, in that it requires delegates to complete independent learning prior to each live session. In the Face to Face, you turn up, you sit there and hopefully listen and participate for two days, you go away. Again, hopefully afterwards you pick up your manual and read it now and again, you look at the resources on the website. but maybe you don’t. The online requires you to read sections, to watch videos, to answer questions and reflect on your learning. You have to do this in order to get signed off at the end of the course. I’ve come to realise that how much people engage with this, in the right order – can vary depending on how far apart the live sessions are, how good the messaging is, and how busy / the kind of work the people are doing. It works best when people take the time in advance of each session, a few days before so they can let me know if there are any problems or questions – and then in the session we build on that work. They are more likely to have thoughts or questions to ask, to fuel discussion.

Some say they find online learners to be less engaged. I don’t agree. However having gone back to face to face I think I recognise what people mean. People are more spontaneous in person. People speak up, interject, talk amongst themselves. The weird thing about online training is how quiet it can be. How orderly. If everyone is on mute – If they are talking to others in the background, we don’t hear it. Break out rooms happen out of earshot. People raise their hand to speak, or even bringing themselves off mute takes a little time and you see it happening so make a space. If you ask the right questions, if you invite people to speak, or contribute, they do. If they want to. But they also have other options too – that aren’t available in face to face training. If you are a quiet, thoughtful type – an introvert, or socially anxious, less confident – you might find it hard to speak up in front of colleagues. Whereas in online training, you can answer questions in the chat – even privately to the trainer. I also think it’s easier to contribute verbally when you are safe in your own space, rather than sitting next to and opposite people around a conference table.

I think some people will always prefer face to face. If you are an extravert, confident, chatty. If you never worry about what others think. If you just prefer to keep work and home separate, or if home is not so great a space for you, or you have no privacy. If you aren’t used to computers, don’t work with them – have to be on site, it may not be an option.

There are definitely pros and cons to both, for both learners and trainers. The learning outcomes should be the same, but which you will get the most out of will depend on your personality and preparedness to do the work. I do my best to give you the best experience I can, and make a safe space for people to share and contribute as much as they want to. If you are wanting to arrange a course for your organisation, various factors will come into play in deciding which you prefer.

“The course was really interesting and Sarah was an excellent trainer, obviously very experienced in this field and easy to listen to and approachable. A good split of theory, case studies and activities.”
Delegate, Face to Face course

Scheduling – is it easier for you to free people up for two days together, one day a week, or a few hours a time for four sessions, which can be spread over any period between two days to four weeks. (Albeit you will need to give people time for independent learning too – you might decide this should be homework).

Travel and accommodation costs. – Are you bringing people together from multiple sites across the country – while this can be a great networking opportunity, it can also be pretty costly in expenses. Having people attend from their own office or the comfort of their own homes is a lot cheaper. This also goes for my fees – if i’m training outside of my “home zone” – I will need to charge for train/taxi/bus fares, accommodation and expenses. If I’m delivering in my spare room – not so much!

Equipment / Space – do you have a suitable training environment, a large room with tables that can be arranged suitably, audio visual equipment, flip charts or white boards, coffee / tea / water facilities. Even though covid restrictions have been stepped down, it is still preferable to have a large space so we can have breakout groups, and good ventilation. Do you have up to date computers/laptops with video cameras, microphones, headsets so people can take part individually. It can be possible to manage with a few people in a room together but it is not ideal, and loses some of the functions of the online platforms. Or do people generally have their own laptops they can use at home? Can people have privacy to engage in sensitive conversations without being overheard by colleagues?

As for me – at the moment I still prefer online. It is easier to find work-life balance, involves less travel and time away from home. And I have come to be confident in it. I feel less vulnerable, behind my screen, than I do standing in front of a room of people.

