Thursday, 24 November 2016

Boxing Shadows - The Welsh Mental Health Arts Festival 2016

Boxing Shadows is an exhibition of over 30 artists made up of sculpture, paintings, drawings, films and ceramics in parallel with artist Stephen Park's Residency Exhibition at Celf o Gwmpas in Llandrindod Wells. It is on until 5 January 2017, and last week I attended a panel discussion and artist talks as part of the second annual Welsh Mental Health Arts Festival. Other activities scheduled at Celf as part of the week long event in partnership with Disability Arts Cymru and Making Minds 'WALLS: MURIAU' included a Comedy Evening and a drop-in workshop with new arts group Celf-Able.

Artist Rachel Dunlop wrote about the year-long Learning and Practice project at Celf o Gwmpas back in the summer, taking an in-depth look at the sessional weekends for artists who have experience or knowledge of the arts and mental health. Artist in residence Stephen Park and Powys artist Blue MacAskill have been engaging and working with artists "who have knowledge and experience of mental ill health from across the county. Working together, they have developed knowledge, practice, experience and creative aspirations and promoted wider understanding of arts and mental health".

Jane Cooke from our team with sculpture by Geraint Edwards
The panel discussion provided a great opportunity for a more in depth discussion around arts and mental health. It was attended by individuals, artists, voluntary organisations and professionals engaged in both the art and mental health sectors.

Stephen Park, a graduate of Goldsmiths College and the Slade School in London, was first up to speak. He told us that for 10 years he had been a mental health support worker, and for 15 years he was on the periphery of the art world working in art colleges. This was the first time, however, that he had spoken to both sectors "in one sentence". 

Artist-in-Residence Stephen Park
He said that in mental health there is the perception that there are lots of different approaches, probably conflicting. "It is a mix-and-match approach to help you. It is the same in art college – people are trying to become themselves and flourish. There are lots of confusing approaches."

Stephen does not feel he belongs to the art establishment – the academic world of art colleges, museums, and critical thinking. He feels the same about mental health. Institutions such as hospitals and charities have their own agenda that does not quite correspond to the internal experience of the person in it with mental health difficulties. Or the novice artist trying to find/identify a way of working.

He said that in mental health there is the idea that art is good for you. Yet staff have no understanding whatsoever what art is. "Art is terribly important. You should do it even if it is bad for you. For artists the worst eventuality is to become a zombie – doing everything to tick a box.... pay a mortgage... Artists see this and are frightened of it".

Stephen explained that he was invited by Celf o Gwmpas to run a workshop with a mental health angle. He did not take the angle of mental illness – he does not have the language for that. He can, however, understand confusion and distress. So he designed a course – having spoken to hundreds of creative people – that is one size fits all.

"If you have a creative impulse it is an infinite space which is very daunting. You need a compass and confidence and faith in what you have done. You don’t rely on other people too much".

Much lively debate ensued. Some of the points raised included:
  • There is always a focus on being positive. Society has an obsession with being happy all the time and there is something wrong with you if you have negative feelings. We should be allowed to be sad. 
  • An acknowledgement of the beauty of this project – it took people as they are and let them express their feelings in art if they wanted to – or not. 
  • The job of the artist is to ask questions. 
  • The job is to make something that was not there before. It might be questioned.

Next on the panel to speak was Sean Burns  a writer, performer and outsider artist whose work has been influenced by his experiences of psychosis. He read some of his poetry and spoke about the politics of mental health.

 “Words are weapons and I’m in a war. The war hasn’t stopped.” Andrew Vachss

A mental health support worker once said to Sean: “What d’you need books for? You’re homeless.”

Artist and poet Sean Burns, with Rachel Dunlop on his right
Sean was the first artist in residence at Celf five years ago. His latest project is Waters of Life – “creative mappings related to mental distress” – a journey along the River Usk from source to sea. His experience of the source – “it was the first time I had seen such wide horizons and it really opened my thinking.”

