Day 997

Moving home

The experts on the gardening programme  on the radio said that repotting is traumatic for plants. I had never thought about that before. Should it be any different for children and families moving house?

By virtue of my dad’s job, we moved more or less every 2 years. Some of the places we lived in are not easy to find on the map of India. I completed 12 years of schooling in 8 different schools in India. It was normal to be the new girl in class. We went to schools that catered to families that moved frequently. So, often there would be other new kids in class too. It was heart-breaking to leave friends just when our friendships were deepening. As time went on, it became a part of life and although it was sad, I could handle it much better. That was partially because I altered the quality of my relationships. I didn’t allow them to get too deep. I protected myself by holding back a bit of me for myself. That bit would always be safe. I didn’t know I was doing it then but I see it now.

The cycle repeated itself with Saagar. The difference was that he travelled outside India to places where he would be the only coloured kid in class, where they spoke a different language in a peculiar accent, where he had no close friends or extended family, where it was normal for people to live all their lives in one place and be buried in the cemetery two streets away from their primary school.

Grief can come in intangible forms – loss of trust, loss of innocence, loss of safety, loss of childhood, loss of control and loss of faith.  A 2010 study of 7,000 American adults found that the more times a person had moved house in childhood, the more likely they were to report lower life satisfaction and well-being, irrespective of their age, gender and education.

Reasons, timing and location matter. The good news is that something can be done about it.

Day 993

Ruth

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Broken glass

“You are well enough to safely go home now”, said the panel.
“But I can’t! I need one more day to complete my church!”, said Di, who was being treated at Bexley hospital for Postnatal Depression in 1966. She had a brilliant occupational therapist who took them to the swimming pool, organised hair-dressing days and helped patients to make things. Di made a church with bits of shattered wind-screen glass, put together with resin but the spire wasn’t on yet. This beautifully tactile piece of art was named ‘Faith’ by Ruth, her daughter.

Ruth

Ruth was a talented young lawyer. She was an actor and singer. She was kind, generous and gorgeous! She travelled extensively. She was diagnosed with Bipolar Disorder in her late 20s. She coped well with the help of health services, her friends and family but tragically lost her battle at the age of 47.

Di is in her second year of missing Ruth terribly. She has created the most beautiful garden in her memory. Some of the plants there are from Ruth’s house. Her mediterranean wall is stunning.

Mediterraneanwall

Being bereaved by suicide is a huge risk factor for suicide. Around 125 youth suicides a year occur soon after the person involved has experienced a bereavement. One in four (25%) of under-20s and 28% of 20 to 24-year-olds had lost a relative, partner, friend or acquaintance around a year or more beforehand. In 11% of suicides among under-20s, the person who those involved had lost had also taken their own life.

In a recent inquiry, bereavement was found to be an important theme in many deaths, said Prof Louis Appleby, the director.

People who have been bereaved need greater support to reduce the risk of them killing themselves. Agencies who are meant to help are not good at recognising this risk and need to improve.

This morning I caught up with Di over a cup of tea. We both believe that if Saagar and Ruth have met each other wherever they are, they must get on famously. The link below is a conversation with Di. She talks about her insights on mental health services over 5 decades. Thanks a lot Di!

Day 989

Accidental findings

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In the mid 80s, Dr Vincent Felitti ran an Obesity clinic in America. Many people enrolled and hundreds of pounds were shed by them. But he found that the drop-out rate from his programme was as high as 50% despite good results. He did not understand this and went back to look closely at patient notes.

“I had assumed that people who were 400, 500, 600 pounds would be getting heavier and heavier year after year. In two thousand people, I did not see it once. When they gained weight, it was abrupt and then they stabilized. If they lost weight, they regained all of it or more over a very short time.”

The turning point in Felitti’s quest came by accident. He was running through yet another series of questions with yet another obesity program. How much did you weigh when you were born…when you were in first grade…when you were in high school…when you first became sexually active…

One female patient replied – “Forty pounds” and broke down in floods of tears, “I was four years old.” He found similar common themes emerging from various stories and went on researching this subject for the next 25 years.

The obese people that Felitti was interviewing were 100, 200, 300, 400 overweight, but they didn’t see their weight as a problem. To them, eating was a fix, a solution like IV drug user calls a dose a “fix”.

Eating made them feel better. Eating soothed their anxiety, fear, anger or depression – it worked like alcohol or tobacco or methamphetamines. Not eating increased their anxiety, depression, and fear to levels that were intolerable. For many people, just being obese solved a problem. In the case of the woman who’d been raped, she felt as if she were invisible to men.

Felitti went on to further explore the  impact of childhood trauma on people and coined the term – ACE, Adverse Chilhood Experience. He found a strong co-relation between the number of ACEs and early death.

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Film: https://www.youtube.com/watch?v=v3A_HexLxDY

 

Day 988

Transition is the cliff edge.

