Mekong Delta

I have suggested before that the best way to relax when out walking is to observe the surroundings rather than bring along your problems and think about them - if you want to do that then my advice is to sit at a table with a pen and paper, preferably with a friend to hand.

Not that observation will not carry you elsewhere. This afternoon while clocking 12,000 steps on the pedometer it strikes me that the Towy valley resembles the Mekong Delta (scene of the USA's only definitive military defeat...until Afghanistan that is) rather than temperate West Wales. This is because the river is full and muddy, the vegetation rank and dark green, and there are lines of leafy maize where there used to be grass in the valley bottom which looks just like paddy fields. My picture gives you the idea but doesn't quite capture how lush and steamy it all appears when the sun deigns to come out.

I like the look of the maize (grown for fodder in this climate - you can't ripen corn north of, hmm, Nantes I'd guess) even though it isn't traditional. It makes the countryside a bit exotic. I recollect a lot of anxiety expressed by conservative types when oil-seed rape became a common sight in the UK: they thought the vivid golden yellow of this remarkably successful industrial crop "polluted" the visible landscape but I think it looks great.



Postscript:

Mrs Blog treats me on Friday to a dish of cuttlefish with meatballs and peas (sepia amb albondigas y guisantes in the original Catalan) which was exceptional. It's easy to make and Rick Stein's version is here. Apparently you can use squid instead of the cuttlefish but that would be a shame as it's cheap and available certainly in Swansea market and surely elsewhere. It has a distinctive flavour which translates you straight to Barcelona and makes a hearty meal which only requires a green salad to accompany it - although my sister-in-law in Spain told Mrs B it's just a starter!

The Real Killer Facts

A warm welcome was given to Minister of Health and Social Services Lesley Griffiths AM when she visited Hafal in Wrexham this morning. She is of course the local Assembly Member but was attending in her ministerial capacity so this was a really good opportunity for our Members and clients to get across their views about mental health services in Wales - and sure enough they did just that in a constructive and positive discussion. Hafal has several trained Expert Patients among our Members in Wrexham so we knew they would give a good account of themselves.

Lesley heard service users express how they have benefited from the Agored (Open College) courses running in the project. She also gained an insight into serious mental illness by listening to service users talk about their experiences. Service users spoke to the Minister about how meaningful service user involvement can benefit the development of mental health services and they discussed their work with the Care Standards Inspectorate for Wales promoting an audit system for social care.

Hafal Community Link Worker Denise Charles said: "The Minister has been very supportive of Hafal’s work. She spoke at our World Mental Health Day celebrations at the Senedd last autumn and in June this year she launched a new guide Care and Treatment Planning: a step-by-step guide for secondary mental health service users - which was produced by Hafal in collaboration with the Mental Health Foundation and Bipolar UK. The guide is designed to help service users get the most out of the new Care and Treatment Plans which were introduced, as part of the Mental Health (Wales) Measure, on June 6th. The Minister has visited the Link Service in Wrexham previously it was great to welcome her back today."

Meanwhile the Minister may have been somewhat preoccupied - but didn't show it - with the vote of confidence (see the BBC story here) but as privileged readers of this Blog you will recollect that the political difficulties of hospital reorganisation were presciently covered here before this latest hoo-ha - see this post (last two paragraphs).

Whatever the rights and wrongs of the "killer facts" emails we should support any Government which finally addresses the massive elephant in the room of the Welsh NHS which has been trampling around unchallenged ever since devolution - WE CAN'T AFFORD NOT TO CLOSE OR DOWNGRADE HOSPITALS AND TO CENTRALISE NHS SERVICES - those are the real killer facts.

You may ask "What's this got to do with mental health?" but the truth is that all NHS provision will be relentlessly squeezed, important services will close, and the quality of treatment and care will deteriorate until this nettle is grasped (or should I say, in order to avoid mixed metaphors, "until the elephant is shot"?).

This is also why the Government's ring fence around NHS funding for mental health services, crude though it may be as an instrument of policy, may prove more important than the new mental health Strategy - because another real killer fact is that nothing will be achieved in mental health if its resources are syphoned off to preserve in perpetuity all-singing and all-dancing (but hugely inefficient) local general hospitals.

Cynon the Egalitarian

The Welsh Government’s draft Mental Health Strategy was a key talking point at yesterday’s Movin’ On Up event in Aberdare.

Aberdare service user Ioan Bevan who has bipolar disorder tells us: "For me the main focus in the new Strategy has to be on delivery. We have very good legislation in Wales, the key is to ensure that the new laws are fully implemented. That’s going to be difficult in the current economic climate but now that we’ve got the Measure and the new holistic Care and Treatment Plans we’ve got to strive to make the most of them. There’s no excuses now we have the Measure - services have to deliver!

