What could be different in mental health care, what helps, and what have you found to be useful reading?

[OwFriggingOw]

First off - this is a thread inspired by another thread - not about another thread.

I am a lecturer who teaches mainly MH nursing students, but also Adult, Child and Learning Disability field nurses about MH, and also occasionally medical students. I have no agenda for this thread bar a genuine desire to listen, share ideas, and have an open discussion about what is helpful / less so. I worked in NHS MH for 13 odd years.

In case anyone links the other threads that inspired this thread - I have been comissioned to edit a book about people's experiences (service users and carers / family / friends) within MH services and with MH issues. NONE OF THE POSTS HERE WILL BE USED IN ANY WAY, SHAPE OR FORM FOR THIS BOOK. You have my ABSOLUTE word on that. Similarly, NONE of the posts here will be used in any of my teaching.

My aim in starting this stems from several PM's and several on-thread comments about how this would be useful/ I hope it can be a helpful, supportive and productive meeting place for thoughts and ideas about what people have found helpful with regards MH care / services / support (statutory and non statutory) and what has been less helpful. Most importantly with regards the less helpful - what can be done differently?

And - beacuse I like books - maybe we can share reading ideas :)

Would it be helpful if I shared parts of my long thread from earlier regarding what I see as needed, without any other details from the thread?

Sorry - awesome because she apologised and acknowledged :)

Checking into thread.

maryz that's so tough - I can't imagine anything worse than watching your child go through such a challenging time :(

It's something I've heard a lot too - that carers / parents / family / friends don't feel heard or supported. I wish I knew what a middle ground was that respected the right of individuals to confidentiality and choice over who they see / have involved, and support that meets the need of exhausted and naturally worried supporters / parents etc.

I know there are some REThink carer support groups that used to be up an running in London and major cities - not sure if they're still around?

I wasn't sure about adolescent services either maryz, and the horrible overlapping period - my daughter ended up in an adult ward when she was 17 and I have never forgotten the suicide of a 17yo on an adult ward and had to push very hard to get her transferred to an appropriate hospital (there are no beds for adolescents in Suffolk and the hospital tried to tell me that adolescent wards don't exist anywhere, despite her having previously been an inpatient in one in Cambridge).

Have also had the same difficulties with daughter not engaging with the services and refusing help and have had to have her sectioned on more than one occasion. It is an extraordinarily difficult thing to do.

Not a ramble at all :) So pleased you had a supportive GP - as a first point of contact that can make all the difference. More GP training would possibly be a helpful route forward?

And I'm not sure about computerised CBT - it wasn't around before I left the NHS - I always thought that the personal relationship as well as the intervention was really important? Happy to be proved wrong if people HAVE found it helpful :)

So so pleased people are able to share positive elements of care as well as those that are less helpful :)

X-posted - YES a million % - self harm is a really misunderstood experience, and very stigmatised :(

someone was telling me about a hospital ward where patients who cut (I know there are a lot of ways to self harm but that is often what people mean?) are given blades so they can do it under controlled conditions but I can't remember if it was in the UK

I find it difficult to understand even though most of my favourite behaviours are quite harmful one way or another

There is an approach to self harm known as harm reduction or harm minimisation whereby the aim is to reduce the overall damage rather than preventing people from harming at all - I think the aim is to acknowledge it is a coping strategy that can't just be stopped, but that it's one that can be really damaging hence trying to support a person towards reducing the amount of damage?

Prob not explaining it very well!

First book suggestion :)
Really good book that I THINK acknowledges harm reduction as well as other approaches is Barent Walsh 'Treating Self Injury: A Practical Guide' - I remember reading it a few years back and finding it really empathic, supportive and understanding rather than patronising or inaccessible?

It is aimed at clinicians as are most books on self harm - but accessible and clear?

I don't mean that patronisingly by the way - just a lot of clinical texts can be quite detached from the experience if that makes sense and very clinical focused - I seem to remember recommending this one to a friend who harmed herself - and she found it really useful.

alameda a project that i worked in had that ethos. harm minimisation. access to clean blades and steristrips etc. but the focus was also on peer support and talking in groups and one to one also so it did actually work.

xposted with ow- sorry :)

Ah not come across mindgym - one to research tomorrow thank you :)

i posted this on another thread but this centre is an amazing resource for sh

www.selfinjurysupport.org.uk

and maryz, sorry to hear about your son- must be heartbreaking

www.selfinjurysupport.org.uk

And yes to self harm inducing polarised reactions - I hope o was always supportive, though I remember finding it frightening because i so wanted to help the person 'get better' initially, which may well have come across as alarmist or not useful. I had a fantastic manager at the time who gave a pile of books which helped me learn about different reasons, unhelpful and helpful approaches, and that its generally not about suicidal feelings but coping with immense and usually negative emotions.

thanks, I might look that up when I'm in the mood - my daughter used to cut herself a lot and sometimes badly but she has either moved on or replaced it with other things, generally she seems much better at the moment

maryz am just wondering if you too have had to have a lot of family therapy and whether any of that was helpful? I was exasperated by the constant focus on it, regardless of the problem, perhaps it was the CBT of its day but we did have some very good and useful family therapy at one hospital.

Can I just ask, how do you access this IAPT thing? I hadn't heard of it before today. Do you still have to go through your GP (in which case I'm stuffed) or can I get in touch with the nearest big psych hospital directly?

There is a CMHT in this very small town - I had excellent therapy there - but they've signed me off and won't have me back.

that is really good to hear! :)