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Alas, poor Yorick…

Eighteenth birthday! Yay! No more a child. You are mentally, emotionally, socially, spiritually and physiologically an adult. That’s it. Over to Adult services now. Easy.  The number ‘18’ is completely arbitrary. It is designed for the convenience of the service providers, not in the best interest of children. There is a strong case being made now for raising the ‘transition’ age to 25 and rightly so. The recent publication “State of Child Health 2017” has recognised that the transition from Paediatric to Adult services is poorly organised and unsafe for mental and physical health conditions.

This is how one of the parents felt: “In my experience the teams did not work together. They each did their separate thing. When Rebecca left school, she was left with without regular support or advice. When she turned 18 we just stopped receiving information. Emails and phone calls didn’t get answered.”

Chronic conditions such as Epilepsy, Asthma, Diabetes, Juvenile Arthritis and Childhood Obesity are often associated with significant mental health problems. The budget for kids was 6% of the Adult MH services until recently. The government promised an increase and guess what! It has gone up to 7% now. Hurrah! Considering that mental illness most often begins in adolescence and early intervention is of paramount importance, the allocation of funds is highly disproportionate.

Piet Jansen, Director of International Relations, Yes We Can Youth Clinics, Netherlands, commented:

‘There was a lot of talk at the CAMHS congress about the Green Paper, but in my view the only green thing that matters here are dollar bills (in this case pounds). Without sound financial and genuine political commitment, structural changes are not to happen.’

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Day 983

How many?

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“Work out how many vulnerable children there are in this country today…Four months, 12 experts, 500 pages and four spreadsheets later, and our answer is: we don’t know.”

The report produced by the Independent Jersey Care Inquiry into the abuse of children in the Island’s care system over seven decades was published yesterday. The findings were shocking:

  • Having their hair forcibly cut off
  • Having their mouths washed out with soap
  • Spending long periods in an isolation room
  • Having fat from a frying pan poured over them
  • Being punched and slapped
  • Being sexually abused
  • Live electrical wires applied to legs
  • Being hit with a pre-war army stick with a metal end
  • Being beaten with nettles as a punishment for bedwetting

The “Jersey way” is a term used to describe a system where “serious issues are swept under the carpet” and “people avoid being held to account for abuses”. However, Jersey is not the only place in the world where this has been happening and still carries on.

Studies show that children and adolescents in care are at greater risk of suicide and attempting suicide than those who are not in care. Rates of suicide attempts and hospital admissions within this population were highest before entry into care and decreased thereafter. Health and social care professionals should be made aware of this research. The care home experience is a prominent risk marker for suicidal behaviour among teenagers and young adults.

 

 

Day 979

“Helping others is the way we help ourselves”
-Oprah Winfrey

Simple ideas change the world. A Clinical Psychologist, Dr Charlie Howard was taking a walk around her area. Having recently had a child, she was looking for her next “thing”. She asked random people what would make a difference in their community. “A Problem-Solving Booth right here on my street” answered a young man in the queue in a sandwich shop.  “A place where people can go with the stresses in their head and where we can help each other”. The idea was genius and Charlie’s head built on it quickly. “Maybe we could try one here?” Charlie suggested, “we could do it together”. The young man smiled at Charlie and said “yeah maybe” and then his phone rang and he ran off down the street. No one knows his name and no one has seen him since. He probably has no idea just what his throwaway words have since inspired.

Problem-Solving Booths are a great way to bring members of the community together to have conversations that they might not otherwise have, by helping each other with their problems. One chair is for the “Helper”, the person listening to the problems. The other is for the “Helped”, the person describing their concerns. The aim of the Booth is that people swap roles regularly as we all have both the potential to have problems as well as to offer help.

Thrive London is a citywide movement for better mental health for Londoners supported by the Mayor of London and the London Health Board. Problem-Solving Booths have become the local arm of Thrive and we’re working out what they are, what they do and what they can do, with everyone we meet from street to street, borough to borough and organisation to organisation. It’s cool.

Watch this space!

 

Day 977

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Rebecca

Rose Polge. Rebecca Ovenden. Lauren Phillips.
All junior doctors. All deaths by suicide, in just over one year.
The only three publicly known. Total number not known.

Polge’s mother linked her suicide directly to conditions at work – exhaustion because of long hours, work related anxiety, despair at her future in medicine and the news of the imposition of a new contract on junior doctors.

This problem is not limited to the UK. Earlier this year, 4 deaths within 5 months in Australia propelled the launch of an urgent investigation into the problem. No such investigation in the UK. Indeed, the law here explicitly excludes suicide from the requirements to report work-related deaths. A GMC report in 2016 stated that the low morale amongst junior doctors was putting patients at risk. Signals of distress and a dangerous level of alienation are an indication that the system cannot simply go on as before.

At the 2017 BMA junior doctors’ conference, delegates gave the union a mandate to lobby for all suicides to be investigated formally by their employer, jointly with the GMC, Health Education England and the BMA.

In France, workplace suicides are a well-recognised entity.
Yes. Suicides are complex. There can be many contributory factors. But when there is clear evidence of a link to work pressures, that should be given appropriate attention.

Ref: BMJ Article: Suicides among junior doctors in the NHS followed by an interesting discussion.