MC Magazine - Autumn 2021

MCMAGAZINE

LET’S TALK MENOPAUSE

Our six page guide to joining the revolution.

INSIDE...

3 WELCOME

4 LET'S TALK MENOPAUSE

6 WE SHOULD ALL WEAR THE BIKINI

7 WHY THE SECRECY?

8 READY FOR REVOLUTION?

WHAT IS YOUR BABY THINKING?

Find out from the experts.

MAMA USED TO SAY...

Terhemen swapped engineering for nursing. Now he's urging young people to follow in his footsteps.

I HEAR YOU

Learning to listen can be a life changer for families.

11 BOSOM BUDDIES

14 WATCH, WAIT, WONDER

16 I HEAR YOU

18 DO I HAVE OCD?

20 MEET THE QUEEN OF GLUTEN FREE

22 WRAP UP AND DINE OUT

24 BREATHE EASY

28 HUB OF HOPE

30 THE HEROES HAVE ARRIVED

MC magazine team:

Managing Editor: Steve Murphy.

Editor: Jackie Rankin.

Contributors: Sophie Brown, Jo Henwood, Tamara Lawrence.

Editorial: Julie Crompton.

Photography: Joel Goodman, freepik.com

Illustrations: Ella Byworth, Shae Fowlis, Vecteezy.com.

Design: Jo Hadfield.

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

MerseyCareNHSFoundationTrust

@Mersey_Care

@MerseyCareNHSFT

32 AMONG THE FIELDS OF GOLD

34 MAMA USED TO SAY...

35 MEET YOUR GOVERNOR

The GDPR is the General Data Protection Regulation, a European-wide law, which governs how organisations can collect, use and transfer personal data. It came into force on 25 May 2018 alongside the new Data Protection Act 2018. As a Foundation Trust, Mersey Care has a statutory requirement to develop and maintain a membership and it is necessary for us to process our members’ personal data to perform this task. Our members are drawn from the public, people who use our services or care for people who use our services and staff. We request and securely hold data on our members, which they provide when joining our membership. The data we hold on our members enables us to show that we are representative of the community we provide services for, to keep members updated through our quarterly MC magazine via email or post and to invite all members to the Annual General meeting. We also engage with all members advising when the election for governors will be taking place, giving members the opportunity to nominate themselves to become a governor and to vote in elections for the council of governors. Should you no longer wish to be a member of Mersey Care please email membership@merseycare.nhs.uk with your details or call 0151 471 2303 asking that your details be removed.

MEMBERSHIP AND GENERAL DATA PROTECTION REGULATION

WELCOME

Living well has taken on a whole new meaning during the past year. This issue comes as a new season approaches and we have to adapt once again. There’s plenty to think about in these pages, with real people telling their stories to give hope, and experts offering advice that can make a difference.

Our grandmothers called it ‘the change of life’ and for some women, living with the menopause can be tough. Our extensive feature looks at the menopause revolution – and how men are getting involved too.

Find out how to be a Zero Hero and help raise awareness for suicide prevention.

One call is all it takes for students at Liverpool universities to get mental health support. If you’re a student or you know someone – go to page 29.

Having to stop breastfeeding before they are ready can leave women grief stricken years later. We talk to the volunteers helping mums keep going. And we sit in on a session to find out what your baby is really thinking!

Could you be a Zero Hero? Just eating donuts or digging out your general knowledge will help raise awareness of suicide prevention and help towards zero suicides.

Embrace autumn, live well and enjoy the season!

The MC Magazine Team.

Reporter Sophie Brown (above right with her mum Ann-Marie) asks why young people aren't taught about menopause so they can support those they love.

With her Sex Myths and the Menopause documentary, Davina McCall has turned a taboo on its head.

Mariella Frostrup had started the debate back in 2018 –but Davina shouted it from the rooftops and urged us to do the same.

LET’S TALK MENOPAUSE

Even in this enlightened age, vaginal dryness and lost libido are still far from making the list of after dinner conversations – or any other conversation, except maybe among (very) close circles of women of a certain age.

Community sexual and reproductive health consultant Dr Liz Stephens watched the documentary with her husband and teenage son (more about that later).

It brought her joy. She‘s campaigned for more awareness and better services since the 90s.

Liz is frustrated, not just by the lack of discussion, but a reluctance among decision makers and employers to recognise how much menopause impacts on society.

Back in the 90s, as a doctor in one of the country’s few specialist menopause clinics in London, she saw how dedicated services could dramatically improve lives. Now a consultant in Mersey Care’s sexual health services she says not much has changed and services are still not joined up.

“There’s a real shortage of medical specialists and menopause services still aren’t regularly commissioned. Women are balancing work, family life, elderly parents and the symptoms of menopause. It’s not reasonable to expect someone experiencing significant symptoms such as sleep disturbance to fully function at home and in work without support. It’s about flexibility, being able to say, ‘I’ve had a bad night’s sleep and I need a couple of hours’. We could all do a lot more.”

"I’m on hormone replacement therapy (HRT) which has helped. It’s enormously frustrating how women are suffering because they’re embarrassed to tell their GP, or they’ve been refused treatment. They go on struggling when we could help them.

“Lack of oestrogen can affect tissues and contribute to prolapse and bladder leakage, and many women feel uncomfortable talking about urinary incontinence. Contraception is still an issue – conception rates are rising in women over 40. Being pregnant at 48 can be disastrous for a woman. We need to take a more sensitive approach so they can share their concerns.”

“To see Davina really covering the big issues was fantastic. She’s articulate and successful, so showing that level of honesty about subjects that are still taboo has opened people’s eyes and empowered women to be more open about what’s happening to them.”

At 52, she’s now able to draw on her own experiences - and she’s refreshingly honest.

“I’ve always been able to sleep, function well, and speak confidently in public. Now I’m having sleep disturbances. When I’m in meetings I’m often struggling to find the word I want to say.

Davina's honesty about subjects that are still taboo has opened people's eyes...

Dr Liz Stephens, sexual and reproductive health consultant, applauds Davina McCall and other menopause campaigners.

GP Louise Newson has stimulated wider debate on openness about menopause and HRT.

by Jackie Rankin

She’s infuriated that women are being unnecessarily denied HRT and supports GP Louise Newson and MP Carolyn Harris (see page 7) in their national campaigns to offer HRT as standard, and to stimulate a wider menopause debate.

“National best practice guidance is very clear – there’s no need for blood tests on women over 45 who have symptoms. If they have symptoms then they are menopausal. Talk to them about what they want to do – it’s that simple.”

“I’m not saying HRT is the answer for everybody – you should always start with your own lifestyle and what you can do to help yourself. But that’s sometimes not enough. If we take a detailed medical and family history, and there are no risk factors, then a trial of HRT could help.

“You have to take a balanced approach, but it’s not right that a woman who is symptomatic and desperate should not have access to a discussion.”

Liz wants to see more education in schools for both sexes. “It’s a cruel irony that as teenagers are going through adolescence, their mums are going through menopause.”

MORE INFORMATION

For more information on the menopause, symptoms and treatments go to:

Menopausematters.co.uk

nhs.uk

And she’s right behind Davina in calling boys and men to be supported to help the women in their lives.

“I asked the men in my family to watch Davina’s programme with me. They replied ‘what’s it got to do with us’? I said ‘everything’! So they did, and I was proud.”

Get out there, get online. You’re not alone but unfortunately, with the situation as it is at the moment, you might have to fight, but don’t give up – on yourself or your marriage or your job – keep going, you’ll get there.

Davina McCall

WE SHOULD ALL WEAR THE BIKINI

To be fair to me, that conversation happened as she lay in a hospital bed in my house, rigged up to an oxygen machine in what I now know was the last few months of her life. My daughter was about to sit an A level, I was managing a stressful job, my husband was working away. And I was menopausal.

