Autumn magazine final by Mersey Care NHS Foundation Trust

MAGAZINE

Autumn 2015

Your Future Your Way Feeling Stressed?

Seeing the Whole Person

Beating the Winter Blues

YOUR COMPLIMENTARY COPY

Making a Stand

One suicide is too many. Read all about our public commitment to having no suicides among our services users by 2020.

22 Young Hearts

Our mythbuster will tell you if you’re at risk of getting flu this autumn. If so get your jab early and protect yourself and your family.

What’s life like for a young carer? We look at a project that supports young people whose life includes looking after a parent with a mental health issue.

Autumn... take time to watch the leaves turn

A Day in the Life

Our new series lets Mersey Care people take you along - onto wards and into their communities.

inside... Welcome 3

Searching Safely

Your Future, Your Way

Speaking Out?

Zero Zone

Were Recruiting

Young Hearts

Score! 30

Beating the Winter Blues

Feeling Stressed?

Making a Stand

A Day in the Life

Flu Myth Busters

What’s On

Seeing the Whole Person

Self Help Guides

MC magazine team: Managing Editor: Steve Murphy Editor: Jackie Rankin

Facts about Flu

Contributors: Myles Hodgson, Natalie Dunn, Graham Hignett Editorial: Joanne Cunningham, Julie Crompton Photography: Joel Goodman, Steve Murphy, Rick Gem Design: Jo Hadfield

Searching Safely

Where should young people go for online mental health advice?

You can contact us at: communications@merseycare.nhs.uk

Autumn brings opportunities for the whole community to join together to stamp out the stigma associated with mental health. We asked people ‘how far are you prepared to go and by the time this edition hits the streets many of you will have joined us for our ‘Talk Walk’ 5k walk around Aintree Racecourse. We will also have joined with our partners in Liverpool to celebrate World Mental Health Day. In this edition we follow a day in the life of Dr Stephen O’Brien, a consultant

psychiatrist at our new Clock View hospital. We have achieved some great things with the therapeutic environment at Clock View and it has already been shortlisted for several national design and art awards. The latest addition here is Imago, a statue created from worn copper. It is a beautiful object that will hopefully prompt people to stop, take notice and reflect upon. You will also find features on the importance of recovery, the role that young carers play and more details on our newly announced policy to work towards no more suicides. Let’s not forget staff are the lifeblood of the NHS and we rely on their dedication and commitment to quality on so many levels. We have many long serving members of staff here at Mersey Care and I’d like to pay tribute to all those celebrating significant anniversaries in

the NHS, including my own personal assistant Sharron Morgan who has given 40 years service. Thank you all.

Beatrice Fraenkel, Chairman, Mersey Care NHS Trust

“We have achieved some great things with the therapeutic environment at Clock View”

The Imago statue

Your Future Your Way A close up look at Mersey Care’s new look Recovery College, why it’s different and what it can offer.

“Imagine a college where courses are geared around helping you to enjoy a better quality of life after a mental illness.”

Many of us have been in the situation whereby we or someone we know has received excellent health care. But recovery from a mental illness often also requires help with social care – such as helping a person get back into the community, managing relationships and providing protection for some from vulnerable situations. Imagine a college where courses are geared around helping you to enjoy a better quality of life after a mental illness; where course content is based on students’ own experiences and the ‘campus’ is a library or a fire station.

New programme The college has been re-launched with a whole new programme of courses and activities and is open to anyone whose lives are touched by a mental health condition, an addiction or learning disability. If you’ve lived with or recovered from a mental illness, or been a carer, you become an expert. We harness that expertise to help us to design and deliver the courses; it’s called co-production and it’s pivotal to ensuring a quality, effective service worthy of the people who will use the college.

Because we aim to reduce the stigma of mental health in communities, courses are run in community venues across Merseyside – the hub is Walton library, This is Mersey Care’s Recovery College, but we’re using other venues, including not a college in the traditional sense of local fire stations! The College has also the word, but a place where courses, been adapted for people while they learning programmes and activities are are inpatients at our hospitals, including designed around you, to help you those in secure care. recognise, develop and make the most • read what some of our students of your skills and achieve what you say on page 6. want in your life.

For more details and to download a prospectus go to merseycare.nhs.uk/about-us/our-recovery-programme/ mersey-care-recovery-college

Why does an NHS Trust run a college? “When we think about the NHS many of us think first of hospitals, doctors and nurses, sickness and disease. In mental health services the notion of Recovery turns all of that on its head and challenges us simply to think about human beings who have real needs and real lives. Experiences of mental illness really can provide opportunities for change, reflection and discovery of new values, skills and interests that help you build your future your way.

Experiences of mental illness really can provide opportunities for change. The Recovery College doesn’t wave a magic wand but instead it starts with you, your life, your needs, your aspirations, then and through a range of learning experiences, enables you to find new hope and opportunity.” Michael Crilly, Director of Social Inclusion and Participation.

Phil

I’m in a Better Place

Morgan

Hayley

and then being useless for my mum. I’m able to take a step back and look at myself in a better light.

college straight away, it’s given me back the confidence that I completely lost. My way of dealing with the huge It’s tapped me back into what I used to amount of stress in my life was to do in my commercial professional life, snort huge quantities of cocaine, stick I’ve always been very harsh and people valuing my opinions and what as much alcohol down my head as I negative about myself; I’m learning I think. I suffer from social anxiety but could and hope that nobody realised how to be more positive and kind. I in a group setting or in something that I was a fraud. I had vast self see that I’m not an abject failure, I’m that I know something about then I will hatred, feeling like I was a burden to not a monster and I do have value talk and get involved. It’s empowering everyone; too scared to actually live a and worth. hearing people take on board what I life and too scared to commit suicide. People have pointed out qualities that have to say. I got sick of being sick and nobody I didn’t realise I had and without that There are courses on anxiety else was going to fix me. I knew I kind of support and help I don’t know management and depression and had to look at myself, find out what where I would be. I never thought reading clubs where you read a section I needed to change and take steps I’d say it but the recovery college is of the book or a poem and dissect to do that to have some quality of actually something I’d like to be more it. There’s a facilitator there but the life. Now I’m in a much better place, involved in - when I started there that ethos is very much getting people to I don’t drink anymore and I don’t do wasn’t on my mind but it is now. learn from each other and discussing drugs anymore. My mum has dementia Phil things. so I’m able to look after somebody else as well as look after myself a little I had zero self confidence; it’s somewhere bit better. where you can find your own voice I’ve been looking at my confidence building and trying to be a little more assertive. That helps me get some time for myself so I don’t end up moving backwards, getting really ill again

I had zero confidence

I’d had anxiety attacks and I spent a long time looking for something that would tackle the cause. I loved the

again. It’s given me the opportunity to reflect on what I actually want, what will make me happy and what I’m capable of doing.

