Blog – Page 6 – Sarah Long – Mental Health & Wellbeing

Mental Health First Aid – New Date

Book now to join us on the Adult Mental Health First Aid Two Day course:

Hebden Bridge Town Hall
Monday 4th / Tuesday 5th June 2018 (9am-5pm)

Learn to understand the relationship between stress and mental ill health, spot signs and symptoms of some mental health conditions, and how the Mental Health First Aid Action Plan can be used to help offer support to people experiencing a range of different forms of emotional distress.

Hebden Bridge is easy to reach from across the North – being near the West Yorkshire / Lancashire border, with excellent transport links to Halifax, Bradford, Leeds, York, Manchester, Burnley, Rochdale and more.

Read more about the course here: https://slongmhfa.com/course-costs/mhfa-2-day/

Book with Eventbrite here: https://www.eventbrite.co.uk/e/mental-health-first-aid-hebden-bridge-adult-2-day-course-tickets-43162860277

Contact me to enquire about discounted rates, or in house training for you organisation.

MHFA

Recovery

When I deliver training – be it Mental Health awareness, or Mental Health First Aid courses, I bring my own experiences into the classroom. I don’t have to. The course content is fairly comprehensive – but it is the aspect most frequently mentioned in positive feedback. I think it is important for two reasons – firstly to put a human face, a context on what we are talking about, make it real, for those trainees who have no previous exposure to mental ill health – but also to help create a safe space for people if they do have relevant comments they wish to share.

Over the past month, I have reflected on my recovery. Where I was once, where I am now. What got me here. I am not “recovered”. I don’t know if I will ever think of myself as that. It feels more like an alcoholic’s recovery – a process – being “in recovery”.

At one point, I was just about holding on to my job. I was lucky to be in a public sector role which was not as strict on sickness absence as some places (though it later became more so). 22 days off in a year – not long term, lots of short term absences. I was also late a lot. And I mean a lot. I suffered severe depression and anxiety issues – I couldn’t get to sleep at night, and/or couldn’t wake up in the morning. I found it hard to concentrate, to hold my tongue and not snap at managers or colleagues about the injustices or petty behaviours I encountered. I cried in the toilet nearly every day. I self harmed, and made myself sick fairly frequently. I was tired beyond belief, and suffering with aches and pains. I was prone to picking up every bug that was going, so suppressed was my immune system. My long term relationship had fallen apart, I was in tens of thousands of pounds of debt, renting, hating my job. I drank too much – self medicating? Maybe – distraction, pleasure seeking. I occasionally veered into hypomania, losing my inhibitions and common sense for periods of more spending, drinking, risk taking behaviours.

That’s not my lowest point. There had been other previous bouts, some suicidal – but this is the one from which I track my recovery.

Where am I now?

Before I left my job – my sick leave was down to 6 or 7 days in a year. Which had been mostly flu related. Now – I am self employed, working sporadically in terms of payment, but putting in plenty of hours behind the scenes. I am doing something I really believe in. My fingers are firmly crossed that it works out – but so far so good. And I am happy that my mental state is thus far allowing me to make a go of it. It is a virtuous circle. I am doing work that uplifts me – it feels worthwhile, important. People thank me and say it makes a difference to them. This in turn boosts my wellbeing. Hopefully I can hold on to that effect.

My old job did not have such a positive effect. Not so much the work – I loved some of the work, and my colleagues. But the culture and constant restructurings, the lack of resources and respect. It ate away at me. I had good terms and conditions and felt partly trapped by them (because of my debt) and partly like I was selling out my principles for material gain. The stress levels were awful sometimes – and the conflict around me as others struggled with their own stresses was uncomfortable for me to deal with.

My mental health is not 100% marvellous. I am having a good patch. Last year was less good. In between taking redundancy and starting to really work at getting my training business going – I had surgery and an injury, and spiralled into quite severe health anxiety, with panic attacks, paranoia, obsession and depression. I was prescribed new anti depressants I was too scared to take, saw a counsellor for guided self help up until just before Christmas. I gradually improved. I still have my moments, but I am doing well for now. (I won’t talk about physical health. I am a wreck in that department but what do I expect, I turned 40 a year and a half ago – all downhill now right? And I still drink too much.)

What has helped me to get here?

When I was in my job that I hated, I tried to find things to make me hate it less. I got involved in other things to keep me interested. I volunteered. I took part. I joined the Disabled Staff Network and ended up running it for 10 years. I attended health and wellbeing events, took up opportunities for training courses. That’s when I first encountered Mental Health First Aid – and then became a trainer. I ran mental health awareness events, time to talk sessions. I found a passion.

As it happened, I also got promoted. Different work, different responsibilities, in fact much more work and responsibility. But the stress didn’t get more – it changed. And became more bearable for me. Perhaps because I felt more in control. I had more agency to shape how things were done. So felt less powerless and disgruntled. Not completely because I was still under ninety other layers of management, but it helped.

