issue 07 autumn '09
Inner space for women’s mental health & wellbeing (across Surrey and the south east)
Is the NHS sick? Modern food a recipe for madness? Stranger danger just who is that in the mirror? It’s a two-way street not just you in a relationship
Advertise in Sanctuary
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We are looking to raise revenue from advertising, advertorials or sponsorship to enable us to continue to produce Sanctuary magazine and make it bigger, better and more widely distributed. Currently we distribute around 3,000 copies per quarter in Surrey and the south east to: Statutory and private mental health and social care organisations Local authorities Selected GP surgeries Inpatient settings Community mental health teams Voluntary sector Individuals including national mental health leads, patients/service users, carers, mental health teams and other interested parties We have an in-house facility to create your advertisement or advertorial to reflect the editorial style of Sanctuary, or to ensure your organisation/ service/facility gets the message across in simple, eye-catching style. We can also accept your own camera ready artwork. We can provide quarter page, half page or full page, or a double-page spread advertorial. To discuss your needs and costs, please call Megan on 07824 364703. Please note, we have an ethics policy and may not be able to accept some advertising.
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Just a few of the comments we’ve had: “I wanted to let you know that l think your publication is brilliant. I stumbled across it quite by chance but was really taken aback by the range, quality and presentation of the whole thing.” Female service user Surrey “I felt driven to call you such was my delight that such a splendid magazine exists for mental health 'stuff'. Would be super if there was one of equal quality for men too!” Male service user - Surrey
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Community groups / Voluntary sector / Private health organisations / Pharmaceutical companies /
“I’ve just taken 10 minutes out, and read some of the Sanctuary magazine that I found in my intray. It’s great! Can I subscribe please?” MH worker Gillingham, Kent
Editorial comment Relationship
, relationships, relationships: our lives are full of them, and very much all about them. In anyone’s circumstances maintaining, creating and enjoying fulfilling relationships can be fraught with challenge. For people diagnosed with a mental health problem, intimate partnerships, friendships, family ties, workplace relationships can change in an instant. The world suddenly becomes a very different place. Things are distorted with almost immediate effect. Your view of all around you, and your view of yourself, is shaken. Once you might have considered yourself worthy and confident, now you are feeling isolated, alone, threatened, scared. No-one can see what has happened to your mind, and whilst some family, friends and colleagues are amazingly perceptive and supportive, some have immense problems dealing with this person they hardly recognise. Then their inherent desire for self preservation kicks in. They take a step or several back. Can’t blame them – but oh how wonderful it would be to help you face this ‘affront’ to your very existence, if everyone around acknowledged that as an individual, you are still who you are, despite this burden, this manifestation of ‘madness’ that has taken you prisoner. Where that would be particularly welcome is with the very people who are there in a professional capacity to help and treat you! In this issue one woman writes about how she has had to re-create her relationship with herself after having a mental breakdown.
Another describes making new friends and finding the strength to take the plunge into a new relationship after being hurt and abused so often. We also look at the ‘abstract’ relationships people have, with food for instance or their body image; and the relationship some people discover through a creative medium such as art or writing that can bring out hidden talents and even help set them on a road to recovery. If you have a story you would like to share, about how things changed for you once you found yourself having to be a patient of mental health services, send it to us. We want to create something that will educate people – be they staff in mental health services or the wider public – about what it feels like to have your whole being – and life – change. Perhaps we should call it ‘This is Me – whoever I am!’ Send your story, comment or letter to Sanctuary magazine Let’s Link PO Box 533 Betchworth RH4 9FL Or email: megan.aspel@sky.com PS. I’m having a little rant on page 14 – don’t miss it!
Megan
Sanctuary is free to everyone. Managing Editor: Megan Aspel Assistant Editor: Louisa Daniels Editorial Group: Elaine, Ashley, Diane Sanctuary is commissioned by NHS Surrey Design by Aspects: tom@aspectsgd.com www.aspectsgd.com Printed by Reliant Colour Solutions: www.reliantcolour.com No part of this magazine may be reproduced without prior permission of the publishers. ©Aspects 2009.
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Dear
diarµ Just had another row; now I’m looking up about relationships – always trying to get to the bottom of things as you know. Find out what I’m doing wrong... Here’s one. It’s about ‘sabotaging’ relationships. It’s an article on an American website. It says ‘Do you unconsciously sabotage relationships?’ Why women do it, it says…
Wait a minute! Why women? I know I said what am I doing wrong, but there’s no need to level it all at me! Why is there nothing about how the other half is a past master at ruining something! The article is telling me (and anyone else bored enough to be reading it) that I have unrealistic expectations. ‘Women sabotage relationships by expecting perfection from their partner’ it chants. Uh? Perfection? Excuse me? ‘They (women) set the scenario’, it goes on, ‘so he can either be a knight in shining armor (sic), or prove the early belief that no one will ever come through for them’.
