Tag Archives: talking therapies

Cashpoint

26 Aug

Talking potatoes Family Superfoods

You know the first thing friends from the psychiatric ward ask when we bump into each other? “Have you been back in since?” We just want to stay out. Our ward wouldn’t pass the “friends & family test”: going back to that place is seen as the worst thing that could happen. “Hi! How you doing? Been back in? “No. You?” “No, thank goodness. What’ve you been up to?” “Doing what I need to do to stay out.” “Me too.”

Last night at a cashpoint, a tall young woman approached me. “Got any spare change? My benefits were stopped. I’ve got no food or electricity.” She looked into my eyes, from eye to eye, imploring. “I’ve got no money. My benefits were stopped.” Hang on … We looked again and recognised each other from the ward. Back then, she was so vulnerable, so easily led, so naive. Just a teenager. She’d been in for 18 months.

“Are you still with the community mental health team?” I asked? Last time I’d seen her, she’d been there with her mum, waiting in the waiting room for an appointment. “Yes,” she said. “Let’s make an appointment with the benefits adviser. She’s really good. She’ll help with your benefits. They’re stopping them for the least little thing at the moment. Maybe she can get you help with a loan or a grant or something.” She looked around. “How’s your mum? Is she okay?” “I don’t know. We had an argument. We don’t speak any more. Do you have any spare change?”

“What would you like me to buy you?” I asked her. The cashpoint was outside a supermarket. “I was just going into the shop. Come with me and choose something nice to eat.” She shifted from foot to foot, looked down, looked up into my eyes again. “I just need cash. I’ve got no electricity or food at home. Can you give me some cash?”

“Come back to my house then.” I lived just round the corner. “I’ll cook you dinner. What would you like?” “No thanks. I just want money. Have you got any spare change?” Her skin was bad. She’d cut her hair short. Her glow was gone. She kept looking around behind my head, shifting from foot to foot.

In hospital, she’d been beautiful, naive and full of enthusiasm. She wanted to be a doctor. Or a model. Or both. She had no street smarts or guile. Just an enormous smile.

As a girl, she’d had an argument with her bullying brother one night and had run away from home. She’d been placed in a hostel, a safe place for vulnerable young people to stay. In the hostel, she’d been sexually assaulted by another resident. The mutual friend she’d confided in hadn’t believed her. Had blamed her. She hadn’t told anyone else about the assault. She was young and naive and hadn’t known how to deal with it. She’d kept living at the hostel. With her attacker. Who’d come back for more.

She’d stopped eating when her food started talking to her; when she could see little mouths in the baked beans speaking to her. When she’d become so skinny people noticed, she’d told them about the little mouths in the baked beans. She hadn’t told them about the assaults. It takes time and trust to build up to telling someone something like that. And she hadn’t had that.

She’d been taken from the hostel to the psychiatric hospital. They’d given her drugs for the little mouths in the baked beans; for the food that was speaking to her. They’d kept giving her more drugs and more drugs till she’d told them the food wasn’t talking to her any more and had put on weight.

When I met her on ward, she’d been there for 18 months. She hadn’t had any talking therapy. Just drugs. She hadn’t had any help to prepare for life outside the ward. Just weekly group sessions with the occupational therapists where we painted our toenails or tasted smoothies. But at least she wasn’t skinny any more.

When I met her on ward, she was so sweet and helpless that everyone was protective and did stuff for her. I encouraged her to learn to do things for herself: she’d need that when she got out; or at least the confidence to believe she could learn to do things for herself.

One day, she asked me to put on false eyelashes for her. Instead, I taught her how to do it herself. It took the whole evening. But she did it. Next day, she came back & showed me she’d done it herself. They weren’t on quite straight, but she was so pleased and proud. I was too. False eyelashes rock. She looked fabulous on the outside, with her dramatic eye make-up; and she felt fabulous on the inside, with her sense of achievement.

Next day, she told me about the assaults. She told me about her life and how she’d ended up on ward. She told me she was due for discharge soon. She said she’d started to see the little mouths in the baked beans again.

