Omid has an incurable condition and wants to die – it’s time the law changed | Saimo Chahal

Omid, a 54-year-old man who lives and works in London, was diagnosed with multiple system atrophy in 2014, a condition that cannot be cured and affects the nervous system. He has a wife and children but rarely sees them in order to spare them the agony. He attempted suicide in 2015 and was then moved to a nursing home. Even with care and family support, Omid wants to die to relieve his suffering. The alternative is to seek assistance to die abroad, but this will cost £10,000-£14,000, and he can’t afford this.

Omid wants to change the assisted dying law in England and Wales – a courageous and selfless act considering his condition. He wants to help others and to leave a legacy. The current law, although it does not criminalise suicide, forbids helping or encouraging suicide.

Omid argues that the law violates his right to private life, in breach of the Human Rights Act. The law does not allow him, and other competent and informed people in his situation, to choose how and when to die. He wants the high court to declare the law incompatible with the concept of human rights.

Rather than being terminally ill Omid has several years to live in this unbearable condition. Previous, failed attempts to change the assisted dying law, by Lord Falconer and Rob Marris, restricted assisted dying to terminally ill people with six months to live. This is a crucial difference with the current, ongoing Noel Conway case. Omid is asking for a change of the law for those with incurable conditions who may have many years of misery and pain ahead. The passing of an assisted dying law for terminally ill people would not have helped him.

The most recent right-to-die case in the UK involved Tony Nicklinson and Paul Lamb in 2014. A majority of judges (5-4) in the supreme court said that, although the court could make a declaration that the law on assisted dying was incompatible with the concept of human rights, they would allow parliament the opportunity to debate the issue first.

Parliament has recently considered the law on two occasions: in 2013, Lord Falconer’s bill proposed that terminally ill, competent adults should be allowed to request and receive assistance in dying after approval by two doctors. The bill did not have enough time for a full review in parliament, but in any case, would have been too narrow to help Omid who has an incurable, yet non-terminal condition.

Rob Marris’s bill was hastily defeated by the House of Commons on 11 September 2015 by 330 to 118 votes. Many found the debate unimpressive, raising questions as to whether parliament is the right forum for such legally complex and morally charged questions.

The main arguments against Omid’s case are that it will lead to a “slippery slope” (for instance, assisted dying leading to the legalisation of euthanasia) and that it will make weak and vulnerable people susceptible to harm. But there is no evidence from other countries that problems of this sort have occurred. It would not be difficult to devise a system that makes sure that the system is not abused – for example by having two independent doctors certify that the decision is freely made and without pressure from relatives.

The courts have tried to duck out of the responsibility once for not making the decision – they cannot afford to do it again if society is to have confidence in the legal system. The pain and misery this is causing is unbearable for people like Omid. They require and deserve the protection of the courts. The time has come for a change in the law.

• To find out more about Omid’s case, click here

Omid has an incurable condition and wants to die – it’s time the law changed | Saimo Chahal

LGBT people are prone to mental illness. It’s a truth we shouldn’t shy away from | Alexander Leon

I almost didn’t write this. It wasn’t from not wanting to. I cradled my head in my hands, desperate to contribute to the reams of social media positivity I had seen surrounding Mental Health Awareness Week.

I almost didn’t – couldn’t – because I was depressed.

There came a certain point in my experience of being LGBT where I accepted that I had to be strong and uncompromising in the face of disapproving glances and withering remarks. I made a pact to throw myself into my community with zeal, no matter how exhausting, and to make full use of the privileges I was afforded in the tolerant metropolis I’d landed in.

And yet, for some reason, I find this an incredibly difficult attitude to transfer over to my struggle with depression. I will share with my co-workers that I am going on a date with a man or going to an LGBT-themed event with an almost belligerent pride, but am overwhelmed with fear in having to admit to those same people that I’m leaving slightly early to see my therapist or that I need to take some time off due to another episode.

Indeed, the word “depression” still has a bite to it, in the way that the word “gay” did when I first dared to say it to someone else in reference to myself. The tone of my voice takes on an odd quality as I approach it in a sentence, to the point where I sound intolerably meek by the time “depression” tumbles out.

The thing is, in many cases, mental illness and being queer go hand in hand. It’s an uncomfortable but important reality that LGBT youth are four times more likely to kill themselves than their heterosexual counterparts. More than half of individuals who identify as transgender experience depression or anxiety. Even among Stonewall’s own staff, people who dedicate themselves to the betterment and improved health of our community, 86% have experienced mental health issues first-hand. It’s a morbid point to make, but it makes perfect sense that we, as a community, struggle disproportionately.

At a recent event I attended, set up to train LGBT role models to visit schools and teach children about homophobia, no one explicitly mentioned their struggles with mental illness. We told one another stories of how we had come to accept ourselves in the face of adversity, talking in riddles about “dark times” or “feeling down” or being a “bit too much of a party animal”. But these problems have other names – depression, anxiety, addiction – that we consistently avoid, despite being in a community in which a large percentage of us will have undergone similar experiences.

And this phenomenon replays itself over and over. Despite there being a common understanding between me and my queer friends that we’ve probably all been vilified in the same way and made to feel a similar flavour of inadequate, we will rarely acknowledge, even within the safe boundaries of friendship, that this has had a lasting impact on our ability to maintain a healthy self-image.

But part of being proud of who we are as LGBT people is being able to be open about the struggles we’ve faced. It’s in naming and wearing the uncomfortable badges of anxiety, depression and addiction that we take the first step towards fully accepting mental illness as an important part of our collective identity. After all, how can we be true role models to the next generation if we refuse to tell the whole story?

And so, this Mental Health Awareness Week, I’m issuing a challenge to my community. If you are LGBT and suffer from a mental illness, be defiant in your acceptance of it in the same way that you would about your sexuality or gender identity. Bring it up, speak it out and feel sure that your voice, however seemingly small or insignificant, is a valid one. After all, we have been, and will always be, a community of fighters – it’s about time we dared to show our battle scars.

LGBT people are prone to mental illness. It’s a truth we shouldn’t shy away from | Alexander Leon

Supporting LGBTI pupils: "It"s important a school is ready for anyone"

It was not long ago that LGBT pupils at the Priory School in Hitchen, Hertfordshire, hid behind a mask of silence. Fellow students used the word “gay” to describe something that was rubbish. Faced with homophobic language, they felt unable to come out in the classroom and kept their true identities secret.

Three years later, dozens of students have come out thanks to a “massive culture shift” in school. Today, diversity and inclusion are celebrated across all aspects of school life: from the setting up of an LGBT drop-in group and appointment of an LGBT student champion, to changes in the curriculum and the building of gender-neutral toilets and changing rooms. Indeed, the school has established such a reputation for equality it is attracting transgender pupils from neighbouring areas.

