BORE DA - GOOD MORNING

1. BORE DA - GOOD MORNING

2. FACTS AND MYTHS ABOUT MENTAL ILLNESS Jayne Anderson / Bleddyn Lewis

3. Facts and Myths about Mental Illness 1.Mental health problems only happen to other people • Fact: 1 in 4 of the adult population will suffer from mental health problems in any one year, and one in six experiences this at any given time. - The Office for National Statistics Psychiatric Morbidity report (2001). It is estimated that approximately 450 million people worldwide have a mental health problem- World Health Organisation (2001) 2. People with mental illness are violent and dangerous • The risk of being killed by a stranger with a severe mental health problem is roughly 1:10,000,000, about the same probability as being hit by lightning*. The number of homicides by people with schizophrenia is around 30 per year. This is 5% of all homicides, the prevalence of schizophrenia in the population being 1% or less – Avoidable Deaths, Five year report of the national confidential inquiry into suicide and homicide by people with mental illness (December 2006).

4. Facts and Myths about Mental Illness 3. People with mental illness are poor and/or less intelligent • Mental illness, like physical illness, can affect anyone regardless of intelligence, social class or income level. Celebrities such as Stephen Fry, Nick Drake, Paula Yates, Kurt Cobain, Virginia Woolfe, Brooke Shields and Winston Churchill have all experienced mental illness. 4. People who self-harm are attention-seekers • This is untrue. Most people who self-harm do it in secret and it’s only when they need to seek medical attention, that they come to the attention of others

5. Facts and Myths about Mental Illness 5. People with poor mental health are weird • Everyone suffers from low mood and 1 in 4 of the population will experience mental ill health at some point in their lives. Think of 12 people you know. Are 3 of them rocking in the corner muttering to themselves? Thought not. 6. Mental illness is caused by emotional weakness • People do not choose to become mentally ill. As with other medical conditions, like heart disease or diabetes, it has nothing to do with being weak or lacking will-power.

6. Facts and Myths about Mental Illness 7. Once you’ve had a mental illness, you never recover • People can and do recover from mental illness. Medications, psychological interventions, a strong support network and alternative therapy treatments from cognitive behavioural therapy to improved diet and exercise habits are also very effective in leading to a complete recovery 8. Since ‘care in the community’ was started, people with mental health problems have been left to roam the streets • Even before the closure of the old large scale psychiatric hospitals, around 95% of people received care and treatment for mental illnesses in the community. What has changed is the type of accommodation and treatment available. For example, people requiring long term care in a hospital are usually no longer in the same building as those requiring short term admissions.

7. Facts and Myths about Mental Illness 9. All people who suffer from depression are suicidal • Suicide is not a mental illness. Not everyone who is depressed will consider suicide. It is as inaccurate as saying that all football fans are hooligans. However it is true to say that individuals experiencing a mental health problem are, generally, associated with a higher risk of suicide. If you suspect someone is feeling suicidal ask them – it could help save their lives. 10. If I seek help for my mental health problem, others will think I am "crazy" • Early treatment can assist with a faster recovery. If you broke your arm would you delay getting a cast applied incase people thought you were weak? Not likely!

8. Risk Factors: Certain factors can indicate an increased risk of physically violent behaviour . The following lists are not intended to be exhaustive and these risk factors should be considered on an individual basis.

9. Demographic or personal history indicators • History of disturbed / violent behaviours • History of misuse of substances or alcohol • Carers reporting service user’s previous anger or violent feelings • Previous expression of intent to harm others • Evidence of rootlessness or ‘social restlessness’ • Previous use of weapons • Previous established dangerous acts • Severity of previous acts • Known personal trigger factors • Evidence of recent severe stress, particularly a loss event or the threat of loss • One or more of the above in combination with any of the following: • Cruelty to animals • reckless driving • History of bed wetting • Loss of parent before the age of 8 years D(GPP)

10. Clinical variables • Misuse of substances and / or alcohol • Drug effects (disinhibition, alcathisia) • Active symptoms of schizophrenia or mania in particular • Delusions or hallucinations focused on a particular person • Command hallucinations • Preoccupation with violent fantasy • Delusions of control (especially with a violent theme) • Agitation, excitement, overt hostility or suspiciousness • Poor collaboration with suggested treatments • Antisocial, explosive or impulsive personality traits or disorder • Organic dysfunction D(GPP)

11. Situational variables • Extent of social support • Immediate availability of potential weapon • Relationship to potential victim (for example, difficulties in relationship are known) • Access to potential victim • Limit setting (for example, staff members setting parameters for activities, choices, etc.) • Staff attitudes D(GPP)

12. Reference:Violence - The short-term management ofdisturbed/violent behaviour inpsychiatric in-patient settingsand emergency departmentsNICE 2005

13. These were just a few of the most common misconceptions surrounding mental health and mental illness. Unfortunately, there are many more!