Morgan

“It’s given me the opportunity to reflect on what I actually want, what will make me happy and what I’m capable of doing...” Morgan

Beth

I’ve learned not to be ashamed

my skills from my previous job and I needed to do something outside the family.

I have Emotionally Unstable Personality Disorder, which means I find it harder to familiarise myself with my emotions. I have to know in my head how something is going to be - if it changes and I feel different emotions to what I was expecting, I feel confused and upset.

It has changed my life. Through the volunteering and training courses I’ve got hope again, and a chance to use my experience to help others.

I’m always telling people about the recovery college, It’s helped me massively because it’s given me the confidence I need to go and speak to family and friends and tell them I’m suffering with mental health issues. I can tell them what I need and how they can help me. It’s also helped me get back into my job and I’ve learnt not to be ashamed.

I’ve got hope again I was a senior lecturer in education but gave up my job when my husband had a brain tumour. At the same time my parents in law became ill with mental health problems.

People feel like they have lost confidence and the control of their lives and the recovery college helps them recognise their skills and abilities. It could be learning more about their health condition but it opens up opportunities that they didn’t have before. Some people just need a reason to get up in the morning and the Recovery College can be that routine. Many people who come have made strong friendships and meet outside the college.

It’s given me hope and opportunities that I didn’t know were there, it’s I go to Journeys through Film; we reminded me of what I can offer and meet every month at FACT and pick it’s given me new skills and opportunities a film that highlights mental health. that I was never aware of. You just Afterwards we group together and I became depressed. I’d lost my status don’t know by taking that first step discuss how we perceived the film and my pay. I got to the point where how much your life can improve. and whether we can relate to certain I didn’t feel like I had anything, all aspects. Beth my achievements where behind me Don’t be afraid to go - you are with and now I was struggling financially people who are sharing your story. I’m and being a carer. I used to drink too feeling good; I know where I’m going much and eventually ended up seeing and know how to move forward with alcohol services. I became a volunteer support. You get to know the staff with Mersey Care on the recovery and build a relationship with them… forums working with people with it’s a brilliant service. drugs and alcohol issues and I found that very positive because I was using

Hayley

Sean

“I know how it feels to be alone with your thoughts and feeling that there’s no one who can help you...” Sean

A recovery road less travelled Ashley Power (right) has had an eventful year; he moved into a flat, met his future wife, went on his first holiday abroad in many years and visited his dad in China. Each is a milestone in his often arduous journey towards recovery.

It’s got me reading which I always loved

The Recovery College was a vehicle to gain training, education, develop my confidence and a career pathway. Not just in terms of employment but I know how it feels to be alone with your thoughts and feeling that there’s in structure and belief in myself that I had something to offer other people. no one who can help you. I’ve been The course content is developed by involved with Mersey Care now for people who have lived experience eight years. I had a breakdown and of that issue. When you find yourself I was diagnosed with psychosis and in the room with other service users with bipolar disorder and I was with the same experiences as you, sectioned into Broadoak Unit. It’s you get really close to them, you been an up and down process; I learn that you’re no longer alone, couldn’t even concentrate to read a letter or paragraph in the newspaper. which puts you at ease. There’s no pressure to talk about your There was a reading course which experiences but you will end up I went to and really enjoyed. A few actually wanting to because other months later I was co-facilitating the people are. It brings people together. course, it’s got me reading everyday which is what I have always loved doing. Sean

Six years ago Ashley was a patient at Ashworth High Secure Hospital. He tells about a life that had revolved around extreme self harm and a string of prison sentences. And he recalls the support that has seen him move along a path to recovery and out of secure services altogether. “The first time I can remember self harming I was 12 years old; I’d been at boarding school and had difficulties there. It was only superficial, I’d make scratches and pinch myself with nail clippers until it bled.

Escapism I went to jail at 15 and started self harming more seriously; partly for escapism, but because I had learnt that I could use it as a manipulation tool.

Ashley

“The first time I can remember self harming I was 12 years old...” Ashley

My dad was living overseas due to work commitments and when I wanted to talk to him on the phone I’d harm myself until a phone call could be facilitated. If I ran out of cigarettes I’d self harm until the staff gave me a smoker’s pack.

he started to cry; it was the first time I had heard my dad cry. When I got back I told my doctors that I saw self harming as an addiction and I needed help.

They worked with me to devise a mood ratings scale - I would say how I was feeling and what input I Over various prison sentences my would require from staff. This started self harm increased and evolved to to work and I was moved onto a low cutting, burning, swallowing items for example, glass, razors and chewed dependency ward. My primary nurse was fantastic and the ward manager batteries; I’d insert items into cuts, was always so helpful and supportive tried to contaminate wounds. I bit a chunk from my arm – that was what to me. I started to work a lot more closely with my psychologist Dr led to my admission to Ashworth – Jennifer Kilcoyne. With the help of the self injurious behaviours I was these people and many others my exhibiting couldn’t be managed in any other setting other than maximum self injurious behaviours started to disappear. security. My doctor told me that if I could refrain from self harming for a year he would get me moved to somewhere of lower security and closer to home; but I carried on. I stole batteries from the ward clock, bit them in half and swallowed them. A third of my bowel had to be removed from the battery burns.

I started doing various courses in woodwork, catering and graphics. My escorted leave gave me something to look forward to each month. I abstained from self harm and was able to move to Caswell Clinic in Bridgend, South Wales. After a year of hard work there it was decided I could move to an open unit and a year later on I moved into my own flat.

Turning point

I found a job, things were going very well until I had to go into hospital for an operation on a hernia. The morphine I was prescribed reacted badly to

The turning point came when I had a phone call in hospital from my dad -

clozapine and a drug I was on for ADHD was making me gain weight so I stupidly decided to come off it. When it came to having a blood test I knew my nurse would know I’d not taken it. I absconded to Ireland - but after three weeks I decided to go back and face the music - I couldn’t be on the run for ever. I had to prove myself once again, building up my community leave, finally being granted discharge and moving into a shared house, then a flat. I am currently employed by Ashworth Hospital, Rampton Hospital and Cygnet Hospitals as an expert by experience and I’m going to be a judge at the National Service User Awards next year. The best news yet is that my tribunal for absolute discharge is to be heard soon. I’ve moved in with my girlfriend Georgie. She’s is now my fiancée, and the wedding’s set for next October – we’ve even booked the venue, Llangoed Hall near Brecon – she’s made my dreams come true!

