Tuesday 29 April 2014


Take a look at our classy new web-site for Tŷ Adferiad, our equally classy recovery centre based in North Wales supported by the National Lottery.

And why not book it for a corporate event? It's a fantastic place for professionals to meet up and get work done.

Or indeed take your extended family there and enjoy this beautiful area.

Top tip: if you are not self-catering in our centre's state-of-the-art modern kitchen then get your fish and chips at Allports (hidden away behind the main street but any local can point the way), a good enough reason to visit Porthmadog even if you didn't want the sea, the mountains, and the best views from a steam-train to be had in Europe.

Sneak Preview

Our Mobile Health Centre, one of the practical tools of this year's campaign - definitely about action not just words!

For the privileged elite who read this Blog here's a link to our new Campaign website which will be publicised later this week ahead of the launch event on 8 May.

The website gives you everything you need to know about the campaign plus a host of useful links which cover:

● sourcing and preparing healthy, high quality, good value food

● finding ways to become more active

● getting the right support from health professionals to stay well.

Plus there's a page setting out what politicians, policy makers and health professionals can do to support us.

And here's another practical tool which will be available for users and carers from the Launch onwards...

A pedometer has three qualities which make it the diametric opposite to a rowing machine: it costs very little; you are actually likely to make use of it; and it makes you feel good rather than sitting in the corner unused and making you feel guilty and inadequate.

A quite ambitious target is to achieve 10,000 steps in a day but if you can't do that straightaway you can immediately start measuring and celebrating what you can achieve and build up from there.

My hot tip for car drivers is to park for free outside the city centre and walk in. If it takes 25 minutes to walk in and 25 back you will do about 5,000 steps and save yourself a few pounds from the exorbitant parking charge to buy some healthy food - perhaps new season UK asparagus or a nice lean lamb steak (both on offer at Tesco this week) - and have a second helping because you have done the exercise!

I know the nearest places to park free in Swansea (Brunswick Street) and Cardiff (Gordon Road) - not very far out actually and big savings - but Carmarthen is a swine: the Council seems to have tracked down all my favourite places and slapped a half hour limit on them. Best bet is to park at Tesco and walk in (but you are supposed to buy something at Tesco of course - see above for some ideas).

Thursday 24 April 2014

Unofficial Mascot

An excellent meeting yesterday between the partners for this year's Let's Get Physical! campaign.

The only worry about the otherwise fantastic materials was that one person thought they could see a maggot feasting on the apple in the campaign logo - see above.

I assured everybody that this could not conceivably have happened but this morning we looked very carefully and to my horror and embarrassment the close-up shows this...

Too late to change anything now so it seems the campaign has an unofficial mascot.

Any suggestions for a name for the little fellow?

The campaign challenges people with a mental illness and their families to set their own physical health goals by:

● sourcing and preparing healthy, high quality, good value food
● finding ways to become more active
● getting the right support from health professionals to stay well.

Throughout Summer 2014, 22 county events will give service users and carers across Wales the opportunity to:

● get a physical health check up from a qualified healthcare professional
● take part in physical activities
● receive practical information and advice about how to minimise the side-effects of medication
● take part in cookery sessions and get advice and information on nutrition and diet
● get advice on reducing drug/alcohol/nicotine intake.

And the politicians, policy makers and service providers need to play their part too - see this previous post.

The campaign website goes live on 1 May and the Minister of Health launches the campaign on 8 May.

Tuesday 22 April 2014

Mad About The Buoy

J M W Turner famously annoyed John Constable by adding a crude blob of orange - a buoy - at the last minute to a seascape which won him the Royal Academy's prize that year - see the story here. Above is my tribute to the great impressionist - he invented the genre before the French even dreamt of it.

Now, let me tell you, I have done Newport (Pembs) over the long Easter weekend and in the process got my own Let's Get Physical! summer campaign off to a good start.

Among many explorations in the gorgeous sunshine I have been out onto the sands and the estuary (see above);

I have climbed up to the west of the village onto Carningli (see selfie below) and down to the east of it;

I have inspected its two castles, one partly intact with a dwelling built into the old gatehouse (local man and Herald Bard Dillwyn Miles rented it for a while I recollect), the other earlier Norman stockade now just some mounds of turf next to the rugby pitch;

I have explored all its footpaths and felt the cool waters of its many streams (see video proof below - if you repeat the film a few times it's quite therapeutic);

I have stared incredulously at the Mayfair-priced menus of its restaurants (but not eaten in them, obviously);

and I have discovered for the first time the medieval stepping stones across the Nyfer (see below).

