mental health

I wasn’t going to write another The Archers blog but….

My first Archers blog was about why it’s wrong to accuse someone of having a mental illness as if it were an insult. My second was about the chicken and egg relationship between mental illness and domestic abuse.

And this one? Well, it’s about the anguish we feel for women like Helen who find themselves caught in an abusive relationship trap. And my wish to make sense of this gripping story in both literary and psychological terms

How the story makes us feel

I defy anyone who has actually listened to The Archers recently not to find Helen’s situation upsetting. This week’s interview with her barrister, the apparently brilliant Anna Tregorran, was particularly so.

I know some people are saying it is too much. I understand. But I also disagree. Fiction plays an important role in our emotional and psychological development. It helps us to understand the bad things that can happen and practise emotions that we may one day need to use in real life. This is why so many children’s books feature cruelty, unfairness and loss – Bambi, Black Beauty, Little Women, Harry Potter.

Most listeners to The Archers don’t need to prepare for domestic abuse themselves. But they will undoubtedly come across someone else who experiences it. If Helen’s story has raised people’s awareness even a little, so that they are alert to the signs and don’t pretend it can’t happen in any family, then that is a very good thing.

Reflections in literature

I heard The Archers producer Sean O’Connor on the Today programme this week speaking about the literary references evoked by this storyline. He mentioned the Thomas Hardy classic Tess of the D’Ubervilles, which I could not bear to re-read because what happens to the central character is so awful. It made me think of that other classic, A Pin to See a Peepshow by F Tennyson Jesse, which has an equally grim denoument.

Women touched by madness who turn on their cruel husbands appear in other works of fiction, including Jane Eyre and Wuthering Heights. Both meet sticky ends, whereas their husbands survive, albeit scathed.

In real life, the last woman to be hanged in the UK was Ruth Ellis. She killed her abusive lover, handed herself in to the police and stunned everyone including her trial jury and executioner with a dignified acceptance of her fate.

Why can’t the police see through Rob?

I’ve been puzzling about this. Of course, it works for the story that Rob remains plausible for the time being. But is he faking it? Probably not. People like Rob, ie narcissists, really do believe their own hype. His reaction, being pathetically sorry for himself and yet capable of sticking his own metaphorical knife into Helen as soon as he gets the opportunity, is not how most of us would react to being stabbed by our partner. We would be deeply traumatised, shocked and inarticulate. Like Helen. I am really hoping that Borsetshire’s finest have got a good psychological profiler on the team who will help them see through his glib account.

Is it better for Helen that Rob has survived?

Initially, perhaps not. Rob is now a witness. The police must listen to his story and he will do his best to implicate Helen as a mad, bad attempted murderer. Plus he is allowed to see Henry and so has the opportunity to manipulate him and plant untruthful ideas to confuse the child about what he may have witnessed. Which at the very least was that Rob got the knife out and was inciting Helen to cut her wrists just before the incident occurred.

On the other hand, attempted murder is better than murder. At some point, Helen will start to remember how Rob made her feel. Without the guilt of having killed him, and with the help of her legal council, she will hopefully start to judge herself less harshly than she is doing at the moment. And the pain of Rob being allowed to see Henry when she cannot may just be the motivation she needs to make her fight for herself. As she was doing when the incident occurred.

What could happen to Helen?

I’m no legal expert. But I know a bit about mental illness. If Helen is convicted of attempted murder, I hope she would be assessed not to have been in her right mind at the time of the assault. She would then hopefully be sent to a secure mental hospital to receive expert treatment and care. With the right help, she could be released on licence within a few years. And with luck, she would see the children while she was in hospital and get help to look after them when she comes out.

But in reality there are not enough places in secure hospitals for women. And in any case Helen already seems to be being led down a criminal justice pathway rather than a mental health one. And so the likelihood, if she is convicted, is that she would go to a women’s prison and spend a number of years behind bars. The baby would probably be removed from her soon after birth because she would be considered a risk, based on the nature of her offence. And Rob would go to court and probably be successful in getting full custody of both boys. Helen is already at high risk of suicide; this outcome would increase her risk level.