Ashley

DON’T LOOK BACK

YOU’RE NOT GOING THAT WAY

At the Recovery College everything is designed to help you discover and accept who you are and to learn to live with yourself and relate to others in healthier and 10

happier ways. So don’t look back, look forward to recovery. Let the Recovery College point you in the right direction.

THE MERSEY CARE RECOVERY COLLEGE Your Future, Your Way

For more details and to download a prospectus go to merseycare.nhs.uk/about-us/our-recovery-programme/mersey-care-recovery-college

THIS IS A

ZERO ZONE.

TOGETHER WE CAN PREVENT VIOLENT, THREATENING OR ABUSIVE BEHAVIOUR.

Let’s work together in giving the green light to positive behaviour. “Staff side and the Trust have worked hard together to develop this campaign. We work in a challenging environment and everyone has the right to feel safe. Zero Hero helps people who are cared for by us, work for us or come into contact with us, know what is expected from them and that they will be supported to become Zero Heroes. And more importantly our staff and service users will know they have the full support of the trust when behaviour falls below what’s expected.” Amanda Gregory, Staff Side Chair.

If you want to learn to control your anger before it controls you, help is at hand. If you are a service user talk to a member of staff. If you are a member of staff talk to your manager or to someone from staff support services. Please remember that we will prosecute people who are violent, threatening or abusive.

ZERO HERO Our Zero Hero campaign encourages service users, their relatives, staff and visitors to be Zero Heroes; to find an alternative to aggressive behaviour in all its forms. In an environment where they will feel safe and secure and be treated with dignity and respect.

“It’s not until you get older that you realise you’re not in the same situation as everyone else” Katie

Young Hearts When someone encounters mental health problems the role of carer often falls to a family member. But what happens when that person is a child or teenager? Three young carers tell us about their lives and we look at a project that is helping them cope and thrive.

Jamie Fifteen year old Jamie cares for her mum who has mental health issues. 12

She finds it hard to ask for help and it’s often the people around her who notice a change. “The school or one of the youth workers contact Barnardo’s when they notice a change in me. I have very understanding friends and they help me whenever possible. They

stick by me and understand if I can’t go out with them.” Still Jamie is frustrated when teachers ask her to stay behind for study. “That’s what annoys me the most, people not understanding why you can’t stay, or why you haven’t finished your home work or revision.”

Missing out on childhood There are 166,000 young carers in England. Their average age is 12 and they are looking after parents and family members with mental health problems, illness or a disability. These young people are not only coping with chores, they may be providing emotional and physical support for those around them.

young carers in the area rather than wait for them to come forward. They must also take into account the young carer’s education and future plans.

Mersey Care’s partnership working with Barnardo’s helps families where a parent with mental health problems is being cared for at home by their children. Its aim is to make sure children and young people don’t miss out on their child and teenage years because They often lag behind in school; carers of their caring role. between 16 and 18 are twice as likely Louise Wardale, Barnardo’s Keeping to not be in education, training or the Family in Mind Coordinator, is employment. passionate about making sure young Young carers often struggle to ask children and people get support and for help, afraid they are letting the can come together with others in a family member down. With so many similar position to take away the sense responsibilities, they invariably miss out of isolation. on opportunities to take time out and She said: “We developed Keeping the spend time with friends. Family in Mind to make sure children The Care Act and Children and Families and young carers are supported and Act which came into force earlier this listened to. It’s about making sure we year, strengthen the rights of young carers get support for the whole family so and their families by strengthening the that its works for all individual family right to assessment and support. Local members. authorities are now required to identify

Katie O Katie had to leave university to become full time carer for her mum who suffers from vascular dementia and needs 24-hour care. With the help and support of the Barnardo’s young adult carers services project, she has been able to arrange full time day care and is now starting a new course at university.

“These young people can so easily miss out on their childhood and youth because of the demands they face. The biggest feedback we get from our young carers is how essential it is that we see them as individuals with their own needs, and not just as carers.”

“I saw a Barnardo’s poster for young carers - but I never knew I fitted into that category. I’d say to people - if you know a young carer tell them what’s out there and don’t be afraid to ask for help.”

Katie F Katie first went shopping at six years old. But it was less of a novelty,

Where to turn Are you a young carer and need help? Do you know a young person caring for someone? • Action with Young Carers can be contacted on: 0151 708 7323 and email at youngcarers.liverpool@ barnardos.org.uk • Barnardo’s website: barnardos.org. uk/youngcarersnorthwest • You can listen to our three young carers talking to Adrian Chiles on our YouTube Channel MerseyCareNHSTrust.

more a necessity. She was by then carer to her mum who suffered from short term memory loss. She admits that she gets frustrated and irritated by her situation: “But if you’re down, she’s down, and if she’s down, you’re down, so you have to remember to be positive. “I wasn’t very aware that I was a young carer at that age. It’s not until you get older that you realise you’re not in the same situation as everyone else, up until then caring for your parent has been normal for you.”

BEATING THE

WINTER BLUES We know winterâ&#x20AC;&#x2122;s not far way when festive gift adverts dominate our TV screens, soap stars don their sequins, curtains get drawn earlier and heating is switched on.

Autumn days are often fresh and bright, but as the weather changes so can our mood. Why do dull days and dark nights make us feel down? Most scientists believe that the problem is related to the way the body responds to daylight, producing higher melatonin which causes lethargy and symptoms of depression.

There are lots of things you can try to beat the blues: Keep active

See the light

Research has shown that a daily one hour walk in the middle of the day could be as helpful as light treatment for coping with the winter blues.

Some people find light therapy effective for seasonal depression. One way to get light therapy at home in winter is to sit in front of a light box for up to two hours a day. Light boxes give out very bright light at least 10 times stronger than ordinary home and office lighting.

Get outside Go outdoors in natural daylight as much as possible, especially at midday and on brighter days. Inside your home, choose pale colours that reflect light from outside, and sit near windows whenever you can.

Keep warm If your symptoms are so bad that you can’t live a normal life, see your GP for medical help. Being cold makes you more depressed. It’s also been shown that staying warm can reduce the winter blues by half.

Take up a new hobby Keeping your mind active with a new interest seems to ward off symptoms of SAD, such as playing bridge, singing, knitting, joining a gym, keeping a journal, or writing a blog. The important thing is that you have something to look forward to and concentrate on.

Eat healthily

A healthy diet will boost your mood, give you more energy. Balance your Keep warm with hot drinks and hot craving for carbohydrates, such as food (you can get grants to warm your pasta and potatoes, with plenty of home.) Wear warm clothes and shoes, fresh fruit and vegetables. and aim to keep your home between 18C and 21C (or 64F and 70F degrees).