Eventually I also reconnected with my profession for a while – pursued my Chartership – got interested again, did some reading, training, followed stuff on twitter. More things to think about, be interested in – to distract myself from the mess in my head. Something to feel proud of.

I moved house. I had to – because my ex and I had to sell the house we had bought together. But I had a choice about where I went. I decided to make a massive leap and move to Hebden Bridge. Beautiful countryside. A community I hoped I could be a part of rather than the anonymity and clash of ideologies I had experienced in Leeds.

In work, as part of my work with Disability – I came to understand what a reasonable adjustment is. And that Occupational Health can be your friend. Over time my management and I agreed adjustments which helped me.

Work from home 1 day a week regularly where possible
Extended flexitime where needed
Work from home on emergency basis if couldn’t get in early enough, or if my state of mind was not good enough to deal with commute or face to face

Working from home regularly gave me a day’s decompression, a bit of space, somewhere I could concentrate. To begin with this was unusual, but by the time I left, nearly everyone did this anyway – seeing the benefits of being away from the distractions of the office. [Reductions in office space meant that this was also being seen as a necessity, with desk ratios of 8:10 or less, you had to arrange for someone to be out of the office].

We had flexitime, but some areas were funny about you using it. Also we were meant to be in by 10am. Ok normally, but when I am ill, I had what I call “bad nights”. Late night panic / anxiety / crying fits – not being able to sleep, lying awake in despair. The later it got the more I would worry about the morning and not being able to get up, being late for work. Because of bus and train connections – I either had to be up at 7 to get there for half 9, or I would be after 10, often closer to 11.

Agreeing that if it happened, it happened, and I should get in if I could – and that so long as I worked my hours it wouldn’t count against me, meant that when those worries started, I could break the spiral. I might feel dreadful, but I didn’t have to worry about the morning. Over time, this actually defused many of those bad nights, and meant I didn’t need to use the flexibility anyway.

If I had felt I could not get in before 11, I would often think there was no point, and have to take leave, or a sick day. Ditto when I had “bad mornings” – when sleep was like treacle and I couldn’t wake, or when I opened my eyes to feel like the world had collapsed, in abject misery – often I would actually be ok by late morning, but it was too late, I had to phone in sick. “Emergency” working from home days meant that I could contribute more, either full or half days. In the former case I could be online and working by 8 or 9 even if in my pyjamas for the first hour. In the latter, I would work when I felt fit, and continue either for my full hours, or less if I felt I needed it. I would then log as flexitime and make up on a better day.

Overall, I probably worked more when able to work from home than I ever had when expected to be in the office regardless every day.

Removing the fear of being disciplined, or losing my job – (for the most part) – meant my anxieties had less to feed on.

I tried various medications. citilopram, fluoxitine (didn’t work for me, made me vomit) – venlafaxine (ever increasing dose, made me sleep for hours and hours and hours). They weren’t compatible with full time working.

I sought counselling from the NHS. I did a group stress course, CBT, guided self help. I learnt from these things. Waiting times meant I was seldom getting the therapy when I really wanted it, (i.e. when I had been referred). I didn’t get the kind of therapy I thought I wanted, or needed – but I can’t say that what I did get wasn’t helpful in the long run. Once I opened my mind to it and gave it a try, it’s given me useful additions to my toolkit I suppose.

I got married – which was lovely in itself, but also gave me a focus and structure, and led to the development of new interests and hobbies as I DIY’ed a lot of the decor etc. I connected with friends and family for at least that brief period (though that held stresses of its own.)

I learnt a few really useful principles from Mental Health First Aid – which I really credit with helping me stabilise things.

Understanding stress. Looking at my life and evaluating the balance between stress, and what I am or am not doing to offset it. Thinking about whether I can amend or influence any of the stressors.
Self care, and self help. The importance of the first, and the fact that the second can work sometimes. I had always pooh-poohed self help books, and all that stuff in the “Mind/body/spirit” sections. But I found that reading about depression, anxiety and other things helped me understand it more, and feel I had more power over it. Different ideas and techniques – I’m willing to read, to try. I caveat that I wouldn’t usually spend (any/too much) money on something unless I was convinced about it helping me – but if it’s free, or cheap in a charity shop or sale – it’s not a lot to lose.
5 Ways to Wellbeing / 10 Keys for happier living – another thing that is good to check in with when I am feeling rubbish. I think – how does my life measure up against these things. Are there areas where I could try something else which might start to help? Again – worth a try.

Small steps. I am still working on it. I am “lucky” in that when I am bad, it interferes more with my nights, my home life, than it does work. I have periods of functioning very well externally. I throw myself into work to distract from my pain.

