Treatment versus Care

It was a clean, warm and open space with well-designed floral furniture in pastel blues and greens. It had plenty of natural light and pots of healthy looking plants thoughtfully dotted around the floor. The artwork on the walls was selected by someone who knew their stuff. It would be hard to guess that this was the entrance to the New Hampshire Hospital. which provides acute inpatient psychiatric services for all age groups.

As I was guided through the facility, I was enamoured by a lush beautiful big greenhouse, two well-stocked libraries, a massive gym for staff and patients, 3 cafés, an outdoor patio and play area for kids, a vegetable patch, a healthy colourful aquarium on wheels, loads of Halloween decorations all around, an art workshop and cooking class in progress, television screens, a chapel, a small shop, a pool table, a ping-pong table, lots of board games and cheerful group therapy, treatment and visitor’s rooms.

Each kid had a room to himself or herself with nice bed-linen of their choice. 2 adults often shared a room. The age groups were appropriately separated. The youngest patient there was 6 years old and the oldest a septuagenarian. The nurse’s station was not a demarcated area. It was part of the ward layout. Social workers, occupational therapists, doctors and nurses didn’t wear any uniforms. They were dressed in everyday clothes. Everyone spoke softly and the atmosphere was relaxed and caring.

The most impressive part of the service was the presence of an Aftercare Liaison officer. It is well known that patients are at the highest risk within 30 days of discharge from inpatient services or Emergency department. (Ref: Luxton, June and Comtois 2013) They concluded that repeated follow-up contacts appear to reduce suicidal behaviour.

Aside from following up on these patients, the Aftercare Liaison Officer has the following roles before the patient is discharged:

  1. Speaks, listens and connects to each child and adolescent patient. Educates them and their support system about warning signs of suicide, triggers, risk factors, protective factors and restriction of means of self-injury.
  2. Draws up a detailed Safety Plan with them and their carers.
  3. Helps them identify sources of social support (trusted adults) and develop personal resources through open conversations.
  4. Interface with other professional agencies (eg. for DBT) and community services that will help dilute their identity as a person diagnosed with a Mental Illness. For example, they match their interests to activities such as therapeutic horsemanship, a running group or a Mountain Teen Project.
  5. Engage their parents, families and friends and anyone they would like to involve.
  6. Use technology if possible – MY3App.

I don’t think we have this service in the UK. I know we don’t.

The one thing that is most important to me and worth living for is … to continually express my love for Saagar and help other parents do the same for their kids.

Little things

Croydon, Berlin, Lebanon, Antrim and Troy, all within a few miles of each other. Yes. This is the New Hampshire (NH) part of New England. But the capital city of NH is not New London. It is Concord.

1.35 million inhabitants of NH live in 9,300 square miles.

9 million inhabitants of London live in 600 square miles.

It’s a different world. Time and space assume a different dimension here. They are both expansive. I have a sense of abundance and connection.

I have met nothing but kindness since I’ve been here. On the very first day, I was offered two lifts, one from Manchester airport (yes, they have a Manchester too) to Concord and then from my AirBnB house to the grocery shop and back. I have no car as I can’t trust myself to drive on the right (wrong) side of the road. I can literally hear the wires clanging and short-circuiting in my head as I watch the cars move on the roads.

Apples, maple syrup, random conversations with the locals on the street, excellent assistance in shops, witty Halloween decorations and the fall colours. Within the last week, a festival of colours has unravelled in all their glory. I don’t think any camera can do full justice to the drama of Orange, Yellow, Red, Terracotta and Green.

I have really noticed the small things. I spent yesterday morning cutting out small squares of felt in preparation for a community meeting at a small village school where they have recently lost a student to suicide. These pieces are for everyone who attends. They serve as tiny ‘blankies’, something for people to hold on to and fiddle with, to help them cope with the difficult conversations taking place in the room. I would have never thought of that.

When we got there, each table was decorated with twines, hydrangeas, little pumpkins and squashes to make the atmosphere a little bit festive. Warm and welcoming. Not too sad and drab. These little things made such a huge difference for everyone present.

On World Mental Health Day and every other day, let’s remember the little things. They are the big things.