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Mental health and exercise

Me on my bike

This week, we heard about a US study which apparently showed a link between exercise and improving one’s mental health.

“How marvellous” cry quite a few people who have been fortunate enough never to experience any sort of mental illness. “Here is proof” they go on to say “That lying around in bed all day is bad for you. Next time I meet someone who says they are depressed, I will tell them to go out for a jolly good walk. A bit of fresh air will blow the cobwebs away. After all, I always feel better after a walk/run/session with my personal trainer/ swim in the health club pool ” they remark helpfully.

Thank goodness for wise owls like Dr Dean Burnett who, while welcoming the study, reminds us of the likelihood and risks of overstating the findings, and of its limitations, such as that the participants self-reported their improved mental health, that most of them didn’t have a serious mental illness to start with, and that anyone with anything other than depression was excluded from the study.

Exercise can play a positive part in managing our mental health. But it’s not a magic cure-all. Here are some things I’d like anyone feeling excited by this study to do. And a few that I and others with similar experiences would prefer you not to do.

  1. Please read Dr Dean Burnett’s brief analysis here.

  2. Learn how depression is a physical illness and why exercising when you are having a severe episode can be very harmful here.

  3. Remember that prevention may be better than cure, but that to muddle the two is both dangerous and cruel. Imagine telling someone having chemotherapy just to eat more vegetables? It’s the same with mental illnesses (of which there are many) as with cancer. What helps us stay well is not an alternative to the treatment we need when we are poorly.

  4. Remember that many people who experience mental illness face other challenges which compound their situation, including poverty, insecure housing and post-traumatic stress. So please tread gently. Don’t make suggestions that seem obvious to you but may be daunting, even terrifying, or that they just can’t afford.

  5. Do all you can not to offer advice to your friend who seems be showing signs of mental illness. Instead, sit with them and just listen. Help them by showing that you care enough to stop whatever else you are doing and giving them your undivided attention. Be patient. Be courageous. Be quiet. Be there.

  6. IF they should decide that they want to try a bit of exercise, offer to walk, run or cycle beside them. Show them that you have their back.

Finally, in case you or anyone you know needs it, here is My Letter To You. 

Take it gently. This world is a tough old place.

Thank you.

 

 

 

 

My Brew Monday

This morning, Samaritans volunteers were shivering on Brighton Station, Hove Station and 80 other railway stations around the country. We’re at it again tonight. If you see us, feel free to say hi, and take one of our free Brew Monday teabags or SHUSH Listening Tips leaflets. You can pop a few coins in our collecting tins. And talk to us about how you are doing.

You can even discuss the possibility of volunteering as a Samaritan yourself. Samaritans are ordinary people. We have no special powers. We don’t get paid but we do get the most excellent training and a great deal of support to do what we do. Read more here.

Let’s be honest. There is no such thing as Blue Monday. It was a clever advertising gimmick thought up by a travel company 15 years ago. And yes, Brew Monday is a bit of a gimmick too. But it’s a good way of grabbing people’s attention for a much better reason than selling them a holiday they may not be able to afford. Brew Monday is a way of reminding people that they have the most valuable thing that other people need. And that’s the gift of their own time. Time to ask the other person how they are. And to really listen to the answer. Time to be with them if they are OK but even more if they are not. And time to help them come to their own conclusions about what action, if any, they want to take. And what better way to help the conversation flow than with a lovely cup of tea? This link will take you to the Brew Monday part of the Samaritans website.

Here are the SHUSH listening tips:

S = Show you care – stop what you are doing, put away your phone, perhaps offer a cup of tea

H = Have patience – forget the emails piling up. And don’t give up.

U = Use open questions. And include space for the other person to think.

S =  Say it back – use their words, without offering an opinion or judgement.

H = Have courage. This can be hard, especially if you get initially get a dusty answer. But please keep trying.

If you want to hear yours truly talking about Brew Monday, Samaritans, and the listening tips mentioned above, you can find me here on Radio Sussex talking with the lovely Allison Ferns from 2hrs 46 minutes – 3hrs.

And most of all, please try to find time this week to have a cuppa with someone and really listen to them. It could make a huge difference.

Thank you.