At the moment I am trying to shape my life to be something which promotes good mental and physical wellbeing. I am starting to understand myself, what I need. Retrospectively, I might had advised myself to pack in my job earlier, go bankrupt – make the change. The benefits feel worth it, and I find I need a lot less money than I thought I did. But I can’t know it would have all worked out. I can’t regret all of my experiences at my previous employer. They may have taken a lot out of me, but they did give me skills, knowledge, memories and friends that I wouldn’t be without.

My motto is to keep trying. Keep learning. The more I understand about myself, why I am how I am, what provokes negative responses – the more I can play my system. Monitor my mood, adjust, seek help early when it gets out of hand.

I know not everyone finds this approach to be useful or effective for them. That not everyone has supportive employers or works in a role that can be adjusted helpfully. That it’s not always possible to do things even if you want to. We need services to be more available and accessible and effective so that people can be supported in whichever way they need. And can try a range of different medical or therapeutic interventions to see which is most helpful to them.

But I do think it’s important to know that even when medicine or therapy isn’t working or available – sometimes other things can help. Even if only a little. Lessening a depression from a 9/10 to a 7/10 is still worth doing, and can make life more bearable.

Mental Health and Violence

Today again the headlines are full of mourning for the victims of another school shooting in the USA. Questions are being asked about how to stop such horrors. From across the ocean in the UK, where guns are strictly regulated and not widely available – the US obsession with firearms despite the terrible price, is quite baffling to many.

Whenever there is a mass shooting, there is a holding of breath, and some people argue the way the media will respond is predicated on the colour of the perpetrator skin. If the shooter has an Islamic name, darker skin, the response will be one way, calls for tighter immigration rules and Islamophobic rhetoric perhaps. If white, the response will suddenly be to shouting about mental health, and lone wolves. People use these tragedies for their own agendas.

But the issue of Mental Health and violence is an important one to think about. There are, sadly, a great many people out there who think that people with mental health issues are dangerous. More likely to be violent, commit murder even. Given the way mental health is often handled in the media, in TV programmes, in Film, it’s hardly surprising. Psychosis, Schizophrenia, have been used as a lazy shorthand in horror movies for decades. And for some people, when they hear the words “mental health” – their minds instantly jump to the most severe diagnoses. Of which they have little understanding.

What is the truth? What is the relation between mental health and risk of committing a violent act? This report goes some way to exploring the issues in the UK – the US of course has its own landscape made of a different healthcare system and readily available guns…

It’s a complicated issue. Because people with mental health issues are people. And people are complicated. Do people without mental health issues commit violent acts? Murder? It’s an interesting question as to whether it can ever be “sane” to punch someone in the face, to stab someone, to shoot someone – whatever the motivation. As a non-violent person myself, who rarely even gets angry – it seems alien.

Is it ever sane or rational to put on a suicide vest and blow yourself up, taking others with you (willingly, I mean – I can understand how the vulnerable may find themselves coerced through threat and/or promises of reward for their families). Or to do the coercing, the radicalising, the recruiting? Is that sanity? We have a spectrum in society of what we say is acceptable, or tolerable in our society. There are many ways in which things like aggression, or sexualised behaviour can spill over in ways we deem unacceptable – as is being evidenced by the wave of sexual harassment – abuse scandals. Some people think it’s ok to get into fights. Ok to kill for this cause, not for that. Where is the line that we say certain behaviour is alright and a step beyond is a sign of mental illness?

The vast majority of people with mental health issues, even severe diagnoses, are never a risk to other people. If anything – people are more likely to hurt themselves, and sadly also at great risk of being victims of violence from others.

That is not to say it never happens. People with mental health issues do sometimes get involved in violence, or kill people, In cases like the shootings in America – people may leap on a history of one thing or another. The perpetrator of the most recent shooting was described as “depressed and a little quirky”. Is that why he did it? Depression doesn’t make a person violent. It’s not surprising that he was depressed given his situation – having lost his adoptive parents relatively recently.

Do we ask other questions about people like this? What has their life been like? What influences are around them, what media have they been consuming to shape their attitudes and behaviours? What pushes them from angry young man to murder, or bomber, or terrorist? Have these influencing factors led to the development of violent thoughts, as well as increasing the risk of concurrent mental health issues. i.e. the former are not caused by the latter, rather both are caused by the same set of precursor circumstances.

Without serious study and analysis, it’s hard to say – and sadly a lot of people are only interested in punishing or even killing criminals and terrorists, not seeking to understand why they become the way they are (in order to prevent others repeating this path).

There are some conditions, which can be related with risk, with anger management, with erratic behaviour and potential delusions, but in all cases, it is never true to say that x diagnosis = violent. People with mental ill health are no more violent than people with supposedly good mental health. Sometimes people do horrible things.

What is certain, is that accessing mental health services at the earliest possible stages, reduces the risk of a problem getting worse, and helps people to recover positive wellbeing, improve strategies for coping with difficult situations, and be able to engage in life and do the things they want to do, and be healthier and happier.

