Healthcare bodies want to scrap the term ‘patients’. As a GP, I have a better idea | Ann Robinson

Many healthcare organisations want to dump the term “patients”, according to participants at a major event in London yesterday called the Future of People Powered Health. “Patient” is widely disliked – with its connotations of having to wait patiently, quietly and uncomplainingly to be the passive recipient of a doctor’s largesse. “Customer” isn’t much better; “client” or “service user” have some takers, and “partner” may be the best of a bad lot. But do we need a term at all?

Halima Khan, executive director of Nesta Health Lab who organised the event in partnership with Guy’s and St Thomas’ Charity , says the debate about whether to ditch the term “patients” has been bubbling up for some time. Many feel that the word, derived from the Latin “patiens” (one who suffers) is now obsolete. There’s support from patient and professional groups to consider changing the language in the hope that some entrenched attitudes will change too. “The Royal College of General Practitioners, for instance is teaching trainee GPs to talk to and about patients in a different way.”

But mental health campaigner Gillian Lamb (not her real name), who has been treated for serious mental health problems, sectioned and admitted to psychiatric units, says she couldn’t care less what she’s called so long as she’s treated with dignity and respect. “I’ve never minded being called a patient because I don’t feel inadequate, secretive or ashamed of having a mental illness. But I know others who are very sensitive about the medicalisation of their condition, and they do object to the term.”

Opponents of ditching the word “patient” say the original meaning of the word doesn’t matter, there’s no suitable alternative, it doesn’t carry connotations of passivity any more, attitudinal change can occur without ditching the name, and changing the name may not lead to meaningful change.

One suggestion is to borrow the language of intentional and therapeutic communities, set up like house-shares in which people are called members and are all expected to muck in and have equal status even if they have different roles. Lamb says that on her ward, “patient meetings” were called “community meetings” – or a “coalition of the unwilling” as an off-message staff member called it.

But the language that organisations use can reflect their philosophy and intended style of delivery. So an upmarket care home wanting to sell itself as being like a hotel may call residents “guests”. The term “service users” has become popular in the NHS though it’s (unintentionally) ironic given that accessing services is often a key problem for people suffering from chronic conditions – “service hopefuls” might be more accurate. “Stakeholders” crops up a lot; I have no idea what it means; don’t we all have a stake in our health and social care?

As a GP and occasional “patient”, I don’t see the need for any term at all. We have 4500 people registered at our surgery. Every person who comes into see me is, just that, a person. When I was in hospital recently for an operation, I didn’t morph into a patient when I entered the ward. I was the same person that I am in the street, but requiring a particular service. After a particularly dehumanising experience with a night nurse, I felt like screaming “I am not a patient, I am a free person”, in a parody of the The Prisoner. Needless to say, I didn’t do that but instead behaved nice and patiently. I say, let’s ditch the term patient altogether and replace it with … person.

Healthcare bodies want to scrap the term ‘patients’. As a GP, I have a better idea | Ann Robinson

3 Ways Every Mom Should Try to Better the Mental Health of Kids

It’s often noticed that kids don’t even cross adolescence but go into depression. You must be very worried as a mother, perplexed to figure out how can you care for mental health of kids so that they don’t develop any mental health disorder.

Here are 3 tips that you can follow to keep children healthy:

Encourage them to play board games:

As a mother you must be understanding how much pressure kids go through these days: Be it parental pressure or academic pressure or something else. You also find yourself helpless sometimes as you can’t compromise on kids’ education for their shining future, but you can always try to lessen their burden in some other way. Playing board games is a great way to lessen the stress of kids. Bring educational board games at home and start playing with them. They will have fun playing such innovative games. More they will enjoy the happiness of playing together, especially with parents. Your kids will be learning playfully without even their knowledge. If you are confused about which game to buy, let me get you the solution:

A brand new, interactive board game is going to be launched in market soon, which is designed with the purpose of developing STEM skills of children. This family-friendly tabletop game will take your kid on a journey to a tree squirrel’s world. The animal loving nature of an aerospace engineer, named Randy Hecht, inspired him to invent this game. He even wants to donate a certain percentage of proceed to local animal charities. This game will truly inculcate confidence and competitive spirit in your child as well as will improve their cognitive skills. It’s a fun game that will make your kids happy, hence will reduce their pressure and stress. Your kids will learn about squirrel behaviors. Moreover, the game will improve their verbal and communication skills as well as logical and reasoning skills. Children also will get the opportunity to practice math and negotiation skills through this educational game. Do you intend to support the creators of this board game? You can surely do so, theres a kickstarter campaign being created for you to go and pledge for the project and contribute for the noble cause. It’s not a bad idea because they’re giving back to the community in a positive way.

Make them Eat Healthy

You must be wondering what connection does our brain have with healthy eating. Let me give you a clear picture. Human body needs vitamins and nutrients in order to make the brain function. If you don’t feed your kids correctly, their brain will not function properly. It will affect their academic performance as well as mental health. So, don’t forget to give them energy drink, meat, fish, milk, vegetables, nuts, seeds etc.

Encourage them to do physical activity

Physical activity is very important for kids to keep their brain active. You should encourage them to practice yoga or play in parks. When your kids are physically active interacting with others, they will develop social skills and will learn how to deal with emotions. Physical activity will help them with healthy mental growth. As a mother, you must be the role model of your child. What can be better than if you accompany him in playground or yoga? Think about it.

Chloe Paltrow, MD, is a psychiatrist with more than 20 years of experience. She is also a researcher in the field of neurology. Dr. Paltrow sees patients with different neurodevelopmental disorders and intellectual disabilities. She has shared her knowledge in various websites and blogs like Collective Evolution, PsychCentral and Pick The Brain. Currently, she is studying how brain injury and brain disorders can be treated with hyperbaric chamber, of which OxyHealth is a leading provider.

