Mental Health Awareness Week #MAW2017 – Read Sarah’s Story

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Mental Health takes many forms and affects us in many ways, and it doesn’t discriminate between race, religion, colour or gender. It can gradually creep up on us or hit us like a truck. No 2 people will suffer the same.

I have struggled with mental illness for half of my life now.

I remember aged 17, being in the bath after another argument with my parents, thinking how easy it would be to just stick my head under the water and end it all.

Every teenager has their struggles and will say that their parents just don’t understand them, but this was especially true of mine. Even now, 15 years later, I still look back on my teenage years as a very traumatic time.

From the age of 18, I spent 7 years in an emotionally abuse relationship. It started with the odd accusation here and there, until eventually, it became an every day occurrence. Every time my phone pinged, he demanded to know who it was. If the person wasn’t female, then clearly I must be cheating. When I was 25, we finally separated and I was left alone with a house and all the bills to pay for.

My counsellor recently told me a saying that they use in her sector: “The road is full of potholes”. This was very true of this point in my life, only they weren’t potholes, they were an abyss that I was circling and about to fall into at any moment.

I recall driving home from work one afternoon and all I wanted to do was drive my car flat out into a brick wall. I knew then that I needed help, so I made an appointment with my doctor and was prescribed antidepressants and signed off work for 2 weeks. I will never forget my manager’s reaction to that note: “you could always just rip it up and get on with it”. Words failed me and I hurriedly left the office and didn’t return for 2 weeks.

Things got a little better as the tablets started to take effect but it wasn’t just the feeling low, it was the insomnia, the numbness and the anxiety that can accompany Depression. I didn’t sleep properly in weeks and this only hampered my recovery.

Over the following months, I became stronger and began to like living on my own, it was then that I very unexpectedly met my husband.

Within a few months of meeting him, I had weaned myself off the antidepressants and I felt amazing. We were married 9 months after meeting and shortly after we were posted overseas with the military. Moving away was the fresh start I needed, we made some great friends and had our two children.

So how can I still feel sad?

A question I have asked myself so many times. After all; I have the perfect marriage to my best friend and soul mate and we have two healthy and wonderful children.

So what can I possibly have to feel depressed about?

The answer is nothing. But Depression doesn’t need a reason.

My latest battle with Depression really started last year. I knew I was struggling so I went to the doctors and requested to go back on antidepressants. But as the year went on, my mental health continued to decline and after the loss of a close friend to cancer last July, things just got worse.

The thing with Depression though is that it doesn’t just affect you, it affects everyone around you. I became less and less tolerant with my children and I withdrew from my husband- some days feeling so angry with him just for sitting down on the sofa next to me. I wanted to scream at him, even though he’d done nothing wrong.

My husband thought it was all his fault that I felt this way, like he wasn’t enough to make me happy anymore. But it wasn’t anything to do with him or our children. The truth is; I still don’t know what caused it.

It wasn’t just my home life that was suffering, but my job too. I struggled to complete every day tasks and made so many mistakes.

I’m very fortunate to have a boss who understands and helped me to get back on my feet. I now know that if I’m having a bad day, I only have to let her know and she will support me as much as she can. This makes all the difference to my struggle.

By September last year, things were back at their very worst. I didn’t have the suicidal thoughts that I’d had previously because of my children, but I knew I needed more help. The doctor had doubled the dose of my antidepressants but this was not helping, so I sought a counsellor. I found her listed on the Counselling Directory website and instantly liked her from her photo.

I’ve lost count of how many sessions I’ve had with her, but every single one has helped to get me back on track and feel better. We’ve been through the ‘nitty gritty stuff’- the abuse etc. but I have left every session feeling a million times lighter.

I don’t have regular weekly sessions anymore, I just go when I feel like I need a bit of support or help. For me now, it’s a bit like an MOT for my brain when I need it.

Mental Health takes many forms and affects us in many ways, and it doesn’t discriminate between race, religion, colour or gender. It can gradually creep up on us, or hit us like a truck. No 2 people will suffer the same.

I’ve been lucky to make many new friends since my eldest started school last year, and I have been very surprised to learn how many of those other parents have been effected by their own mental health- some just the once, for others it’s ongoing. And it always seems to be the parents who are (sometimes rather annoyingly!) always happy. It just proves that, despite appearances, you never know what personal battle someone is fighting.

Don’t ever be afraid to ask for help; more people understand than you realise.

Health, Wellbeing and Dementia

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Tier 2 (Subject 6) Dementia Health and Well-being Training Course

This course outlines the importance of maintaining physical and mental health in relation to someone living with dementia. This course provides information on how to tackle: nutrition, hydration, pain, continence care and sleep. Participants will develop a basic understanding of holistic approaches to health, but are provided with some practical information in supporting activities of daily living. The course is mapped to tier 2 – Dementia Core Skills Education Framework (subject 6). This course is delivered in an engaging way, and participants get the opportunity to engage in experiential learning activities.

