Day 884

“Hi. My name is Joe
And I work in a button factory
I’ve got a wife
3 kids
And one day my boss said to me
He said, “Joe?
…Got a minute?”
I said,”Yes.”
He said “Push the button
With your left hand

Repeat….right hand
….left foot
….right foot
….head
….tongue

It was like being a kid again. The Theatre workshop at the Dragon Café let loose my imagination and opened up a whole new world of possibilities. I was part of a community full of great ideas, all of which were real in that room. Colourful currents of creative juices were flowing, intersecting and mingling within that sacred space. Every suggestion was validated, every feeling acknowledged. I felt safe and uplifted. For that one hour I could be anyone, anywhere with any story.

The interaction induced empathy. For a few minutes, each of our characters felt what it must be like to be in the other one’s shoes. We formed strong connections and had great fun.

I can see why Drama therapy works in schools, prisons, mental health centres, businesses and hospitals. It is an instrument for change, individual and social. It can help us work our way through a problem, discover some truths about ourselves, understand the meaning of images that resonate with us and explore and transcend unhealthy personal patterns of behaviour.

Saagar was a natural mimic and actor. Every time he auditioned, he got a good role. Predictably, he played one of the 3 wise men in his primary school nativity play. Then, he was Badger in Wind in the Willows. His last school play was Of Men and Mice in which he played the character of The Boss. He loved the team aspect of putting a production together. The last play he watched was ‘Book of Mormons’.

He was a star and still is.

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Ref:

http://playingon.org.uk/playing-on-at-the-dragon-cafe/

Day 856

Every investigation into an avoidable death is a learning opportunity for Trusts, clinicians, families, wards, patients, management, boards and the community. The lessons learnt can be passed on to other organisations and future generations. But unfortunately, often investigations are done in order to not find any deficiencies. They are defensive in nature rather than exploratory. They are reductive and analytical (Root cause Analysis) rather than holistic and empathic. Both approaches bring value to an investigation but often the greater good that can come out of them is overlooked.

200 avoidable deaths take place within the NHS every week. Each of them holds valuable lessons for the future but they are buried. Hence the same mistakes happen over and over again, costing more and more lives. In some organisations serious near-misses are recorded as ‘no-harm caused’.

We need collective intelligence, not individual genius. We need responsibility and accountability, personal and professional, shared and individual.

In 2015, a report was leaked to the BBC from Southern Trust that looks after 45,000 people. They had 1454 unexpected deaths over a 4 year period, 2011-2015. Of those, just 195 (13%) were treated by the trust as serious incidents requiring investigation. Deaths of adults with mental health issues were most likely to be investigated (30%). For those with learning disability the figure was 1%, and among over-65s with mental health problems it was just 0.3%.

“To err is human, to cover-up is unforgivable, to fail to learn is inexcusable.”
– Sir Liam Donaldson.

Ref: NHS Failure to probe deaths: Shocking: http://www.bbc.co.uk/news/health-35061716

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 841

His bathroom has 3 lights, one on top of the mirror and the other 2 on the ceiling. The switch for the mirror light is just underneath the mirror. The switch for the ceiling lights is outside the bathroom door. I sometimes found the mirror-light switched on, on the way to his room even when he wasn’t there. I would tell him off for repeatedly forgetting to turn the light off after use. Now, it is my bathroom. I still find the mirror light on sometimes when I go upstairs, even if I haven’t been there for hours.

It is so easy to forget to turn the mirror-light off. I know that now.

I would arrange mail-order deliveries for the times when he would be home. Sometimes he would be in his room on the second floor and fail to open the door for them, especially if they came very early in the morning. We would then have to go around chasing our parcels. Again, I would get a bit annoyed with him for missing out on the deliveries.

Now we sleep in his room. One morning last week, I almost didn’t hear the deliveryman’s knock on the door. I thought I heard something like a knock in my sleep but disregarded it, believing it to be a dream. An identical sound came again and nudged me out of my slumber. Had the man not had enough patience, he would have left us a note and gone to his next destination. But I did manage to bundle myself up and roll myself down the stairs in a semi-comatose panic to get to the door just in time.

It’s so easy to miss a delivery. I know that now.

 

Day 839

A few weeks ago Desert Island Discs completed 75 years on BBC Radio4.(http://www.bbc.co.uk/programmes/b08cd2fk) A brief excerpt of an interview with Archbishop Desmond Tutu caught my ear. He talked about his experience of freedom when he came to England in the 1960s. He could go into any restaurant, speak openly and be himself. White policemen spoke to him with respect. He said that anyone who had never experienced such a great contrast as the one between his home country and the UK would not understand how wonderful that freedom felt.

This made me think about what freedom means to me. I read some of the Archbishop’s teachings and found the ancient Bantu word ‘Ubuntu’ meaning “the belief in a universal bond of sharing that connects all humanity”.

“Ubuntu .. the very essence of being human. A person with ubuntu is open and available to others, affirming of others, does not feel threatened that others are able and good, for he or she has a proper self-assurance that comes from knowing that he or she belongs in a greater whole and is diminished when others are humiliated or diminished, when others are tortured or oppressed.”

“We are made for goodness. We are made for love. We are made for friendliness. We are made for togetherness. We are made for all of the beautiful things that you and I know. We are made to tell the world that there are no outsiders. All are welcome: black, white, red, yellow, rich, poor, educated, not educated, male, female, gay, straight, all, all, all. We all belong to this family, this human family.”

