Care in the Community

12th March, 2019

I made a journey on the underground a couple of days ago and my heart sank when a man with mental health issues boarded the crowded train. He did not even look for a seat; he was here to orate and this he did for the next 15 minutes, continuously, without taking a breath. He immediately got everyone’s attention with a rant about the evils of white supremacy.  The almost imperceptible stiffening, sitting up, pulling back of feet and legs and an even greater blanking of expression communicated the increased tension in the carriage. He went on to cover most of today’s major political and social issues of our times: Race, politics, the church, wealth, crime and other things and mixed into his crazy stream of consciousness were other more metaphysical themes of love, hate, evil and good. His delivery was so powerful, so loud and so passionate he had his captive audience in an absolute thrall. Most people sat or stood eyes cast down, some apparently engrossed in books, listening to their headphones or their own thoughts. None, I notice, attempted conversation with companions and certainly no one responded to the lecturer.  It seemed to go on forever and though he repeated himself and jumped from one topic to another there was a thread of something that made sense as he made his final statement: “I love you people” and there was a collective breathing out and lots of smiles as we continued on our journey.

The incident made me reminisce about my sixteen-year old self who worked as a cadet psychiatric nurse (now referred to It does http://deeprootsmag.org/2015/03/03/enduring-values/ buy generic cialis not show any warning symptoms, that is why it is known as silent killer. It is indicated pharmacy viagra in conditions like spermatorrhea, premature ejaculation, neuralgia, incontinence, chronic diarrhea etc. There may be chance that the accident that occurs is not generic cialis browse for source now your fault. This problem can be solved out with the help of a speon line viagra click here nowt. as mental health nurse) in one of the huge asylums (now usually referred to as mental health institutions). It was called Knowle and like most institutions of its kind its austere Victorian buildings were located in deep countryside, hard to travel to and tucked well away from public consciousness. I am not aware of any particular scandals attached to this institution but many others like it were found guilty of impersonal, inadequate and even abusive treatment of their patients.   It was a strange choice of first job but looking back, I realise I had always been fascinated by the occasional crazy (mentally ill) person ranting in the street whilst at the same time being deeply scared. Over fifty years later I still feel like this and I know I am not alone.  These days with the de-institutionalisation of mentally ill people arising from the National Health Service and Community Care Act 1990 it is commonplace to encounter individuals on the streets who behave in unusual and/or disturbing ways.  A lot of people feel scared that with the more immediate and greater presence of the mentally ill they may become the victims of violence but ironically it is those with mental health issues who are much more at risk as according to some research they are three times as likely to be victims of crime than the general public. It is also a sad fact that a large proportion of the homeless are people with mental health issues who have no assigned caseworker or active involvement with public services, i.e. Health and Social Services, thus, the problems which so often give rise to ill health, violence and criminality remaining unaddressed. 

Returning to the man on the train, I can only guess about his situation and about the events that have happened to him but it does strike me as a kind of miracle that he was able to make everyone on a crowded rush hour train smile with his “I love you people”.


Lessons in Terror

Contribution to Talk Radio

Presenters – Jamie East & Co-Host Anna Williamson

23rd March, 2018

I am often asked to provide a professional psychologist perspective to news and current affairs programmes on TV and radio. My first response is obviously to ask about the subject under discussion, the prompt and the programme’s particular angle.

For a view of the full article see: https://www.thesun.co.uk/news/5866034/children-as-young-as-four-to-be-given-lessons-on-what-to-do-during-a-terror-attack/

Fighting the urge to refuse on principle and contribute to the ‘any publicity is good publicity’ dynamic for this publication, I agreed and went through my usual process of bringing myself up to date and researching at speed the topic to be covered so that I could say something relevant and psychologically informed.

Four main points leapt out:

1. We need to view this topic with perspective. All schools have a duty of care for their pupils and staff and the actions to be taken in the case of a terror attack are, in many ways similar to that of other threats to life, health and wellbeing such as a fire

2. Teachers have the hard-earnt, day-to-day knowledge, skills and experience of their children that places them in a good position to explain in age- What are the safety sign? Teenagers, children & female should completely say no to this anti-impotence pill. purchase generic levitra If you foam roll as well as feel no pain, and with the time you will, you will have to take proper guidance from the physician pertaining to it. sale of viagra Nutrition level in the strawberries helps removing viagra for sale india bad breath away, helps maintaining weight and promotes reproductive system to avail good erection health to male individual. 7. The existence for erectile dysfunction is when a man is incapable of obtaining and viagra without prescription online preserving an erection, for successful penetration .Some Guidelines to Use Kamagra 100 mg Jelly contain sildenafil citrate, an active ingredient in the medicine of Forzest and that is Tadalafil. appropriate language what is happening in the event of an actual attack or, much more likely, during a rehearsal of their measures for following their school’s safety plan