I thought this would be a really long 2 days but I found they flew by. Sarah the instructor had so much useful information to talk us through. Although I never love the group breakout activities actually they were fine as they were only 10 mins long and they broke things up. I think it really worked to have a 2 hour break between sessions. I also got more out of this course personally than I expected to which is great.
Delegate, Online Course

Nine years into training – I still feel sick before I do a face to face course. I’m fine once I get going but it is very draining. It’s also physically demanding. Some of that is to do with my own fitness and health issues – I’m not used to standing most of the day any more, and my health issues mean this can be painful so I have to manage myself carefully – ditto when dragging cases heavy with materials and equipment around.
But I do enjoy some aspects of the face to face. Seeing different places, both towns and work environments. Meeting people, conversations held in breaks, over lunch or at the end of the day. Some of the activities we do in session are great fun. And I have to give honourable mention to some of the great lunches I have had provided over the years! The North East is so hospitable. Evenings on my own in hotels give me headspace away from the demands of home too.

Online training gives greater flexibility – and my favourite courses are those that stretch over a month. People have the time to do the work properly, to think, digest. And also a relationship builds between delegates. Sometimes bonds form in a two day course, where people share their personal experiences – but there is more space for it to mature over a longer time period.

We will see how things progress, if things continue to “return to normal” – in any case there will be change to come later in the year as a new version of the course is rolled out – I wait with baited breath as to what that will entail. Regardless, I am sure that both face to face and online training are here to stay, each bringing its own merits – suiting different people better. Variety allows us to reach more people, and has contributed to MHFA England reaching 1 in 50 people in England with Mental Health training. I’m proud to have been a part of that.

If you’d like to talk about what would be most suitable for your organisation, and get an idea about costs – drop me an email at sarahlongmhfauk@gmail.com

Alternatively book your place on an open course – Upcoming Dates

God grant me the serenity

The world is a lot right now isn’t it? Maybe it always is. Always has been. Just some have the privilege at different times to not be affected by, or even notice the turmoil that tears lives apart on distant shores. But the last two hundred years have brought us ever closer together, news and people travelling faster and faster – trains, cars, planes, telegram, telephone, television, internet… What once would have taken weeks, maybe months to appear in black and white print in a newspaper only a minority of the population could read or afford, now unfolds before us as it happens in high definition technicolour on our tv screens and social media feeds.

War. Pandemic. Terrorism. Cost of Living Rising. Homelessness. Unemployment. Climate Disaster. Corruption. Social Division. Hatred. Discrimination. Bigotry. Misinformation. Slight of Hand.

It sounds like an interpretation aid for a really bad tarot card.

How much we are directly affected by some of these things varies of course. Mostly a matter of luck. Where are you born? What is your background? What circumstances does life throw in your way? Even if we are not directly affected we may be troubled or impacted, one way or another. Feel compassion for people, feel angry, frightened, threatened.

I lay awake the other night haunted by despair and anxiety. Something which used to be a nightly activity – the feeling that life is over, pointless, that all the hope and promise I saw in the future when I was younger – was a mirage. We were cheated somehow. Or I made a mistake and it sent us down this dark path, and now there is no way back. Feelings of responsibility for global calamity are a particularly masochistic kind of delusion of grandeur. I know it isn’t really true. Well. I have played my part, as have we all, in building the world we live in, flapped our butterfly wings to create the hurricane. Even if in my waking, lucid state I am able to recognise that, it doesn’t ease the anxiety. The pit in my stomach, the growing sense of dread. Which adds then to all the other anxieties, the worries, the responsibilities, the stress.

How do we keep going? To quote Midnight Oil – How do we sleep when our beds are burning? Both literally, and figuratively. Because even when we are in the centre of a danger zone, we must find a way through our very real and warranted anxiety to be able to survive, to live. Just as we must be able to function on a day to day basis even when we can see multiple crises rippling across the world, becoming ever more likely to destroy us.

Three things come to mind. And I think they apply regardless of the nature of the stressors or anxiety we are facing. I saw a comment on a linked in post yesterday – someone had delivered what sounded like wonderful training to help job seekers handle their anxiety around interviews. Most people praised and supported the initiative. But one person responded suggesting (more or less) that it was stupid to be anxious about an interview – imagine living in a war zone, fearing for your life. Now – this person from their name, and the fact that they were clearly not writing in their first language, I think may even have been based in the Ukraine or somewhere in similar turmoil. So the troubles of people in a currently peaceful nation might well seem trivial. But it is to misunderstand the nature of anxiety, to think that one is real and warranted, and another not.

