Josephine NwaAmaka -The meaning and understanding of Mental Health in Nottingham…150 questionnaires, three questions, 150 voices, 5 student volunteers, The Lord Mayor of Nottingham and a cold rainy day

blogpicThe ESRC Public Engagement Event successfully took place on Saturday 12th November 2016 at St Peter’s Square in Nottingham. This event follows the successful RAMHHE conference which was held on 10th October 2016 and the ongoing campaign which encourages students to leave one sentence about how we can support students in higher education with mental ill-health experiences.

As a mental health nurse and an economic and social research council (ESRC) PhD student in Mental Health, I am aware that mental health does not affect only higher education students, so it was important to facilitate a space of interaction for student volunteers and the public to dialogue on the issue of mental health.

The main aim of the Public Engagement Event was to engage in dialogue with the non-academic audience in Nottingham and explore their views on three questions:

What do you think mental health is?

Who or where would you go to for your mental health?

How can we better support mental health in Nottingham?

This was an event that nearly did not happen. You see, this was my first grant application and I did not know to ask for funding. Fortunately, I decided not to let the lack of funding stop me, so I self-funded the event and I am glad that I did.

Initially, the event was supposed to be held at the Queen’s Medical Centre (QMC) but my Head of School, Jo Lymn advised that it would be better held in town where we could interact with diverse groups of people rather than only people visiting the QMC. Luckily, my efforts to obtain permission paid off and we were allowed to host the event at St Peter’s Square.

Prior to the event, I met the Lord Mayor of Nottingham Councillor Saghir at the Royal College of Nursing Tea Party. We talked about the successful RAMHHE campaign and the Public Engagement event, and he promised to attend. A week later, the Civic Office wrote to confirm this.

On the morning of the event, I remember arriving at St Peter’s Square on that freezing cold and rainy day. I was anxious because I was not sure if the other volunteers and the Lord Mayor would attend because of the rain. That feeling soon changed as the volunteers arrived and we quickly set up a tiny sheltered space in front of a vacant store. We put up the ESRC banner, clipped the questionnaires to the clipboards, grabbed our umbrellas and smiled our way through the cold and rain. At 11.00am, the Lord Mayor arrived and he joined in the voluntary effort by speaking and taking photographs with people, answering their questions and interacting with us. The Lord Mayor’s selflessness inspired myself and the volunteers, for which I remain grateful.

We approached more than 500 passers-by and although some of them did not participate, they were polite as they walked by with either a wave of their hand to signal a no, a sorry I am not interested or I am in a hurry. However, we were able to obtain 150 completed questionnaires/surveys from 150 people who gave their verbal consent to taking photographs with us and answered the following three questions above.

It was a privilege to listen to people as they expressed their views about the questions and shared their family member’s experiences of mental ill-health. Several common themes emerged out of our 150 survey answers from the three questions above, of which the three most common themes included:

1:More funding to employ more mental health providers.

2: Early intervention to mental health.

3:More anti-stigma awareness campaigns.

As we packed up to leave, I could not help but wonder how useful this Public Engagement Event was, how my resilience to host the event despite the funding challenges paid off and how much I have learnt about public mental health from a few hours ’interaction and three questions.

The questions now is, how can we sustain such important mental health awareness events, so as to engage with the public and hear their views, perceptions and experiences?

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. She is also the founder of Raising Awareness of Mental Health in Higher Education. Contact: llxjnb@nottingham.ac.uk

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For more information and sources of support:

Mind

Student minds

Graduate school advice about mental health

RAMHHE

 

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Directors commentary: 10 years of the IMH

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House for a Gordian Knot, Ekkehard Altenburger

As the bunting is taken down, and the remaining sausage rolls are cleared away following our 10th Anniversary celebrations, it is an ideal time to take a moment to reflect on the achievements of the past 10 years, and look to the exciting future ahead of us.

We aim to be the leading centre in the UK for applied mental health research and education. Being a true partnership between the University of Nottingham and Nottinghamshire Healthcare NHS Trust enables us to research and innovate in the best way possible to support service users and carers, as well as promoting innovation, evaluation and clinical excellence across NHS services.

Narrowing down the highlights from the last 10 years is a challenge but worth a mention is the launch of our first Centre of Excellence in 2011 – the start of a journey that reaches a new milestone in November 2016 with the launch of the latest of our seven Centres of Excellence. Another highlight was the opening of our new IMH building on Innovation Park in 2012, part of the Jubilee Campus at the University of Nottingham.

Our Centres of Excellence provide focus and strategic leadership around each Centres key themes. The network of researchers and clinical staff provides a conduit for common interest, greater depth of information sharing, knowledge pools and support under the umbrella of a coordinated frameworks. Masterclasses, education, exchanges and training form part of the core objectives of Centres to further support the IMH vision of excellence in research and education.

Looking forward to the 20th Anniversary my belief is that we will have been on an extraordinary journey during which we have delivered really useful research projects and training that have had a direct benefit for those living with mental health issues; Improving the identification and speedy implementation of treatment and support methods that help service users, and promoting good mental health and sustainable recovery in people across the world.

The Institute in numbers:

– 7 Centres of Excellence
– 9 Managed Innovation Networks (MINs)
– 33 full and associate professors
– Over 100 PhD students
– Over 350 external members
– Over 400 peer reviewed journal papers per year
– Nearly £11 million of new grants launching in 2016/17
– Over £28 million in active research grants

Our Seven Centres of Excellence:

  • CANDAL: Advancing the translation of research into practice for ADHD and neurodevelopmental disorders across the lifespan
  •  Health and Justice : Improving the understanding of and provision for mentally disordered offenders
  •  Social Futures : Transforming how service users, carers and professionals work together in a new community of understanding
  •  Translational Neuroimaging : Building on recent advances in neuroscience, diagnosis and treatment
  •  Dementia : Tackling one of the biggest health challenges facing the population
  •  Education : Providing accredited and non-accredited training in the form of one-off modules and courses, undergraduate and postgraduate programmes in healthcare practice
  •  Mood Disorders : Launching soon

This blog post was written by Martin Orrell, who is the Director of the Institute of Mental Health at the University of Nottingham.

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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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