Epic

Lee McCabe (left) shooting the breeze yesterday with the S Wales Constabulary

Inspirational film blog by Lee McCabe from yesterday's Lights! Camera! ACTION! event in Merthyr.

Lee is himself an inspiration: his story, which is eloquently set out in Twelve Lives, shows how people can progress from the shocking place which is the first onset of serious illness to personal success and then go on to make a big difference to the lives of those who face the same starting point. Lee does this in two ways - directly as a Recovery Practitioner with Hafal and indirectly by engaging with our successful campaigns including the epic struggle which brought about the Mental Health Measure.

Cool shades too, Lee.

And back in 2010... Lee and Jonathan Morgan AM marking the Royal Assent to the Legislative Competence Order which paved the way to the historic new Welsh law

GAD Fly

Prof David Kupfer, Pittsburgh University

Really interesting discussion this morning between Radio 4's John Humphrys and Professor David Kupfer, the author of DSM5 - the "psychiatrists' bible" here (2hrs 36mins in). The prof was defending DSM5 from the widespread criticism that it invites psychiatry to interfere with normal feelings and behaviour like grief, sadness and childhood naughtiness.

He half convinces me that you can't blame his book if it's misused by practitioners but the fact remains that this text can be used to dress up normal conditions with fancy diagnoses.

And it is not just a matter of interfering with normal conditions - it's also about lazily over-simplifying real conditions.

Many people have quite severe symptoms of mental illness for which there is no easy diagnosis, still less a meaningful label. In these cases it is necessary for clinicians to take time to analyse the set of symptoms and carefully explain them back to the patient and work through options to treat them whether with psychological or medical treatments or life changes which can alleviate the problems. This takes time.

An alternative approach is to get rid of the patient quickly by deploying a simplistic and vaguely scientific-sounding diagnosis like "Generalised Anxiety Disorder" and giving them a prescription for "happy pills".

If you are told by a doctor that you have G.A.D. how sure can you be that he/she doesn't really mean "I don't know what is wrong with you and I haven't time to find out. In fact I have a private consultation in two minutes time where I will get £300 for ten minutes work so that an overworked high flier can blag some Ritalin in order to shut their boisterous toddler up (diagnosis "Conduct Disorder"). Here are some pills and now please get out of my office"?

Yet Another Ceredigion Libel

June at last and weather to match!

A good year for buttercups as you can see from my snap taken Sunday afternoon. Everybody knows the buttercup test - you hold the flower under the chin and if it reflects yellow then the person likes butter. It always reflects yellow because everybody likes butter, don't they?

But do you know the origin of the buttercup? Some fairies (members of the Tylwyth Teg) stopped a man from Tregaron carrying a sack of gold coins and asked for alms. The man refused so as he passed the fairies surreptitiously cut a little hole in his sack and the coins sprinkled out as he walked and that is how buttercups came to be.

And the bluebells have stayed out late (picture from the same walk below). Unlucky to take them into your house, they say, but it isn't true that it's illegal to pick them in spite of what some busybodies tell you.

Are We Mugs?

I hope the Welsh Government isn't feeling smug about their survey which shows what the Welsh think about statutory services (follow this link).

There is an interesting comparison with Scotland where people seem to be more contented generally (so much for the stereotype of "dour Scots") and yet more sceptical about the effectiveness of public services. Concrete measurements of that effectiveness absolutely do not suggest that Welsh services are superior.

So are Welsh people mugs who know they are a bit miserable but can't identify the Government's share of the blame for that? To some extent we may be mugs I'm afraid. Take the case of education which indicates quite high levels of satisfaction among parents about their children's schools. However, objectively Wales is in a severe educational crisis with a high risk of the gap in exam results for pupils compared to England opening up still further. Little comfort that parents and children get along okay with the schools if the LEAs and teachers are complacently letting standards slip.

But there is more to it than that. Welsh people have generally given the devolution settlement a lot of support and the Welsh Government is still enjoying a ten year honeymoon with the public giving them the benefit of the doubt. This contrasts with the Scots who took devolution for granted right from the off and have given successive Scottish Governments a hard time, expecting better results.

It is time for us to take devolution for granted too and look for much better performance from the Welsh Government (and indeed from politicians of all parties) not least in health and social care and mental health services in particular - because they aren't very good!

Oh, and anyway we shouldn't take too much notice of surveys which purport to measure our "well-being". The general public's happiness has little to do with what governments do and even less to do with what mental health services do, apart of course from the well-being and happiness of people who actually rely on those services.

Our message to the Welsh Government should be: we will get on with our lives and find our path to happiness thank you very much; you should get on with your job, which is not to conduct surveys but to work hard to make public services better quality and more cost-effective, measured by objective facts not opinion.

Stamping Ground

Stewart Harding, Information & Communications Officer, Diverse Cymru; John Davies, Hafal RCT Practice Leader; Jennifer Thomas, Wales Mental Health Network; Suzanne Duval, Director of Operations Diverse Cymru at today's Lights! event in Aberaman

As I write the legendary VW Microbus is parked up, along with the more ephemeral but equally impressive Mobile Studio, bang in the middle of the Valleys this afternoon - in my own old stamping ground of Aberaman to be precise.

We are there as part of our summer-long Lights! Camera! ACTION! campaign providing an opportunity for users and carers from Rhondda Cynon Taf to tell us through film blogs (and more informally) about their experience of the Mental Health Measure and Wales' new mental health strategy "Together For Mental Health".

