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Every year, over 800,000 people die from suicide; this roughly corresponds to one death every 40 seconds. This is shockingly high and something which we can all help to change. Three words lie at the heart of suicide prevention : connect, communicate and care; find out more about this and world suicide prevention day  by clicking here.

 

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Clare Knighton – The mystery of recovery

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When people ask me about my job, I tell them that I use my lived experience of mental health to help other people recover. They smile and nod, but I wonder, should I give them a flavour of what that really means? They see me with my name badge on and I get a sense they assume I’m ‘cured’ or ‘better’ or ‘recovered’; so I think it’s important for me to reflect on what ‘recovery’ means to me and to think about how I can share the magic as a peer support worker with service users.

I’m 18 months past my last section and an inpatient alcohol detox. I’m also in full time employment and was ticking along quite nicely, until one April morning, let me take you to that day……..

I drove to work as usual and sat in the office reading the handover notes. Only, something wasn’t quite right. I couldn’t read the words on the page; it was if I was looking at a foreign language. I got up and walked onto the ward. I stood there, and a cavernous voice was shouting in my head, I remember looking round and a patient asked me if I was ok.

Fast forward a day, and I’m under the care of the home treatment team. They were coming in twice a day, bringing me medication, talking to me, encouraging me to wash and dress and open the curtains. I also received support from a Peer support worker, someone who I could be incredibly honest with, and someone who would just sit with me in my distress.

Fast forward another five days and the strong medication had silenced the turmoil in my head, and I could bear to have the TV on, up to that point, background noise was unbearable. At this point, I began to think about recovery. I felt I had failed. How could I ever support other people when I was no more than a page ahead?! What was recovery? How could I think I had recovered? For a short moment I felt a failure, I even felt I could no longer work as a peer support worker……. until someone said to me ‘Clare what better person to help someone in distress than someone who not only has lived experience but RECENT lived experience?!”

So, as I began to stand back up on my feet, and grow strong again, I realised my perception of recovery had changed. It’s not a linear journey; well not for me anyway, it’s full of twists and turns. I began to tell myself that it was ok to fall back……….as long as I got back on track. This is my recovery, my journey and I remembered how passionate I was about using my lived experience to help others recover.

I returned to work, and quickly felt able to fully function in my role. It helped me having a great support network and a team of people who I work with who just accept me as part of the team and who support me unquestioningly. But what really helped me, was not allowing my view of recovery to remain fixed. Allowing my definition to change allowed me to change and grow, and learn. It allowed me to return to the peer support work that I am so passionate about. It allowed me to story share with patients, to let them know that I too struggle, and that it’s ok. They take strength from seeing me at work, supporting them, knowing that I too am vulnerable.

Being a peer support worker helps me to stay well, but I am not infallible as that brief interlude in April showed me. I have no idea what lies ahead for my recovery journey, but peer support has taught me that its ok, and that recovery is there for us all……………..

 

Clare is an accredited peer support worker based in Worcestershire, a passionate coach, mentor, cat owner and lover of kindness..NHS champion..survivor….expert by experience. You can follow her on Twitter @knightonstar

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Blog news

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This year the blog has had over 6,830 views from 47 countries and we have you to thank! We would also like to thank our wonderful contributors who have allowed us to cover diverse topics such as prejudice in mental health, brain stimulation,  academic/creative writing, peer support, schizophrenia and the media , creative practise and many others.

We have no new content this week, but there’s plenty of fantastic posts from the last few years which we would invite you to browse through. As always we would welcome some new material so please do get in touch.

 

 

 

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Miguel Granja Espirito Santo -Does it work, or does it not? What to look for when considering ‘alternative’ therapies.

blogpicbrainTypically, my point of view on the matter of alternative medicine or treatments, is pretty simple. If it has a prefix before medicine, it is not medicine. Medicine, is a science, and as a science it should be susceptible to intense scrutiny and review, open to change, and open for criticism. Many of the prefixed ‘Medicines’ do not pass this standard.

Many people with mental health issues are looking for new treatments, therapies or drugs, and during this search may come across things like hemp oil, colour therapy, aromatherapy, acupuncture and magnetotherapy (not to be confused with magnetic stimulation).