Priory now has a resident counsellor and has forged close links with local child and adolescent mental health services. Sixteen staff have also been trained in mental health first aid.

Assistant head Katie Southall has led the transformation. Responsible for student wellbeing, Southall realised that more needed to be done to promote equality and diversity. Surveys of young people who identify as LGBT revealed that many are at high risk of mental health problems.

The 2016 Youth Chances survey, conducted by the charity Metro in collaboration with the University of Greenwich, found that out of the 6,414 respondents aged 16-25 who took part in the survey and identified themselves as LGBT, some 44% said they had considered suicide.

Southall says: “We realised from an annual survey on student wellbeing that lots of students identified as gay or LGBT, but didn’t want to be open about it. We are now in a position where pupils are openly transgender, gay, bi, lesbian or gender questioning. For those who are transgender we have procedures in place for name changes and work together with the young person. That can mean getting people who have transitioned to come in and talk to young people.”

LGBT role models have also visited the school, including actor Sir Ian McKellen, co-founder of LGBT charity Stonewall, who spoke to 35 student members of the weekly LGBT drop-in group. “One sixth-former who is gay said he wished the school had been as open when he was in key stage 3,” Southall says.

Meanwhile Arbury primary school in Cambridge is working hard to promote diversity and has become a beacon of good practice. It has adopted a range of initiatives to stamp out gender stereotypes across the school, from abolishing pink- and blue-coloured name badges for reception children, to having a non-gendered school uniform.

Children are taught to respect difference from the start in reception: through picture books showing different types of families, and talks during circle time highlighting the school’s golden rules. Displays of materials from Stonewall with the slogan: “Different families, same love” are posted around the school, which also celebrates LGBT history month.

Staff are trained to understand how stereotyped views of how boys or girls should behave can prevent them from reaching their potential. Senior teacher Kathy Whiting says the school advises other schools on creating a trans-inclusive environment, including training on the use of inclusive language.

Headteacher Ben Tull says: “It is really important that a school is ready for anyone who walks in. For children at primary level, the more we can do to non-stereotype them the better. We steer away from the binary model.”

Supporting LGBTI pupils: "It"s important a school is ready for anyone"

It"s good to hear cycling to work reduces your risk of dying. But that"s not why I do it | Laura Laker

It may not be a surprise to see another study suggesting that cycling to work can drastically reduce your chances of getting cancer and heart disease – those who ride bikes for transport already know how good it makes them feel. However, it’s perhaps yet another motivation for those who don’t, to dust off their bikes – and remember some other reasons cycling to work is so great.

In a five-year study of 263,450 UK commuters, published in the BMJ, researchers at Glasgow University found regular cycling cut the risk of death from any cause by 41%, and the incidence of cancer and heart disease by 45% and 46% respectively.

The cyclists in the study were riding an average of 30 miles per week; that’s three miles each way, five days per week. Cycling at a leisurely 10mph, that would take about 20 minutes each way – a manageable distance for most people.

At present only 3% of the UK population commute by bike, while 36% use a car. If we increased cycling in this country to German levels by 2025, we would save £1.8bn in health benefits and £284m thanks to less congestion.

Ask anyone who cycles to work why they do it, and they’ll have a story to tell, whether it’s about how good it makes them feel, how they saved money, lost weight, or won a battle with depression. Most people will tell you how enjoyable it is.

My commuting story began at university. I remember being astonished one morning when I realised my friend Szilvia had cycled from Finsbury Park in the rain. Getting on a bike and riding five miles in such conditions sounded miserable, but she looked happy and bright, and told me how great it was.

We lived fairly close to one another and she offered to ride with me one day. As I pedalled frantically to keep up with her through Regent’s Park, and Camden, it was like I’d grown wings. Before long, like her, nothing short of a gale force wind with pigeon-sized hailstones was going to stop me from experiencing this feeling every day.

For the first time in my life I started getting fit. I arrived at university feeling awake, alert, and generally in a good mood. I continued to cycle to various temp jobs around London after graduation, carrying my work clothes in a pannier and getting changed in the loos.

On crisp, sunny mornings, I’d cycle through the city feeling like it had rolled out the red carpet just for me. I’d levelled up on urban living: I’d whizz past the stationary traffic and queues for buses and try not to look too smug.

I’d chat to others at the traffic lights. Often I’d get to places quicker than public transport could carry me. Often it was the best part of the day.

Fitting exercise into your daily routine is infinitely easier than trying to carve out a slice of it to go to the gym. Without even trying, you get fitter if you cycle. It is no surprise that levels of physical activity are declining as fewer people cycle or walk to work.

In the cities of cycle friendly countries, such as the Netherlands and Denmark, up to 41% of people commute by bike because it’s easy to do and it feels safe. Decades of investment in cycling infrastructure have made it that way. These countries have learned that most people prefer protected, direct routes on main roads, and low-traffic neighbourhood streets. This means people of any age can cycle, from the very young to the elderly. In the Netherlands, for example, 20% of 80-84 year olds regularly cycle.

Imagine if the UK was like the Netherlands, where 20% of 80-84 year olds regularly cycle. Photograph: Rory Buckland L/Alamy Stock Photo

In the UK, meanwhile, we’ve had decades of car-centric planning, and minuscule levels of funding for cycling. Even though cycling is statistically safe, it doesn’t always feel it, and this fear of sharing road space with motor traffic is the key reason people don’t cycle or stop after trying it.

The government knows that every £1 spent on cycling brings £5.50 of benefits, but at present it spends just 72p per person per year on cycling, compared with £86 per person per year for roads. There is huge potential for more journeys to be cycled if that were to change.

Increased levels of cycling can bring benefits for everyone, whether they cycle or not. Bicycles take up far less road space than cars and emit no toxic fumes. They’re good for our high streets: on New York streets where cycle lanes were introduced average trade rose by a quarter. What’s more, bicycles are great social levellers – according to research, mass cycling could increase mobility of the nation’s poorest families by 25%.

If a magic pill were invented that could generate all of these benefits, we would be falling over ourselves to buy it. As it is, no magic is required, just steady, long-term planning and investment, and a commitment to the humble bicycle, so that more of us can enjoy the simple, life-giving joy of cycling from A to B.

It"s good to hear cycling to work reduces your risk of dying. But that"s not why I do it | Laura Laker

"It can"t be much worse than licking a battery." What it"s like to have ECT

I have had depression and anxiety, mainly depression, on and off since I was a teenager. After dealing with it for 10 years I had a particularly bad winter when I was working almost 24-hour shifts at work.

I went to visit my aunt overseas because I got a few weeks’ sick leave. I thought I’ll go, I’ll decompress, but while I was there I got sicker and sicker.