But the most hopeful scenario is that, with support, Helen will be able to mount a successful defence that she acted in self defence and/or provocation because of the abuse. She might then be given only a suspended sentence.

But she will still have to fight Rob for custody of her own children. She faces a long, hard battle. And we all know her resources are already depleted.

What does the story tell us about the way we treat women?

For me, this is the key question. There are numerous real life cases of women serving sentences for the murder or attempted murder of abusive partners, despite suffering years of cruelty and abuse. When partners, usually women, act as Helen did either in self defence or because something finally snapped, they are judged harshly by the media and by juries.

And is it also disturbingly the case that only a fraction of those who abuse their partners are ever convicted of assault. The new offence of psychological abuse has only seen a handful of convictions. Plus it will only apply in Helen’s case as a defence – Rob is not the one who has been arrested and charged.

There are no winners in domestic abuse. Victims often get blamed not only by the abuser but also by others. If there are children, their long-term mental health can be permanently affected by living in a culture of fear and violence or even being separated from their mothers, like Henry.

We need a more humane, honest approach to domestic abuse. We need to talk openly with boys as well as girls about what loving relationships are. And what they are not. And we need to find better ways to challenge the way partners, male or female, are treated by complete and utter tossers such as Rob.

The next time someone you know puts their partner down in public, speaks dismissively about them or seems overly possessive, remember Kirsty. Maybe you could find a way to speak to the person you are worried about, and ask if they are ok. Even if they brush you off, know this: at some level they will have been listening.

And that might just be the catalyst for them to get help. Before it is too late.

What mental health means to me

I took part in a Twitter chat recently on the above topic. Thanks to @AnthonyLongbone for encouraging me to join in. Below are some thoughts I shared in advance.

What does mental health mean to me?

  1. Mental health is the most important part of health. And it is integral to physical health. You can’t look after your body if your mind is in a poorly way.

  2. Mental health is a continuum with optimal wellbeing at one end of the spectrum and mental illness at the other. Some people seem to be able to take good mental health for granted. For others, maintaining our mental health requires almost constant vigilance and care.

  3. Facing up to my tendency to depression has been the most important self-help step I have taken in my life so far. I’m hopeful I won’t ever sink as low as I did in 2013. But I’m not making any assumptions. And I do not plan to judge myself negatively if I do experience another bout either.

  4. Judging myself – or indeed others who experience mental illness – is the least helpful thing any of us can do. Who knows why I or anyone else has this tendency? What does matter is what I do from now on to help myself and allow others to help me. Which includes understanding my own triggers and warning signs.

  5. All serious illnesses require some degree of courage, so that we can face the pain and the treatment required to help us get better. But mental illnesses can be harder to bear than physical illnesses . They mess with your head.  They make you believe bad things about yourself and others. They take away your hope and they affect your judgement and even your personality. They make you isolated and afraid. Some people hear the voices of others telling them bad things. In my case, I only hear my own voice. When I am poorly, my internal voice is harsh, judgemental and cruel. It tells me I am worthless and evil. I am still learning how to notice that voice when it starts whispering to me, and how to answer it.

  6. Since I decided to be more open about my own experiences, I have made some extraordinary friends. Our mutual support during rocky moments via social media undoubtedly saves and enhances lives. I love the equality and the loving kindness of these relationships. We all have something to bring.

  7. It’s because of all this that I know how amazing other people who experience mental illness are. How courageous, funny, honest, thoughtful and kind – hearted.  And this is how I know, beyond all reasonable doubt, that people who have had such experiences have assets that should be applauded and sought by others. Rather than deficits to be pitied or avoided.

…………………………………………………………

After the chat, I felt a bit overwhelmed. The people who joined in were just amazing. Brave, honest, intelligent, thoughtful, generous and kind. I am in awe of them. They have far more of merit to say than I do.

In conclusion, what mental health means to me is being part of a group of wonderful people like the ones I was talking with tonight. They are helping me to become the best version of myself, which includes being kinder to myself. Through this, I can become kinder to others and do my tiny bit to help them too.

And I’m really grateful to be on that journey.

The ones who matter

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It was nice that 12,500 people read my two recent blogs on the mental health angle of a current The Archers storyline.