Sadly, not everyone has had the benefit of learning about empiricism, control groups, and placebo effects; nor is everyone aware of pseudo-science ‘wooisms’ that are aimed at tricking you into thinking that it is scientific.

So, when considering some form of alternative treatment ask yourself, and/or the other person trying to sell it to you (yes, they will try to sell it to you) these things:

1:  Ask how it works

This is probably the best question. Ask how it works, and if you get an arm-wavy, exoteric, angelic answer, it is probably something you should avoid. Also be aware of the ‘bait and switch’, where something may work for one tiny aspect, and practitioners will try to extended to everything. One interesting example is Yoga. Many practitioners make claim about the benefits for mind and body, and suggest that doing specific routines can heal your anxiety, or cure your depression.  However, any of the benefits that people have from doing yoga are exercise related and not yoga specific. This rose in a field of daisies  effect can also be seen in media coverage surrounding the Medicine Nobel Prize in 2015, where Artemisinin a traditional Chinese Medicine, was scientifically tested and found to be an effective anti-malaria compound. Despite the original compound being marketed quite differently and not originally considered to have anti-malarial properties, the finding of some effectiveness gave way to a barrage of vindication articles about alternative medicine.

Here’s a list of ‘alternative’ therapies and how they work. Notice that many of the explanations given are either based on some esoteric, mystical explanation, or on pseudo-science that defies logic:

  • Homeopathy: giving patients medicines that contain no medicine whatsoever. You fight the illness with a diluted version of a substance that can cause your ailment. This is because water retains ‘shape memory’ of previous substances that were diluted in it will act as some form of inoculation. By this logic, we are all drinking poop water.
  • Reiki: Literal arm waving above someone’s body whereby you transfer some form of energy (or remove it?) and you cure someone of their pain or condition.
  • Angelic Reiki: as above, but angels power you up, like a videogame bonus.
  • Aromatherapy: smelling certain smells will treat specific things, and make you feel better.
  • Colour therapy: as above but with colours, possibly auras have something to do with this too, the website is not very clear. You can also buy a colour making machine for a reasonable price at the end of the page.
  • Acupuncture:  So this one is a controversial issue, because there are some good studies that show that it may work for back pain. However, there are no biological mechanisms offered to explain the effects and the studies are rarely double blind. But the original explanation for this treatment is that all sorts of pain, psychological or physical, lead to Qi blockages (life force -you know what it is if you ever watched any Japanese Anime). By placing needles in these specific blockages you break them down and restore the life force flow, thereby feeling better.

2: Are the [insert treatment/therapy] results’ published in any reputable medical/psychological journal?

Many times alternative therapies only refer to old books, or in-house conducted studies. This is highly dubious because they are not peer-reviewed. Peer review is, perhaps, the most important ‘bullshit’ detector that there is in science; if the study or idea does not hold up to the scrutiny of academic peers then it is no good. Peer-review usually works by having experts in the field carefully read the contents of a report and identify any flaws in the experimental design, statistics and interpretation of results. The author will receive numerous comments on their manuscript to which they have to answer to the satisfaction of the reviewers.  This creates an exchange between the author and reviewers which aims to raise the scientific quality of the report. The author of said report may disagree with the comments of the reviewer and reply with added evidence in the manuscript. Or, they could simply just directly address the reviewer’s concerns by doing an extra experiment, or doing the data analysis a different way. A little caveat to this is, if you send a study about colour therapy to Journal of Alternative and Complementary Medicine, the peers reviewing it may have a vested interest in publishing the report, even if it does not survive the highest scientific standards. Therefore, extra care should be taken when reading about the results and interpretations.

3: Is the study for the [insert treatment/therapy] double blinded?

This is important! Having a controlled, double blind study, where both the researcher and/or subject are unaware of the experimental condition, is the gold standard of good science. If you cannot find research for the treatment, or the ‘expert’ cannot answer it is probably best just to ‘#forgetaboutit’.