The GP there prescribed something called Lyrica [an anti-seizure medication also known as pregabalin]. I don’t know whether that had anything to do with it, but I went into a psychotic episode – I thought I was going to be deported, I had a lot of paranoia.

I suddenly started getting very, very anxious – and took an overdose. That landed me in hospital. I was a voluntary patient but I think I would have been forced if I wasn’t voluntary.

I was there for a really long time – a couple of months. I saw a lot of people come and leave and I wasn’t really able to do anything. They had an ECT [electroconvulsive therapy]clinic downstairs and the psychiatrist kept on suggesting it.

Eventually it came to the point where they had tried all these medications that weren’t working and I was an absolute nightmare – I was really difficult and I couldn’t do anything. After being really reluctant I finally gave in. I thought either I am going to die this way, or ECT might help. My aunt was like: “Well, we have tried everything else.”

They scheduled it super quick. We said yes on Friday and they scheduled it for Monday, then they did it three times a week for two weeks.

At first I was worried because of the image you get from the horror films of people being strapped up and electrocuted. Then I learned a little more about it, although I couldn’t do any reading on my own because I was so anxious – I couldn’t even cope with the phone. But I talked to my aunt who put it in really simple terms and talked about all the side-effects.

The thing that scared me the most was the memory loss. I went to an elite university and I really pride myself on my brain, so I was worried. Was this going to make me stupid? But I reached the point when I said: “Well, I don’t care if I am stupid. If I’m stupid and happy it’ll be fine.” So that is what made me go for it, even though I had a very bad perception of it.

The doctors talked me through the entire process. I had never been under general anaesthetic before and because I was anxious and paranoid about not being in control of my body, that was something I was really afraid of. I agreed to do it if my aunt could be in the room – but she wasn’t allowed in the room when they gave the electric shock because it is so traumatic for loved ones.

Before the ECT, they showed me the equipment and said: “The amount of electricity we are putting through your brain is enough to light a lightbulb for a second.” I was thinking: “How is that going to do anything? It can’t be much worse than licking a battery.”

After the first session all the nurses said: “You are so much calmer. I think this is really working. This is really good.” I thought: “I don’t know what you are talking about. I am still super-anxious and I hate my life.”

But looking back, the change happened almost immediately. After the first week I had hoped that I was going to leave the hospital and by the end of the sixth session, after two weeks, I was ready to get on with my life.

I had problems though – mainly short-term memory. I compensated for that by using a journal. Whatever my therapist advised, I’d write down and look over every day and try to do it. But I constantly found myself being told that I had already just told people something I had said. I had to monitor my medication very carefully. The memory issue went away in the course of the month. The benefit of ECT stayed for about six months and I needed to keep taking medication to prevent a relapse. But it didn’t work.

I was hospitalised again – this time in the UK.

I really wanted ECT. But they said the memory effects can be worse if you do it again and again and at that point I wasn’t psychotic. It is much harder to reach someone once they are psychotic because you can’t really rationalise with them, whereas I did what people told me to do, so that drastic measure of ECT wasn’t really necessary. But as soon as I mentioned ECT to any medical practitioner in the UK they said: “Oh my God, seriously?” The only semi-positive reaction I had from one of my GPs was: “Wow, how was that? I have never met anyone who had it.” He wasn’t judgmental, just really surprised and fascinated. In hindsight, I don’t think ECT was the right thing to do.

Sometime later I relapsed again. This time I had ECT on the NHS. They then diagnosed me as bipolar.

After I first had ECT I was really freaking out about whether I was going to tell people. But because of my short-term memory problems I was forgetting who I had told what and it was getting really stressful. It got to the point where I was anxious to meet people because I was wondering: “How much do they know? What do I say?” Which is why I put it up on Facebook, because that way everyone knows the same thing. But I am quite reluctant to tell people that I had psychosis. Because although mental health issues are more accepted and depression is quite common, psychosis is like really crazy. Taking medication is more accepted now, going to therapy is more accepted, but ECT … I think people think of One Flew Over the Cuckoo’s Nest.

There is definitely a lot of concrete evidence of ECT working. My aunt was absolutely floored by the results and she talked to the nurses and they said: “It is almost like a miracle but we see it every week.”

(*Name changed for confidentiality)

"It can"t be much worse than licking a battery." What it"s like to have ECT

I"ve had to remove all of a toddler"s teeth. It"s time for a war on sugar

It is the end of an afternoon in theatre and I have extracted more than 100 teeth from my operating list of eight patients, the youngest a two-year-old who needed all 20 baby teeth removing because they were so decayed. I watch in silence as a child younger than my own is transferred from the operating table and I wonder how we reached this point as a society where I don’t believe we truly value oral health, nor realise the implications of failing to do so.

Nearly 20 years after observing my first general anaesthetic as a student it doesn’t get any easier. I regularly see parents overcome by guilt and emotion as they watch their child being put to sleep, or recovering dazed and confused in the recovery suite. Sometimes after a busy afternoon I sit in the theatre and wonder if there is more I can do, sometimes I have nothing left to give.

Responsibility for oral health promotion has been devolved to cash-strapped local authorities

As an NHS consultant in paediatric dentistry, it sadly comes as no surprise to me that removal of decayed teeth remains the most common reason for a child aged five to nine years to be admitted to a hospital in England. In these straitened times, it seems so wrong that every year we spend around £35m on operations to treat a disease that is almost always preventable.

The frustration is that the solutions are already out there. Ten years ago, the Scottish government agreed to invest in a programme of oral health prevention called Childsmile. Now every child in Scotland has access to free daily supervised toothbrushing in nursery and free dental packs to support toothbrushing at home. Dental registration is encouraged and those communities and individuals who are higher risk have more support. The result? Scotland is reducing the millions of pounds it spends on general anaesthetics and turning around the oral health of its children, for the princely sum of £17 per child per year.

Wales has a similar Designed to Smile programme but in England, responsibility for oral health promotion has been devolved to cash-strapped local authorities. This means that it is a postcode lottery with some excellent programmes, such as Teeth Team in Hull, while in other areas existing services are being decommissioned.

England needs urgent investment in oral health prevention. It is actually more cost effective to prevent, rather than treat, dental disease but more importantly we could be preventing tens of thousands of young children, and their families, from potentially experiencing pain, swelling and sleepless nights and time away from school or work.

Every child has a right to good oral health yet still we see one in eight three-year-old children with obvious signs of decay. We need a more radical approach to reduce the persistent inequalities in oral health, which are immoral in this day and age. We need more compassion, an accelerated programme of product reformation so that the sugar content is reduced, and a war on marketing of high sugar products aimed at children.