3 Ways Every Mom Should Try to Better the Mental Health of Kids

How Nano Technology is Changing Farming for the Better

Utilizing nanotechnology to improve the water quality is an innovative way of improving crop nutrition, improving our natural health.

Abrupt changes in the weather are only one of the many reasons why farming is getting more and more difficult. Crops produced are of lower quality with less nutritional value, and the volume harvested is significantly fewer. Ground-breaking technology has been developed in order to address the issue of low yield and low quality yields by ensuring that the nutrients are delivered to plants more effectively.

How does nanotechnology improve plant nutrition?

Nanotechnology is an innovative technology which protects the nutrients in the soil against impurities and reactive molecules, resulting in improved crop nutrition.

What is nano technology and how does it work?

“Nano” comes from the Greek word that stands for “dwarf.” It is now, however, used to refer to a scientific scale. Consequently, nanotechnology makes use of a very small scale of measurement, about one billionth of a meter. Manipulating matter at the nanoscale has profoundly influenced different industries including manufacturing, textile, medicine, computing, and cosmetics.

This new technology’s primary function is to remove impurities in the water; thus, improving crop nutrition. It works this way: Water is pumped into a lab and is carefully processed to remove any particles and impurities from it. In essence, the particles are crushed, reducing their size up to 100 times smaller. This water is then fed to the necessary crops, allowing them to absorb the nutrients more effectively.

What are the implications of using this technology?

With a more efficient delivery of nutrients to the roots and leaves of the crops, there is a higher vegetative and germination rate. Moreover, farmers can now maximize soil nutrient and reduce the volume of required fertilizer, increasing the yield’s quality and quantity per hectare.

The full impact of these scientific advancements on the global farming community have not been measured.  If this technology is used as part of modern farming practices, farmers will be able to address issues such as the pH levels in the water, and they will be able to reduce the percentage of fertilizer used during the crop’s lifecycle. Finally, since it is a fairly new technology, there is scope for major improvements in the water purification process.

Final Words

This scientific know-how has successfully helped improve modern farming methods.

While this innovation makes use of the smallest measurement, there is no doubt that its impact on the farming industry will be tremendous. We live in a world where droughts, famines, and consequently, poor nutrition play a major role in starvation, deaths, and poor health of the people affected by the lack of proper nutrition. Therefore, any technological advancements that will improve the quality of the food produced, will go along way towards improving the quality of life for the impoverished.

Author bio: The article on improving crop nutrition has been written by Ignacio D. Pena who is a very active blogger and loves to write in the agriculture niche.

How Nano Technology is Changing Farming for the Better

Fewer but better clinics ‘will save more stroke victims’

Dozens of hospital stroke units should be shut and the service reorganised into fewer centres of excellence in order to improve care, the charity representing stroke survivors has insisted.

Centralising stroke treatment at a much smaller number of hospitals will increase patients’ chances of survival and reduce their risk of long-term disability, the Stroke Association says.

Juliet Bouverie, the charity’s chief executive, accused hospitals of risking lives by retaining stroke units when medical evidence suggests they should be moved. While reconfiguration is controversial, patients and their families generally understand that travelling longer distances to get a higher standard of care and reduce the risk of dying is worthwhile, she insisted.

“At the moment there are 126 hospitals in England which routinely admit stroke patients. That number needs to be reduced to somewhere between 75 and 100. But progress on that is very variable across the country and so unnecessary costs are being incurred and unnecessary mortality is happening,” she said.

She urged hospital and NHS chiefs to learn lessons from studies showing that scores of lives are being saved every year by the reorganisation of stroke units in the capital in the 2000s. “Previously there were more than 20 hospitals providing acute care in London and there was strong evidence that actually reducing the number of acute stroke units and creating a hub and spoke model [of bigger hospitals supporting smaller ones] on stroke would not only save lives but it would also save the NHS money.

“So they reduced the number of acute stroke units from 20 down to eight and the evidence shows that each year more than 100 patients extra are saved as a consequence. That’s now been replicated in Manchester, with equivalent numbers of lives saved.”

Tony Rudd, the national clinical director for stroke at NHS England, says: “The changes to stroke services in London have saved lives, proving it is right to concentrate expertise in selected centres. One advantage of the local planning arrangements is they can identify where there are opportunities to provide this more focused care for stroke patients.”

Centres of excellence would offer better care by having larger numbers of patients and would tackle the shortage of specialist doctors and nurses by concentrating them in fewer places. They could then offer patients clot-busting drugs and, potentially, 35 to 50 could undergo a new surgical procedure called mechanical thrombectomy, in which even large blood clots in the brain can be enclosed in a stent. Many more hospitals than the current handful should be offering the £7,000-a-time “game-changer” operation, said Bouverie.

Hospitals’ self-interest is “stalling” what should be an NHS-wide drive to improve stroke care, she claimed. “Too many hospitals are protecting their own interests and not doing what is in patients’ best interests. No hospital wants to give up some of those life-saving treatments, but it’s not in patients’ interests for these smaller hospitals to be delivering services.”

Too many of the sustainability and transformation plans drawn up by NHS leaders in 44 areas of England do not include clear ways of reorganising stroke care, despite evidence that fewer units reduce the risk of death and disability.

Hyper acute stroke units usually administer life-saving treatment for three days and then transfer patients to a stroke unit, with patients then moving to a rehabilitation unit or going home. Centres of excellence would help overcome the postcode lottery that means that 82% of stroke patients treated at Ipswich hospital, for example, receive clot-busting drugs within the recommended four hours but only 15% of those attending Wexham Park hospital in Slough.

Bouverie blamed the NHS for neglecting survivors after their discharge from hospital: “More than 46% of patients told us in our most recent survey that when they’re discharged from hospital they feel isolated and abandoned. They say that physiotherapy is not adequate and they’re not given access to the right psychological support. People are not getting access to speech and language therapy in a timely manner,” she added.