‘Grumpy’ did not quite hit it.

The trouble with the menopause is you never know when it’s coming, and it happens alongside other stuff – parents’ declining health, teenage hormones.

Mix all that with a cocktail of dry eyes, dry mouth, dry vagina, brain fog, lack of sleep or any of the other 34 symptoms and it’s a wonder one makes it through the day, never mind book an appointment with a doctor.

In the midst of terrible grief of losing my honest, loving, feisty, hilarious, sweary mum, I found myself in the surgery, discussing my options for HRT.

SYMPTOMS OF THE MENOPAUSE

My periods hadn’t stopped – in fact some of them were so heavy I couldn’t leave the house. Yet I was only in ‘perimenopause’, a vague term meaning around the menopause, a phase that could last for months or even years, along with the heavy periods.

My doctor advised patches – I have coeliac disease so it would avoid stomach absorption issues. I opted for the Mirena coil to help with the bleeding. I’m lucky, my doctor recognised and understood the condition, and was prepared to prescribe drugs. Five years on I’m still experimenting with doses. But I have a new dilemma – do I wear my favoured bikini on the beach with my patches on full view? The sisterhood Twitter has been alive with ‘wear the patch – wear the bikini,’ ‘think of it as body art’ and the pragmatically put ‘the HRT generation are invisible to the general population so wear what you want’.

What would my mother say? ‘Wear the b****y bikini!’

Jo Henwood

As well as irregular, painful periods symptoms of the menopause may include...

“You’re really grumpy, you ought to get on HRT” said my mother. She didn’t say ‘really’ – she swore with gusto – but you get my drift.

WHY THE SECRECY?

The menopause is a hot topic for women over 40 – but only among themselves.

Why aren’t partners and family members prepared for the knock on effects of living with someone going through it? Why aren’t young women prepared for what’s to come? And why are we still turning to Google for advice?

As naïve as it sounds, I knew nothing on the subject until my mum began her ‘change’. No school subject covered this. My friends didn’t discuss it.

What I was least prepared for was the deep emotional turmoil, the confusion whether there’s something really wrong. I wonder if other young women (and men) feel the same. We’re suddenly thrown into watching our strong, independent, resilient mothers knocked down by something they say is ‘normal’ and are unable to help them.

I think back to the countless appointments, medications and side effects, which were not only overwhelming for my mum, but for all of us around her. Some symptoms – hair thinning is an example – are so drastic, yet families and friends still don’t make the connections, and how can they with no prior knowledge?

With a male manager and no workplace support, is it any wonder my mum’s daily struggles left her emotionally and physically drained by the time she got home from work?

Kathie Cooke, a menopause specialist at Liverpool Women’s Hospital has met many women who simply stop coping. “Through fatigue from sleeplessness and anxiety about severe flushes they lose a sense of self and become withdrawn... isolated... depressed.” Her role is to give women

Why aren’t young women prepared for what’s to come?

the sense that they’re not alone and their feelings are not only justified, they are completely normal.

There seems to be a great gap here, one which Kathie alone cannot fill. The situation could be so much different if we were prepared and had basic knowledge of side effects and how to deal with them.

Right now we’re still searching for the answers. And our wives, mums and colleagues are suffering alone when they don’t need to.

THE HIDDEN SYMPTOMS

Writer Tamara Lawrence reveals some menopause scenarios only close friends would share.

• ‘I’ll DM you my thoughts –if I remember, my fingers aren’t too fat to type and I’ve finished plucking my chin.’ Kate, financial services administrator

• ‘Road rage – if someone blocks me in the red mist descends’. Ellie, mum of three

• ‘Severe joint stiffness as well as the general aches and pains. I thought I was working out too hard, but my GP said it was a symptom’. Sally, a personal trainer’

• Heartburn. ‘Everything I ate seemed to sit on my chest, or make an attempt to reappear later.’ Liz

• Anxiety. Successful women who have raised families, held down jobs and ‘kept it all together’ for years describe feelings of unease, inadequacy or loss of confidence.

What can be done?

‘Talk about it,’ says Kate. ‘Knowing other people are experiencing these things gave me the confidence to go to the GP and get help.’

Sophie Brown

READY FOR REVOLUTION?

If a Welsh MP gets her way, hormone replacement therapy (HRT) will be free to every woman in England who needs it.

IS POLICY CHANGE THE KEY?

Swansea East MP Carolyn Harris is spearheading a campaign to improve policy around menopause, and make HRT exempt from NHS prescription charges in England. Prescriptions are free in Wales and Scotland but women in England are still paying for pills, patches, pessaries or gels.

Launching the #MenopauseRevolution, backed by Davina McCall, Carolyn Harris said: “I know from my own experience that for too long, menopause has been overlooked in so many policy areas, from the workplace to healthcare.”

THE MEN IN MENOPAUSE

At Timpson, no one is overlooking menopause and it is high on the agenda. Originally cobblers and shoe menders, the Timpson team was traditionally male but following the acquisition of Max Spielmann, Tesco photos and Johnsons Dry Cleaners with predominantly female workforces, the balance of the sexes evened out.

According to the Faculty of Occupational Medicine almost eight out of 10 menopausal women are in work and, according to the CEO of Timpson, James Timpson, it is important to keep them there. Writing in The Sunday Times he said: “It is important women are assured that if their work is affected [by menopause], they won’t receive a warning letter or a P45.”

With symptoms like poor concentration, feeling low and tiredness, the menopause can cause problems for any woman worker. Excessively heavy periods and hot flushes can also be excruciatingly embarrassing.

Timpson’s aptly named Director of Happiness Janet Leighton says that their key is an open culture where people aren’t afraid to talk to their team manager about anything that is bothering them. There is a regular wellness email, a wellness page in the newsletter and every week James distributes a three-minute video to all colleagues via WhatsApp. The week Janet spoke to MC Magazine, he had chosen to talk about the menopause.

“He doesn’t profess to be an expert on the matter but it just prompts everyone to think about it.

“The menopause obviously affects women but the young men on our team have got mothers and the older men have wives or sisters who might be going through it so they all need to understand more about it.”

Colleague support worker Laura Garside is leading the company’s wellbeing strategy around menopause.

She said: “There is a lot of information for teenagers about puberty when they are at school and then again when a woman gets pregnant. The next major change for women is the menopause and there is very little support or discussion about what is, after all, a natural process.”

“Our area managers and development managers know their teams and we encourage everyone to be open about anything that is bothering them. The more they know about the menopause and the more they understand, the easier it is for them to open up that conversation.”

• The Menopause (Support and Services) Bill will get its second reading in Parliament on October 29 this year.

Working

in a female dominated workplace can be tough for any man, just as it is for women if the tables are turned.

But the chief executive of Sefton Council on Merseyside is taking steps to understand more about what makes women tick, or not tick, when they reach menopausal age.

Dwayne Johnson took up the gauntlet laid down by Active Workforce to join a men only session to find out more about how the menopause affects women.

Dwayne said: “Local government is nationally a female dominated workforce with an average age of around 40.

“This means a significant proportion of our workforce will be affected by menopausal symptoms during their working day.

“There are so many employees suffering without any support or understanding, resulting in absences from additional anxiety and unnecessary stress and that is why Sefton Council has introduced a policy so people understand the issues and how we can support people.

Husband and father Dwayne added: “As a male employee, it is important to understand the menopause, recognise the symptoms and be aware of the treatments to be able to support female colleagues.

“Men can make a difference in the workplace and at home!”

Timpson’s Director of Happiness Janet Leighton (right) and colleague support worker Laura Garside are leading the company's wellbeing strategy around menopause.