"From a personal point of view I think service users need as much help as we can get particularly when it comes to returning to work. Employment is my ultimate goal. I’ve attended training courses which have helped my confidence; coming to Hafal has helped me enormously too."

Spot on, Ioan, and check out the Mental Health Service User and Carer Panel which has compiled this response to the Draft Strategy.

The aim of the campaign is to maximise the opportunities for recovery from serious mental illness which are provided by the new Strategy and the historic Mental Health (Wales) Measure. The Measure is hugely significant because it affords service users key new rights and has finally given users of secondary mental health services in Wales the legal right to a comprehensive holistic Care and Treatment Plan covering areas such as accommodation, finance and training.

The campaign is run by service users and carers and supported by us along with our friends in Bipolar UK and the Mental Health Foundation, all of us united in our determination to achieve equality of opportunity in every field of life for people with a serious mental illness. 22 weekly county events are taking place and the campaign will culminate in a climb of England and Wales’ highest peak, Snowdon, in September. The campaign will also feature an interactive stand at the Royal Welsh Show and on World Mental Health Day at the National Assembly.

Support the Panel!

To Cardiff this morning to see the Minister of Health, Lesley Griffiths AM, along with voluntary sector colleagues.

We raise four points in a very short meeting, all concerning the new mental health Strategy currently out for consultation: the need for measurable outcomes based on clinical and holistic assessments plus patients' own reported experience; the necessity for a change in the ethos and approach of staff of mental health and wider services; the economic case for investing in mental health services, for example through improving the speed and success of recovery for patients; and the need for a robust national steering group to oversee implementation.

The jury is out on whether the new Strategy will make a difference. Much will depend on the accompanying "Delivery Plan" which should set out what mental health and other services will actually have to do. It is a fair assumption that it is this Plan which hard-nosed managers will reach for in the future, not the Strategy itself, when they want to check that they are safe in their jobs.

The law, specifically Part 2 of the Mental Health Measure and its Regulations and Code of Practice, provides a solid platform for the development of improved services. The Delivery Plan will have to go beyond that baseline to make a real difference, spelling out what patients and families can insist upon in terms of care, treatment, and support over and above the legal requirements. We shall see.

The Minister is visiting Hafal on Friday in Wrexham and I'm quite sure our members and clients there, who also know her well in her capacity as the local AM, will articulate their expectations more clearly than I ever could.

To see the well-argued response to the draft Strategy of the user and carer Panel supported by Hafal and our colleagues in the Mental Health Foundation and Bipolar UK please follow this link: you can also see how you can support the Panel by writing to the Government.

Summer Reading

I have been asked about summer reading which I have previously covered but this is difficult because I haven't been very lucky with books recently. For a start I think I will stop reading historical novels. Their plot-lines are of necessity wooden and inefficient because they have to follow the historical record while as history they are obviously unsatisfactory because, well, what they say is largely made up and not true.

I have already damned with faint praise Victoria Hislop's The Thread about early 20c Greece (see here) but I have now been further disappointed by two fictional accounts of Shakespeare.

Warwick Collins' The Sonnets is a mercifully short but grindingly contrived novelette "explaining" the boring "mysteries" behind WS's sonnets (you know, all that stuff about the "dark lady" etc) which are extensively quoted to pad out the book. The "explanation" is completely unbelievable.

Robert Winder's The Final Act of Mr Shakespeare describes production of a lost play about Henry VII (the Welsh king who is a favourite of mine and of the late North Korean dictator Kim Jong-il - see here). But this plot is also completely unbelievable and, worst of all, the final 100 pages comprise the text of the play which you have to read in order to solve a central riddle in the book. Now I like Shakespeare but reading his plays, as opposed to seeing them on stage, is a dispiriting experience (and the cause of millions of children shying away from the world's greatest playwright - something everybody seems to agree about but nothing is ever done) but reading Winder's feeble pastiche is just torture and, after all that, the answer to the riddle turns out to be predictable and banal. You have been warned, although this book has been widely praised so what do I know?

As an aside it is interesting to note that both books make use of the idea that Shakespeare was caught up in politics and espionage. This seems to be yet another effort to make WS more "interesting" instead of recognising what is obvious to anybody not obsessed with conspiracy theories. He was quite a boring businessman who lived an unexciting but successful life and retired into bourgeois comfort back in Stratford just as soon as he had made enough money. This humdrum reality is seemingly too much to bear for some people, just as others cannot bring themselves to believe that a person who went to grammar school and not to university could write plays.

