Day 850

Findings of National Confidential Inquiry into suicides and homicides by people with Mental Illness – 20 year review published in 2016 :

Key elements of safer care in Mental health services

  1. Safer wards: Removal of ligature points /Reduced absconding / Skilled in-patient observation
  2. Early follow-up on discharge from hospital to community
  3. No ‘out of area’ admissions for acutely ill patients
  4. 24 hour crisis resolution/home treatment teams
  5. Community outreach teams to support patients who may lose contact with conventional services
  6. Specialised services for alcohol and drug misuse and “dual diagnosis”
  7. Multidisciplinary review of patient suicides, with input from family
  8. Implementing NICE guidance on depression and self-harm
  9. Personalised risk management, without routine checklists
  10. Low turnover of non-medical staff

Key elements of safer care in the wider health system:

  1. Psychosocial assessment of self-harm patients
  2. Safer prescribing of opiates and antidepressants
  3. Diagnosis and treatment of mental health problems especially depression in primary care
  4. Additional measures for men with mental ill-health, including services online and in non-clinical settings

There is strong evidence for all of the above.

5 items from the first list (MH Services) were missing for Saagar.
4 were not applicable. One, I am not sure of(rate of staff turnover).

All 4 items on the second list were missing for Saagar. The ‘wider’ health system did him more harm than good.

Can we turn this evidence into action before hundreds more die? Please.

Reference: http://research.bmh.manchester.ac.uk/cmhs/research/centreforsuicideprevention/nci/reports/2016-report.pdf

Day 849

School playgrounds are challenging places. Many of us haven’t quite survived them or their equivalents. They are part of growing up and some of the memories created there, stay with us for a long time. Our childhood never leaves us.

The playground has now extended itself into our private spaces via the World Wide Web. There is nowhere to hide. No place is safe. The aggressors can be cowardly and hide but the attacked are exposed even when sitting alone in their bedrooms. Any child from any background can be a victim and any child from any background can be a culprit.

How easy it is to make people feel they don’t fit in, by words or by indifference. Many agonise over fitting in and being accepted for who they are. The deep desire to fit in can cause misery for life. The feelings of non-acceptance are deeply damaging when internalised, leading to long term mental and physical health problems.

It must not be easy for kids to talk about being bullied. It must hurt. It must be embarrassing. Attention needs to be paid to what they say to alert us to the subtle or overt bullying that goes on. Every blessing requires care and commitment. Everyone needs to feel loved and valued. While meanness may afford short-term gains, kindness is transformative.

In Primary school, Saagar’s friend Adam always stood up for him in the ‘school playground’. They were best friends for many years and I am very grateful to Adam for his kindness. Saagar was too even though at the time he did not know that he would not survive the playground. Neither did I. 

Henry James said, “ Three things in human life are important: first is to be kind; second is to be kind; and third is to be kind.”

The ‘Special K’.

 

 

Day 848

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Three centuries ago, Newton thought that reality had 3 basic components: time, particles and space. This model didn’t explain everything. Soon other forces that govern movement of particles came along like electromagnetism. Photons, gravitons and gluons emerged yet the essential ingredients of reality remain a mystery.

To explain gravity, Einstein merged space and time into a composite, space-time. Michael Faraday added the concept of a classical field that carries forces through empty space. Quantum Theory showed that all mass and energy are really excitations of underlying quantum fields. Quantum fields and space-time are incompatible, so perhaps there is a more basic component hidden beneath.

In the late 1990s, String Theory was proposed. I don’t understand it fully but basically it says that elementary particles emerge from the vibrations of one-dimensional strings. Therefore, an electron is not really a point, but a tiny loop of string. If it oscillates one way, we see an electron. If it oscillates in another way, then we call it a photon, a quark, or a …

Julian Barbour, a British physicist believes that space and time, united by Einstein must be uncoupled. The only way to define space is to consider it as the geometric relationship between observable particles. He argues that the universe is a set of possible configurations of the 3D geometry of space. He believes that these configurations or ‘snapshots’ exist in a space of possibilities. Time is not real but merely something we perceive – an illusion that comes about because the universe is constantly changing from one snapshot to another.

Spiritual masters have been teaching the concept of everything being an illusion for thousands of years. Physics seems to be catching up.

