Friday 31 May 2013

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.

Thursday 30 May 2013

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.

Wednesday 29 May 2013

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....


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.

Tuesday 21 May 2013


Tennis chums at Oxford: Feldman standing second from left; Cameron standing right

In the late 1970s I decorated my Parka jacket with a "The Who" logo as a bit of jokey retro chic and recollect being shouted at across the street by somebody who must have been a greaser or rocker - "Spastic mod!" was his satirical cry. You don't hear the word "spastic" used as an insult much these days in polite society. In fact it isn't used as a neutral label either for cerebral palsy: hence the Spastics Society long since became "Scope".

It really isn't acceptable to use physical disability labels for offensive purposes and even quite potty-mouthed people steer clear. It isn't just rude - there is now a sort of taboo.

No such taboo attaches to mental illness labels. Thus the alleged use of the term "mad, swivel-eyed loons" by Lord Feldman (or possibly the Prime Minister himself) has certainly landed him in trouble - but not for insulting people with a mental illness but rather for insulting his fellow Conservatives.

What should we make of this and what, if anything, should we do about it?

I don't think it is simple. I doubt I would use those particular words but ordinary, decent people frequently refer to somebody like a politician on the telly who is making bad judgements (or maybe somebody they just disagree with!) as "crazy", sometimes "mad" or even "bonkers".

I notice that most people with a mental illness, including thoughtful and liberal-minded people, also use such terms casually. And some (but much fewer) also use such words to refer specifically to mental illness which I guess is their privilege. When Hafal was being set up and we were looking for a name for the new organisation there was serious consideration, led by a minority of more progressive service users, to adopt a startling name like "MAD" (I think this was going to be an acronym but can't remember what it stood for) or suchlike as a way of moving onto the territory of discrimination and somehow neutralising it (rather as some gay people have adopted the term "queer").

Looking at the twittersphere this morning I see that many people with a mental illness are commenting on the "loons" issue. It is noticeable that not much offence is being taken but rather there is a lot of humorous commentary, for example taking mock offence at people with a mental illness being compared to Conservatives. I think this is rather well judged and reminds us that the only people who can effectively counter discrimination are the people who are affected, not bleeding-heart Guardian-readers who are liable to make the wrong judgements on these matters.

Just for the record I was never a mod (too young) and I don't much like The Who although I did once possess a badly scratched LP, one half of the double Quadrophrenia album which somebody must have left in my room when I was a student - pretentious rubbish mainly.

Jo's Blog

Great film blog by that brilliant advocate for patients Jo Roberts here.

I well remember Jo torpedoing the infamous Mental Health Bill (R.I.P.) when she gave evidence to the Westminster Scrutiny Committee now some years ago. The Committee's report, which damned the Bill and consigned it to the bin, explicitly acknowledged the decisive effect on their conclusions of Jo's testimony.

Subsequently Jo was behind "Jo's Blog" which assertively steered the Welsh Government towards a superior Code of Practice for the Mental Health Act. This was the first appearance in law of Hafal's 8 "life areas" (actually 9 at that time before the Government unwisely joined up medical treatment with psychological and other treatments having listened to some politically correct ninnies who thought the separation gave too much credibility to medical treatment).

She has lost none of her incisive honesty and she's quite right to raise the issue of money management which can be a huge problem exacerbating people's mental illness. Jo is real proof that an individual with extensive personal experience can really change things for the better for all patients.

Monday 20 May 2013


A productive weekend including a remarkable achievement on the DIY front. I managed to remove and replace the broken-down waste system under our kitchen sink and it doesn't leak! You may not be impressed but you need to understand that I am the person who does not know how to open the bonnet of my car - embarrassing when you are asked to do so by the mechanic at Stadium Garage.

The Great Sink Crisis came about because of a significant deterioration of a three-year-old blockage in the waste to the point where no water was getting out. Ham-fisted investigation of this led to disintegration of the bolt holding the waste onto the plug-hole and consequent catastrophe. Having bought the parts from Homebase I composed myself with maximum Zen coolness (like a bomb disposal operative) in order to address the problem and miraculously the parts fitted together as the instructions promised and it all worked a treat.

A top tip for fellow unhandy DIY chumps. Buy a Tesco sink plunger (£1.50) which has a formidable concertina of rubber which, applied with modest vigour after the sink was fixed, forced out a huge chunk of festering gunk into the outside drain (I didn't look too closely but couscous seems to have been the decisive factor in completely blocking the pipe). For maximum effect you need to hold a wet cloth firmly over the sink overflow while you are plunging - to stop the pressure escaping that way. A plunger will usually do the trick and should be deployed before any unpleasant dismantling of the trap and pipework is attempted (I now realise).