It might be true to say that our anxiety response is useful in one circumstance and not another. Fight or Flight is quite appropriate in a war zone, but not much use in an interview. We might think the war zone is a “real” danger to be responded to, and an interview not – but in effect when we have that anxiety going to an interview, we are not really fearing the interview, the questions, the panel. We are fearing a) not getting the job, not getting the next job, or any job, and ending up unable to pay our rent, feed our families and ourselves, and ending up without food or shelter and safety. We are fearing being judged and rejected by the panel, and our peers, and society. Just as the person in the warzone fears. We all try to keep ourselves safe. Just from different threats. It all goes back to that bottom tier of Maslow’s hierarchy of need. It is only when we are completely safe and secure that we can truly focus on the higher elements. There is always a hierarchy of danger – we might think the bombs falling are the biggest danger, until perhaps – we are injured, and we realise that if we do not brave that danger to seek medical assistance, then we will be dead anyway. In more peaceful times or settings, the threats similarly adjust, depending on circumstances. In the last few years, people have juggled risk of infection, illness, maybe even death, with the need to earn money, the need to interact with others, the need to seek help for other illnesses or problems. One person’s priorities are not the same as another. And how we are affected very much depends on what else is going on for us, or has gone on for us in the past.

We need to think back to our stress container. Our stress bucket. Which holds within it all of the worries of our lives. From bombs to business, Covid to Cars not starting. When it gets too full, we start to see problems forming, our anxiety rises and becomes more difficult to manage. It might be the horrors we see on the world stage, on the horizon, that make our day to day stresses harder to manage. It makes the stakes seem higher – the potential for disaster closer to home. Or it just uses up some of our resources, our energy, our resilience, our head space.

If we are starting to be overwhelmed, to experience problems, to be unable to take action to deal with those stressors, then that’s when we need to take steps to try and get back in control if we can. My first step in this, after writing down everything i’m concerned about, that’s bothering me – is asking questions to see if I can pare things back to only what I need to worry about, and what I can do anything about.

My 5 Questions: 1) Is it real? 2) Is it current? 3)Is it my business? 4) Can I impact it? And if yes – 5) what can I do, what am I going to do, who can help?

On a certain level these questions are easy. Lets take a relatively trivial, if still sticky situation. If I’m thinking about running out of toilet paper for instance. Most of the time, running out of toilet paper is not a real concern – I can usually get some from somewhere, or get some delivered. But as we know, during lockdown, it became a thing. Shortages, hoarding, lack of delivery or transport options, the prospect of finding ourselves without became real in a way it maybe hasn’t been for many of us for many years in the UK. So real. But what is it in reality? Its unpleasant, but not the end of the world. Other paper, or cloth would be available to do the necessary, and sooner or later a solution would emerge.

Is it current? Maybe the thought passes your mind that you might run out – if you look in the cupboard – and there are 10 rolls – clearly no, it’s not current. There’s a long while before it’s going to be a problem, time to source replacements and plan. On the other hand, if there are 2 rolls, and we know we’re not going to be able to get out, that might be more of a concern. If we’re picking up the last roll and finding there are only 2 sheets left, it’s a clear and present danger. If we’re sitting staring at 10 rolls but feeling anxious because we remember with horror that time we did run out and had to use a sock, then the “danger” we are dwelling about is from the past – we are reminded of it to try and ensure it doesn’t happen again. But worrying too much ceases to be helpful.

Is it my business? Well if i’m the one with no paper, yes, quite literally it is my business needing to be attended to. If it’s my husband shouting down the stairs, I’m going to be the one running around finding alternatives. If it’s someone outside of my home / family – maybe I can help if possible, if I have spare, if I can get some and travel. But sometimes the toiletting mishaps of another are sad, but not really my fault or remit to address.