He spoke about Gwyneth Lewis's book "Sunbathing in the Rain" – a cheerful book about depression. “The cure for depression is the truth… It teaches you slowly to live better.”

Sean read "Gob Squad Arriving" – a poem he wrote after going to his first punk gig in 1981 in Brecon against his psychiatrist’s orders. “Learn to love your madnesses.”

Celf-Able - a new art group
Celf-Able is a new group of disabled artists in Mid Wales, meeting regularly in Newtown and Llandrindod Wells. Amanda Wells (second from left) introduced the group and encouraged people to join. There was a brief discussion on the difference between a disabled artist and a disability artist. Amanda said that the latter looks at issues of disability through art. 

The debate continued - and there was much lively discussion about the values (or not) of receiving funding to pursue artistic aims, whether as an individual or an organisation.

Stephen said that "Art and creativity is not something done by experts elsewhere. It’s done here and now. You dive in. Participate. Resourcefulness is a prime quality for artists. We can either say – they won’t let me in – and just sit there. Or we can do it ourselves. You will feel vulnerable, exposed.... scared even. But it has to be that way. That’s how you become strong and find your voice and participate. Art will always surface regardless of funding. People will use what they have in the time available."

Jane and Jackie: PAVO mental health team
Jane Cooke attended the panel with three hats on – as the Mental Health Senior Officer at PAVO, as a counsellor, and as a trustee of Celf o Gwmpas.

She talked about the language of mental illness, and asked the question – why art and mental health? How do people feel at the end of taking part? Elated? With increased confidence? Courage? Self-esteem? Involvement in other projects such as sport or the environment could attract those words. It is about oneself – referring to oneself and the rest of the world and how you make sense of things like stigma.

She spoke about the work of the PAVO mental health team, and involvement on various boards and partnerships. "When the words mental health are used, people are not referring to feeling great about yourself, "that was terrific, fantastic…" Rather it’s another way of saying mental illness".

"Health is a good thing. The language of mental health is of illness… disorders… conditions. It’s not the truth, it’s a construct. A lot of intelligent people are now challenging that." She likes to think what it would be like to create a project for “well-ordered” people. Jane encouraged us not to use the language of mental illness when writing funding bids or reports. 

She concluded by saying that "projects like Boxing Shadows help people to get beyond their internal difficulties and barriers – so there is a real value to getting funding. It gets people to a place they wouldn’t have done without it".

To find out more contact Celf o Gwmpas, tel: 01597 822777 or email:

Monday, 14 November 2016

Prevention & Early Intervention - the mental health conversation

The mental health conversation; PAVO's CEO Carl Cooper; Jane & Jackie PAVO mental health team

Last Tuesday 8 November I attended the PAVO AGM and Conference at Cefn Lea Conference Centre near Newtown along with colleagues and respresentatives from voluntary sector groups, the statutory sector, and numerous other individuals. The theme this year was: Prevention & Early Intervention - the Third Sector role in Powys.

The conference invitation stated: "It is widely acknowledged that Third Sector organisations and services have an essential role to play in prevention and early intervention. This conference will explore how these services could be an integral part of a common direction in Powys".

Carl Cooper, our PAVO CEO, opened the conference by saying: "We are delighted to have this as our theme. It is important particularly in light of the Social Services and Wellbeing (Wales) Act which highlights that support and care should be provided at an early stage to those requiring it to prevent worse things happening later in life's journey. The Third Sector has a crucial role to play in that." 

Carl then introduced the first speaker, Dylan Owen, the Head of Social Care Transformation at Powys County Council.

Dylan explained that the Early Intervention and Prevention agenda is driving council services forward to make sure that people's wellbeing is supported in the community. This includes working to support people to re-engage with their communities, and to do what matters to them.

In the past social care planning has followed a path of assessment - providing care - looking at the deficits and weaknesses - and solving problems. Now this approach is being turned on its head, with a duty to support people to make their own decisions. 

