Wednesday 27 March 2013

Gambas A La Plancha

Following the scandalous events in the NHS in North Staffordshire it might not seem very ambitious to seek parity for mental health services with physical health services. But in practice you would have to be living on Mars not to have noticed the massive shortfall in quality and resources for mental health services in England and Wales (and beyond, no doubt).

Mental health patients and their families dare not even dream of getting the quality of response they would get for a broken arm or similar. And that is part of the problem - the spectacularly low expectations of patients to the point where it is almost impossible to measure unmet need because so many people have long since stopped bothering to ask for help because they know they will be wasting their time.

So we should welcome the Royal College of Psychiatrists' new report Whole-person Care: from rhetoric to reality (Achieving parity between mental and physical health).

My one caveat would be about public health. Messages to the public about maintaining physical health can occasionally go wrong but they generally say roughly the right things - for example about diet and exercise.

By contrast messages about maintaining mental health can be seriously misguided, especially when they are developed by mental health service insiders (including the voluntary sector) who are not necessarily the people you want explaining to mentally healthy people how they can stay mentally healthy. In particular it is unhelpful to invite people even inadvertently to treat their general problems as mental health ones, smothering them with the disempowering language of mental health. How much damage has already been done by the public's lack of differentiation between "sadness" and "depression", for example?

The best support that can be offered to people to maintain their mental health is available from families and friends, the Citizens' Advice Bureau, the local gym, and for that matter discotheques, the seaside, gambas a la plancha, Radio 4's Just a Minute, a cat nestling on your tummy while you read the Sunday papers with a giant cup of tea and a digestive biscuit...these are the things which give you "resilience", not studying an NHS (or even Hafal's or other mental health specialists') pamphlet or listening to some gloomy training.


Gambas a la plancha? Just scorch raw, unpeeled prawns at high heat on a cast-iron bakestone (planc in Welsh of course - interesting that we share this simple terminology with the Spanish) or frying pan. Fresh raw prawns are now available in Swansea market and elsewhere - much better than those cooked Norwegian ones or tiger prawns from thousands of miles away. For something fractionally more complicated check out this short film made by Eroski (the Basque equivalent of Tesco). Don't worry if your Spanish is dodgy - the pictures show it all.