Wardipedia has arrived!!

·         Wardipedia (www.wardipedia.org)  is a project of Star Wards..... which is the one and only project of the social justice charity Bright. Star Wards provides practical ideas and inspiring examples from and for mental health ward staff. About 600 wards are members and enjoying introducing small changes which make a massive difference to patients.

·           There are over 1,000 examples of imaginative approaches by wards eg:

             ‘Virtual pets corner ‘ i.e. developing a pet photo display of patients’ and staffs’ pets and wards sponsoring an animal e.g. a retired donkey or a guide dog 

             At the weekly Prepare and Share cooking group, the modern matron not only makes the coffee and washes up, but also does decorative serviette folding. The group is led by a ward manager who is a trained chef – including the skill of decorative pineapple carving!

             Football leagues, visits, stadium tours etc. The tour was to promote interest in local sport, active lifestyles and the importance of physical fitness.

             Podcast and music studio

             Remote control car races, and spacehopper races. Spontaneous paper plate Frisbee games.

             Repositioning a bed to give better view of outside

             Self-harm project run by a specialist nurse, including a camouflage clinic, support group, staff and training.

             The Catering Department have ‘Just for You’ where the patients are invited to design a meal themselves and the catering department will cook it for them.

             A  four week poetry workshop (also for community clients) in conjunction with Radio Stoke.

·         Wardipedia includes 77 ideas for enhancing inpatients’ experiences, with 11 in each of seven domains, structured around the concept of IMAGINE:

Imagination – what’s it like for the patient?

Mindfulness – chilling out

Activities – social, recreational, physical

Generosity - sharing, kindness, giving

Involvement –influence, information, independence

Neighbours – friends, family, fellow patients

Empathy – for self and others

For example:

7.        Mentalising

17.      Music

24.      Wii

33.      Men’s stuff

35.     Bring yourself to work day

44.     Gay patients

45.     Patient involvement

47.     Minority languages

53.     Bank staff

55.     Brain

59.     Social media

70.     Comfort objects

One in four

I'm sure I have used the "one in four" statement many times. I have argued like many others before me that one in four people will have an episode of mental ill health/distress in their lifetime. The figure has been used by many to make people realise how we need to recognise and indeed de-stigmatise the number of people who need help but above all compassion for their situation.
But now we seem to have a new one in four. This new figure (actually based on a 2007 paper) argues that of those who have a mental health problem only one in four will actually be receiving treatment/help/assistance/support.So of that quarter of the population that need help only a quarter will be receiving it.
Quite an astonishing figure. Especially as the cost of this failure to treat /help is dwarfed by the savings to be accrued by returning people to a better place. As you can tell the argument is being underpinned by financial arguments (not surprising considering the London School of economics are involved) but isn't this really a moral issue?
Imagine if you will a quarter of diabetics only receiving treatment and a situation where retinopathy or gangrenous extremeties or indeed blindness were casually accepted. You can't really can you. Or even where a failure to treat for up to a year was accepted as a consequence of "how services are organised"
We do seem to be dogged by low expectations, fatalism and even a sense of nihlism when it comes to mental health.

"Homeland" and the issue of memory.

Quality drama, well thats the title afforded certain types of drama, along with the term "high production values" its meant to convey something extraordinary about what we choose to watch.
I guess the "Killing" seemd to be dominated by jumpers, "Borgen" by lamps and now the "Bridge" seems to focus on architecture and beautifully shot  enigmatic locations in Sweden  and Denmark.
But what of "Homeland" what will be your enduring memory of it? Theres no doubt it was a tense and gripping drama and not since "Twin Peaks" have I felt not only compelled to watch but also came to actually care about some of the characters. I suppose its nicely contemporary and also had that hard "real politik" with just an suggestion of dark and menacing forces (on both sides).
For me the really memorable episode was the penultimate one when Carrie became manic and distraught at the failure by others to understand and agree with her view of what was going on. I have never seen a more accurate depiction of the features of mania as she worked relentlessly to solve the problem of Abu Nasir. At the scene where her work was torn down off the wall the sound was faded and we saw her complete distress at not being believed. It seemd to me that could be the lived experience of many who we consider "unwell" or "ill". I found it sobering to see that so accurately depicted and for me will remain as an enduring memory.
Which is kind of neat as the series ended with Carrie hoping her memory would endure the ECT she was having. We wait to see if it does.