“Many stroke survivors have a physical disability, depression or psychological needs, suffer chronic fatigue or have aphasia, where they cannot speak. You’ve got stroke survivors at home with serious disability, often still in wheelchairs, unable to communicate, suffering the damaging psychological effects of what is a life-changing condition and not being given the proper support. ”

She criticised NHS bosses and ministers for refusing to draw up a strategy to reduce the UK-wide toll of 40,000 deaths caused by the 100,000 strokes that occur every year, despite the government’s pledge to reduce premature deaths. Stroke campaigners feel “ignored” because NHS England chief executive Simon Stevens is concentrating on improving cancer, mental health, maternity care and dementia services rather than prioritising Britain’s fourth biggest killer.

Fewer but better clinics ‘will save more stroke victims’

Can tech make banking better for those with mental health issues?

A recent report from the Money and Mental Health Policy Institute has revealed what many people with mental health problems already knew – mental illess can have a significant, and often terrifying, impact on your finances.

Anxious? Good luck tackling the bank statements piling up, unopened. Having a manic episode? Time to spend thousands of pounds on things you’ll never use! Depressed? … What was my pin again?

Banks, the report argued, are simply not doing enough to protect people in this position. Many of the options available to other vulnerable people are simply not offered to those with mental health issues. People with visual or hearing impairments, for example, have a wider range of communication options – these could also benefit those with anxiety. Adults with conditions like Down’s syndrome are sometimes offered “third party mandate” accounts, and even corporate or high net worth accounts have options to set spending limits or delegate permissions to named individuals – functionalities that could be advantageous to many others.

The British Bankers’ Association has agreed that the financial industry should “raise its standards” with regards to mental health. But until then, what can people do to protect themselves financially?

Zander Brade, designer at banking start-up Monzo, thinks tech might be the answer.

In a blog posted last week, Brade detailed how his team has been working on making Monzo a “powerful and helpful financial service for people suffering from mental health problems”. And to do so, they’ve made a seemingly counterintuitive move: increasing friction in their app.

Brade describes the decision as “tough for a product person”, but hopes that providing “safety barriers” will protect vulnerable users and prevent them from experiencing serious distress around spending and debt.

“It makes sense that every tech product aims to be as fluid in its user experience as possible – minimising friction tends to help maximise profits,” he told me. But he explained: “In Monzo’s case, because money and the shape of one’s bank account is so closely attached to each customer’s state of mind, adding in layers of functionality to help protect them from potential spending crises will hopefully be anything but counterproductive.”

Polly Mackenzie, director of the Money and Mental Health Policy Institute, agrees that preventing people getting into financial difficulties could be key. “Over the past 10 years or so, the processes for helping people with mental health problems who are in serious debt have improved,” she told me. “What’s missing is work to try and help people with mental health problems from getting into financial difficulty in the first place: making sure people get the support they need with day to day financial management, that they don’t take on debts they can’t afford, and can get help from friends and family to stay on top of things.”

Monzo is currently working on a series of workshops with groups of people suffering from a range of different mental health conditions. Photograph: Alex Hern for the Guardian

Mackenzie also highlights the benefit of “more friction” options – she mentions Monzo’s plans alongside work by fintech company Squirrel, who “make you wait a day before you can access your savings”.

“We desperately need tools like this to come into the market right now, because the overwhelming trend is towards less friction in transactions,” she said. She points towards plans by Facebook Messenger to allow in-app purchases and Amazon’s ‘instant credit’ on large purchases.

“There’s growing evidence that people think about contactless transactions less that they would if paying in cash or with their pin,” she says. “Unless we see banks and fintech companies develop ‘more friction’ options to go alongside this trend, we risk entering a slippery world where we all make a lot more financial mistakes, particularly if we have mental health problems.” Additional friction here can also be beneficial for those who aren’t experiencing poor mental health, who simply want to manage their budgets or better grasp what they’re spending.

Monzo is currently working on a series of workshops with groups of people suffering from a range of different mental health conditions so its development teams can “understand what they would need and like to see to make the product as useful and reassuring for them as can be”.

One example Brade uses is overspending in people with bipolar disorder, which often occurs late at night during a manic episode. Implementing “a method of double checking with the user the next day” could provide a safety net for people regretting their purchases in the morning. He also highlights “instant notifications on your spending, a real time view of your balance and transactions and in-app budgeting” as potentially supportive features.

He also hopes that opt-in features can be designed for “more specific use cases for particular conditions”.

“For the example of bipolar sufferers who have trouble with spending in manic episodes, the goal is to add a layer of confirmation and protection. It’s a powerful feature but a more unique functionality. That might not be required by every single user, and it would make more sense to be an option.”

Both Mackenzie and Brade are optimistic about the potential that technological solutions could have on people suffering from mental health problems.

“Designing Monzo with our most vulnerable customers at the forefront of our minds is a crucial part of the product development process,” Brade said. “Just by the very virtue of our world becoming more and more digital – I think that tech will become more crucial in providing solutions for vulnerable customers.”

Mackenzie is slightly more cautious. “It will never be the only answer,” she says. “But so long as we don’t deceive ourselves into thinking that it’s the answer to every problem, technology offers huge opportunities to transform our mental health and financial wellbeing.”

Can tech make banking better for those with mental health issues?

On Time to Talk day, solidarity on mental health would be better than sympathy | Mark Brown

If you have been inundated today with people on Facebook, Twitter and daytime television imploring you to discuss mental health, that is because it is Time to Talk day. Mired in politeness and caution, people with mental health difficulties across the UK have gently requested kindness and understanding. Perhaps you’ve made the right noises and nodded sympathetically. You’ll probably feel you did the right thing, but unfortunately your compassion will not be enough to change anything.

In his novel Things Can Only Get Better, John O’Farrell recalls having the Jamaican poet Michael Smith as a guest at an early 80s university radical poetry evening. Afterwards Smith was turned away from a club for being black. Back at a student house Smith exclaimed: “I want justice!” to be answered by a young woman saying “I can’t give you justice but I can give you a hug.” This is where we’re at with mental health in the UK.