But it wasn’t all good. I am a sucker for positive reinforcement, including WordPress stats. And I doubt I will ever again get 4,500 views in a single day.

And that’s the thing about maintaining one’s mental well-being if you are one of the 1:4 people like me for whom it is sometimes a struggle. I’ve been a bit down since those two blogs. I’ve questioned whether I’ve got anything interesting left to say. And yet I know I need to write about stuff to work out what I think.

Here’s what I’m thinking about today.

Someone said to me recently, with real sincerity, that the tide is turning on the stigma of mental illness. They said they thought that the battle had been won because people like me can stand up and say that we sometimes need help from mental health services. And not be judged.

But I thought hmm.

Because it doesn’t feel that way. Not to me, nor the friends I’ve made through social media and in real life. Especially not those who haven’t been as fortunate as me and are forced to grind out an existence on state benefits juggled with occasional paid work. The positives from such work are overshadowed by arcane, dis-empowering rules of which it is almost impossible not to fall foul. Nor does it feel that way to those who live in fear of losing their homes, or who haven’t even got a place to call home. Current government policy feels deeply discriminatory and the exact opposite of therapeutic for those already experiencing the potentially crippling challenges of mental illness.

It doesn’t feel that the stigma has gone away for the people who can’t get the right mental health treatment, or even any treatment at all. As a wise person recently said, imagine telling the parents of a child with early stage cancer that they have to wait until things seriously deteriorate before they can see a specialist. And even then, the care will be rationed and probably not what is recommended. That’s the reality in many parts of the UK, for children and adults too.

I heard a senior commissioner say the other day that they would love to invest more in mental health, but the evidence just isn’t strong enough (my italics). What planet are they living on?? True, spending on mental health research is woeful. But there is nonetheless masses of really good evidence about what works. And it starts with intervening early via properly funded local services delivered by highly trained, well-supported staff.

What also doesn’t help reduce stigma is the almost constant service redesign and reconfiguration. Indeed, the billion pounds of “new” money announced by Jeremy Hunt after the Mental Health Taskforce Report was published is not, in fact, new at all. It has to be achieved through efficiency savings. I know from experience that such initiatives rarely achieve all that is promised. And they almost never take account of the collateral damage to staff well-being.

Not to mention competitive tendering, which mental health services face at disproportionately greater levels than other parts of the NHS. Plus the drip-drip reduction in mental health funding and the erosion of national data collection so that it takes the skills of investigative journalists to uncover the ongoing cuts that have been made over the past 6 years despite government rhetoric about parity of esteem for mental health.

And what adds further to the stigma is that the media rarely mention mental illness or mental health services except when something appears to have gone wrong. Where are the motivational stories like the ones about people who have “beaten” cancer? Even when no mistakes have been made, the finger of blame gets pointed. Imagine how this feels to staff who work in these services, being pilloried for doing a job that most people couldn’t begin to contemplate because they don’t have the skills, patience, courage and compassion needed to work in mental health. They should be lauded and supported, not ignored and criticised.

So no, the stigma of mental illness is not a thing of the past. It is ugly, cruel, destructive and ever-present. Like racism, sexism and homophobia, it will never truly go away. We have to be vigilant. And we have to keep working at it.

Despite the job I once did, it took me until I was 58 to get over my own self stigma and admit that I experienced clinical depression from time to time. Coming out about it was the hardest but also one of the best decisions I ever made. I take my hat off to others who have got to that point sooner than me. You are braver than anyone who hasn’t been there will ever know. Showing the world that people who experience mental illness have hopes and ideas and other wonderful human assets to share is the best way there is to make others want to join us and change the way things are.

Writing about mental health and The Archers was fun. Writing this piece was harder but far more satisfying. I will try not to care how many people read it.

Because the ones who do are the ones who matter.

 

What should poor Helen from TheArchers do now?

It was nice to get such a lot of interest in my blog about whether it was Helen or Rob Titchenor who needed to see a psychiatrist. As they are both fictional characters, it felt OK to surmise about their relative states of mental health, and also to remind people who were getting excited on Facebook and Twitter that having a mental illness is not a character flaw.

