Monthly Archives: January 2015

Social media and mental health

Yesterday I was able to attend an event at the ORTUS about social media and mental health. A variety of topics were covered, including how staff in the trust felt about social media and the ways in which patients are using it. A lot of questions were raised and it got me thinking about the uses and positive aspects of social media as a communication tool.

Social media can be a vital tool for some people who struggle with their mental health. One of the best things that social media is able to do is connect people – which is good for members of the community who may be isolated for some reason. When I am ill I find myself actively isolating myself, and often places like Twitter and Facebook are my first ports of call when I feel able to “re-integrate” and feel ready to put myself out there again. You can reach existing friends and family, but also make new relationships with people. The ability to do so all in one place can be quite appealing for some. I have made some of the most amazing friends through the internet and it has opened up so many opportunities for me, helping me to stay connected to people who I care for and work with.

People also find social media therapeutic. There are countless blogs where people write openly about their day-to-day struggles and find support in other people. Of course this is not just limited to bloggers, there are vloggers (people who blog to a camera), twitter users, tumblr users and instagramers just to name a few. There is an online mental health “community” which provides people with a (mostly) non-stigmatizing environment where users are free to express how they feel and help others. One of the things that came up yesterday was how empowering it was for people to have a space to do so – to feel listened-to and cared for, and to be able to speak up and share their experiences is immensely validating. Social media also provides the choice of anonymity which is incredibly valuable. Speaking out also helps to reduce the stigma that surrounds mental health problems and works at making it something that everyone finds acceptable to speak about openly.

But while social media can play such a large role in patient’s lives, it was clear that some clinicians weren’t sure how to approach it, or how to speak to their patients about their social media use. A comment was made that in CAMHS “service users are worlds away from clinicians… [the staff’s ‘world’ growing up] is not the world that the young people we are treating live in”. A concern raised was that staff didn’t have the “correct vocabulary” for them to be able to speak to their patients. As a young person accessing CAMHS services, this made me think. As well as positives, social media can be used in negative ways and I’m unsure that I would feel comfortable speaking to my therapist if a situation had arisen online and was impacting on my mental health in some way. Although my current therapist seems quite tech-savvy and seems to understand the complexities that can be found online, I’m not sure that every professional I’ve come into contact with is the same. This would probably prevent me from speaking to them because I wouldn’t be sure what they would be able to “grasp”. In my experience, often when things go wrong on social media there’s many levels to it and even explaining to the most knowledgeable person on the planet could be a challenge! I think that this creates some grey area between the clinician and patient – staff not feeling confident enough to approach the subject and patients not feeling as though they would understand. It was suggested that there should be some form of training on social media for staff and I genuinely think that it would be a good idea. Even just basic knowledge could improve the communication between staff and patients.

Resilience

Resilience seems to have become a buzz word at the minute. More and more nowadays I’m hearing the term in a variety of contexts, not always directly related to mental health.

However to me, resilience seems to be a bit of a wishy washy term. Maybe it’s because you can’t physically “see” it as such? When I was first introduced to the idea of resilience in a direct way it took a while for me to get my head around it.

I am part of a project called HeadStart. The aim is to build the emotional resilience of those aged 10-14, equipping them with tools to succeed and in doing so hopefully preventing the onset of common mental health problems. On Monday I co-facilitated workshops for young people at the National HeadStart Conference in London. We covered the idea of resilience, who helps us to build resilience and how they do so, why it is important to reach young people who may find it hard to engage for a variety of reasons (those not in school, those with other responsibilities like young carers etc) and how everyone’s input is vital for successful co-production. What we tried to show was that resilience is not just from within us – other people and situations can contribute to our resilience, and likewise, we can contribute to the resilience of others. It struck me that this is what I had struggled in understanding initially, I had thought that it came solely from within me and if I wasn’t particularly resilient one day then I was just a failure. I have a tendency to think catastrophically and in a very “black and white way” meaning that to me if I wasn’t resilient enough then I may as well just sleep away the rest of my life because why not?
It has taken a while for me to grasp the fact the resilience is fairly “liquid”, there are times in our life when we will be masters of bouncing back, and other times when we will be more vulnerable to difficult situations becoming overwhelming. That is no reflection on us, or our abilities! We can all harness our resilience and take simple steps to improve it.