Anyone can endorse nice sentiments. Theresa May raised the issue of the importance of such conversations just last month. But the fact is that people with mental health difficulties often experience shorter, poorer, unhappier lives. In the UK, people diagnosed with schizophrenia run the risk of dying 20 years earlier than the average British person. Those who have psychological problems during childhood earn 25% less than those who didn’t by the age of 50.

Experiencing mental health issues often leads to exclusion. You either take yourself away from others or others take themselves away from you. Suddenly relationships you thought you were driving career into the central reservation at high speed in a tangle of steel and glass. Work, school or college might go wrong. But none of these things cause exclusion. How society treats and stigmatises a person when that happens is what causes exclusion.

If you care about people with mental health difficulties then you have to be prepared to make changes, not just to your attitude but in the way you want your country to work. As a starting point, it would be wise to stop telling people to seek help and support that you know isn’t there. Austerity has gutted our communities of organisations that can make life liveable with mental health issues. Admit that it is not mental ill health that plunges people into crisis, it is the lack of support, protection and assistance that does that.

Mental health treatment is underfunded, so society needs to start paying for it. If people have to leave work because they are in distress do not punish them by forcing them into poverty and then make them beg for the tiniest crumbs of financial support in the form of benefits.

The country we live in does not give second chances and is unlikely to do so without pressure. Opportunities for education, opportunities to find a comfortable place to live, opportunities to progress: all take investment and the political will to pay for them instead of something else. If you really care about people with mental health difficulties think about what you would be prepared to give up in return for their safety, their security and for them to thrive.

We talk about fighting cuts but the money to achieve equality for people with mental health difficulties has never been there. We need to be fighting for a future where supporting and protecting the lives of those experiencing mental distress is not an optional act of kindness but an obligation hard-wired into all of structures and thinking. The man on the street might say that sounds like special treatment, like whining instead of pulling your socks up. But the man on the street will keep saying that until we seize the political initiative. Or until his brain flips over one night and he can’t trust his own thoughts and feelings and suddenly he discovers the world doesn’t work for him any more.

Being in distress hurts. Finding you are treated unequally at such a time even more so. So it’s understandable that people will try to end the pain of exclusion by asking politely to be let back into “normal life” without any fuss. The imbalance of power remains when a dominant majority thinks it is doing a favour by bestowing benevolent and charitable understanding upon an insecure minority. But until that majority is prepared to alter structures, laws and practices that they benefit in favour of those they discriminate against, all we have is warm sentiments.

On this Time to Talk day, fight the rosy glow you’ll feel at having listened to someone’s hard life and remember it is possible to be a lovely person in a discriminatory system. Reflect on what you have heard then think about what must change. Because while your sympathy is welcome, your solidarity and political voice as part of the dominant majority will go further.

On Time to Talk day, solidarity on mental health would be better than sympathy | Mark Brown

How can I cope better with stress?

How do you feel when bad things happen? Do you bounce back from adversity or sob indefinitely? Emotional resilience, the ability that some people have to withstand stress, was once thought to be a genetic gift. You were either lucky and had it, or you didn’t and struggled. Studies show that teenagers who fail exams have an increased risk of depression as adults, while athletes who lose can feel long-term guilt and humiliation. But recent psychological research suggests that emotional resilience can be developed. A systematic review of what makes people able to deal with failure looked at results from 46 studies.

The solution

The study found that having higher levels of self-esteem, a more positive way of explaining why things happen, and avoiding perfectionist thinking were strongly linked to bouncing back when things go wrong. Dr Judith Johnson, a clinical psychologist at the University of Leeds and lead author of the review, says we can build resilience. “Self-esteem was shown to be significant in two thirds of the studies we looked at in mediating the link between failure and distress,” she says.

Johnson adds that there are proven cognitive behavioural methods that raise self-esteem. You don’t have to believe you are wonderful to have emotional resilience, just that you are adequate. All you need to do is write a list of your positive qualities and examples of when you have shown them.

How you explain things also matters: if you attribute personal success to fluke rather than your own work and talent, then you are less able to use success to boost your self-esteem. If, however, you can brush off a disappointment by attributing it to external factors, such as not getting a job because they wanted a different skill mix, then you have the equivalent of emotional armour.

Finally, if you have perfectionist tendencies, lower them. Perfectionists hold rigid standards that don’t bend in the stormy weather of life. Johnson says we need to set more realistic standards. ‘‘Encourage people to be the best they can be,” she says. “If that doesn’t work out, then they should be assured there is a plan B. Being happy doesn’t depend on passing an exam. Flexible thinking is very important, especially in the young.”

She also advises self-awareness and noticing when you are stressed. “Negative emotions tap into the basic instinct of fear, so they narrow your life. If you feel stuck, do something that cheers you up. You need to plan these things into a schedule – doing them will chip away at your negative mood, even if you do enjoy them a bit less than usual.” Other research shows that the support of friends or family also helps emotional resilience, as does being physically active.

How can I cope better with stress?

Don"t loose your snooze: the technology that"s promising a better night"s sleep

A bed that adjusts itself in the night to stop people from snoring. A princess and the pea-style gadget that fits under a mattress and monitors sleep. A “water-based, app-controlled mattress topper”, which will encourage deep slumber.

Sleep technology is one of the biggest trends at CES, the world’s premier electronics show, which opened to the public on Thursday.

The range of products on show reflect the growing interest in solutions to insomnia and other sleep problems – as well as the predictions that the global sleep market will be worth $ 80bn by 2020.

The “Sleep Number 360 smart bed”, made by bed company Sleep Number, is among the most eye-catching products. The mattress can detect a change of body position during the night and uses air chambers in the mattress to contour to the sleeper’s frame.

