compassion

The ones who matter

Lisa oval

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.

 

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. 😎😎😎

One day mental health stigma will be a distant memory

Back in 2014, the team at Time to Change held a round table event that forced those of us who care about NHS mental health services to face an unpalatable truth. Which was that 1 in 3 people who used services experienced lack of compassion and even stigma from where you would least expect it, those working in those very same services. This finding has been repeated several times, and featured again in last week’s Mental Health Taskforce Report.

In August 2015, I wrote about how this made me feel and about the Time to Change project I volunteered to chair here. And about the negative reactions it initially invoked here.

Now it’s time to pop my head above the parapet again.

Along with some amazing people, including 4 experts by experience and senior colleagues from our 2 pilot sites Northumberland, Tyne and Wear NHS FT and 2Gether NHS FT, we have carried out some action research directly with NHS staff to explore what gets in the way of compassionate care and the shifts in attitude that are needed.

It hasn’t all been plain sailing. But we have learned a lot, especially about what works. And this week we are launching a campaign within 6 volunteer mental health trusts, which include our 2 pilot sites plus 4 others. From the early work with our pilots, we know that staff value time out in a safe place to talk about attitudes and values, and to discuss why sometimes they fall short of providing care to a standard they aspire. The materials are being made available online via Time to Change across the whole NHS.

I want to make a few things clear from a personal perspective. We won’t shift attitudes by finger pointing and blame. The people at Time to Change know this. Their approach is positive, supportive and empathetic. They know what they are talking about. They have achieved measurable, sustained success in shifting public attitudes over 7 years of work. Our project with NHS mental health professionals builds on the same approach, tailored to local circumstances.

We are acutely aware that staff who work in mental health services are under greater pressure than ever before. We know this from the hard-hitting findings in last week’s Mental Health Taskforce Report. Our project doesn’t deny this. But we are operating in the real world. And we have to start where we are now.

Stigma is an ugly word. And the stigma of mental illness is deep-seated and far-reaching. It manifests in the way mental health services get side-lined. Two weeks ago, my old boss Lord Nigel Crisp published his report about access to mental hospital beds. With charm and precision, Nigel ticked off Nick Robinson on the Today programme for trying to change the subject to the junior doctors’ dispute.  Nigel pointed out that it was illustrative of the very problem mental health services face, lack of sustained attention. And whilst the Mental Health Taskforce Report got top billing on the day it was published, we also know that it will disappear without trace unless we all stop talking and actually do something to turn mental health into a priority.

Not all journalists are guilty of stigma. I thank Shaun Lintern at HSJ, Andy McNicholl of Community Care and Michael Buchanan at the BBC for their sterling work uncovering swingeing cuts over the past four years, which some still deny despite the evidence laid bare.

Stigma exists amongst some politicians and parts of the NHS. The rhetoric of parity of esteem has been trotted out whilst at the same time commissioners, faced with unpalatable choices, are allowed to disinvest in those services people are least likely to make a fuss about, i.e. mental health. And not just in the NHS, but also the third sector, where much vital provision has been wiped out in recent years and is at least in part the cause of the current mental health bed crisis besetting most of the country.

The unkindness I experienced many years ago from a nurse in A and E is repeated across acute hospitals and other parts of the NHS daily. I recently heard an acute trust chief executive say this: “These people don’t belong in A and E.” (My italics).

So who exactly are “these people”? They are people like you and me. And people like him think we are undeserving. And many, including him, still believe being mentally ill is somehow our own fault.

Our Time to Change project isn’t aimed at tackling everything at once. We have to eat this elephant together, in bite size chunks. Working with Time to Change and supported by NHS England, I know we can succeed.

Lisa Rodrigues CBE

Writer, coach, mental health campaigner. And a recovering NHS Chief Executive

This piece also appears today in the Health Service Journal

A mixed week: updated Sunday 21 Feb 2016

It’s a good thing we don’t know what the future holds. Otherwise we might never get out of bed.

On Monday, the long-awaited Mental Health Taskforce Report was published. And it made grim reading. Behind the awful stories about people being let down or receiving no treatment at all is the spectre of stigma. How else can it be that government ministers have spouted forth about No Health without Mental Health and Parity of Esteem whilst at the same time services have seen real terms reductions to funding far greater than other parts of the NHS. And despite referral rates continuing to rise? The suicide rate is rising again too, even among groups not previously considered to be at high risk.