Explain why it is important to maintain good physical and mental health.
Describe how to identify a person’s heath needs including malnutrition, pain, dehydration, falls and fatigue
List the signs of delirium and the signs of dementia, recognising delirium is a medical emergency
Describe the possible impact, including psychological and social impact, of incontinence.
Describe the potential causes of, and impact of loneliness and the importance of maintaining social engagement
Describe possible ways to support ADL’s in a person centred manner.

Wellbeing is Outcome by Trish O’Hara

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Wellbeing is Outcome – by Trish O’Hara March 2015

So the opening chapter of The Care Act is all about wellbeing. I presume every agency has wellbeing in their mission statement. We talk about wellbeing all the time in services today. It is the main driver of our delivery. It is how we are measured. It is the point. And yet, in my experience, practitioners struggle to define it.
Let’s be honest, care packages are created on the back of need, not want. Budgets mean that only ‘need’ is eligible. Any social worker who thinks their assessment processes are person centred must accept that their assessment processes are purely needs led. Person centred planning is aspirational and dreams led – it’s about want not need. What is important for the person is often in direct conflict to what is important to them. Whilst a person’s care package is based on need – the service providing said package is then measured on outcome. This means the provider must know how to move on from the initial assessment and turn the process on its head – still making sure that the person is in receipt of the service they are paying for.
This is not easy.
In essence, the budget meets the persons needs – but your service will be measured on the persons wellbeing and outcome.
So let us define outcome focused practice;
Input The resources required to provide agreed service
Activity The action plan that delivers said service
Output The service is evidenced as delivered
Outcome How this makes the person feel
An example to help us as follows;
Colin is a man with Down Syndrome and a mild to moderate learning disability. Colin has had a life long dream of meeting Elvis in Vegas. Colin lives with 5 others in a registered care home. Colin has the capacity to make his own decisions in the main and chooses to eat very surgery and fatty foods. Colin has diabetes and is about 5 stone overweight which is putting a great strain on his heart and effecting mobility. Colin often refuses his medication and has uncontrolled epilepsy with several seizures per day. Colin is very gregarious and friendly, often singing Elvis songs and making people around him feel good. The staff at his care service have spent years attempting to support Colin to make ‘better’ decisions about his diet and medication. He ignores them. Colins mum is very involved in his care and is worried about his health.
It is when Colin begins a person centred plan – using PATH that his life changes.
Starting with the dream – Colin is in Vegas meeting ‘an’ Elvis.
Colin has a hotel room and a ticket to an Elvis concert
Colin is on the plane with a ticket, passport and visa
Colin has saved £3500
Colin has permission from his GP and insurance to fly

We can see there are a myriad of barriers to this trip. We can see that there a many risks.
Colin tells the staff his dream – staff work from the dream to support Colin to take control over his life.
Colin is excited about going to Vegas. Colin takes his medication without fail and even agrees to a blood test. Colin actively involves himself in healthy eating and manages to lose 3 stone. Colin chooses to walk from the bus the final mile to the day service every day – this was his idea. Colin no longer drinks fizzy drinks. Colin is offered money from his mum and his uncle toward the trip. Colin saves and budgets toward his trip. Colin goes to see Elvis impersonators in the UK. The GP agrees that Colin is now fit to fly. Colin flies to Manchester to see family who he had lost touch with and to see how flying felt. Colin gets a passport.
Let’s use the language to describe events.
Input:          Staff time – Actions plan creations – Appointments with health professionals
Action:       Nutrition Plan, Exercise Plan, Budget/Savings Plan. Colin begins to shop, cook and eat according to plans – along with medical appointments, taking of his medication – controlling his epilepsy and blood sugars.
Output: Colin goes on his dream trip to meet an Elvis in Vegas
Outcome:    Colin has outcome long before output – Colin takes control of his health, his diet, his life. Colin loses weight, becomes more active, controls his seizures and enjoysa full active life in his community. Colin makes plans, budgets and makes decisions.
It is often presumed that outcome comes after output, but as you can see by this example, often outcome arrives before output. In fact, Colin may never get to Vegas, (although I jolly well hope he does) – but still the outcome comes pouring in.
Staff have been working on Colins health and diet for years – but never before had Colin engaged in it. Colin needed to be heard. Colin wanted a trip to Vegas to meet Elvis, which was seen as impossible – Evidently, people believing in Colins dream and supporting him to work toward it – meant that he felt in control, empowered and made his own great steps to achieve his dream. The outcome is clearly filled with evidence of wellbeing.
It is this example that helps us think about what we measure. Output is not where we stop and is not what we measure. Wellbeing is outcome – and it is wellbeing that must be documented as evidence that we are providing the services that the person is paying for – Not need.