But right now, Helen is in turmoil. And because the writers, the producers and the actress have created someone people care about, there is a lot of advice flying around – to Helen herself, to her friend Kirsty, to her parents Pat and Tony, to her odious mother-in-law Ursula and to her abusing control-freak husband Rob. I realise that the scripts have already been written and the recordings made weeks ago, but nonetheless, here are my thoughts. They can’t help Helen, but they might help someone like her. Or their children, family and friends.

Should Kirsty break her promise and tell Pat that Rob hit Helen?

No. Because Helen has only just started to confide in her. It is really important for women who are abused by their partners not to experience what might feel like abuse from others. Helen is not in immediate danger. The best thing Kirsty can do is be there for her, listen to her and gently help her work out what to do for herself. It helps that Kirsty has sought advice from a domestic abuse website such as the wonderful Rise UK http://www.riseuk.org.uk/ It is important that Kirsty stays calm, despite how angry and upset she feels. There may come a time when she has to break her word, but not now.

Why hasn’t Helen’s psychiatrist done something already?

Again, it is vital to build trust. If the psychiatrist is doing their job properly, they will be carrying out a careful assessment of Helen. This should include checking for signs of abuse. I just hope they don’t allow Helen’s history of previous mental illness to mislead them. It is one of the curses for people who, from time to time, experience mental illness, that they can become defined by their medical history rather than it simply being a small part of who they are.

Isn’t it a good thing that mother-in-law-from-hell Ursula is going home?

I’m not sure. While Ursula is truly ghastly, she does offer some degree of protection from Rob’s more diabolical deeds. As far as we know, she isn’t the one who has been tampering with ovens and bathwater, hiding things or messing up orders at the shop so that Helen has started to doubt her own sanity.

What should Pat, Tony and Tom be doing?

They should also be listening to Helen, which means not necessarily believing everything they see or hear. And they should talk to each other and give voice to the individual concerns they are undoubtedly keeping buried under the surface. Family secrets are rarely a good thing.

But then they should be careful not to approach her together, as that could feel like ganging up. I think Tom might be the one most likely to gain her trust. Pat and Tony should make it clear that they are always there for her, no matter what has happened.

And finally, they should avoid recriminations and guilt. None of this is anyone’s fault. Except Rob’s.

Surely the idea of Henry being sent away to boarding school will bring Helen to her senses?

That’s a comment I read on Twitter. It is unkind and judgemental. Helen is vulnerable, abused and unable to think clearly. The chances are, Rob will make her believe that the pain of sending Henry away is something else she must bear for the greater good. But it could well be the trigger for Pat and Tony to stop trying to convince themselves that Rob is a wonderful husband and stepfather. Because whilst there are those who extol the benefits of boarding school, Pat and Tony are unlikely to be amongst them, especially not for their beloved five year old grandson.

What will happen to the evil Rob Titchenor?

Who knows? If life were fair, he would be prosecuted under the new laws covering psychological domestic abuse. He would go to prison, where he would get help to recognise that his own narcissistic tendencies are not only hurting other people, they are also damaging to him.

But life isn’t always fair. The chances are, Rob will somehow get away with having nearly ruined Helen and Henry’s lives, wrecked Charlie’s career, punched the saboteur, damaged Adam and Ian’s relationship, plus whatever he really did in the flood. And anyway he will be part of Helen’s life forever because of the baby, not to mention the claims he will undoubtedly make on her inheritence.

So we will have plenty more opportunities to discuss him on social media.

Surely this storyline has gone on too long? It’s making me distressed/mentally ill myself.

I disagree. Domestic abuse and mental illness are commonplace. If soaps were realistic, they would have many more such storylines. And this one is subtle. The woman is mature and the abuse is mainly psychological. I like the different angles the storyline takes. And that we can’t guess how it will end. If the most exciting thing to happen in The Archers was a risqué calendar, we’d be disappointed.

So I hope this particular storyline is allowed to run its course. It certainly isn’t making anyone who listens to it become mentally ill. That isn’t possible.
But it may trigger feelings in those who have been abused. Which is why helpline numbers are given at the end of the programme.

If you or someone you know needs help, call the National Domestic Violence Helpline on 0808 2000 247 http://www.nationaldomesticviolencehelpline.org.uk/

And if this story saves even one woman – or man – from domestic abuse, won’t that be wonderful?