I didn’t know what to do. My mind was blown by that place, by what they’d done to me there. It was too big for me to process. Hearing her disclosure scorched my brain as I listened. All I could think of to do was to tell her to tell the nurses.

She told the nurses about the little mouths in the baked beans. But not about the assaults. She still hadn’t talked about those. They increased the drugs dose to make the little mouths in the baked beans go away again. She was discharged shortly afterwards and placed in a shared flat with a stranger. After 18 months on ward. And still a teenager. She didn’t know how to wash her clothes, cook, or budget. She couldn’t even keep her room on ward tidy.

Looking at her last night, I wondered whether, all these years later, she’s had any help to process the sexual assaults. Any help with the voices. Any help with managing her life. I wondered if it mattered. Or if drugs were enough. I couldn’t tell how she was. I only knew that she was different. I only knew that I held both her hands and squeezed them as I looked into her eyes, and hugged her and hugged her, then saw her slowly walk away.

And, of course, we both knew – because it’s the first thing we ask when we meet a ward friend – that we hadn’t been back in since.

So tomorrow I’ll drop a note to CMHT asking them to check up on her. She’s too vulnerable to be begging at cashpoints. I don’t know what else to do for the best.

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Links to related websites:

  • My Storify story of tweets – Cashpoint
  • A rather creepy video of talking food (1 min) used to promote TV show Family Supercooks, an initiative of the Food Standards Agency and the Good Food Channel
  • Eleanor Longden: The voices in my head (14 mins) – her recent fascinating and inspiring TED talk

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When I came out of hospital, I thought I’d be focussing on getting better …

23 Mar

Way out sign

Here are some tweets about the bumpy road I’ve been on since being discharged from hospital. I thought I’d be focussing on getting better.I thought I’d be resting my mind and doing things to nurture myself mentally and physically. Instead, I’ve had to focus on lots of other things.

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Hot baths & how I relax

4 Feb

The new cover for The Bell JarIMG-20130124-00982

“There must be quite a few things a hot bath won’t cure, but I don’t know many of them.” So wrote poet Sylvia Plath in her novel The Bell Jar, whose central character has clinical depression. Hot baths are certainly a remedy I turn to when feeling out of sorts. There’s a reason my Twitter avatar is a bath filled with hot water.

Last weekend, I was with a group who took turns to share one thing they did to nurture themselves, as a pick-me-up, to relax. Naturally I  mentioned my favourite cure all, the hot bath. One woman, when asked what she did to nurture herself, burst into tears and said she never had any time for herself. Then she remembered she’d recently had her nails done, and her nails were indeed a glorious deep berry colour. And, as we went round the group, we all learned new ways we could try out to relax ourselves.

I was really inspired by some of the suggestions, so thought I’d share them with the lovely Twitter people and at the same time ask them for their tips. If you can’t think of some way to nurture yourself, or are looking for some inspiration from things that work for others, take a look at the suggestions below and in the linked Storify story of tweets where there are many more.

I’m pretty sure there’s something for everyone! And if you have a tip of your own to share, please feel free to comment below or tweet me to be added to the Storify story of tweets.

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Here are some things the women in the group said they did to relax, to nurture themselves, to care for themselves:

“I sit in a coffee shop & watch people.”

“On Sunday, when I go for my long run, I take off my watch, leave my phone behind & just go.”

“I read gossip magazines like Okay. It feels good to focus on something completely superficial.”

“I put on my snuggly dressing gown. Whatever I’m doing, it’s really comforting.”

“One Sunday a month, I turn everything electrical off for the whole day.”

“Walking in nature” & “Walking my dogs.”

“On summer afternoons, I lie on the trampoline in the garden in the sunshine. In winter, I watch TV series.”

“I go to a spa or get a pedicure” & “I paint my nails”.

“I try on clothes in expensive shops!”

“I sit on my prayer mat & imagine it’s a magic carpet transporting me somewhere calm.”

“I spray my favourite perfume in the air” & “I use aromatherapy oils”.

