Last But Not Least

The "Taking the Wheel" campaign rolled into Swansea yesterday for the last of 22 county visits - and what weather! Quite a challenge for the 1964 microbus which of course has no radiator but improbably relies on air blowing through side-vents to cool her diminutive and under-powered engine.

Service user Sarah Stanyon, 23, who has depression and Post Traumatic Stress Disorder, tells us: "Before going into hospital I felt trapped in a downward spiral. I couldn’t see any light at the end of the tunnel, I couldn’t cope with many day-to-day activities, and I really felt like the mental health services available from the NHS were not helpful.

"Since being admitted to hospital things have changed. Hafal found a social worker to talk to my parents about my treatment and after hearing their views of how poorly I had been treated the social worker got to work. I now have a Community Psychiatric Nurse, I will have a home of my own soon and I will be returning to education shortly. I feel my mental health is being taken seriously and this, along with the developments that are taking place in my life, has made me feel empowered.

"Without the support of Hafal over the last year I would not be where I am today. The services they have provided have increased my confidence and opened my eyes to new experiences and ways of thinking. I’ve also made some friends along the way, too."

Thanks, Sarah, for an uplifting story to mark the end of this summer's remarkable campaign alongside our partners and friends in MDF the Bipolar Organisation and the Mental Health Foundation. Not that this is really the end - the microbus can be rested up but we will be carrying messages from the campaign to the Senedd on 11 October where we are celebrating World Mental Health Day with the Minister of Health Lesley Griffiths AM. I'll do a link to our joint report when it is published next week.

The Optimism of Recovery

Congratulations to Nerys Price from Hafal RCT who was awarded first prize in the Wellbeing and Recovery art competition at the Mental Health Research Network Cymru Annual Conference held at the Millennium Centre in Cardiff. The judge said Nerys’ picture best portrayed the "optimism of recovery".

From Dusk to Dawn

In 1990 when I was working in youth crime prevention I accompanied a crowd of teenagers from Mountain Ash to see the recently released Ghost, the slushy but popular film starring Demi Moore and Patrick Swayze. The setting is modern New York and the characters are everyday and naturalistic but when the villains in the story die they are seized by howling demons and dragged screaming into hell, watched over by Swayze's saintly ghost - he was murdered at the start of the action. The contrast of modernity and literalist mediaeval damnation is startling.

Last night I see Welsh National Opera's new blockbuster Don Giovanni at the Millennium Centre. It is a very well done if not quite historic production and I enjoy the witty portrayal of human folly which affects all the characters as the Don (David Kempster) seduces, murders and deceives through two and a half hours until finally this colourful antihero is seized by howling demons and dragged down into hell under the supervision of the saintly ghost of the "Commandatore" whom DG knifed in Act One.

Since its first performance in 1787 people have wondered why Mozart and librettist Lorenzo Del Ponte introduced this massive shift from an "everyday" human story to one of eternal damnation. Wasn't Mozart a man of the Enlightenment, they say, indeed a Freemason; surely he didn't believe all that stuff? Of course not - it just makes a great story with an amazing twist. And unlike the predictable Ghost with its simplistic, black-and-white characterisation (indeed there are casually racist undertones distinguishing the two-dimensional goodies and baddies) the opera has unexpected qualities including Don Giovanni's response to the ghost who offers him the chance to repent at the very gates of hell - no, he says, get lost you old fool. You have to admire his guts! See this version with Bryn Terfel on YouTube which illustrates how unexpected the scene is in a Mozart opera. It looks more like Wagner except of course the music and words aren't rubbish.

The funniest bit about the opera is the anticlimactic final scene (often left out in the past by humourless producers) after the Don has been dragged away and the other characters look at each other and say "What was all that about?" - after a little thought the earthy Masetto opines that it's time for his dinner...