 

 

Watching my privilege

Trustees of the Mary Seacole Trust (from left) Jean Gray, Lisa Rodrigues (vice chair), Karen Bonner, Dawn Hill (President), Trevor Sterling (chair), Roxanne St. Clair (treasurer), Jermaine Sterling, Ros Trennick, Steve Marsh (secretary), Raf Alam.

In 1973, aged 18, I joined the NHS. My first job was at a learning disability hospital. It was a backwater for patients. And also for staff, 50% of whom were Black, Asian or other ethnic minority (BAME) backgrounds. Since its inception, the NHS has recruited internationally in order to meet staff shortages in less popular parts of the service. That hospital relied on nurses from Ghana, Nigeria, the Philippines, Mauritius, Sri Lanka and the West Indies to look after some of the most vulnerable people I have ever met.

Three months later, I left my new BAME friends to start nurse training at the prestigious Hospital for Sick Children, Great Ormond Street (GOS). Here, things were different. Of the 150 student nurses who started in 1973, 150 were female, almost all were middle-class, and every single one was white.

There were of course BAME staff at GOS. They worked in the kitchens and cleaned the wards. They served us in the canteen. There were a handful of black and Asian nursing assistants, and the occasional agency nurse. And there were BAME pupil nurses, doing a shorter, less academic course than ours, who would eventually become State Enrolled Nurses, a second-class role which precluded them from promotion to becoming a staff nurse or sister. I cannot recall a single black ward sister.

This is not a criticism of my alma mater, by the way. Things were the same across all the London teaching hospitals.

41 years later, we discovered that not much had changed. In March 2014, the year I retired from the NHS, Roger Kline published his excoriating Snowy White Peaks report. We learned that whilst 70% of the NHS workforce was female, and 20% BAME (30% BAME amongst nurses, and 40% BAME amongst doctors), the top of the NHS was almost totally white and predominantly male.

This stinks. It is institutional sexism amd racism. I have written about it before, and how Mary Seacole can help us challenge such shocking stigma and discrimination.

On Thursday 29 June 2017, 1 year minus a day since Mary’s beautiful statue was unveiled outside St Thomas’ Hospital, we launched the Mary Seacole Trust at the Black Cultural Archives in Brixton. Our aim is to use Mary’s legacy – compassion, creativity, dynamism, entrepreneurship and most of all, never giving up – to inspire people of all ages to achieve their best in whatever walk of life they choose. You can read about our first two programmes and a bit more about us on our new website. Plus a lovely 5 minute film made by one of our trustees, Jermaine Sterling. Do take a look – it’s great!

But when I was asked by our chair, Trevor Sterling (who left school at 16, yet is now a renowned lawyer and partner in a prestigious law firm plus one of the funniest, nicest and most effective people I have ever met) if I would be the new charity’s vice chair, I had to think hard. I felt the need to challenge myself about whether such an honour was deserved. I have had my share of difficult experiences, but I have not experienced racism. White people like me have to take care to avoid cultural misappropriation. We have to watch our privilege.

So I talked to my BAME friends, including some of the other trustees. And they said this. They reminded me that we are all part of the human race, brothers and sisters under the skin. And they welcomed my support because making sure everyone achieves their best is not just their fight. It is our fight.

So I said yes. I promise them and all of you to use my talents, such as they are, plus my experience and connections to help inspire people of all ages to achieve their best, based on merit, passion and hard work. Not what school they went to, who their parents are or the colour of their skin.

Just like Mary Seacole. Mary had to fight many fights. She never gave up. And nor shall we.

To sign up as a member of the Mary Seacole Trust, or just to learn more about us, click here.

Thank you.

The Grenfell Tower fire – the political dimension to this tragedy

Andy Winter's Blog

This has been a week full of tragedy – the fire at Grenfell Tower. There has been an appalling loss of life and acts of amazing heroism.

We have been told that this is not the time to be political. But why not? Housing is political. The death of even one person is political

This was not a natural disaster. It was avoidable.

Everyone, rightly, is praising the emergency services. Fire fighters going into a burning building. Their bravery is beyond words.

But it was not so brave to close the three fire stations nearest Grenfell Tower.

There are 5,000 fewer fire fighters than there were 5 years ago. There has been a 25% reduction in fire prevention visits.

There has also been a 15% increase in the last year in the number of fire-related deaths in the UK, from 264 to 303.