See your friends and family It’s been shown that socialising is good for your mental health and helps ward off the winter blues. Make an effort to keep in touch with people you care about and accept any invitations you get to social events, even if you only go for a little while.

“The important thing is that you have something to look forward to and concentrate on.”

FEELING

SAD? Leaving and returning home in the dark; this lack of daylight affects most of us, but if these changes are having a bigger impact on your mood maybe leading to symptoms of depression and sadness that can affect your day to day life you may be suffering from seasonal affective disorder (SAD). If your symptoms are so bad that you can’t live a normal life, see your GP for medical help. Talking treatments such as those offered by Talk Liverpool may help you cope with symptoms. You can self refer by calling Talk Liverpool on 0151 228 2300 or go online at talkliverpool.nhs.uk • SADA is a voluntary organisation that offers information and support to the public and health professionals: sada.org.uk/ • Hints and tips courtesy of NHS Choices website: nhs.uk www.nhs.uk/conditions/ stress-anxiety-depression/pages/ dealing-with-winter-blues-sad. aspx

MAKING A

STAND Since going public with its intention to adopt a zero suicide policy earlier this year, Mersey Care NHS Trust has received plenty of praise and admiration from fellow healthcare providers and in the wider community for their bold stance. Yet the commendable ambition will count for little unless it can be implemented successfully and tangible results are evident.

“If we can get the right set of actions in place we can reduce the number of people dying by suicide.”

What is driving it?

“Every time there is a suicide we need to find out what we could have done Launched earlier this month in to prevent it. We think there is evidence conjunction with Champs Public Health that things sometimes could be done Collaborative, Mersey Care’s policy is the that aren’t done. We have to start with result of years of analysis of methods that premise. It’s a brave thing to do and statistics to determine what works. and it’s difficult, but that’s a decision we There is also a real determination to have taken.” change the culture – the common public perception that suicide is inevitable will No blame culture not be tolerated within the organisation. There will be a greater emphasis on a no “We absolutely feel that, from all of our blame culture, encouraging people to knowledge, there is a lot more we can come forward and discuss incidents so do,” revealed Joe Rafferty, Mersey Care’s Mersey Care can be better prepared to chief executive. “There are many ways, prevent them in the future. we feel, where we can reduce the risk around people’s suicidal thinking. If we “That culture of no blame is a priority,” can get the right set of actions in place stressed Joe Rafferty. “It is not the same as no responsibility and no accountability, we can reduce the number of people which must of course exist to keep our dying by suicide because that, in the end, is the measurable thing – it is what services and patients safe, but it is about learning as an organisational principle will decide the success or failure of our desire to eliminate suicide in our care.” and is very much about levelling up - not ‘beating up.’ If we cannot talk openly Dr David Fearnley, Mersey Care’s Medical about incidents and how we can better Director, has emphasised the need for prevent them, we cannot learn and everyone within the organisation to be formulate better plans.” properly trained if the new policy is Staff have been involved in workshops going to be implemented properly. to embed the new policy into clinical “You may think in mental health services services with recent workshops discussing that everybody is highly qualified to Safety Plans, Post-Incident Reviews and talk about suicide and difficult subjects, Suicide Prevention Training. but that isn’t the case,” he explained. Rebeca Martinez, Associate Medical “People need to be trained, they need Director for suicide prevention, said: to practice, they need to get feedback and they need to know they are doing it “Staff response at the launch showed they are engaged with us in support effectively.

of suicide prevention. This is vital - the most important thing we will do as a mental health trust is to eliminate suicide in our care.” As part of the drive to change perceptions that suicide is inevitable, the trust organised a Big Brew Talk Walk, with people coming together to make a collective stand against the stigma surrounding mental health that often stops those with suicidal thoughts asking for help. The launch and the Talk Walk, however, are just two days of the year and, as Joe Rafferty has underlined, they are just 48 hours out of the year and that effort must be repeated for the other 363 days in the year if Mersey Care - and society in general - are to make tangible progress. Mersey Care shares the ethos of Professor Louis Appleby, Professor of Psychiatry at the University of Manchester and Chair of the National Suicide Prevention Strategy Advisory Group with the Department of Health. His research has been used extensively by the trust in developing our policy. While he is enthusiastic about Mersey Care’s approach, he has warned that it will not be an easy journey. “Suicide is a constantly changing phenomenon and we need to be constantly vigilant,” he said.

Our Zero Suicide Policy for example, providing high quality The foundations for the zero suicide policy evidence-based interventions at high are built on four key strands, with each one risk times as important as each other in changing the working culture within Mersey Care. • Competent Workforce – develop and The emphasis will be working better and implement a learning strategy across revising current practices rather than the whole organisation, including adding to already heavy current workloads. competency based suicide prevention training for all staff, and ensuring an • Service User and Partner Engagement – adequate staffing skill-mix. All staff will co-production of material and resources have mandatory Level One training, to aid self-care with service users and which will be introduced by the end of collaboration with primary care, October 2015, while all clinical staff will emergency department clinical teams have team-based Level Two training and wider health and social care partners to ensure effective joint • Research and Evaluation – standardised approach taken at critical risk points. post-incident reviews will collect, analyse Models of care will be co-designed to and disseminate data related to suicides make sure they fit with the needs of and near fatal suicide attempts to people that require our support optimise the learning from these incidents. Continual evaluation of • Safe and Effective Care and Treatment – existing practice, and our models of integrated community services, care, will ensure that improvements establishment of intensive care following can be made quickly. All learning from inpatient care and in times of crisis, suicides will be shared in an open, ensuring medicine safety, and restricting honest and constructive way. access to means and modification of other risk factors. This will concentrate on evidence based interventions so,

“The foundations of the zero suicide policy are built on four key strands ”

Campaigns such as ‘Switch on the Light’ are helping raise awareness about suicide

FACTS AND

FIGURES

• There are around 800,000 suicides a year worldwide • 6,233 suicides of people 15 or over were recorded in the UK in 2013, the last recorded figures • Suicide is the biggest killer for men under 50 in England and Wales, while for women suicide is the leading cause of death in the 20 to 34 age range • The highest rate of suicide is among men aged 45 to 59.

WHERE SHOULD I GO FOR

If you are having suicidal thoughts it is important to know you are not beyond help and you are not alone. There are several options to consider, including talking to a family member or a friend about how you are feeling. There are also several helplines: • Samaritans 08457 909 090 (open 24 hours) • Sane 08457 678 000 (open 6pm to11pm) • Mind Info Line 08457 660 163 (open Mon to Fri, 9am to 5pm). If you are already in touch with mental health services, you should contact your team immediately or visit your GP.

Paula’s Story

I had nothing to live for but drugs.