Swansea East MP Carolyn Harris

There is very little support or discussion for what is a natural process...

Words: Jo Henwood Photo: Joel Goodman

Julie Roberts is a wellbeing counsellor. One of her most memorable moments was a manager asking for help to support colleagues going through the menopause.

The best bit? He was a man.

“It felt like a breakthrough – he didn’t know how to manage the situation, but he did feel able to ask for help. The Trust is working hard to give managers the understanding and skills to support women at work. It can make what can be a very difficult time so much better.”

Julie and colleagues run informal menopause groups over a cuppa and online, for staff from Mersey Care Foundation NHS Trust. Medical advice is provided by the sexual and reproductive health team.

Sessions are highly charged and evoke raw emotions.

“Women may struggle to accept they are menopausal. There’s sadness around the end of fertility. Women have told us they know their marriage ended because of the menopause,” said Julie.

Administrative service manager Joanne Greer says while the menopause has been debilitating, she feels lucky to have the sessions, and support from her manager. “Our mothers didn’t have this platform, I want my daughters to have better choices.”

Julie Roberts can truly empathise – her menopause came suddenly and brutally following treatment for breast cancer.

“As my chemotherapy ended my periods stopped and the hot flushes, sleep problems and constant aching started. I was still facing surgery and radiotherapy. I’d wake up in the morning think ‘how am I going to get through the day at work’?” She was referred to a menopause specialist at Liverpool Women’s Hospital.

Julie oozes a passion to give back control through knowledge.“Women are making decisions on HRT based on flawed research.

by Jackie Rankin

WELCOME TO THE MENOPAUSE CAFE

It’s vital they have up to date evidence based information on things like HRT.” They’re also taught the importance of self care. We explain that menopause is so much more than hot flushes – it can affect your heart health and bone health. Women are often at the bottom of their own pecking order, putting family, elderly parents and work before their own wellbeing. We can’t function without recharging.

“It’s not always easy, but start with you. Look at what you’re doing – are there things that are draining you? There’s lots of information about food and eating. A bit of cardiovascular exercise – not going to the

gym, just getting a bit sweaty. We give people ideas to take away and make the choice.”

Her best advice?"Try to speak to a health professional with an interest in the menopause. Ask at your GP practice if they have someone who specialises in women’s health. If it’s not available consider changing GP. Don’t suffer in silence.”

• Mersey Care menopause sessions are run by staff health and wellbeing counsellors Julie Roberts, Becky Dickens and Charlene Senior. Medical support is provided by Dr Liz Stephens, Consultant in Sexual and Reproductive Health and her team.

We explain that it's so much more than hot flushes...

Julie Roberts (right) and Dr Liz Stephens run menopause support sessions for NHS staff.

BOSOM BUDDIES

Breastmilk is the ideal nutrition for babies, says the World Health Organisation. Research shows 80% of pregnant women in the UK want to breastfeed. Yet half have stopped by six weeks, citing feeding difficulties and lack of support*. Six months after birth, only one per cent of babies are still entirely breastfed.

Mersey Care infant feeding lead

Pippa Cardwell says it’s a massive public health priority. “We talk of breast milk as a food source, forgetting it gives protection to a person right up to the end of their life.”

There’s also a psychological cost to giving up.“It’s distressing to watch women become grief stricken because they haven’t been supported to achieve their breastfeeding goals and desires. If they don’t go on to have other children to repair that grief it can stay with them.”

She knows how it feels. “I was a teenage mum and nobody ever talked of breastfeeding. I was given a steriliser and bottles as a gift. I did what society expected of me. I breastfed my other two children, but I still look back with sadness.”

Pippa says the remedy is simple – stop blaming women. Instead give them the knowledge they need to make crucial decisions for their own and their baby’s future wellbeing, and support them to do it.

“Health and other services need to do much more to help women stay motivated and prevent them stopping breastfeeding before they want to, because they’ve not had the education or support that is so important when things get tough.”

She refutes claims of professional pressure on women to breast feed.

We give the facts and tailor advice. A woman may say ‘I haven’t had a drink for nine months’, and she’s surprised when we say having the occasional drink while you’re breastfeeding is OK. If there are allergies, or diabetes in the family we explain how breastfeeding can protect the baby against those things.

When we know better, we do better. If a woman knows the facts and chooses to bottle feed we’d support that decision. It’s about a woman’s autonomy over her own body. But breastfeeding would be every baby’s choice and we mustn’t lose sight of that. It’s my dream that every woman can experience the right support.”

Health and other services need to do much more to help women stay motivated.

Carol Miles coordinates a team of breastfeeding volunteers in Sefton, giving mums vital support.

*Source: ncbi.nlm.nih.gov

BE KIND TO YOURSELF

I sometimes apologise to mums for the misleading image of a little milk drunk baby, plump and asleep in its crib while you sit and enjoy cake and coffee. The reality is you spend half your life covered in vomit, sanitary pad stuck to your back, suffering post natal cramps, exhausted because you’re sleep deprived. Then baby is feeding vigorously and everything she's heard about static feeding regimes doesn’t come to fruition and she struggles even more.

"We say to mums be ‘kind to yourself.’ It’s OK to sit in your pyjamas, to crumble now and again, but ask for help and know that it will pass. You’ll look back and say ‘I don’t know how I got through that – but I did’.”

“We help mums to understand why babies feed. A newborn baby will feed between eight and 10 times in 24 hours – more often when they go through a growth spurt. The mum is constantly making antibodies so they know to go back for more.

“Babies feed for comfort too, just to be held. And in hot weather they’ll take shorter, more frequent feeds, to quench their thirst. Knowing all these things can help mums understand and be gentler on themselves.”

THE EUREKA! MOMENT

Understanding how to position your baby for feeding and attaching to the breast can be the difference between succeeding and stopping breastfeeding through pain or poor milk flow, says Pippa.

That’s where breastfeeding support groups play a vital role.

“Midwives and health visitors support mums, but it can be difficult to explain positioning if the baby isn’t ready to feed. Our breastfeeding groups run for a few hours, we wait for the baby to be ready and spend time explaining.

It’s a Eureka! moment for both mum and a professional or volunteer – that small tweak that means the pain stops and the milk flows. Just repositioning the baby or mum can be the difference between stopping breastfeeding or being motivated to carry on.”

The Feelgood Factory support group links mums with volunteers who can give advice based on their own experiences.

"A lot of our support is around having realistic expectations," says Pippa Caldwell.

We help mums to understand why babies feed.

Ateam of volunteers in Sefton, Merseyside, has been a lifeline to mums through the pandemic. Sefton breastfeeding support group links mums who have breastfed their children, with those needing support. They’ve just begun face to face meetings again – during lockdown volunteers supported mums through phone and video calls. A Facebook group provided constant contact and removed the sense of isolation many mums were feeling.

Volunteer coordinator Carol Miles is proud of her team’s readiness to give their time during difficult times. “We’ve worked really hard to stay in touch with our families and the feedback has been amazing. Our volunteers are incredible. They even managed to recruit 15 new mums during lockdown!”

... MY BABY WAS ALLERGIC TO MY BREAST MILK

The Facebook group has been a huge success. One mum wrote: ‘The Facebook group is really useful to communicate with other mums when you need an answer at silly o clock, or you can't talk on the phone because your baby is asleep or being held whilst feeding and the noise would disturb them. It was a godsend to me, my baby was five months old when lockdown started and I was completely cut off from other mums face to face…’

Infant feeding lead Collette Palin never asks an expectant mum how she intends to feed her baby.

