Obtuse

Some of what I missed this summer

So, I have been back in work for a couple of weeks on light duties, the pain from my back largely relieved but a pale shadow of my former self - not that I've lost a lot of weight but I feel drained of physical energy and somewhat mentally flattened too. Not helped by having to wear a heart monitor for a week - 7 weeks after the previous cardiac event (you wait 2 weeks in England, incidentally).

I am now going to take some holidays which will hopefully reinvigorate me - "rejuvenate" might be a better word as I felt about 100 years old in the worst of the last few weeks, maybe 70 now, and look forward to lowering that to my real age (54) and not stop there but move on down to (let's not be too ambitious here) 35ish? I am optimistic and that will get me there.

There were no surprises when I got back to the office because I've been well briefed but it's good to report excellent continuing progress with substantial new services developing (more later on these) in spite of the continuing squeeze on money in the wider economy.

We've also had our best campaign ever - Lights! Camera! ACTION! - with the last of 22 local events tomorrow in Ammanford and culminating in a big celebration on World Mental Health Day on 10 October where we will return to the Senedd and present our report to Health Minister Mark Drakeford AM along with assembled dignitaries and user and carer activists. See the amazing variety of film blogs and other reportage on our flourishing Facebook platform here.

In due course I'll give you some privileged advance sight of some of what we have found out during the summer but for now a reminder of what the campaign has been about. We have been calling 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 "Lights! Camera! ACTION! user and carer panel:


It's giving nothing away from our panel of users and carers' final report to say that the great thing about the campaign is how it has been about achieving these things (especially the first two) not just demanding them and making the argument for them.

Underpinning this has been the distribution of a staggering 40,000 of our Care and Treatment Planning Guide - that's in response to specific requests not sending them out unsolicited. And we are following this up with a brilliant training course for users and carers - again, more about this soon.

We may truly find ourselves entering a time when users and carers, as individuals and through their own organisation Hafal and our partners Bipolar UK and the Mental Health Foundation, are leading the way in modernising - revolutionising even - mental health services - let's hope the politicians and professionals can keep up!



Postscript:

The Daily Telegraph has been publishing a series of letters arguing about where the remains of Richard III should be reburied. Much of this has been about the dispute between Leicester (near where he was poleaxed by Sir Rhys ap Thomas and subsequently buried at the time in what later became a parking area) and York (his home territory).

Other claimants include Westminster Abbey (where his nemesis Henry VII - that's Henry Tudor - and many other monarchs lie) and even the RCs have weighed in suggesting a tomb in Westminster Cathedral (home of English Catholicism) on the basis that he was a Catholic. Well, of course he was but proper Anglicans - not the wishy-washy ones around today - would say that the Church of England is the true inheritor of Richard's faith because the Reformation wasn't about a breakaway faction from Rome but a revolutionary continuation of England's ancient church when Rome had lost the plot.

You might wonder why any of them should want to celebrate and dignify this bad man who stole the throne and murdered the Princes in the Tower? Time is evidently a great healer. Perhaps in 500 years time they will all be squabbling about who can rebury Jimmy Savile with pomp and ceremony?

But some of us have longer memories and the Telegraph published this letter in today's paper...

SIR

Put him back in that car park – an appropriately humiliating resting place for a tyrannical infanticide. Thank heavens Henry Tudor won at Bosworth and ended the Middle Ages. We haven’t looked back.

Bill Walden-Jones

You can find it on-line too here along with other letters on the matter plus a contrary comment posted this morning...


The letter from Bill Walden-Jones is perhaps the most obtuse that I have read in a long time. I dare say there will be a riposte or three winging their way to this newspaper ere long.

...which I publish here in a spirit of providing the scrupulous balance which readers of this Blog have come to expect. But you could gently remonstrate with me if I ever write "ere long" other than satirically.

That car park: the cross marks where he was found (and should go back):


Henry VII's tomb in Westminster Abbey, a fitting memorial to this great Welsh king who founded the modern state:


And, lest we forget, here's Sir Rhys ap Thomas' more understated but dignified resting place . You can see him in St Peter's, Carmarthen, but you really need a step-ladder if you want to look the celebrated regicide in the eye:

Marking Time...

Apologies for the lack of posts and I owe you an update which I'm afraid is basically about me...

Following my heart problems last month (now almost resolved - probably an arrhythmia only and recent tests show the organ itself in reasonable working order) I developed a slipped disc now exactly 4 weeks ago which has completely prostrated me.

Those who have experienced these things will know that very acute pain can be alleviated but only with painkillers which themselves have severe narcotic side effects so long as you require a lot of them - and remain debilitating until you can more or less abandon them except for the purposes of getting to sleep for example. I am only now gradually emerging from a fog of dulled pain and dulled intellectual functioning - and hence only now getting around to this Blog again.