Can I impact it – can I do anything about it? If there is loo roll in the shops, I have money and the ability to travel – I can solve my own papery crisis. If the shelves are bare, I can’t afford it or the bus is cancelled, or I have to isolate – maybe not. Maybe I can ask for others to help, but maybe they’re powerless too. I can write to my MP, toilet roll makers, whoever, but it might not do anything. If all of town is without tissue, unless I have the right connections or funding or want to set up some kind of charity to keep our collective backsides wiped, maybe I can’t do much except wait for things to be resolved and make do in the mean time.

Sometimes the questions are not so material. Not so easy to put a tick or a cross against. War in the Ukraine. Fear of Nuclear War. Climate change. Financial Hardship. Racism / Sexism / Homophobia / Transphobia.

Is it real. Is it impacting me this minute? Is it likely to? Is it impacting those close to me? Is it impacting other human beings or creatures or our environment?

War in the Ukraine is real today. Real violent threat to life and health to those there on the ground. Current. Their business. Can they influence it? Maybe. Some can, most probably not – as in most wars.

Outside of the Ukraine – people worry on behalf of those involved, and also themselves, the prospect of escalation, expansion – and therein the spectre of Nuclear war, Cyber attacks and global devastation. Some of these worries are current – some are fearing potential futures, some are echoes of past worries, the when the wind blows fears of the Cold War.

Is it my business? As a person in Russia / Ukraine, of course. As a person in a neighbouring country. As a human being, who believes we have a moral duty to protect others and prevent harm if we can. Of course.

Can I influence it? Can I do anything? What can I do? It’s a sad fact that often with these big issues those with the most influence and ability to effect change choose not to. Or not to think about it. Or actively make things worse. Ordinary people? What can we do – what do we do? Within an affected country – Fight? Flee? Protest? Protect? Be a part of a resistance, a counter movement, call for peace? Outside – our options become more limited, protest, march, petitions, letters, donations, arguments – pressuring our own governments and organisations to take action. But what action is the right action? Sanctions? Weapons? War? Diplomacy. We’ve seen before the costs for all concerned when international military interventions are launched. It’s hard to know what to do. Even sometimes to know what is really going on.

What do we do with our anxiety when these questions are not simple to answer. When the problem is real, but outside of our control, or uncertain, or in the future, or affecting others more than ourselves and we don’t know how to help?

Considering that alcohol is such a common unhealthy coping mechanism for many of us, when we try to manage our stress – it is apt that Alcoholics Anonymous adopted the Serenity Prayer, which deals with these very thoughts.

God grant me the serenity
To accept the things I cannot change
Courage to change the things I can
And wisdom to know the difference.

Reinhold Niebuhr’s full version goes on – but these are key lines. Courage to change the things we can – if we can, to do what is in our power, that we have the ability, capacity, skill, privilege, resource -to do. But also knowing that there are things that no matter what we do, we cannot change, no matter how hard we try, or how much we worry, and we need to find a way to live with that knowledge. That these horrors are happening. That things might get worse. Indeed perhaps that the worst has happened sometimes. The wisdom to know the difference. To know when our efforts are wasted and would be best focussed on something else. To know when to stop. To let go.

Acceptance. Does not necessarily mean giving in. Does not necessarily mean stopping fighting or seeking change. But it may mean a moment of realisation, and shift – to a different course of action.

Many people for instance when it comes to Climate Change believe the time for trying to prevent catastrophe has passed, that it is too late – that what we should be focussed on is trying to prepare for and mitigate the inevitable impacts of the change to come. To develop new technologies to produce clean energy, to de-pollute, to cope with floods, fire and famine – to generate clean water and resilient crops.

Acceptance is an important concept in mental health – sometimes our anxieties are unwarranted, and out of proportion, and we can learn to recognise and overcome. The job seekers for instance – their self esteem and skills can be boosted, they can be taught to calm themselves and be able to present their best selves and have hope that if not this job or the next, something will come up to keep the wolf from the door.

But when the concern is more concrete. When the trauma happened, or is happening. When we do have cancer. When our loved one did die. When there is war. When we do face prejudice day after day. How do we keep that in check. Pretending it isn’t happening will only work for so long.