The coverage was wide and mainly pretty fair. (I say mainly; the Metro managed to annoy almost everyone on my Twitter feed with an offensive headline.) I was impressed by what Paul Farmer and all my other friends on the taskforce have achieved, and by the measured response of NHS England and the Secretary of State. But instead of feeling proud to have played my tiny part, and girding my loins for the sustained effort that will be needed to hold the government and the NHS to account, I noticed my mood gradually getting lower throughout Monday. By the evening, I was overwhelmed with sadness that it has taken so long for so many people to be heard, and that many lives have been lost along the way. And I was assailed with despondency and a sense of utter failure for what I hadn’t managed to achieve in all those years I was running mental health services and had so much opportunity and influence.

Things got worse on Tuesday. I woke to find myself the subject of an article in my local paper, the Brighton Argus, along with a massive photo of me with a long-forgotten hair colour. It said that 19 staff at Sussex Partnership, the trust I used to run, had received severance pay-outs totalling several millions in the past four years, and that I had received the largest sum, £275k, in 2014.

It was wrong in every respect. The highest payment was £27.5k not £275k. And I hadn’t received one at all. And I felt tearful and scared and powerless and all the other things I remember about being public property for the 13 years I was a chief executive.

I minded most because leaving the trust caused me great anguish. Anticipating it almost certainly led to my last serious depression. Going back to work after my breakdown for another 8 months was very hard. It mattered greatly to me that, having managed to do so, I should leave on my own terms.

A few phone calls later, I was reassured that the story had appeared because of a combination of cock-up and further cock-up. Thank you to everyone concerned for your honesty; mistakes are always forgivable when people tell the truth. By the afternoon, The Argus had removed mention of me from their website and agreed to publish a correction the following day. Which they did. And today they published a letter from me here (there may still be issues with this link if you are on a smartphone. Try Argus Letters in your preferred search engine and ask your browser to use the Argus desktop site. Or try this link directly with the trust website http://www.sussexpartnership.nhs.uk/whats-new/no-severance-package-former-chief-executive-note-lisa?platform=hootsuite)

As I left the house yesterday afternoon somewhat surreptitiously to do some local errands and keep an appointment to give blood, I wondered what people must be saying behind my back. And I was reminded what it felt like to have no place to hide.

However, the week wasn’t all bad.

I was asked to appear on Radio Surrey and Sussex this morning to talk about the stigma of mental illness as part of the BBC #InTheMind series. You can catch me, Danny Pike and the wonderful Sue Baker of Time to Change here 1hr 10 mins into the programme.

Our choir has been rehearsing for a charity concert on Saturday afternoon – details here https://twitter.com/slondonchoir/status/699507596353499136 All welcome.

Brighton and Hove Albion drew away on Tuesday night with Championship leaders Hull and are now third from top, and only one point away from an automatic promotion spot to the Premiership.

And I have at last finished the first draft of my book, which is about being a chief executive who occasionally experiences doubts and depression.

One day I hope you will read it.

Update: I spoke too soon, which after 21 years following the Seagulls, I’ve found it’s easy to do. We got stuffed 4-1 yesterday by Cardiff City. Have a feeling this season could go right to the wire, just like every other year!

But the choir concert was – well I don’t have enough superlatives. Life – affirming will do. And today I helped my lovely husband Steve, who supports me in all my endeavours, to raise money for The Tall Ships Trust, a youth development charity to which he is very committed, via a jumble sale of boat stuff. The two of us were up at 5.00 am. By 2.00pm, we had made just shy of £1,000 which will help kids from disadvantaged backgrounds to experience the joys and lessons that can be learned through sailing.

And I’ve heard from hundreds of people who’ve said kind things. Which for someone like me means more than I can possibly tell you. On Tuesday I was in the depths of despond. Today, on balance, I’m really happy to be me.

Thank you.

 

Cock-up or conspiracy?

Blogging can be addictive. I try to limit myself to one a week. But after the Secretary of State announced yesterday that a pay “settlement” will now be imposed on junior doctors, given that extended negotiations have so far failed to reach a conclusion satisfactory to all parties, I feel I have something to say.

I know many junior doctors, including the daughters and sons of friends plus those I meet directly through ongoing contact with the NHS. These young people, who hold other people’s lives in their hands on a daily basis, are sensible, bright, compassionate, committed and driven. I don’t understand how a Secretary of State who was brought in to settle down the NHS after the mess the previous one created can have allowed himself to get into an intractable dispute with so popular and articulate a group of NHS staff.

But nor do I buy into conspiracy theories about privatisation by stealth; there would be better ways to achieve this than by alienating an essential section of the workforce. It is far more likely to be a cock-up. Someone probably advised him that the existing contract was, as most senior NHS managers including senior doctors know, overly complicated and no longer fit for purpose. (If indeed it ever was. This is not the fault of the junior doctors, by the way.)