Something I also wanted to address was the idea that simply building up resilience is the answer to everything. Now I am not a mental health professional, I am a 17 year old service user – but I think that the importance of early interventions should not be forgotten. Resilience and looking after your well-being is all well and good but is not a complete answer if someone is struggling with their mental health. I am just hoping that it is not seen as a replacement for other types of intervention for those who need it. Building emotional resilience and teaching young people the “5 ways to wellbeing” isn’t necessarily going to eliminate the risk of them developing mental health problems. If I had been aware of things I could have done to help myself at 12, I’m still pretty sure that I would have got ill regardless. Maybe it would have manifested in a different way but it wouldn’t have stopped it.

Just some thoughts for today!

#MHConf – real concern or just pre-election talks?

This morning I woke up to my Twitter timeline being flooded with the talk of suicide prevention and the hashtag #MHConf. After some rooting around I found that Nick Clegg was holding a conference in order to address suicide – more importantly, calling for the NHS to adopt a “zero suicides” policy. I had seen an article last night announcing the Lib Dem’s proposition, however hadn’t realised that it would be being discussed today.

Here’s the link to a transcript of what was said this morning if anyone was interested: https://www.gov.uk/government/speeches/nick-clegg-at-mental-health-conference

I am all for any measures being taken to reduce suicide levels and help those at risk of suicide. Everyone who works in mental health services and the NHS work tirelessly to prevent suicides. But as many people were saying on Twitter, it goes beyond saying “well we’ve had an x amount decrease in people completing suicide since whenever so clearly everything is going well”. A decrease would be welcomed, of course, but what about people’s quality of life? Just because the suicide rates may go down, it doesn’t necessarily mean that people are thriving and living their lives to the full.

It’s also struck me recently that there has been a lot more talk around mental health and a lot of promises being made by politicians. We’re also fast approaching the General Election, with pools of new potential voters who have come of age in the past 5 years and can now vote. Nick Clegg has been a part of a government that has overseen mental health services being cut to the bone, cut 1600 mental health beds and left people in crisis with little consideration to their mental health. I heard little objection over the past 5 years from the Lib Dems. However with the next GE on the horizon, Clegg is now “passionate” about mental health. I, and many others, failed to see that “passion” being demonstrated over the past few years. Towards the end of last year however, people like Norman Lamb started to speak up about the importance of funding in mental health, especially in CAMHS.

This is all well and good but I can’t help but see it as a publicity stunt to some extent. A “look at us, look how much we care” last ditch attempt to try and swing some more potential voters. They don’t have the backing, nor the money, nor the dedication to make the change they claim they want to make. I’m sure that mental health is a concern, and having met Norman Lamb, I know that he does want to see a difference. But having spent 5 years dismantling the services which they now want to see working again to the best of their capacity is bordering on rude.

Is the current state of crisis in the NHS a mirror of mental health services?

Ask anyone in Britain right now about the state of the NHS at the minute and they’ll tell you this: “it’s in crisis”. This fact is everywhere at the minute, and rightly so. The media reports and statistics are very much focused on physical health, a&e waiting times and the unavailability of GP appointments. Hospitals are declaring major incidents left right and centre as they struggle to cope with the demands on such underfunded services.

This is causing outrage – how can the NHS be struggling so much at the minute? It strikes me that this is a mirror image of what mental health services look like in many places, and have done for quite some time now. In 2013, whilst waiting for an inpatient (CAMHS) bed, I was told there were none in the country. None. I was later told that the closest bed was in Birmingham – I live in London. Thankfully a bed became available in London for me. I don’t recall the media having a field day over the fact that there were no beds in the entire country for young people. I was lucky, but some young people find themselves on adult wards, stuck in general hospital for prolonged periods of time, or even in police cells following a s135/136 where no alternative places of safety were accessible. Rarely do these instances make the headlines and even if they do, by no means do they dominate them with the same ferocity as we have seen recently.