Dylan described how the council is already working closely with the PAVO Third Sector Brokers to find alternatives to help people to live independently. Isolation and loneliness are often the first step to becoming dependent on social care services, and other initiatives, such as the Powys Befrienders project, where paid co-ordinators work with trained volunteers across Powys to support people to engage with their communities, (ideally in their own language), have also proved very successful.

Community Wellbeing Co-ordinators and Home Based Support, working from community hubs, were other key services also covered in Dylan's presentation.

Next up was Stuart Bourne, Assistant Director of Public Health at Powys Teaching Health Board.

Stuart referred extensively to the Health Board's Integrated Medium Term Plan (IMTP) which sets out the health priorities for Powys up until 2018 (it is discussed in more detail in our March post Engaging with PTHB to shape future services). The IMTP contains many elements of early intervention and prevention, including approaches which benefit from joint working with the Third Sector.

Stuart emphasised the impact of quick and easy early intervention by referring to "the 30 second chat that can trigger weight loss" as recently reported widely following a University of Oxford trial. Here at PAVO we are already familiar with initiatives such as The Five Ways to Wellbeing and Making Every Contact Count.

The formal presentations were followed by 10 "conversation" groups, of which Mental Health & Wellbeing was one. Jane from our team facilitated, with support from Val Walker of Brecon & District Mind. Those who signed up included Third Sector organisations such as Hafal, Cymryd Rhan, Hay Day Cafe and Ponthafren Association, individuals who have been in contact with mental health services, carers and employees of PTHB. 

The mental health "conversation" gets underway at the PAVO Conference
The group was asked to consider some key questions as part of a larger discussion around the conference theme, including: What will this new approach to Prevention and Early Intervention mean for our organisations and the services we provide?

Some interesting points and questions were raised. There is not the space to outline them all, but here are a few to give a flavour of the session:
  • If people have dementia then making cognitive decisions about their future care could be stressful. How would this be handled?
  • People want safety and security, particularly as they grow older. Not all people will wish to stay in their own homes. There needs to be a broad range of options made available.
  • Community based means person-centred. Learn from the Third Sector who have been working this way for years.
  • A lot of community services are being closed down and there is a huge dependence on volunteers. Where is the money coming from to support this volunteering?

It was clear from the conversation that there is a gap in services before people who are distressed seek support around mental health from their GP. What does that look like? Is it more than an Information Service? Is it an additional specific role, and if so doing what?

There is also a huge issue because of the waiting lists for talking therapies in Powys. In many ways talking to someone is a form of early intervention, but if we cannot meet the demand currently what can we do differently?

Good practice around early intervention was identified in pockets around Powys and all agreed that it would be excellent if such activities could be rolled out throughout the rest of the county. We found out a little more about one particular project.

The Active Monitoring project being run by Brecon & District Mind
Val updated us on the progress of this new service which operates out of Hay and Talgarth GP surgeries, and is a joint project between the GPs in that area and Brecon & District Mind. This early intervention service will mean that the practice clinical team are able to refer anyone with symptoms of anxiety, depression, low self-esteem or stress directly to a Mind Practitioner in the surgery to be seen straight away.

To date 29 people have been seen by the Brecon Mind Practitioner in the first 6 weeks of the project. They have progressed through five sessions and the results show a definite improvement in their state of wellbeing. Others have been signposted to other organisations such as Cruse, the bereavement charity, for ongoing support. Val believed further signposting should be instigated so that the massive waiting lists for talking therapies could be addressed.

Active Monitoring is popular in other parts of Wales, including Merthyr Tydfil, and started in North-West England where it is now embedded in Primary Care services after being rolled out in 47 surgeries.

Val Walker, Service Director, Brecon & District Mind
We also heard about a relatively new Hafal pilot project in Bridgend and Swansea "to provide early intervention services to service users and families, focusing on the direct needs of young people (14 - 35) experiencing a first episode of psychosis". Referrals are made by the Community Mental Health Team and picked up by one of three part-time Hafal workers. The staff support individuals through a programme with a view to move on to community engagement or further education using Hafal’s Recovery Programme as the basis for doing this.

