Mental Health in the LGBTQ+ Community

This last week has been Happy Valley Pride in Hebden Bridge – a celebration of our LGBTQ+ community and families. Yesterday was the “Big Day Out” – a day of music and cabaret, and a disco in St George’s Square. It was a lovely uplifting day. (Spoiled a little for me by overindulgence but more on that another time)

The past month of Pride events are a marker of how far equality as regards sexuality and gender have come in the past fifty years in the UK. Others across the globe are not so free or fortunate, and indeed the rolling back of some laws and progress in the US reminds us that hard won rights are not irreversible and the fight goes on.

Even in our relatively progressive society, the impact of generations of prejudice, discrimination and taboo can be seen in the fact that there are huge inequalities in all sorts of outcomes such as health and education for LGBTQ+ people. A few selected statistics from the LGBT Foundation and other show a picture in need of much work:

Over 50% of young gay people have self harmed in the last year, compared to between 1 in 15 and 1 in 10 of the general population.
LGB people are twice as likely to have suicidal thoughts or attempt suicide, and two to three times more likely to have depression.
Prevalence of eating disorders in the LGBTQ+ community could be around 1 in 5 or 20%,

There are similar disparities relating to physical health – and variations within the communities, which show it is far from a simple picture. Many people have experienced bullying in school, homophobia and hate crimes in later life. People go to seek help from doctors and are faced with prejudicial or inappropriate attitudes. Even with a more accepting society, young people who come to realise they are not straight, or that their gender identity is not that which they have been assigned at birth – can have a difficult time as they grow to adulthood. Adolescence is hardly a cake walk for anyone – but processing your identity in a world which assumes you to be a way that you are not, figuring out how you feel about it, fearing that others will reject you because of it – and in some cases being right. It is an extra load of strain in life that can leave its traces. And something which can stop you from having the kind of supportive relationships with parents and friends that might otherwise help you to deal with the stresses and strains of figuring out how to have adult relationships.

There are lots of reasons why anyone can develop a mental health problem – lots of possible explanations, biological, hereditary, biochemical, experiential – but it is certain that increased stressors, discrimination and lack of support lead to increased risk of ill health. LGBTQ+ people are more likely to have taken drugs, and there is a high prevalence of binge drinking and smoking. I remember a discussion on this issue in university – different angles being the use of substances to self medicate and deal with depression, anxiety, isolation etc., but also the observation that the “gay scene” is in most cities heavily dependent on pubs and clubs. If you want to make like minded friends, and potentially meet a romantic or sexual partner, it’s likely going to be through going out drinking. Some areas may now be better served, and the youth of today in those areas may have a more “normal” experience of growing up than LGBTQ+ youth of twenty years ago, but we cannot kid ourselves that the problems have all been solved.

Those of us who feel the importance of this issue, can try to do what we can to keep progress moving, and be vigilant and not allow rights to be stripped back, for the sake of generations to come. If we want to help reduce the disparity between the experience of young LGBTQ+ people and everyone else, a good place to start is by increasing our understanding. Both of the issues faced by, and relating to LGBTQ+ people, and of mental health in general. Admit what you don’t know, what you don’t understand – find out more, listen to those whose experiences are different from yours, and ask questions. Read, learn, and be a part of making the world a place where everyone can be who they are, love who they love, without it meaning they are destined to have a greater incidence of mental ill health, suicide or self harm.

Mental Health Courses in Halifax

I am delivering two training courses at the Elsie Whiteley Innovation Centre in Halifax:

MHFA Lite – Half day Introduction to Mental Health
Tuesday 29th August 2017 1pm-5pm Edit – unfortunately I have had to cancel this session – but there are others in Leeds & Hebden Bridge in October (see booking pages below)

MHFA Lite is a basic introduction to mental health, ideal if you are new to the topic and want to understand a bit more. We all have mental health – learn how it can be influenced by various factors, and what can help us to stay well. Do you understand what is really meant by “depression”, “anxiety” or “psychosis”? Would you know the signs of mental ill health if you saw them in a friend, family member, or employee? This course is a good place to start.

Book online here: https://www.eventbrite.co.uk/o/sarah-long-14624952023
or email me about discount places for students / benefit recipients.

Mental Health First Aid – Two Day Course
14th & 15th September 2017 9am-5pm

For a more in depth look at these issues, and the opportunity to learn techniques to support others experiencing mental ill health and help people towards recovery – the two day course is ideal. Become a “Mental Health First Aider” and be a part of a movement that aims to increase understanding of mental health, help us all improve our own wellbeing and build workplaces and communities where we are better prepared to help others.

Book online here: https://www.eventbrite.co.uk/myevent?eid=36397081651
Email me for discount rates for students / benefit recipients.

More information to help you decide between the courses can be found in my previous blog post – here:  Which course is right for you? 