14. WHAT AFFECTS MENTAL HEALTH AND WELLBEING ?

15. There is now a considerable amount of evidence about the factors that promote and protect mental health and wellbeing and those which are associated with risk of poor mental health. • Improve Your Mental Health: No matter how old or young you may be, mental health is there in everyday life – in how we think and how we feel, how we react to others and how we are with ourselves. We all need to look after it, just as we do with our physical health.

16. Top Tips for Positive Mental Health • Staying mentally healthy isn't just about treating illness – far from it! There are lots of things we can do to help prevent ourselves getting ill in the first place, and plenty more we can try if we (or those around us) do encounter problems. • So, to get you started, we've put together these Top Tips for Positive Mental Health. Don't keep them under your hat either – tell your family, friends and colleagues. Everyone should know this stuff!

17. Top Tips • Talk about your feelings • Write it down • Keep active • Eat well • Sleep well • Drink sensibly • Keep in touch with friends and loved ones • Get the knowledge, take control • Get professional help • Look beyond drug therapies • Change the scene • Time for another cuppa? • Hold that thought • Go for green • Let there be light • Listen up! • Improve your coping skills • Set realistic goals • Keep an eye on personal stress • Three good things... • Get involved • The long way • Find a hobby • Do good • Ask for help • http://www.wellscotland.info/top-tips.html

18. MEDIA – ENTERTAINMENT OR INFORMATION: HHOW BALANCED IS THIS?

19. Media – Entertainment or Information: How balanced is this? • Some programmes and media outlets are seen as being significantly more helpful than others. In a surveys regional newspapers, regional TV news and regional radio news programmes were all felt to be fairer or more mixed in their coverage than national media. • The Big Issue, The Guardian and EastEnders were all highlighted as fair and balanced reporters of mental health issues. • Sue Baker of Mind said: "Really, it is tabloid coverage which gives us most cause for concern. They are looking for snappy headlines which will sell papers and they inevitably go for 'psycho' angles.

20. Bonkers Bruno Locked Up On Tuesday 23 September 2003, The Sun published the offensive headline "Bonkers Bruno Locked Up". For later editions, this was toned down to "Sad Bruno in mental home". The coverage was roundly condemned by the main groups in the mental health field. At SANE, chief executive Marjorie Wallace said it was "ignorant reporting" and that "it did both the media and the public a huge disservice".

21. Brit, don’t end up like your Gran THE life of troubled BRITNEY SPEARS appears to be unravelling before the eyes of the world. On the surface it seems the pressures of fame have pushed the former Pop Princess to the brink. But today The Sun can reveal that the seeds of the star’s dramatic downfall may well have been sown in her troubled childhood. The demons of suicide, mental and emotional instability, addiction, homelessness and violence all lurk within the multi-millionairess’s dark past. Even her great-uncle, Earnest, has said of Britney: “She didn’t have a hope of turning out normal.” In a chilling parallel to her situation, The Sun can today reveal that Britney’s own GRANDMOTHER committed suicide aged just 31, after her baby son died. And some fear sad Britney’s own sad life could come to a tragic end, just like her poor grandmother’s.

22. I'd kick Britney off the bi-polar express Britney Spears appears to be locked in a downward spiral which, we're reliably informed, is a result of bipolar disorder. Strangely enough Kerry Katona is also a sufferer. This, apparently, accounts for the way these young mothers end up in desperate domestic brawls splashed all over the front pages. The path to self-destruction is not, as we might have imagined, due to an excess of mind-bending drugs, alcohol or general self-indulgence, but in Britney and Kerry's case, the mental disorder, bipolar. So much sexier and hip than manic depression - as it was called until it became trendy.

23. KNIFE THREAT TO COPS Addict slashes own throat after police zap him with Taser. A mental patient slit his own throat after being shot by police with a 50,000-volt Taser. Disturbed Justin Perry suffered massive blood loss which led to a heart attack and he died despite efforts to save him. The drama happened after officers rushed to the home of crack addict Perry when he threatened to kill his mum June.