How are you doing today?

I love talking about mental health. What could matter more? This blog is drawn from ideas I have developed (and squirreled) while thinking about well-being at work for a slot I did at the Health at Work Conference in Birmingham last week, and in advance of an NHS Employers webinar on staff well-being yesterday. I used an earlier version of this blog to give my talk, and I warmly thank everyone who contributed. Your questions and comments were wonderful and you will be able to see that i have made some changes because of them.

And what an exciting day yesterday was. Because the Girl Guides Association announced their first mental health badge. It has been developed with the excellent charity Young Minds. It uses theories about emotional literacy and resilience to help young people take care of themselves and help others. If only they had done this 48 years ago was I was a Girl Guide. And wouldn’t it be great if such an approach could be rolled out across all schools and colleges and youth groups? What a brilliant start this would give young people facing the world.

At the conference last week, we heard from companies large and small who are putting employee wellbeing front and centre of their investment strategies. And this isn’t because of any sense of duty or even kindness. They know that it pays. They want to know the best ways to help staff achieve optimum health and how best to work with employees who have physical or mental illnesses to manage their conditions and get back to work quickly and well.

If we consider the NHS as one employer, it is the largest in Europe, many times bigger than even the largest multinationals at that conference. And yet we seem slow to follow suit. I say we…I don’t work for the NHS any more. But having done so over a period of 41 years, I feel deeply concerned for its staff. So I was very grateful to take part in the NHS Employers webinar.

Well-being and resilience are the new buzzwords. They are being used everywhere. I like them. But I also have a few issues with them. If we aren’t careful, well-being strategies can feel as if they place responsibility on the individual. And I see well-being as a partnership between the individual, their employer, their co-workers and anyone else they choose to invite to help them achieve their optimum health.

I like the Maudsley Learning model of mental health very much. It shows a series of steps and explains that we are all on a spectrum of mental wellness. I like the way it removes a sense of us and them.

But there are nonetheless inherent dangers in such models. Unless you have felt the terrifying symptoms of psychosis, clinical depression, an eating disorder or any of the other hundreds of mental illnesses, you might think that mental ill-health is merely an extreme version of the distress that anyone might feel when something bad happens. Using well-intentioned euphemisms like mental distress, intended to reduce stigma, can add to the isolation felt by people who experience mental illness. It’s important to say that most people won’t ever experience mental illness, just as most people won’t ever experience cancer or diabetes.

But 1:4 of us will. And we need skilled help from our employers if we are to go back to work at the right time and give of our best. The last time I was ill, I was lucky that I got the right help. Not everyone does. And that is why I do the work I do now, campaigning to improve things in the NHS and beyond for patients and staff.

I shared two specific insights at NHS Employers webinar. The first is that we separate mental and physical health for laudable reasons but at our peril. Obesity might get more sympathy if it were treated as an eating disorder; the most effective treatments combine diet with psychological support, including CBT techniques. Exercise is known to increase endorphins and improve mental wellbeing as well as physical health. People with serious mental illnesses die on average at least 20 years too soon, mainly because of associated poor physical health. And there is an increasing evidence base that people with chronic physical conditions such as cancer, heart disease and strokes have a greater tendency to experience clinical depression. Which comes first doesn’t really matter.

Employers should, in my view, use this knowledge of the inherent links between mind and body to devise their wellbeing strategies and make this explicit. Bringing the mind and the body back together needs to become the next Big Thing.

And secondly, I am increasingly of the view that people who experience mental illness, who are open about it and learn to live well with it despite the massive challenges it poses, can become even better employees than those who don’t have these experiences. I’m talking about people like many of the friends I have met since I came out about my own depression. Such people show extraordinary resilience, compassion for themselves and others, patience, creativity and highly developed social skills that would be valuable in any workplace. They are truly amazing. I try not to have regrets. But one of mine is that it took me far too long to realise that my experience of mental illness could become an asset, if I let it. So now I’m trying to make up for lost time!

I want to share links to my other blogs that I think might be helpful to anyone thinking about wellbeing at work.

This one is about taking the plunge and talking about your own mental health, perhaps for the first time.

