Day 998

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Good fortunes.

Today is your lucky day.
She says, ”Why not?”
The traffic cop is sleeping.
Everyone assumes you were just kidding.
You’re upgraded to first class.
Your client is even later for the meeting. Bingo!
You got the good genes.
You win the lottery(and haven’t lost the ticket).
Surprise. It’s on sale!
It’s sunny at Wimbledon.
You bet on the wrong horse, which wins.
Blackjack. It goes in.
The test is negative.
You find 100 pounds in your old jeans. You’re OK.
Your mother-in-law is really cool.
You guess right.
There is no traffic.
You are the millionth customer.
You are proven innocent. Near miss.
Refund. No one got hurt.
You find your cell-phone.
Your kids are healthy.
They accept your ridiculous offer.
The one you love, loves you back.
Your dead, really rich uncle really really liked you.
You have a sense of humour.
It’s just a mole.
No one ever finds out.
Tomorrow will be even better.

  • By John Nieman

hartje

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 996

 

Tying the knot

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Today my friend and her fiancé tied the knot. 2 individuals and families came together and entwined their love and destinies forever. The sun and the flowers smiled as they poured out blessings. The fragrance of jasmine flooded the air as the pretty little white flowers adorned the hair of most women present. Chanting of Sanskrit verses in a rhythmic baritone meter sanctified the atmosphere. The fire at the centre of the auspicious ceremony bore witness.

The sights, sounds and smells conjured up images from the past. The food and music. The silk and gold. The gifts and festivities. The smiles and promises. The coconuts and beetle-nuts. The salutations and offerings to deities. The hopes and dreams of lifelong friendship, companionship, health, happiness and prosperity. Mischievous traditions of the bride’s friends hiding the bride-groom’s shoes and little competitions between the bride and groom. A reminder of times and people gone by.

In the last 2 years and 9 months I have turned down three wedding invitations. Couldn’t face the thought. Today was the first. It was good.

The last wedding Saagar and I attended was in September 2012. We drove to a small village near Brighton on a very wet day. Our Tom-tom took us to the middle of a field and declared, ‘You have reached your destination’ . We had to laugh. We drove up to the nearest set of houses, knocking on doors of complete strangers to find out more. We finally got there. It was great!

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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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Day 985

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‘Children and Young People’s Mental Health – Taking Early Action’ : title of a conference I attended today.

The hall was packed with 350-400 people, working for the well-being of kids as teachers, social workers, decision makers and others. Two speakers mentioned suicide in the passing – Rt. Hon. Norman Lamb MP, who lost his sister through this tragedy 2 years ago and Richard Andrews, who set up the charity Healios after experiencing serious difficulties in accessing support for friends and family affected by serious mental illness.

One of the professors spoke about the reasons for early deaths of people with mental ill-health.  He attributed this mainly to physical problems such as hypertension, obesity and smoking related problems. Death by suicide wasn’t mentioned.

I learnt a lot, some of which I shall share in the next few days. A Green Paper is being drawn up to set out proposals for delivering better mental health support for children and young people. During one of the question times, I suggested that bearing in mind that suicide is the biggest killer of young people in this country, 2 things must be included in the Green Paper –

  1. Suicide Prevention Training for all medical and nursing staff and students, just like CPR training, to bring parity of esteem between physical and mental ill-health.
  2. Meaningful sharing of information about para-suicidal young people between medical teams, police, first-responders and families, in the best interest of the patient.

This remark was met with a stunned silence. The room froze. The chairperson mumbled something like ‘eloquent…’ and rapidly moved on to the next person.

Stigma lives here too. Inside the healthcare community.