So, it would be gratifying to be able to report to you about interesting books I have read and internet studies which I have undertaken while unwell but the effect of the drugs - essential though they are - has been that I have been unable even to read newspapers, still less actively assist my colleagues in Head Office, though of course I have kept in (fairly passive!) contact with them especially about key matters.

Not that this should cause too much concern to those who care for Hafal because our excellent management and wider staff team obviously do not depend on me to progress the organisation's business and this they have been doing with their usual vigour - see for example the amazing range of activity reflected on our Facebook pages which I have found most cheering - albeit from the sidelines.

I am hoping to get back into work soon but it will take time - please bear with me!

"Lights!" Sheds Light

I'm busy catching up with Hafal's summer campaign having been preoccupied recently with my own health problems...

This seems a good moment to reflect on the campaign so far and consider what we are learning from it (and thanks to Hafal's public affairs chief Peter Martin for briefing me). But first a reminder about what we are up to.

The Lights! Camera! ACTION! campaign is being led by mental health service users and carers, capturing their experiences of using mental health services and how effectively the Mental Health (Wales) Measure 2010 and the new mental health strategy are being delivered.

The Campaign was launched on 9th May 2013 by Mark Drakeford A.M., the Minister for Health and Social Services, and representatives from each of the 4 main political parties also spoke at the event in support of the campaign: Ken Skates (Labour), Mark Isherwood (Conservative), Leanne Wood (Plaid Cymru) and Kirsty Williams (Liberal Democrats).

So far our mobile studio has broadcast from 12 local events across South Wales and has now moved up to cover 7 North Wales counties during the high summer before heading south again to complete all 22 counties by the end of September.

Service users and carers have been talking openly and honestly at the events, many through film blogs, about their experiences and how services have either helped or hindered their own personal recovery. Also as part of the Campaign service users and carers are completing a feedback questionnaire asking about their experiences of primary and secondary mental health services.

A wide range of issues have already been highlighted by people who use mental health services, including:

• the importance of peer support in a person’s recovery

• the need for people to have somewhere secure to live

• the importance of people having greater control and more power over how services are planned and delivered

• the need for effective care and treatment planning

However, one particular message is emerging already from the campaign, and this is the need for psychological (talking) therapies to be made more widely and readily available for people with a serious mental illness, and for easier and faster access to these services. For example:

• Nigel from Newport spoke about the shortage of trained practitioners, and how it wasn’t tea and sympathy he needed but good professional therapy to help him and others with similar needs move on in their personal recovery.

• Steve from Torfaen spoke about how his psychiatrist referred him to see a psychologist but that he had to wait for over 2 years before he got an appointment to see one.

The feedback sheets also show that for many people the only option they are being offered is prescribed medication, despite a clear need having been identified for some form of specialist psychological intervention.


The Lights! Camera! ACTION! user and carer panel

So what should our response to this be? Our campaign service user and carer panel will respond formally at the end of the campaign but the feedback so far demonstrates once again that all people with a serious mental illness should have access to a range of psychological therapies. Specifically mental health services should ensure...

• routine availability of a range of psychological therapies for everyone diagnosed with a psychotic illness

• a priority for access to psychological therapies for those in greatest need

• psychological therapies for people diagnosed with a psychotic illness are available and widely used within mental health units and hospitals and becomes a standard provision

• psychological therapies begin as soon as possible for people diagnosed with a psychotic illness, and as a minimum follow NICE guidelines

• As well as making available access to specialist psychological interventions, a full range of psychological interventions are made available for people diagnosed with a psychotic illness to meet their primary care needs also (e.g. anxiety disorders, depression, etc.)

Meanwhile we have learnt a lot about implementation of the Care and Treatment Plans prescribed by the Mental Health (Wales) Measure 2010 which established a platform for people to have a greater say and more control over a range of care and treatment services they receive. Feedback suggests that more people who use secondary mental health services now have a fully completed Care and Treatment Plan. However, the quality and usefulness of those plans still varies across Wales.

Training is key to this, and not just training for the professionals. Take a look at the training course How to Get a Great Care and Treatment Plan that has been developed for delivery to mental health service users and carers by Hafal and its partners Bipolar UK and the Mental Health Foundation. We look forward to this training being widely rolled out across Wales to help drive up the quality of people’s Care and Treatment Plans.

Welsh Air-Conditioning

Mrs Blog's garden which I have been contemplating now that the cardiologist has allowed me out

An up-date: symptoms permitting I will be back in the office next week. I look forward to catching up and resuming this Blog's commentary on the wider world of Hafal and mental health...