This is my plea to be kinder about obesity, because what we are doing now simply isn’t working.

This is about the things you can say and do to help a friend or colleague who is experiencing mental illness. And the things that really don’t help.

These are my ten commandments for working in mental health

This is a blog in which I thank people who have helped me in my journey of self discovery – still very much a work in progress.

And this is my Letter to You. Which you might want to suggest to someone who you think may be struggling.

Life is hard for most employees these days. Working in the NHS holds particular challenges. Stress at work doesn’t have to make people ill. But it can. Employers can make a difference. And so can co-workers.

Please take a moment to think about your colleagues, especially the ones who are having a tough time, seem a bit quieter than usual or not quite their usual selves. Ask them how they are. And really listen carefully to what they reply.

And if you are one of the 1:4 of us who experience mental illness from time to time, I say this: go us. Because we rock. 😎😎😎

Is it Rob or Helen who needs a psychiatrist?

Last night, some of us were tweeting about The Archers. Specifically, about the scumbag Rob Titchenor whose latest act of psychological warfare against his wife Helen was to hit her and then make her feel so bad that, by the end of the 13 minute programme, she had apologised for making him do it. He then delivered his coup de grace, that she was in need of psychiatric help.

As you can imagine, this generated much debate. Quite a few people said that it wasn’t Helen that needed a psychiatrist, it was Rob. They said he was sick. I believe they are wrong. And I want to explain why I think this.

Is Helen mentally ill? And if she is, could Rob have caused it?

Only someone who is clinically qualified can really answer this question.  But as Helen is a fictional character and therefore unavailable for an assessment and formulation, we are entitled to make assumptions.

Helen has a tendency to depression, anxiety and problems such as anorexia in part because of her personality. She is someone who sets herself high standards and drives herself very hard. She has an overdeveloped sense of responsibility. She judges herself harshly and punishes herself for her own perceived failings. And she reacts badly to criticism from others.

She has some additional risk factors. She is, or rather was, a single mother. She has experienced several major losses: her older brother died in a farming accident when she was a teenager. Her last partner died by suicide. Also, her father was recently very ill. Her younger brother went missing for a year and her best friend felt betrayed by her.

All of this makes her vulnerable. So Rob hasn’t exactly caused it. But he has exacerbated it. And now he is using it against her.

Isn’t Rob also sick in the head?

Rob is also fictional. We only know what the writers have shown us. But again, we can make assumptions.

He certainly shows narcissistic tendencies. He cares a great deal about his own feelings, but little for those of others. He views the world as there to serve him. He constantly reminds Helen that she is Mrs Titchenor now, and that she must dress and act to please him. Henry must be “obedient”. The coming baby is “my son”. The house revolves around Rob . He is jealous and actively excludes those Helen is close to.

He also has a nasty temper, is untrustworthy and lacks morals. He hit the hunt saboteur and later lied about it. He cheated on his first wife with Helen, and lied to them both. There are suggestions he may have lied when he worked with Charlie. And there has been at least one occasion where he either raped Helen or was rough enough during sex to cause her bruising round the neck. She seems uneasy near him.

But these are not signs of mental illness. They are the tendencies of all bullies, cheats and those who get through life by using others. Rob has chosen Helen because she is vulnerable, and has resources that he wants  – she has her own house, and will inherit half of the family farm business. And she can give him a child.

What about his mother?  Is she mentally ill?

Aah, Ursula. She is a manipulator. She probably learned to behave like this as a small child herself because her own family was dysfunctional. Her relationship with Rob is deeply dysfunctional too. She wants to please him, and will go to any lengths to do so. She perceives Henry’s unhappiness as bad behaviour. She thinks sending him away to boarding school will help him. Her interest in Helen’s pregnancy, labour and other intimate matters such as Henry wetting his bed is prurient. I wonder whether she is a sex abuser. She gives me the creeps.

Why can’t Pat and Tony see through Rob and Ursula and why can’t they see their own daughter is so unhappy?

Because they are nice people. And they are deeply invested in Helen having made the right choice. They feel bad about not warming to Rob at the beginning. The truth for them is too awful to contemplate…at the moment.

What will happen to Helen?