 

 

Who should do MHFA? Part 1: Barbers, Hairdressers, Beauticians…

I got married a few years ago. If you’ve met me or my husband we might have mentioned it. It was awesome. Stressful, scary, and really hard work, but awesome. There are lots of things mental health related that I could talk about from that day, and the period before and after, but one thing I learnt was about the value of self care, and that getting your nails done is not necessarily just getting your nails done.

I’ve never really spent a lot of money on my appearance. Don’t have a lot of money to spend, but even if I did I never really saw the point of some of the things “ladies” will do to themselves in the name of glamour. But seeing as I was going to be the centre of attention, I started to give a bit more thought and preparation into my scruffy self. And I learnt something.  Not only did have nice hair and nails and a lack of a moustache make me feel a bit better about myself, a little boost (because I’m worth it) – fewer prompts for the demons in my head to say “God, look at your hair, you can’t even look after yourself”, but also that the interaction with the stylist, beautician, nail technician – could be healing in itself.

Forced to spend this short space of time with a person, you get to talking. Many people in these professions are skilled already in the art of talking. And it is an art. And in getting people to talk to them. The ubiquitous “Going anywhere nice this year” – is quite a well crafted question. Not only is it something few people would feel awkward talking about, but it’s also something that you will usually be looking forward to and talk about with enthusiasm. Even if the answer is no – you can then talk about where you went last. But actually I found the conversations ran deeper than that. Possibly because when asked what I did, it prompted discussion of mental health, or the health service. But whatever the case, we got on to all things, relationships with parents / family / partner, illness, politics. It was almost therapy. In fact if I ever do finish qualifying as a counsellor I am definitely going to learn how to do nails too so I can offer a value added service. Maybe.

So while at first glance, you might not think someone working down the local salon would have much call for learning about mental health, or what help is available, or how to help someone who’s in distress – actually, they could be exactly the thing for hairdressers, beauty therapists, nail technicians, etc. and barbers.  Barbers especially – being one of the only places where a man will go and look after himself. Men are notoriously bad at seeking help – with physical health even, so imagine what they – you – are like about mental health. But they get their hair cut, or their beards tended to sometimes. So there’s an in. The story below shows a wonderful bunch of Barbers who get it – who have started to try and make a difference. Get people talking, creating safe spaces where it feels OK to say, no, actually I’m not OK. Things are a bit rubbish at the moment.

http://metro.co.uk/2017/07/31/meet-the-brber-whos-turning-barbershops-into-safe-spaces-for-men-to-talk-about-mental-health-6819146/

 

If you see someone regularly, but not every day – you can notice more easily sometimes when people are not themselves. Or maybe they don’t turn up, when it’s usually every week. And finding a way to say – “Are you OK mate? You seem a bit down” – might

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image by flickr user fernando barber – CC BY 2.0 license

 

 

 

help them enormously. You being someone neutral, not family, not doctor – might make it less intimidating to talk a little, and give voice to feelings they have been bottling up.

Men are more likely to self medicate with drink or drugs, than go to the doctors and talk about anxiety or depression. Men are also more likely to die from suicide. We really need to talk about Kevin. And Steve, and Mark, and Sandeep, and Joe, and Mohammed, and …

So if you want to help but are not sure you understand things enough, or where to start – Mental Health First Aid training can help:

https://www.eventbrite.co.uk/o/sarah-long-14624952023

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Image by flickr user Nick Kenrick CCBY 2.0 License

Jagged Little Pill

There’s a box downstairs full of pills.

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Having been assured that my leg is not broken (I will trust her, I will trust her, I will…) and discussed the continual waves of anxiety that has been brought on by each possibility of a physical ailment, my doctor and I talked options.

I have two leaflets to self refer to counselling, assured the waiting list is not as bad as it was last time (11 months – we’ll see!). I meant to go for counselling before I left work, for confidence issues and health anxiety but I didn’t get it organised in time. So I will follow it up. It would be good to talk about things before my mood shifts again – hopefully for the better, but with a big perilous risk of worse given the uncertainty of the coming months.

Neither of us wanted me to go back on the hefty dose of Venlafaxine I was on before I came off it about 6 years ago.  It made me sleep for 16 hours, and destroyed any residue of a libido my deep depression left me with. 16 hour sleep is not great for full time working…  And if I’m depressed at all at the moment it is because of the anxiety and insomnia which comes with it. So the anxiety is the thing – and I came away with a tentative, very low dose prescription for Trazodone – a tricyclic antidepressant (an older type of drug than the newer SSRIs like fluoxetine / citilopram). One I’ve not had before. She said this also could make you drowsy, dry mouthed.

She didn’t push them upon me, they were an option.  I filled the prescription and intended to start them that night. But then of course, I had to read the side effects. And think about whether I need to be having severe drowsiness right now, when I am trying to focus my attention on building up this little enterprise of mine.  She asked if I needed a sick note. I laughed, as for the first time, I’d have no one to give it to. And wouldn’t have anyway really at the moment. I’ve never taken lengthy periods off sick with my mental health. I’ve had problems with episodic / short term sick when things were at there worst, before I got more of a handle on my triggers and risk factors. A lot of which came because of the aforementioned side effects of the medication. I had to come off the meds, and feel worse, to stay in work.