Budgets in mental health services are consistently low. CAMHS only receives 6% of the total MH spending, of which £50m has been cut recently. How on earth are services meant to provide a well-rounded service with such little funding? Mental health problems present in adulthood are quite often prevalent in childhood/adolescence, so why does CAMHS get such a raw deal? Increased funding a resources put into CAMHS could change the face of AMHS – early intervention in youth could save lives and prevent problems from escalating. As I write this I am aware that this is well known, so I won’t waffle!

The reality is this: mental health services are in crisis. What seems to be an often overlooked crisis. Staff work incredibly hard and everyone I have come into contact with has been 100% dedicated to helping people. Despite being understaffed and over worked (as was so often apparent when I was an inpatient). Sometimes there’d only be one nurse on shift, co ordinating, bed managing, having to somehow look after the 11 people in their care, call the ETL to dispense meds whilst trying to find other young people a bed up and down the country. Not my idea of a relaxing Saturday morning! But despite that, everyone strives to do the best for those they are looking after. A nurse once said to me “if I could have you all on 1:1 to give you the nursing you all need, I would. But I can’t. ”

I digress. Just a small piece in recognition of all those who work in the NHS.

A&E is in crisis. Where does that leave us?

The media has been inundated with headlines about the A&E crisis recently. Well, the whole of the NHS is really. Around New Year’s Eve professionals were worried about how A&E would cope with a notoriously busy time of year on top of the current over stretched system.

Recently there has been an influx of posters and other resources being used by the NHS to help people decide whether or not they really need to visit A&E for treatment or if out of hours GPs, walk in centres etc may be better to go to. It strikes me as kind of “self triage” system. However what these resources seem to omit is what to do when you are in a mental health crisis. In all my years in mental health services, the thing that has been communicated to me the most is that in crisis you should go to A&E. Even crisis teams tell you to go to A&E in crisis. Seems fairly straightforward. But what happens when you get there?

I appreciate that A&E departments are primarily used to treat those in urgent need of physical treatment. But where do you go if you’re in psychological distress? Especially if out of office hours and you have no crisis team. In my experience, a majority of the time, unless you are in immediate physical danger then many staff have no time for you. (There are exceptions and I have had some amazingly positive experiences but on the whole it’s been largely negative.) While I understand that if you present at A&E in distress but not having harmed yourself you probably won’t be seen immediately, there is a difference between waiting a reasonable amount of time to speak to someone and being blatantly ignored. I feel that crisis is not being taken seriously unless you have harmed yourself/others. For instance you can tell anyone who will listen that you’re suicidal but unless you actually attempt then many won’t listen. Actions do not define the extent of someone’s distress. We should not have to wait for someone to act in a risky way to acknowledge their crisis.

This then leads to the “but am I really ill enough? Do I deserve this treatment?” Because you cannot see mental illness, it can be hard to judge the severity of someone’s difficulties by looking at them. It’s not like a visible wound where a doctor could say “yes… That needs stitches”. But when crisis is not acknowledged it can stir up a whole load of questions in an individual – why are they not listening? Do I not actually need the help I think I need? Someone who had just broken their wrist would probably not question whether or not they need a plaster cast. So why do we question whether or not we are worthy of help? Where does the government urging people to stay away from emergency departments fit into the needs of those experiencing a crisis who don’t feel as though they can go to A&E? I can’t help but feel as though many vulnerable people are being put off going to emergency departments despite needing help urgently for their mental health. The tone of many articles I have read could definitely be misinterpreted as telling people to basically stay as far away as possible from hospital.

If you are in crisis and and feel as though you are unable to keep yourself safe, please do reach out. If you do not want to go to A&E, the Samaritans are an amazing organisation.

I’m not sure that I actually got to the point that I was trying to make but I hope that it did make some sense somewhere haha. I just felt like reflecting on things that I had heard in the news over the last few weeks.