Social media meanderings from Saltaire

Image by Dan Bailey

Saltaire

By the time you read this, I will have given what has been billed by my Twitter chum @PGTips42 at Bradford District Care Trust as a Social Media Master Class. 

In fact you would have to look hard to find someone who is less of a social media master than me. If they were paying me, the 60 attendees would by now have asked for their money back. Luckily, I am doing it for free. This gives me a chance to explore some recent thoughts with them and to visit the beautiful model village of Saltaire in West Yorkshire. The legacy of Sir Titus Salt could teach us a thing or two about philanthropic investment in social capital and infrastucture for the good of everyone, not just the richest.

Back to social media. One of the promises I made to myself when I retired from the NHS was that I would accept speaking engagements only when they were about something that really interested me, and that I would never again use Powerpoint. I’ve stuck to this for 2 1/2 years and it has served me pretty well. I did think about breaking the second rule for this session, as some screen grabs from Facebook and Twitter would have been nice, especially if they included kittens. But I decided against it.

Instead, I will have meandered through some personal insights, drawn from this blog and the references herein, and even better, found out what the attendees think.

My personal approach to using social media is how I tend to approach most things – I jump in and have a go, ignore wise advice and instead 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. But however you choose to get started, putting yourself out there via social media is undoubtedly scary. It is important to take care. I do highly recommend this very well constructed article by Annie Cooper and Alison Inglehearn. It will help you stay safe.

Once you have chosen your preferred social media platform – such as Facebook, Twitter, Instagram etc (and this can feel like a Betamax v VHS choice), here are an updated set of rules I shared in a previous blog that might help a social media novice get started.

  1. Do it yourself.
  2. Listen twice at least twice much as you speak.
  3. Don’t rise to the bait or post when angry or under the influence of dis-inhibitors.
  4. Share opinions but remember they are only your opinions. Others are allowed to disagree!
  5. Where possible, stick to facts and values.
  6. As in face-to-face conversation, seek common ground.
  7. Don’t believe everything you read.
  8. Don’t only talk to people you know you will agree with. Some people describe those who do as living in an echo-chamber.
  9. There ARE trolls out there. But not as many as you might be led to believe.
  10. Be kind, always – to yourself and to others.

It is possible, and great fun, to crowd-source a seminar, as I have now done a few times. 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.) 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. Most of what you see here has been achieved with the help of my social media friends. 

Given my passion about mental health, I must mention the impact of social media, which can either be overlooked or understated, in my experience. I thank my friends for reminding that social media is only a very small part of the world. It can be a source of solace and support, as I have sometimes found.  But it can also cut you off, if you let it. And it can be vicious, self-righteous and damaging. People can hide behind anonymity, so 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  in 2014 which you might find helpful.

Blogging is not compulsory. If you like sharing thoughts in writing, you will probably enjoy blogging and learn to do it well. Like everything worthwhile, it takes practice. And if you don’t, you won’t. 

I would also mention that, however much you like the blog site you have chosen, unless someone (i.e. you and/or your readers) are paying for it, you and they ARE the product. The same applies to all social media platforms and indeed all publications, such as “free” newspapers. If we want original, independent writing to thrive, we MUST pay for books, journals, newspapers, even blog-sites. Otherwise it won’t be long before the only things available are products sponsored from a commercial or otherwise partisan perspective. And that is a very sinister prospect. 

Some people use social media platforms such as Twitter for swift repartee, and blog about more considered and complex thoughts.  I would argue that blogging can help us to work out what we think. And that 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 write a blog.

Just to show that I have been thinking about social media for a while, here is something I wrote for the HSJ in 2012.

This slide deck on the role of social media in health is the extraordinary Dr Helen Bevan, @HelenBevan on Twitter. Helen is a genius in improvement methodology and practice as well as new ways of working, including using social media. 