I sometimes think I should have taken the option to have a longer period to recover – for myself, but also because I think my absence might have highlighted to my employer the sheer volume of work I was tackling, which no doubt contributed to my problems – and maybe they would have addressed it.  But probably not. Time off just meant work would be mounting up and a pile of problems building up to welcome me back. So it was counterproductive.

So no sick note for me right now.

But a box of pills. Which I keep picking up and looking at. And thinking about.

What happens if I am allergic? What if I get palpitations / arrhythmia? (I get palpitations anyway with my panic attacks) What if I forget and have a drink? Can I stay off the drink? Maybe if I were not drinking the anxiety would subside anyway…. Maybe I should go sit in the hospital and take the first pill so I am in the right place if there is a problem? What if I fall asleep in the hospital?

Of course if I just take the pill, the above paragraph might just fade away, and I would stop worrying. But that means taking the pill. And what if…

Mental Health First Aid (MHFA) – which course(s) are right for you?

I’ve just started scheduling courses, so thought I would write something to help people decide which course would be most suitable for their needs.

MHFA England have a range of options, which is constantly being developed – other countries have other options, which hopefully we may catch up with at some point. In order to become an instructor you have to do a 7 day training course, which will qualify you for one of the core areas – Adult, Youth, or Armed Forces. You need to do additional training to take on additional areas. (Nb. For more information on Youth / Armed Forces versions please see MHFA England)

Within each area, there are (or will be) a few different options, which, again, the trainer will have had specific, additional training to be able to deliver.

I am an approved MHFA – Adult – Instructor, at present I can offer the following courses:

Mental Health First Aid – Adult – Two day course
(This gives full Mental Health First Aider status)
MHFA “Lite” – Adult – Half day course
(A basic introduction to mental health)
Mental Health First Aid – Higher Education – One Day Course
(Giving “Mental Health Champion” status, with additional content regarding issues for staff and students in universities)

They are hopefully launching a standard adult one day course later in the year which I will look to add to my portfolio.

So – which should you do? All have different time and cost commitment so it’s useful to think about what you want to get out of it.  If you are looking for just your personal interest, then the outlines below should help you to choose. If you are looking from an organisational perspective, thinking about rolling out some kind of mental health training in your workplace, the answer is “All of them”.  (And I’m not just saying that to get your business!)

Different people in your organisation may have different needs so it is good to have a structured approach.  Everyone will benefit from the basic awareness given by MHFA Lite, and you should definitely have some people in your organisation who are fully trained Mental Health First Aiders. Sometimes organisations send their senior staff or HR Leads, but actually the most sensible approach might be to think who is most likely to be able to offer support? Line Managers, Union reps, members of staff networks, security staff, receptionists / front line staff. All might be more likely to be the one who has the first opportunity to support someone in distress. However – I also really recommend that senior managers and HR colleagues do attend – the “Mental Health Champion” level might be most appropriate for them, and is something every larger team or branch within an organisation would benefit from. At present this is aimed at people in Higher Education, but would be interesting and useful for anyone wanting more that the Lite offering. I think it is important for some senior staff, and HR staff to undertake this level or above, as at the end of the day they are the ones who shape an organisation’s attitude towards Mental Health (and other disability) – I have seen situations where individual line managers or team leaders are trying their best to help and support employees with mental health difficulties, only to be hampered by inflexible and insensitive lines from above, refusal to consider or approve reasonable adjustments, hard line sickness and lateness policies, lack of employee support offerings. This course helps open people’s eyes – firstly to the reality of what diagnoses like “anxiety” or “depression” actually mean, and, if the human / compassion angle is not enough – the very real business benefit to supporting employees with mental health issues (and indeed other disabilities) to be able to stay in work, and perform to the best of their abilities.

What is the difference between the different courses?

Continue reading “Mental Health First Aid (MHFA) – which course(s) are right for you?”

Down to earth with a bump

Life is full of little surprises. Banana skins. Obstacles.

Back at work we would groan each time a manager told us how exciting the “challenges ahead” were. Usually of course meaning more work, less staff or money. Such is life.

But we try our best to plan, to avoid unnecessary problems, give ourselves the best chance to do well or achieve the outcomes we desire. Sometimes we are lucky. And I do think it is just that. I don’t think that if your plans don’t work out, it is always because you didn’t plan well enough. I really don’t. Of course sometimes yes, you come away realising what you should have done differently, what didn’t go quite right. But nine times out of ten I think the sneaky SNAFU that messed it all up is just mischeivous fate hiding behind a door, ready to trip you up.

Quite literally, in my case.