‘Are you disappointed in your partner?’ it asks. I couldn’t possibly comment… ‘Do you find fault with the things he says and does?’ Well of course I/we do, because they’re always saying stupid things and doing stupid things, like getting absolutely bladdered every Friday night, coming home, expressing undying love, falling asleep and not remembering a thing about it in the morning, and then being anything but lovey dovey because they’re bears with sore heads, growling, and managing to blame you for how they feel into the bargain! What else does this ‘enlightening’ article say? Oh – Chronic mistrust. ‘Do you fear he is lying to you?’ Is the Pope a Catholic? Lying is in the genes – well, okay, lying might be a bit strong but we all know the ‘fish that got away’ story. Bigging everything up comes naturally to them – mmm, don’t even go there…
always seem to be more important than me somehow. Talk about stating the obvious. Okay, now it is telling me how to stop sabotaging my relationships. Err, I repeat– why is it me sabotaging the relationship? It says: consider counselling (just me mind you, not both of us); heal the past (do me a favour – where to begin?); develop a healthier self-concept (just like that!); accept and honour yourself as an individual (ditto); look at the big picture – what’s that then? Oh, here we are, ‘some disappointment and conflict is normal – Communicate clearly your appreciation of his good points as well as your expectations of the relationship’ (total recipe for disaster!).
‘Have you searched through his wallet’ it asks. For heaven’s sake – of course! Looking for the money he was supposed to give me for the food. If I happened to see anything else, well, that’s his fault for being so tight.
And finally: ‘with hard work and persistence you can learn to replace the cycle of beliefs and behaviours that sabotage your relationships… it requires courage – yada, yada, yada - but empowered with realistic expectations, positive self-esteem, and the ability to trust, a healthy, satisfying relationship becomes possible’.
Ah, here’s a good one; ‘losing yourself in the relationship’. ‘Girls are raised to be nurturers’ it states. Why not boys? I state. Anyway, according to this we are not ‘taught to honour our own needs’. Oh yes, ain’t that the truth? Our ‘worth is based on what we do for others’. Hey this is getting good. I’m loving this article.
Now I’m angry. Who does this article think it is? Trying to tell me how I sabotage a relationship but then how I can ‘un’ sabotage it! I could scream! I think I’ll sabotage this article. It’s driving me to distraction. Why can’t it see how difficult it is for me? Why is it so blinkered? It’s bigoted, controlling, thoughtless and basically it just doesn’t care anymore!
Oh, wait a minute though -
I’ll just read this bit. If all else fails, it says, go in search of ‘the ideal relationship with someone else who’s more compatible with your desires and treats you well’.
‘Do you compromise your own needs to accommodate your partner?’ What do you think?! And the children, their friends, the parents, the in-laws, complete strangers – everyone in fact because they
Sure will. That’s the end of you my little website friend. At the flick of a switch I have walked away from it, with no regrets. And now, dear diary, I’m off to put the kettle on and just have a little count of my blessings…
Editor’s note: the above is a fictional diary entry from an anonymous writer. It is meant as a light-hearted piece and in no way sets out to ‘diss’ men. I don’t think...
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food: Modern
A recipe for madness? Ever
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wondered if those little bottles of yoghurty stuff that include probiotics and bifida something or other do any good? Or whether you really should be eating more oily fish and fruit and veg? Ambivalence presides in so many of us. We know what is good for us but, arguably, because we are told what is good for us by people who we think look rather smug about it all (e.g those TV personality slim, lithe types or government departments that we imagine ‘nanny’ us), we metaphorically dig our heels in with a ‘Huh, I’ll show ‘em’ attitude. But a new book from Pavilion called ‘Nutrition and Mental Health, a handbook’ looks at how our Western diet interacts with the brain and immune system – and not in a good way. The results give a compelling argument for listening to the food gurus – if not for the sake of our physical health, for the sake of our sanity. With 14 chapters written by experts in different areas of nutrition, mental health and neuroscience, there is a wealth of information and evidence for even the most sceptical amongst us to ponder. Here we are told how our psychological health as well as physical is dependent on what we eat and the nutrients we take in. Our modern lifestyles leave little time to be as aware of what is going on in body and mind as perhaps we should. To be in tune with what is happening internally, some basic biology is required. Some contributors in the book elaborate to degree level understanding, but others confer maximum ‘light bulb going on’ affect with a more Janet and John approach. The book centres around the
relationship between diet and mental health/ill health. These relationships are deeply complex but what is emerging, through continued research, is that inclusion of some foods or nutrients and the exclusion of others really can affect your mental wellbeing. One chapter describes how the body’s ‘innate’ immune system, over 500 million years old – when we eat only natural foods - can react and have dire consequences on our mood and behaviour. In a healthy person the immune system should be doing absolutely nothing at all. It is an observer, waiting until something attacks the body before it fires up. The immune system’s job is to defend us from attack.
“When any tissue in the body becomes chronically inflamed”, the book describes “in response to toxins, substance abuse, trauma, stress, parasitic, bacterial or fungal overgrowth, our immune system will boost the production of inflammatory proteins called cytokines. These cytokines increase the risk, development and maintenance of illness. People suffering from clinical depression have shown 40-50% higher concentration of proinflammatory cytokines.”