So what to read? I am now half way through a marvellous history of the Mediterranean, The Great Sea by David Abulafia, which is a delight. He even manages to make the early history interesting (so often sleep-inducing because based on tiny variations in dull pottery and the like). He also sweeps aside the daft theories which pollute history-writing and exercises a refreshing common sense which completely convinces. My understanding of the classical world has always been based on colourful mythology (Homer) gradually transforming into plausible history (Herodotus) and on to first-hand accounts (Xenophon) and eventually to the whole corpus of history, poetry, letters, etc as the focus moved over to Rome. But Abulafia has opened my eyes to the surprisingly clear evidence for what happened in prehistory and its remarkable fit with the mythology (short of the literalism of Schliemann and similar fantasists). It really feels like my whole understanding of my chosen educational field - classics - has widened massively. But the book is definitely not just for classicists: it is a demanding read but absolutely accessible as I am finding as the time line moves into eras about which I know little.



Postscript:

Not that I am that hot on classical history. I recollect being taught by one of Prof Abulafia's predecessors the late, great Professor of Ancient History John Crook who challenged our tutorial group to name the date of the forming of the Delian League. Answer came there none and, correctly suspecting our ignorance might run deep, he asked for the date of the Battle of Salamis (the classical equivalent of asking for the date of the Battle of Hastings). Silence. "Oh well, no matter," sighed the world-famous leading authority on fifth century Athens "It all happened a long time ago".



PPS:

480 BC (I looked it up on Wikipedia).

Energised

I'm catching up with news from Hafal having spent the last week fishing (or rather not fishing - see last post)...

Fantastic reports from last Thursday's Physical Health Awareness Day 2012 (popularly known as the "Sports Day") which took place at Swansea University. Activities included the traditional tug-of-war now generously sponsored by Unison, the Trade Union which represents Hafal staff. The whole event and attendant campaigning on physical health were sponsored by the Millennium Stadium Charitable Trust and the prizes were presented by paralympian Graham Edmunds who has won two gold medals...




Appropriately Friday's Movin' On Up event in Torfaen continued the physical health theme...


Lynne Neagle, AM for Torfaen (second from right) attended the event. Lynne is pictured with (left to right): Mel Cook (Mental Health Foundation), Michelle Boyd (Hafal Practice Leader Torfaen), Mark Lydon (Hafal Bridgend) and Elin Jones (Hafal Chair).

Speaking on the key role exercise has played in her recovery from anxiety and depression service user Cheryl Bennet, who swims and attends a gym once a week, told us: "I definitely advocate exercise for mental health recovery. Since exercising, my back, which has given me problems in the past, feels better so exercising has helped with my physical recovery, too. I've also found that no matter how tired I am before going to the gym I always feel energised afterwards.

"I have a gym buddy and that's helped give me confidence and motivation with my exercise programme. Eventually I hope to lose weight which will make me feel better about myself.

"I think that the more you exercise the better you feel mentally and physically. For me going to the gym has helped me get out more and meet people which has also been beneficial. I think exercise gives service users like me a good goal to work towards. I feel I have accomplished something at the end of each session, it gives me a really big boost."

How very much I agree with Cheryl! I didn't manage to swim last week but I averaged 15,000 steps a day walking on the Pembrokeshire coast (checked off on my trusty pedometer) and I am 2 lbs lighter for it - I must keep this up through the summer...

Long-Forgotten Shrimp

Fishing has been a dead loss between the cold weather and high winds. The final straw was clinging to my favourite "mark" – a rocky promontory sticking out into St Bride’s Bay - and trying to thread a very angry rag-worm onto my hook. You can’t blame them for being annoyed but they can bite you hard using their sinister 360 degree jaw.

Suddenly I am reminded how much this creature resembles a similar (but much larger) one encountered by Prof Farnsworth’s parcel delivery team in a recent broadcast of excellent sci-fi satire Futurama. For a split second I hesitate and sure enough it takes its opportunity to give me a fierce nip. And at that very moment a massive wave hits the rocks and completely soaks me. This is beginning to feel like something out of "Trawlermen" rather than a leisurely afternoon’s fishing so I give up and concentrate on walking the coast instead.

On the beach the only other person out in the rain is a serious-looking student with a clip-board. He tells me he is a palaeobiologist. You mean a "palaeontologist"? No, apparently this is a new science trying to make fossils (that’s what we’re talking about here) more exciting by associating dusty old trilobites etc with "earth sciences" (no, I don't know what they are either). Anyway, surely slim pickings here (on the south coast of St David’s peninsula)? Not if you are keen – he shows me some tiny holes in the rock made by some long-forgotten shrimp. We agree that there is more amateur fun to be had at Abereiddi (north side of the city) where there are loads of quite large fossils high up the beach.

He patiently and perhaps not wholly approvingly hears me out describing my expedition a couple of years ago to Lyme Regis (a mecca for fossil-hunters; of some interest to palaeontologists; but probably nothing special to a serious palaeobiologist) where I bagged a 50 lb ammonite and carried it triumphantly over a mile back to the car. It now sits by my fireplace, a million year old snail turned to stone or, if you prefer, a six thousand year old false trail planted by the Devil - nobody can say this Blog is not strictly neutral.