I am writing towards the end of my third month after taking redundancy from my “full time” employer. I always intended to give myself few months off, do decompress, and find my feet – recover somewhat from the stress of the last few years. I had such lovely plans for those months off. I was going to get fit, finish writing my best seller, walk every day, paint, and generally be an all round renaisance woman.

But it didn’t quite work out that way. Firstly, some minor surgery I had been waiting on, was suddenly scheduled, much sooner than I expected. Before, in fact, I finished work. Meaning that my carefully crafted plans for finishing stuff up and handing over were also messed up. But then came recovery – which didn’t run smoothly, a minor infection and strange reactions really put the wind up me. Woke a sleeping demon that I had sensed, sometimes, lurking below the surface of my thoughts. “Health anxiety”. Is it just a nice way of saying hypochondria? Or is that different. I don’t think I have every illness. But if something seems feasible, possible, I want to know if that is it. Especially if it is dangerous – so that I can be sure if I, and the health professionals looking after me – are doing what we should be doing to stave off, you know, death.

I have flashbacks to the surgery. Or more accurately, the spinal anaesthetic. Which was horrible, but really mainly because I was so very scared and alone. Not literally. The surgical team and anaesthetist team couldn’t have been better. But no husband, mother, friend there to reassure. The poor nurse probably needed surgery herself for broken metatarsals after I squeezed her tiny hand so much.

They gave me a mild sedative, and it turned out I slept through the surgery anyway. That was the best bit! Never mind that someone was rooting about in my innards. I was calm. Afterwards the waiting, the body figuring out how to respond to the afront it experienced. I was desperately cold for a while, shaking. Had to be given some blankets, while I waited in recovery. Then up to the ward. I wasn’t sure if I was meant to be going home that day or not. The surgeons and nurses at various points had said “we’ll keep you in if there are any problems” – so of course the fact they didn’t come to discharge me made me worry – what is the problem? I’m not sure there was much of one. My blood pressure was low for a while. But in honesty being in hospital reassured me – I’d rather have been there if anything went wrong, than at home. Though of course hospital has its own risks.

Such as infection – and it emerged after a few days back at my parents that I seemed to have an infection, which a nurse gave me antibiotics for, along with some exciting pain killers which were more fun than the ibuprofen I had been coping with. However a couple of days later I had a strange turn, where I nearly passed out and was weak and faint – and was taken to A&E in an ambulance.  We were (I was) worried about sepsis of course. The paramedic had enough doubt to warrant taking me in, so I don’t feel too guilty. But several hours and many tests later, we were no wiser.  They eventually rolled out the anxiety card, and I felt all round stupid. I dread to think what was really in the minds of my parents and husband that I had put through all manner of worry.

I know – I really, really, know – that anxiety manifests in very physical ways. I’ve been there before. But part of me always worries that if I don’t take it seriously, one day I will regret it – that twinge was not the result of too much stress and too little sleep, rather it was the beginning of a heart attack. Or that if I do take it seriously, and go to the doctor with it – they just check my record, see my mental health issues, and assign everything down to that.

Anyway. Of course there was anxiety there. But I am not convinced that was the whole story. Low blood sugar perhaps, which responded to the adrenaline of the ambulance ride. In any case I stopped taking the fun pain killers. Finished my antibiotics, and finally went home after a couple of weeks with my parents. Home where I was on my own most of the time, on top of my mountain, worrying about what I would do if I had another funny turn.

I read everything I could. My husband and mother told me not to, told me that was what was causing my worry. But if anything it was the opposite. I was ruling things out. Trying to find out if there was anything I could do to help myself.  Blood sugar, for instance. I have never been diagnosed as diabetic – but I am overweight and it would never be a surprise. And surgery can do funny things to a body. So I got myself a blood sugar monitor, and checked myself at various times, feeling well, or feeling ill – to see what was going on in my veins at those moments. At first I thought i’d cracked it. A day of feeling weird coupled with low/high readings at the key moments. But then followed the rest of the month, of pretty much normal readings regardless of how I felt, or what I did or ate.

So it at least answered that question. And meant I could stop worrying about that for the time being.

And over time – I started to think less about it. Worry less at every sweaty brow or wave of nausea. Dealing with the day to day practicalities of the physical pain and temporary disability caused by my surgical scar – began to override my preoccupation with imminent death from some cause or other. Along with the physical inability came brain fog, tiredness, weakness. So time ticked by, and I became more and more aware of the housework I was not doing. The walks I was not going on, the book I was not writing. And so my mood begins to slip.

Long term pain and disability are risk factors for developing depression – it’s hard to stay positive sometimes when your usual coping mechanisms, leisure activities, or even work – to give you self esteem – , are out of reach.  So I was kind to myself. Did what I could. Tried to enjoy my enforced rest. After all – how much would I have loved unlimited netflix time back when I was in the depths of the darkest days of my job?