Linking psychological health and the immune system is not new. From observations by a Greek physician in 200 AD to late 19th/early 20th century research by Nobel Prize winner, psychiatrist Julius Wagner-Jauregg, to more recent 21st century developments, there is wide belief of the therapeutic potential in resolving immune disturbances that may ultimately ‘reverse’ psychological states.
Gut instincts In a chapter with the catchy title ‘Gut and psychology syndrome’, the contributor, Dr Natasha CampbellMcBride says, “I have yet to meet a child or an adult with autism, ADHD/ ADD, dyspraxia, dyslexia, schizophrenia,
bipolar disorder, depression or obsessive-compulsive disorder who does not have digestive abnormalities.” She even goes as far as to say, “In fact, it appears that the patient’s digestive system holds the key to the patient’s mental state.” Supporting this bold statement is an interesting concept. The writer studied ‘hundreds’ of cases of neurological and psychiatric conditions in children and adults. What emerged was a typical picture of the children’s mothers. Dr Campbell-McBride writes, “An average modern mother typically was not breastfed as a baby because she was born in the 1960s/’70s when breastfeeding went out of fashion.” The importance of this lies in the fact that bottle-fed babies develop completely different gut flora to breastfed babies. This in turn can pre-dispose a person to health problems later on. The modern mother has also been likely to have had quite a few courses of antibiotics in her
childhood and youth. Dr CampbellMcBride states, “It is a well known fact that antibiotics have a serious, damaging effect on gut flora because they wipe out the beneficial strains of bacteria in the gut.” Another contributor to damaging gut flora, says the doctor, is the contraceptive pill, which can also have a “devastating effect” on good bacteria. What her research found is that “clinical signs of gut dysbiosis (abnormal gut flora) are present in almost 100% of mothers of children with neurological and psychiatric conditions”! The gut flora of a child mainly comes from the mother at the time of birth “as she passes whatever microbial flora she has to her newborn child”. Fathers are not exempt from having the finger pointed at them either, as, if they have abnormal gut flora, they can contribute to the bodily flora of the mother and through her to the child. Talk about your mother and father mess you up they do! Continued over the page…
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Mirror
...continued
Food intolerance
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We all know the culprits: wheat, gluten, dairy, food additives and artificial colourings. They are the most common perpetrators of food intolerance. (Food allergy is different and produces a range of reactions from itching and asthma to anaphylactic shock and possible death; a nut allergy is a good example) Both food allergies and intolerances have been linked with underlying organic causes of mental illness. A group of psychiatrists believes that patients with mental illness should be assessed for ‘brain allergies’. One doctor quoted in the book says “We should be diagnosing paranoia caused by a wheat allergy, dissociation as a manifestation of mould or hydrocarbon allergy, and so forth, according to people’s specific reactions…” (Philpott and Kalita, 2000) That rather puts a different twist on what many believe to be the underlying causes of some mental ill health. For instance, evidence shows that childhood abuse leaves a legacy of illness such as personality disorders including dissociative identity disorder and that other lifestyle events including domestic abuse, poverty and so on contribute to depression and anxiety. The claim that food allergies/intolerance impact on mental health is complex and much more research is needed. However, just looking at how we react to foods on a daily basis can indicate if we have a food intolerance. Seeking the advice of a qualified nutritionist would be the optimum way to do this but even some simple self tests can help.
It can take as little as 30 minutes or even less for a reaction to manifest; here are some of the most common. • Bloating and pain in your tummy • Diarrhoea and/or constipation • Tiredness or lack of energy • Headache or migraine • Craving for certain foods particularly bread, pasta or dairy foods • Racing pulse • Anxiety • Depression • Tenseness • Panic attacks • Mood swings • Inability to make decisions One of the easiest and most convincing self tests is the pulse test. If your body is reacting to something, within a very short time, your pulse rate will rise. If it is a severe intolerance, it can feel quite scary. If this has happened to you, you can now – fairly categorically – know it is due to something you’ve eaten. And if you discover (or confirm) that certain foods are affecting you physically, is it such a leap of faith to consider the idea that those same foods might be impacting on your mental state or exacerbating a mental health problem? More mental health services are responding to the nutrition/mind link. Ask your care coordinator or consultant if you can speak to a nutritionist. Meanwhile, if you take no other supplement, take a good fish oil daily – and try the probiotic drinks and yoghurt; there just might be something in it.
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Nutrition and Mental Health a handbook; edited by Martina Watts; published by Pavilion. ISBN: 978 1 84196 245 0 T. 01273 623 222 E. info@pavilion.com Editor’s note: after reading the book I was able to confirm that my racing pulse that occurred after I had eaten doughy bread with a filling that possibly included mayonnaise (shop/supermarket made sandwiches for instance), was indeed an intolerance to the wheat, gluten and particularly in my case, yeast. I’ve cut out bread except for the occasional piece of sourdough or Danish and it’s certainly made a difference. I also know that if I eat certain foods (still doing self testing) my mood can plummet, or I can start to feel anxious.