See a film of the event including an excellent explanation by RCT service user Gerwyn Jones of the therapeutic value for participants of engaging with Time to Change Wales (nice cross-over of campaigns there! It's a great bonus of our anti-stigma work that it also assists participating clients with their recovery).

A good point about the accessibility of services is made by another RCT service user Ioan Bevan here. For some clients a more passive appointments-based engagement by CMHTs may be appropriate but other clients, including many who require higher levels of support, need a more assertive approach including home visits (and I don't just mean crisis teams).

I think the lesson from Ioan's observation is that the specific method of engagement, not just the level of engagement, needs to be set out in Care and Treatment Plans - and this will vary between clients.

To see all the films and news of the campaign follow this link.

Noble Savage

In London over the long weekend I saw the Tempest at the Globe Theatre with Roger Allam as Prospero.

I wasn't impressed because I couldn't hear a lot of what the actors were saying in spite of having an averagely good seat - it must be because they are used to telly acting (that or I'm going deaf). Knowing the play I could follow the action well enough but I found my mind wandering a bit onto some of the themes and puzzles which the play throws up...

Is this play a swan song (nice Shakespearean pun there) for Shakespeare, giving up his own "sorcery" (creating drama) as Prospero does when he has achieved his ends? Still not sure about this one. It was probably his last play (1610/11) but that doesn't mean you can draw a whole lot of personal detail about his retirement out of the text. WS's previous form would suggest that he was unlikely to have done something so solipsistic as write a play based on a stage in his own life (another Shakespearean pun).

And the other puzzle is whether Shakespeare had read Montaigne's Essays and based the monstrous Caliban (left in the picture above) satirically on the French writer's stuff about the "noble savage"? There is a growing consensus among scholars that he must have read Montaigne and indeed the programme blurb for this production assumes that he had.

But I doubt it. The noble savage thing was a matter for general discussion among Renaissance types across Europe and (here's the clincher) Shakespeare seems to have been a highly economical or even lazy reader. Having had the classics beaten (literally no doubt) into him at his grammar school in Stratford it appears that he confined his reading to whatever he needed to develop plots for his plays. I can't picture him wasting valuable money-earning time wading through Montaigne's musings, excellent though they undoubtedly are.

More originally it struck me that Caliban and his mum Sycorax might represent the universal folkloristic motif of the mysterious original inhabitants subordinated to more recent arrivals. Since Shakespeare was aware of the original inhabitants of Britain (and indeed his grandmother may have been one of them - see this post) is it too much of a stretch to see Caliban as Welsh? Probably, but it's as strong a case as the Montaigne connection....


Postscript:

Also found time to read my Mum's copy of Artemis Cooper's biography of Patrick Leigh Fermor - An Adventure.

This classicist, writer, soldier, and serial womaniser comes across as a selfish social climber. But he is easily forgiven for all that having kidnapped a German general in occupied Crete and then capped his captive's quotation from Horace as they rested on top of a frosty mountain on the way to catch a submarine. Never mind two world wars and one world cup: the real competition with the Germans is about who is top dog in classics.

For the record the exhausted General Kreipe muttered "Vides ut alta stet nive candidum Soracte" ("You see how (Mount) Soracte stands glistening with deep snow"). Major Leigh Fermor recited the rest of this beautiful and evocative poem in response (original Latin plus quite a decent translation here).

General Kreipe and Patrick Leigh Fermor on the run in Crete

Making Tea

I'm catching up as usual!

See Barry Dix at last week's Lights! Camera! ACTION! event in the Vale of Glamorgan here. Barry draws our attention to the indirect consequences of the "bedroom tax" (which aims to encourage those on benefits to downsize if they have a spare room) for people stuck at the other end of the housing scale - that is those living in a bedsit. Whatever the rights and wrongs of the change to benefits rules it isn't right that adults with a mental illness should remain long-term living in a single room, especially if it impacts directly on their illness as Barry points out.



Meanwhile I was up in London doing some training with the Directory of Social Change. And what did I learn? Quite a lot I think because there were some good trainers prepared to challenge turgid orthodoxy. Here's some salient and practical stuff I took away...

• Hafal needs to sort out how it can facilitate its supporters to remember us in their wills. Watch this space!

• We need to do even more to relate formal management systems like supervision and appraisal to the daily, human task of supporting staff effectively to do their job. I'm confident that Hafal is pretty good at this but you have to work hard in the teeth of some plonkers in the world of H.R. (I don't mean within Hafal) who would have us develop excessive paperwork and bureaucracy unrelated to the practicalities of the job in hand which irritate managers and staff alike.

• As I suspected it is a spectacular waste of time to try to distinguish separate meanings for words like goals, targets, performance indicators, outcomes, etc. These semantic distinctions only serve to create a mystique around corporate planning so that people who have been on one of those fatuous "management-by-Gantt-chart" courses can annoy all their colleagues. Better to use one word for all these (let's say "goal") and simply understand that there are short-term goals (like getting a cup of tea this morning so I can face my in-tray) all the way up to long-term strategic ones like achieving Hafal's mission to improve decisively the lives of people with a mental illness. It isn't difficult to see how these two goals (and lots of intermediate ones) connect up, is it? On the contrary it gives a new sense of purpose to making tea which is rather pleasing. And that is the point - to show everybody involved in the mission how lots of short-term goals can lead to achieving great big ones.

• Blogs and other social media apparently need to indulge their readers' low attention spans, intolerance of long words and complex sentence structure, etc. Bad luck - I won't be taking any notice of that one.



The Directory is based in Euston and I took the opportunity to walk all the way south back to Waterloo, capturing the four vistas of central London shown here - if you know the place well you will note that I meandered a little.