If you put money before lives, people die.

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Sssshhhhh….

​My first blog for a month. A number of lovely people have been in touch to check if I am ok. They know that going quiet can be a bad sign with me.

The reasons for my recent radio silence are several. I admit that I have had one or two days of lower than optimum mood. Nothing terrible, just feeling a bit bleurgh. This came as no surprise; my mood tends to reflect the lack of daylight at the start of the year. As usual, I am perking up with the lengthening of days.

I have also been busy. Family stuff, domestic projects, volunteering and my coaching work.

As a coach, it is important that I practise what I preach, and develop non-preferred ways of thinking, doing and being. By nature I am an extraverted thinker; I tend to work things out by writing about them or talking them through. What comes naturally to an introverted thinker, ie working out ideas fully before expressing them, takes considerable concentration and effort on my part. But I can do it when I need to. And I have felt that need recently.

Something I have been pondering is the personal cost of sharing, specifically in relation to the book I have written. It is a memoir of my NHS career as a leader, including a how-not-to-do-it guide plus a bit of polemic about the future. The style is similar to many of my blogs. It is ready to be published this year. But I have been wavering. What added value might publication bring? Maybe the benefit was in the writing of it? Some may find the stories of interest and the lessons useful. But there will also be criticism and negative comments about difficult stuff from the past. Can I face this? Do I need it? I grow increasingly unsure. Thoughts on a postcard please…

I have also been thinking about the nature of mental illness, and how some of us are prone to it while others seem to have greater immunity. I tend to agree with those who say that that there are few people, if any, who, faced with enough mental trauma, would not crack under the strain. Some of us simply experience mental distress more readily than our fellow humans.

But despite all the evidence about the impact of genetics, other inherited traits, early experiences of trauma and loss, plus environmental factors, to have a tendency to experience mental illness is still seen by some as an indulgence, a weakness, even a personality flaw.

Those who, despite all that has come their way, have learned to tame their mental health, are heroes in my opinion. They should be admired for their assets, not pitied or shunned for their deficits. Many are the kind of people you would most want to be stuck on a desert island with. They are kind, resourceful and patient, and often less prone to judge others than those at whom life has thrown less excreta.

I have also been thinking how lucky I am. When I was last off sick with depression (from my old job as an NHS chief executive), I didn’t want to be alive. But I wasn’t worrying about paying the bills, losing my job or being made homeless. A few nameless folk were judgemental, but the ones who mattered most were hugely supportive. I got excellent treatment when I needed it from a wonderful psychiatrist and GP. When I was ready, I had the wherewithal to pay for psychological therapy. And as I got better, I didn’t have to waste precious emotional resources fighting a hostile benefits system. Nor did I find myself in accommodation where I felt unsafe, or removed from a caseload because I no longer met their treatment criteria. And I had no fears of deportation or having to hide from an abusive partner, people traffickers, drug dealers, pimps or lone sharks.

It is true that mental illness can happen to anyone. If we can find the strength, most of us can do something to help ourselves. But people who are lucky like me have many times more chance of a meaningful recovery and successful management of relapses than those who have been dealt a less favourable hand.

It was always so. And as austerity sinks its vicious fangs ever deeper into public services, it is those who already have the least who are most negatively affected. Instead of achieving their optimum, they are diminished and disabled, not necessarily by the condition itself, but by the need to fight battles every day, the lack of immediate and ongoing support, and by not having all the other things people like me take for granted.

And that is why I have been quiet. I have been thinking about this a lot. I am privileged in so many ways, including having a voice. And I feel I have a responsibility to make use of it.

More anon.

Suggested Ambridge New Year Resolutions 2017

Brian

Stop behaving like an ageing alpha male lion. Otherwise you might lose more than your pride. Give in graciously to Adam’s plans. Once you accept that you are, just like the rest of us, completely replaceable, you will be a lot happier.

Adam

See above. Also, maybe you could get in touch with Charlie?  We liked you being with him much better than poor old Ian.

Jennifer

Keep Brian on a shorter leash. Buy plenty of tissues for Lilian. And make more time for your writing.

Lilian

Dump Justin before he dumps you. He’s not nearly as much fun as you think. You can do much better than Ambridge’s answer to Sir Philip Green.