People who are happy with their lives and have the opportunities to do what they want to do in life, free from socioeconomic inequalities are less likely to carry out violent crime. This is one of many reasons we need to increase the availability of these services, make it easier to access them – and a huge part of that is working to reduce the stigma surrounding mental health that makes people not want to access them. The kind of stigma that comes from leaping on the mental health diagnosis of people who do bad things, whether or not there is any concrete evidence that there is any reason to do so.

We need people to recognise when they need help, or when their family members or friends are struggling, and be prepared to support them and love them, rather than ridicule or shame, leading to isolation and worsening of the problem.

Eating disorders – a growing concern

The news this week that there has been a dramatic rise in the number of people admitted to hospital who have a diagnosis of an eating disorder, combined with a leading ED charity reporting similarly rocketing numbers of calls to their helpline, goes to illustrate a distressing state of affairs in terms of treatment of eating disorders in the UK.

As reported in the Guardian and elsewhere, the number of admissions in the year to April 2017 was 13,885 – a figure which has been steadily increasing for many years. Figures for the under 19s were seen to double, from 1050 to 2025.

Listening to a spokesperson from BEAT Eating Disorders on the radio – we hear that the rising figures are part of a more complex picture. Not entirely about increased prevalence, as increased awareness inevitably leads to more people seeking help. But the fact we are talking about admissions is alarming – because there are also reports that a great many people are being refused referrals for treatment (hence would not be included here). Some people are sadly being turned away by doctors who suggest they are not “ill enough” if their BMI is not below a given figure.

While the physical effects of an eating disorder such as anorexia are of grave concern, and are the reason that it is suggested to have the highest mortality rate of all mental diagnoses, to suggest that someone is only ill when they reach the stage of being dangerously thin, is to misunderstand the nature of the condition. That it is a mental health issue, caused by many factors but often rooted in emotional distress, anxiety and harmful coping behaviours which mutate into something very dangerous and disruptive. The earlier someone’s troubled relationship with eating can be recognised and acknowledged, the easier it is reported to help a person to overcome these harmful behaviours through talking therapies and other support. In an ideal world this could be done before a person’s distress and condition deteriorates to the point now being considered as a threshold for treatment.

If this chart of the South London and Maudsley’s Eating Disorder Clinic Guidelines is anything to go by – Hospital Admission comes only with a BMI of 13.5 and below – where a person’s organs are in danger of failure. Is this the stage being reached by the 13,885 people logged above? Comments on the failure of some GPs to help people seemed to suggest that this also meant that they were not being referred for counselling at the earlier stages as recommended by this chart. And if people are not able to access such help at the earlier stage, it is no surprise that they end up needing hospitalisation further down the line.

Of course behind all of this, and potentially the reason for GPs’ reticence to refer, is the lack of available services, waiting lists for mental health services generally, but also quite specifically the postcode lottery relating to specialist inpatient or outpatient services for eating disorders. There are many deeply distressing stories of people having to travel hundreds of miles to visit their family member – who is often a child or young person. This difficulty can cause significant problems in itself – where to be involved in supporting a child through recovery a parent is unable to work, or where travel costs become simply unaffordable.

As ever, spotting the signs and symptoms of emotional distress at an early stage increases the chance of a good recovery – anxiety or depression may be evident before the eating disorder takes hold. Eating distress can take many forms – and does not always involve someone becoming very thin. Wherever a person’s behaviour becomes obsessive and their relationship with food causes them distress, or interferes with their ability to carry out normal daily activities, or social interactions (such as going for a meal with friends) – it could be problematic in the long run.

More about specific eating disorders can be found on the BEAT website – if you are concerned about a family member or friend, do take a look or call their helpline on 0808 8010677

The Mental Health First Aid two day course helps people to recognise and offer support to people experiencing a variety of mental health issues, including a short section looking at eating disorders.

IAPT and Guided Self Help

As a Mental Health First Aid Instructor, I train people to support people with mental health difficulties in a variety of ways, one of which being to “Encourage (them) to seek appropriate professional help”.

With 70% of people who die by suicide not having been in contact with mental health services in the year before death – I feel it is an important message, to try and help people access services, which may then hopefully prevent their distress from reaching the point where they are so desperate that they see suicide as an answer. If Mental Health First Aiders (or anyone) can help someone to a) recognise that the distressing symptoms / emotions they are experiencing are possibly suggestive of a mental health problem, b) understand that mental health issues are very common, part of the normal range of human experience and response to stress or difficult circumstances, and nothing at all to be ashamed about, – and c) recognise that there are many different things that may help them to feel better, from self help startegies, relaxation, peer support, to medication and a variety of therapies; then of course that is all to the good. Hopefully that will lead to some people seeking and getting help that otherwise would not have done so. Or even just begin to understand their mental wellbeing.

