Art and mental health?

Art is increasingly playing a role in people’s recovery from mental health problems, serving for some as a way to make sense of their world, to express feelings or to communicate. Art plays a unique role in each individual’s journey, mine included. While I didn’t want this blog to become too personal in terms of my mental health, with recent news coverage of the Bethlem Gallery opening at the Bethlem Royal Hospital (sister hospital to mine, the Maudsley) I felt like reflecting a little on how art has (or hasn’t) helped me!

If at any point before the age of 15 you had mentioned art to me I would have brushed you off. If you had mentioned how art can be used to help people who struggle with their mental health I would have most likely laughed. Not because I was an ignorant 15 year old, but because art has always been a sore subject for me. I had, for years, resigned myself to the fact that I couldn’t draw to save my life. My confidence was also far too low to comfortably engage in drama lessons at school, which knocked any notion of theatre as good thing in any way right out of my mind. The only art form I would have embraced would be music! I got into my secondary school on a music scholarship playing the clarinet, and music has always served as a rock for me.

When I was 15 I went into hospital. On my CAMHS ward there was a lovely art psychotherapist who ran an art therapy group every Thursday with the help of the consultant. I spent the entirety of my first admission dismissing the group, instead using the time to have my weekly Thursday post-lunch siesta. I tried very hard to convince all those around me who mentioned it that art made me incredibly angry, which would be counter-productive as it was meant to be a therapeutic group. I was eventually discharged having done practically no art at all.
A month later I was re-admitted and this is when I really caught the art bug. Over time I began to go and soon it was a highlight of my week – I’d purposely re-arrange any other appointments/commitments in order to attend! Around the same time I disclosed some things that I had never previously spoken about, and art gave me a chance to process it almost. It became the tool I turned to the most in order to communicate with staff, both about how I was feeling and about things that had happened. It also gave me the ability to say things without really saying anything. I could put things down on paper that to me were monumental, but would put have meant anything to others from glancing at it. It served in giving me some control in terms of what I could tell others as all around me things weren’t in my control at all.

That summer the Young Vic came to us and did some amazing work. It was my first introduction to theatre and how it could be used beyond the west-end. Although being in hospital is not the best of places, with their involvement they transformed my summer and no doubt those of everyone else on the ward. That was the first time in my life where I’d actually thought “hang on a minute, theatre can be quite good?!” We had parties, massive banquets, tree houses built on-site, a Ferris Bueller evening in the gym (everything had been made into an American gym/school hall, with a screening of Ferris Buellers Day Off)… We were even given 2 blank white gazebos one day with a LOT of paint and let at the walls! It was totally engaging and just brilliant fun, and completely transported me away from the real world where I was sectioned and on 1:1 in a psychiatric hospital(!)

Since my discharge from hospital I was lucky enough to be able to go on work experience at the Young Vic which was great! The team are lovely and totally dedicated to their work. I’ve been involved in a couple of projects since and while I’m still not confident from an acting point of view, I now see how immersing theatre can be and completely understand how people would find that helpful.

We make our feelings known on the lack of funding for mental health services, but from what I can see the arts have it just as bad! I would completely advocate for art (in any form) to be used to aid people’s recovery and sadly I don’t see it enough. If anyone is struggling and has never considered art, I would recommend it. Figure out what you prefer, if any, and go for it. Art doesn’t have to be drawings National Gallery worthy, they can be scribbles, or music… Just about anything.

Compulsory sex ed for 5 year olds?

TW: mention of sexual abuse, please take care.

A few days ago, Tristram Hunt MP, Labour’s shadow education minister unveiled plans to make sex and relationship education (SRE) compulsory from Key Stage 1, when pupils are between 5-7 years old. It is part of a bid to tackle homophobia in schools and make them “zero-tolerance” areas for homophobic bullying.

I completely stand by these proposals! I tried to look online in order to gauge other people’s responses to it. In doing so I stumbled on the Daily Mail website, and the comments there completely reinforced my beliefs.
It is so important that SRE is compulsorily taught from an early age. With education comes empowerment. I’ve heard someone say that children knowing about sex at 5 is wrong – what’s wrong is some children being subjected to traumatic experiences and abuse but being too scared/confused/uninformed to feel able to seek help. That is what is wrong. I’m by no means saying that it’s as clear cut as sex ed being taught and all abuse/exploitation being eradicated, but it is absolutely vital to lay down the basics and let children know that their bodies are theirs and no-one else’s. This message may not be one given to them by their parents/carers so it is important that they do receive it from somewhere, school in this case.

On Wednesday we had a YoungMindsVs hub meeting, which focused on sexual health for the first part. Some people thought that sex ed at 5 was too young, why not save it until puberty? For me and so many others this would have been too late. Children need to know about consent, their body and inappropriate behaviour as early as they can. Why would anyone oppose to empowering our youth?

The #camhslogic tag

As a warning – this blog post may read as more of a rant than much else. It may also be quite short.

The last post I wrote was on social media and mental health. This is a branch of that – the #camhslogic tag. For years people on Twitter have used it (and lolcamhs) to express their annoyance with CAMHS services. I first became aware of it when I was around 13 in 2011 on Tumblr and I still come across it to this day on various social media platforms.

But the tag seems to deter people from accessing CAMHS services. Countless times I have seen young people asking others about what CAMHS is like, only to get told that they are disastrous and a service to be avoided. I honestly believe that the tag has damaged the reputation CAMHS has, both online and offline. Which is awful! I have been in services since the age of 13 and I have generally had positive experiences. There will always be exceptions but I do think that all staff do the best that they can to care for their patients. This isn’t just in my local mental health trust (SLaM) either, yesterday I found myself in a crisis in Sussex and the staff I came into contact with were brilliant. But the world of social media for a teenager can be convincing and I know that if people slate CAMHS to the extent which they are slated online it does have an effect. When I was first told that a referral had gone through I tried to research it online (although initially spelt it as cammes so didn’t get very far haha!) and if I’d found some of this content, I’m not sure I’d have gone to my assessment.

I only ever hear “CAMHS are rubbish/I hate CAMHS/they don’t know what they are doing” I’m sure that some comments are warranted, I’m not saying that all care is top-notch all the time, but it is unfair. There’s no money. Many staff are over-worked. They have to make difficult decisions day in day out. Depending on who they are seeing they may be constantly managing risk. When do they let someone who is alluding to the possibility that the may harm themselves go? There is 1 free CAMHS bed in the whole of England tonight, who aren’t accepting admissions overnight. So hospital isn’t an option. They’ve got to let them go and manage risk in the community. That’s their call. That’s not an easy call. Even if they aren’t working with high risk patients, it’s not a walk in the park.

I think that young people should cut them some slack. I also think that professionals should also take a look at the tag and see what they make of it! Maybe we should be making more of an effort to involve young people in PPI events and encourage them to make a difference within the service, rather than turn to social media.
(The #crisisteamfail is also a hashtag which is fairly similar that was quite popular a while ago, but more geared toward AMHS/crisis teams.)

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.