Over time, I could walk a bit further, do a bit more. And I started to plan again. Swimming. Driving lessons. Walking a few miles.

And then I fell down my garden steps and nearly (well, hopefully only nearly) broke my leg.

Fate chuckling behind the door.  If fate is my cat, who I was trying to keep inside when I lost my footing.

So I was back where I started. Only this time in A&E and not day surgery. Worrying that they didn’t stitch it. That they haven’t x-rayed it. Was it going to fall off? Would I need amputation…  (seriously. )  A few days later I couldn’t put weight on it and worried even more that it might be broken, but the doctor says no. Without even examining it. It just doesn’t reassure, but I have to make myself believe he’s right.  I have seen the nurse so often to dress the wound I’m wondering if I should be buying him an engagement ring.  But it’s mending. An unfortunate touch of Ear/Nose/Throat infection or irritation keeps making me think I have tetanus, despite having had the shot.  I lie awake in the night in a sweat, repeating to myself – you’re alright. You’re not about to die. You’ll be fine. I flash back to the strange extended moment of the fall, the realisation this isn’t going to be good, somehow positioning so as not to smash my face into the floor.  I flash back to the surgery.

It makes a change. I used to lie awake obsessing over death. Now at least it is the tremendous difficulty of staying alive… I make small steps towards pushing it out of my mind and living more in the moment. But then with this dodgy leg, small steps are all I can manage.

British Summer Time

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I suppose we are still technically in spring, not that the seasons seem to be following in any logical progression at the moment.  Today the weather is pretty mild, a bit grey, but bright and not too cold. Showers are predicted. It rained all night I think.  At the weekend, it was blistering sunshine, mid 20s, beautiful. A week ago I was snowed in, up on my pennine. Throw in some thunderstorms and I might think the weather gods were taking their cues from my moods.

We each have our own weather systems. Wouldn’t it be nice if each morning we were given a mood report by a smiley and overly enthusiastic type.

“Today will be mainly bright with spots of apathy, with a deep depression setting in just after that meeting with your boss. Overnight anxieties will increase the risk of this depression continuing late into tomorrow morning, but phonecalls from friends in the west could counteract this and lead to better prospects for the afternoon.”

Somewhere in Norway there is a town which apparently has more days of rain per year than any other place in the world. They have a saying there, that there is no such thing as bad weather, only the wrong clothes. I see their point, though I’m not sure there’s such a thing as appropriate protective clothing for a tornado. Unless you count a deep, dark shelter.  Moods are similar. There are always those events and moments where there is nothing much you can do but close your eyes and hold on tight and hope you come out of the other side. But for the most part, we can do some amount of preparation to try and reduce the negative impacts of either rain or shine. (Sitting here with a sunburnt chest, I acknowledge even the sunniest of days needs to be handled with care sometimes)

Learning about our moods, why and how they develop, can help to prepare us for what might be ahead. We can become our own weather report. Knowing our triggers, acknowledging the things which contribute to changes in our mood. If I have been very busy all week, with a lot of travelling and interaction with people, requiring me to appear confident and outgoing – then I know that will take a lot out of me and I will likely be tired, depressed and irritable at the weekend. If I push myself and try to do more socialising, thinking I need to play hard if I’m working hard – then I run the risk of a serious crash, a melt down, with the feelings of being overwhelmed leading to worthlessness, self doubt and hatred, urge to hurt myself and despair or sucidal thoughts. Or – I might skip over that, and work myself up into hypomania, which has its own dangers, to my pocket, my liver, my marriage, – and in the end only postpones the crash for a while.

So instead I know I need to rest hard, not play hard, to be safe in those circumstances. I need to do low key activities I enjoy. Take a stroll if I don’t want to stay in. Stay off the booze, but be kind to myself. I’ve worked hard, gone out of my comfort zone, I need to recharge my batteries.

Maybe medication might be the umbrella you require to weather a storm. Maybe talking or exercise will help you through a thick fog. Maybe mindfulness will help you to enjoy a sunny day without risking your skin.  But with a good weather report, and the appropriate gear, it can be possible to keep relatively safe and warm.  You just have to find some waders that fit.

When life spills over the edge – can you help?

FEMA - 42051 - Flood Warning Sign in Flooded Georgia Area

I mentioned a few posts ago how the Stress Bucket is an easy analogy for how we deal with the pressures of life – and how when things get too much, and our usual coping mecanisms cease to be a match for our concerns, that this can lead us to develop emotional / mental health issues. We are not machines, and life throws things at us that we don’t always know how to deal with very well.

Sadly a lot of people may well be experiencing that overspill in the coming months –  widespread flooding across the North of the United Kingdom has devastated lives, homes, businesses. People are still cleaning up, throwing out years worth of possessions and irreplaceable mementoes, wondering where on earth the money will come from to replace even the more mundane things like microwaves and kettles.