However, when we encourage people to seek help – “appropriate professional help”, often by going to their GP in the first instance, how likely are they to actually get that? How long will it take? Will the help they receive be “appropriate”? It’s something that I have discussed with several MHFA Instructors – something that concerns us. If we’re encouraging people to seek help, are we sure that it is actually going to be there?

Of course the answer is sadly going to be no – in many cases. We can’t be “sure”. We know there are problems, waiting lists, shortages, geographical variations in provision. But we can talk about what “should” be there. What should happen when you go to the GP. What kinds of help you might receive.

The Improving Access to Psychological Therapies programme aims to make counselling services more accessible, and reduce those waiting lists. It has had a degree of success. But is it going about things the right way?

“Stepped Care” – is a principle whereby a person referred, or self-referring to the service is assessed, and directed to a type of support which is considered most appropriate to their level of need. People with mild problems with stress/anxiety, for instance, might be encouraged to attend a group stress management programme. Then there is Guided Self Help, where a Psychological Wellbeing Practitioner takes the person through a range of exercises and lessons aimed at challenging the negative thinking patterns or behaviours which come with, and fuel, anxiety and depression. This is taken further with Cognitive Behavioural Therapy. There are computerised options which some people may prefer to the face to face option. There are also other types of psychoeducation – helping people to understand what influences their mental health and what they could do about it?

The third “step” does mention access to other types of therapy, especially in relation to specific diagnoses, such as Post Trauamatic Stress. But I would be interested to hear people’s experience of how possible it actually is in practice to access therapies other than CBT on the NHS.

I have had a couple of encounters with this model of access. A few years ago I was referred, I remember taking the assessment call at work, sat in a meeting room on my own. I was severely depressed, and occasionally suicidal. I was obsessing about death, and couldn’t understand how CBT could help me with that. After the call I felt deeply alone and upset, and cried for half an hour in that little room. The person on the phone had said “Do give us a call if you things get worse” – I thought the whole thing really unsatisfactory. “There’s a waiting list, I’m afraid”, they couldn’t tell me how long. I suggested I could maybe access some counselling through my work Employee Assistance Programme, but was told that was a bad idea, for some reason.

So. Eleven months later… I got my counselling. I never found out how CBT might help with my thoughts of death, because, my mental state being what it is, the worst had passed. I had endured several months of severe depression, luckily come out the other side – and so when I sat before the counsellor to discuss my problems, and be given homework to try and work on my issues, the topics which arose were totally different than they might have been when I actually first asked for help. Don’t get me wrong, it was still worth doing, in a way. I got to identify and work on some of the issues which endure even when I am in a better state of mind, and probably contribute, over time, to the risk of relapse.

This year, I have had a number of health issues, surgery, a fall, – which combined with a background of extreme uncertainty and change to produce in me some extreme health anxieties and obsessions. It reached a pitch that it was becoming difficult to live with, so I again sought help. This time, it took about a month before my assessment, and then a couple of months after that before I was able to see a counsellor. Or in this case, a Psychological Wellbeing Practitioner – for Guided Self Help. Again, my specific health anxieties had subsided somewhat. I have a long history of learning about my mental state and lots of strategies which I put in place to try and de-fuse the crises when they occur. So I do a lot of work on my mental health anyway. But every so often it gets worse, feels out of control, feels like I might lose my grip and fall into the abyss. That’s when I ask for more support. I want to feel better in the moment, but I also want to find out what causes this endless cycle. Not just get rid of the immediate symptoms, but work on whatever issues I have underneath that cause me to fall into negative patterns.

CBT, to some extent, ignores those underlying problems. It doesn’t matter what causes you to be prone to negative self beliefs, if you can learn how to notice when you are doing it, challenge it, and train yourself to respond differently. For some, that’s enough. But for others, like any kind of therapy – physiotherapy for instance – you learn the technique to deal with the problem, the pain. You put it into practice, the pain gets better, goes away. You keep it up for a bit, but then forget about it because you no longer have the pain to remind you why you are doing it. But of course, after a while, in the absence of the good practice of your exercise technique, you slip into bad habits and the pain returns. So it is with CBT. You may know the principles, the techniques, the exercises – but sometimes you slip, and because the initial problem is still there underneath, your emotional pain returns.

When working on my Counselling course last year I read an article which suggested that this was a major problem in the priority that CBT has gained in NHS treatment. It is measurable, and very effective in the short term for many people. All great for suggesting cost effectiveness in a cash strapped service. But – is it as cost effective as we think, if it means that patients keep coming back? If someone like me, with life long issues with depression and anxiety has repeated relapses which mean I end up back on a waiting list – what is the cost of those multiple short term fixes? And would it be more or less than a longer term bout of a different type of therapy which would explore what has caused my underlying issues, work on them and potentially resolve them? If there is a tumour which you could either treat with a drug which would shrink it for a time, but then it would grow again, and need repeated treatments to hopefully keep it under control – each time risking that it will grow out of control and become really dangerous – or you could cut it out and use chemo or radiotherapy to try and eradicate it all together. Which do you do? Which is more cost effective? Which is more clinically effective?