Two years ago after a particularly frustrating consultation with a parent whose child’s diet was limited to Ribena and biscuits, I decided to begin writing a blog as a way of delivering practical information. I have reached many more families than I would in my day job, but I still feel as though I am wading in a sea of untreated decay. Education is important but it forms only part of the solution. It is too simplistic, and frankly unhelpful, to apportion all blame to the parents. Yes, as parents we have responsibilities and a vital role to play – but we could all be more proactive when it comes to children’s oral health.

I am delighted at the growing number of organisations that are now beginning to collaborate with myself and colleagues via the British Society of Paediatric Dentistry. Health visitors can and are encouraging a dental check before a baby’s first birthday; sports and education settings can lead by example, adopting low-sugar menus and refusing to place sugary drinks in their vending machines; and communities should campaign for water fluoridation. Above all, we need strong, visible leadership by local and national government that says, “This is not acceptable and we are going to do something about it”. Children’s oral health should be everyone’s business.

If you would like to write a blogpost for Views from the NHS frontline, read our guidelines and get in touch by emailing sarah.johnson@theguardian.com.

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I"ve had to remove all of a toddler"s teeth. It"s time for a war on sugar

Race for Life’s branding is cliched and infantile. It’s time to sink the pink | Phoebe-Jane Boyd

Beset upon by pink fluff on all sides, like awaking to find yourself trapped in Barbara Cartland’s musty closet, we’re once more in the midst of Race for Life fundraising season. It’s an important and worthy cause, and yet many hearts (soft, kind hearts) can’t help but sink at the pinkification. “I’ll donate later – I promise” is hesitantly mumbled to beaming participants, and donations are quietly given to the main Cancer Research UK branch instead.

Does avoiding the old-fashioned-gender-cliches-for-charity’s-sake make you a monster? Or should charities receive the same criticism other publicity campaigns get when they use tired stereotyping?

Race for Life isn’t Oven Pride, obviously – it works to save lives, helping those impacted by breast cancer and building a community of support. We know this, we agree with the work. But not always so much with the gender-segregation (men are still banned from running in the races alongside women), and its core brand colour that pulses (however unfairly) with negative undertones, highlighted by such campaigns as Think Before You Pink and Pinkstinks – and the documentary Pink Ribbons, Inc.

Working to balance out Race for Life’s saccharine feather boa-and-cupcake prissiness with some grit are today’s grime-caked Pretty Muddy events, aggressive taglines such as “Hell hath no fury like a woman in pink” and adverts with Braveheart-like line-ups of women ready to run. But can there be any escaping the pink central to it all, and its associations?

After all, the rosy breast cancer awareness ribbons used by organisations such as Race for Life only came about after Estée Lauder turned originator Charlotte Haley’s peachy-orange strips to pink back in the 1990s, after researchers found the colour to be the most “non-threatening”. Ad copy can be packed to the hilt with wrath, dirt, and ferocity, but if its core colour was chosen for its non-threatening impact, then any lately adopted roughness comes across as a weak cover for still-fluffy and asinine insides.

Race for Life’s cutesy and sometimes infantile branding (Real Women Wear Mud, apparently) has a gender problem at its heart. And it’s not necessary. Just because a charity is fundraising for a gender-specific disorder or disease, it doesn’t follow that its efforts should be based around outdated gender cliches to gain support. That belongs to another time; not today, not now. In any case, breast cancer doesn’t just affect women: it’s rare, but men can have the disease too.

A counterpoint to Race for Life’s downsides, if you’re looking for some male-focused charity stereotyping, is the Campaign Against Living Miserably’s (Calm) Mandictionary initiative. “Mandictionary” – sounds just terrible, doesn’t it? Down there with the passive-aggressive phrase “man flu”: it’s that low. Bus stop posters for the campaign feature words such as Mantip (“Disposal of a drink when you’re struggling to keep up with your mates”) and Manbaggage (“A puppy [...] used by a bachelor to heighten ‘cute levels’ in parks”) – so far, so much forced machismo bullshit. But then there’s Imangination (“The capacity to believe in multiple definitions of masculinity”) and Mandown (“One of the 12 men who take their life every day in this country”).

Calm are doing something slightly more subtle – aiming to dismantle the stereotypes that men are pressured to conform to by parodying some of the most trite. Many examples are contributed via Twitter and Facebook by men who are hurt by such cliches. It’s an unexpected, clever way to highlight the harm in gender essentialism.

So how do we get more of these different approaches and voices into advertising and awareness campaigns? The IPA’s diversity quota for UK advertising, marketing and communication agencies looking to hire and promote could be one way. Before three years is up, the industry must have 40% women in senior roles and 15% of its senior people from non-white backgrounds. Prescriptive perhaps, but needed in an industry that isn’t moving quickly enough on its own.

Real charity campaigns – and successful marketing/advertising campaigns – don’t make potential contributors feel resistant and uncomfortable about engaging with them. The industry that puts them together needs new voices that we can relate and respond to. Ultimately that’s the best way to make all of us – whatever our gender or race – dip into our pockets.

Race for Life’s branding is cliched and infantile. It’s time to sink the pink | Phoebe-Jane Boyd

The fog of Brexit is engulfing the NHS. It’s up to Theresa May to provide clarity | Jonathan Ashworth

Everyone knows that after seven years of neglect from the Conservative government, the NHS is undergoing a serious crisis of funding and staffing. The last thing needed is more uncertainty. That is exactly what the NHS faces with Brexit.

On Wednesday Theresa May will trigger article 50 and later this week health bosses publish the updated Five Year Forward View. It is time for the prime minister and the health secretary, Jeremy Hunt, to give the NHS and its patients the certainty needed through the Brexit process. May has already turned her back on the promise of £350m a week for our NHS and now she is walking away from her responsibilities to protect the health service through a turbulent Brexit process that will hit it hard.

The complacency in government is astounding. Last week Hunt published the department of health’s Mandate to NHS England to set “the government’s objectives and any requirements for NHS England”. Amazingly, the 24-page document made no mention of Brexit whatsoever.

It should come as no surprise that the NHS is not a priority for the government. Hunt isn’t even a member of the cabinet committees managing the exit strategy. Yet Britain’s health and social care system is dependent on tens of thousands of European staff, many of whom have settled and built lives here while caring for our sick and elderly. Safeguarding the future of these staff should be an absolute priority in the Brexit negotiations. But in the House of Commons last week Hunt failed to offer any reassurance that he’s prepared to stand up for this essential section of the workforce he oversees.

Will health professionals from other EU countries be able to come to work in our NHS after Brexit, or will there be a cap on their numbers? As long as the issue is left unclear, more and more EU workers are voting with their feet and leaving on their own terms. In a recent survey, 42% of European health staff working here said they are now thinking of leaving the UK. Almost 5,500 have left since the Brexit vote according to NHS Digital, a 25% increase on the 2015 figures. And others are being put off from coming here at all: only 96 European nurses registered to work in the UK in December – that figure was 1,304 for last July.