An excellent example of the importance of the double blind design was highlighted in a study [1] published in the journal Nature. In this study it was found that white blood cells release histamine (which is very important for the immune system) when exposed to a very diluted solution of specific antibodies (1X10129 dilution factor, which technically it is not a solution because at this factor there would be no actual molecules of compound left ). This release was observed via microscopy and with staining techniques which change the colour of the cells, and allowed researchers to count those which had reacted to the solution. Sir John Maddox, then editor of the journal, published this article on the condition that Dr. Jacques Benveniste, open their lab for a close examination and allowed the study to be replicated [2]. Part of the team, and surprising everyone, was James Randi a professional magician, and master of all tricks, who was invited to detect any subterfuge. The team sent by Maddox accurately pointed out that, when counting the number of blood cells that supposedly reacted to the homeopathic solution, the experimenters were not appropriately blind to which condition they were counting for [2,3]. In the end of the counting, when they saw that the control group did not have an appropriate count, the experimenter thought ‘this is not right’ and would recount. This lead to an obvious experimental bias where the results that fit with the experimenters’ expectations were more likely to be accepted. Having found this, the investigating team asked the experimenters to repeat the study, using a stricter blind procedure:

One person codes the samples, these are given to another who is unaware of the initial coding and re-codes them again, then another experimenter does the counting.

The above procedure was the one mentioned in the study, but typically one person codes the samples or conditions, and gives to another experimenter who does not know code and s/he does the analysis. After repeating the statistics, no significant differences were found between blood cells which has been exposed to homeopathic solutions and those which had not.  This highlights the importance of the double blind procedure. Human brains are easily tricked into bias, and perceiving  patterns where they do not exist, therefore make sure you look for the double blind design.

Deciphering the science based treatments from those which are not can be tricky, particularly with the continuous arrival of new alternative therapies. However, these 3 questions are probably sufficient for you to start developing your own bullshit detector, and focus on those treatments that actually improve your well-being.

Miguel is a PhD student in Cognitive Neuroscience, and currently is working on Brain responses to body abnormalities. lpxmg4@nottingham.ac.uk

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References: 

[1] Davenas, E., Beauvais, F., Amara, J., Oberbaum, M., Robinzon, B., Miadonnai, A., … & Sainte-Laudy, J. (1988). Human basophil degranulation triggered by very dilute antiserum against IgE. Nature, 333(6176), 816-818.

[2] Maddox, J. (1988). Waves caused by extreme dilution. Nature, 335, 760-763.

[3]Maddox, J., Randi, J., & Stewart, W. W. (1988). ” High-dilution” experiments a delusion. Nature, 334, 287-290.

 

 

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10,000 signatures needed, a selfie post card campaign and a one day conference…… Josephine NwaAmaka Bardi responds to the question, why mental health in higher education?

‘The challenge facing individuals with experiences of mental ill-health is to retain, or rebuild, a meaningful and valued life and like everyone else, to grow and develop within and beyond the limits imposed by their cognitive and emotional difficulties’ [1].

My passion to Raise Awareness of Mental Health in Higher Education began from my interaction with students who had experiences of mental ill-health. It broke my heart to watch, listen and hear them cry. They cried and I cried because there was very little that I could do at the time. Following this experience I was motivated to write a blog piece discussing the importance of mental health awareness in higher education.

Soon after, I started the Raising Awareness of Mental Health in Higher Education campaign, after receiving a successful ESRC PGR grant to host an event. Nothing was more important than to host an event on mental health in higher education. An event that will bring a diverse group of people together to dialogue on the issue of mental health in higher education. Therefore, the Raising Awareness of Mental Health in Higher Education (RAMHHE) conference will be on the 10th October 2016 at the University of Nottingham. The conference is open to staff and student at the University of Nottingham, Warwick and Birmingham. It is also open to service providers and speakers from all over the UK.

The objective of the RAMHHE conference is to promote an anti-stigma and inclusive day, where people can express their views and perceptions of mental health and recovery through collective dialogue. In order to meet this objective, RAMHHE aims to provide a social learning space.

‘Recovery is about building a meaningful and satisfying life, as defined by the person themselves, whether or not there are ongoing or recurring symptoms or problems’ [2].

‘Recovery is not about ‘getting rid’ of problems, it is about seeing the individual beyond their mental ill-health experiences, their abilities, possibilities, interests and dreams’ [1].