Driving home I realise that this is all more like Quentin Tarantino's From Dusk to Dawn (1996) where a modern and grounded tale of crime and murder with no hint of the supernatural ends in a nightclub full of vampiric demons. But that film is even more amoral than the opera because the lead villain (George Clooney) survives rich and free whereas the decent pastor (Harvey Keitel) whom he had kidnapped is hideously butchered. Very similar humour though.

Incidentally the teenagers (who I naively thought might have found the film disturbing) thought the the supernatural stuff in Ghost a huge hoot just as I'm sure Mozart's audience did in 18C Prague when the opera premiered.

Lush

The "Taking the Wheel" microbus and simulator rolled into Aberavon today on their penultimate county visit - last one in Swansea next week.

Service users and carers from Neath Port Talbot discuss the campaign’s theme of empowerment during the event and one service user tells us that living with bipolar disorder put a huge strain on her family life and personal relationships but her situation has improved hugely in recent years.

She says: "Having attended Hafal for the last seven years, I now feel completely in control of my own life.

"I have sorted out my finances, enrolled in college to do a counselling course, and have built up a good social life. Having previously suffered from agoraphobia my mental and physical health have never been better."

More good evidence that recovery is about life choices not just medicine!

See more about the campaign here.


Postscript:

This morning I shower in the gym and try out a new soap from Lush with citrus notes called "Sexy Peel" (i.e. "sex appeal", geddit?). I beg you to believe that this was not a symptom of mid life crisis but rather just another joyful experiment in male grooming. Anyway, in case anybody thinks this product might indeed make you more "ap-peel-ing" I can testify that it simply makes you smell of marmalade.

Unconflicted

The "Taking the Wheel" microbus reached Abergavenny today where Jane, a service user and carer in her mid fifties who looks after her daughter (who has schizophrenia) and her housebound husband, says:

"Hafal has helped me take the wheel by encouraging and supporting me to do many things for myself which I wouldn’t have believed possible previously.

"For example where once I would have flown off the handle if I had a letter demanding rent from the council’s housing department I’ve learnt to approach tasks like this in a much calmer fashion. I file my letters away and do things like finances step-by-step.

"I used to rely on people and lean on services too much, now I will take the initiative myself and address these problems on my own."

Nice one, Jane, and good luck to all our friends in Monmouthshire working for recovery.





Postscript:

I have drawn South Africa in the office Rugby World Cup sweepstake so I have a half decent chance of repeating my success in the Grand National (see here) although Matt in Publications has drawn New Zealand so the drinks will probably be on him. Deputy Chief Exec Alun Thomas has Wales so he can feel patriotic and unconflicted but he's not making plans to spend his winnings just yet. But at least he didn't get Russia like poor Gavin Williams - I didn't even know they played the game...

Sick as a Parrot

This weekend has been a game of two halves. On Saturday we go to Aberaeron and the elegant 18C bijou gentleman's residence of Llanerchaeron, an early work of London Welshman John Nash who went on to become the pre-eminent architect of the Regency not least as the creator of the Brighton Pavilion. Lovely kitchen gardens where we scrump some juicy plums for lunch and somehow I am attracted to the utilitarian brown linoleum below stairs.

Why do I - and many other people of my acquaintance - not like the National Trust? Could it be the plastic cow in Llanerchaeron's old dairy or is it their hypocrisy in opposing relaxation of planning regulations while themselves developing fancy housing for profit on ancient estates like Erddig near Wrexham in the teeth of local opposition?

On Sunday it's all sport, mine and other peoples'. Running early morning in the gym I see highlights of Swansea City's match the day before on Match of the Day. Their goalie Michel Vorm looks sick as a parrot after letting Arsène Wenger's embattled Gunners off the hook by bungling a clearance which every Swans fan from Sketty to St Thomas is confident they would not have bungled.