I live in Hebden Bridge and have been fortunate that my house is not affected – but my home, my town, most certainly has. The good news is that we have seen the most amazing evidence of the goodness of humanity – people helping eachother to clean up, everyone banding together. Volunteers travelling from near and far, donations pouring in – individuals and organisations and companies are doing a lot to ensure that things are put right as quickly as possible. I have a lot of hope that some minds have been changed, and eyes opened by the sheer generosity and kindness which has been shown by diverse communities from across the country in this little valley.

Hopefully, that evidence of love and kinship will help people in more than just the practical ways. But in the weeks and months to come, people will start to be impacted by the trauma they have experienced. The exhaustion of the effort they have had to put in to get their homes dry, stay fed, keep themselved and their families safe – it will creep up on people and affect them in ways they may not expect.

It is perfectly understandable, and natural, that this should be so. And that each rainfall will bring unease (indeed we know there is always a risk of the waters rising again – our last disaster brought two floods in one month). So it is vital that people recognise that their emotions, their mental health deserve as much care as their physical health, and that they seek help if they are struggling – in the same way they would seek help if they start to vomit / get toilet trouble that may come as a result of being in contact with the polluted flood waters.

There are numerous avenues to support – (I list here those that I know for Calderdale, your GP should be able to help you find local help, or look on the Mind website)

Your GP can refer you to counselling and other talking therapies as well as discussing whether any other options (medication) might help in your circumstances

  • Noah’s Ark has a self-referral service – 01422 300457
  • Healthy Minds provides peer-led wellbeing groups in Sowerby Bridge – 01422 345154
  • Calderdale Talking Therapies (Insight Healthcare) offers psychological support for adults registered with a Calderdale GP; this is a self-referral service – 0300 555 0191
  • SANE mental health charity has a helpline – 0845 767 8000
  • The Samaritans – Call: 116 123 or email jo@samaritans.org

If you work for a large organisation, you may find that you can access counselling or other advice services through an Employee Assistance Provider – or if you are in a union they also often have provision – including financial /legal advice which may help with practical concerns.

I would like to do what I can to help – so I am looking at what I can do to run some Mental Health First Aid courses in the area, hopefully at reduced rates or for free if I can find support to cover costs. This course will raise awareness about mental health, some of the more common diagnoses – how to understand and recognise symptoms, and give a simple method for offering support to others as well as looking after your own wellbeing.

I think it would be particularly useful for those of us in the community who wish to support our friends and families – who perhaps know people they think might struggle to accept mental health difficulties in themselves and so not seek help when they need it.

If there are any unaffected organisations / companies our there who are interested in training for their staff (this is highly useful as stress and mental health are leading causes of sickness absence) – If you are able to book paid places I could offer an equal number of free places to the community. Similarly if anyone could offer an appropriate venue for the training I will be able to offer two more free places. Please get in touch if you wish to work with me in making this training available across Calderdale.

If you would like to offer finanical, or other forms of support, I have collated a list of links here on my other blog:

https://thewillowtwisted.wordpress.com/2016/01/03/hope-floats/

Making a difference – MHFA at Leeds Mencap

dsc_2573_22389755988_oIt dawned on me with some surprise that I’ve been an MHFA trainer for over two years now – I’ve run around 18 courses I think, in Leeds, London, Burnley. I’ve had three different co-trainers, and also run some sessions alone.  Varying sized groups, each one different and with its own unique discussions and lessons to learn. But all have been in the same context – within my “day-job” employer.

Mental health is one of the leading causes of sickness absence, and of disability related unemployment. A lack of understanding of mental health issues in employers can make life very difficult for those of us who are trying to stay in work while managing our conditions. So I do not underplay the value of delivering MHFA in the workplace. Absolutely not – I doubt I would have held on to my job at certain points in the past few years had my employer not accepted their duty to make reasonable adjustments, and my managers worked with me to find out what helped me to keep delivering as they expected.

However, it can’t be denied that it is somewhat of a “safe” environment. A) a lot of our staff have perhaps a higher level of awareness of health issues, as that is the area we work in, and B) – if you go for a course in your own workplace, you are still very much in a work mindset, there is probably a consciousness than anything you might say might get back to your manager – or indeed you might be sharing the room with others who you might work with. There will inevitably be some element of holding back.

So – it was with some nervousness, as well as excitement that I arrived at Mencap Leeds to deliver my first freelance MHFA course “in the wild” – or out in the community. I knew that it would be different, and I was keen to find out how.

My co-trainer Sam had done the hard work of organising and advertising, so all I had to do was turn up, set up and bring my training mojo.

We had a full room, 16 trainees, from a variety of organisations. An interesting mix – from a law firm, construction company, local council, recruitment, charities and individual participants. A good group from the local Nigerian community so some ethnic diversity, though sadly only one man in the group (it really would be nice to get more men along.)