“I’ve been addicted to heroin and crack cocaine since I was 21. I never in a million years thought I’d still be here to tell my story.

daughter, who was 13, ran next door and when he walked in – we’ve become close phoned the police. It was surreal, like a film. again and I’ve still got him in my life today.

I had broken ribs, cuts and bruises, I was in pain. I’d thought about ending my life before but at that point I thought ‘if this is I became hooked after I met my partner. I visited him in prison and when he came all my life is going to be, I don’t want out he moved in with me and the kids. He to be here’. said he was clean but I knew he was still If someone feels bad enough to want to using drugs. I wanted to see what went take their own life they need someone to on in his head so when I tried it for the be there for them. I was lucky; I had the first time, I thought it wouldn’t get a grip police and the hospital staff and then of me - they say it can get you hooked the Mersey Care. I was taken straight from first time and I was. A&E to the Kevin White detoxification unit. My kids saw so much that they should never have seen, I’d take my daughter When I was about to be discharged I was shoplifting, she’d come with me to my still thinking about going back to him – I dealer. When my mum died my dad took had nowhere else to go and I thought he the kids but couldn’t handle me. I dropped loved me. Thankfully my support worker out. I wanted so much to give up but I took me to a mirror, showed me the didn’t know how. bruises and said ‘that’s how much he loves I first came to Mersey Care after I’d been you’. She made me realise I had to find badly beaten by my new partner. We’d had another way. what for us was a normal day, shoplifting, They found me a place at a rehabilitation getting off our heads on drugs and having centre on the Wirral. My dad brought the a chippy tea. I still don’t know why but he kids to see me – I’ll never forget his face jumped up and started to punch me. My

I’ve stayed off drugs ever since, now I get my kicks from the normal things in life, like having food in the cupboard, being able to put the heating on and pay bills. The best bit is that I’ve got my kids back. My daughter is training to be a nurse. I’m so proud of her and so glad I can finally be a mum. I’ve had bad times since. I fell downstairs and eventually had to have my leg amputated; I admit I wallowed in self pity for a long time but I came through it. I volunteer for Mersey Care now, I sit on recruitment panels and work at Brook Place drugs outpatient clinic. It’s like a family; the support is there whenever you need it. I saw my ex partner there not long ago. He’s still a service user. I looked at him and said a silent thank you to him – without going through what I did I wouldn’t be where I am now. I have no bitterness, just joy.”

Wayne’s Story

I’m living proof that things can get better.

“I attempted suicide four times before realising I had a problem and asking for help.

back to Liverpool but within a year I started feeling suicidal again. I went to my GP and told him about my experiences.

depression, even though it was under control, the people interviewing me would change and I wouldn’t get the job.

I was 17 and at catering college when I first tried to kill myself. I took tablets and was violently ill, but I didn’t tell anyone. The second time, five years later, I was working and living in London as a chef. I took more tablets and was violently sick for three days, but I went back to my job and still didn’t tell anyone. The third attempt failed because the belt I used snapped so I was unconscious but still alive.

He prescribed me antidepressants and I was referred to hospital.

I faced rejection after rejection but with help from the Recovery College I was able to get a job. When I was told I’d got it I cried.

I didn’t see suicide as a mental health problem

I was urged not to rush back to work

At 33 and working abroad I tried again, this time slashing my wrists. It was as I was doing it I realised, for the first time in my life, I had a problem. Thinking back I had been unwell since I was around 12. But I just didn’t see suicide as a mental health problem; I felt a failure but only because I couldn’t see it through.

I finally told my parents It took another attempt for me to seek professional help. I then moved

I was working in IT when eight years later the feelings came back. I realised that I had to tell my parents. It was a big step to take; I knew they would be shocked hearing it for the first time. They blamed themselves but they are fantastic parents. My brothers and I had a brilliant childhood and I only have happy memories.

I still have anxiety but through the anxiety management and self esteem course at the college I’ve developed ways of coping. I’ve done stand up comedy and I spoke at a conference for social workers – I was sweating and my heart was racing but I did it!

I’d say to someone in my position, please don’t suffer in silence like I did for so many years. I don’t like having My dad took me to the GP then to A&E regrets in life but a regret I do have is not seeking help sooner than I did. where I was referred to Broadoak Unit. My team there said I had never allowed We all need a little bit of help sometimes. myself time to recover and urged me not Although I have done my bit my employment advisor, the Recovery to rush back to work. College and my psychiatrist have really I finally took their advice. I’m so grateful helped me turn my life around for the to my employment advisor Lin Seerey; better. I am living proof that if you get she helped me think about what I really the right help things can get better. Your wanted to do and how I could get the life can improve like mine has. Please skills to do it. seek help.” I wanted to support people in the same position but getting a job wasn’t easy. As soon as I mentioned my chronic

Anna’s Story

I dreamed of a fairy tale life

“I was always anxious even as a child. As I got older I retreated into a fantasy world where everything was perfect. I’d meet the man of my dreams, get married and have children. Although I wasn’t ambitious and was painfully shy, I did well academically – I think it was to prove my sense of worth - and studied Italian, Spanish and Portugese at university. I thought travel would solve my problems, but I’ve realised it begins and ends with you and it’s a process. You can run away from people and places but you can’t escape yourself.

“Working with people who are going through what I did reminds me how I was and how I got through it.”

Anna (above) with her beloved pet pygmy hedgehog Arwen who she says is a source of therapy and (below) on her wedding day.

I tried to make a new life

I was found, and after a spell in hospital I tried to make a new life. I got a flat and a job, I saw the girls often and met a new partner, things were looking up, but the panic set in again and I went back to the way I was. I joined a self help group and began looking for a job I had tunnel vision where I could help people with similar I met my first husband and moved to his problems. I saw the peer support worker home town. I had four lovely daughters role and thought that’s for me. It’s a and I was a good mum but I couldn’t great job. I’m helping other people but cope with life. I had tunnel vision and it also helps me in my recovery by when my marriage and my life weren’t reminding me of how ill I was and how how I imagined they should be my I got through it. This illness doesn’t go problems spiralled. away, but with my coping strategies, I My parents looked after me wonderfully don’t have the extreme reactions that previously caused my breakdowns. I and helped with the kids, but I had a worried about so many things that I breakdown. I was making everybody wasn’t doing anything. I know now you around me miserable and I genuinely can’t be in control all the time. felt that they would be better off without me. So one day I took myself When my partner proposed six years ago off to somewhere quiet with the intention of never waking up. I couldn’t by the Trevi Fountain in Rome, it was a see any hope, I had no peace – the pain complete and perfect surprise. However when my illness reoccurred he followed it wouldn’t go away.

up with a second question – could I cope with the stress of planning a wedding? I stopped and thought ‘if I say no I could be throwing everything away.’ We got married in our local town hall last year, followed by a church blessing. My four daughters were bridesmaids – it was the most wonderful day there was no anxiety, just celebration. We’re so happy – so maybe my fairy tale wedding did happen. I want people who have suicidal intent to know that they are not alone and there is help available from others who have lived experience of this. You don’t have to suffer on your own as I did for many years. My life today is living proof that it can be overcome.” 21

FLU JAB

mythbusters We are given so much information about illnesses and ailments these days it is easy to fall into the trap of believing we know everything about winter flu. Below are some of the most common questions about flu, the vaccine and its impact:

“do I need the vaccine if i’ve never had

the flu?”