3. Teachers are similarly well-placed to listen to and notice children’s anxieties if they arise in relation to the terrifying topic of terrorist acts and to share and address these with the children’s families

4. Intrinsic to best practice for teachers pre and primary school-aged children is to have good communication with parents and carers. Actually, I’d go further and say this applies to teachers of children and young people all the way through formal education.

This is an important and topical subject and comes on the back of actions taken last year (2017) by The National Police Chief’s Council in collaboration with the National Counter Terrorism Security Office and supported by the Department for Education (DfE). Key Stage 3 and 4 Lesson plans, films and even an emoji representing the slogan ‘Run, Hide, Tell’ are all available on line. The sensationalist article that gave rise to this radio item chose to focus on the idea of four-year-olds being taught about what to do in the event of a terror attack but is partial and emotive. However, there is no getting away from the fact that acts of terrorism are a part of modern day life. On the day of this broadcast the teatime news programmes on television were broadcasting details of an attack on a French supermarket.  Parents will quite rightly want to shield their children from this grim reality as much as they can and also get things into proportion, i.e. make it clear that such events are extremely rare.  However, on reflection, if popular newspapers draw attention to what schools are doing to keep children as safe as possible it has to be a good thing for everybody’s peace of mind and general wellbeing.





Adolescent Mental Health

 

 [contact-form][contact-field label=’Name’ type=’name’ required=’1’/][contact-field label=’Email’ type=’email’ required=’1’/][contact-field label=’Website’ type=’url’/][contact-field label=’Comment’ type=’textarea’ required=’1’/][/contact-form] Adolescent Mental Health

March 2018

I’ve been to CPD events run by ACAMH before so I expected that it would be well organised and offer a full day of quality speakers talking about their work and cutting edge research and I wasn’t disappointed. Educational Psychologists often have to deal with mental health issues as a factor in children’s and young persons’ learning, development and progress in education generally so I thought it would be a good use of my time and CPD budget but I didn’t expect to meet many fellow Ed Psychs.  From the few people I spoke to in the well provisioned coffee, lunch and tea breaks at the impressive Royal College of Physicians at Regent’s Park, I was right. I met several psychiatrists, a couple of GPs, mental health nurses, social workers and academics but no psychologists of any persuasion, i.e. clinical, educational or otherwise.

The day included five talks and a plenary. I listened with interest to the talks on cannabis use and psychosis, gender dysmorphia, whole school development work to support pupils’ mental health and wellbeing, evaluative research on treatment for depression in young people and the effects of peer relationship on young people’s mental health. The talk that interested me most was that of Professor Sir Robin Murray from Kings College and the Maudsley in London talking about the interface between adolescent and young adults’ cannabis use and psychosis. His headline point is:“Irrespective of whether use of cannabis is decriminalised or legalised, the evidence that it is a component cause of psychosis is now sufficient for public health messages outlining the risk, especially of regular use of high-potency cannabis and synthetic cannabinoids.”

Things that interested me were:

– Although trends in cannabis use are hard to measure in exact terms it appears that usage by the 15 to 34 year-old population is relatively moderate in Scandinavia, In France and Spain is increasing and in the UK is decreasing
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– Until relatively recently funding for research into the relationship between cannabis use and its variants, such as Skunk and psychosis has been sparse

– Many studies, by necessity, use non-naturalistic settings, for example, Prof. Murray described an experiment in which participants smoked cannabis and then boarded a ‘virtual’ train carriage in which a variety of other passenger avatars stared at them and the degrees of ensuing paranoia were then noted

– The risk of long-term and heavy use of cannabis is associated with an increased risk of psychosis and is exacerbated by age of starting usage, i.e the stage of brain development, by socio-cultural factors and by predisposing vulnerability, E.g. neuroatypicism and/or family history of psychosis and the presence, type and proportion of synthetic cannabinoids

As a pragmatic practitioner psychologist I always hope the ‘so what’ question might be addressed. I wanted to know about any implications this research held for ways of helping young people? Why is the incidence of cannabis usage and psychosis so gendered? Why has government not prioritised this area for more research ? What are the individual stories of the young people involved? What protective factors can be identified amongst the 90+% of long-term and regular young people who do not develop psychosis?