And I thank another wonderful friend @AnnieCoops for introducing me to this lovely video poem about the social media imprint we leave behind us. Like all good things on social media, it will make you think really hard. Which is the best sort of thinking. 

Here are some of my new friends at Bradford District Care Trust. They were AMAZING!!!

And given that I mentioned kittens, here is William to wish you all well for 2017.

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.

My nine lessons for Christmas 2016

  1. In November, my friend Sally took me to The Church of St Mary the Virgin, Putney and reminded me about The Levellers. As she read aloud from Thomas Rainsborough’s famous quote, I felt a shiver. “For really I think that the poorest he that is in England hath a life to live, as the greatest he. After this terrible year, surely we can remember this, and act accordingly?
  2. History shows that, when times are hard, false prophets can persuade those who are suffering to blame the “other” rather than the ones who are the true source of their misery. And cause them to use their precious vote in ways that challenge more liberal values. But if we merely condemn such choices, we have no hope of turning the ugly tide lapping our shores. After the results of Brexit and the US presidency, I have come to realise that we need to judge less and listen much more so that we can understand why people are so angry with the established order.
  3. This year we lost far too many extraordinary people, including the wonderful Jo Cox MP. She wasn’t afraid to work with those on the opposite side of the political divide nor to challenge orthodox views. I have concluded that members of political parties who spend all their time arguing or blaming one another rather than seeking common cause, as Jo did, are a major part of why so many are mistrustful of politicians.
  4. This month, the government announced that, as a society, we are not doing enough to prevent suicide. And that there will be league tables published soon to show which areas are lagging most. As one who devotes time to volunteer in suicide prevention, I find this extraordinary. We can do a great deal to reduce the incidence of suicide by tackling stigma, offering education and training and supporting voluntary services such as the Samaritans. But ignoring the main reasons for the rise in the rate of suicide is dishonest. Benefit sanctions, fitness to work assessments and cuts in social care support are causing hunger, homelessness, and shame from being a burden amongst the most vulnerable of our fellow citizens. And for a growing number, the only options at night are a tent, a homeless shelter or a shop doorway. No wonder that life feels increasingly unbearable to some.
  5. And while the government congratulates itself on low rates of unemployment, zero hours contracts and minimum wages are directly causing the rise in reliance on food banks, payday loans and other expensive credit. It is not refugees or so-called benefit scroungers we need to fear. It is people who “create value” (what a meaningless and loathsome phrase) from the misery of others. The Mike Ashleys and Philip Greens of this world. And the Rupert Murdochs and Paul Dacres who would have us believe that fear of the other, rather than compassion for our fellow citizens, is what should drive us. But I realise that grumbling to those who already agree with me is not enough. I’m going to do better in 2017.
  6. I have been learning how to apply the Myers Briggs Type Indicator (MBTI) to use in my practice as a coach. I could bore for Europe on this subject, but suffice to say, it has been a revelation. And the greatest insight of all has been finally appreciating at a very personal level what Carl Rogers meant in 1961 when he said: “What I am is good enough, if I would only be it openly.”
  7. I have also been learning how to be a Samaritan. I will be writing more about this next year. All I need say for now is that I gain as least as much as I give, and that the training and support for volunteers is absolutely wonderful. And with all that I mention above, and at this time of year, Samaritans are needed more than ever.
  8. This year, we lost so many wonderful people, including Twitter friends @GrangerKate and @GraceAndGloryDan. I would like to thank Zoe, courageous mother of Adam Bojelian. Adam sadly died last year. And Zoe reminded me that people who are bereaved value nothing more than being given the kindness of time to talk about the person they have lost.
  9. Finally, I have learned that people like pictures of cats. So here is William, my personal pet therapist, to wish you peace at Christmas. And may those who are lost, lonely or grieving find kindness among strangers as well as friends.

Dear Govia. Dear Government

Dear Govia

Another week of cancellations, delays, overcrowding and stress-inducing journeys for passengers who travel on Thameslink, Gatwick Express and Southern trains. Please don’t insult us by calling us customers. We can’t make a choice – you run all of our trains. And you treat us with as much contempt as you treat your staff.