So our first test of the government plans will be whether they deliver a right of remain for the 140,000 EU nationals working in the NHS and social care system. Secondly, on funding, we know that the EU’s Horizon 2020 scheme is due to invest £7.5bn in health research across the EU over the next five years, and the UK will be by far the largest recipient of those funds. We also receive EU funding from the Innovative Medicines Initiative, the European Cooperation in Science and Technology programme, and the Active and Assisted Living programme for older people.

This long-term funding is vital in giving security to those medical institutions and universities planning major research projects. They cannot just wait and see what will happen after 2019. So we need to know whether access to these funding streams will continue after Brexit. If not, how do the government propose to make up the shortfall?

Our third test is on reciprocal healthcare arrangements. It is a key principle that British citizens can obtain free healthcare elsewhere in Europe, just as they would at home. That is an important safety net for British holidaymakers, and for UK citizens living elsewhere in Europe. Does the government intend to maintain those arrangements? If not, how will it address the increased insurance costs for UK holidaymakers?

Our fourth test is on EU healthcare collaboration. Working effectively with our European partners, on everything from infectious disease control to the licensing and regulation of medicines, has been vital for the NHS in recent years. The sector desperately needs to know whether it’s the government’s intention to maintain the UK’s participation in pan-European public health initiatives after Brexit. Will the UK continue to participate in the centralised marketing authorisation procedure for the licensing, sale and regulation of medicines, governed by the European Medicines Agency? The government needs to be clear about how Brexit will affect the UK pharmaceutical industry when exporting medicines to other member states in future.

These are difficult and detailed questions, but they are all of absolute importance to the future of our health service and of our medical research sectors. There is no reason why May should refuse to give us the answers. That will allow us to understand with greater clarity what the impact of Brexit will be on the NHS – and most importantly, it will allow patients and staff the opportunity to scrutinise the government’s plans closely over the next two years.

The NHS is already in crisis over funding and staffing. But Brexit has the potential to tip those crises into disasters. Patients and NHS staff should not be bargaining chips in May’s hard Brexit negotiations. They want a world-class NHS delivering the best quality healthcare. As article 50 is triggered, the very least the public deserves is clarity and certainty from its government.

The fog of Brexit is engulfing the NHS. It’s up to Theresa May to provide clarity | Jonathan Ashworth

It"s good to talk: pupils gather for world"s largest mental health lesson

“Talking about mental health does not make you weak,” the world’s largest mental health lesson has been told. Til Wykes, a clinical psychologist, told an audience of more than 500 13-18-year-olds from around the country: “We want to get people to come to treatment early because if they come early, they recover faster and they recover better.”

The event on Tuesday at Hackney Empire in east London, compered by the 4Music presenter Maya Jama, was designed to teach children and young people about what mental health is, how to protect it and deal with problems when they arise. Officially recognised as the Guinness World Record for the largest-ever mental health lesson, with 538 young people present, the hope is that it also raises general awareness about the issue among young people and helps combat the stigma surrounding it.

There were gasps from the pupils as they heard one in 10 five-to-16-year-olds have mental health problems, amounting to 850,000 children, and 75% do not get the help they need.

Wykes, who works at King’s College London, told pupils that in a class of 30 that meant on average three would have mental health problems at some point – or possibly more as the current estimate of one in 10 is believed to be out of date – so they were all likely to be touched by the issue in some way.

Dame Til Wykes, who helped organised the event, said if people come early, they recover faster and they recover better. Photograph: Martin Godwin for the Guardian

Hussain Manawer, the poet, mental health campaigner and soon-to-be astronaut who organised the event with Wykes, told the audience: “If you are going through something you need to speak to someone about it, but if you don’t feel comfortable about talking to your friends then maybe you need to evaluate who your friends are.”

Video messages of support from a host of celebrities were played and there was even backing from the Duke and Duchess of Cambridge and Prince Harry, who stressed “how important it is to talk about mental health”.

Manawer, who has his own YouTube channel, Hussain’s House, and has just released his first single, I’m ashamed, also drafted in entertainers to talk in person about mental health and entertain the children after the formal part of the lesson, which conformed to strict rules dictated by Guinness World of Records, including no toilet breaks or talking by pupils, except when asked to respond.

The 30-minute lesson touched on famous figures of the past such as Virginia Woolf, Isaac Newton and Winston Churchill who have suffered from depression, alongside contemporary names such as JK Rowling, Professor Green and Kelly Holmes, illustrating that being successful does not offer immunity from depression.

Pupils were told that that in a class of 30 on average three would have mental health problems at some point. Photograph: Martin Godwin for the Guardian

The dangers of cannabis – particularly high THC skunk – were also discussed, the damage done by using pejorative terms to describe people with mental health problems and the importance of sleep, as well as how staying online at bedtime has the potential to disrupt it. The audience was told about the importance of communication and the services offered by the Samaritans, Childline and Young Minds.

After the lesson, the pupils were entertained by the YouTube comedian Humza Arshad, Jordan Stephens (one half of hip-hop duo Rizzle Kicks) and singer Sinéad Harnett, although there were still serious points to be made.

“Hear me, I would have this [subject] on the national curriculum, I have no idea why it’s not,” said Danny-Boy Hatchard, who played Lee Carter – a character with mental health problems – in EastEnders. “Not all of us will use the circumference of a circle or algebra [but everyone will use this].”

It"s good to talk: pupils gather for world"s largest mental health lesson

It"s official: access to green spaces leaves you in the pink

People living close to trees and green spaces are less likely to be obese, inactive, or dependent on anti-depressants, according to a new report.

Middle-aged Scottish men with homes in deprived but verdant areas were found to have a death rate 16% lower than their more urban counterparts. Pregnant women also received a health boost from a greener environment, recording lower blood pressures and giving birth to larger babies, research in Bradford found.

Overall, nature is an under-recognised healer, the paper says, offering multiple health benefits from allergy reductions to increases in self-esteem and mental wellbeing.

A study team of 11 researchers at the Institute of European environmental policy (IEEP) spent a year reviewing more than 200 academic studies for the report, which is the most wide-ranging probe yet into the dynamics of health, nature and wellbeing.

The project first appeared as an unpublicised 280-page European commission literature review last autumn, before being augmented for Friends of the Earth Europe with analysis of the links between nature-related health outcomes and deprivation.

“The evidence is strong and growing that people and communities can only thrive when they have access to nature,” said Robbie Blake, a nature campaigner for Friends of the Earth Europe, which commissioned the analysis.