There will be inspirational and motivational speakers with lived experiences of mental ill-health and recovery, mental health service providers with information on mental health and wellbeing and mental health practitioners to answer any questions that attendees may have. Information from the conference will provide an interdisciplinary insight into how to raise awareness of mental health in higher education.

I have also developed the RAMHHE16 selfie post card, so that people can handwrite or print, snap and tweet to #RAMHHE16.

blogI believe in the power of many, so in addition to the conference and RAMHHE selfie post card campaign, a petition had been submitted and we require 10,000 signatures before the government will respond to the call to debate the issue of mental ill-health in higher education. Please click the link or scan the QR Code to sign the petition. Please remember to check your email and click the link from the house of parliament to sign the petition.blog2.tif

Thank you to all of the people who have shown tremendous support by signing the petition and tweeting their selfie post cards to #RAMHHE16. It is my hope that with the combination of the three campaign strategies and other supporting efforts, we will collectively make enough noise to sensitise the government about the prevalence and incidence of mental ill-health in higher education.

 Josephine NwaAmaka Bardi is a Registered Mental Health Nurse, and an Economic and Social Research Council PhD student on the mental health and wellbeing pathway.  Contact: josephine.bardi@nottingham.ac.uk

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For more information and sources of support:

StudentMinds

UoN Counselling Services

NightLine

UMHAN

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References

[1]  Repper, J. and Carter, T. (2011) ‘A review of the literature on peer support in mental health services’, Journal of Mental Health, 20(4), pp. 392-411.

[2] Shepherd, G., Boardman, J. and Slade, M. (2008) Making recovery a reality. Citeseer.

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Call for content

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Dear reader,

Do you have something to say about mental health, integrated health care or wellbeing? Are there any issues that you feel passionately about and would like to communicate to a wider audience?

Well good news….we are looking for content and would love your input! We would welcome any content broadly related to mental health and health care. This could be anything from personal accounts to discussions about recent research, current affairs or interesting books (and everything else in between!).

The blog really does depend on your kind contributions and support and we would really love to hear from you, so please don’t hesitate to get in touch with any ideas you may have.

Kat Dyke, PhD Student, Psychology (lpxksd@nottingham.ac.uk)

Charlotte Horn, Medical School (msxceh@nottingham.ac.uk)

 

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Josephine NwaAmaka Bardi -Giving higher education students a voice about their mental health

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Recent research I carried out has brought home to me how difficult it is for students to be honest about their mental health. I am a mental health nurse currently doing a PhD in mental health and wellbeing. A couple of months ago, I decided to conduct participatory action research on mental health, to give students a voice and opportunity to participate in a mental health research project. However most of the students that I invited refused to participate.

But who can blame this student? With the stigma, shame and social isolation associated with mental health, it is no wonder that higher education students want to be seen as “normal”.

As a mental health nurse, I am very aware of what the Nursing and Midwifery Council (NMC) Code of Conduct says about my responsibility and accountability to patients. However, there is no code on my responsibilities to vulnerable students who do not have a diagnosis of mental illness, neither is there a code for the ones with a diagnosis who refuse to disclose.

The question is why mental health education is not a significant part of university student inductions, health promotion campaigns and mental health awareness initiatives? It is not enough to put up A4 posters, leaflets and sign with messages like “confidential counselling team”, “feeling stressed about your exams, want to talk it?”  Stigma, shame and social isolation seems to ring through the information leaflets.

Experiences of mental health among higher education students are not limited to the student alone, but friends and family members may also have a diagnosis of mental health. This is huge mental responsibility for any student, in addition to studying to achieve academically.

Higher education authorities must recognise the importance of the student voice in facilitating help-seeking behaviour among higher education students with experiences of mental ill-health. The time has come to prioritise the voice, opinions and experiences of mental health among higher education students, so as to provide a platform for students to express their views on their mental health without the fear of stigma, shame and social isolation.

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Josephine NwaAmaka Bardi is a Registered Mental Health Nurse and an Economic and Social Research Council PhD student on the mental health and wellbeing pathway. Contact: llxjnb@nottingham.ac.uk

 

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For more information and sources of support:

Graduate School advice about mental health

Mind

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