Born to middle class parents in Jamaica
Sylvia's father died when she was eight and this
seemed to increase her need to write, and she
Plain, Massachusetts, Sylvia Plath published
affected her profoundly.
often worked between four and eight in the
her first poem when she was eight. She was,
In 1956 she married the English poet Ted
morning, before the children woke, sometimes
on the surface, a model daughter, popular in
Hughes but less than two years after the
finishing a poem a day. In these last poems it
school, earning straight A's, winning the best
birth of their first child the marriage broke
is as if some deeper, powerful self has grabbed
prizes. By the time she entered Smith College
up. The winter of 1962-63, one of the coldest
control; death is given a cruel physical allure
on a scholarship in 1950 she already had an
in centuries, found Sylvia living in a small
and psychic pain becomes almost tactile. On
impressive list of publications, and while at
London flat, now with two children, ill with flu
February 11, 1963, Sylvia Plath killed herself
Smith she wrote over four hundred poems.
and low on money. The hardness of her life
with gas at the age of 30.
Stranger Danger Sometimes
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a moment arrives when you no longer recognise the person staring back at you in the mirror. Everything looks distorted and alien, as though your face is that belonging to someone else. It is easier not to look and avoid the past slashing like a razor through the hopes and dreams you used to have. It is devastating when you feel a stranger to yourself because you are no longer the same person. It is like being lost inside a photograph and unable to escape, and this is because it is hard to let go of who you used to be. Like an old comfy sweater that no longer fits, there comes a point when one must simply accept that it is time to find a new one. It has been said that ‘life is not about finding yourself, it is about creating yourself’. Therefore, we should try to focus on the times yet to come. In a sense, the self is an ever-evolving entity, constantly mutating and shape shifting. Your reality does not have to be your destiny; you can still pick yourself up and chase those dreams. When I opened up in therapy it caused so much pain to spill out of me, but the hardest aspect to face, was that I was no longer the girl I used to be, or so I thought. I felt as though my aspirations had been shot into space, unattainable, and that my courage was obsolete. After some seriously low times, I eventually realised that I had to look at ‘her’ for what ‘she’ was; the old me. One doesn’t get to a certain point in life and suddenly stop changing. Yes, the past determines who I used to be, but not solely who I am and who I will be, for they are also determined by what happens now. At the time I felt like a loser and a wreck. But now I feel like me again, because I have accepted that I will never be the same. Instead I am better because I found that part of me that was, and will always be there, and I am strengthened because of it. To support a sense of self, I found it helpful to write a journal. A journal, as suggested by Ira Progoff, who developed the Intensive Journal Method, often used in hospitals and prisons,
can be a therapeutic tool for becoming more aware of one’s life and one’s relationship with life. I wrote until I had flushed out the toxic self doubts and fears and until cleaner waters emerged. I found that I cleansed the wounds and then, after doing this, I found my voice again, and I was writing about what could be. The key is to write without stopping, and in an honest manner. Speak from your heart. Nobody else ever needs to see it. You could make a start by writing about your likes and dislikes, and let some things off your chest. Then, write about the hopes you may have for the future and the things that you would like to achieve; make tomorrow your focus. It is important to remember that the past is and will always be there when you look in the mirror, but so is the person you are now. Extend some compassion towards yourself, you are capable of so many things and you will be ok. The relationship with oneself, just like any other, commands love, trust and respect. Love yourself and others, trust that you are a good person and respect yourself as you should everyone else. A foundation like this will eventually lead to an understanding that you are what you are and that what has happened has happened, and that despite everything, there is still a beautiful world out there waiting for you to experience it.
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Directory Mental health NHS trusts across the south east................................................
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• Sussex Partnership NHS Foundation Trust. T: 01903 843000 • Kent & Medway NHS Social Care Partnership Trust. T. 01732 520400 • Isle Of Wight Healthcare NHS Trust. T. 01983 524081 • Hampshire Partnership NHS Foundation Trust. T. 023 8087 4300 • Berkshire Healthcare NHS Foundation Trust. T. 01344 415 600 • Oxfordshire and Buckinghamshire Mental Health NHS Foundation Trust. T. 01865 778911 • Milton Keynes PCT. T. 01908 243933 • Surrey & Borders Partnership NHS Foundation Trust. T. 01883 383838
Alcohol and drugs........................................