Who knows? Only the writers. Perhaps her love for Henry will override her feelings for Rob, and she will confide in someone like Tom or Kirsty and they will help her to escape. Or perhaps she will be assessed by a mental health professional who will ask all the usual questions about things that are troubling her, and leave her enough space to express the doubts about Rob that we can already see lie just below the surface. Or perhaps she will continue to be terrorised by him until something even more awful occurs. This is what happens in real life. And even if they get away, women who have been abused like this may suffer from a form of post-traumatic stress disorder for the rest of their lives.

Why do I mind when people confuse mental illness with bad behaviour and say that people like Rob Titchenor are mentally ill?

Because badness is different from madness. You can have both. But they are not the same thing. And until people stop equating them, and the media stops using terms such as  “paranoid schizophrenic” as a term of abuse, we have a very long way to go.

Of course we need to provide skilled intervention for those who abuse. They may have defects in their personalities (sometimes called narcissistic personality disorder, psychopathic personality disorder or sociopathic personality disorder) that cause them to lack empathy and feel compelled to hurt others. These terms are understandably helpful in forensic mental health services. But they should not be bandied about by the rest of us. Because this is skilled work. And also because, for people who have been diagnosed with a Borderline Personality Disorder, which has at long last been recognised as an extremely traumatic, treatable mental illness, being lumped together with people like Rob under the overall heading of personality disorders is distressing and adds to their stigma and alienation.

Time to Change is the national mental health anti-stigma campaign. Over the next five years, for which most of the funding is now secured, they will be tackling some of this harder, more intractable stuff with people who need more persuading. And people like me will be volunteering and writing stuff and speaking at events in support of their campaigns until we have achieved greater awareness, understanding and empathy for people like Helen.

The use of mental illness as an explanation for people who do abhorrent or otherwise inexplicable things is part of the stigma that those of us who experience mental illness face on a daily basis. Please try not to do it. Thank you.

PS: I’ve just noticed people on Twitter saying this storyline is affecting their mental health. Hmmm….It may trigger thoughts and feelings in those who have been abused and/or experience mental illness. But it won’t cause mental illness.

Anyway, people who don’t like it can always switch off. And watch Happy Valley maybe….

 

 

Wishing and Hoping and Blogging and Tweeting

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Bad selfie with 2 lovely Twitter chums @AgencyNurse and @AnnieCoops

Last Thursday, 3 March 2016, I facilitated a couple of seminars at the East Midlands Leadership Academy social media conference. Two days before the seminars, I invited anyone who felt so inclined to help me prepare via Twitter and a blog. I then used an updated version of the blog I had initially written as my audio-visual aid for the seminars. It was my very own small action research social media project.

Thank you to the 450 people who read the original blog, commented on it and/or joined the two seminars. I called the seminars Wishing and Hoping and Blogging and Tweeting, which hopefully gave attendees a hint that I’m no expert and that I take a don’t-wait-for-permission-but-ask-for-forgiveness approach to my own use of social media.

You can see the first blog and the comments on my blogsite directly below this one. Thank you very much indeed to Zoe Bojelian, Liz O’Riordan, Chris Richmond, John Walsh, Phil Jewitt, Annie Cooper, EM, Natasha Usher, Sian Spencer-Little, Lloyd Davies, Linda, Vicki W and Laura Hailes for taking the time to comment on the blog.

I apologise to Fenella Lemonsky, Gill Phillips and anyone else who tried to comment but were stymied by WordPress and/or their own social media platforms. I don’t know how these things work, but I know how annoying it is when they don’t.