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Here are some suggestions from the lovely Twitter people when I asked the following:

What helps you to nurture yourself when you’re feeling out of sorts? What says “me time” to you? What do you to relax? What are your tips? #howIrelax

  • I bake, put radio 4 on and create yummy food … lifts my spirits always (Fibrogirl @fibro_girl)
  • I always watch police programmes – watch someone else get into trouble for a change! (Petrolhead999 @Petrolhead999)
  • My garden, birdwatching, long hot bubble baths, my cats and music (I make ‘rescue’ cds/playlists) for when things are bleak (Liz (@redliz)
  • Do something you enjoy: baking, reading, dancing, seeing friends/family, walking, running, painting. Put a hole in your stress bucket. (LYPFT Library @lypftlib)
  • Hot bath,relaxing music, undersea nature documentary, drawing/painting/collage, writing poetry and masturbation (Michael Brown @brownie1983)
  • Long hot bubble bath seconded. (Stroppy Ambo Woman @Stroppyambo)
  • Watching my pets, baking, knitting, youtubing animals. (Just another one @priorynutter)
  • With mental health specifically: just stopping & forgetting any responsibility I feel to “work through” the feelings of anxiety & depression. (Coffee Zombie @xcoffeezombiex)
  • I play the keyboard. When low it brings me out of myself, when high it burns off rocket fuel safely (Polarbearcub @megandoodah)
  • Knitting, as it helps to keep my mind and my body occupied. I also essential oils as smell is an easy distraction technique. (Bexatron @DuckBeaki)
  • Bath, music, horlicks, clean sheets. oh, and crochet! (Ceri Jones @liberatedwomble)
  • People watching is great. Listen to music. (ForeverMorrissey @Mozgirl71)
  • I take a nice long hot bubble bath, light some incense and candles and play calming music (Sarah @sarahxXx1990)
  • I tend to put headphones on to block out the world with music or a marathon of a favorite tv show. (Roiben @roiben)
  • I’ve always been helped by music, both listening and playing, can relax, elate, or show you’re not on your own (Shaun Blezard @cluttermusic)
  • I watch the sunrise, and sunset! (Rokayah415 @Rokayah415)
  • Read novels, swim, workout at the gym, pat my cat, go shopping (not food), watch movies (Anna Butterfly @aButterfly123)
  • As a nerd I play computer games to purge my mind of the insanity of my day. Nothing like wiping out Alien hordes to destress (Notjarvis @notjarvis)
  • Has to be the relax cd by Paul McKenna for me with benzoin aromatherapy oil! (Michelle @oldtrouty)
  • Favourite music, lush baths & clouds. Oh … and Twitter – for good virtual support from good people. (Kimbohud @Kimbohud)

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If you have any suggestions of your own, please comment below, or tweet me to be added to the Storify story (check it out – there are many more helpful suggestions here too).

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  • Storify story “How I relax” of my tweets & those of others. (Last week I learned from Victoria Betton (@VictoriaBetton) that asking people to contribute in this way is called “crowd sourcing”!)
  • Another good way (backed up by science) for reducing stress and anxiety is to look at images of nature & other cute stuff – so I also have a page of cute stuff that I update as I come across new material.
  • Sylvia Plath’s novel The Bell Jar was in the news last week when a new 50th anniversary edition was issued with a controversial “chick lit” cover (pictured above) – eg “The Bell Jar’s new cover derided for branding Sylvia Plath novel as chick lit” (Guardian, 1st February 2013)

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What advice would you give someone recently discharged from psychiatric hospital?

31 Jan

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What advice would you give to a patient who’s recently been discharged from psychiatric hospital? What would you have wanted to know when you first came out? I was asked these questions yesterday evening by someone I’d known for a long time, someone who’d visited me on ward 2 years ago and thought I might be able to help someone who’d come to them in despair.

The woman had recently been discharged from a mental health ward in the hospital where I’d been detained.  She was angry. Her world had falled apart. Her marriage had fallen apart. She was appalled by her treatment on ward. She wanted the hospital to hear what she had to say about her care, to know it was wrong. She wanted to meet with people who would know, through shared experience, what she had been through. Would I meet with her face to face to offer advice and support.