• Drinkline, 0800 917 8282 • Al-Anon, support for family and friends of alcoholics, find a local group 020 7403 0888. • Alcoholics Anonymous, find a local group – 0845 769 7555 • Drugscope, for information, www.drugscope.org.uk • Frank (for young people and parents) www.talktofrank.com • Surrey Drug & Alcohol Action Team – for local services, www. surreydat.org.uk
Anger................................................................. • British Association of Anger Management, 0845 1300 286 www.angermanage.co.uk
Anxiety............................................................. • No Panic, 0808 808 0545. www.nopanic.org.uk; • National Phobics Society, 0870 7700 456 www.phobics-society.org.uk; • First Steps to Freedom, 0845 120 2916 www.first-steps.org; www.anxietycare.org.uk (enquiries@anxietycare.org.uk to find out about accessing free advice and support)
Bereavement and loss................................... • Cruse 08701671677 www.crusebereavementcare.org.uk
Counselling..................................................... (but please note, waiting times can be long) • British Association of Counselling & Psychotherapy, 0870 443 5252 www.bacp.co.uk (for details of local practitioners)
• Heads Together (young people 14-25) 01737 378481. No fees • Croydon Pastoral Foundation, 020 8760 0665. Negotiable rates according to means • North Surrey Community Counselling Partnership, 01932 244070 www.nsccp.co.uk A sliding scale fee basis operates (up to £40.00 per session) • Pathways Counselling Centre, Epsom, 01372 743338. Professional counselling, normal rates apply • Redhill Counselling Centre, 01737 772844. Negotiable rates • RELATE, relationship counselling, 0845 4561310 www.relate.org.uk, for a local branch. A fee is charged for appointments. • Relateen, Epsom (part of RELATE but for young people disturbed/worried about parent’s relationship problems) 01372 722976 • Seastone Possibilities, Trauma Resolution Treatment 01306 640073 / 01737 249364 email: seastone@talktalk.net
Debt counselling........................................... • Christians Against Poverty; freephone 0800 328 0006 www.capuk.org
Depression....................................................... • Depression Alliance, 0845 123 2320 www.depressionalliance.org
Direct Payments............................................. this is money allocated directly to a patient/service user to enable them to have more choice and independence about the support/facilities they can access in the community. For more information contact: • Surrey Independent Living Council (SILC), Astolat, Coniers Way, Burpham, Guildford GU4 7HL. T. 01483 458111
Domestic abuse............................................... • Surrey Domestic Abuse Helpline (24hr) – 01483 776822 • East Surrey Domestic Abuse Services (covering Reigate & Banstead, Mole Valley & Tandridge) - 01737 771350 Email: support@esdas.org.uk Website: www.esdas.org.uk 9am – 4pm, Monday to Friday, confidential answer phone out of hours. • North West Surrey Outreach Service (covering Woking, Runnymede & Surrey Heath) run by Surrey Women’s Aid 01483 776822 (24hr)
Sanctuary magazine started in Surrey, commissioned by Surrey PCT. With extra help from Care Services Improvement Partnership in the south east, the magazine has a small circulation across Kent, Sussex, Hampshire, Isle of Wight, Berkshire, Buckinghamshire and Oxfordshire and Milton Keynes, as well as Surrey. We will continue to list organisations and help lines in Surrey in this directory but we’ve added each mental health trust in the south east and will include other important contact details as we can and space permitting.
We are building on this directory all the time. If you have anything to add that you think will benefit women’s mental health and wellbeing in Surrey, please let us know. You can contact Santuary magazine c/o Let's Link, PO Box 533, Betchworth, RH4 9FL. Tel. 07824 364703; email; meganaspel@sky.com
• North Surrey Outreach Service (covering Epsom & Ewell, Elmbridge & Spelthorne) run by Walton & Hersham Citizen’s Advice Bureau - 01932 260690 Email: nsdvoutreach.walton@cabnet.org.uk Website: www.waltonadvice.demon.co.uk 9.30 am – 4.30 pm Monday to Friday, confidential answer phone out of hours • South West Surrey Outreach Service (covering Guildford & Waverley) run by CAHA - 01483 577392 9.00 am - 3.00pm Monday – Friday, confidential answer phone out of hours
Survivors of childhood abuse................... • C.I.S.‘ters for adult women sexually abused as children Run by survivors for survivors – helpline Saturdays 10am – midday 023 80 338080
Eating disorders........................................... anorexia, bulimia • Eating Disorders Associations, 0845 634 1414 www.eduk.com
Hearing Voices................................................ • Rethink, 020 8974 6814 www.rethink.org
Post natal depression pregnancy and birth issues....................... • Association for Postnatal Illness, 0207 3860 868. www.apni.org; www.surrey.nhs.uk; www.babycentre.co.uk; www.netmums.com
Self harm......................................................... • www.selfharm.org.uk; www.lifesigns.org.uk; • www.rcpsych.ac.uk/cru/auditselfharm • Bristol Crisis Service for women (national helpline); 0117 925 1119. Friday/Saturday evenings 9pm – 12.30am. Sunday 6-9pm
Other useful contacts................................. Crisis numbers; • Samaritans, 08457 909090 www.samaritans.org.uk • Sane Line (12noon – 2am daily) 08457 678000. National out of hours helpline for anyone coping with mental illness – sufferers, carers, relatives or friends. • Surrey & Borders Partnership NHS Trust, 01737 778142 (24hrs) • Childline; 0800 1111