There was some practical / logistical learning for Sam and I – the group was a bit more prone to discussions amongst themselves, and the use of workbooks meant they could see ahead of time some of the exercises which benefited from the element of surprise – so we will need to learn to be a bit more “teacherly” and keep things more under control in future.

We had some excellent discussions – it is always a challenge to fit all the content in and still have the chance to share some  of the thoughts and experiences we each bring to the session, but it is I think where a lot of the real learning and changing goes on. We had people with personal experience, and who developed new understanding about people in their lives.

One aspect that particularly stood out for people was the number of men who die through suicide. Some of you may have seen recent campaigns aimed at raising awareness of mental health issues in men – getting people to realise there is nothing unmanly or wrong about talking about your emotions, admitting you are having a hard time, asking for help. It is a huge problem – and one which is even more pronounced in cultures, or sections of society which have more exagerrated or strongly deliniated gender roles.

Of 6,233 suicides in the UK in 2013, 4,858 or nearly 78% were men. And if anything we know this is under-reporting. For a variety of reasons some suicides will end up being coded as misadventure, accident or other reasons. Suicide in general is a major public health issue – it kills many more people than die on our roads. Most people who take their own lives have not been in touch with mental health services in the year previously, which suggests there is a major opportunity to help prevent these deaths – if we can help people to feel able to admit they are struggling, and talk about things with friends – then hopefully we can help them to seek help, and find the hope they need to hold on.

We also discussed the challenges faced in trying to increase understanding in some cultures where mental health is viewed in a very different way. It is difficult to manage our own frustration, disagreement, even anger, when faced with someone who, for instance, might see mental health problems as a sign of possession by demons, or even evil – but simply shouting over or dismissing another person’s belief is unlikely to help anyone. Even in our own country and society there is plenty of stigma and misunderstanding, and many people who would rather turn their back on people with severe mental health problems, or view people as lazy or weak, than take the time to understand psychosis or appreciate the impact of depression and anxiety. It’s not long since the standard approach to someone who experienced extreme distress, or detatchment from reality was to lock them away and forget about them. We can hardly be surprised that there are places in the world where this still stands (or is perhaps the best someone can expect). Our job is to keep trying to educate, and help people to understand mental health as a normal spectrum of experience – how this can develop and also that it can be helped.

At some point in the afternoon I realised – or more accurately, remembered, the importance of the work we do. That it is bigger than ensuring your manager understands to help you manage your stress levels and gives you the adjustments you need (though these are important in their own way) – but actually at root, the reason I teach MHFA, and strive to raise awareness and understanding of Mental Health – is that this is a life or death issue.

I have been on the brink of death. Though it is many years since I did anything about it, I have wanted to die. And I am sure I would have taken that step had I not learned some of the things which keep me hopeful, which help me remember that the clouds will pass.  But I did get help, I continue to find ways of coping with life and the muddle of emotions that sweep me this way and that. I can even control them more than I ever thought possible. Helping more people to understand that this is not something someone pretends for fun, or attention, but a very real and painful illness – is so very important.

And as we help to keep people alive, we must also help them live, build lives, families, relationships, have jobs, dreams and desires. Because we all deserve to be happy and fulfilled, and I am confident that with the right support and understanding, we can.

If you’d like to come along and learn how you can help make a difference, we’re running another session in February – you can book on Eventbrite, here:

http://www.eventbrite.co.uk/e/mental-health-first-aid-standard-course-tickets-19277083275?aff=erelexpsim

 

All things to all men

MHFA logo

I keep saying to myself that I will do a bit of a reflective wash up after each course – to think about what I have learnt, what went well, what didn’t, what could be improved. So. Here I go.

I just ran a course on the 19th & 20th August – in my workplace. Slightly larger group than I have done before mostly, thanks to being able to get one of the larger “board” rooms which are usually occupied by branch meetings, large video conferences, or appearances by our senior management. Another thing that differed from usual was that it was two consecutive days. Feedback in the past has been that people find it hard enough to get one day away from the office in a week, let alone two – but August is a quieter month for some, and as my co-trainer was travelling from London it was more convenient for them to do it in one chunk.  After all, that is how the course is designed to be delivered – though it does feel quite intensive, and very tiring.

So – logistics wise. The room itself was a bit strange. It is large – the left hand side of the room has a big screen, which had rows of chairs laid out infront, theatre style – (and a smaller screen behind them); the right hand side of the room has a large board room set up, table with chairs around.  This presented a bit of a dilemma, as we needed trainees to see the screen for the presentations and videos, but the table area was more appropriate for group exercises, and general discussions. I initially intended to stick with the theatre arrangement, and move over to the tables for the exercises, but I could tell it wasn’t really working. People weren’t talking to eachother as much as usual, they were a bit closed off, – and not surprising as they were sat with their backs to others. So we decided to switch things around at lunchtime, and moved the tables over so people sat around – but could still see the screen.