Sampling the bed on Thursday morning, a Guardian reporter was promised “the most comfortable, effortless sleep” of his life.

The reporter did not actually fall asleep during the three minutes he spent on the bed, but could feel the bed adjusting to support his lower back and shoulders. Invited – by a video demonstration screened above the bed – to turn to his side, the bed adjusted again.

The Sleep Number 360 smart bed at CES in Las Vegas, Nevada. Photograph: Alex Wong/Getty Images

A video presentation explained that the Sleep Number 360 bed is “even smart enough to sense snoring before you do”.

Should it detect a snorer, the bed will raise the top of the mattress by 7%, which Sleep Number claims will stop the snoring. “It’s the only bed that goes to work when you go to sleep,” said Kelley Parker, senior product brand manager at Sleep Number.

The bed is able to detect the sleeper’s heart rate, breath rate and motion, to provide an excellent premium sleep experience, Parker said. It can adapt to two different sleepers’ positions. But this kind of sleep, it seems, does not come cheap.

Parker said that “pricing is not finalized” but that it would be similar to existing Sleep Number pricing. (The manufacturer’s top-of-the-range bed retails at $ 7,099.99 – although it is currently on sale for $ 5,899.99.)

A recurring theme at CES is connectivity. Almost every device on show – including some washing machines and ovens – will connect to cell phones and even smart home devices like the Amazon Echo or Google Home.

The Sleep Number 360 bed, and most of the other sleep devices on show at CES, connect to an app on a smartphone to give the user information on how they slept, and even remind a person when they should go to bed. The Sleep Number 360 will also connect to your thermostat to control room temperature during the night. (If you can afford a wireless thermostat after buying the bed.)

A few stalls along from the magic bed, Sleep Ace was demonstrating its own line of sleep-friendly products. The Sleep Dot attaches to the sleeper’s pillow and feeds information back to a cell phone on movement and sleep cycles.

Some wearable devices already to this, but the attraction of the Sleep Dot, which costs $ 49.99, is that you don’t need anything strapped to your wrist.

The National Institutes of Health estimates that 50 to 70 million Americans suffer from some kind of sleep disorder. Nearly one in five adults are said to suffer from chronic insomnia, while in February 2016 the Centers for Disease Control and Prevention said more than a third of people in the US do not get enough sleep.

Another product at CES, 2breathe Sleep Inducer, is a device that helps people sleep using guiding tones composed from the user’s breathing. Photograph: Alex Wong/Getty Images

Sleeping less than seven hours a day can lead to increased risk of obesity, diabetes, heart disease and “frequent mental distress”, the CDC said.

One product that may be appreciated by fans of the Hans Christian Andersen, author of the The Princess and the Pea tale, is the Emfit QS. It’s a sensor that can be installed under a mattress to monitor sleep. It connects to a smartphone to provide “comprehensive reports” about “physical recovery, stress levels, and sleep quality”.

The company says it will be of particular interest to athletes seeking to track physical recovery. Like the Sleep Number the Emfit QS will also send alerts telling a userwhen to go to bed, which could potentially be helpful (or annoying).

Another sleep device generating interest at CES is the “Kryo Sleep Performance System”: a mattress topper that cools down to 60F(16C), which the company claims is optimum for deep sleep.

The Kryo connects to a smart phone – of course – and within ten nights of collecting data it will understand a sleeper’s habits enough to optimize its temperature. The mattress topper has been financed by an Indiegogo campaign, and Kryo estimates it will ship out some of the Kryo sleep performance systems in 2017. It is expected to cost $ 299.

Don"t loose your snooze: the technology that"s promising a better night"s sleep

I have seen Britain shrouded in darkness before. Better times will come | Harry Leslie Smith

Hope is hard to find in the grey teatime light of this December, because despite all of the holiday cheer around us, darkness gathers. It has been the hardest, saddest and cruellest of years – a sour vintage which has brought to everyone’s doorstep heartache, financial worries and political unease.

Austerity seems eternal, and for many it is as if they are living within a new circle added to Dante’s inferno for the 21st century. Callous and barbarous wars in Yemen and Syria test our faith in humanity, while the unstoppable refugee crisis it produced makes us want to weep in despair for the decrepitude of our civilisation.

Hope is as absent from society today as cash is to a pauper’s wallet because a noxious populism fuelled by hate now smoulders. Everywhere we turn it feels like optimism has been eclipsed by a world we don’t want to recognise as our own. Despair is in the breath of our words because we are frightened.

But as my life has been long, I have seen Britain up against the setting sun of history before. I witnessed our country on its knees from the Great Depression; with its back to the wall and under threat of invasion by the Nazis. Over my nine decades of life, I’ve known despair but never hopelessness.

My hope for a better tomorrow for everyone in our country doesn’t come from our military victories against fascism. It doesn’t come from Churchill’s defiance or the words of present-day politicians. No: the source of hope that has carried me through decades of existence comes from the collective will of my generation in 1945 to beat our swords into ploughshares and harvest a just society through the erection of the welfare state.

My hope has always come from the humanity, kindness and intelligence that inhabits the majority of people who reside on our shores. It may seem dormant now, but it will rise again because those sparks of decency that built the NHS, gave affordable housing to each and every one of us, and provided free education to all, are in each Briton alive today – because you are the children and the grandchildren of my generation. If we did it before, then we can do it again.

The 1945 general election was called after our long and brutal war with Germany. It would decide whether our country would cling to its feudal past or accept a bold egalitarian future. I was 22, a member of the allied occupation force and stationed in Hamburg. And it was there that I cast my ballot for the first time – and it’s been a love affair with democracy ever since.

On the day I voted in that occupied city, which looked more worse for wear than Aleppo does now, sorrow could be found on every street corner because of a dead tyrant’s madness. While I queued to vote, I remember how conscious I was of both what I had endured as a boy and teenager during the Great Depression and what I’d witnessed during the war. I felt by making my mark and voting for a welfare state, I was declaring to my country, my peers and those that did not live to see that election day, that my destiny mattered regardless of my humble station in life. The hope that has kept me going all these years came from that election, when ordinary people said their lives mattered just as much as any elite class.