Anyway. So I am currently undergoing “Guided Self Help”. It is interesting. Funny – because on more than one occasion my counsellor is taking me through things I actually teach. Stress Buckets. ABC. Negative thinking. I know this stuff. It’s not to say it’s useless. It isn’t. Knowing is different than doing. It is useful to have someone else help you to look at these things. And deadlined homework to make me think about it. But I do spend a lot of time thinking about whether it is a good use of the time of qualified counsellors.

I mentioned that last year I did the PG Cert in Interpersonal and Counselling Skills at Leeds Beckett University. I had been planning on carrying on to become a qualified counsellor myself. I still might. But it means another two years to to a PG Dip, and placement /counselling commitments which come at a cost I can’t currently afford.

We have a massive shortage of counsellors. Given the length of time, and financial investment that is needed to become qualified to BACP registration level – surely we need to ensure that those counsellors are used to best effect when they are employed within the NHS?

So why are they being used to deliver some of the same messages we teach in MHFA? Is it necessary? Is it about trust? That patients wont listen if these messages don’t come from someone “qualified”? Or is it that the counsellor has to monitor the patient to check that the problem isn’t more serious than initally thought – that the patient doesn’t need more help? That would make some sense, but how would he tell? I have hardly had the opportunity to speak, in the several sessions I have had. I fill out my questionnaire. He checks in on my thoughts of suicide or self harm – a simple assurance that I have no plans to act on them. I do my homework, sometimes writing some quite intense thoughts – but he doesn’t really review them much. We move on, to the next lesson. Indeed in my first and second session I actually felt like crying afterwards because I had been talked at so much. Talked at about things I know, I teach. And inside I was screaming “I just want someone to talk to!”

Person Centred Counselling. Psychotherapy. How does one access that, if, like most of us, the prospect of £40 a week for private therapy is a pipe dream?

MHFA Higher Education

Going to university can be a wonderful time. Exciting, life changing, memorable. But it can also be a difficult time. A perfect storm of factors colliding, and it doesn’t always go smoothly:

Leaving home – family & friends – your support network up to this point
Having to make new friends – maybe struggling to find people you click with, or maybe the drama that comes from new group dynamics where not everyone gets on.
New romantic relationships, or casual sexual encounters
First time looking after yourself – feeding yourself (are you getting the right nutrition, or, living on cup-a-soup, pot noodles and vodka, like I did for a while?) – washing your clothes, making sure you have loo roll.
Maybe the first time dealing with your finances – balancing the need to pay rent, buy books, clothes, food – with your desire to socialise. Do you get a part time job? Or will your studies suffer.
Debt – for most people, studying now equals considerable debt. Despite reassurance that you won’t have to pay your student loans back until you’re earning enough – you may end up in more debt than just those loans. And of course the university doesn’t kindly give you your fees back if you end up not passing or dropping out of your course, so this compounds any worries you have about your capability to meet the requirements of the course.
Social Media – everyone sharing their perfect lives, pouty selfies, body shots – trolls and bullying have become a horrible fact of modern life, along with the always on – 24 hour rolling news culture that gives the mind no peace at all.
Studies. Oh yeah! That thing you are actually there to do can often involve considerable work, and be quite difficult. Sometimes you might struggle – and if other issues such as needing to work for money, relationship problems or a hectic social life start to encroach on your important library & essay writing / lab time – then concern about performance can really start to bother you.

It is no wonder that sometimes young people start to struggle and maybe experience symptoms of anxiety or depression – or even worse. 78% Students in fact say that they have had mental health difficulties, but only half seek help. Even more troubling is the significant number of students who feel so trapped and without hope that they sadly take their own lives each year.

The ironic fact is that, in theory, Universities are places where it can be much easier than some others to access support. Student support services, Counselling, Chaplaincy, Student Union services. There is often a lot available. Financial advice, academic support – mitigation & extenuating circumstances policies, library services, study skills & disability support, wardens etc in Halls. But one thing even 18 year olds bring with them along with whatever the modern version of a Klimt or Monet poster and Alanis Morisette CD (showing my age there) – is stigma.

Admitting that you are finding things hard is incredibly difficult. You race towards this wonderful freedom, and want desperately to be seen as “grown up”. Be able to cope. So how many first years admit to their parents that they are lonely, they miss home, they’re struggling either financially or academically. People often will put a brave face on until things are so bad they don’t know how to even start. Admitting to tutors that you need help can be difficult too – though if you were heaving your guts up with a stomach bug when you were meant to be writing an essay then I doubt you’d think twice of applying for an extension.