Toby

Don’t let people’s low expectations define you. Get a proper job, preferably in Brighton.

Tom and Kirsty

Buy a pram.

Helen

Do not, on any account, let Rob back into your life. Whatever he tells you, abusive males like him are extremely unlikely to change. Do everything you can to keep your lovely boys safe. One day you might meet someone else. But for now, while you recover from such a damaging few years, you are much better off alone.

Pip

Do not let other people tell you who to go out with. But equally, don’t let the poor opinions of your family cast Toby as Romeo to your Juliet. Like Lilian, you can do better. You won’t meet new people working on your parents farm and living at Rickyard Cottage. Time to spread your wings in 2017.

Jill

What is going on with you, Jill? Why do you hate Toby Fairbrother quite so much? You have alienated your beloved granddaughter, you risk doing the same with your daughter-in-law, and as a church-goer, you are showing some extremely un-Christian attitudes. And you won’t listen to reason.  It isn’t really about Pip, is it? Nor is it about Toby’s father and his long-ago affair with Elizabeth. It goes much deeper than that. I suggest you talk to someone outside the family who you trust, possibly Reverend Alan, and explore these feelings. You may need some professional help. Because such uncharacteristic vitriol at your age is really worrying.

Ed and Emma

Stay as sweet and honest as you are. Undoubtedly we could do with more working class characters who are in the cast for more than just their comedic value. But you two are brilliant. Please don’t change a thing.

Usha and the new vet lady

Likewise, we need to see much more of you both, as well as a few more characters who just happen to be Black, Asian or from other Minority Ethnic backgrounds. Or those of us who argue that The Archers is no longer totally white and middle-class will have to admit we are wrong. Bring back Iftikar Shah; he is much more glamorous and interesting than that boring doctor, Elizabeth!

Pat and Tony

If you thought semi-retirement was going to be quiet, think again. Prepare for incoming grandchild number 4. And congratulate yourselves on being true to your characters but at the same time amazing in 2016.

Here’s to a wonderful 2017 in Ambridge, which remains an oasis of compassion and commonsense compared with the rest of the world.

Calling the Jubilee

yestolifeblog

“It may well be that we will have to repent in this generation. Not merely for the vitriolic words and the violent actions of the bad people, but for the appalling silence and indifference of the good people who sit around and say, “Wait on time.” – Martin Luther King

Several years ago I sat with my good friend Yvonne Coghill having dinner. We talked about many things. It was night of deep conversation, much laughter and real energy. Yvonne then told me something that shocked me. She explained that across the NHS when you go up the structure people like her – black people and people from minority communities – start to disappear. The top was all white. Yvonne explained all the evidence shows that this occurs all over our health systems. Yvonne also explained there was good work going on to change this. I was deeply disturbed and…

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Three blogs and a bike ride

This week has been Mental Health Awareness Week.  I’ve written three articles, visited a friend, given a talk, attended a party and been on a bike ride.

There’s been some other more difficult stuff which I don’t feel able to write about just now. More anon.

I wrote this piece about the loss of Sally Brampton through depression and what is assumed to have been suicide.

Suicide casts a long, cold shadow. My heart goes out to all who have lost someone that way. And to all who have tried to keep them safe. There is sometimes talk of failure in such circumstances. I fully understand why. But it can be cruel and destructive to those left behind. It can affect the grieving process and have terrible repercussions. I decided a while ago to devote some of my time to being a volunteer in suicide prevention. This work can of course be distressing. But is so worthwhile. If more people were involved in understanding about suicide, it would improve compassion and more lives might be saved. Blame doesn’t save anyone. If anything, it can have the opposite effect.

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On Monday I popped up to Rugby to see the lovely Gill Phillips and learn more about the groundbreaking work she does through her company @WhoseShoes. Gill had a special birthday this week – now she’s nearly as old as me! I love the way that this entrepreneurial woman has started a new adventure. I hope I can support Gill to bring Whose Shoes to the world of mental health. Go us!

Just Giving asked me to write this list of ideas to help people to manage their own mental health. It’s been fun watching the list grow throughout the week, and hearing comments from unlikely places about the tips. I just curated the list – none of them were invented by me. I try to follow them, not always successfully.