I have seen Britain shrouded in darkness before. Better times will come | Harry Leslie Smith

Better than prison: life inside the UK"s secure hospitals

One day in early August, 36-year-old Gavin bumped into an old friend outside That’s Entertainment music and DVD shop in Preston market.

“He pulled me to one side, but I didn’t recognise him,” Gavin (a pseudonym) says when we meet a week later. “He was like, ‘How you doing? I’m just going to get some stuff, make some money.’ He’s opened his bag and it’s full of razor blades. He’s selling razor blades for a tenner a pop, all of that business.”

Gavin says that he and the man were former “grafting partners”: commercial burglars and thieves, working around Lancashire. But in the six years since they had last seen one another, their lives had taken divergent paths.

“He’s ended up on the gear, shoplifting,” Gavin says. “I was like, ‘See you later mate.’ I felt guilty, tight, leaving him, but I thought: ‘What would happen if I’m with him and he gets pulled over and I’m in the hospital?’ I’d be in a lot of trouble, wouldn’t I? I gave him a couple of quid to buy himself a couple of pies, a cup of tea, and he wandered off … I sat there and thought: ‘If I’d not been in here, it’d be me doing that.’”

Guild Lodge hospital in Lancashire

Gavin relates the story inside a meeting room at Guild Lodge hospital, in the Lancashire village of Whittingham, where he has lived for the past three years. Guild Lodge is one of 60 medium-secure mental health hospitals in England and Wales that house people deemed to be a danger either to themselves or others on account of their mental illness. Most of the 149 patients have committed offences while mentally ill, or have been diagnosed with a mental illness while already in prison. Some have been in higher-security institutions; almost all are being held under the terms of the Mental Health Act.

Gavin, who has schizophrenia, describes a life of substance abuse and crime, sometimes with violence, that took him in and out of prison and secure care settings for the past 18 years – his entire adult life. He was most recently admitted to a medium-secure ward at Guild Lodge in 2013, and is now in low-secure, from which he is permitted release to go into town, as he waits first for a tribunal hearing that could clear him for discharge and then, crucially, for a bed in supported accommodation.

“It might not work if I was just kicked out like I was in the prison system. I would have nowhere to go,” Gavin says. “I’d be on the street, in a hostel, back in crime or something. When I’ve been released from prison, it’s been a few weeks at the most. I’ve been straight back in for something else.”

From 1873 until 1995, the leafy park that surrounds Guild Lodge’s complex of modern buildings concealed Whittingham Hospital, which was Britain’s largest psychiatric institution and a centrepiece of the notorious Victorian asylum system. But Guild Lodge, which opened in 1999, is a striking representation of the advancements in secure-care provision across the UK – particularly at a security level one step below Broadmoor, Ashworth and Rampton, England’s three high-secure forensic psychiatric services.

Staff helping a service user (right) during a crafts session at Guild Lodge. Photograph: Christopher Thomond for the Guardian

From the outside, the pale bricks and long windows of the medium-secure area of Guild Lodge could pass for a leisure centre. Even the high mesh fence that surrounds it could be for tennis courts or a five-a-side football pitch. The low-secure area that sprawls outside looks and feels like a business park. There is little to distinguish buildings containing administration offices and meeting rooms from the wards in which patients sleep.

Service users (the preferred term for patient) considered low-risk are free to wander through the adjacent woodland, around an Anglican church, a cemetery and even a cricket pitch. One service user, who told me he spends much of his days watching wildlife and listening to music on a wind-up radio, insisted that a relative of local hero Andrew Flintoff was the groundsman.

As with all hospitals, the aim is that patients will one day be discharged from Guild Lodge with their illnesses under control. It is recovery-focused rather than punitive, and although the Ministry of Justice retains a controlling interest in the onward progression of many patients (some will go back to prison), funding for medium-secure hospitals comes entirely from NHS England’s special commissioning budget.

The unique challenge is to balance care with custody; to maintain the public’s security while effectively treating patients’ illnesses. For thousands of people like Gavin, who is genial, articulate and rational when his schizophrenia is under control, secure care units can prove the difference between what might be considered a worthwhile life, and one wasted as hostage to an unpredictable and often dangerous illness.

Such endeavours are not cheap. According to figures from NHS England, expenditure on medium- and high-secure mental health services during the past year was £1.23bn, which accounts for 74% of the special commissioning budget and is one fifth of all public spending on adult mental health care. Accurate figures on a patient-by-patient basis are difficult to obtain, but conservative estimates put the cost of a bed and care for a year in a medium-secure hospital at £150,000, nearly five times as much as a male inmate in a category B prison.

A view of one of the security fences at Guild Lodge. Photograph: Christopher Thomond for the Guardian

Partly because of their cost, forensic psychiatry hospitals are under almost constant review. Medium-secure services in particular have remained a focal point for mental health campaigners, who say patients are often too readily admitted to an unnecessarily high level of security and then stay too long. The most recent government taskforce report on mental health – titled Five Year Forward View for Mental Health, released in February – made fresh commitments to “prevent avoidable admissions”, support recovery in the “least restrictive setting” and “address existing fragmented pathways in secure care”. In essence, it emphasises a need to get patients hastily into secure care when mental illness is the root cause of their offending, but also to discharge them quickly and safely, with adequate continued care, to get on with their lives.

Yet there remain frequent claims that the Ministry of Justice is overly cautious in approving discharge from secure hospitals, and that there is inadequate onward housing provision for patients reintegrating into communities. In general, treatment for mental illness has progressed significantly since the days of the asylums, but age-old misconceptions persist about psychiatric institutions. Patients still suffer familiar prejudice on account of their illness, compounded by their detention in hospital.