“She may not have even thought about it so we wait, encourage skin to skin contact, see how she feels. We’ll ask what she understands about breastfeeding, which may be based on what she’s heard rather than facts. We’ll give her the most up to date information and reassure her that if she does choose to breastfeed we’ll support her.”

Collette leads Knowsley’s Bosom Buddies, a team of four workers trained in infant feeding, who offer support from before birth for up to three weeks before handing over to Homestart.

Contact Bosom Buddies: 0151 244 4387

WE KNOW WHAT IT'S LIKE

HomeStart

Knowsley

Breastfeeding support worker

Bernadette volunteers to help other women overcome difficulties and empower them to persevere to achieve their breastfeeding goals.

After extreme challenges feeding her son Leo, now five, she wanted to ‘be educated to help other women’.

When Leo was born, Bernadette and partner Alison were determined he would be breastfed. But the little boy screamed in pain after every feed. Advice from friends and professionals was to give up. With a family history of breast cancer and feeling a strong instinct to carry on, she researched extensively and discovered Leo was allergic to 14 different food products, from soya to beef. So she removed them all from her diet and Leo became a contended baby, reaching all his milestones.

When Leo contracted meningitis and had to have a spinal tap, Bernadette stayed at his bedside and fed him. “Doctors said he should have top ups of formula, but the nurse overruled and helped me express. She empowered me to carry on.”

Her resolve continued when she herself needed surgery, with Alison bringing Leo to Bernadette’s hospital bed. Leo finally self weaned from the breast at two, helped by the designation of a living room chair as the feeding chair, which he would go to and pat if he was hungry!

“It was important to me and that’s why I volunteer. If a woman wants to breastfeed there will be challenges, so we should do everything we can to make sure she can fulfil her wish.”

Helen Bushell supports mums with any feeding options parents choose to explore. She and her team offer a listening ear on all aspects of parenthood and signpost to other groups.

“We may be professionals but we’re all mums ourselves, we’ve all had those experiences, we know what it’s like.”

Helen is grateful for the support of volunteers like Sarah Godenho. The mum of three was shocked to be told that her breastfed baby was failing to thrive.

"I knew she was well, just small. But I had no family close by to ask. My GP confirmed my thoughts and that made all the difference. I had completely different experiences with my other children so I can see situations from all sides.”

Contact Knowsley Homestart: 0151 244 4387

WATCH WAIT WONDER

Lie on the floor, put your hands up to the sides of your face and get a friend to dangle their favourite toy over your head. If you’re lucky you will just about make out Winnie the Pooh’s big bottom, Po’s toes or the underbelly of a well known baby shark.

Welcome to the world of the newborn baby – tunnel vision, seeing only black and white, but not yet able to focus on which marine creature that might be.

"Any new mum or dad knows how hard it is to get parenting right but what if you have no positive reference points to even begin to build a bond with your baby?

In steps Building Attachments and Bonds (BABS) – an award winning service that supports parents to build secure attachments and loving bonds with their babies at the same time as breaking negative life cycles.

“When I was pregnant, I joined a group and we learnt how your baby can hear you when it is inside so I started talking to my bump,” she says. Turning to health visitor Mel Harrison and mental health practitioner Gemma Docherty, they laugh at how she reacted when they suggested she might play Ed Sheeran to her baby in the womb.

“He’s not my favourite!” she smiles.

The Getting to Know Your Baby course is delivered jointly by BABS and Knowsley Early Years Service.

When Mel and Gemma talk to Crystal about what to expect when she weans him on to solid food, once again they focus on the messages baby gives out.

Consultant clinical psychologist Dr Lisa Marsland said: “When you become a new parent it brings to the fore your own experiences, your relationship with your parents and feelings and thoughts that have been locked away since you were a baby yourself –we call them ‘ghosts in the nursery’.

“Lots of things can get in the way of a parent’s ability to bond with their baby –if there was a childhood spent in care, domestic violence, alcohol abuse, adverse mental health or even a traumatic birth they can all get in the way of building attachments.

“We work with mums, dads and other members of the family to help them separate out their past and present difficulties and start developing positive bonds with their new baby.”

Crystal, 27, has had mental health issues throughout her life and was referred to BABS by her midwife during pregnancy. Her baby Clayton is just four months old but, thanks to BABS, she began building a bond with him before he was even born.

With help from BABS, Crystal is able to describe her feelings in the first weeks of Clayton’s life as ‘amazing, happy, strong, caring’. She has learnt baby massage and her eyes light up when she talks about how much Clayton loves seeing the ducks in the park. She describes his joy at watching stars on his ceiling at night but how much he hates the noise of the blender. And she learnt on the day we met that Clayton is not that interested in make-up.

“He will start watching you eating and may make a grab for the food,” says Mel. “What do you think he will like best – main meal or pudding?“

Without hesitation Crystal replies: ‘Oh main meal – definitely.”

It’s clear from watching the loving bond between Crystal and Clayton that BABS’ work pays massive dividends, but the real saving is when one less child is taken into the care system.

• If you would like to find out more about the Parent Infant Mental Health Service BABS ask your midwife, health visitor or GP.

“I put him in his cot this morning and chatted to him while I was putting on my make up. I looked around and he had fallen asleep!”

Gemma is clear: “Relationships are everything. We encourage mums to watch, wait and wonder – to think about what their babies are seeing and feeling, what they are smelling, what they are hearing – and hold their baby in mind.”

We encourage mums to think about what their babies are seeing and feeling...

Lots of things can get in the way of a parent’s ability to bond with their baby.

When you become a new parent it brings to the fore your own experiences.

Words: Jo Henwood

Health visitor and BABS team leader Mel Harrison.

I HEAR YOU

We look at a new course that’s changing the lives of carers and those they support.

Getting a diagnosis for a mental health condition can bring huge relief to carers. But what then? How do you support someone with a complex condition you know nothing about? Trying to help can make things worse and cause friction.

Sue and Steve’s daughter Jennifer was always a sensitive child. “She’d cry easily. You’d think ‘what did I say?’ says Steve. Jennifer was bullied at school and Steve and Sue became ever more protective.

by Jackie Rankin

“We’d tell her not to worry, that things weren’t as bad as she thought they were” said Steve. “We couldn’t see things from her perspective. You feel you’ve failed. I’ve had mental health problems. You think is it my DNA? Should I have had kids?”

Sue heard of a carers’ course to help parents and carers better understand their loved one’s perspective and to consider their own role. It was during the pandemic so the couple did the course online.

Sue says it was a revelation.

At university she began to self harm. An intelligent young woman, she sought help and was making progress with her talking therapy. But in their efforts to support their daughter, Sue and Steve were unknowingly adding to Jennifer’s distress.

”When Jennifer had tried to confide in me my reaction had always been to tell her what to do. It was all I knew. The course taught me that Jennifer was trying to share her problems. She didn’t want me to judge, fix or solve the problem – she just needed me to listen. After doing the course I said to her ‘I think I know what the problem is – me!”

Steve agrees.“You have quite a few light bulb moments as you understand why someone might think in a certain way and not feel guilty about praising other family members.” Sue and Steve would discuss what they’d learned with Jennifer.“She’d be really pleased that we got how she felt. Now when she stays in her room or is quiet, we don’t ask why we just accept that like everyone, she might be having a bad day”, says Steve. They both praise course leader and carer John Chiocchi, (read John's story on page 17). “John shares his own experiences, so you don’t feel it’s text book stuff. It’s much more personal.”

Jennifer has recently been successful in getting a new job. She’s also stopped self harming. Sue says the balance of support has shifted. “I’ve been under pressure at work recently and I shared my worries with Jennifer. I’d never have done that before the course. She’s got her self worth back and she’s now supporting me.”

She just needed me to listen.

We couldn't see things from her perspective.