And I wrote this piece called Serendipity for NHS Employers. It was also Equality and Human Rights week. It was serendipitous to bring two things together that matter very much to me but which I hadn’t realised before had so much in common. I’ve had some useful feedback. It has sparked conversations about how we can use Mary Seacole’s legacy to inspire young people not just to dream, but to work hard and not be deterred by setbacks from achieving their ambitions.

One of my ambitions is to see the top of the NHS become less white and less male. Nothing against you guys, but as it says in my blog, the way things are now just isn’t representative. And having an unrepresentative leadership breeds alienation and resentment which has a negative impact on services.

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On Thursday afternoon I spoke at a Brighton Housing Trust Health and Wellbeing Service event (photo above). I was invited there to inspire the women with my experiences of being a high profile woman who is also open about my own mental illness. But to be honest, it was they who inspired me. I heard some stories I will never forget. I want everyone to know what we agreed, which is that people who live with mental illness have assets to share. Rather than deficits to avoid or accommodate. I’m going to be returning to this theme in the future.

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I was at the beautiful Black Cultural Archive in Brixton on Thursday evening at a comedy night with a purpose – to thank all the ambassadors and trustees who have spent 12 long years raising money for the Mary Seacole Statue.  That’s me with our brilliant and indefatigable Vice Chair Professor Elizabeth Anionwu CBE. Mary’s statue goes up in six weeks – much more about this soon.

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And on Friday I was out cycle training with my friend Sally who is joining me on Ride 100 on 31st July when we will be raising money for Samaritans. You’ll be hearing a lot more about that shortly. Suffice to say, after doing 20 miles of hills, including the notorious Box Hill (twice) we felt pretty smug 🙂

 

Please join my social media experiment

I haven’t done a blog like this before. I’m trying what I hope will be a relatively simple experiment to help me run some seminars on Thursday 3 March 2016 for the East Midlands NHS Leadership Academy.

And you can help me!

  • If you read the blog before Thursday, I would love to have your comments at the bottom of this blog to help me help the people in the seminar groups think about the use of social media in the NHS.
  • And if you read it afterwards, you can help me to think about it some more. Comments would be really welcome from seminar participants and others. Because like all of you, I am a lifelong learner.
  • I intend to use this blog as my main audio-visual aid for the seminars. It is therefore shorter than usual and presented mainly as
    • Bullet points!
  • As well as seeking your comments in bold, I will be encouraging comments and discussion from the attendees.
  • I plan to start by asking people where they are on scale of 1 – 10
    • 1 = a social media virgin
    • And 10 = social media savvy warrior
    • I am pitching the seminars and the blog towards the people who place themselves towards the lower end of this scale, but I will try to engage the more informed attendees by inviting their comments, as I am inviting yours.
  • How does that sound to you?
  • I will then introduce social media as a form of media where the control lies with the individual.
  • I will illustrate my point with a newspaper story that ran about me recently (two blogs down from this one if you haven’t heard about it) and how I was able to redress the balance myself via Twitter, Facebook and my blog.
  • Is the above example too self-indulgent, do you think? And if it is, can you think of a better one?

I will then list the different forms of social media thus:

Social media products:

  • Facebook: An early product. I use it to stay in touch with family + friends. But people use it very successfully for work, even instead of a website
  • Instagram – good for sharing photos, I am told.
  • Linked-In: For keeping in touch with people at work, finding jobs, making connections. Again an early product. I don’t like the interface. But I’ve missed some important messages from people who have tried to contact me that way, so be warned!
  • Skype: Free video calls. Can be erratic. But great for interviews or meetings with people far away. Much cheaper than video conferencing
  • Twitter: Admission time – my favourite. I love the discipline of the character limit.
  • Viber: Similar to WhatsApp. Also free calls

    • YouTube: used by President Obama, Justin Beiber and me!

  • WhatsApp: Great for staying in touch with individuals and groups. And free phone calls!

Does that sound overwhelming? Any glaring omissions? And does expressing my preferences help or hinder?

Benefits of using any/all of the above:

  • Control
  • Thrift
  • Contacts and connections
  • Equality

Things to look out for:

  • No such thing as a free lunch – you are the product for the companies providing these “free” services
  • Warning: social media can be addictive
  • Loss of privacy with some formats (see my blog On Forgiveness)
  • Trolls and other monsters (see my blog Please Take Care, Twitter can be Cruel)

Again, your thoughts please?