Last week, when some commuters were stranded overnight in London after all trains to Brighton were cancelled for 3 1/2 hours, we learned it will get even worse. Your train drivers have voted Yes in the ASLEF ballot to join the RMT industrial action, stopping all overtime and holding strikes on additional days to the RMT. We face further disruption, plus 3 strike days a week throughout December on top of the usual railway closedown for the holiday period. And more in the New Year.

We have had problems with reliability for at least two years. They got much worse in December 2015 when a new timetable was introduced. And yet you refused to admit the dispute until April 2016. Why not?

You communicate as though only Southern trains are involved. This is more deceit. We know to our cost that all your trains are affected.

The excuses you give are pathetic. “Short-term unavailability of train crew” is the default. Is a year short-term? How about employing more staff? People want permanent jobs, after all. You knew 2 years ago that you were heading for a driver shortage. Was it greed or just incompetence that you let it happen?

Other excuses include broken down trains at stations unrelated to the journey in question, line-side fires  – sounds reasonable until we remember we are no longer in the era of The Railway Children, signal failures – in other words, blame Network Rail – and an epidemic of passengers being taken ill on a preceding train. The best one so far is “congestion on the line” –  are we to believe that runaway trains have trespassed onto tracks that only YOU are franchised to use?

And instead of accepting responsibility, when you aren’t blaming Network Rail, you blame your staff. You “apologise” by saying that the unions are causing the problems. As anyone who has ever managed anyone could tell you, Rule Number 1 is that you support your people in public. You do not badmouth them. Especially when times are tough or you are in sensitive negotiations. For this alone, you should be drummed out of office. You are a disgrace.

I am a season ticket holder at Brighton and Hove Albion, where customers are treated with respect. We pay for home game travel via our tickets, with the football club passing a substantial sum each year to Govia. The train service to and from Falmer station on matchdays has always been unreliable and overcrowded, but over the past year it has become unuseable. After our last evening game, with no notice whatsoever, you cancelled all trains. Thousands of people, including young children and the elderly, were stranded late at night. Many had to walk miles home along the dual carriageway. Those from further afield, including away supporters, were forced to spend the night in a car park. Despite the club chasing you for several days, you gave no apology. Eventually, you blamed your own staff. Again.

We have to ask why you have completely lost the goodwill of your people when other railway companies have not. We appreciate that the margins for error on our crowded railway are tight. We know it is not difficult for staff to cause delays and worse by small acts of sabotage. But the decision to strike and to stop overtime affects them personally. So they must be desperate. You control the trains and you employ the people. The answer lay with you. But you blew it. After the latest announcement and your woeful response, there is no way back.

Hand the franchise back now. It is the only honourable course of action left.

Dear Govia, please resign. Thank you.

Dear Government

Our national economy is being affected through lost productivity. Commuters are losing their jobs. The negative morale of millions of passengers and staff affect safety on the railway and the mental health and wealth of all of us.

Please do not hide behind franchise rules. They are in your gift to change.

And there is a feasible alternative. Transport for London have longstanding expertise in running a complex transport network. The Mayor for London has offered to take over the franchise and sort things out.

If, as we suspect, part of the solution requires major investment in rail infrastructure in the South East, know this. The people who are forced to use these trains pay higher rail fares than anywhere in Western Europe, up to six times in some cases. There is no law that says that rail companies are entitled to create huge surpluses. Govia are taking you and us for a ride as they oversee a burgeoning catastrophe while they continue to trouser profits.

It is time to stop making speeches about how bad things are. We know. Instead, take action. Yes, it may be complicated and will require cross-party co-operation. But that is why we elect you, to do difficult things on behalf of all of us.

Thank you.