“It’s very, very risk-averse stuff,” says Jenny Shaw, the recently retired clinical director for specialist services at Lancashire Care Foundation Trust, which oversees Guild Lodge. “Even having conversations with some of my friends, who should know better, [I hear] ‘How can you ever let people who have committed those kinds of offences out?’ It’s a complete lack of understanding of what we’re trying to do. I think there’s still a massive stigma around mental health, and people with mental health problems and who are offenders – it’s a massive double whammy.”

I visited Guild Lodge twice earlier this year, touring the medium-secure unit and talking to some service users about treatment programmes and the challenges they face. Journalists are rarely permitted inside secure care environments: service users are often vulnerable and their recovery programmes easily undermined by external distractions. Administrators are also wary of the sensationalist reporting mental health hospitals have been known to attract, while victims and their families stand to gain little by repeated exposure to the perpetrators of the crimes against them. All names have therefore been changed and details of offences omitted.

Staff in the woodwork room at Guild Lodge. Photograph: Christopher Thomond for the Guardian

In general, people who have committed offences as a result of a mental illness tend to be blighted by extreme guilt for their actions. Many people hear voices or suffer delusions that have encouraged their offences. Hospitals house people suffering from a vast range of illnesses – schizophrenia, psychosis, acute depression, bipolar disorder – from hugely varying backgrounds, many of whom have suffered extreme trauma. The propensity to self-harm is also high.

The area “over the fence” – as one service user described the medium-secure part of the hospital – has the atmosphere of a vocational college, albeit one in which most doors are permanently locked. Staff and visitors pass through an air-lock security door, past a small office where patients can meet guests, and then into a courtyard, with various separate buildings situated either side of an access road and areas of green lawns. After appropriate risk assessment, service users are allowed access to an art room and wood and metal-working workshops, or to learn gardening skills in an on-site greenhouse and nursery. There is also a music room, and a service-user band regularly plays gigs both in and outside the hospital.

My visit to the medium-secure unit coincided with lunch, when the common areas were almost entirely deserted. Patients were in gender-specific wards, where they sleep in single-occupancy rooms, with washing facilities, and are locked in overnight. Although neither staff nor service users denied that tempers can flare, and that patients’ moods and illnesses can often raise tensions inside the hospital, I saw no threatening behaviour. Patients at different stages of recovery demand varying levels of supervision, but I met service users for interview in the low-secure area to which they brought themselves and left unescorted.

Many patients in secure care have co-morbidity issues – drug or alcohol misuse, or personality disorders – and programmes work to tackle these, as well as to improve patients’ physical health. Smoking is entirely prohibited inside Guild Lodge, and service users are encouraged to use an on-site gym and sports hall. Weight gain remains one of the most damaging side-effects of many psychotropic medications, leading both to physical ailments and reduced self-esteem.

The horticulture polytunnel at Guild Lodge. Photograph: Christopher Thomond for the Guardian

Guild Lodge is also relatively unusual in that its administrators have won a battle to permit computer use for service users. Access to technology brings out the most risk-averse tendencies of lawmakers, who fear that vulnerable patients may be drawn to the darkest fringes of the internet. (Mobile phones are also strictly forbidden.) But a lack of even rudimentary IT skills may be damaging to a patient’s prospects of reintegrating to the job market on release. Service users can suffer an extreme sense of isolation, as though they are separate from the community in which they hope to reintegrate. Any further barriers, such as a lack of basic skills, only compound anxiety issues surrounding discharge.

One low-secure service user named Janet, who was not at Guild Lodge and who met me in a coffee shop in London, described a scenario where she was required to go online to arrange her own onward housing in order to be discharged from a hospital, but was not permitted access to the internet before she left.

“In the five years I’ve been in hospital, the world has moved a lot,” Janet says. “One of the people I live with has been in hospital for 16 years. She is about to be discharged and she has got no concept of how to use the internet. None at all.”

She adds: “No matter how confident you are as an individual, your confidence just plummets. Even the most arrogant individuals in hospital – it’s quite interesting watching them go out into the community, all that arrogance and bravado seems to quite quickly crumble. It’s fearful. We have a bridge at the front of the hospital. It’s called ‘life beyond the bridge’. Patients fear crossing that bridge.”

In recent years, studies into the effectiveness of treatments for mental illness, including schizophrenia, have centred on involving patients themselves in planning their own recovery. Research has shown that patients respond better to treatment when they are engaged in it and given more control over the direction of their own care.

In the secure environment, attempts to empower patients in this way can be seen to run counter to the demands of security, but initiatives are now in place that focus on service-user involvement and are aimed at hastening recovery and expediting discharge. “These things are related,” says Ian Callaghan, a former service user, with experience of both low- and medium-secure hospitals, who now works for Rethink Mental Illness. “As soon as a person’s mental health is stabilised, things should change. Stabilising mental health and managing risk go hand-in-hand.”

Callaghan is the national service user lead for a Department of Health initiative named My Shared Pathway – a programme followed throughout a patient’s stay in hospital. My Shared Pathway is tailored to an individual’s specific needs and defines closely their shared relationships with the clinicians, support workers, other service users and eventually the community they hope to return to. Meanwhile, a scheme launched by Rethink Mental Illness’ Innovation Network is aiming to involve service users in planning their futures in a far more detailed way than has been the norm.

These initiatives aren’t to everyone’s taste. One 57-year-old service user, who had spent many years in Ashworth high-secure hospital before transferring to Guild Lodge seven years ago, said: “They have meetings about when to organise meetings.” The same service user was also not a supporter of the smoking prohibition, and said fellow patients squirrelled cigarettes just outside the fence.