I also warmly thank everyone who helped share my requests to get involved or commented themselves via Twitter, including @bipolarblogger @hpiandycowper @davidgilbert45 @AgencyNurse @whoseshoes @jbmccrea @kirsti79 @andrew_davis @noshinakiani @carolinewild @LindsayHobbs51 @HubTube @OrganicLemon @LisaMillerVC @NHSE_PaulT @AlysColeKing @PeterMEnglish @HollowDave @MargoJMilne @endless_psych @JYoolz @QueerAndConcise @ethicConsult @allyC375 @HealthWKTD @ pgtips42 @LearnHospice @alisonleary1 @Lindawr45160138 @Lucy EMLA @LucyMorley1 @JennyTheM @PatientOpinion  @DaniG34 @JOMWLever @emetalic @DanileOyayoyi @MConroy09  @GeorgeTruSATCGirl @AMKane87 @ImtiazGiriach @ElizabethJSays @DebElSayedd @GeorgeJulian @LyndsayShort1 @NickiH @bigronstevenson @wendynicholson @andrewbeee @rosgodson @wendyJNicholson @gremlin2C @mynameisAndyJ @sara_J_Brown @penny_thompson @jackiecassell @claudemmx2 @roz_davies @sweeternigel @nonnazoo74 @garethpresch @anyadei @beckyOT @claudia_writes @spencer_sian  Sincere apologies to anyone I have misspelt or missed out.

Most of all, I want to thank the two sets of participants at the seminars. When I asked them where they were on a scale of 1 = social media virgin – 10 = social media warrior/maven, the lowest score anyone gave was a 4, and I think that person was being overly modest. There were lots of 7s and 8s and quite a few 9s. Given I would put myself at 6.5, it felt rather like a master-class in reverse. Which is the story of my life.

I’ve drawn my personal learning points from all of this into a list below, and included some references for you.

  1. It is possible, and great fun, to crowd-source a seminar, even a podium address in the way I’ve just done. Yes, it takes more time than the usual approach. And it doesn’t finish on the day. It is important to thank people properly who have made the effort to help you. I hope I have paid enough attention to this. The benefits are the potential to engage many times more not only with your direct audience but also with others via social media. And to widen your own learning in ways you could not have imagined.
  2. My personal approach to using social media is how I tend to approach most new things – I jump in and have a go, and work out the rules as I go along. This isn’t the wrong way, but nor is it the right way. It’s just my way. However you choose to get started, putting yourself out there is undoubtedly scary. It is important to take care. If you are in a high profile role and/or a health care practitioner, this very well constructed article by Annie Cooper and Alison Inglehearn is just great. It will help you stay safe.
  3. My session last week was about using social media as an individual who may (or may not) happen to work for an organisation. NHS social media guru Joe McCrea (@jbmccrea on Twitter) gave a fascinating presentation at the same conference about the use of social media by NHS organisations. He is about to publish a seriously interesting report – please do keep an eye out for it on his wesbite.
  4. The mental well-being side of social media can be either overlooked or understated, in my experience. I thank several folk for reminding me to remind others to be aware that social media is only a very small part of the world. It can be a source of solace and support, as I have often found.  But it can also be vicious, mean, self-righteous and damaging. And because people can hide behind anonymity, bad behaviour is invariably worse, goes more unchecked and can be more intrusive than in face-to-face interactions. I wrote this blog about Twitter  last year. I think what I said then still holds true.
  5. Lots of people want to share their ideas by blogging but have yet to get started, and are keen to choose a good blog-site. I can’t recommend any specific sites because I’ve only used WordPress. I do like it, but like all software, it has downsides. I would just remind you that, however much you like the site you have chosen, unless you are paying for it, you and your readers ARE the product. If we want independent writing to thrive, we MUST somehow pay for books, journals, newspapers and maybe even blog-sites. Otherwise it won’t be long before the only things available to read are the ones that carry adverts or are sponsored from a commercial or otherwise partisan perspective.
  6. Quite a few people have pointed out the difference between posting comments on social media sites like Twitter, and blogging. Which is that the former is for swift repartee, and the latter is for more considered thoughts.  I agree. But I would also argue that blogging helps us to work out what we think. And we can use Twitter and other chat sites for this too. After all, there is no point getting involved in conversations if we have already made up our minds about something. Here is a bit more about why I blog.
  7. This slide deck on the role of social media in health is from my extraordinary friend Dr Helen Bevan (@HelenBevan on Twitter – if you don’t know who to follow, follow Helen). Helen is a genius in new ways of thinking, including social media. She presented this at a social media get-together event at the beginning of last week. I’m sad I couldn’t go, because it looked highly informative and fun.

Finally, I thank Annie Cooper for sharing this lovely video poem about the social media imprint we leave behind us. Like all good things on social media, I promise it will make you think really hard. Which is the best sort of thinking.