“I had the flu vaccine last year, surely that means I don’t need to have it again this time?“ “Flu really isn’t a

serious illness is it?” “is it true that

The flu virus mutates every year, so even if you have had the vaccine in previous years, it does not mean you will be immune to any new strain that is circulating.

Most people who catch the flu find it very unpleasant, but for some it can be far more serious. Seasonal flu accounts for around three to five million severe illnesses globally and between 250,000 and 500,000 deaths. Around 4,700 people die from flu ever year in England.

pregnant women

Pregnant women can have the vaccination at any stage of their pregnancy. In fact, having the vaccination while pregnant is beneficial and helps protect the baby from flu over the first few months of their life.

“doesn’t the vaccine give you the flu?”

The vaccine is not a live vaccine. It contains a killed virus which cannot, by its nature, cause flu.

can’t be vaccinated?“

Even if you are not exhibiting the symptoms of flu, you could still be carrying the virus and passing it onto others. Studies by Flu Watch show that less than a quarter of people infected in recent flu outbreaks actually showed any symptoms.

“are there any side effects to the virus?“ “does the vaccine

The World Health Organisation cites clean water and vaccination as the two interventions that have the greatest impact on public health. Seasonal flu vaccines generally give 60-80 percent protection against infection.

really work?” “i’m really busydo i really have to get the flu vaccine done

straight away?” “doesn’t washing your hands regularly

safeguard you

The most common side effect is soreness around the site of the injection and occasionally aching muscles, but most people suffer mild or non-existent side effects.

There is a chance you may already be infected with the flu virus when you are vaccinated. If this is the case, you will still develop the flu. That is why it is important to get vaccinated as soon as you can at the start of the flu season.

It is vital to wash your hands, but once flu has been passed on to your family, colleagues or patients, clean hands alone will not keep flu at bay.

from flu?“

The enemy close up... 1 Sneeze = Millions of germs transmitted

the time flu germs can stay alive on our hands of the average office is covered in the cold virus

15-20 seconds

the time you need to wash your hands with soap before touching other things

SEVERAL HOURS The time flu germs stay alive on the objects around you, from phones to doorknobs.

SEEING THE WHOLE PERSON

Why social care plays a vital role in good mental health 24

“Social care is a fundamental part of our work to improve mental health.” Denis Cullen, Strategic Lead for Social Care

“As a profession, social work has always played a key role in managing risk and complexity and working with people with the most profound and enduring health and social needs who are often the most socially excluded and at risk of harm. By focusing on the ‘whole person,’ their ‘whole life experience’ including the family, good social workers treat people as equal citizens, which is not only highly valued by those who use services but vital to aiding recovery and maintaining health and wellbeing.

Public services however are in a period of unprecedented change and challenge; one thing is certain, simply carrying on as we are with the current funding arrangements and facing ever increasing financial constraints will inevitably result in more people with growing needs A recent Panorama programme focusing getting fewer services.” on public health across North Liverpool highlighted that without a fundamental change to the way health and social Why does Mersey Care get care services are funded and delivered, involved in social care? the provision of existing essential care services for people will not be sustainable “Social care is a fundamental part of our work to improve mental health. into the future. Within Mersey Care the majority of Trust Strategic Lead for Social Care, social workers work within community Denis Cullen has over 30 years experience services and although they are employed as a social worker in mental health by our partner organisations, Liverpool, services. He explains the importance of Sefton, and Knowsley local authorities, social care for people with mental health they are seconded into the trust and are issues, the challenges ahead and how an integral part of our mental health things are changing for the better. teams. NHS trusts and local authorities continue to face enormous financial challenges with continued budget reductions and people have and still do often find themselves stuck between differently funded health and social care systems.

Good quality social work can transform the lives of people with mental health problems and learning difficulties. Social workers within the trust play a key role in meeting people’s needs at an early stage, and reducing the risk of crisis and more costly demands on our acute hospital services. They also work within the law to protect people who may be vulnerable, to prevent them coming to harm and help them live safely in their communities.”

How are things changing for the better? Transforming the way we work, particularly through integrating health and social care services across our neighbourhoods, is leading to positive changes for all of us who use or work in mental health services. The ways in which mental health services are now designed and located is bringing marked improvements in treating people earlier and ensuring people who experience mental health difficulties get the information and enabling support they need. The challenges ahead are enormous but with the very positive relationships we have with our partner organisations we are confident of progressing the changes together in a way that will ensure people continue to get the services they need.”

Searching safely

Evidence shows that young people go online for mental health advice – what’s out there and how safe is it?

More and more young people are seeking mental health advice. Four of the top ten issues reported to the Childline charity relate to mental health problems. The 2015 Girlguiding UK Attitudes Survey showed that two in five girls aged 11 to 21 needed help with their mental health. Unlike their parents they have a wealth of information in their own hands. Or at least their handsets. There’s a web page, a social media group, a blog for every topic imaginable. Research by mental health charity Mind shows just how much young people ‘shelter in the anonymity’ of

the internet and seek help online.’ In the instance of self-harm, 73 percent of young people relied on TV, radio, social networks and websites to get information, compared to just 11 percent who sought information from healthcare professionals. Being a click or two away from help is convenient – but for a young person in crisis it could also be the only help available at the time. Half of those questioned by YoungMinds, the young people’s arm of the mental health charity Mind, felt they should be talking to their parents about it, but only one in ten felt comfortable doing so.

Where to go for help But how reliable is online information and advice? Is it up to date and most importantly safe? It depends, it seems, on the source and that in itself can be a minefield. The main young people’s charities will always give best and latest information. Mind has a dedicated YouTube channel with videos offering advice, guidance, tips and stories based on people’s experiences. They’ve capitalised on that all important social networking ‘must have’ the ‘selfie’ - asking people to send them a #mentalhealthselfie – a short video clip talking about what helps them with their issues. The videos are then included in a playlist to help others tackle similar issues. A Mind Facebook account gives young people who need help a chance to talk to others in the same situation. It’s the age of the app where help can be installed to be there when you need it. Mersey Care’s own Self Help Guide Apps are designed to download, print or watch as films. They cover a wide range of mental health issues and selfhelp techniques. (Guides are free to download via Google Play and can be printed and shared directly from your device.)