Baby boomer meets digital natives

The organisers @DanielOyayoyi and @RebsCullen and me

On Friday I spent a morning in Leeds with 100 trainees from the 2015 and 2016 intakes of the NHS Graduate Scheme. They had arranged a conference about digital media #NHSGetSocial. Thank you  @DanielOyayoyi and @RebsCullen for inviting me to talk about raising awareness via social media. That I, an ageing Baby Boomer, should address a group of Digital Natives on this subject felt hilarious. As so often these days, I gained much more than I gave.

En route to the event I did a bit of crowd sourcing via Twitter to help illustrate my session. This was the first response:

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The audience seemed to agree. They could think of examples of leaders who seemed uncomfortable with social media using it poorly, mainly to broadcast rather than interact.

There were also differences between how those with extrovert and those with introvert personality preferences interact with social media. Some had very sensible anxieties about tweeting first and regretting later. And others were honest about how hard they found it to decide what, if anything, to say via social media.

So I shared my social media tips:

  1. Do it yourself.
  2. Don’t rise to the bait or tweet when angry or under the influence of dis-inhibitors.
  3. Share opinions but remember they are only your opinions. Others may disagree.
  4. Where possible, stick to facts and values.
  5. Don’t believe everything you read.
  6. There ARE trolls out there. But not as many as you might be led to believe.
  7. Be kind, always – to yourself and to others.

And I shared some of the responses I had received that morning, including these from @nedwards1, @forwardnotback and @anniecoops

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The audience also seemed to agree with the Twitter response to my second question. We talked about the Daily Mail and other media that love to name, blame and shame politicians and those who work in public services but seem much less keen to call out wealthy tax avoiders or those who “create value” by paying minimum wages and offer zero hours contracts. And how even when they get things wrong they rarely apologise.

We talked about agent provocateurs and others who make things up and then either delete them or simply deny they have said it, even when there is photographic evidence to the contrary. The conspiracy theorists who lap this stuff up. And the anonymous characters who lurk on comments pages and bang on about no smoke without fire.

And we talked of the damage this all does to those who dedicate their lives to working in public life, but also how clinicians and managers can work together to call this dishonesty out, live by their values and counteract the post-fact world poison.

My other three questions were about patients and a paperless NHS.

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Again, although hardly a representative sample, my Twitter replies accorded with the audience. They said that attitudes mattered as much if not more than IT. I told them the story of a medical colleague who would write to me every six months or so during my 13 years as an NHS CE listing everything that he felt was wrong with how I was leading the trust, including the inadequacy of his secretarial support, in a 3 -4 page letter typed, somewhat ironically, by his secretary. I would always reply, by email. By contrast, my own psychiatrist, a world renowned professor at another trust, personally typed his update letter to my GP during our consultation and gave it to me to pass on. He would have used email but it wasn’t yet sufficiently secure.

We also discussed the pros and cons of clinical staff spending increasing amounts of time away from patients collecting and recording data that someone somewhere thought might be useful. And that the gold standard of a fully connected wireless NHS when patients and staff  freely shared information via iPad or other tablet device would happen one day. But that given the current state of connectivity, they probably shouldn’t cancel the contract for supplying paper and pens anytime soon.

Finally, I shoehorned in a reference to my muse Mary Seacole. I said that she, a 19th century health care entrepreneur, would have loved social media. And I gave Daniel and @HPottinger, in the picture below, my last two Mary Seacole enamel badges.


At the end I said that I would be writing a blog about the day. And I really hope some of them read it. Because those 100 young people made me think. Despite the financial challenges, morale problems, almost infinite demands plus the debilitating impact of our post-fact world, I think the NHS may be OK.

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And you know why I think that? Because these young leaders, and thousands of other clinicians and managers like them, will make it so. With shining integrity, stunning academic AND emotional intellect, insatiable appetite for understanding, capacity for working smart as well as hard, courage to speak truth to power, and wisdom far beyond their years, they will do it. They will help our creaking NHS adapt for the new era. Whilst holding hard to our core values of high quality, safe care for all, regardless of ability to pay.