Community Mental Health Teams (CMHTs) • Spelthorne CMHT 01784 440204 • West Elmbridge CMHT 01932 876601 • Runneymede CMHT 01932 723392 • Woking CMHT 01483 756318 • Hollies CMHT 01252 312788 (8.30-5.30 Mon -Fri) • Surrey Heath CMHT 01276 671102 • Guildford CMHT 01483 443551 • Waverley CMHT 01483 517200 • Godalming CMHT 01483 415155 • Haslemere CMHT 01483 783090 • Farnham CMHT 01483 782095 • Conifers CMHT – cove, Fleet & Yateley area, 01483 783555 • Early Intervention in Psychosis, 01372 206262. For 14 – 35 year olds who have had a first episode of psychosis within recent years. • MIND, national organisation for mental health with local branches – www.mind.org.uk Infoline 0845 766 0163. Mind produce booklets on various mental health issues and campaign for better services • Mental Health Foundation, national organisation for information, campaigns, news, interaction, including information on the relation between diet and mental health; www.mentalhealth.org.uk Primary Care Mental Health Teams (PCMHTs) • for long term and complex mental health needs and for referral to specialist services such as Crisis Assessment & Treatment Team, Eating Disorders service, Continuing Needs services. Open Monday – Friday 9am – 5pm • East Elmbridge PCMHT – 020 8873 4300 • Epsom, Ewell & Banstead PCMHT – 01372 204000 • Mole Valley PCMHT – 01306 502400 • Redhill PCMHT – 01737 272301 • Tandridge PCMHT – 01883 385481 • Psychotherapy Service (Surrey & Borders Partnership NHS Trust). • Referral only but you can access an information leaflet; contact the Psychotherapy Service at Shaw’s Corner, Blackborough Road, Reigate RH2 7DG. T. 01737 277706 • Samaritans; 08457 909090 • Surrey & Borders Partnership NHS Trust, for mental health and learning disabilities services - 01883 383838 • Surrey Police; 0845 125 2222
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Is the NHS sick? Having
worked in the voluntary sector for over a decade and had a brush with employment in a mental health trust and in social services, I have observed how time and again it seems, local commissioners, providers, staff – under pressure as it is – have to respond to a considerable number of new government diktats or ‘innovative’ schemes, not least reorganisation. I recall one manager in social services saying when New Labour came into power; “This government hasn’t come in hitting the floor running, it’s come in hitting the floor reforming!” But has all that reforming had a backlash effect? Almost every day recently there have been news and reports in the media that serve as scathing indictments on the health service and its Whitehall protagonists. From an appalling report on patient neglect that levels deep criticism at some hospitals and its nursing staff (it must be stressed that the majority of
nurses are hard working and dedicated), the crisis in midwifery services with women having babies in corridors or toilets because of lack of space, to the news that the NHS must find £15billion ‘efficiency savings’. The latter is due to wide ranging reasons that include ‘horrendous’ – as described by a leading economist - debts incurred by the Private Finance Initiative (PFI). Then there is the revelation that the department of health (DH) has spent £500million on consultants during 2007-08; and don’t forget the billions spent on a national IT programme. Now the DH is performing a slow and rather quiet turn away from central control of IT, saying trusts should be allowed to develop their own solutions! Picking up on a couple of points:
Private Finance Initiative (PFI) PFI is a scheme whereby trusts can build hospitals through private finance. Contracts with more than 100 NHS
trusts have now locked those trusts into a period of repayment for the next 30 years or more. But because of our economic climate public sector budgets are being frozen, whilst the PFI costs continue to rise. The result, we are told, will be a financial bombshell for the next government. Already, trusts are being ordered to make ‘efficiency savings’ of £15billion. The outcome (a word government health departments are very fond of with regard to the patient ‘journey’) according to economists and Opposition politicians, will rebound on the very people the PFI drive was supposed to support - the patient, plus the taxpayer of course. Some trusts are looking at their estates ‘portfolio’ already and in one case a trust with four hospitals in its patch is closing the one that doesn’t have PFI debt attached to it. An A&E unit will close and maternity services downgraded.
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How many management consultants does it take to change a light bulb? The department of health has spent almost £500million on management consultants. A breakdown in a national newspaper informed us that 111 consulting contracts worth £132m were given to private firms in 2007-08 (many of which had government ‘cronies’ on the board); £2,000 per day is what some consultants in the NHS get; £15bn is the ‘efficiency savings’ hospitals must plan for; 62,000 is the number of hip operations lost to management consultant’s fees; and then compare all that with the starting salary for a qualified nurse - £20,710. Can that amount of input really be needed? Does it ensure grass roots improvements? How will we ever know? To the question ‘how many management consultants does it take to change a light bulb’ – well, we can’t answer that yet either because the
consultation period hasn’t finished! So is the NHS in the clutches of a terrible disease? Is it a patient in dire need of specialist care? A dichotomy exists between the disturbing reports of elderly patients being neglected and the government’s well documented and broadcast (conferences, speeches, reports, reforms) drive on quality and the patient’s experience. One thing is certain; we all have a vested interest in the NHS. Another newspaper article suggests the people and departments that deliver public services are averse to listening to we, the proletariat, amongst whom are many experts (what is the patient if not an expert on his/her condition?). According to some wise person this is because the public sector is inherently flawed. Through the ‘obsessive control of delivery by a central command structure’, targets, inspections and the like have become an orthodoxy ‘that few dare challenge’.
And doesn’t that lie at the hub of it? From commissioners to front line staff, to patients and carers and the voluntary sector, we all have valid and fair comment to make. Isn’t it about time government actually practised what they preach and listened? I’m sure we’d all give our comments free – or should we form a collective people’s management consultancy?