When I got home I sent this series of tweets which sets out my reaction to the question. I’ve also added in the responses of other tweeps, and there’s some good advice in there so take a look. Read the tweets to see my gut reaction at the time, or read on for a slightly edited version (tidied up from yesterday’s stream of consciousness), including my 10 tips.

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Open quotes“Will you meet a woman who’s just been discharged from psychiatric hospital?” I was asked. “She’s so traumatised by the experience.  Her  world has fallen apart. She doesn’t know where to turn. She feels so angry about the experience.” More details were given about her difficult circumstances and how she wanted to make a complaint to the hospital but didn’t know how to do so or where to turn. “Can you meet her?”

“No,” I said. “No, I can’t meet her. I’m still too traumatised myself to take on someone else’s pain. I have to take care of myself first.” Her experience in late 2012 seems similar to mine in 2011. So nothing has changed. The hospital hasn’t changed, despite a programme of improvements to the physical environment. The culture hasn’t changed. Same leaders. Same nurses. Same bullying, abuse and poor care. I don’t want to relive it with someone else who’s suffered in similar ways to me, nearly two years later.

“Did you know,” I said, “that I was discharged requiring treatment for harm inflicted on ward? For mental trauma and a physical injury? That I’m being treated for PTSD from the ward experience? And I’m being treated by a physiotherapist for a restraint injury?” The trauma of being held in seclusion, forcibly treated, repeatedly restrained, yanked around by my arm by a bully nurse, has left scars that still need help to heal. I’m still vulnerable.

“Did you know,” I said, “that, when I raised a sample complaint with the hospital, I was disbelieved and blamed?” Which felt like being assaulted a second time. Making a complaint made me feel worse, not better. Much, much worse. I don’t want to go through that process again with someone else.

“Did you know,” I said, “that I have to measure carefully how I use my brain? To flex & strengthen the mental muscles but be careful to not stress or weaken them. Did you know,” I said, “that, although I tweeted all day about the Mental Health Act report, I’m not going to read it?” It would be too harrowing for me to read about others’ difficult experiences on ward. To read about forced treatment, restraint, seclusion, lack of care as being far too common an experience on ward. I look like I’m coping, but that’s because I’m practised at measuring out my energy so I can hold it together in public when I need to.

So no. No I won’t meet them. No I won’t offer support or comfort. Right now, for me, I want to meet happy people. To smile and laugh. To rest my brain. To enjoy life. To put clear blue water between me and the hospital experience. Having caring responsibilities before contributed to me landing up in hospital before. I can’t take on someone new to care for.
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“But,” I said, “I can give you some advice to pass on. Some things I would have wanted to know when I was discharged. That will still be some help.” Here are the tips I passed on:
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  1. It’s good to have someone on your side. If you’re within 8 weeks of discharge, the ward IMHA should be able to help you make a complaint or get your voice heard. They know the ropes. Even if the ward IMHA can’t help you, your local branch of a mental health charity like Mind, Rethink or Sane may have advocates who can help you be heard.
  2. PALS can also help you if you feel you’ve received poor care on ward.
  3. If you feel like you want to be heard, that’s different from making a complaint. Hospitals will have a procedure to help you be heard, outside of a formal complaints procedure, and that may be a better option for you.
  4. If you’re thinking about making a complaint, what end result do you want to achieve? What do you want to get out of it? Do you want “justice” and, if so, what would that look like to you? Do you want to get an apology? Do you want financial compensation? Do you want a review of procedures? It’s helpful to have an outcome in mind before starting the complaints process, to ensure it’s worthwhile going through it.
  5. If you want to make a complaint, are you up to it at this time? As the saying goes, you cannot break concrete with a feather. Organisations can become defensive in the face of complaints. They can fight back. Is that something you want to deal with now? Weigh up the costs to you of doing so.
  6. If you want to make a complaint, can you achieve the end result you desire by some other means? For instance, you can report poor care or abuse – anonymously or using your name – though the Care Quality Commission. They can send an inspector to the hospital or ward to check on care. That might lead to improved care for others in future.
  7. If what you want is to know that you’re not alone, that there are others who share your difficult experiences, then one place to start is yesterday’s Care Quality Commission annual report on the care of patients under the Mental Health Act (voluntary and sectioned patients, and those under CTOs).
  8. Don’t focus exclusively on the negatives of your hospital experience but make sure you also do positive things. For instance, find out what support services are available in the area which play to your strengths or develop new ones – eg art, creativity, music.
  9. People you’ve met on ward can be a valuable support. They were there with you. They know what it was like. They’ll know what you mean when you talk about what happened. But also mix with people who nurture your sense of funClose quotes and make you smile.
  10. Consider returning to the ward and thanking the staff who helped you, then walking away. Doing this helped one of my ward buddies to draw a line under the experience and move on.