Acceptance and Commitment Therapy brings this into treatment. We must acknowledge where we are and why, where we want to be, and commit to take action to change. I may be full of fear and anger because of something that happened – maybe an ex was abusive, or cheated on me and left me. I may be full of rage and resentment, unable to trust anyone, pushing everyone away. That rage might be righteous – justified. But might also be damaging. I can accept that it is true that I have a right to be angry because I was mistreated. A right to seek justice, if laws were broken, apology if I want it. But it can also be true that I want and deserve peace, to be loved and supported. To move on. To find a partner who will treat me as I deserve to be treated. And that in order to get that future I deserve I may need to let go of the past – whether or not I get the justice or apology I desire. Commitment to moving towards that. Doing what we can.

Acceptance that the worst has happened. The bombs are falling. I am justified in being afraid, angry, confused, betrayed. But that I need to keep safe, need to keep moving, to try and find the small moments of peace and joy that can be found even in the midst of disaster – which give us the strength to keep going. To survive.

Acceptance that I am afraid. That my voice may be small. That my ability to use it may vary from moment to moment, context to context. Commitment to doing my best, whatever that might be, in the moment, to moving towards whatever goal I have set for myself or the world.

To some extent it is a reworking of the old “Feel the fear and do it anyway”. But with more of an acknowledgement of how difficult that can be. That it can take work. But that in the right circumstances it becomes Feel the fear, and do it until you are not frightened any more. Until you realise you are strong enough. You got this. Or if you don’t – use that wisdom to let go, and focus on what you can do. What you have got.

Wishing strength, resilience, peace to all.

Upcoming events:

Online MHFA Refresher Training
Friday 25th February 2022
Friday 11th March 2022

Online Mental Health First Aid
Friday 18th/ Monday 21st 2022
Fridays 22nd April-13th May 2022

Online Mental Health Aware (Half Day)
Wednesday 6th April 2022
Monday 11th April 2022

Online Mental Health Champion (One Day)
Friday 25th March 2022
Wednesday 30th March 2022

More Dates

How Refreshing – Update your MHFA Skills

At the beginning of 2020, just before everything changed, I ran my first MHFA Refresher course. A small group, from a few different organisations, but enough to get a real feel for how enjoyable this new course was going to be. Over the last 18 months of course we have gone online, but i’ve run many more now and every one has the same vibe. People who are really committed to caring for their colleagues and friends, who did their Mental Health First Aid or Mental Health Champion course some time ago, and have been trying to help people ever since.

Some people have used their knowledge now and again, maybe in one off, quite extreme scenarios, others find they are using it every day, even in the most mundane of conversations. Some remember most of what they learnt, others think they have forgotten it all, and are pleasantly surprised as things bubble back up to the surface when given a prompt.

Everyone wants to be there. Everyone is interested. Everyone is playing an active role in making their workplace and the world more supportive for those who are going through difficult times. It is one of my favourite courses to deliver so I decided to schedule more regular dates. If your MHFA crown could do with a polish (MHFA England suggest at least once every 3 years) – come and join us.

All courses subject to a need for a minimum number of bookings – Discounts available for early booking or special circumstances – if you need several places contact me to see if there is a more cost effective option for you.

Online MHFA Refresher Courses – Delivered via Zoom – Workbook/Manual & E-Certificate Included

Upcoming Dates

Thoughts on friendship

Listening to a recent Brene Brown podcast on friendship today gave me, as they say, “all the feels”. Friendship is such a difficult but important topic. Connection. Love.

I don’t have many friends. I am quite difficult to get to know I think, much more so than I once was. It gets really hard to make friends as you get older. Or at least I don’t think my experience is totally unique. It was never that easy to really make a connection. And life makes it hard to hold onto them sometimes.

When I was at school, my earliest friendships were cut short by moving house, mine or theirs. I reflected on this in my counselling course – what impact did it have that I made these bonds, one after another, only for them to be severed, again and again. And so I tended to be on the periphery, floating around other friendship groups. Until middle school, and after that friendships and relationships became intense and complicated and muddled.

Friendships in high school were strange because there was a huge part of myself that I had to hide away – not being able to come out as bi (indeed the lack of discussion of the issue at all meaning it took me a long time to settle on a label – thanks Section 28) – so not being my whole true self with friends, or with family, or even with my then girlfriend, for a variety of reasons. But I did meet some wonderful humans back then. I wish I were still in touch with more of them.