Megan Information from the Daily Telegraph, Health Service Journal, internet.
e i l I
e k a awat night...
e on me in th h’, it dawns ‘A . a re o in m t a e ncholy once the and sw have to wri haze of mela ’t t n le o io d v ‘I a t, n h .i .. of nig ire d’ivoire e corner of deepest no .’ ir t stands in th a a sp th e y d it f ct o n e lamp that e sa viridian hu nd rush to th ll but illuminating table a d e b e th a on its easel. I leap from I turn on a sm it is: the canvas, ready , ss le th a re re the room. B e light. The tanium whit ti h it ep across w s w glo already swe s e k ro st sh set out bru . I carefully urnt sienna o b d d n st a u r m e I b t m lee. I know wha A few raw u inous with g space. Now ig e rt it e h v w m e a I rg . this la . I begin ints, palette reveal brushes, pa eart lifts to h y m f o d n me in ht a ns, bathing y of the nig ig re re g w ’s o e n n y n a su ke n eP er brush stro rising crimso In no time th ft e a h e T k . n ro w st a d lue d fluid. Brush l. My paintbrush is my a cerulean b I am free an t. h prism g li and skil w o ll ultramarine f my desire e deep ye o th s e m u o h fr st e e deep to release m unveils the er. It seeks lp e h y m d n partner a eeds. I sigh – and it succ re and life, tu of solitude x te t, h g li rn to bed re of colour, tired. I retu mes a pictu y ll co e fu b ti u g a n e ti B d. digo and As my pain ent. I’m tire in a sea of in tm g n in te ft n ri d co l m lt blue. It is .Ia with viscera ream I have ne and coba d ri a e n m a o u ly q n a O d and sleep. ermillion an ochre and v d n a ta n e g ma lete. d I am comp heavenly, an
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Painting, writing, sculpting or another form of creative medium is therapeutic to many people who suffer mental distress. Many discover hidden talents and become accomplished artists. If you think you have it in you, there are several places that offer art and craft therapy, creative writing and drama workshops. Contact your care coordinator to be referred to something near you. In Surrey you can contact Art Matters on 01737 766 212.
It’s a two way street
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Nutrition and mental health
Strategies from the book (see page 6) to support a healthy mind:
1 ����� drink plenty of water; perk it up with a slice of lemon if you think water is just for fish to swim in! 2 ����� eat a healthy diet – food high in nutrients; vitamins, minerals, antioxidants, polyunsaturated fatty acids. Your body ‘speaks’ to you; unrefined foods, low saturated fat and sugar is the ‘language’ it prefers!
3 ����� buy local and seasonal and eat wholegrain; oats if you have an intolerance to gluten. 4 ����� eat quality protein every day if you can – meat, fish – and if you are vegetarian include beans and pulses with wholegrains
5 ����� two to four portions of fish per week are recommended. A good fish oil supplement is advised,
particularly if you can’t meet your fish quota. For mood, one gram of EPA and DHA (contained in fish oil, check the ingredients) is suggested
6 ����� avoid common blood sugar disrupters: sugar and other forms of concentrated sweetness, caffeine, nicotine, alcohol and stress
7 ����� eat the right fats: fish, nuts, seeds, avocados and olives are highly beneficial. Avoid hydrogenated fats (they should be listed on the pack)
8 ����� check labels for additives and long lists of ingredients. Less is more; fewer things added means maximum health benefits
9 ����� improve intestinal bacterial flora by taking probiotics, including lactic acid and bifido bacteria, found in yoghurts and those little drinks
10 �� de-junking your diet can cause withdrawal symptoms (just as coming off drugs and alcohol can) so
beware particularly if you suffer mental ill health. Make changes slowly and seek professional advice. Don’t stop taking medication, even if you are starting to feel better
11 �� consult your GP or mental health services about seeing a nutritionist and finally – adequate sleep, exercise, fresh air and sunlight are all just as important as the food you put into your body. Perhaps, by doing the one – eating well – the other, particularly sleep, will naturally follow…
As someone who has suffered the awful blackness of depression I am only too aware of the difference it makes to relationships with friends, family and partners. When things go wrong you blame yourself, not recognising that relationships by their very nature involve more than one person. A relationship is quite obviously a two way street.
For a time
my depression meant I was unable to find my “off” switch. I couldn’t relax, I just had to try to get through every minute of every hour. I felt very, very alone - isolated. Anyone reading this who has suffered from depression probably knows only too well how bad it is to feel lonely, even when you are with people. It is hard to get out and try to meet people when your confidence is shot to pieces. So it is inevitable that relationships, at best, change and, at worst, disappear altogether. That has certainly been my experience. I have lost a lot of friends – how true is it that when you cry you cry alone? But luckily for me through groups and courses I have made new friends who are in the same boat. As these friends have been down there in the depths of the black hole themselves they know how it feels. They have been able to help me through the bad times when “normal” people could not. You really do have to have been there to do it. We have now become a sort of loose network who meet to catch up and have a coffee. By so doing we have done more for ourselves than we could
19 possibly get from an over-stretched NHS. With apologies to Annie Lennox, service users are doing it for themselves. Meeting up is important as while we have other good friends they can be counted on the fingers of one hand and, to boot, are frequently busy working during the day. We are all now beginning to make contact with other people – the synergy we have together has helped us to grow stronger and more confident about who we are, our abilities and even our looks (not that easy for a woman...) As a result of this, one friend has gone from being completely agoraphobic to doing two different courses, working in a charity shop and getting a bus to meet up with her family on a regular basis. Social occasions are no longer the absolute nightmare that they once were. I myself have found that I now have the courage and the energy to use my skills as a writer and communicator for the benefit of a series of different charities, which, although it’s unpaid, has boosted my confidence no end. And on a lighter note, I can also go into the local pub alone to meet people without feeling totally sick from nerves.