These are completely neglected and yet are a fantastic monument to another time - shame on whoever is in charge (perhaps nobody knows who is in charge?).

There was a bridge many years ago but it was knocked down to prevent the spread of plague from Nevern. Can you can still detect a little froideur between these villages, or am I imagining it?

The modern bridge is 20th century replacing one from the 1890s so the stepping stones were important until relatively recent times. When the weather improves I will attempt to cross them and report back to you.

Oh, and I rested when the opportunity arose...

Not Pie In The Sky

I like this poster on our excellent Facebook platform.

This is a simple and fun reminder of our long-term but vital campaign to accord real choice and control to people with a serious mental illness and their families. That doesn't just mean "take it or leave it" (some choice! But that's typical unless you are subject to the Mental Health Act in which case there are services and treatments you will simply be forced to accept).

No, choice and control means giving power over resources to patients and families so that they choose and commission what they want.

There has been a sorry history of delivery on this: a grudging and bureaucratic option to control funds in social care (through Direct Payments) and no commitment in Wales on choice in health care.

Not that it is all rosy in England where individual budgets are still in troubled infancy. We don't need the English solution; we need to learn from their mistakes and find a Welsh solution which is transparent, human in scale, and practicable.

This is a ten year project because Wales isn't yet ready for choice politically but believe me it will come to health as well as social care in some shape or form - it's the future in modern, consumerist western democracies, whether services like it or not - but the challenge is to make it work well and in particular to work well for people with a mental illness.

Wouldn't it be great if we could see a time when even patients compelled to receive inpatient care could insist on their choice of hospital? This isn't pie in the sky - patients and families are already consulted sometimes about a choice of beds where staff exercise best practice.

That, above all things, would change the culture of provision. Choice is not a substitute for inspection and accountability but in the end it is the most effective driver of quality because patients and families will vote with their feet if they don't get a decent and respectful service.


"Pie in the sky"? We all know what it means but it was coined by American labour activist Joe Hill who was executed for allegedly murdering two grocers in a robbery. Actually Hill didn't mean by the phrase that the prospects were negligible; rather he meant (as a satire on the Salvation Army which he despised for helping the poor but not mobilising them) you wouldn't get the pie until you died (and went to heaven). A sort of variant on religion being the opium of the people.

Tuesday 15 April 2014

Premonitory Reminiscences

Summer reading...

I have just finished Kate Atkinson's Life after life (2013, now in paperback) which I strongly recommend.

It is the story of Ursula Todd who is born in 1910 and goes on to live through the Second World War and beyond. Or not. Because the novel keeps restarting and her life in some instances ends immediately, strangled by her umbilical cord, and otherwise ends at different times and following a variety of experiences.

In one life she even kills Hitler in 1930 because she has premonitions of his later activities based on her alternative lives (I'm not spoiling the plot for you because this scene actually starts the book).

Cripes, I hear you say, this sounds like one of those experimental novels which endlessly confuses the reader or else yet another example of "magical realism" of which there have been far too many since about 1990.

I suppose both are true, but the book is astounding in capturing so accurately the lives and mores of the upper middle classes in the 20th century, the echoes of which are still with us today. And its playing with the heroine's alternative lives is devilishly dark and at the same time moving. Somehow the moral worth of mankind transcends fate.

Heady stuff, up there with the great modern American writers who are superior to ours (but she's from Yorkshire). And it's a very long book too: it should carry you comfortably through several days of wind and rain this August in Aberdovey or other resort of your choice.

There is also a mental health angle which is interesting. Not surprisingly Ursula's mum and dad are worried about her mental health because of her "premonitory reminiscences" (my coinage but you see what I mean) - and it seems possible to the reader that the reason for her sense of déjà vu is in fact a mental aberration of some kind.