During the fierce heat and my worst moments of illness a week ago Mrs B filled two pop bottles with water, froze them in the freezer, and then played a blow-heater (on "fan only" setting) at them and onto me on my sick bed

Important New Comparative Study Of European Healthcare Systems

Dr Rhys inspects the heart monitoring machine

I'm still "under the doctor" as they say around here, in fact under an orgy of them as the specialists move in to prod and poke.

The good news from my cardiologist after a thorough exam last night is that some kind of electrical fault is most likely causing my heart to fire erratically, information which does not of itself relieve the symptoms of breathlessness and fainting but at least removes the sensation that I am about to meet my Maker or else enter eternal oblivion (take your choice).

As a classical philosopher and admirer of Montaigne I don't think I'm particularly afraid of death but I can report that its seeming imminence over the last week was...distracting.

As I write I'm wired up to a contraption which records every flicker of life in my mortal carapace and will be compared with a diary which I am instructed to keep about what grindingly mundane activities I'm up to and how I minutely feel, all in interminable and tedious detail - exactly like what everybody puts on their Twitter page.

Apart of course from Hafal's always relevant and useful tweets to be found here.

This Blog is supposed to be at least partly corporate and not just about me but I can't yet do justice to the much more exciting things happening in Hafal - see the links to the right especially our Facebook platform which has no rival anywhere for the amazing film reportage of people with a mental illness and their families. Humbling stuff.

I shall return, as General MacArthur said sucking on his corn-cob pipe.



Postscript:

There again I should really get something in about health policy etc so try this...

Comparing notes on Skype yesterday my older brother who lives in Spain reports an interesting conversation with his GP who has practised across Europe. He told my brother that patients require different things to satisfy them according to where they live.

Apparently he found that British patients want to be told that there is nothing wrong with them and to be sent on their way; by contrast the Spanish (perhaps because they are still excited to get free stuff from their relatively new healthcare system) want to be given lots of different pills in exotic shapes and colours.

"And you know what the French want of course, Señor Walden-Jones?"

"Are we talking suppositories here, doctor?" guessed my worldly and perceptive brother.

"¡Exacto! The Frenchman does not believe anything can do him good if taken only orally".

Conforming to national trends my brother, who is at least as healthy as me, takes a colourful cocktail of pills for obscure prophylactic purposes - while I take nothing at all.

But we both agree that if we lived in France we might object to the medication on offer but it would be superfluous to tell the doctor where he can stick it.

Prostrate

So far in my life I have been lucky with my health. Indulgent readers will know that I am an occasional martyr to gout but I rarely get nasty bugs or even colds and have a pretty good sickness record - some recent years without time off and others with just a day or two (usually gout).

So, it was an unwelcome surprise to spend much of my holiday last week in the Isle of Wight, plus all the current week, poleaxed by a mystery illness which has left me prostrate, breathless, and miserable in a way I have not experienced before.

The tests continue but the money is on either an electrical fault (causing an arrhythmic heart) or an unknown virus. Not knowing doesn't help but of course that isn't so unusual as medicine is a less sure science than we would like to believe. The reason I am writing is that the first signs of remission are upon me (touch wood) so that I can bear to switch on the pc and contemplate life beyond lying on my sick bed drinking sweet tea.

But I can't do justice here to all the exciting stuff going on at Hafal, not least the Lights! Camera! ACTION! events and the annual Physical Health Awareness Day (though lordy am I aware of the importance of physical health right now) but instead I will lazily steer you towards our brilliant Facebook presence here which tells you about what we are doing and much more besides - and there's a lot of your feedback too.


Postscript:

In my enforced indolence (and as a distraction from the tests and probing) I have been playing with a machine on the net where you can upload your mugshot and it looks for similar faces. You can find it here.

My best match was Michael Gambon about which I am fairly neutral but Mrs Blog seems quietly satisfied to get Jennifer Ehle. I hope Mr Gambon won't take it the wrong way if I say that he would be lucky to bag Ms Ehle. And indeed I am a lucky man myself...any chance of another cuppa?

Newport, Newport, Newport

Nothing ever really happens around here
Just smoking, fighting, and drinking beer

Newport's own rap satirists Goldie Lookin Chain were proved wrong yesterday - it was all happening because of another successful visit for the Lights! Camera! ACTION! "motorcade of cinematic thrills" - camper-van and mobile studio - to the city including a forthright plea by Rachel Ayriss for basic information to be provided to carers telling them what's available locally - see the film here.

For Hafal's guide for carers follow this link.

It is quite difficult to find repeatable lyrics from GLC but I like this...

Newport
Twinned with Guangxi, Province in China
There's no province finer
Josie D'Arby's from Newport
Yes, it's strange, we didn't know either...
Thank you Wikipedia
Let's say some more
Newport, Newport, Newport.