Steve and Sue are learning to support their daughter Jennifer in a different way after taking part in a course to help carers gain a new perspective.

DON'T PUSH THE PANIC BUTTON

When John Chiocchi’s adult son was diagnosed with borderline personality disorder, John had no idea how to help.

I’d never heard of BPD. I thought ‘it can’t just be me that needs help’, so I started to find out.”

John became a service user and carer volunteer. He’s spoken at Board of Director meetings and helped develop a Personality Disorder Hub in Cheshire.

John always felt valued and listened to – but his unique perspective made him realise training missed a key component – carers needed to learn about themselves to improve relationships with their loved one. He now works with clinicians and carers to offer a 20 week clinically approved psychoeducational programme.

He explains: “Carers can be fabulous at fixing things. We suffocate the person, assuming we know what they need, which can leave

them feeling their views are invalid, which causes more friction.

“The course trains carers not to push the panic button and to recognise they could be a trigger for them, and to accept that having bad times is part of normal life.

“My son dreaded Christmas. He’d begin worrying in October and we’d tell him not to. We finally established it was because he feared he wouldn’t have enough money for presents and didn’t want to let anyone down. We created a Secret Santa and he doesn’t worry any more.”

John is especially keen to support young carers. “A lad whose mum had psychosis asked if he could join the session. At the end he thanked me and said he wouldn’t be scared next time his mum started talking to people who weren’t there.”

We’ve had service users who say “thank you, my family finally understands who I am.”

Moving courses to Zoom during the pandemic has reduced waiting lists and carers find it easier to study from home.

John says feedback is good.“Most say they wish they’d done the course years ago.”

TO FIND OUT MORE about the Training, Education and Support (TES) course contact: john.chiocchi@merseycare.nhs.uk

NEED SUPPORT?

Help yourself – our self help guide on anxiety can be read online, downloaded or watched as a video. merseycare.nhs.uk

My family finally understands who I am...

Carer and course leader John Chiocchi

Actor Ben Miller has revealed he broke down in tears on set while playing Channel 4’s Professor T, the unlikely investigator struggling with obsessive compulsive disorder.

Miller said in a recent interview he was able to relate to his character. “I had OCD myself quite badly. For me it was about anxiety and trying to control the one thing you can control, be it the position of an object on a table or trying to repeat the same patterns of behaviour… to sit in the same chair for example."

Miller had cognitive behavioural therapy to ease his symptoms. Talk Liverpool therapist Ann Ingham talks to Jackie Rankin about how therapy can help – and how simply being super tidy isn’t OCD.

DO I HAVE OCD?

Therapist Ann Ingham wants to make one thing clear. Straightening cushions doesn’t mean you have OCD.

“Many people have compulsive tendencies. You might feel it’s important for you or your house to be clean, having things symmetrical, or rearranging items. It’s part of the way we organise ourselves and have control over situations. It only becomes OCD if your compulsions interfere with your functioning in life and you’re finding having to do the compulsions unpleasant and a burden.”

“I liken it to ivy growing up a wall. It creeps into cracks in the brickwork and eventually covers windows and doors so you can’t get out. Unless you root out every little bit it can come back.”

Talk to us

OCD is a mental health condition affecting almost one million people in the UK. It causes someone to have obsessive thoughts and compulsive behaviours, and can cause feelings of anxiety and unease. Ann explains: “Life is full of uncertainties – without them it would be incredibly dull. But some people struggle dealing with uncertainty and feeling out of control causes them great anxiety. OCD is very clever at letting them think they have that by giving them control over one small thing. But reality kicks in and the person develops more compulsions, doing them over and over until it feels right again.

What are the signs? “Actions include repeated showering, saying numbers or phrases, or checking the door is shut. Or it could be a mental behaviour - worrying you’ve harmed someone, or constantly going over things in your mind.” says Ann. Talk Liverpool therapists use exposure and response prevention therapy, which involves therapists supporting clients to put themselves in the position where they feel a compulsion – and then not carrying it out.

“It’s hard work for the person, it takes courage and determination – but once someone understands why it’s happening and what they need to do they can stay in remission for the rest of their lives,” says Ann.

“OCD is an ingenious mental contortion. People are confused and trapped – their life is so full of compulsions there’s no time for anything else. To see someone unravel that and get their lives back is wonderful.“

Need help with OCD, stress, anxiety or depression? We can help. FIND

OCD – UK: ocduk.org

OCD Action: ocdaction.org.uk

TOP UK (the OCD and phobia charity): topuk.org

You can refer yourself online by visiting talkliverpool.nhs.uk or calling 0151 228 2300, alternatively you can be referred by your GP or another health professional.

OCD is very clever at letting people think they have control over one small thing.

Therapist Ann Ingham

Blogger and author Becky Excell talks exclusively to MC magazine’s Sophie Brown about living with coeliac disease* – and the bakery that changed her life.

MEET THE QUEEN OF GLUTEN FREE

When Becky Excell was diagnosed with coeliac disease, all the foods she loved suddenly seemed out of reach – so she started creating her own recipes, and blogging about them.

Since then, she’s had 30 million blog views, become a bestselling author and been dubbed the ‘queen of gluten free’ by Nigella Lawson!

In her new book ‘How to Bake Anything Gluten Free,’ Becky busts the myth that ‘gluten free food has to always taste or look worse.’

She recalls constant mealtime struggles. “I’ve struggled most with missing the normality of being able to eat what I want when I want. Mealtimes, especially eating out, require planning. If I don’t plan it can be stressful.”

She’s also candid about how a restrictive diet fuelled her eating disorder, and how it took her ‘own motivation and decision to want to get better’, along with help from health professionals and her family, to ‘come out the other side’.

The idea for the book came during a visit to a gluten free bakery on her travels. Becky recalls being enamoured by what she saw. “There were so many cakes and pastries. I wished every gluten free person could experience the overwhelming feeling of choice, the bliss of eating something you’ve craved for years and the joy of just feeling like a ‘normal’ person again.

“Since I couldn’t take all my followers there personally, I decided to write a book… it shows you how to transform your kitchen into your own personal gluten free bakery.”

@beckyexcell @beckyexcell

Becky Excell Gluten Free

GOING

GLUTEN FREE? Becky advises anyone thinking of removing gluten from their diet to speak to their GP and do some research. Her top tips are:

• Visit the Coeliac UK website and consider joining

• Learn how to read ingredients lists so you know what products are safe

• Remember that so many foods are naturally gluten free

• If you’re going gluten free because you’re coeliac learn to understand cross contamination

• Join gluten free Facebook groups – there’s no limit to the amount of helpful info and advice you can learn from others!

BANANA UPSIDE DOWN CAKE

INGREDIENTS

For the topping 50g butter, softened 50g light brown sugar

2 to 3 ripe bananas

For the sponge 100g butter, softened 100g light brown sugar

2 medium eggs

1 tsp vanilla extract

1 tbsp maple syrup

100g gluten free self raising flour

1 tsp gluten free baking powder

50g chocolate chips (optional)

Preheat oven: 160°C fan: 180°C/350°F.

SERVES: 8 to 10 TIME: 45 MINS

METHOD

• Topping: grab a medium mixing bowl, add the butter and sugar. Cream together until light and fluffy. Spoon into a 20cm (8in) cake tin spreading the mixture all over the base and up the sides too. Slice your bananas lengthwise and place across the base – as many as will fit!

• Sponge: grab a large mixing bowl and cream together your butter and sugar until light and fluffy. Crack in the eggs, then add the vanilla, maple syrup, flour and baking powder. Mix until well combined. Lastly, fold in your chocolate chips, if using.

• Pour the mixture over your bananas and spread it out so it’s nice and even on top. Bake in the oven for 30–35 minutes until cooked through and golden on top.