“We all need nature in our lives, it gives us freedom and helps us live healthily; yet deprived communities are routinely cut off from nature in their surroundings and it is suffocating for their well-being.”

The report makes use of several studies that depict access to nature as being inextricably linked to wealth inequality, because deprived communities typically have fewer natural environments within easy reach.

Despite this, the study cites research that 26% of England’s black and minority ethnic populations visit natural environments up to three times a year, compared with 15% of the rest of the population.

Patrick ten Brink, the IEEP’s director, praised cities such as Oslo and Victoria-Gasteiz for taking steps to make nature accessible to all.

“We should be inspired by this and work together so that all Europeans have nature within 300 metres of their homes in the next 10 years,” he said.

Previous US research has found that that hospital patients with tree views from their windows were discharged a day earlier than those whose rooms faced walls.

An extra 10 trees on a Toronto city block provided health benefits to residents equivalent to a $ 10,000 increase in annual income, or being seven years younger, another study in 2015 found.

It"s official: access to green spaces leaves you in the pink

I hate restraining mental health patients but often it"s the only option

People imagine mental health nurses like me as kind and gentle, as mother figures in uniform. What they don’t see is the harm we do to our patients: we lock them away, we restrain them and we take away their freedom. We do this in line with the law and we firmly believe we are doing the right thing. We are not “nice”, but when I look at my colleagues, I see strong, selfless, determined heroes.

I wish I could offer service users something better: a peaceful outdoor space, their own room, something less clinical than easy wipe armchairs. Most of them do not even agree that they are unwell and this deeply felt sense of injustice permeates the ward.

I remember one woman, Sarah*, was so psychotic by the time she entered hospital that she was not eating and had not washed in weeks. She could not see that she was unwell and was convinced we were trying to harm her, so would not accept medication. You could see how much she was suffering from her disheveled emaciated body to the distant horrified look in her eyes. We couldn’t just leave her like that. Her psychiatrist decided we needed to give her a long acting antipsychotic injection. She would need this to treat her psychosis.

The time comes to give her the injection. Despite doing everything we can to persuade her, she refuses to accept it and we have to do it under restraint. She is terrified and struggling so much to try to get free that we need five people to restrain her so she is lying on the floor. Her injection is licensed for the top of the buttock only, so we need to lower her trousers and underwear to administer it. We constantly check our techniques and her posture. We make sure that she can breathe freely and that we are not damaging her joints. She needs to be very still so we can inject her in the right place and not near important nerves or arteries. We explain this and try to reassure her but she remains terrified of our intentions. She lets out a primal wail of fear and then starts to scream. The room smells of sweat and anxiety. But we still have to inject her. I stay with her afterwards and she cries uncontrollably.

What really cuts right through me is that restraint is not some awful mistake, it is a carefully planned intervention. Everything in your being wants to stop this, to let the poor women be, but you have to carry on because you know it’s the right thing to do. It takes more than “niceness” to be here, you have to have a heart as big as the earth and, at the same time, be made of stone. Of course it helps that I found out a few months later she was rebuilding her life again: she was eating normally and looking after herself.

In my experience, there are very few decisions in nursing that weigh on us more heavily than whether or not to restrain someone. By the time someone is in hospital, they are often in extreme states of crisis and all the kind words in the world will not persuade them to take medication.

Prevention, in mental health, is everything. If we catch people in the community, as they start to deteriorate, they are more capable of engaging with services, of expressing their wishes, of maintaining their dignity and autonomy.

In the case of Sarah, and so many others, services were so under pressure that there were not the resources to catch her at this tipping point. The answer is not just medical intervention, it’s about keeping Sarah well by supporting her to live a rich and purposeful life.

Now, with so many cuts to social care, she is increasingly isolated. Real terms spending in mental health services dropped by 8% between 2011 and 2015. The success of these savings is constantly being rated against efficiency criteria like length-of-stay and symptom reduction but, for me, the real human cost is harder to quantify.

*Not her real name

Some details have been changed

If you would like to contribute to our Blood, sweat and tears series about memorable moments in a healthcare career, read our guidelines and get in touch by emailing sarah.johnson@theguardian.com.

Join the Healthcare Professionals Network to read more pieces like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views.

I hate restraining mental health patients but often it"s the only option

Vitamin D is not just beneficial, it’s a necessity | Letter

Great to see vitamin D on your front page at last (Vitamin D ‘proved to cut risk of colds and flu’, 16 February). Those of us in the British Society for Ecological Medicine, a group of doctors who take the nutritional aspects of our patients’ treatment very seriously, have been banging on about the benefits, and indeed the necessity, of vitamin D for decades. Indeed, the society’s president, Dr Damien Downing, published a book about it back in 1988 entitled Day Light Robbery – The Importance of Sunlight to Health.

I would just like to add two points: first, vitamin D is vital not only to the health of the immune system, thereby in fact reducing the likelihood of cancer as well as of infections, it is also essential for mental health. In young people with depression and in older people with onset of dementia, we find desperately low levels of vitamin D. Vegans are particularly at risk, because in the British climate they have virtually no source of vitamin D at all.

Second, with regard to the proposal to add vitamin D to our food: it is crucial that this be the real thing, vitamin D3, cholecalciferol. Too often, what is added to foods and cheap multivitamins is vitamin D2, ergocalciferol, which is synthetic and far less useful.

Thank you again for publicising this excellent research.
Dr Jenny Goodman
Barnet, Hertfordshire

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

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

Vitamin D is not just beneficial, it’s a necessity | Letter

It’s painful watching the male crisis onscreen – more painful in real life | Deborah Orr

Had Moonlight not come along, hard on its heels, Manchester By the Sea might have seemed like the most emotionally revealing film about a man to have been released in years. But since Moonlight is probably one of the most emotionally revealing films about a man ever to have been made, it wins.

It isn’t fair to set the two in competition. They’re doing similarly important things in their different ways – exploring negative aspects of masculinity. In Manchester By the Sea a single, unlucky catastrophe turns a warm, fun-loving young man into an angry, aggressive, emotionally shut-down loner. In Moonlight, a whole childhood conspires to drive a man to become a numb synecdoche of all that has blighted his own upbringing.

It’s undoubtedly because I’ve recently been diagnosed with a trauma-induced anxiety disorder myself. But I immediately saw the symptoms of chronic or complex post-traumatic stress disorder in both leading characters.

In Manchester By the Sea, Lee Chandler, played wonderfully by Casey Affleck, displays symptoms of chronic PTSD, in which a single trauma comes to dominate the brain’s neural pathways in an extremely unhealthy way. You can also see these symptoms simply as emotional reactions that any person in Lee’s situation might develop. But the point is this: we are so used to these destructive and damaging responses to life’s vicissitudes that they seem natural rather than horribly dysfunctional.