Jane summarised the key point to feed back to the conference
We had to pick one key point from the mental health conversation to feed back to the conference. Impossible! We had loads! Eventually we narrowed them down to three as a group, and magically Jane managed to merge them as one!
  • A lot more work is required in consultation with the Third Sector.
  • Communication is massive.
  • A better understanding of mental health is required by all. It needs to be normalised.
If you were not able to attend the PAVO Conference this year, what would you have liked to add to our mental health conversation on Early Intervention and Prevention? Let us know in the comments box below, we always love hearing from our readers.

Adrian Osbourne is Assistant Director, Engagement & Communication, at Powys Teaching Health Board. Read his Twitter Storify summary of the day.

Monday, 7 November 2016

The Blue Boy

Our guest post this week is by a member of the new Llandrindod Autism Support Group which takes place monthly at Mid Powys Mind's Resource Centre in Llandrindod Wells.

Llandrindod Autism Support Group is a place where people are accepted for who they are and can be themselves without being misunderstood or unfairly judged for being "different".

We like to talk about what it's like to see the world in a different way from those around us and how we try to cope with the everyday world.

At the next meeting, on 11 November, we shall be discussing anxiety and what we do to reduce or avoid it. I would encourage anyone who is on the autistic spectrum, or who thinks they may be, to come along and meet others like them.

This is my story…

When I delivered my son Mark on the first of July 1995, I had no idea of the incredible journey I would take in learning about Autism and how differently I’d see the world 21 years later.

There was nothing particularly unusual about Mark’s first year and my wife and I settled into parenting our first child thinking we had it all worked out. The first indication that Mark’s brain was wired differently was when he crawled into the kitchen, put the palm of one hand on the oven door and just left it there. I pulled his hand away and the blisters healed quickly. What we now know are autistic meltdowns became common, especially in shops, and we became accustomed to withering looks directed at us by other shoppers as Mark lay on the floor screaming.

From about age four, it became clear that Mark didn’t understand other children – if they caused problems he would neither try to stop them or walk away. My heart went out to him – deep down I recognised this from my own childhood.

We had already decided to educate Mark ourselves and looking back we all agree this was the best option. It gave Mark the chance to learn with less distractions than in a class room and gave us the chance to make sure Mark’s social life was one he would benefit from.

When Mark was about ten years old, we went along to our own local group for children with Asperger syndrome and met other parents struggling with oppositional behaviour, meltdowns and problems coping with school. The groups supported each other by sharing their troubles and listening without judgement. There were also books to borrow and I read avidly about other parents' experiences bringing up autistic children.

There were unexpected things such as sharing interests in historic architecture and the paintings of Gainsborough with Mark from age six, and reading and discussing philosophy from age ten. Mark developed a passion for Jazz and we played most days until he started college.

What made life so difficult was seemingly compulsive oppositional behaviour which happened many times every day and drove us close to nervous breakdown. For example, he would not get dressed to go out, even to do his favourite things such as spending a day on the local steam railway, and as the time to leave got closer we became more and more frustrated and stressed and Mark got more resistant to our pleas. Imagine this behaviour in almost every situation and you might just begin to understand why autistic children and their parents need all the support and understanding they can get.

Embracing Individuality – a group for those on the autistic spectrum or those who think they may be – takes place on the second Friday of each month, 10.30am – 12.30pm at the Resource Centre, Mid Powys Mind, Llandrindod Wells, LD1 5DH. 

For board games, a chat and a discussion about what you would like to happen next.

For further information please ring Paul on 01686 440716, email or check out the Powys Autism Facebook page.

Wednesday, 2 November 2016

National Stress Awareness Day 2016

The PAVO mental health team’s way of trying to reduce stress in the workplace – 
“Havin’ A Laugh” whilst promoting the elephant in the room recently.