• Remove from the oven and allow to sit in the tin for around 5 minutes before inverting onto a serving plate – it’s ready to serve immediately. Serve warm with vanilla ice cream, or enjoy cold.

TIP: You can always switch up your toppings from bananas to canned pineapple or sliced pears. Dairy free – use dairy free choc chips and a (hard) dairy free butter alternative.

Recipe extracted from How To Bake Anything

Gluten Free by Becky Excell (Quadrille, £20 RRP), published

WRAP UP AND DINE OUT

It’s been a summer (or two) of glorious outdoor dining. As eateries embraced and equipped themselves for pandemic induced al fresco, so have we. As temperatures drop heaters are coming on and rugs and blankets are coming out. Sophie Brown shares a few of her favourites.

The benefits are many. Viruses and germs spread less outdoors. Fresh air relieves anxiety, helps you sleep and strengthens your immune system.

But it’s also the sense of social. The Danish call it Hygge. Add in some twinkly lights and a fire pit and the ambience racks up. If the food’s delicious it makes for a magical experience.

In my neck of the woods, Liverpool, three dining delights stand out:

• Maray, located on Bold Street, Allerton Road and the Royal Albert Dock. With outdoor pods at their dockside branch, you can watch people paddle boarding, kayaking, and relaxing on barges, Disco Cauliflower is among the mouth watering small plates. Al fresco rating: 8/10 Food: 10/10 Maray.co.uk

• The Watering Can, Greenbank Park. The inside outside feel lets you soak up the low autumn sun, surrounded by stunning outdoorsy décor. It’s an ideal brunch spot after an early morning autumn park walk –warm up with a mug of their signature hot chocolate.

Al fresco rating: 10/10 Food: 9/10 thewateringcanliverpool.com

• The Old School House, Lark Lane This place steals the show on ‘the Lane’, with its open plan conservatory and suntrap terrace and wood fired pizza oven. Their all day/night deal means they’re open seven days a week, early to late.

Al fresco rating: 9/10 Food: 8/10 theoldschoolhouse1889.com

Sophie Brown blogs about food and eating out at:

@liverpoolfoodblog_ on Instagram or visit liverpoolfoodblogger.wordpress.com

The Watering Can, Greenbank Park.

The Old Schoolhouse, Lark Lane.

Maray, Albert Dock.

STAY UPBEAT IN AUTUMN

As summer nights become a distant memory, general tiredness and sniffles can gather on the horizon like autumn leaves.

Nurse consultant Dr Phil Cooper (pictured wrapped up and ready for autumn!) shares his seasonal thoughts on raising spirits and energy levels…and appreciating the little things.

BANISH AUTUMN TIREDNESS

“You may feel tired and sluggish with the change in season. Less sunlight and the clocks going back can disrupt our sleep and waking cycles. Try to get outdoors as much as possible to top up on vitamin D and make the most of crisp, bright autumn days.”

HAVE A HEARTY BREAKFAST AND HIT YOUR FIVE-A-DAY

“Porridge is the perfect breakfast. It’s starchy and full of fibre. We’re all tempted to fill up on comfort food as cooler days arrive – try to include a juicy clementine or satsuma each day.”

KEEP MOVING

Encourage the whole family to try out a new activity, or go kicking up leaves in your local park.”

FOCUS ON THE LITTLE THINGS

“For me it’s taking in the smell of freshly baked bread in my local shop, singing along to the radio when I’m driving, or having a good soak in the bath…and saying thank you to someone for doing something for me. Set goals and do things you love.”

BRIGHT IDEAS

35 things to do in autumn: dayoutwiththekids.co.uk

Find places to go: countryfile.com

Take an autumn break: visitengland.com

Dr Phil Cooper.

COVID-19 has had a horrendous impact on our patients’ mental health. You could often hear the trauma in their voices,” recalls Jacqui Martin, advanced nurse practitioner with the community respiratory team in Sefton, Merseyside (pictured on page 25). I had one gentleman in hospital tell me that he woke up every morning wondering if it was his day to die.”

During the pandemic, keeping these patients out of hospital, or getting them home again as soon as possible, has been a huge challenge. But as chest consultant Paul Walker puts it: “Keeping people out of hospital and taking care of them at home is what we do.”

Quick thinking was crucial to carry on with the ‘day job’ while keeping patients, carers and the team safe.

Staff who had to shield switched their workloads to phone and video call assessments. Clinics continued virtually, although some patients took a while to understand that pulmonary rehab and eating lunch at the same time wasn’t a good mix!

Now there is a new threat to people with a respiratory condition and new challenges for the team – ‘long COVID’ is rearing its ugly head.

“People are being hit hard in new ways. Mobility problems, loss of general functioning, deconditioning of muscles and fatigue are all on the rise,” explains team physiotherapist Sophie Bussey.

Even more surprising is the age of those affected.

“We’re seeing people in their 40s and some in their 20s. They’re showing signs of anxiety and a lot of people who were hospitalised at the beginning are now suffering from post traumatic stress disorder.”

New symptoms are coming to light all the time, and no one knows just how long ‘long COVID’ can last. The team is gearing up to treat sufferers for a new raft of physical and mental health issues.

Still, Paul Walker and his team are resolute and prepared for these unprecedented challenges. Paul has nothing but praise for his team.“We are a dynamic, reactive service. These are highly trained, highly skilled professionals who are all determined to push the boundaries for their patients – whatever the circumstances.”

BREATHE EASY

To people already living with a respiratory disease, contracting COVID-19 can be a terrifying experience. Tamara Lawrence gives an insight into the lives of a specialist team caring for some of the most vulnerable within our communities.

I'M IN GOOD HANDS

As COVID-19 victim Thomas Brooker lay in hospital, oxygen being pumped into his lungs, nurses from Sefton’s community respiratory team were working closely with hospital staff to get him home.

Although Thomas had been in hospital for four weeks and was still on oxygen 24 hours a day, the specialist support offered by the team meant he could be cared for at home.

Thomas was anxious. “At first I wondered if I’d ever get out,” says the 64 year old, who was already known to the team. “But the nurses came to visit me in hospital, and told me that as soon as my oxygen levels improved I’d be better off at home.

“I was so relieved. I was well looked after in hospital, but being able to go home to my family was something else.”

Thomas is still on the long road to recovery. He’s been forced to give up his job in catering at Aintree Racecourse and he’s still noticeably breathless. Being hospitalised was obviously a traumatic experience. But he’s optimistic and full of praise for everyone involved in his care.

“I was told I’d be on the machine for at least six weeks, but came off it after five. I have regular home visits, as well as phone consultations. They even left the oxygen machine in case I felt poorly.”

“They’re all great,” he says. I’m in good hands and I know help is only ever a phone call away.”

Tenor or soprano? Read how breathing like an opera singer can reduce anxiety on page 33.

Keeping people out of hospital and taking care of them at home is what we do.

Specialist respiratory nurse Jacqui Martin supports people in their own homes.

Thomas with specialist nurse practitioner Jacqui Martin.

TENOR OR SOPRANO?

Has the pandemic left you anxious? Try breathing like an opera singer.

English National Opera is offering its breathing and wellbeing programme, developed specifically for people recovering from COVID-19 who are still suffering from breathlessness and associated anxiety.

Delivered by ENO in collaboration with Imperial College Healthcare teams entirely online, the programme focuses on breathing re-training through singing.

You don’t have to be the next Katherine Jenkins or Alfie Boe. Short lullabies expressly designed to calm and soothe are taught. Attendees become part of a support group, meeting people in similar situations.

Respiratory specialist physiotherapist Sophie Bussey says: “We encourage our patients to refer to this programme to give them some guidance. People can do it whenever it suits them.”