Blogging

  • Why do it? (see my blog called Why do you Blog?)
  • And why not do it? (hint: there are lots of good reasons)

This is where I hope we will have the richest discussion.

I’d really welcome your comments here too please.

Some NHS-inspired bloggers that I think are worth following:

  • Zoe Bojelian Wonderful mother of a brilliant boy who we will never forget
  • Annie Cooper Senior nurse + social media genius – she will be at the conference
  • Andy Cowper The most original writer on health policy I know. Also v funny
  • David Gilbert Writes in a brilliant, challenging way about patient leadership
  • Paul Jenkins Ex CE of Rethink, now runs a mental health trust. Deep thinker
  • Liz O’Riordan A breast surgeon with breast cancer. Stunning
  • Charlotte Walker A mental health patient (like me). Writes in real time. Gutty, startling insights
  • John Walsh My personal compassion guru
  • Rob Webster A brave, wise leader who shares generously

The list is of course not exhaustive, but I’d love your thoughts – who would you add?

My plan is to share this blog via the seminars, including all comments received, to stimulate discussion. And I will invite those who take longer to decide what they want to say, to add their comments after the event.

My final question to readers of the blog is this:

  • Would you find a seminar structured in this way useful?
  • And if not, and I really want your honest answers, please tell me how you would improve it.

I promise to incorporate your ideas. And I will also let you know how it goes.

Thank you very much indeed for joining my social media experiment!

 

 

 

 

 

 

 

 

January can be a wicked month

Whether you call it Seasonal Affective Disorder, the winter blues, even depression, January can be a wicked month for those of us who have problems maintaining our mood. The combination of miserable weather, not enough light, post-holiday flatness and getting back on the treadmill can feel pretty grim.

So what to do? Reading breezy articles in lifestyle magazines might lead you to believe that the answers to your woes lie in spending money you almost certainly don’t have on new clothes, visits to spas, holidays or even a home makeover.

Such advice can make people like us feel even worse. As can admonishments to start a new you via a radical change to your diet, new hobbies or an unrealistic exercise regime. When we are feeling low, stuff like this plays into the isolation and hopelessness that already beset us. We know we probably should do these things, but we can’t because we believe we are hateful and lazy and useless and undeserving and anyway, there isn’t any point because nothing will ever get any better.

From my somewhat extensive experience of Januaries past, I offer an alternative list, proven, on the occasions when I have actually taken my own advice, to work.

  1. Stop being mean to and about yourself. You deserve kindness. Start thinking of yourself in a kinder way. When you find yourself putting yourself down and focusing on your deficits, turn this on its head and make a list of your assets instead. Practice being proud of who you are.
  2. Walk places, if possible every day. Walking is proven to lift our mood. It releases endorphins. And it’s free. The first ten minutes may be hard going but after that it will feel a bit easier. The rhythm of walking is soothing. It strengthens the heartbeat. And even if you find meditation impossible in the more usual way, walking will help calm any troubling thoughts.
  3. Tidy something small. Start by making your bed. Do the washing up. Put out some rubbish. Creating order in our surroundings helps to us to create order in our minds.
  4. Whatever you are doing today, do it to the best of your ability. Even if it something you hate, like cleaning or filling in forms. And at the end of the task, take pride in what you have achieved. Tell yourself you did well. And remember to praise yourself not for the outcome, but for the effort you put in to achieving it.
  5. Force yourself to talk to someone else. It may feel easier to hide away, but this is statistically proven to make things worse. Humans need contact with other humans. Parties and large groups can feel overwhelming unless you are at your best. Instead, arrange to have a cup of tea with a friend. Or pop round to see a neighbour. Ask how they are. And when they ask you, answer them honestly. If you are really isolated, think seriously about calling a helpline.

If you are feeling desperate, please, please seek help. Try this wonderful app created by Grassroots, a charity I am deeply grateful to be associated with as a trustee. Or call Samaritans,  who are there 24/7 to listen, without judging. They really can help. I know, as I’ve tried them myself in the past.

January can be a horrid month for many of us. But we can get through, if we are kind to ourselves and reach out.

Because, as the advert says, we’re worth it.