Still talking to a real person is often the best way. Mind’s ‘HeadMeds’ website answers questions about medications but they warn it’s not a substitute for specialised support. If you aren’t happy to go to your family doctor you can go to a walk in centre or join another practise – ask a friend to help you. The advice from Mind when searching for information is to use sources you know are reliable. Both Mind and NHS Choices are certified by the Information Standard, an independent quality mark of good practice in health information. Some useful questions to ask yourself when you read online content are: • Is this factual information or is it someone’s personal experience or opinion? • Who has written it? • Are they a reliable source? • Is it up to date? When was it written? • Is it relevant to my situation?

Samaritans provides confidential, non-judgmental emotional support for people experiencing feelings of distress or despair. Tel: 08457 90 90 90 Email: jo@samaritans.org samaritans.org Mind provides confidential mental health information services. Mind Infoline: 0300 123 3393 (9am to 5pm Monday to Friday) Email: info@mind.org.uk mind.org.uk YoungMinds is dedicated to improving the emotional wellbeing and mental health of children and young people. Tel: 020 7089 5050 Email: ymenquiries@youngminds.org.uk youngminds.org.uk You can get Mersey Care self help guides on your smartphone or device – search Mersey Care self help guides or go to our website merseycare.nhs.uk CALM (Campaign Against Living Miserably) for men aged 15 to 35. thecalmzone.net The Mental Health Foundation provides information and support for anyone with mental health problems or learning disabilities. mentalhealth.org.uk Papyrus, the young suicide prevention society. HOPElineUK: 0800 068 4141 (Monday to Friday 10am to 5pm and 7pm to 10pm. Weekends 2pm to 5pm). papyrus-uk.org Childline (NSPCC) Tel: 0800 1111 childline.org.uk 27

Michelle’s Story

SPEAKING

In the first of a series we speak to Michelle who is 27 and has bipolar disorder I’VE ALWAYS BEEN

QUITE VOCAL…

BUT IF IT HELPS SOMEONE IT’S WORTHWHILE There’s an idea that when teenagers react in a certain way they are ‘just being teenagers’ when they are actually struggling.

not just to skirt round the issues, they are often the closest ally a young person has.

You write a blog about your There are harmful blogs where own mental health?

“I’ve always been quite vocal… and a bit cheesy, but when I get low it can Why do young people turn seem like there’s no light at the end to the internet for advice? of the tunnel. I started to blog so that when I’m low I can remember the It’s often because they don’t know good times and when I’m good I’m who else to turn to. There’s an idea that when teenagers react in a certain able to help other people. way they are ‘just being teenagers’ It’s usually about advising someone when they are actually struggling. about something as simple as having If a young person does something a routine, a time to go to bed, a plan drastic ‘for attention’ it’s usually so you’re not anxiously wondering because they need attention! what to do next. It’s not doom and My job as a teacher taught me that teachers need to be supported and trained to give honest information 28

so honest he felt he could talk to me about his own anxiety and sense of worthlessness. If it helps someone it’s worthwhile.

gloom, in fact it’s full of jokes. Just recently a friend said he’d read my blog and said that because it was

people who would never class themselves as bullies join in. I would always make sure the blog comes from a source you know is reliable. But if you can, try to talk to a friend or a teacher or lecturer or someone else you know you can trust.

If you could recommend one source of help what would it be? Talk Liverpool website - it has a lot of self help stuff and links to other reliable sources of help. talkliverpool.nhs.uk

We’re Recruiting Working for Mersey Care means so much to our service users and carers. We continually strive for excellence and many of our service users tell us we give them their ‘life’ back and hope for the future. The models of care and services we provide means that the opportunities on offer are extensive. We put our services users and staff at the heart of everything we do. We want to be the best, so we want you to be your best. Every member of staff is responsible for the delivery of our mission and living our values and behaviours through our staff charter.

Our values are: Continuous Improvement Accountability Respect Enthusiasm We can give you skills, but your values are part of you. So during the selection process for a role, as well as asking you to demonstrate your skills and experience, we will ask about your personal values and how they align with ours at Mersey Care. Our service users and carers are actively involved in developing and delivering recruitment and training for managers; they choose interview questions about values and will be an active part of any interview panel.

Want to join us? View more details or apply directly on: jobs.nhs.uk/in/merseycare or phone recruitment: 0151 473 2992 option1 You can find our Staff Charter at: merseycare.nhs.uk All posts will be subject to Disclosure and Barring Service check.

It was easier to appear drunk or high than it was to be honest about my bipolar

Score! Colin Dolan, award winning volunteer and avid football fan talks frankly about his beloved sport, his battle with bipolar disease and the ways he fights stigma and supports people to talk more openly. I love football and played a very high standard as a youth. I was still playing Sunday League in my mid-forties living in Spain. I moved from club to club but never really fitted in anywhere. On the face of it I was cocky, I used cocaine, and when I moved to live in another football friendly city, Liverpool I became greedy and busy chasing money through dodgy sales offices in Liverpool city centre in my nice suit.

I lied to family and friends I hid my bipolar and my depression for years. I thought people would see me as a freak, or weak. It was easier to appear drunk or high than it was to be honest. It only hit me four years ago that if I continued to lie to myself, family and friends I wasn’t going to be around for much longer. I spent time as an inpatient at Windsor House adult mental health unit. When my partner and my Mersey Care support team suggested I join Imagine Your Goals a football themed recovery programme run by the Trust with Everton FC, I wasn’t sure – I’d become isolated and unfit - I wasn’t too keen to try playing football against, or even with people half my age!

But I agreed to give it a try - I wasn’t a fan of Everton as a club and never imagined in a million years that I was going to say ‘I fit in here’, but at Goodison I found somewhere I felt comfortable and a support network that I could never have imagined. Playing football gives you the thrills passing, shooting, scoring goals and winning matches - but it’s being in the company of others with similar lived experience that gives the sense of belonging, a sense of security and comfort. You can be yourself, no one has any prejudices and that alone takes a huge weight off your mind. I’ve seen people who have gone from being aggressive to an empathetic team-mate. Lads who had low selfesteem come out of their shell and move forward with their lives.