For more go to: eno.org

by Sophie Brown

BREATHING EXERCISE TO RELIEVE ANXIETY

Make yourself as comfortable as you can. If you can, loosen any clothes that restrict your breathing.

If you're sitting or standing, place both feet flat on the ground. Whatever position you're in, place your feet roughly hip-width apart.

• Let your breath flow as deep down into your belly as is comfortable, without forcing it

• Try breathing in through your nose and out through your mouth

• Breathe in gently and regularly. Some people find it helpful to count steadily from one to five. You may not be able to reach five at first

• Then, without pausing or holding your breath, let it flow out gently, counting from one to five again if you find this helpful

• Keep doing this for three to five minutes.

People can do it whenever it suits them.

Breathing like Katherine Jenkins and Alfie Boe can make you feel less anxious.

DALEY RELAXATION

Feeling stressed? Take the plunge and follow Olympic gold medallist Tom Daley’s pastime of knitting.

Asurvey of over 3,500 knitters worldwide, published in the British Journal of Occupational Therapy, concluded that "knitting has significant psychological and social benefits, which can contribute to wellbeing and quality of life."

It can distract from chronic pain, lower blood pressure, reduce depression and anxiety, and even slow the onset of dementia. The repetitive movements are said to induce a meditative-like calm, distracting knitters from their symptoms, while those who join charities and form groups benefit from these effective social support networks.

READY TO DIVE IN?

Tom Daley

(@madewithlovebytomdaley)

UK hand knitting: ukhandknitting.com

NEED SUPPORT?

Help yourself – our self help guide on anxiety can be read online, downloaded or watched as a video. merseycare.nhs.uk

by Tamara

HUB OF HOPE

Living away from home for the first time, managing finances, trying to ‘find your tribe’ – it’s small wonder university students are vulnerable to struggles with their mental health.

Since 2019, a team from the University of Liverpool and Liverpool John Moores, Brownlow Health, The Innovation Agency and Mersey Care NHS Foundation Trust has been working on a multi organisation approach to helping students in Liverpool find the right support.

As the project enters its final year, the focus is on its new liaison model – a way for students to access the services they need through just a single call or visit to a health professional.

“There’s a lot of help available to students, but identifying what support you need and accessing it can be tough,” says Michelle Barsoum, innovation lead on the project.

“We were developing a new pathway – an ‘in one end, out the other’ approach. But students don’t work like this – they might access mental health services via a GP, the urgent care line, or even at A&E. And they might not understand, or even remember, what they’ve been told to do, particularly if they’re in distress.

“The GP system and the universities are massive, and services are changing all the time. We needed a relationship

Students

based system, a hub. So when a student contacts a mental health access point, we can do everything to ensure they get the help they need.”

Michelle says differing levels of experience within services, and even the different language used, can be confusing.

“If someone in student halls says they’re suicidal, the person supporting them might call an ambulance, because that’s the level of their training. If that student calls the urgent care line, the outcome of the same scenario based on an assessment could be completely different.

“I followed up a student who had been discharged by a service as her level of risk was considered low. On her follow up student liaison telephone call, I was concerned she was showing signs of psychosis, so I arranged for her to access Mersey Care’s Early Intervention service for a thorough assessment.

“Previously, that young lady could have slipped under the radar, and reappeared a few months down the line in crisis with her mental health further deteriorating, which could have greatly impacted her life. I’m really proud we were able to get her the help she needed early.”

TO FIND OUT MORE To learn more about the service, get help in a crisis or book an appointment, go to: liverpool.ac.uk/studentsupport/studentmentalhealth

in crisis can get the right support with just one call.

Lawrence

Illustraion: Ella Byworth

MIND THE GAP

Students say self harm therapy service was the first time they had been truly listened to.

When Danielle Young joined the University of Liverpool in 2017 she was struck by the lack of mental health provision for students. Her concerns were starkly emphasised when a fellow student in her halls took her own life.

Since the introduction of the student support programme U-COPE self harm therapy programme, Dani says she has noticed an enormous improvement. Her research project for her Masters in Clinical and Health Psychology was a qualitative review of U-COPE, a self harm therapy service for students at University of Liverpool and Liverpool John Moores University.

U-COPE offers patients who have self harmed six sessions, including a three week gap to enable them to put into practice the techniques they have learned.

“Some of the students I interviewed described it as the best service they had accessed, the first time they felt truly listened to”, says Dani.

“Self harm is a good indicator of a potential suicide attempt,” says Dani. “U-COPE supports people who were falling through a gap in the service. It’s a novel approach and it’s clearly a popular one.”

STUDENT RESOURCES:

(Rethink Mental Illness, 2019)

“They liked the rapid access to the service, and the flexibility to see their therapist both face to face and virtually. Students can continue their therapy when they are off campus, or at times when they might not want to leave home. They can also access a ‘top up’ session after the initial six, should they need it.”

The Samaritans www.samaritans.org

Tel: 116 123 (24/7)

MIND mind.org.uk

Info line: 0300 123 3393

YoungMinds youngminds.org.uk

Text: YM to 85258 (24/7)

Shout giveusashout.org

Text: 85258 (24/7)

Kooth kooth.com

Almost 1 in 10 students are thinking about self injury ‘often or all of the time’

Former student and researcher Danielle Young has noticed improvements since the new student mental health support system was introduced.

AMONG THE FIELDS OF GOLD

Tucked away behind a housing estate in Garston, a suburb of Liverpool, lies the woodland utopia known as Dutch Farm. It’s not easy to find – even with directions. But for those who walk through its rusty gate there’s a haven of nature, wildlife – and hope. Reporter Jackie Rankin and photographer Joel Goodman went to meet them.

We were lucky enough to be given an invitation to visit and instructions to enter. What we couldn’t have pre-empted was the feelings this idyllic spot evokes, and the impact on the lives of those who make up this remarkable community.

Annie Kilroy emerges from a huge Dutch Barn to greet us. Gently spoken and smiling, she explains that the main work today is creating a wildlife pond.

A group of people are busy at work under the shade of a huge sycamore tree. Their task is to line the new pond.

There’s a real sense of camaraderie. Those who prefer to do their own thing include Stevie, who is using his artistic skills to fashion a metal bird sculpture, perhaps for the edge of the pond?

The project centres around an allotment. It’s run by Person Shaped Support (PSS) as a wellbeing centre for people living with a mental health condition.

As senior practitioner, Annie’s role is to support clinical services through therapeutic activities. She and her colleagues adopt what she describes as a ‘light touch’ approach.

“Unless someone chooses to share information we don’t enquire. But if they want to talk we’re there to offer support.”

There’s a ukulele group and a singing group. In warm weather they meet outside, surrounded by wildflowers and beehives. The Dutch Barn, paid for by Liverpool City Council through a £30,000 grant, stands magnificent, in dappled shade, offering respite and solace to those who enter, for an activity, or just a cuppa between tasks. Even planes overhead and a train line behind can’t spoil the serenity of the spot.

A 12 week beekeeping course was funded by suicide prevention funding from Public Health Liverpool.

“When we came back after lockdown we had five new members for the beekeeping course, all men. Two had lost someone to suicide, so they were able to support each other.”

Flexibility is key to success. “The focus is on managing anxiety and improving someone’s mood. We want people to leave feeling better. They’re at different points on their journey and there may be times when they need a different type of service, but they know they can come back.”

Annie expects an influx of new recruits – an inevitable impact of the pandemic. They’ll soon be in a good place, in more ways than one.

“The beauty of this place is awe inspiring. Something happens when people come here. It makes people feel special. It’s unique.”