In Moonlight, Chiron, played by three actors as a child, a teenager and an adult, already has complex PTSD, to my eyes, as a little kid. Complex PTSD is brought on when a person is subjected to a series of traumas, most often by a caregiver they ought to be able to trust unconditionally, but from whom there is little chance of escape. Abused or neglected children are very susceptible to C-PTSD. By the time Chiron is an adult, from my reading of the film, C-PTSD is rampant.

There’s a lot of controversy at the moment about whether armchair diagnosis of mental health problems should be indulged. I think it’s totally valid when the character being examined is fictional. I’d say it’s more than valid. It’s necessary if humans are going to get to a point where we can understand ourselves and the messes that we make.

In Manchester By the Sea, Lee is a man who really, really needs therapy, though this isn’t mentioned as an option in the film. The culture he’s in is far too blue-collar for that. Lee fights his miserable losing battle with his trauma, guilt and shame alone. As with Chiron in Moonlight, his symptoms are classic too. It’s so plain in the film that what a psychiatrist would call symptoms are also self-protecting emotional responses, recognisable to anyone who cared to view them in that way.

Having mentioned the controversy around amateur diagnosis, I’m now going to tread carefully. After the screening of Moonlight I attended, there was a Q&A session with Tarell Alvin McCraney. He wrote the play on which Moonlight is based, In Moonlight Black Boys Look Blue.

McCraney makes no secret of the fact that the early part of the story, of a boy growing up in Miami with a crack-addicted mother, a flawed father-figure who loses his life very young, and the experience of being bullied as a “faggot” by his peers, is based on his own life. McCraney’s life clearly has not followed the trajectory of Chiron’s because, you’ll be glad to know, the film doesn’t end with our hero sitting down to write an amazing play that becomes a film. You’ve seen that movie already, more than once.

Boys are told not to cry, told to fight back, told to toughen up, in a way that girls less frequently are

McCraney – intelligent, gloriously articulate, handsome, elegant, funny, charming, polished, self-deprecating – is also frank. On the platform he acknowledged that he knows how people see him, which is pretty much the way I saw him, as listed above. It wasn’t just me. The room was full of love for him. However, he says, this is not at all how he sees himself. Instead, he is “terrified”, has “intimacy issues”, sometimes can’t bear crowds and has to be alone, and sometimes finds himself drifting away from feeling present in the world. He has survived his upbringing and thrived fantastically well. But the psychological scars are there and he is aware of them.

McCraney says that he doesn’t find writing about his past cathartic. Instead, it depletes him. It costs him a lot. I think that while some men, men like Lee, fight with their fists, McCraney fights with his creativity. It’s a much healthier way to do battle with trauma. But that’s still what it is – a battle with trauma.

I find myself thinking that while both Lee and Chiron are extreme examples, a lot of the cliches about the transformation of boyhood into manhood centre on the suppression of trauma. Boys are told not to cry, told to fight back, told to toughen up, in a way that girls less frequently are. (Although girls do toughen up. I did.) Sure, this can result in creativity like McCraney’s. But our experience of the world and its history suggests that very often it results in bombast and aggression, anger and violence.

We are used to hearing about theories of gender as a performance. I wonder if that’s too glib. Maybe gender is more of a neurological response, with hyper-masculinity a pathological response to trauma, and hyper-femininity a defence against an aggressive masculine pathology. Or maybe I’m barking up the wrong tree. Who knows?

The crucial thing is that these films are urging people to look hard at these profound issues around human behaviour, and really think about what makes people who they are. I’m thankful for both of them, and for the pain and struggle sometimes involved in “being a man” that they so sensitively portray. Especially Moonlight. I don’t think there’s ever been another film quite like it.

It’s painful watching the male crisis onscreen – more painful in real life | Deborah Orr

Wild sea swimming in my 60s: "it erases problems, it"s being a child again" – video

A workaholic with grown-up children, Julia found herself lonely and facing retirement without a plan. Living in Italy, she visited England to see her daughter living in Plymouth and decided to stay, but her first winter saw her hibernating from the cold and she put on 20kg. But now the 66 year old says the sea has become a symbol for her re-invigorated life, after she took up daily cold water swimming at Porthcurno beach, near Penzance – ‘it’s freedom, joy, pleasure’

Wild swimming in the UK: 10 top spots

Wild sea swimming in my 60s: "it erases problems, it"s being a child again" – video

Dementia Diaries: "It"s like trying to go through a brick wall" – video

Dementia Diaries is an audio diary project that captures people’s diverse experiences of living with dementia, now the leading cause of death in the UK. While the origin of the disease is still unclear and symptoms can vary greatly, these recordings, here with accompanying film, aim to capture some of the complexity of each caller’s individual perspectives

Dementia Diaries: "It"s like trying to go through a brick wall" – video

Mario, you crossed into our world at the worst time – it’s no game over here | Emily Reynolds

Mario is coming to a street near you. His latest outing, Super Mario Odyssey, was unveiled in a Nintendo trailer earlier this month, and shows the moustachioed plumber gleefully sprinting around a facsimile of New York, hopping over taxis and scaling skyscrapers. Elsewhere, he swings through dewy forests and slides through realistically animated streams. The angry, sentient plant pots may be slightly less believable, but that’s besides the point – Mario has been plucked from the multicoloured fantasy of the Mushroom Kingdom and dumped into our much less palatable reality.

Unfortunately for him he appears to have crossed dimensions at the worst possible time. Super Brexit Odyssey doesn’t sound like a very appealing venture, though Boris Johnson’s foppish faux-blustering would probably slot disturbingly easily into a fantasy game. In an ideal world, Donald Trump would remain a harmless parody of the boorish, hard-to-beat final boss in a video game; in the real world he is the newly inaugurated president of the United States, and already having a marked and negative impact on people’s lives.

His picks for cabinet have included a raft of ardent anti-choice climate change deniers, including a vice-president who supports “conversion therapy” for members of the LGBT community, and believes women should have to state in writing whether aborted or miscarried foetuses should be buried or cremated. The real world is currently looking pretty overrated.

And not only that, there will be no predetermined paths for Mario’s coin collection anymore. Unlike previous iterations of the game, which have taken place in set, closed-off levels, players will be able to roam a more open-ended world. Mario can cross roads, climb ladders, scale buildings and hitch a ride on taxis. That might sound like a good idea until you consider some of the political decisions made by the general public over the last year – maybe a lack of choice is good for us after all.

Tortuous analogies aside, there may be some genuine benefits to ignoring the real world in favour of unashamedly escapist entertainment. Games have long been posited to help with anxiety and stress: alongside bucketloads of anecdotal evidence, numerous studies have found positive links between gaming and mental health.