One of the most popular posts on our blog over the past five years is from the very early days and simply called National Stress Awareness Day. In it we highlighted the sad fact that at that time in 2012 stress levels in the UK had doubled in the past four years, and outlined some of the well-known causes of stress. We also listed the Top 10 Tips for addressing stress, and, given the fact this is one of our most popular ever postings, hope these have proved helpful to many readers over the years.

This year the theme for National Stress Awareness Day – Wednesday 2 November – is Workforce Wellness – Your Prime Investment. The International Stress Management Association, the charity which promotes this national day, has drawn up a new list of tips specifically related to the theme:

1. Start to put yourself first
If you eat and drink healthily, schedule regular physical activity that you enjoy, and manage your time effectively, you’ll be in a better position to help others.

2. Start to prioritise tasks
There are only so many things we can do well during each day,so choose your top 3 most urgent tasks each morning and make them your priority. Reschedule, renegotiate your commitments or delegate – you can make it happen!

3. Start to make time to relax and mentally unwind
Relaxation, breathing and meditation exercises have been proven to be effective in reducing stress and anxiety, they are ideal ways to switch off AND they boost your immune system. Just a few minutes a day will pay huge dividends.

4. Start to empathise with others
There are many different behaviour styles that affect how we communicate with each other. Be aware that different people can perceive your words and actions in a way you didn’t always intend. Take time to listen to others and look for solutions.

5. Start to live life to the full
Bring some fun into your life and spend a few minutes each day appreciating the good things you have in your life. This will help you to see opportunities for growth and learning, even from the most challenging situations.

6. Stop ignoring your needs
Know what is expected of you and what is reasonable. Take short breaks throughout the day and know when and how to say ‘No’ both at work and home.

7. Stop getting distracted
If you’re experiencing too much pressure or just have a lot going on in your life, staying focused isn’t easy. It may help to ask for support from colleagues or friends and prioritise urgent, important and non-urgent tasks.

8. Stop allowing others to make you feel inferior

The key to stress-free living is to accept yourself for exactly who you are today, including past mistakes and things you might not be so proud of. Work on your self-belief and confidence and just go for it!

9. Stop being judgemental

Try to adopt a more flexible thinking style which will improve your mental well-being, whilst reducing unnecessary pressure for both you and those around you. Practice being objective and understanding.

10. Stop avoiding the things you least want to do
We often put off tasks that can become a recipe for worry. Take control and promise yourself a reward when you get it done.

The Royal College of Nursing has also produced an excellent guide: Healthy workplace, healthy you. It is aimed at nursing staff, but much of the information about the signs and symptoms of stress, and tips for reducing and managing stress, are relevant to anyone in the workplace.

Finally, if you are reading this in Autumn 2016, feeling stressed and living in Powys, there are other things you can do to help address the situation. Several courses are just about to start up across the county which are looking at stress, anger management, and positive approaches to managing your life including addressing how stress impacts on day-to-day activities and what you can do to reduce it.

Mid Powys Mind
Stress and Anxiety Management course – Llandrindod Wells, Mid Powys
23 & 30 November, 2 December.
Tel: 01597 824411 for further information.

Pain & Fatigue Management Centre
ACTivate Your Life course – Bronllys Hospital, South Powys
28 November, 5, 12 & 19 December.
The 4 week ACTivate Your Life course was developed by Professor Neil Frude, a Clinical Psychologist with over 40 years’ experience of helping people to learn and practice the core principles of Acceptance, Commitment Therapy or ACT. Tel: 01874 712449 for further information.

Ponthafren Association
Anger Management course – North Powys
The charity is currently drawing up a waiting list of people ready to start a new course in the next few months. Please let staff or volunteers know if you are interested by ringing 01686 621586.

Ystradgynlais Mind
Confidence & Assertiveness course 
This 4 weekly course will be starting again in the New Year. Please let staff or volunteers know if you are interested by ringing 01639 841345.

These are just a few examples of courses and activities running in Powys this Autumn and Winter. To find out more check out the Powys Mental Health website events calendar.

Do you have experience of stress in the workplace? And do you have some good tips which you could share with us which may help others? Let us know in the comments box below.