Jack Nicholsons finest moment?

Well was it in Easy Rider, or in "The Shining" (who will forget his cry of Here's Johnny)? I think for many people his most exciting or indeed mercurial performance was in the movie adaption of "One flew over the Cuckoo's nest". He plays the part of one Randle McMurphy sent to an institution for evaluation. The rest is well known and I won't repeat it here. Suffice to say the adaption of Ken Keseys book (also a top read) won many plaudits and awards.
Its influence has been vast and for many that depiction of 1950's institutional care has become synonymous with mental health care "full stop". I was once interviewed for a place on a Masters Degree in mental health and the first question to me (as a nurse in particular) was "Why do you think Nurse Rachet behaved as she did"?
I watched the film (and enjoyed it) and I guess filtered it through a nurses values and culture. I saw clear brutality of a subtle and insiduous nature on behalf of Nurse Rachet. and also the actions of the male orderlies (am I right in remembering one using a cosh?), were really grim. They seemed to be not only institutionalised but also willing to engage in pretty forceful and dehumanising actions.
The patients themselves, well again pure drama and a good drama to, but a more sensationalist collection of stereotypes you couldn't hope to find. Does it have merits though? I guess it does, its pretty realistic in some senses, Its critique of psycho-surgery to ameliorate difficult behaviour is pretty accurate and the numbing routine of a neat and tidy ward is captured well. Perhaps this was because it was filmed in an actual hospital location.
There's much to commend the film as drama, my problem comes when its the main point of reference for peoples understanding of mental health services today.
Don't get me started on the infamous "Titicut follies" whatever you do. Well perhaps another time!

Can someone explain this to me?

Interesting piece in the propoganda war that now surrounds the NHS Bill, you know what I mean , all of a sudden research and reports are produced that support a certain view. All published under the guise of  news. I was really fascinated by this piece in the online Guardian today. It reports that a collection of NHS directors are arguing the elevation of the private commercial earning ceiling to 49% will benefit NHS patients. they say......
"Examples of these benefits include developing treatment innovations and specialisms - such as complex paediatric treatment, robotic surgery, and employer-funded mental health treatment - and mean that trusts will be able to provide services on the NHS that can no longer be commissioned or are now rationed, including IVF."
Now my eye was drawn to the term "employer funded mental health treatment". What could that treatment be I wonder. I assume its psychological therapies that are currently delivered by Employer Assistance Programmes and which engage with independent contractors. Now this could be an absolute fillip to the psychology services couldn't it? They could recruit more and more psychologists and their assistants and  deliver an IAPT style programme for the employers who would pay well for such a service.
But hang on Clin Psychs are a very small group and the low and high intensity workers are being trained to provide IAPT, and in particualr we are now working on a plans to develop that service into greater provision to people with a label of Serious Mental Illness, and indeed Young people.
Could there be a potential diversion of resources here? Could we see a client group neglected because there is more revenue (and less hassle maybe) in treating those employee clinets stressed out as they struggle with the impending recession
I think we need to keep a very careful eye on this one, it would be a real tragedy if a client group that has consistently called for such services sees the promise of delivery lost.
But hey thats the "Market" for you!!!

Diabetes led the way

Interesting day today, discussing and considering how primary care services could and probably will care for people we consider labelled as having "serious mental illness"(SMI). In other words the psychoses such as Schizophrenia and Bi-Polar disorder. Why Diabetes in the header to this entry? Well not so long ago people with diabetes would attend diabetic clinics in hospitals, spend times in waiting areas and have their blood sugars measured and their insulin levels titrated. Something that a GP or Practice nurse was not considered competent to do. Then a change occurred and the staff in Primary care were trained up (or developed competencies if you prefer) and the ongoing care of people with diabetes was transferred to primary care. No more trips to hospitals, and only probably going there at all if matters became outwith the scope of primary care.
Now could the same occur for people with  SMI? Could their routine care be in the primary care setting, could this be achieved with the presence of existing secondary mental health staff located in primary care for support of their colleagues? Consider the gains. no more attending out patient clinics in possibly stigmatising settings, no more six monthly appointments where you see a different person each time, and possibly the chance to address the issue of poor physical health which still blights the lives of these clients.
Could it happen?