24. 'Gascoigne thought aliens were coming to abduct him' Paul Gascoigne, pictured here in 2006, has been arrested and sectioned after his allegedly menacing behaviour at the Malmaisonhotel in Gateshead. He became wired and unpredictable and would flip and turn violent over nothing. He was uncontrollable.

25. A more balanced approach?

26. Rethink calls for urgent national attention to prevent another Taylor tragedy 14 December 2007 • Spokesperson for Taylor family says they are “vindicated but destroyed” • Mental health charity Rethink today (December 14) called for national action to prevent the catalogue of failings that led to Garry Taylor killing his friend.

27. Rethink call for action on report from the Disability Rights Commission 27 September 2007 • Leading mental health charity Rethink today (September 27) called for immediate government action to save the lives of thousands of people with schizophrenia after a damning report on health inequalities from the Disability Rights Commission.

28. NEWS RELEASE Monday December 4 2006 • OVER 50 HOMICIDES PER YEAR BY MENTAL HEALTH PATIENTS • National study finds 1 in 20 homicides committed by people with schizophrenia; many are preventable.

29. Avoidable Deaths (2006) • Over 50 homicides are committed each year in England and Wales by mental health patients, according to a new report by the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness (NCI). • Many follow poor recognition of risk by mental health services. However, the number of cases is not increasing, and the risk of random killings by mentally ill people has not risen in the last 30 years. • The NCI examined all suicides and homicides by mental health patients over a 5-year period. Of the 600 homicide convictions per year in England and Wales, it found that 30 (5%) were committed by people with schizophrenia, although only half were known patients.

30. Avoidable Deaths (2006) Cont. Key findings and recommendations from the study on homicide (data collected from April 2000 to December 2003) include: • The Inquiry investigated 249 cases of homicide by people with a history of mental illness – 9% of all homicides in England and Wales during this period. • In the week prior to homicide 71 (29%) patients were seen by services; only 9% were thought to be of short-term moderate or high risk of violent behaviour. • Stranger homicides, i.e. random attacks on members of the public by people with mental illness, have remained at five per year indicating that community care has not increased the risk to the general public. • Services should ensure that high risk patients receive enhanced CPA, backed up by peer review in the most high risk cases.

31. The way forward ! We all have a duty to: • KEEP AN OPEN MIND • BE INFORMED • PROMOTE GOOD MENTAL HEALTH • TACKLE STIGMA

32. STEPPING STONES. ONE STEP AT A TIME … Richard Jones

33. Recovery

34. A process of recovering from a mental health problem

35. What is Mental Health? • The concept of ‘madness’ is one which is accepted globally across many different cultures. • In modern Western culture it is viewed as an ‘illness’ or ‘disease’. • Because people are viewed as ill they are generally relieved of their usual responsibilities and their support becomes the domain of professionals.

36. The mentally ill person is often seen as an ‘other’. • A distinct class of person. • Different and apart from ‘normal’ people. • They become the illness that they are deemed to have ‘schizophrenic’, ‘manic depressive’, ‘anorexic’.

37. “Is it possible to restore these people to full humanity when we actually fear their difference so much and when they themselves secretly feel less than human?” Campbell (1998)

38. The difference between the medical view and the person’s experience beyond symptoms and deficits…

39. The person “Today I wanted to die. Everything was hurting. My body was screaming. I saw the doctor. I said nothing. Now I feel terrible. Nothing seems good and nothing seems possible.” Written in a patient’s diary

40. The Doctor Flat. Lacking in motivation, sleep and appetite good. Discussed aetiology. Cont. LiCarb 250mg qid. Levels next time. Written in medical notes from Repper & Perkins (2003)

41. What do people want frommental health services?

42. Choice • Accessibility • Advocacy • Equal opportunities • Income and employment • Self help • Self organisation Read (1996)

43. What do they feel are their unmet needs?

44. Adequate income • Intimacy • Privacy • Meaningful work • A satisfying social life • Happiness • Adequate resources • Warmth Estroff (1993)

45. So… What is recovery?

46. It is not a cure

47. “A personal process of overcoming the negative impact of a psychiatric disability despite its continued presence.”

48. It involves • personal development and transformation • acceptance of the illness • a sense of responsibility or control over one’s life • hope • the support of others • and working collaboratively with others on treatment and rehabilitation.

49. What matters? • Are we living the life we want to be living? • Are we achieving our personal goals? • Do we have friends? • Do we have connections with the community? • Are we contributing or giving back in some way?

50. Recovery is a process, not a place.Looking at where we want to be and what we want to achieve. Not where we came from.