And as one who is likely to need a lot more from the NHS in the future, that makes me very happy.

Take good care of yourself

Leaving flowers

Leaving flowers 2014

Another longer blog based on a talk, this time for Point of Care Foundation Community Conference on 27.10.2016

These days I usually introduce myself as a writer, coach and mental health campaigner. Sometimes I say I’m a charity trustee. I might talk about Grassroots Suicide Prevention and how we help to save lives by training people in mental health awareness and suicide prevention techniques. Or the Mary Seacole Trust and that now we have achieved a beautiful statue to the first named black woman in the UK, we intend to smash the glass ceiling that still holds back the careers in business and in public life of women and, even more so, BME people. Occasionally I mention my voluntary work with Time to Change, or that I am training as a Samaritan. And I might say that I love writing fiction, cryptic crosswords, cycling, making jam, Brighton and Hove Albion FC, the Archers, and my family and friends.

Only if relevant do I refer to my 41 year NHS career as a nurse and health visitor, then manager. I prefer not to be defined by what I used to do. I don’t want to live my life in retrospect. I may be over 60, but I feel I have so much more to do and give.

However, for the purposes of today, I need to explain that I was chief executive of a mental health trust in Sussex for 13 years, from 2001 – 2014. And now I am a recovering chief executive. I have Professor Sir Simon Wessely, President of the Royal College of Psychiatrists to thank for that description. And he is right; it describes me well. I have been writing a book about my experiences. I thought I had finished it. But then a few things happened and now I’m less sure. Nonetheless, I have insights I want to share with you.

The main one is this: please don’t do what I did as far as looking after yourself is concerned. I didn’t always make a good job of it. And it wasn’t only me who suffered.

It started with that over-developed sense of responsibility that many of us who choose a career in healthcare seem to have. We are often the first child in the family. If not, we are the one who looks after our siblings, even our parents. In my case, I was also the only girl. Being caring and helpful was expected, and the best way to evoke praise.

People with certain personality preferences have a tendency to choose a career in a caring profession. Another tendency of those with these profiles, and I am one, is to find it hard to say no. We also tend to take criticism personally, we can be overwhelmed by setbacks, and we can experience guilt more readily than those with other profiles. We are also find it very hard to tell others when we are not OK. None of this is set in stone, of course. They are only tendencies; one can learn to modify one’s responses.

The classic personality profiles for people in senior leadership roles are different. They tend to be confident go-getters, driven by vision, analysis and logic rather than feelings of responsibility. They like making decisions, challenging others and being challenged themselves. And so the tendency of leaders who do not fit such a profile is to try to act as though they do. And to pretend not to mind things that they actually mind very much.

I struggled a bit as a student nurse. But once qualified, I got huge satisfaction from clinical practice. I loved helping people, especially those down on their luck. I always will. 

I eventually moved into management via a series of lucky accidents.I had no long-term plan to become a chief executive, even a director. It just happened. I fell in love with the trust I eventually ran because of a chance meeting with some adults with learning disabilities who I had known as children many years previously. Their care wasn’t terrible. But it could have been so much better. And then a senior colleague told me that mental health services were a backwater and that if I took such a job, I would never escape to do anything else. And that was it really; I was hooked.

For the most part, it was wonderful for me to be able to influence the care received by people who were usually at the bottom of the pile, to challenge stigma and discrimination locally and also nationally, to be busy and in demand, and to have the opportunity to work with a bright, engaged team I had the good fortune to build from scratch. Whilst we were all different, we each cared deeply about providing care that we would be happy to receive ourselves or for a member of our own family to receive. And when the care we provided failed, we minded very much and did whatever we could to put it right.