Universities are recognising that they need to help students and staff to deal with this avalanche of stress inducing circumstances. As well as providing the services we have already mentioned, a whole university approach to Mental Health is key.

Make sure policies and practices are reviewed to a) try and promote good mental health, prevent undue stress which may contribute to mental ill health, and b) support those who may experience mental ill health to recover and resume their studies or work.
Have a wide range of well staffed support services to help deal with some of the causes of stress, advice lines, educational support, as well as a range of counselling options for both staff and students.
Seek to improve the culture of the University relating to mental ill health by raising awareness and improving understanding about the impact of mental health conditions. (MHFA Lite courses are a good broad based starter to get people thinking about mental health as something we all have, and need to manage just like our physical health)
Provide plenty of opportunities for people to develop strategies to support their wellbeing – physical activity, nutrition, volunteering activities, social activities, short, fun, non compulsory learning opportunities, mindfulness/meditation/relaxation support.
Ensure key people throughout the organisation have a more in depth understanding of Mental Health and the importance of embedding a positive approach right the way through both student and staff structures. (Mental Health First Aid’s One Day Higher Education course aims at creating “Mental Health Champions” – an intensive look which would be ideal at this level)
Train appropriate people in Mental Health First Aid, so they are better equipped to spot signs and symptoms of mental ill health – enabling them to provide comfort and information, and hopefully help individuals to recognise that there is support available out there, and signpost them to appropriate professional help. Deciding who should take on this role – it is important to think about who is most likely to find themselves in a position where they might need to help someone. Often it is more likely to be security staff, late night library assistants, wardens, or even bar staff – who might come across someone in a moment of crisis. Union representatives or members of staff or student networks are also good candidates, where people may go for help.

If you are interested in Mental Health First Aid in a University environment – please do get in touch. I am compiling a list of interested people to set a suitable date for a HE course in West Yorkshire – hopefully Leeds in January. But I am very happy to discuss your requirements.

(P.S. of course it isn’t all bad – otherwise I wouldn’t keep going back for more – here’s me in my latest silly hat for PG Cert Interpersonal and Counselling Skills.)

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MHFA & Wellbeing Retreat

I have an idea brewing, which I would love to bring to fruition sometime in the next year or two if I can get enough interest.

Two, no three, things prompt it, aside from being a nice idea.

The two day mental health first aid course is packed. Ram packed with information. The recent update has if anything added more to be squeezed into that two day session. Which is great, in a way – but can be tiring or a bit intense if you are not used to that kind of thing. And at the same time there is often more we want to say, more discussions to be had, questions to be answered. How can we make it both more informative and less grueling – staying till 9pm won’t do it – or be good for anyone’s mental health!
I’d love to spend more time on the “what helps” side of things – especially the self-help / other supports. For me, MHFA has been hugely important in reminding me that I do have some power to improve my state of mind. I do not have to wait idly by until a doctor or counsellor is available to perform their magic on me. There are things I can do which sometimes are enough to reverse a negative trend. The opportunity to share and try out different options which may help people to take back a bit of their own control would be wonderful.
Cost – now – I offer the course at what I feel is a reasonable rate, – “subsidising” the MHFA England recommended rate by at least 50%. And I think that in terms of many of my clients – who come via an employer – looking to improve mental health awareness and literacy in their organisation, that is a decent price for two days training in any field. But I recognise it can be a lot for an individual. However, while I can’t afford to do for any less, and still be able to pay costs and my own bills – it strikes me that there might be those who would be interested in an added value option which combines the course with a retreat in a pleasant location, with some extra content and also leisure time.

So what I am thinking is a 5 or 6 day retreat – either somewhere local to me in Yorkshire, or maybe Cumbria. MHFA course content across four mornings, and then in the afternoon we look at self care and wellbeing ideas, based around the five ways to wellbeing / 10 keys to happier living. The middle day could pick up the physical activity angle with a walk in the countryside, giving a break from the classroom (Weather permitting. I’ll cast my mind to alternatives if it doesn’t) Nice, wholesome food, the chance to get to know each other better – or just take some time to relax in the evenings. Oh – and there will have to be books and cake. I am a librarian still you know.

What do you think? If you are interested in hearing more about this or other courses / options – drop me a line at sarahlongmhfauk@gmail.com

New MHFA course date: Huddersfield

I have just scheduled a new date for the two day Mental Health First Aid (Adult) training course.

22nd/23rd November 2017 – 3 M Buckley Innovation Centre, Firth Street, Huddersfield.

https://www.eventbrite.co.uk/e/mental-health-first-aid-huddersfield-adult-2-day-course-tickets-38690401031

I am looking at Bradford for December, and maybe Rochdale in the new year. Please get in touch if you would like to register interest in another location.

Adventures of a free range trainer. Month 1.

My first month of freelancery is done. Some progress made – a two day course in Halifax, an awareness session in Bradford, delivering for a Trade Union, and an arrangement to work with them through next year which makes this viable for now at least. Great news! A few other irons in the fire, possible interest in working with organisations and companies.