We (the trainers) were happier with this. The group did seem to open up and gel a bit more then. However the table layout was mentioned negatively in some feedback, as it meant looking at the screen side on. I guess you can’t please them all – everyone has their own preferences. I still think I would do the same, as I don’t think we would have got the same development in the room had we stayed in neat little rows.

The room was relatively well air conditioned – with opening windows (like hens teeth in our building) – which again, was great for the trainers, who were overheating, but some people found it cold. On balance, having been in overpopulated tiny rooms that turn into saunas – I think it preferable, but I wonder is there a middle ground to be had anywhere in the building. All of the rooms make you feel like Goldilocks – this one is too hot, this one too cold, this one is too small, this one too big…  We can only work with the resources we have.

I had been a little concerned about the slightly larger group, wondering if I woud be able to keep control, if discussions would go on longer than we had time for, etc. but it was alright. In the end we still had three spaces below maximum, and it worked pretty well. Had there been more “talkative” attendees it might have been different but there was a balance really of the quieter and the “loquacious”.

Content wise – I will be honest and say it wasn’t my most successful session. We still got good feedback, but sometimes I come away feeling like people have really benefited / enjoyed / learned / bonded. Not so much this time. And I think it comes back to the issue of trying to be all things to all men. The people there were wanting quite different things, I think – some of them got what they were looking for, some of them maybe didn’t.

What is the course for, after all? We aim to raise awareness of mental health issues, challenge stigma, educate about symptoms and treatment, and give people some skills to use in offering first aid for people in mental health crisis situations. There is applicability in a work setting, and it is discussed, but it is a very holistic view. What you get out of it comes down to a number of factors – what is your level of understanding about mental health when you come in, what are your expectations, and can you empathise with what you are being shown? Everyone has different learning styles, so there are different kinds of content: statistics, images, video, group exercises, personal reflection. Different people in the same group will find different aspects more or less useful. Personal anecdotes and background discussion add depth to the content – but sometimes people want more.

The course is very recovery focussed, because that is the most important message. It is about giving people with Mental Health issues hope – because for the vast majority, recovery is possible, with the correct treatment and/or support. It is also about letting everyone know that recovery is possible, and that consigning people with Mental Health problems to the rubbish heap of life is not only wrong on a personal and moral level, but also a massive waste. Friends and family need to know that they can play an enormous role in helping someone recover, employers need to know that if they support a member of staff with mental health issues they will remember, and could be repaying that investment and belief for years to come, once they come through the other side. For there is another side, for an awful lot of people.

That being said, some people comment that they don’t get a real feel for exactly what some of the people talking about different issues in the videos were feeling before they reached the stage of recovery they are in. Sometimes we talk in euphemisms, which mean a great deal to someone else who has experienced a feeling, but nothing to someone who hasn’t. Perhaps there is a need for a little more bluntness.  But then – I don’t really want other people to understand how I feel. I wouldn’t wish that on them, if they didn’t need to. What I do want, is for them to take my word for it that it is as bad as I make out, and not assume I am faking / exaggerating / weak.

There is a note of caution in this kind of work – just as best practice reporting on suicide does not give details about the methods used, lest it encourage others to follow suit, – we don’t want to trigger worsening of individuals conditions by dwelling on the dark details. But sometimes it might be important to describe more clearly the way we feel and thing in our worst moments, to those who only ever see us when we are well.

We had a couple of more senior people in this group – which was interesting, they seemed more practically driven. How can I use this to support my staff, what does it mean. Which is heartening, as we certainly need to see managers thinking this way – and improving their understanding. However I think some of them were frustrated by the more basic elements of the course, feeling that what they needed to get out of it could be done in a shorter time, in a more directive way. But – MHFA doesn’t assume any basic level of knowledge, and it is not just for managers, or people with a good grounding in health already. Part of the important learning for me is about self reflection, and sharing amongst the group – and that only comes with time.

Which brings me back to the two consecutive days – it has its benefits – a good focus, perhaps. However I do think that a little gap in between, ideally including a weekend, gives time for processing, absorbing, discussing – and somehow makes for a more satisfying experience. Which is an interesting thing for me, as I always kind of wanted to be able to do it as originally intended. I don’t know. There’s also the issue of feeling rushed, and like people want to be back at their desks – which is inherent in a) being in the same building as said desks, and b) not being external trainers.

I only flicked briefly through the feedback, which was mostly good. some people rating my co-trainer better than I, some vice versa – only natural as I say – we will all have preferences, and relate more to one person’s style than another.  I don’t think I was at my best, but I’m my own worst critic – so long as other people are happy I will have to take their word for it.

My next training will be in Hebden Bridge, on 19th / 26th September – if this goes ahead. I currently don’t have sufficent bookings, so if you are interested do get in touch as soon as possible as I have to cancel in early September or I have to pay for the room anyway! If these dates are no good for you please also get in touch as I will be looking to plan something else in Calderdale soon.