But I also got some things wrong. I can ignore details if they don’t tell me what I want to see or hear. And I wanted every project to go well. So I sometimes reacted badly when not all of them did. I was often overwhelmed by self doubt and imposter syndrome. I had sleepless nights, especially after incidents when things went wrong for patients. I felt very lonely at such times, but I didn’t feel I could tell anyone – I thought I had to tough it out. And this was counterproductive because trying so hard to appear competent made me less approachable to others who were also struggling.

I also wanted my team to be one happy, harmonious family. Without breaking any confidences, I would overreact to disagreements and try to play the peacemaker when what we needed was more discussion and debate. It took me a long time to realise that I had assumed the role of parent or older sister, when a more adult to adult relationship would have served us better. I am grateful to those who persuaded me eventually to see this – we got there in the end.

Although suicide amongst those using mental health services accounts for only a quarter of such deaths, it is, very sadly, not an infrequent occurrence. It took me a long time to admit to myself that the reason I found it so distressing was because I knew something of how desperate those who took that step must have been feeling. And even longer to admit it to others. Although I worked hard not to show it, I found it almost unbearable to be criticised by regulators or via the media for failing to stop someone from taking their own life. I felt guilty both that we had failed, and that I wasn’t always successful in defending the efforts of the staff, who had often kept the person concerned safe for many years and were themselves also devastated. I also know that the effort of hiding my own distress sometimes made me less sensitive to theirs.

Risk assessment, of which much is made these days, is an imprecise science. Some believe it has no scientific validity in preventing suicide or homicide by someone who is mentally ill. And yet people lose their jobs, even their careers, over not applying it correctly. They are judged by those privileged to look at the full facts of a case at leisure, with the benefit of hindsight. Rather than under pressure in real time in a busy hospital or clinic or on a difficult home visit. And without enough of the right resources. Families can be led to believe, sometimes erroneously, that a chance event that has changed their lives forever might somehow have been predicted or prevented, and that someone must therefore have been at fault. Unless NHS staff have erred deliberately or been recklessly careless, it is seldom the right thing to do to blame them, whether they are a junior nurse or a very senior manager. It is cruel and reductive and unlikely to bring about positive change. In fact it is likely to make people fearful and to drive poor practice underground.

I am extremely grateful to those who helped me to understand a more nuanced way of thinking about suicide, especially to Dr Alys Cole-King of Connecting with People, my friends at Grassroots Suicide Prevention, and Samaritans. I also thank John Ballatt and Penny Campling, whose book Intelligent Kindness enabled me to understand what was wrong with the traditional NHS approach to serious incidents, as well as a few other things. And to the Point of Care Foundation, whose outstanding work helps professionals to nurture their compassion and non-judgemental curiosity, despite the challenges of today’s NHS.

Some people reading this know that I saw my first psychiatrist aged 15, and have been troubled off and on with anxiety and depression throughout my life. I am still trying to make sense of why i felt so ashamed of this for so long, and how I managed to get through 12 of my 13 years as a chief executive of a mental health trust without blowing my cover. All I can say is that I am well-practised at pretending to be OK when I am not. 

I eventually began to talk about it the year before I retired as my personal contribution to reducing stigma. It was even more painful than I had expected. I felt exposed and brittle. I couldn’t sleep or think straight. I was forgetful, jumpy and irritable and my judgement went downhill. I wondered if I was going mad, and in a way I was. I had such terrible stomach pains that I thought I might die. It would honestly have been a relief. And then I started to cry, and couldn’t stop. Driving home, I nearly crashed the car on purpose into the central reservation. It was only the thought of the fuss it would cause for others that stopped me. For the next 8 weeks I huddled in the dark. Slowly the kindness of my GP and psychiatrist and that of my family, closest friend and work colleagues made me realise that perhaps I wasn’t the worthless pile of ordure I had thought I was. 

Although I will let you into a secret; it wasn’t until I had been back at work a few months and had undergone a course of therapy that I finally accepted that I hadn’t been faking my latest bout of depression. And that I wasn’t the selfish, lazy, waste-of-space I was called by a nurse when I made an attempt on my own life many years earlier. His words stayed with me because I agreed with him.