A little later I am in the biggest pub in Wind Street watching the Rugby World Cup over a cup of tea (it's still only 9.30 am). Hafal Senior Employment Officer Andrew Mulholland's £20 bet at 80/1 on Wales to win the tournament starts to look well-judged as we outplay and are ahead of the current champions South Africa...until the closing minutes when the Boks go one point ahead and then Wales bungles both a penalty and drop-goal opportunity. Robbed!



Postscript:

My own rugby career peaked early and went rapidly downhill. I played for my school first fifteen aged 12, for my house at my next school aged 17, and for my college's third fifteen aged 19 - and never since for shame. As a callow youth I showed some promise because I was both fast for my size and also unusually aggressive. I mainly played wing-forward (I'd never heard the word "flanker"), a great position in the low-grade game as the scrum-half frequently fumbles the ball and so you can descend sadistically upon him - and of course he's generally much smaller than you. Happy days.

A Second Chance at Life

The microbus brought the "Taking the Wheel" campaign to Bridgend today where Doreen Shields tells us that managing her recovery through writing her own care plan has been an empowering experience:

"If you haven’t worked for a long time and you have a mental illness it’s hard to know what the first step to take is. It can seem like you’re written off. I was desperate to get back to work so I could get my life back into a routine.

"When it comes to writing a care plan it’s OK writing things down but in your mind you think: ‘I can’t possibly do that!’ but before you know it you have a review of your goals and you can see the progress you’ve made.

"My initial steps were: enroll in an IT course, do the IT course and pass it. I did that and now I’ve moved on to my second course in IT.

"The next step was to do volunteering work and since making that goal I’ve started doing some mentoring work at the local hospital.

"I’ve never felt judged during my training and now, six months since beginning the programme, I feel really motivated. My short-term goal is to do more courses to improve my CV, in the long-term I’d like to do some work in health and social care.

"When I came here I used to walk in with my head down, now my kids say to me: ‘What have you been doing?’ They notice the change. It sounds like a cliché but I feel like I’ve had a second chance at life."

Not a cliché, Doreen, but an inspirational story of courage and determination!

Read more about the campaign here.

Monmouthshire next on September 14th...

Chancers

Having been rude about the word "collaborative" last week (see here) this week I attend a rather useful group meeting at the Swalec Stadium known as the Adult Mental Health Leaders Collaborative which brings together, as the name suggests, senior people in the NHS and local government plus key officials in the Welsh Government and some voluntary sector chancers like me.

This is an interesting networking opportunity and I renew acquaintances in what I realise is really quite a small world - the minority who are in management among people working in the narrow field of mental health in the small country that is Wales. It makes me realise that the very high recorded hits on our websites Hafal and Mental Health Wales are getting to a high proportion of the people we need to engage with. Though not competing remotely with those professional offerings even this wretched Blog has 1,000 visits a month by 400 people regularly looking in though admittedly that includes my mum as well as, one hopes, the great and good in Welsh mental health services.

Back to the Collaborative where Welsh Government officials spell out their intention to draft a new or perhaps reiterated mental health strategy for Wales. It sounds promising to me, having a clear focus on individuals achieving recovery through the Care and Treatment Plans required under Part 2 of the Mental Health Measure (though there is concern in the audience that the new strategy may be rushed).

But we will have to work hard to make this a reality, in particular ensuring that in future services are planned and financed as a response to individual patients' Plans rather than the other way round...

Autumnal

Beautiful weather today but my autumnal pictures were taken before the sun burnt off the dawn mist. I've taken to walking out early with a tiny radio and this morning's news kicks off the new political season with three startling stories.

Alastair Darling's revelations about trench warfare in Downing Street in the dying days of the last UK government is trumped by the serious project announced last night to disband the Scottish Conservative Party; this in turn looks a small thing compared with the news that British intelligence services exchanged Christmas presents (and possibly prisoners) with Gadaffi's torturers and sadists.