IT STARTED WITH THE BEES

A hive of bees changed Danny’s life. Left jobless and homeless following his mental health issues, he’d come to the Dutch Barn project with little hope.

I’d had anxiety for years, I wasn’t expecting much. I’d tried different types of support but when I was feeling down I’d want to lock my self away.

Danny’s anxiety had become overwhelming. During a hospital stay he’d been evicted from his home. Mersey Care’s Early Intervention service helped him find accommodation and referred him to the project.

“On the first day I was really nervous. Then they showed me the bees. I was completely mesmerised just watching them. I wanted to keep coming back to see them and be involved in looking after them. It was amazing, being so close to nature, watching them pollinate.

“It’s become the place I go to get some relief from stress. For the first time I feel like I can look forward. The hardest part is when I have to leave.”

He looks across at project members making a new wildlife pond. “We’re learning about each other, you’re with people who understand. I just wish I’d found it earlier in my life.”

Julie is one of a team of volunteers creating a wildlife pond

THE ZERO HEROES HAVE ARRIVED

by Tamara Lawrence

They’re here. The Zero Heroes are in your town. They’re where you work, and where you play. There’s probably even one in your house. Are you a Zero Hero?

The Zero Heroes are hard at it, raising money to support the Zero Suicide Alliance and spreading the word about our life saving work. So what exactly is it that they’re doing?

DONUT LICK YOUR LIPS –DO DONATE

What can you achieve when you do nothing? Well the Zero Heroes are turning ‘doing nothing’ into a real conversation starter. People around the country are challenging each other to eat a donut without licking their lips and share their efforts on social media. At the same time, they’re opening up about mental health. Why not join the conversation? Grab your donut, film your efforts and post with the hashtag #ZeroLipLick.

FIND OUT MORE about the Zero Heroes and how we’re coming together to raise money, raise awareness and have fun. zerosuicidealliance.com/zeroheroes

To make a donation visit our Virgin Money Giving page: virginmoneygiving and search for Zero Suicide Alliance.

THE BIG QUIZ

The Zero Heroes are beside themselves. Because TV’s Mr Gameshow himself, the legendary Roy Walker, has only gone and agreed to host our major fundraiser – The Big Quiz!

The host of iconic TV show Catchphrase in the 1980s and 1990s, Roy is joined by soap stars and celebrities, including Coronation Street’s DS Swain (Vicky Myers), TV Gladiator Vogue (Suzie Cox) and TV and radio presenter Dan Westwood.

HOSTED BY TV'S MR GAMESHOW ROY WALKER

WHAT THE ZSA DOES

Suicide is such an emotive word, and it’s a very difficult subject to talk about. But talking to someone who is having suicidal thoughts is so important –saying the right thing could literally save a life.

The ZSA’s FREE suicide prevention training is available to everyone. It means anybody can support someone presenting with suicidal thoughts or behaviour, then help them find the right services or support.

WHY NOW?

Suicide kills more than 6,000 people a year in the UK. It’s the leading cause of death for women under 34 and men under 49. It’s devastating for families, communities and the economy.

The impact of COVID-19 on people’s mental health is still unknown – but we need to be prepared. The effect on suicide rates of the economic slow down in 2008 didn’t hit until 2012 – so the next three years could be vital.

It’s time to take the training. It’s time to fundraise. It’s time to make a change

COMING SOON...

Anyone fancy a walk?

The Big Quiz is available ‘on demand’ at zerosuicidealliance.com. Unleash your quizzing superpowers and join us for 10 rounds of fun – from mysterious song lyrics to geography via the 1990s. Why not get your family and friends, clubmates and colleagues involved and make a night of it? Check out The Big Quiz details at zerosuicidealliance.com.

STEP 1 TAKE THE TRAINING

ZSA provides free online training that gives you the skills to help someone who may be contemplating suicide. It helps you spot the danger signs and teaches you how to reach out and support a person in need. The full training takes around 30 minutes, and there’s a shorter version that you can complete in just a few minutes.

Take the free training today: zerosuicidealliance.com/ training

STEP 2 JOIN US

Become a ZSA member and encourage your family, friends and everyone you know to take our training. Together, we form an alliance that believes all premature deaths are important, that suicide is preventable, and that more must be done to help people in crisis. Because one life lost to suicide is one too many.

ZSA Membership is free, join today: zerosuicidealliance. com/get-involved/sign-zsa

STEP 3 GET INVOLVED

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Find out more: zerosuicidealliance.com

MAMA USED TO SAY...

Terhemen Adamu is a mental health nurse. He wasn’t always a nurse – and his mum’s reaction when he decided to abandon a successful career as a software engineer in telecoms was less than enthusiastic.

Mama used to say ‘why are you giving up a well paid job’? She thought I wasn’t making the best choice, but I knew it was right for me and my son,” he told MC magazine.

After years of study and now enjoying his dream job, Terhemen is giving back by becoming a career ambassador. He’ll go into schools, sharing his inimitable enthusiasm and passion for nursing.

He uses his engineering mind to awaken students’ curiosity, always on the lookout for new ways to demonstrate the need for resilience and teamwork. And who better to turn to for advice than his 16 year old son? “If you’re at a careers conference you have to be competitive, you have to stand out against hundreds of others. I ask him the best ways to get their attention.”

“I may not know everything about mental health, but I can tell them about our values. I say as long as you care we’ll help you with the rest. It doesn’t matter when you join, we’ll be here. It’s important. Our children are our legacy.”

And has he made his mama proud? Terhemen grins. “Yes I think so. She was a nurse herself, in London. She enjoyed telling people her son was an engineer, but she’s seen how it’s transformed my life.”

TO FIND OUT MORE about career ambassadors contact Lesley Cradduck: lesley.cradduck@merseycare.nhs.uk

I knew it was right for me and my son.

Terhemen with mum Christina, nephew Dooyum and son Leighton.

Words: Jackie Rankin

Photos: Joel Goodman

KARI KVAMME

Service user governor

I can’t believe how far we’ve come in talking about our mental health. Three decades ago, when I was 18 and struggling with depression, there was no information or support. I felt ashamed and where possible kept it secret.

I’ve been married for 20 years with two very active boys. Depression remains part of my daily life, but I feel stronger and braver. It’s been lonely and frightening at times – I’ve experienced stigma mainly at work and I know how stereotyping can affect someone’s confidence. But I’ve had such fantastic care and my husband is enormously supportive.

My vision is for people to talk as freely about mental health as they do about their physical wellbeing. I’ve just started hormone replacement therapy (HRT) and I think nothing of talking about it. I look forward to the day when it’s OK to talk about psychiatric medications in the same way.

I’m a volunteer with the spiritual and pastoral care team at Mersey Care. I think participation and sense of belonging aids recovery and helps maintain wellbeing. It does for me.

I feel now is the right time to be a governor. Depression has given me so much grief –I thought ‘let’s turn the tables on it and put it to good use!’

I always say to my kids, ‘you can’t change the world on your own, but you can do something that means you’ve done your little bit’. Being a governor is my little bit.

To learn more about our Council of Governors, go to merseycare.nhs.uk

The Annual General Meeting is a great opportunity for you to find out more about our Trust, including our achievements and challenges from our Annual Report and Accounts from last year. All our members will shortly receive details of the event, how to register to attend and how questions can be submitted. This year the meeting will be held virtually.

Find out more about our membership and governors at: merseycare.nhs.uk.

Tel: 0151 471 2303 or 0151 473 2778 Email: membership@merseycare.nhs.uk

14 October 2021, 10am to 11am

Write to: Alison Bacon, Mersey Care NHS Foundation Trust, V7 Building, Kings Business Park, Prescot, Liverpool L34 1PJ

My vision is for people to talk freely about mental health.

Photo: Joel Goodman