And so he decided to immortalise his legacy as a moderniser by spearheading the introduction of a new contract. But because he isn’t a manager himself, he set out without understanding that the only way to change the contracts of any group of public sector staff, especially doctors who have possibly the most effective union in the country to negotiate for them, is to improve on their current terms and conditions. There is nothing that upsets people more than attempts to introduce changes that significantly worsen their position. And at the heart of the dispute is the fact that for everyone else in the NHS, Saturdays are not part of the core working week. And although there is little choice for the majority but to work on at least some Saturdays, doing so incurs additional payment. (That people in shops and restaurants don’t get paid extra for working on Saturdays these days is of no relevance.)

The Secretary of State also fell into a communications trap by talking about a 7-day NHS, when the group he was targeting already work shifts across 7 days. He chose the wrong example. To get a true 7-day service, he needs to persuade all other NHS staff who don’t already do so to work shifts over 7 days. And to find considerably more of them because spreading 5 across 7 just makes a thinner spread. And that would cost a great deal of money, which he doesn’t have.

What I know from my junior doctor friends is just how difficult it is to get onto a training programme that takes account of personal circumstances. These young people are already in their mid – late 20s. They have slogged away for 10 years plus to get to where they are now. Only the most elite get the pick of training jobs in university teaching trusts; everyone else is bundled around the country with little choice on short placements that have to be filled, because they are the medical workhorses of our NHS. This plays havoc with personal relationships and family life. So they are not a group for whom losing what little control they had over their Saturdays was ever likely to go down well.

With all this in mind, chief executives of trusts work to a bottom line, which is to deliver safe services within the money available. And 20 of them have found themselves in an invidious position.  These 20 were asked whether the latest offer being made was, in their opinion given the circumstances, fair and reasonable. Having replied in most cases that on balance, they felt that it was, they found their names being included in a letter from the chief negotiator to the Secretary of State in support of something about which they had not been asked, ie an imposed settlement. For the sake of the point I want to make next, it doesn’t matter whether this was a cock-up or conspiracy. (I suspect cock-up, because they are far more common. And we humans make mistakes.) The letter caused a massive flurry on social media. And these people had to decide whether to keep quiet, incurring the wrath of their own junior medical staff and others who support the doctors, or come out and say that they had not agreed to the imposition, potentially putting their own careers at risk. That the majority did the latter fills my heart with hope for the NHS.

And my key point is this. To be a leader in today’s challenging NHS, there are seldom going to be obvious right answers. You will frequently be faced with dilemmas of this nature. If you don’t have the nous to work out when to put your head above the parapet and when to stay quiet, plus the courage to do the former at the very time it seems most lethal to do so, you haven’t got what it takes.

In other news, the Head of Google, Europe told the Public Accounts Committee yesterday that he couldn’t remember how much his own remuneration package was. Either he really couldn’t, in which case he is an idiot and has no right to be in charge of anything. Or he dissembled because he knew it to be a sum of many millions, embarrassing with Google under fire for paying so little corporation tax. Chief Executives of trusts have their salaries published every year and get pilloried for it in newspapers like the Daily Mail. And they all know exactly how much they earn, which is a tiny fraction of the forgetful man from Google. And yet each carries many times more responsibility than he would have a clue how to handle.

My worry is that there is a scarcity of people with the right attributes and courage to do these NHS leadership jobs. And we really, really need them. As we do our wonderful junior doctors.

A bit of courage

The more worried I feel about expressing my views on a particular topic, the more interest a blog seems to generate.

I’ve written this in anticipation of the Mental Health Taskforce Report, finally due out next week. Although, I’m unsure what you’ll think, I feel the need to say some things I could not have said when I was doing my old job running mental health services.