All professionals involved in supporting young people’s mental health and wellbeing recognise and value the research that is underway and expect a day like this one to precedent this but how refreshing it would be to vary the didactic nature of the day to one that also includes the voice, experience and perspective of practitioners. Some would argue that the token question and answer space at the end of each lecture and the final plenary session allows for this. I don’t agree. These Q & A sessions are all too often a platform for the most vocal and confident, ‘tweeting’ is impersonal and limited and as for the plenary session, well I have to say that by the end of a day of listening to the academics it is no coincidence that most people have had sufficient and attendance is usually sparse. My ideal CPD day would always feature a blend of interactive small group discussion and co-presentations by academics and practitioners with expertise in common areas.

 


Free School Meals

FREE SCHOOL MEALS

Steve Jardine Show – BBC Radio Scotland 

March 2018

I was asked to comment on an initiative currently being piloted in North Lanarkshire as part of the 365 Programme of providing a cooked meal not only during the school day but at weekends and holidays as well via breakfast groups and lunch clubs. Scottish Parliament voted in support of this, recognising that children are enduring weekend and holiday hunger and that the pressure on food banks increases especially in holidays. This is in line with the National School Lunches programme and is supported by a finding by a recent NUT England research that 80% of children have poor eating/nutrition in school holidays.

On a commonsense level eating a healthy, balanced and consistent diet is key to physical health and wellbeing but perhaps less obvious is the essential role this plays in supporting the brain’s health and optimal function.  Children and young people must be provided with the right balance and quantity of nutrition in order to support the brain’s role in mood regulation, behaviour, attention, reason, decision making and planning, memory and recall and without it problems can arise affecting behaviour, learning and general wellbeing.  The links with poor eating and nutrition and increased rates of depression and anxiety and other mental health, emotional and social difficulties are being made increasingly too.

As a psychologist I’m aware that food and eating are significant and loaded subjects.  One of my favourite theorists, Maslow,  places food at the foundation level of his ‘hierarchy of needs’ and along with other core needs like shelter and protection recognises that this supports and makes possible the actualisation of higher order needs such as cognition, learning and social and emotional development and function.  Again, it is obvious that children and schools are going to work better if you get this basic building block sorted.  Then there is the emotionally loaded nature of food and eating, which any psychodynamically-oriented psychologist/therapist so often translates food as love/self-worth/self-esteem etc.
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Schools are well placed to support children’s healthy eating but how far should they go?  When I was at school many decades ago the system for providing free school lunches was a crude one in that many children suffered social stigmatisation. I remember dreading Monday mornings when children, including me, whose parents’ incomes qualified them for free lunches would have to line up outside the school office in order to collect their vouchers and handing these over to the dinner ladies before being served was a source of shame and feeling somehow inferior.  Over the years schools have developed more sensitive systems for ensuring children in need receive a midday meal without identifying them so obviously to their peers but it is still an issue of which staff must be aware if children with less than ideal family means are not to have their existing challenges exacerbated.

Cross-cultural studies often provide ideas and different perspectives in addressing social issues and in the programme to which I was contributing two journalists talked about how school children in their countries fared.  In France a relatively small proportion of children receive free school meals and parents pay a modest amount of about 3 .3 Euros for a three/four course meal and every school-aged child in France should be provided with a daily piece of fresh fruit.  The journalist added that there is no such thing as ‘kiddy’ food as children and adults eat the same high quality, well cooked and presented food.  In addition, schools are required to allow at least 45 minutes for children to consume their meal.   In Sweden their 1997 Education Act had resulted in legislation, policy and provision ensuring that all  7 to 16 year olds, irrespective of family income, received free meals so the dangers of social stigma were eliminated.  In addition they engaged in something loftily titled ‘the pedagogic lunch’, which in plain language means that teachers and pupils eat together as a matter of course and in this way children learn from their adult teachers and school staff models how to eat well.

Interestingly, in this short radio piece the topic of celebrity campaigners such as Jamie Oliver didn’t come up.  It’s not that I don’t think he and others don’t do great work in raising people’s awareness of the importance of healthy eating and good nutrition but I do think that the celebrity and media banner can, if you’ll forgive the pun, be hard to swallow for regular, non-celebrity people.  Most parents are aware, in my experience, of the importance of regular, consistent, healthy and balanced meals for their children so will welcome the support schools, Local Authorities and Government offer.

 

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