“My humanity is caught up, is inextricably bound up, in yours. We belong in a bundle of life. A person is a person through other persons; you can’t be human in isolation; you are human only in relationships” ― Desmond Tutu

Nelson Mandela said something similar – ‘For to be free is not merely to cast off one’s chains, but to live in a way that respects and enhances the freedom of others.’

Freedom cannot be achieved by isolating oneself. Waging wars in the name of freedom is a fundamentally flawed concept, be it nations or individuals. Freedom is uplifting and life enhancing for everyone, not for one at the cost of the other. Ubuntu.

‘I am what I am because of who we all are.’

Day 837

NSPA Conference: Part 2. Suicide Prevention: the changing conversation.

4. State of Mind Sports Charity (http://www.stateofmindsport.org/) made a dazzling presentation about how they promote positive mental health in sportsmen and women, fans and wider communities, thereby preventing suicides. Danny Sculthorpe gave a moving account of his dark times when his brilliant rugby career was seriously threatened by a very painful back problem.

“I just felt like I had lost everything and that nobody cared. After a couple of months, I couldn’t afford to pay the mortgage, and because Bradford were denying any responsibility for the injury, I had to try and find £3,000 for the physiotherapy I needed to give me any chance of getting back playing. At that time, all I could think about was how I was unable to support my family, that my career was over and that the only way out was suicide.”

Sculthorpe found help after opening up about his feelings to his parents and through support from the Rugby Football League. He now works for the State of Mind charity, which established a partnership with the game after it was rocked by the death of Wigan and Great Britain hooker Terry Newton in 2010.

Their resounding message is: “We are all one big team.” So true!

5. Professor Tim Kendall, National Director for Mental Health, NHS England presented the 5 year forward view. He appeared rushed, ill-prepared and unempathetic to a room half full of people whose children had died.  Considering he was the most powerful person in the room, he was most disappointing.

6. Counsellor Richard Kemp has been a member of Liverpool City Council for 30 years. He is passionate about providing good housing, community centres and parks for the well-being of people. Ironically he also seemed to think the suicide was a relatively small problem. Interestingly he got this insight from a  psychiatrist. However, I strongly agreed with this statement he made – “We need fewer guidelines and more vision.”
We can’t have a speaker from Liverpool who doesn’t mention the Beatles – All the lonely people, Eleanor  Rigby, Father McKenzie… This song was well used to speak about the widespread problem of loneliness.

7. Panel discussion at the end had representatives from – Public Health England, Champs, Grassroots and Mental Health Foundation. They discussed finding the ‘seat-belt’ of Suicide. May be there isn’t one. We should work with the information we have in addition to continually looking for stronger evidence. It is important to identify protective factors and talk about them too. Policy makers need to embed these into schools and colleges. Staff must be educated to enable them to spot the warning signs of suicide in a young person and to keep them safe.

Overall, it was clear that the conversation is changing, even though  there is plenty of dead-wood around. It is apparent that the motivational level of charities is much higher than the government. There are big questions about the funding of government plans. GP training is still something that is not being addressed as it should be. Somehow there is a level of denial around it, even when it is clear to many of us as an area that needs serious attention.

The drivers of these changing conversations and policies should be survivors of suicide and those bereaved by it. Lived experience is an invaluable source of a wealth of information on the lessons that can be learnt and the changes that are required.

Ref: http://www.itv.com/news/calendar/2015-07-24/the-only-way-out-was-suicide-former-rugby-star-speaks-out-about-case-over-sacking/

Day 836

The National Suicide Prevention Alliance (NSPA) is an alliance of public, private and voluntary organisations in England who care about suicide prevention and are willing to take individual and collective action to reduce suicide and support those bereaved or affected by suicide. (http://www.nspa.org.uk/)

Today I attended a conference organised by them. The room was filled with people who care. Here are some of the highlights as seen from my eyes:

  1. Jeremy Hunt, Secretary of State for Health sent his apologies and a recorded message that said all the right things, unconvincingly. (Yes. I am a cynic.)
  2. Professor Louis Appleby (Professor of Psychiatry, University of Manchester. Chair, National Suicide Prevention Advisory Group. Department of Health) talked about National Strategy and emphasised that every component of the strategy has to line up in order to impact everyday lives of people. The 5 main points on the strategy were: Local Suicide Prevention plans a must for all Local councils; a sound policy on self-harm; special attention to middle aged men, mental health patients and prisoners, better data collection and bereavement support.

He proposed that if the data was looked at differently, it could mean that the suicide rates were on a decline. Hence, the rising rate of suicide argument may not work. However, we know that suicides are grossly under-reported. So, this statement reminded me that at the end of the day he is an academic and while he does brilliant work, part of his job is playing with numbers.

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(Statistics are used by some as something to lean on rather than to illuminate.)

  1. Rt. Honorable Norman Lamb MP for North Norfolk was the speaker with most conviction and the biggest vision. I am so proud that he is the Patron of the charity I work with, PAPYRUS. He spoke of leadership, immediate investigation of deaths so valuable lessons can be learnt before the facts get fudged and forgotten, GP training and same day referrals of patients with depression to specialist services, stop sending patients out of the area for in-patient care and provide meaningful patient support in the community. He set out a clear ambition of – Zero Suicide. He was the only one in the room who stated:  “Death toll from suicide is intolerably high.”  There is hope.

To be continued tomorrow.