Relationships with partners
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Need is not enough
Relationships with partners can be one of the underlying causes of depression, although this is often not recognised by sufferers themselves, let alone by healthcare professionals. I speak from personal experience – my ex husband was very credible to all and sundry as a “supportive partner” and had me well convinced at the time. In retrospect it is obvious that he was anything but supportive, but it sure seemed like it. I didn’t realise that he was isolating me from my friends by making it difficult for me to see them in the first place
Why do we want to try again anyway – surely once bitten, twice shy? I guess it’s the need to be wanted, to be valued, just to be held tight by someone – but need can seriously affect your judgement. Relationships based on need rarely work, as I know to my cost. After my divorce I screwed up big time by falling for a man more damaged than me by his previous relationship. While we shared almost perfect sex there wasn’t an awful lot more to it. Ever hopeful, ever romantic I kept right on in there for far too long, hoping it would all end happily ever
and then giving me a hard time afterwards when I got home. So I stopped going out. My world got smaller and smaller and my self esteem lower and lower. I honestly believed that he was right when he said I should just “pull myself together,” “stop being pathetic” and “... get on with things.” Only recently have I remembered so many things that I blanked at the time. It took going to a Domestic Abuse group, ironically to support a friend, to make me realise that I had been systematically abused myself. Although it was mainly mental rather than broken bones, he did often hold me against a wall while calling me every sort of slut under the sun. Talking to other women, it seems that almost everyone I have met suffering from depression has had a negative experience with a former partner. My own pales into
after. I knew it wouldn’t but my logic was no match for my need. Entering into any sort of relationship is scary when you are still patting yourself on the back for getting out of bed every day. Having someone interested in you, attracted to you, caring about you, is glorious, amazing, not to mention completely surprising. One of my friends couldn’t believe that her new man really did think she was clever, attractive and a really worthwhile person – why? Looking at the situation objectively I just couldn’t understand where she was coming from until I too met someone who thought I was great. We talk for hours on the phone every day, he does all sorts of things for me, he tells me about things we are going to do in the future. But can I accept that it is a good thing? No way.
insignificance when I think of two friends who discovered their partners were paedophiles, of another who suffered from appalling physical and mental cruelty and yet another whose ex husband tried to get her sectioned as a way of running off with another woman. Every single one of us had sex forced upon us (rape is perhaps not too strong a word), every single one of us was left feeling ugly, worthless and hopeless. Worse than that, it makes it hard to form any sort of new relationship. But you have to try and we help each other fight against the negatives we are left with. And things can pay off – one friend has seen her ex partner change for the better through going on the Freedom Course (for male abusers.) I admire her determination and strength.
Luckily for me I have really good friends who have been telling me not to run like the wind in the opposite direction (tempting, when you’re scared stiff of being hurt) but to stick in there and see what happens. And if it doesn’t work out then I will remind myself that there are two people in this relationship, not one, two. This time round I’m not just looking at myself but at him too. It is, as they say, a two way street, and armed with that knowledge I will be brave, stay positive and see what happens – who knows?
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Serendipity t u o h t i w e c n e d fi n o c f ! l g e a S t e c i r p y t f e h a 22
nce differe urself e h t o e. It is n of y lled lif r perceptio ect your lfi u f e f u af or us. Yo gam tically to livin ling ambitio it can dras h yourself. y e k e e o it e is th and fe you, and s ou have w y fidenc hopeless e n e ip s o rd to c h s s Self ling ther tion ashca e o fl la e f e a w r o n g e h e in p it betwe greatly on hers, and th y writ t. Kee live, t , but b ny momen ts o ll c a a h o t p it s y w in im a re u ard to yourself at where whe nships h io t e la b e r e an ge it som g, it c coura thinkin you can en in, or place f o y a r, he tra As a w a reminde it on t s d a a irror. e p r e ke and the m g n a o b it r ... in you even stick to try ps u a e o h r y e p deserv e for
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Just when you think there’s a light shining through you open your eyes and it’s still ever true just when the candle of hope is alight it’s blown out by the winds and in comes the night Alone I will lie with only my mind to keep me from slipping away from mankind for fear of the dark is much greater to me as although no light is shed, there is more I can see Through life I will stray undirected, unguided who I am, why I’m here I am yet undecided my purpose unknown, my path so unsure the battle goes on as dawn calls me once more On we must march through life’s weary game and tied to out backs the worry and shame for no-one is there to lighten the load so we must march on down life’s weary road. (written by a survivor when aged 16)
A-Z of Mind Matters will be back in the next issue
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