University brought more freedom, and authenticity, and amazing friendships. It was a chaotic time but I look back on that luxury – living on campus, sharing every day and night with a group of people just starting out in life and living it with such intensity.

Part of me would live like that again in a shot – some kind of communal living. But another part of me has become a bit of a hermit and would hate it.

Leaving university was the biggest wrench. The artificial end of so many friendships. We didn’t have facebook back then, so letters and phone calls and visits were required to keep any relationship going. That takes work. On both sides. And when friends are scattered to the four winds, and life becomes full of work and new relationships, people drift. Some quickly, some over years, some gently and some in angry resentment.

New friends were made at work. My second golden era, a close knit group of people of similar age who worked and played and laughed together. Mid to late twenties for me. But things change. Relationships soured, people moved on, and those that stayed, our priorities changed and it just wasn’t the same. It became harder to be friends at work. People seemed to resent it. I’ve even seen people say you shouldn’t be friends with colleagues because you can’t trust them and that’s just the most depressing thing I’ve ever heard. In my experience I work best with friends. With a team who care about each other.

In my depression, I sometimes feel so very lonely. And like everyone left me. Which is nonsense for I have left them as much as anyone ever left me. But there was for a long time a feeling that I remained the same while everything changed for everyone else. I think because people had kids and I didn’t. And my I didn’t get to move through some of the changes I had hoped for in my life at the time I hoped for them.

But coming out the other side of that, making friends was different. There are people you feel a connection with, and those that you don’t. I’ve come to realise that other neurodivergent people tend to get me better than others. My view of the world, my communication style.

There have been times when I have met someone and they have said “we’re going to be the best of friends!” and I have recoiled. Because the connection wasn’t there, but also, it felt wrong – isn’t friendship to be earned? Something that builds over time and familarity and learning one another’s strangeness? Why though? Why does it have to? When the connection is there, it doesn’t. When the connection is there I can meet someone for the first time, and being introduced feels like, “Oh yes. It’s you. I know you. I’ve always known you.” Maybe it is a past life thing, or a wavelength thing.

And here I am at 45 and there are several groups in my mind when I think of friendship.

My husband who is my best friend.
My two closest friends – who live too far away, but who I am still in reasonably regular contact with. One from work, one from university.
The two close friends (it feels too little to say friend for people who felt a part of yourself for so long) that I have lost in recent years, way too soon.
The two close friends, one from university, one from school, who I am not really in regular touch with, and I wish I were. One I check in irregularly with on Facebook, or vice versa – the other who moved away a long time ago and seemed to sever all ties.

The people I used to know well and wish I still did but its long enough to feel weird and stalkery to reach out.

Then there are those people who I didn’t get to know well at the time when life brought us together, but who social media has given a second chance to learn about and now I kind of wish we could be better friends.

There are people I know in real life (I know – how old fashioned) who I kind of feel are friends, could be good friends, but I’m not sure how to develop that. Life doesn’t give the opportunity for deep and meaningful connections and conversations.

How do we make friends as adults? How do we make new connections?

Social connection is an important factor in our wellbeing – we grow through other people, through relationships. Love helps us deal with pain. So trying to reinforce those connections which are there, and build new ones is important, but it can be really hard. When I moved to Hebden Bridge, I was here for years before I started to get to know people. Joining the WI gave me the opportunity to meet people, but not really to connect. But over time, those faces you know to say hello to might become people you see in a coffee shop, or a bar, and stop and have a conversation with. But how does it evolve beyond that? I’m not sure.

Maybe I expect too much. Maybe I already have what I am looking for. But can I be vulnerable enough to find out? To risk testing the strength of these connections and find out if they hold. But then I also wonder if others are feeling just the same. I wonder if they are thinking if they’d like to go for coffee, or talk about life or ask for help, or company – and then thinking, no, it’s presumptuous, I don’t know them that well, they don’t really like me. We’re all daft and vulnerable and afraid.

We should all be a little bolder.