If speaking up was hard, going back to work in January 2014 was harder. But it was also part of my recovery. It felt liberating to be able to be open about why I had been off. I found conversations with clinicians, managers and most of all patients were deeper and more meaningful. I was a better listener, and I wasn’t rushing to solve everything, as had been my wont. I found that I could listen properly to criticism, and appreciate what the other person was trying to say without feeling the need to defend the trust or myself. My final eight months before retiring in the summer as planned were the happiest of my whole 13 years.

If you have the sort of tendencies I have, here are five tips from me to help you take care of yourself.

  1. When something goes wrong and you or those for whom you are responsible make a mistake, try not to be disheartened. Allow yourself time to process what happened and why. Apologise wholeheartedly. But do not be rushed into snap decisions. Treat yourself and your team as a work in progress.
  2. When someone offers you criticism, try hard not to be devastated by it. But also try not to reject it out-of-hand. Take it for what it is, just an opinion that may or may not be useful.
  3. Don’t pretend to be someone or something that you are not. It is exhausting.
  4. Exercise is important, and so is eating well. But sleep is healing. We all need it or we can’t function. If you are having trouble sleeping, then you deserve some help. This advice from Mind is a good starting point.
  5. Remember that being kind to yourself is not selfish. It is actually extremely unselfish. Because it is only through being kind to yourself that you can truly be kind to others.

It was Carl Jung who initially wrote about the wounded healer. There is nothing wrong with being motivated to help others partly because one has issues oneself; such experiences can help the care giver to be more empathetic. But if we truly care about others, as I have learned at great cost, it is very important that we do not pretend to be OK when we are not.

Because, as Karl Rogers, a successor of Jung said: what I am is good enough if I would only be it openly.

 

 

 

 

 

Happy World Mental Health Day 2016

The theme of World Mental Health Day 2016 is helping people in distress. I’ve been asked to speak at an event organised by Mental Health First Aid. This blog is a precis of my talk. 

My brother lives in the US. With a foreign passport and a surname like Rodrigues, he – and we – are watching the American presidential election with vested interest.

Many times we have heard Donald Trump express views we know to be racist or sexist. But recently, he took aim at a new target: those with mental illness. He opined that soldiers who experience post-traumatic stress disorder are in some way weak. As though being strong equates to having no feelings. Given recent revelations about other things Trump has said, there wasn’t a lot of fuss about this. Vice President Joe Biden said that the comment just showed how out of touch Trump is.

But actually he isn’t. Donald Trump is popular in certain quarters because he says what he knows many people are thinking. And in doing so, he speaks not only for some Americans, but for people in other parts of the world. Including the UK.

I want to tell you why Trump, and others who think like that, are wrong.  And not just because thinking that way is unkind. It is also wrong intellectually and on economic terms too.

Mental illness is in some ways like physical illness. If you know what you are looking for, you may be able to see it through a microscope or on a scan. And you can use chemicals to treat the symptoms, although not the causes.

And as with physical illnesses, the causes are multi-factorial. Just like cancer, which doesn’t happen to “weak” people, mental illnesses are triggered by genetic, environmental, social and behavioural factors.

But unlike with most physical illnesses, people make judgements about you if you are mentally ill. Nor do they think the sort of thing Donald Trump said. That people like me, and many of you, who experience mental illness from time to time, are weak.

In fact we are far from weak. Because another thing that differentiates mental illness from physical illness is that as well as having to cope with that sort of stigma plus the challenge of having an illness that messes with your head, people like us also have to learn to reframe our thinking and our behaviour if we want to achieve recovery.

It is important to understand the links between psychological trauma and mental illness so that it can be prevented as well as treated. And to realise that, with enough trauma, almost all of us will exhibit symptoms of mental illness.