This success massively impressed Mrs Blog who, I am afraid, had had zero confidence in my ability to meet the challenge ("Oh ye of little faith!") and so had to eat her words. Bucked by this triumph I went on a celebratory walk among the spring flowers and performed a good gym session including a swim outside in the sunshine under an azure sky - I felt as Lord Byron must have done when he swam across the Hellespont (well, a bit).

Tiring but very satisfactory...

Thursday 16 May 2013

Alex Ferguson

I'm playing catch-up following the launch of Lights! Camera! ACTION! and the local event in Neath Port Talbot plus today's event in Bridgend. Best bet I think is to point you straight to the Facebook page where it's all happening.

Excellent support from the new Health Minister Mark Drakeford A.M. who entered into the spirit of the occasion, grasped completely what we were set on doing, and gave the whole campaign a big endorsement plus a really encouraging send-off to the vintage microbus and mobile studio as they set off on their on-location tour of every county in Wales.

He didn't even flinch when I wondered out loud whether he would last longer than most Ministers (there have been five in ten years) or even do an Alex Ferguson and become an enduring fixture. But I'm not serious - that's not how politics work.

Anyway, we managed to cover the political territory, seeing many A.M.s from all parties including:

Lib Dem leader Kirsty Williams...

Plaid Cymru leader Leanne Wood...

Labour's Ken Skates, Chair of the All Party Mental Health Group...

and Conservative Mark Isherwood, Shadow Minister for Communities and Housing...

Now put your feet up and watch the film version here.

Wednesday 8 May 2013

"Lights!" Launches (It's Official)

Looking forward to tomorrow when Lights! Camera! ACTION!, our groundbreaking 2013 campaign led by mental health service users and carers in Wales, will be officially launched at the National Assembly in Cardiff by Health Minister Mark Drakeford AM. The event will be attended by service users and carers from across Wales as well as AMs, policy makers and health professionals.

During the day those attending will be able to record their views about the future of mental health services in the Lights! Camera! ACTION! mobile studio which will be on location outside the Pierhead Building along with Hafal's iconic VW microbus.

Our commitment is to give a voice to service users and carers and make sure they are heard by the decision-makers. Film is the perfect vehicle for this. Service users and carers from across Wales will have the opportunity to be both behind and in front of the camera to record their messages and share their experiences of mental health services.

Speaking about the campaign Sue Wigmore, Self Management and Wales Manager at Bipolar UK, tells me: "Following on from the introduction of the Measure and Strategy this is a great opportunity for service users and carers to make sure that the words are put into action and to feed back about the services in their area."

And David Crepaz-Keay, Head of Empowerment and Social Inclusion at the Mental Health Foundation, adds: "People who need or use mental health services really know what works and what doesn't. This is our chance to use our experience of the best and worst of what Wales can offer and share our learning with people who have the power to make a difference."

Lights! Camera! ACTION! is supported by mental health charities Bipolar UK, Hafal and the Mental Health Foundation. During the summer service users and carers across Wales will produce their own film blogs which point local services and national policy makers to good practice in mental health service delivery across Wales - and flag up local deficits in delivery. Service users and carers will talk to camera about what changes we want to see in services as a result of the exciting new law and policy.

Specifically the campaign calls for:

• high quality Care and Treatment Plans for everyone receiving secondary mental health services
• full choice and control for service users on the content of Care and Treatment Plans
• prompt delivery of quality mental health services in response to those Plans and to the needs of people with a serious mental illness using primary care services
• further reform of services which increases service user and carer control over the choice and commissioning of services
• a longer-term move towards full equality in Welsh society for service users and carers including equal access to health and social care, housing, income, education, and employment.

The mobile studio is on location at 22 local county events taking place throughout the summer. The campaign will conclude with a red-carpet event at the Senedd on World Mental Health Day in October.

Tuesday 7 May 2013

Gawdy Pre-Reformation Tat

Early yesterday morning on the cliffs west of Caerfai on the St David's peninsula

As a tonic to refresh my mental health I try to get to see the spring flowers at their best each year on the Pembrokeshire coast. Twenty years ago this meant early May but in recent years more like mid-to-late April. Greenies will tell you this is because of global warming: I have no idea but there have been cycles of temperature change throughout history so who knows?