So her parents take her to a psychiatrist who makes a stab at understanding the girl but never really gets anywhere, being more interested in his own theories and his sad obsession with a son who died in the Great War. Typically the small part played by the psychiatrist in the book is nevertheless no cameo but a very human and deep character.

Kate Atkinson: she studied American literature for her doctorate - it shows

Black Dog

The Germans naively used this picture in the US to portray Churchill as a gangster - such was their misunderstanding of British and American humour

Interesting piece from our friends in NAMI about famous people who had a mental illness (follow the links from our piece on Facebook here).

On their list is Winston Churchill, whose depressive problems (what he called his "black dog") are now quite widely discussed.

I recollect a few years ago our sister charity Rethink causing a major stink by putting up a statue of WC in a straitjacket. The Churchill family was apoplectic and perhaps there was an error in taste though it certainly drew attention to the issues.

But I remain sceptical about the alleged positive affects of mental illness on the achievements of famous people (or indeed on anybody) and Churchill is an interesting case.

The eminent psychiatrist Anthony Storr wrote of Churchill "Had he been a stable and equable man, he could never have inspired the nation. In 1940, when all the odds were against Britain, a leader of sober judgement might well have concluded that we were finished".

Hmm. It is pushing matters to suggest that it was irrational not to come to terms with Hitler in 1940 even if some people like the Foreign Secretary Lord Halifax rather thought that. Doubtless some of Churchill's thinking was instinctive and visceral rather than purely calculating but that isn't the preserve of mental illness.

I think it is more credible to celebrate the achievements of people in spite of their mental illness and I am not sure that it is helpful to look for advantages, though I do understand why people will explore that as another way to nurture hope.


When Churchill's funeral was repeatedly covered on the TV news over several days in 1966 my Mum recollects me (aged 6) saying "Why are they still wheeling around that poor old man?"

Postscript 2:

"Straitjacket or "straightjacket"? Both are used but I think the former is correct, coming from the archaic "straiten" meaning restrict, now only commonly used in "straitened circumstances".

Churchill's grandson said of Rethink's statue "This is probably a good cause in search of publicity and they have let some idiot ruin their case" - a chip off the old block then

Friday 11 April 2014

Gardeners' Question Time

Question: How many people in Ceredigion read the Guardian?

Answer: I don't know but you could get an idea by seeing how many people from Ceredigion have taken up the excellent Guardian offer (in conjunction with Thompson and Morgan) for 5 free packets of salad and pea seeds and a dibber just for the postage cost of £2.30 - see this link where you can do the same without even having to buy the Guardian.

Far better to get out there and plant seeds than stay in reading that worthy but often tedious in-house magazine of public sector professionals (I read it on Saturdays when it has some more interesting stuff in it).

Growing vegetables combines two of the strands of our brilliant summer campaign Let's Get Physical! (link here) namely exercise and nutrition. Our web-site for the campaign will be going live soon - I'll tip you off.

As a good Cardi myself I got my order in before posting this in case the offer is over-subscribed - after all it is possible that more people from Ceredigion read this Blog than read the Guardian. So don't delay...

Platform Not Tickety-Boo

Derek Hughes (Hafal client, RCT project), Health and Social Services Minister Mark Drakeford AM, Jane Miller Smith (Service User Representative Pendine CMHT), Gertrude Bleasdale (Hafal client, Tenby project)

A good launch event yesterday for the interim report on implementation of the Mental Health Measure - see the story and links here.

The report was launched by Health Minister Mark Drakeford and Hafal service users spoke about their experience of mental health services and care and treatment planning - very appropriately as it was Hafal Members who inspired the original legislation and provided the detailed content of the new legal right to a Care and Treatment Plan which was adopted by the Government.

Hafal's Members - people with a serious mental illness and their carers - have always strongly supported the new mental health legislation and we are delighted to see that this report shows implementation is on track.

The Measure, unique to Wales, provides legal rights to patients which make a real difference - rights to an holistic care and treatment plan, rights to advocacy, and rights to get back into services when things go wrong.

The Welsh Government developed effective legislation precisely because it listened to patients and carers and Wales should be proud of its mental health legislation which makes it a world leader in supporting vulnerable people on their pathway to recovery and social integration.

Does this mean mental health services in Wales are all tickety-boo?

