Non-writer’s Block

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Brindisa, a Spanish Tapas Bar sits at one corner of Borough Market. I sit at the window at one corner of Brindisa, sipping hot chocolate after a long day at work. A wee treat. It’s raining just short of cats and dogs. Umbrellas are out in all their colours and varying degrees of wind-induced angular crookedness. Hoods are up and hair flying off scalps at funky angles. Some walk hunched and shrunk, others wear big smiles, facing the sky. Many pairs of crisp city shoes step off the kerb and dunk straight into puddles. Squelch. Squelch. Squelch.

The last few weeks of writing less traverse my mind. In the first week, that vacant hour seemed contrived – like a designer hole in the evening. I strapped myself in a brace of immobility, letting it pass, pretending I wasn’t watching. On a couple of occasions I was desperate enough to turn to the TV for help. It felt unnatural and abrupt to break the rhythm of writing every day. I had a non-writer’s block. I knew it was coming but it was more unwelcome than I thought it would be. It made me feel like I was being denied the sweets I loved. I felt redundant. I thought of Saagar and missed him more than normal, if that’s possible.

The second week was a week of late nights – emergency surgeries at work, friends visiting from abroad, reading an ‘unputdownable’ book. Sleep and energy deficit was huge. There was no time to think or write. An e-mail came as a reminder that the last of 36 instalments towards the payment for my bike had been made. Yes. I got it in July that year. Saagar helped me with setting the height of the seat, inflating the tyres and oiling the chain. He worried about me cycling on London roads. He was an avid cyclist. Once a female driver of a car nearly hit him because she was on her mobile phone. She apologised to him. He used to answer my phone when I drove. He also used to answer my text messages. He felt strongly about mobile phone use by drivers. He hated that we lived on a hill. The last bit of the bike ride home was hard for him, as it is for me but I am getting used to it. One e-mail and a barrage of memories!

The third week was quiet. Cats. Music. Food. Candles adorning Saagar’s picture. Time to record a podcast with an eminent Consultant Psychiatrist, Dr Dele Olajide. Lots of cycling. Sleeping. Si and I pottering around the kitchen. I wash the spinach and he wilts it. He clears up the sink, I put the dishes away. Si boils the kettle, I prepare the mint for the tea. We dance our culinary waltz and Milkshake sits as a spectator on the upper stall of the kitchen island. In the pauses between ‘doings’ we dance. We rejoice, we dance, we create new memories. 

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I am not my diagnosis.

While I continue to struggle to figure out Twitter, forget how to update my website, get confused while recording podcasts, consistently get my innumerable passwords mixed up, stay oblivious about Instagram and Snapchat, the digital world gallops ahead.

Digital Interventions in mental health Conference 2017 was recently held in London. It explored topics across psychiatry, technology and culture to identify innovative ways of addressing mental health needs.

Dr Becky Inkster is a Neuroscientist, passionate about digital interventions in mental health, social media data analysis, genomics, molecular biology, and neuroimaging. She co-founded Hip-Hop Psych as she is passionate about working with hard-to-reach, disadvantaged groups and youth culture.

‘Views from the street’, ‘Prison transition tools’, ‘Beyond the bullets’ and ‘The Digital Psychiatrist’ are some of the workshops that were conducted at the above conference. The range of topics was rather fantastic. It was aimed at improving our understanding of how social media is helping to create and facilitate new spaces for mental health practices and support, exploring the benefits of social media and social networking to improve a sense of identity, self-expression, community building and emotional support through examining a few popular international examples. Participants and facilitators engaged in interactive sessions to understand how new tools for self-expression via pictures, videos, captions and short personal narratives can help break down the stigma surrounding mental health and perhaps even lead to more people seeking help. They explored how to empower young people to use social networks in a way that promotes their mental health and wellbeing, how to harness the power of social media to nurture mental health innovations that the future holds.

Impressive stuff. I carry on doing what I do. I write another article for the Huffington post – Darkness to light. I talk about my darling Saagar and emphasise the importance of us, the people, educating and empowering ourselves so that we can help ourselves and each other through the light of knowledge and empathy. I continue to speak with ordinary people living extra-ordinary lives. Here is a conversation with Sara Muzira, mother of the beautiful Simba. Both, mum and son are artists. She talks about the state of inpatient mental health services in her experience and things that can be made better for patients and their families. Thank you Sara.

 

 

 

 

 

 

 

 

 

 

It takes a whole village to raise a child.

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When I was 9, a music teacher came home every Tuesday evening to teach me singing and Kathak dance. That was my favourite time of the week. One week I waited and waited for what seemed like a very long time but he did not come. That evening I had a very high fever and had to be taken to the doctor.  Last week I have been having a high temperature, a cough and a cold. Withdrawal?

Growing up in the UK’, a report published by the BMA in 2013 found that we fail many children and young people every year. 2.6 million children in the UK live in absolute poverty. Children are at higher risk of living in both relative and absolute low income than the overall UK population. 14% of the most severely materially deprived kids from 30 EU countries live in the UK – same percentage as Romania. The severe economic hardship from the 2008 financial crisis in the UK and consequent spending cuts have been disproportionately detrimental to children, young people and low income families, particularly those who were already at a disadvantage such as migrant children and lone parent families.

‘We like to think of ourselves as a child-friendly society, but the facts do not support that comfortable, complacent assumption’  – James Appleyard, treasurer of the BMA.

Nelson Mandela said: ‘There can be no keener revelation of a society’s soul than the way in which it treats its children.’

According to the World Happiness Report 2013, Dutch kids are some of the happiest in the world. Here are a few possible reasons. Dutch parents are the happiest people. Dutch Mums have found the perfect work-life balance with 68% of them working part time, 25 hours per week or less. They don’t care so much about being charming or about how they look. Dutch dads are more hands on and play a large role in child care. Many of them also work part time. Dutch kids feel no pressure to excel at school. They have no homework before the age of 10. There is no competitive university application process. They can simply attend school for learning rather than competing in academic performance.

The Dutch breakfast mostly consists of a slice of white bread with butter and chocolate sprinkles on top. The United Nations called it healthy. What makes it ‘healthy’ is that breakfast is taken as a family every morning. The kids have a right to express their opinions as they are meant to not just be seen but also heard. Grandmothers have an active role in bringing up the grandkids and that has a huge positive impact on the kid’s self-esteem. The Dutch government gives money to families to help with expenses. People, including kids safely cycle everywhere. A huge emphasis is placed on ‘gezellighied’, a concept of pleasant togetherness that is more bracing than coziness and more exciting than contentment. ‘Gezellighied’ is an untranslatable Dutch word. Its closest meanings are convivial, sociable, fun, nice atmosphere resulting from general togetherness of people giving rise to a strong sense of belonging and a warm feeling. People work hard to bring this into their everyday family lives.

Why do we fail so many kids in our country?

Politicians make blunders because they surround themselves with like-minded people who are completely disconnected from the general populace. There is a failure in advocacy for children. As a society we need to examine and change our attitudes towards the importance of children. Mentally and socially some people manifest a bunker and silo attitude leading to isolation and exclusion. We need to create nurturing communities locally which could be based around the arts, music, exercise, spirituality, sports, play groups and after-school clubs.

Families, government and education policies and practices need to emphasise the importance of creating nurturing environments for kids.

 

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.

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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.

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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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