  1. Mental health services are undoubtedly scary. But they are not all the same. The atmosphere and standard of care even on different wards in the same hospital can vary widely. It depends on the expertise and most of all the compassion of the doctors, nurses and the people in charge. If you have had a poor experience of care, either as a patient or a family member, that is terrible. It is vital that we face the fact that 1 in 3 people say they experience stigma within services. The Time to Change project I’ve been chairing addresses this, with more to report later this month. But at the same time, we must do all we can not to terrify people who need treatment. The chances are they will receive care that will really help. And if they start out assuming the worst, it will be even harder for the staff working with them to establish a therapeutic relationship. And this is the most valuable treatment tool available. I know this from personal experience.
  2. The standard and availability of care in mental health services also depends on the attitudes and expertise of those running and commissioning these services. There is a real and present danger that, faced with wicked choices of saving vast sums of money from the NHS, commissioners look to make savings which will cause the the least outcry, ie from mental health. This isn’t an opinion, by the way. It is a fact. In particular, they look at most expensive care, which happens to be in hospitals, and persuade themselves that the local population can do without most or even all of it. But they can’t. To try to “re-engineer” aka cut beds without careful testing and sustained investment in evidence-based alternatives is irresponsible and dangerous. And yet this is exactly what has been done and continues to be done all over the country right now. Lord Crisp’s report into the availability of acute mental hospital beds published yesterday laid the facts bare. It was a good start. And the access targets it proposes will help. But we still have a long battle to rid ourselves of stigma towards mental health services not only from society but also from the rest of the NHS.
  3. Alcoholism and misuse of drugs are symptoms of mental distress and/or of underlying mental illness. To treat them simply as addictions is cruel and pointless. It may seem cheaper in the short term to separate such services from the NHS and employ unqualified staff to provide care. And it may be politically attractive to take a punitive, non-therapeutic approach to those who self medicate with alcohol or illegal drugs. But to do so condemns vulnerable people to a half life of pain and a premature, horrible death.
  4. There are millions of treatments available for physical illnesses. The same is so for mental illnesses. But why is it that people think they have a right to comment on the treatment of others who are mentally ill in a way they would be unlikely to do for, say, diabetes or heart disease? It’s true that psychiatry and psychology are inexact sciences. This is why they take more expertise, humanity and humility than the other disciplines of medicine. So if you feel tempted to comment on someone else’s treatment, unless you are their trusted clinician, please don’t.
  5. There is no hierarchy of mental illnesses, and no patients who are more “deserving” than others. People who experience psychosis don’t deserve more pity than those who have bipolar disorder, or vice versa. And a short bout of clinical depression can be just as fatal as anorexia nervosa. Please remember this and put away your judgements.
  6. You can’t see mental illness. And that’s part of the cruelty. Getting up and going to a cheap cafe to spend the day with others who understand the challenges of mental illness might sound easy to you. If you feel inclined to bang on about the value of work to those for whom the thought of being compelled to attend a job interview causes them to seriously consider jumping under a train, please shut up. Just because some people don’t get sympathy from tabloid newspapers doesn’t make them any less of a human being than you.
  7. I’ve no problem with the use of words like bravery to refer to those experiencing cancer. And I know from friends with cancer that they have no choice but to be brave. But can we please recognise the courage, guts and determination of those who experience life with mental illness? And can we stop talking about suffering, because it implies passivity and weakness. The one thing I know about every person I have ever met who lives with a mental illness is that they are anything but weak. They are creative and heroic, in ways those who’ve never faced a life such as theirs can only imagine.

People who live with mental illness should be applauded and lionized. Not criticised, preached at, commented on, misunderstood and shunned. I hope next week’s taskforce report will recognise this.

Go us. Thank you.

How do you feel today?

IMG_go72yj

They say you should do something scary every day. I’m not sure. Although I do know that I need the occasional exhilaration of putting myself in an uncomfortable position and overcoming my nerves to make me feel fully alive. Such opportunities came along a bit too frequently when I was a chief executive. But these days I probably don’t scare myself often enough.

Today is the annual Time To Change #TimeToTalk day. Last night, the choir I recently joined held an open mike session. And I decided to terrify myself at the last minute by offering to do a turn.

Although I can follow a tune and love to sing, I am not like the other wonderful acts that got up and entertained us. I have no special musical talent. But I can talk about stuff.

So I found myself standing there and explaining to a packed pub why I had decided to join the choir. Which is that singing with other people is really good for me. Since school choir days, I have yearned to sing again in a choir. I am full of wonder at being part of something greater than myself. I love having to concentrate really hard in order to follow the music. It moves me when a piece we have faltered over suddenly comes together in glorious harmony. Singing with others of a much higher standard helps me to raise my own game. It feels visceral yet sublime.

And I told them about my history of anxiety and depression, and the impact it has had on me, off and on, over 45 years since I was 15. I talked about stigma, including self stigma. And I told them them that I knew I wasn’t alone, because at least 1:4 people in that pub were like me, possibly more. I told about the research of the positive impact of singing on mental well-being.

And then I asked them to join me and celebrate Time to Talk Day by talking to someone else about mental health.

How did it go? Well, I was nervous of course. But they were lovely. I got clapped and cheered. There were a few tears. And some lovely conversations later. I shouldn’t really have expected anything else. The choir is amazing and our conductor MJ is not only a multi-talented musician. She is also an inspiring, compassionate leader. She gets the best from all of us, as singers but also humans.

If you have experienced mental illness but feel shy about telling people in case they judge you, maybe you could do something scary today? Please think about taking the plunge and talking to someone about it, what you do to cope but also how it is only one thing about you. Talk to a colleague, a friend or just someone you happen to bump into. Use Time to Talk Day as your excuse. And ask them about their own mental health. Listen really carefully to what they say. I think you will be pleasantly surprised by your conversation.

And how do I feel today? I think you can probably guess :):):)