Of course not. The law is a strong platform upon which great services could be built and that is the next (and greater) challenge.

Friday 4 April 2014

Plus Ça Change

Early French art circa 16,000 BC - wonderful, the forerunners of Gauguin etc

The National Eisteddfod has many attractions for the visitor and among them is the delight of observing other visitors laughing and shaking their heads in disbelief at the poor quality or impenetrability (or both) of the exhibits in the visual arts tent.

It is a good laugh and an opportunity to brush up your Welsh - you can learn plenty of colourful, pejorative expressions for both pre- and post-watershed use.

This may be a peculiarity of this event but I'm afraid there is some feeling that Wales just isn't very good at this kind of thing.

So I was intrigued to hear today that the earliest example of Welsh art in history was coming back to Llandudno this Spring (see the story here). I hoped this might show at least some depth in the visual arts which we could be proud of.

Alas, the shapeless piece of bone which a bored caveperson had scratched at idly is of no better standard than the modern stuff (nor any worse it has to be said).

But perhaps this lends credence to the theory that we have been here all along (see this post) failing to get our eye in?

Early Welsh art circa 14,000 BC - oh dear, don't give up the day job

Thursday 3 April 2014

Now Who Is Out Of Control?

It's an international scandal and now it's specifically a scandal for Wales.

The practice of drugging children who are allegedly out of control is itself out of control, with huge increases in the use of methylphenidate (better known as Ritalin) against a background of (i) little understanding of the long-term affects on vulnerable, growing minds and (ii) grave concern about over-diagnosis and over-treatment and even doubt about the existence of the illness which it is supposed to treat - ADHD.

For the story see this link. For a sceptical view about the illness follow this link.

Readers of this Blog will know that I am not knee-jerk antipsychiatric or unthinkingly hostile to medication as a treatment but this use of drugs on children is deeply disturbing and, I suspect, easily the worst consequence arising from busybodies intruding mental health service thinking into everyday life.

Common sense tells me that resorting to drugs for children with behavioural problems should be vanishingly rare and there is probably more harm than good being done through present practice.

The last word should go to a young person - and who better than ace satirist and commentator on the vicissitudes of youth Bart Simpson? Look here.

Wednesday 2 April 2014

The Ballad Of (not) Reading (in) Gaol

Oscar Wilde was denied books in gaol until late in his sentence

I imagine most people have wondered what it is like to be in prison. I have visited local prisons in Cardiff and Swansea, Shepton Mallet (long-term, now closed) and Grendon (which has an interesting therapeutic/psychiatric regime addressing violence and sexual crime) but never, mercifully, long enough to find out what it is really like.

When I try to imagine the experience of being locked up I mainly think about the loss of privacy and also (and I doubt I am alone in this) the problem of not getting clean clothes every day. And of course there are many more serious challenges for prisoners.

One of the things which I imagine would give me some comfort would be being able to "escape" by reading books - not just to use up time usefully or entertainingly but to find other worlds to explore in fact or fiction.

So it was dismaying to read that Justice Secretary Chris Grayling has stopped families sending books to prisoners - see this link.

A high proportion of prisoners have a serious mental illness (perhaps 30% of women prisoners) and they obviously have enough trouble already in coping with the loss of liberty. It seems particularly cruel to deny easy access to books which I do think are a staple not a luxury.


What would your desert island book choice be?

Under the rules you get the Bible and complete works of Shakespeare anyway (because they assume everybody would otherwise go for one of those - actually I would too, Shakespeare I mean although the Bible could also be good even for pagans like me - lots of rattling yarns in the Old Testament even if the New Testament is a bit repetitive and goody-goody).

I might be tempted to take Joyce's Finnegans Wake on the basis that nobody would ever read that if there was anything else available to read. But I'm not sure even a desolate island environment would compel me to read it - I'd probably end up using it to kindle fires.

Montaigne's Essays would be a possibility. I realise that sounds rather intellectually hoity-toity but actually they are quite accessible and funny too - and it's a very long book so you could finish it and start again having forgotten the beginning, if you see what I mean.

But I'm glad I'm not being sent to Chris Grayling's desert island.

Finnegans Wake: "A formless and dull mass of phony folklore, a cold pudding of a book, a persistent snore in the next room" (Nabokov)