Blagger turned Blogger As I became more involved I realised that, although there are around 240 mental health football programmes up and down the country, we knew very little about what was going on within the sector or about each other. I began researching, bringing together like-minded people who believe in using football therapy as part of their recovery or therapy. It developed into a network, Mental Health Football UK – we have 1100 members and keep in touch through Facebook, Twitter account and LinkedIn. I have since met people who have been influenced by what I post online and can openly talk about their experiences. My own recovery is a complicated and twisting journey, but Mersey Care has always helped me have input into my recovery and wellness plans. The forward thinking attitude of Beatrice Fraenkel and Joe Rafferty and having so many people with lived experience of mental illness join the trust as staff, is driving things in the right direction. The Recovery College helped me to tap into business skills I hadn’t used for years and I left the Peer Support Worker course feeling very confident about myself knowing I could put these skills into practice. Mental Health Football UK is almost a full time volunteer job now but I also work with EITC support Liverpool Homeless FC and run a MHFUK 5-a-side team. Everyone around me has encouraged me to do so many positive things I like to think that we all inspire each other. I now have so many people I can trust when discussing my mental health issues, so many empathetic friends. That’s truly a strength in its own right.

Facebook: Mental Health Football UK Twitter: @soccer_4_all Email: mentalhealthfootballuk@yahoo.co.uk Tel: 0151 384 6184 Mob: 07905 572 126

A lesson in

Controlling Stress Classes in managing stress are being run across Liverpool. We went along to a session to find out how it works…

The group is equally split between men and women, with a significant number of younger people in the room. They take their seats in rows, ready for a session on controlling panicky feelings and getting a good night’s sleep. Sessions are 90 minutes In a cosy room in Dale Street, long but there are plenty of breaks Liverpool, Talk Liverpool group and participants can leave the room facilitator Collette Graham welcomes anytime if they need to. the 30 strong group – this is week Three tutors take turns to lead five of a six week stress control different parts of the session, using course, part of a city wide talking simple and often humorous slides to therapy programme run by Talk illustrate a point. The slides clearly Liverpool for anyone aged 16 or over resonate with people’s own experiences living in Liverpool or registered with with heads nodding as tutors cite a Liverpool GP. scenarios. Hand outs of the slides are It aims to help you feel better by a useful aid allowing participants the teaching you better ways of handling added comfort of revisiting the advice common problems such as anxiety, when at home. depression, low self-confidence, poor There’s a sense of anonymity that is sleep and panic attacks. It’s free and a key part of the approach. Collette you can refer yourself. explains: “I think the appeal is no-one Collette has already explained that stress has to speak, you can sit back and is a normal reaction; but if it starts listen. Also everyone’s here for the to impact on your life it’s time to get same reason.” help. Talking therapy focuses on a We spoke to Peter, 24, who came person’s thoughts and behaviour, helping to stop himself falling back into a them to develop coping strategies. 32

depression that had caused him problems with work and family life. “My GP suggested I come, but I hate groups of people so by the time I arrived I was sweating with panic. But I stayed and just kept thinking ‘everyone’s here for the same reason’. Now I look forward to coming. It’s helped me to look at the big picture, not just one small thing. I used to be hot headed, but the course has taught me how to let it go.” People get most from the course by coming to all six sessions and drop out rates are low but Colette is mindful of the effort that people make to attend and people are welcome to come with a friend or relative. “If you are caught up in your stress, it’s like being in the eye of a storm, so we always congratulate people for staying with the programme. It’s a pleasure to be involved, I’m passionate about this sort of therapy so it’s amazing to watch people get so much from it.” Please call Talk Liverpool on 0151 228 2300 for more information or to register your place on a course.

What is stress? ‘Stress’ describes a range of problems from anxiety, depression, panic, insomnia, to poor self-esteem, low self-confidence, irritability and anger.

Stress Control what you need to know • Stress Control is a FREE course which runs over six consecutive weeks in venues across Liverpool • It will help you feel better by teaching you better ways of handling common problems such as anxiety, depression, low self-confidence, poor sleep and panic attacks. Sessions are 90 minutes long including a break • As long as you’re 16 or over you can refer yourself. Your GP or another health professional can also refer you • You will be contacted for a brief telephone call to explain what happens at the course and to take some details which the team needs to enrol you • Stress Control is a class, not a group therapy. We don’t discuss anyone’s personal problems.

Feeling stressed? Talk to us Book your FREE stress control class today

Please call us on 0151 228 2300 for more information or to register your place on a course.

The Course

week by week

What is stress? Controlling your body Controlling your thoughts Controlling your actions Controlling panicky feelings and getting a good night’s sleep Wellbeing and controlling your future.

For more information call: 0151 228 2300 or go online at: talkliverpool.nhs.uk 33

A Day in the

Life In the first of a series Consultant Psychiatrist Dr Stephen O’Brien gives an insight into his day on the wards at Clock View Hospital. It’s 8am. My colleague Dr Ruth and I are consultants for the Assessment and Immediate Care Service and our first job is to review what’s been happening overnight ahead of our Acute Care Team morning meeting. In the ACT meeting we review every inpatient that we have each weekday morning with the ward staff, community mental health team, and others. We look at what should have been done what needs to be done, and who will do it.

majority of people with mental illness are not a risk to anybody else – in fact they are more likely to be the victims than perpetrators of violent crime - a very small number do need extra care and they are treated in our intensive care unit.

As the afternoon progresses there are the usual questions about what may or may not happen over the Today we were nearly successful in weekend. There is another batch of finding a way forward for a patient new referrals to be assessed; some of who needs a very specific type of care; it’s been difficult but it’s reminded them will be seen over the weekend. me that although people’s needs are We need to further develop our sometimes complicated, we need to service ‘out of hours’ but we are keep on going for them. working on it.

Next job is to assess the first batch of new referrals for the day and then to We will also admit somebody from a prison quite some distance away. the wards. When people are mentally unwell in One of the great things about Clock prison and refuse to be treated there View is that as you go from ward to is a need to organise treatment in ward you walk through open gardens, hospital – our last PICU bed, but we which is nice, especially when the sun have managed to find a few general is shining. beds for the weekend. I visit our psychiatric intensive care Most patients want to be here unit (PICU) for the most acutely and we work together with them. unwell people and those that are Sometimes someone doesn’t accept most at risk of harming themselves that they need treatment or they or somebody else. Although the vast may not have the capacity to make 34

the decision. The decision to detain someone is not taken lightly or alone; it’s governed by law and involves lots of safety checks, with rights to appeal and independent tribunals.

As usual, Friday ends with dictating notes into our clinical information system and there are decisions to be made with practitioners and ward staff. Some decisions are easier and, it’s fair to say, some are more popular than others. It’s the end of a busy week and I’ve been shouted at a few times but that’s ‘par for the course’!

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