A crafts session at Guild Lodge. Photograph: Christopher Thomond for the Guardian

Nevertheless, initial feedback from staff and patients has mainly been good, and further trials are also currently under way to enhance the role of peer-support workers in secure hospitals. The idea is that experienced service users can volunteer their support and advice to other patients, building on informal relationships on some wards and broadening networks of trusted individuals. Service users are known to respond well to people who have been through the secure-care system and have successfully returned to the community. Janet says: “It does sometimes take somebody who has recovered to let you see the light a little bit.”

Service users and staff both told me that it can be detrimental to recovery if, after being cleared for discharge by a clinician, a patient is denied release either by the Ministry of Justice, or by a lack of onward accommodation provision. After the taskforce recommendations, NHS England is trialling a reorganisation of budgets to allow local administrators to manage pathways out of hospital and into community mental health care teams. The aim is that medium-secure services be used only to address the most pressing clinical needs, rather than by patients for whom there is simply nowhere else to go.

Gavin says that the severity of his illness did not allow him to understand the benefit of his treatment during previous admissions to secure hospital. He returned to the prison system and stopped taking medication, leading to a deterioration in his condition. (Prisoners can reject medication, but some sections of the Mental Health Act, under which service users will be in hospital, allow for doctors to administer it without consent.) Eventually, after returning again to secure care, a course of therapy helped him manage his illness and turn over a new leaf.

“You get to a certain point where [you think], ‘What’s been going on? What have I been doing with my life?’” he says. “I just want to leave now. I don’t smoke anymore, I’ve not done drugs, I’ve not drunk alcohol and I don’t intend to. I don’t want to go back to that life.”

Better than prison: life inside the UK"s secure hospitals

5 Great Ways to Sleep Better and Be More Rested

Getting quality sleep is essential to your well-being. If you’re not well-rested, chances are you’re going to be extremely cranky. In order to avoid this situation, try to take heed of these five great ways to sleep better and be more rested.

1. Turn off the electronics.

We stay up really late on our smartphones, tablets, laptops and televisions. The light emitted from all of these electronics isn’t conducive to getting a good night’s rest. If you’d like to get good sleep, turn off all electronics an hour before bedtime. This allows your brain time to unwind and prepare for rest.

2. Create a bedtime routine.

Your bedtime routine might involve warm milk and a cookie. It could also involve a warm bath. Try to do something every night that triggers your brain’s ability to begin to shut down. If there are bright lights in your bedroom, start to dim them an hour before bed. The human body responds well to rhythms and cycles. As a result, try to create a bedtime rhythm. Over a period of time, the body will respond positively.

3. Find a book to read.

It’s not uncommon to get in bed with a good book and end up falling asleep. Something about reading a book causes many people to fall asleep when it’s late at night. Make sure the book you’re reading isn’t on an electronic device. This will only keep you awake. To get better sleep, choose a hard copy of a book. It’ll help your brain detach from anything electronic and focus on something else before you drift off to sleep.

4. Use a supplement

Melatonin is a known sleeping supplement many people use in order to experience deep sleep. If you choose to use a sleeping aid, just remember to use it as a temporary solution. It’s definitely not meant for long-term use.

5. Keep it cool in your home.

It doesn’t need to be cold in your home, but keep it on the cooler side. There’s science that proves it’s actually healthy to fall asleep in a cool room in a warm bed. Our bodies naturally cool down during sleep. If you turn the temperature to somewhere around 67 degrees, your body gets to a lower temperature faster. This, in turn, helps you experience deeper sleep.

Getting good rest is vital for your body to function properly during the day. If you struggle with insomnia, restlessness or even sleep apnea, try these methods and don’t give up.

Dixie Somers is a freelance writer and blogger for business, home, and family niches. Dixie lives in Phoenix, Arizona, and is the proud mother of three beautiful girls and wife to a wonderful husband. Dixie recommends that you follow the PDMA when dealing with supplements and medication.

5 Great Ways to Sleep Better and Be More Rested

Getting better all the time? Not any more… | Brief letters

“We continue to push VW to take action to compensate the UK consumer,” says the Department for Transport (Report, 12 December). But why is it that comment on the “dieselgate” scandal focuses on compensation to owners? It is city residents in general that suffer the health impacts, and it is the NHS that bears the costs of caring for them. VW should make payments that reflect these costs, and city leaders (including London’s mayor) should be holding Chris Grayling to account for achieving this.
Alan Wenban-Smith
Board member, Transport Planning Society, and former chairman of Birmingham Health Authority

• “Whatever happened to convalescent homes?” asks Mary Conn (Letters, 7 December). First we need to ask “Whatever happened to the concept of ‘convalescence’?” I haven’t heard this word used in decades. Perhaps there’s been the odd PhD about its demise; if not there ought to be. Its bizarre disappearance coincides to some extent with the ever-increasing brutality (and short-term stupidity) of government policies and practices that oblige people to function fully before they are recovered (whether being prematurely discharged home before they are ready, and/or prematurely forced back to work).
Jill Rakusen
Leeds

• I am a wheelchair user who has been very impressed by the help provided by platform staff and train guards. They help me board the train, show me to the right seat, and phone ahead to advise staff at my destination that I will need help leaving the train. If guards are abolished (Q&A: Why Southern rail passengers are facing such travel misery, 14 December), who will provide this service – or will I no longer be able to travel by train?
Sarah Benton
London

• So there is to be a leadership election in Unite (McCluskey rival attacks focus on Labour, 14 December). I’m not a Unite member myself; but I wonder if I would be allowed to register as a “supporter” and vote for Gerard Coyne?
Simon Elliott
Brighton

• A self-sown Helleborus x hybridus has been in flower since September. One giant leap for plantkind (Letters, 13 December)?
Margaret Waddy
Cambridge

• “Antwerp passes London as cocaine capital” (15 December). Is this another unforeseen Brexit effect?
Anders Clausager
Birmingham

• Join the debate – email guardian.letters@theguardian.com

• Read more Guardian letters – click here to visit gu.com/letters

Getting better all the time? Not any more… | Brief letters