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These are my tips, off the cuff last night. But what advice would you give to someone who’s just been discharged from a psychiatric ward? What would you have wanted to know? Please comment below.

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  •  Storify story of tweets I sent together with responses of others – some great advice in there from other tweeps, so take a look
  • Some tips from Wardipedia (the resource for inpatient psychiatric staff) of things to think about when planning for discharge, but a useful to do list post-discharge too
  • Link to the Care Quality Commission‘s website where you can report poor care or abuse
  • The CQC’s most recent report into the care of patients under the Mental Health Act – voluntary and sectioned patients (and those under CTOs)

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Monitoring the Mental Health Act: the CQC’s annual report

30 Jan

Care Quality Commission logo

Today, the Care Quality Commission (CQC) published its annual review for 2011/2012 of its monitoring of the Mental Health Act. The Mental Health Act covers powers to detain people against their will in psychiatric hospitals, to treat people compulsorily outside hospital and the treatment of people on psychiatric wards voluntarily. CQC inspectors visit hospitals and other venues where the Mental Health Act applies in order to produce these annual reports.CQC infographic

The report covers such areas as:

  • What is the Mental Health Act and how is it used?
  • Are care plans focused on individual needs?
  • Are patients involved their care?
  • Are patients given the opportunity to give consent?
  • Is there a culture of control over patients?

Below are some useful web links from the CQC, mental health charities, the social care sector & the media, together with my Storify of tweets throughout the day using the hashtag #MHAreport, as a helpful one-stop-shop today. If you have any helpful links to add, please tweet me or comment below.

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From the Care Quality Commission:

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Comment from mental health charities:Rethink mental illness logo

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Comment from the social care sector:Community Care logo

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In the press:

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On radio:BBC Radio 5 Live logo

  • Radio 5 Live radio call in: overcrowding on mental health wards puts patients at risk of abuse & neglect, with Victoria Derbyshire (30 January)
  • BBC Radio Norfolk: Chris Goreham at breakfast radio phone-in. Staff are the treatment in mental health services yet 20% cuts planned in Norfolk & Suffolk (from 7 mins 30) (28 January)
  • BBC London: Drivetime with Eddie Nestor. The CQC’s report found overcrowding & containment was prioritised over care (from 16mins) (30 January)

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What does mental illness look like? Panorama & the Great Disability Scam

29 Jan

Panorama - The Great Disability Scam

Last night, BBC One’s Panorama presented a half hour documentary on the government’s Work Programme. This was introduced 18 months ago to help people who’ve been out of work for a long time get back into employment. The focus of the documentary was on how this programme was working for those with disabilities – the “hard to place” candidates. It exposed a culture of paid-by-results private providers cherry picking the easiest to help, parking those considered hard to help and insulting attitudes towards clients who who some staff labelled as LTBs – Lazy Thieving Bastards.

When I watched the programme earlier today, I was shocked by the interview with Mark Gould, diagnosed with anxiety and depression and out of work for several years.Panorama - The Great Disability Scam 3 The interviewer, Samantha Poling (pictured left) appeared to goad him into demonstrating behaviour that would make him “look like” he was mentally ill. It’s not an easy segment of the programme to watch.