What else have I learnt? Some social media stuff, some about the pros and cons of different kinds of networking. And some about the particulars of solo working, working at home most of the time. Am I lonely? I’m not sure. I’ve taken to listening to LBC and occasionally interacting with it via twitter. Substitute for office conversation I suppose. But my office wasn’t particularly friendly by the time I left it. Once upon a time I had a group of good friends and colleagues and we used to socialise and get along well. But time and tides changes things, and it became a pretty lonely place in the end.

We spend so much of our waking life at work – we should make it as bearable as possible, would it be so bad to aim for enjoyable? Something we discussed in the Mental Health Awareness session I ran – about how many of the changes made in workplaces over the past few decades, in the name of cost cutting, professionalism, time & motion, productivity etc, have had unintended consequences for our wellbeing. Little things, someone looks at a spreadsheet of costs, says, we don’t need to pay for this, say, license to be able to play music in a factory. Or they decide that people shouldn’t be listening to music or the radio because it means they aren’t focused on the job, or it’s not professional enough. But what they don’t realise is that while they may save 5% in costs, they are losing a 10% productivity boost that the increased wellbeing benefit of such a simple thing might have been having. Taking the worker’s mind off of a repetitive task, giving them something to think or talk about, masking industrial noise which can be linked to increased risk of developing mental ill health.

Little things. Like pleasant working environments, bright decorations, natural light. The ability to go outside for breaks, get some fresh air. A green space to sit and maybe eat lunch.

Working for myself – this is all in my hands of course. I said I would go for a walk every day, eat a healthy lunch, do something creative, keep on top of my housework. I need to work on that. I need to develop a routine, make myself stop and have breaks. And I do need to get some human contact. Much as I love talking to my cats. I haven’t escaped work related stress or anxiety. Not yet. But it is of a different quality, and feels more in my hands to resolve. I have had some bad patches of insomnia, and anxiety before training which had me shaking and nauseous. But I got through them with mindfulness, breathing exercises, problem solving.

I’ve learnt some other things too.

The Japanese have a word for suicide caused by excessive work stress. Karojisatsu. (Not sure I’d call it suicide if an employer puts you in that position.)
Mental health can be influenced by workplace exposure to chemicals, noise, light, and even aromas.
MHFA Lite doesn’t seem to attract much interest. I had to cancel the three I had planned. (I have decided I probably will only offer these as part of a wider in-house programme for workplaces. I don’t like messing venues around by cancelling.) I think I might develop something more affordable for community use.
I need to remember to carry business cards.
But – I can do this.

October is busy – courses in Leeds and Hebden Bridge next week, Awareness training in Wakefield, and then co-training in Todmorden. Hopefully I will get to run the Higher Education course on the 25th in Leeds but we will see.

We have lift off

Last week’s course at the Elsie Whiteley Centre was great. That place is fantastic by the way, very much recommend if you need a meeting / training / coworking location in Halifax. They looked after me very well and the cafe is lovely and good value.

Not only did I get to meet a lovely group of people from varied backgrounds (Firefighter to primary school teacher) – and introduce them to the simple tenets of Mental Health First Aid – which hopefully they can now go away and use in supporting others, but also understanding their own mental health, but I also covered my costs. Yay! That’s a win, at this early stage of my freelance endeavour.

mhfa halifax

As always, the people in the group brought their experiences to bear on the material we discussed, and I learnt many things myself. Not least of which was not to have the celebratory drink until after the second day of training… Oh well, it was my first day.

Now my attention turns to getting the next few courses off the ground. I have a couple of people waiting but need a few more before I can confirm. So if you are interested please get in touch! I’m more than happy to answer any questions you have about the courses.

Coming up :

MHFA Lite (A basic introduction to Mental Health Awareness)
— Leeds – 4th October, 1pm – 5pm
— Hebden Bridge 9th October, 1pm – 5pm

Mental Health First Aid (Two Day First Aider course)
— Leeds – 10th/11th October, 9am – 5pm
— Hebden Bridge – 12th/13th October, 9am – 5pm

MHFA Higher Education (One Day Mental Health Champion Course_
— Leeds – 25th October, 9am – 5pm

You can read more about each course, (and book online if you want) on the Eventbrite pages here: https://www.eventbrite.co.uk/o/sarah-long-14624952023 or contact me about discounts/ other forms of payment.

Do also let me know if you are interested but a) can’t make these times/places, or b) might have difficulty with costs. I’m considering where and when to go next at the moment so open to suggestion, and I have some flexibility with places once a minimum number of bookings are received. I need to pay my rent eventually of course, but I also want to make the course as accessible as I can within reason.

I’m also thinking of developing some non-MHFA branded training down the line, which I will have even greater flexibility with. There is always so much more I would like to say!