These are troubling times but I reflect that it doesn't do to dwell too much on these matters. Over the weekend I read Hesketh Pearson's "Lives of the Wits" (1962) in which I learn that Jonathan Swift became so enraged by corrupt politics and injustice that it literally drove him to insanity; and Dr Johnson, arguably Swift's successor as the most humane voice of his time, said: "I'd as soon have a man break my bones as talk to me of public affairs, internal or external". Both men not only talked the talk but also impoverished themselves through tireless support of the poor and oppressed.

Dog's Breakfast

Unsurprising news from the Welsh Government that they want something short of full reorganisation of local government, meaning that the 22 Councils stay but they should form six collaboratives in order to manage education and (important to mental health) social care. More here.

In spite of my rude headline I am quite sympathetic to the Government which has to deal with what's there now. Everybody agrees that the present system is completely unworkable (like the old NHS set-up with 22 LHBs - you have to pinch yourself to believe we had such a system) but if you change it then it'll cost a lot and everybody stops delivering while the musical chairs game is played out over two or three years...at which point it becomes clear that we still haven't got it right...

As an aside it should be pointed out that unlike the NHS botch this local government system wasn't the fault of a devolved government but rather of the UK Government in 1996. But it's there.

Hafal, always coming from a vigorous consumer position on such matters, was vocal from an early stage about the NHS structure - indeed we opposed its establishment all those years ago correctly predicting that it would prove inefficient if not unworkable. How little pleasure we took in being right!

I'm not sure whether Hafal will take a position on this quasi-reorganisation but for my part I would offer an alternative based on our experience that consumers of health and social services are (i) not interested in local politicians determining how such services should be delivered differently in their area (indeed they prefer uniform and consistent services across Wales) and (ii) have no strong feelings that health and social care should be provided by separate organisations (indeed they are driven to distraction trying to deal with two separate organisations).

On that basis my suggestion would be to keep the present councils but restrict their work to something like the old pre-1996 district councils' function; not my bag but perhaps run education on an all Wales basis but devolving wherever possible to local schools where these show competence; fully merge health and social services along the new LHB lines; and stop paying councillors other than expenses and return to a voluntarist approach to local government.

We are constantly being told that certain "accepted" things can no longer be afforded. I wonder if it is affordable (or was ever justified or supported by the public) to pay politicians below the all-Wales level in a country of just three million (half the population of Yorkshire)?


Postscript:

This word "collaborative", often these days transmuted into a noun, is getting used a lot. No doubt some "collaboratives" are a great idea but we should always be suspicious of institutions which defensively describe themselves in ways you can't easily disagree with - who can argue against setting up something "collaborative"?

Although on reflection it might be refreshing to set up an "uncollaborative" which worried less about talking and negotiating internally but instead got on with the job.

Go West

The microbus went to the far west yesterday to park in the centre of Tenby and spread the message of mental health service-users taking control of their recovery.

Service User Lynn Hudson, 55, who has bipolar disorder, said: "I have been unwell since I was 18. I have had a difficult life and struggled in an abusive relationship for years.

"Since coming to TRI I have been empowered through friendship, care and support and can at last say that I am recovering. I enjoy writing children's stories and painting: my ambition is to be a published children's author.

"I'm receiving support from Hafal to realise my talents and enjoy my hobbies. I take part in workshops and courses at TRI and am now writing children's stories for my grandchildren. I hope that one day they will become a published piece of work.

"Events like 'Taking the Wheel' give Hafal members like myself an opportunity to display our work and have a real sense of pride. I know I haven't completely recovered; I know it will take a long time; but with the continued support from staff, volunteers and friends at TRI I know I will reach my goal."

Thanks, Lynn, and good luck to all our friends in Pembrokeshire who, as usual, have been tireless in backing this important campaign to empower service-users to:

- Take the driving seat in managing their own recovery from mental illness

- Make use of their new rights under the Mental Health Measure

- Make choices about the care and treatment they receive – and who provides them

- Develop and manage services themselves

- Engage with the providers of mental health services so that they can get more involved in planning and commissioning those services

You can read more about the campaign here.