“Reality is merely an illusion, albeit a very persistent one.”
– Albert Einstein

Ref:

Day 847

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My box…

I will put in my box
A confirmation certificate
And words of praise for my bishop.
My husband’s compassion
And the heart beat of the sea.

I will put in my box
Chinese fire crackers that
Spit and spark at the devil.
Silhouettes of palm trees
And lightning during the monsoon.

I will put in my box
A teenage tomboy
Forever-happy climbing mango trees.
A far away memory of mother’s laugh
And a fisherman’s hook.

I will put in my box
Only good stuff
A glowing friendship and
A sweet cup of tea.

I will put in my box
My youth and
All the fun of the fair
With donkeys and candyfloss.

I will put in my box
The smell of my first baby
A lot of understanding
And a day in the New Forest in a church
Waiting to hear Dancing Queen playing on the organ.

I will put in my box
A guinea pig from long ago
So sensitive and soft,
Squeezing into a ball like a cat
An orange tree I climbed,
Scared of nothing and such rewards!

I will put in my box
The circus at Blackpool and dancing
Girls in swimsuits.
The smell of mango
And juice of young coconut.

My box is made of
Garden scents and music
With ribbons and buttons and all sorts
On the lid.
You can unlock it by wishing quietly.

I shall keep my box
High on a roll of thunder
And watch the dice
As they tumble down
An evening by the beach.

  • By a creative writing group of elderly patients with mental illness.

What would I put in my box?

I will put in my box
The infectious laughter of my young man
The warm embrace of my sweetheart
The healing touch of my mother’s fingertips
running through my hair
All the colours of autumn.

What would you put in your box?

Day 846

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Simba Muzira, son of Sara Muzira.
Exhibition of Art, Long Gallery, Maudsley Hospital. London.
Simba Muzira. Doing it again.

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Spray paint. Street art. Bold statements. Clear expressions. Innocent eyes. Pure soul.
Courage. Suffering. Passion.

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Pigeons telling him not to wear his shoes. Pigeons everywhere! No words!

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A mother’s tribute to her talented son who died at 32 after living with mental illness for a few years, in and out of the hospital. Her accounts of doing things in his best interest which turned out otherwise. Her heartbreak at having to live away from him when he was too ill to be at home. Her sense of an utter waste of a young life full of promise. Her guilt. Again and again. Her love. Immeasurable.

I salute you. Sara and Simba Muzira.

 

Day 845

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The art of pottery has held my fascination for as long as I can remember. It is my secret dream to be a master potter, someone who creates magical ceramics that can hold the world in them.

This evening I happened to watch a pottery programme on TV. It featured 7 highly talented potters. Some of their creations brought tears to my eyes. Watching them make these artful objects step by step from scratch was a real treat. One thing they all had in common was that if the clay on the wheel went wonky in any way, they would start all over again. They made no attempts to fix the broken, damaged, warped, marred, misshapen, spoilt, wrecked potential pots. That clay went straight from the wheel onto a waste heap. However, it can be reprocessed, kneaded and made ready for the wheel again.

I identified completely with one of those accidentally wounded pots, even in the hands of master potters. No fresh clay is needed.  I just have to refashion this existing clay into a divine vessel that lovingly cradles the world.

Day 844

Maybe he has a nice little flat to himself up there, with a high ceiling, big windows and an airy verandah, properly kitted out with a fancy drum kit, a ping-pong table and a cricket pitch nearby. Maybe he hangs out with his new friends and they talk about ‘stuff’ and go to the gym together. They possibly do all kinds of accents and have a good laugh. Maybe they have fancy dress  parties too. Maybe he cooks meatball curry for them and they tell each other stories about their time on Earth.

Maybe he sometimes looks down at his house that is now like a shrine filled with flowers and candles, his Mum’s eyes now lustreless, some of his socks and t-shirts that she pretends to borrow from him, his fine black Sharpie pen in her bag along with a random Arabic worksheet of his from University, Milkshake fast asleep against his favourite rectangular blue floral cushion from Ikea. Maybe he can also hear the deep haunting silence.

Maybe he remembers what happened that day. Maybe he regrets it. Maybe he visits and revisits. Maybe he is right here, right now.