Anyway this year I calculated that, because of the grimly bad weather in March, early May would be right and sure enough it was all happening yesterday. Needless to say my photo completely fails to capture the profusion of colour and form which spills over the cliffs - you really have to see for yourselves and next weekend will be about the last good opportunity before rank grass smothers the effect somewhat.

The spring flowers are a bit like Blackpool's famous Illuminations - a good reason to visit outside the main summer season - but of course I'll be back at every opportunity for the swimming and fishing from June to September.

After a good walk I visited the Cathedral for a nose around, something I usually do at least once a year. All Welsh people should make the pilgrimage even if like me only out of antiquarian curiosity.

But it's a bit of a disappointment in some respects. The Victorians cleaned up much too vigorously what was apparently a crumbling but authentic shambles. There remains much which is interesting, not least the drunkenly-leaning internal architecture, but a lot of what you see today is hygienised or frankly fake and the Mediaeval stuff is optimistically labelled as relating to famous Welsh or Norman characters - most of this pure hokum I'm afraid.

On the whole I support the idea that the Anglican Churches in England and Wales should continue to run these buildings rather than, say, Cadw or the dreaded National Trust. But a heavy price is paid because the church authorities will often litter the building with philistine rubbish and St David's is sadly no exception.

The latest addition is a ridiculous "reconstruction" of the "shrine of Saint David" which blots the very centre of the building. This monstrosity appears to be the result of an unholy alliance between New Age "artisans" and High Church anglo-catholics attempting to insinuate gawdy pre-Reformation tat into this otherwise austere and beautiful setting.

We will have to wait for a future Low Church Dean to be appointed who can rip it out and burn it gleefully in the churchyard like a righteous Cromwellian trooper. I'll be there to cheer him or her on.


Friday 3 May 2013


Great fun had - and good work done - yesterday at the first of the Lights! Camera! ACTION! events which received much public and professional attention at its prominent location in Castle Square, Swansea. Lots of use made of the mobile studio including these film blogs...

• See service user Richard Timm talking about how physical exercise helps to ground him here.

• Service user Paul Bevan explains how he used his Care and Treatment Plan to commit himself to an ambitious training course here.

• And the Leader of Swansea Council David Phillips talks to service users about his own experience of depression and his Council's commitment to mental health services here.

And we were lucky with the weather - bright sunshine and warm too, hopefully a good omen for the rest of the 22 county events taking place every week until the end of September. I might open a book on how many of these will experience some rain (meaning for betting purposes any rain I suppose, even a drop, in the course of the event, typically a few hours either side of lunch-time): I would put my money on only 5 out of 22 but that may be optimistic.

Plans are now well in hand for the official launch of the campaign in Cardiff Bay next week. Health Minister Mark Drakeford will be doing the honours and no doubt we will get more excellent film blogs from users and carers - and professionals and politicians.

A reminder of what this user and carer-led Campaign is promoting:-

• High quality Care and Treatment Plans for everyone receiving secondary mental health services

• Full choice and control for service users on the content of Care and Treatment Plans

• Prompt delivery of quality mental health services in response to those Plans and to the needs of people with a serious mental illness using primary care services

• Further reform of services which increases service user and carer control over the choice and commissioning of services

• A longer-term move towards full equality in Welsh society for service users and carers including equal access to health and social care, housing, income, education, and employment.

Wednesday 1 May 2013

The New Tarantino

I feel under some pressure to join in the film blogging which is taking off big time this week as part of our Lights! Camera! ACTION! campaign. So, what to do? An interview with the Minister of Health perhaps, or a focus group studying the new Care and Treatment Plans alongside Hafal's excellent new Guide?

Maybe I will get around to those but in the spirit of this Blog it seems only right to give Rhys and Huw the privilege of appearing in the debut feature of my new cinematic career.

In case the significance of the film isn’t immediately apparent let me explain that it illustrates an important psychological phenomenon, namely how excessive proximity and dependence (exhibited through mutual grooming) can lead to tension and discomfort (exhibited by them ferociously grabbing each other by the throat – though this fur-flying behaviour is "only playing" as cat owners frequently have to explain to alarmed visitors).

Important to set this out in case you thought that the clip was really just another example of the self-indulgent trivia which infests the Internet and frankly I should get on with doing some proper work...

Click on the play button in the centre; you can also click on the square box at bottom right for the full Odeon Multiplex-with-popcorn experience

On a more serious note I am looking forward to the first of our 22 "on location" events in Swansea tomorrow. Check Facebook late in the day to see what users have said in the mobile studio.