That sparked a series of tweets, which I’ve collated here (links below), on the subject of what mental illness looks like, how it is perceived by the public and what that means in terms of access to welfare benefits when you’re unable to work – both in terms of the public’s perception of those who don’t “look” ill, and how Atos conducts Work Capability Assessments of people signed off by their own doctors as currently unfit to work. Panorama - The Great Disability Scam 2

I then commented on the fact that what you look like also forms a component of a psychiatric assessment. The Mental State (or Status) Examination includes observations such as whether you have a bizarre hairstyle or unnatural hair colour. I’ve written and tweeted on this before, in the blog post “You can’t dye your hair red”. I look at the contents of the MSE in more detail in these tweets.

It was interesting that the final segment of Panorama ended with an extended shot of a man in a wheelchair making his way slowly up a sloping street. That, it seems, is how people view disability.

Hope you find my tweets interesting. The best part, of course, is the responses of others. All the links are below.

If you have any comments on the post or the programme, please feel free to add them below. I’ll include new tweets that come in by updating the Storify story.

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Ward newbies: what advice would you give to a patient on a psychiatric ward for the first time?

25 Jan

Welcome to the ward

My stay on a psychiatric ward was a bit of a shocker. No one explained what was happening, why it was happening or what to expect. It seemed there were 1,000 unwritten rules for patients to abide by – or, if they were written down somewhere, they were not communicated to patients. And, as a result, we never knew what was expected or what we’d done wrong.

If only I had had someone to explain how things worked, my stay would have been much more therapeutic. If only staff had communicated with me rather than turning up mob-handed to wordlessly pin me down and inject me with unnamed drugs then disappear. If only staff had taken simple steps like telling me when mealtimes were, rather than waiting for me to spot the trolley being wheeled away from the dining area then saying I was too late to eat. Again. If only I’d been given the ward Welcome Pack on day 1. Rather than day 8.

I know there is great psychiatric inpatient care out there and, even where there isn’t, there are hints and tips that will help inpatients get a more positive experience of their stay on ward.

So, what would your advice be to someone staying on a psychiatric ward for the first time?First day

  • Are you a patient on ward now? What questions do you have? What advice so far has been helpful to you? Perhaps you wonder why your phone charger has been taken. Or why there’s someone watching you and making notes on a clipboard several times an hour. Or how to get hold of tampons and a toothbrush.
  • Have you been an inpatient on a mental health ward before? What would you have liked to know when you first arrived? What tips would you like to have been told? What advice do you have for someone who’s being treated on a psychiatric ward for the first time?
  • Are you a member of staff – a health care assistant, nurse, occupational therapist, cleaner, doctor, advocate? What advice would you give to patients on their first stay on a psychiatric ward that would help them understand the experience and get the most from it?
  • Are you an AMHP or police officer who takes people to psychiatric wards or places of safety? What would you like patients to know?

First day 2As TheSchizoPodcaster (@UKschizophrenic) tweeted last night:

“No one has explained anything yet. […] Do staff watch you all the time when you are sectioned? It is normal for this to happen? I don’t like it at all! Makes me angry!”

Student mental  health nurse Kathryn Finch (@Kat_Finch) tweeted back:

“It’s just to monitor how you are and if there’s improvement or not in how you are. They’re looking after you, try to stay calm. You’ll be on obs for at least the first 24 hours. It all depends on how you’re presenting and the risks they feel are there.”

Hopefully that advice was reassuring and useful. Please let me know – either in the comments below or on Twitter – so we can share the best tips for patients on psychiatric wards for the first time.

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  • My Storify story of tips received by Twitter so far … hopefully more to add!
  • The Code of Practice to the Mental Health Act – guidance to staff on their powers and duties, which can give patients an idea of what to expect
  • The Nice Guidelines on Service User Experience in Adult Mental Health – this is the experience NHS care providers are supposed to provide
  • The Wardipedia website’s tips on welcoming new patients

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The politics of mental health: the new mental health task force

15 Nov

Here’s a Storify story I put together from mine and others’ tweets following the major speech by Ed Miliband (leader of the opposition Labour party) on Monday 29th October at the Royal College of Psychiatrists in which he announced the establishment of a new mental health task force.

I started with this tweet:

Dear @Ed_Miliband, good start, but remember there’s much more to good mental health than the NHS, drugs & treatment.

Read on to find out what I mean, together with comments from others tweeps.

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