Let me tell you about two people.

I met Ally a couple of years ago when she and I were invited to speak to new NHS managers. Since then we have shared a lot. She said it would be OK to write about her here. Ally’s Post Traumatic Stress Disorder (PTSD) was triggered through a toxic working environment, plus some specific events that occurred in Chernobyl where she was working, including the death of two colleagues, which were then covered up. She says that prior to this, she was a workaholic who self-medicated with alcohol. After these terrible events, she tried to raise her concerns but was ignored and bullied. She got ill, and eventually lost her job, became homeless and nearly died through self-neglect. But although some sat in judgement of her, there were people who took time to listen to her and to recognise that such terrible things would cause damage to any of us. They helped her to take recognise this and to take her first slow steps towards acceptance and recovery. Some were professionals but some were ordinary people.

Today, Ally still experiences the effects of PTSD. She is also one of the most well-educated, brilliant and funny people I know. She can hold the attention of the most erudite as well as very ordinary people when she talks about improving the NHS. When I watch her speak, I feel honoured to call her my friend.

Then there is Odi. Odi and I came across one another in 2005 over some changes to local mental health services. He wasn’t well, and I struggled to understand what he was trying to tell me. But there was something about him that was unforgettable. We met again, and gradually I learned that he had experienced terrible trauma including torture in troubled parts of Africa. This led to him hearing voices. He didn’t want to take conventional medicine. He wanted to heal himself through traditional non-invasive methods.

He was allocated a social worker who appreciated that to achieve recovery, Odi needed honesty, understanding and acceptance. Over time, and supported by that social worker, Odi used art and music to help himself and then others, eventually taking a dimg-20151024-wa0000egree in art therapy. He then decided to become a social worker himself. This year Odi completed his Masters in Social Work. He was awarded Student of the Year on his course at the University of Sussex, and has been shortlisted as national Social Work Student of the Year. I would be very surprised if he doesn’t win. He is wise and good and has the heart of a lion. Anyone who gets Odi as their social worker will be blessed. Like Ally, it is an honour that he has become my dear friend. The photo is us doing selfies at Brighton and Hove Albion.

And then there is me. I’ve written before about how I got to where I am now, and that I am still a work-in-progress. But for those who don’t know, I saw my first psychiatrist aged 15. He was kind. But he couldn’t help me with my feelings of self-hatred and despair because I convinced him that I was OK.  The next few years were pretty grim. I got through my nursing training by perfecting the art of seeming ok when I wasn’t. And when I ended up in hospital after an overdose and the nurse told me I was a waste of space and selfish because I was taking him away from people who were really ill, I believed him. In fact, I agreed. I had huge compassion for others but none at all for myself.

I have muddled through my life, and achieved some successes. But it was the attention and kindness of others, including Sue Baker at Time to Change, that eventually led me to realise that opening up about my experiences of anxiety and depression would be a generous act. Rather than a sign of my own weakness. I did so, at considerable personal cost, the year before I retired from the NHS. Nowadays, I know being open is not only kind to others. It is also a kindness to myself.

In being more open, I have made some amazing friends and learned so much. And the greatest thing is that people like me, and Ally and Odi, and some of you, are not flawed or weak. We have simply had to face things others have not. And in facing them, we have developed skills, understanding, humility and compassion that make us better humans than we would have been had we not had to do this.

This is why Donald Trump, who is wrong in so many other ways, is wrong about soldiers who experience PTSD. Those men and women who have served their country and found the experience traumatic are far from weak. They are human beings and also heroes. And they deserve gratitude, sympathy and support.

Thank you reading this. Thank you for helping others, for taking time to ask someone how they are. And thank you for really listening to what that person says. It is a wonderful, compassionate and extremely effective thing to do. You are helping to save and change lives.

You can learn more about helping others through programmes like the wonderful Mental Health First Aid courses and products.

I wish you all a wonderful World Mental Health Day 2016.