One, from the universities of Oxford and Cambridge, found that Tetris helped reduce stressful intrusive memories in patients with post-traumatic stress disorder. A study due to be published in March’s edition of the journal Computers in Human Behavior also found that games could encourage positive, co-operative, pro-social behaviour.

‘Numerous studies have found positive links between gaming and mental health.’ Photograph: Wavebreak Media ltd / Alamy/Alamy

More evidence came in a 2012 study from Stanford University that found gamers “hyper-stimulating” the brain’s mesolimbic pathways (associated with goals and motivations) and hippocampus (linked to learning and memory).

In 2014, Dutch researchers suggested that gaming can “foster real world psychosocial benefits” – cognitive, motivational, emotional and social. There’s no lack of evidence to suggest the positive impact gaming can have, especially on someone experiencing low-level stress, depression or anxiety.

And while Mario might not have a depression level yet – arch-enemy Bowser approaching asking “Have you tried yoga?” and saying “Cheer up!” – a growing number of games have been designed with mental health in mind. For example Sparx, a game designed to help residents of New Zealand with depression, which builds upon gaming’s mental health benefits to create something therapeutically valuable as well as fun.

Comments about how rightwing authoritarian regimes create the best conditions for creativity are obviously facile, especially now: people rightfully fearing discrimination need more than limp, empty reassurance that they needn’t worry because music, games or books are going to get really good again. When artists such as Amanda Palmer – white, able-bodied, rich, and privileged – say things like “Donald Trump is going to make punk rock great again” it’s a frustrating distraction from the potentially horrifying realities of the situation.

But that’s not to say that escapism isn’t a valuable tool if used correctly. Playing Mario – or any other game – is obviously not going to make you less miserable about the realities of any given political climate. What it can do, though, is provide a small amount of respite when you’re feeling stressed about something or you just want to pretend that the real world doesn’t exist for an hour or two. Perhaps Nintendo should bear this in mind when they design the next set of adventures for Mario – next time, maybe he should spend less time in our world, and we should spend more time in his.

Mario, you crossed into our world at the worst time – it’s no game over here | Emily Reynolds

The coil isn’t just a great contraceptive, it’s a form of resistance for US women | Nell Frizzell

As I lie back across the thin blue paper runway, my legs open, an Anglepoise lamp shining into the abyss, my nurse (called, ironically, Comfort) warns: “This may be a little uncomfortable.” Oh how we laughed. But I was determined – I wanted a coil.

According to reports, in the first week after the US election, Planned Parenthood (which Donald Trump, vice president Mike Pence, and House speaker Paul Ryan all want to stop funding, by the way) saw a 900% increase in patients seeking IUDs. As the news that Trump was to nominate “women’s health opponent” Tom Price for secretary of health and human services fell across America like sleet, women, nurses and healthworkers took to social media advising one simple thing: get a coil.

It builds on an existing trend for American women to choose intrauterine devices. Under Barack Obama’s Affordable Care Act, insurance providers are required to cover a woman’s birth-control method of choice for free; usually this costs about $ 1,000 for insertion and follow-up visits. For the first time, the IUD was affordable, as well as reliable. And so, according to US Center for Disease Control and Prevention’s National Center for Health Statistics (NCHS), IUD use increased 83% comparing 2006–2010 with 2011–2013. In an anti-abortion, pussy-grabbing climate, American women have been backed into a corner and the IUD seems, at the moment, like their last form of defence.

Coils give us hormone-free control over our wombs and, therefore, lives

Nearly 10 years ago, I had my very own little hammerhead shark of copper wire inserted into my uterus. It would do nothing to protect against sexually transmitted infections, I knew; it might make my periods heavier, I understood; having it put in might make me wince, I’d been told. But, my god, it was better than the alternatives. Even in this new millennium I couldn’t rely on men to carry, let alone use, condoms. And while on the pill I had cried, almost continuously, for three months. Sex wasn’t just off the menu – my body felt like a bovine mass of lustless, listless despair. In that way, the contraception was working brilliantly – I was about as likely to want sex as I was to take up a laboratory position at Massachusetts Institute of Technology.

That the source of my sadness could be linked to the galloping horse-sized quantity of hormones running through my bloodstream didn’t occur to me for longer than I care to admit. But when it did, the solution seemed as clear as it did to that tweeting nurse in Colorado: get your IUD.

As Vicky Spratt of The Debrief has written for their new Mad About The Pill campaign, the link between the contraceptive pill and mental health problems is still just anecdotal. But by god the anecdotes are there. According to the site’s survey of 1,022 women, 46% reported that the pill had decreased their sex drive, 45% said that they believed they had experienced anxiety, 45% said they had experienced depression and 20% reported experiencing panic attacks which they attributed to their hormonal contraception. If we were in America, we’d have had to pay for the pleasure of this troublesome medicine. So no wonder so many of us are looking into alternatives.

The copper coil didn’t make me weep uncontrollably with the curtains closed, it didn’t turn my tits into bricks and I never had to panic that I’d left it at home. You do not forget about your coil and then have to seek emergency contraception; you can keep the same coil in for up to 10 years, which means you can be miles from a chemist, in another country, or simply at work and never have to worry. It will not tear while fumbling in the gloom of your parents’ spare room; it won’t get punctured by the keys in your pocket; you don’t have to pay £2 in a pub toilet for it and, in my case at least, it didn’t hurt.

Coils give us hormone-free control over our wombs and, therefore, lives. On the downside they do nothing to protect against STIs and there are, of course, women who suffer serious side-effects – heavy or irregular periods, damage to the womb, pelvic infections, ectopic pregnancies. But the coil still deserves to move away from the icky, scary reputation it had when our mothers were sleeping around.

Of course I find it exasperating, frustrating, maddening and saddening that the burden of not getting pregnant still falls almost entirely on women. Many men will still assume that she “has it covered”; many still squirm away from condoms; some seem entirely unaware of what sperm may do. It’s 2017, for Christ’s sake – and yet, I know firsthand that many women are expected to be magically infertile right up until the moment their partner wants a baby. And, should that woman want to get pregnant earlier? Well then, of course, the question of coming off contraception must be a joint one. He must have his say. If he’s not ready then you cannot push it on him. If you do, you are branded selfish and controlling.

When it comes to our bodies, we carry all the responsibility; but not quite all of the power. But, perhaps, the coil can help claim some back.

The coil isn’t just a great contraceptive, it’s a form of resistance for US women | Nell Frizzell

How do we fix air pollution? It"s simple but it needs political will

Cutting toxic levels of city air pollution to safer levels is simple, but not easy – it requires resolve. Yet, despite the key culprit in the UK being well known – diesel vehicles – the government has been asleep at the wheel for years.

Levels of nitrogen dioxide have been illegally high across much of the UK since 2010. In 2015 86% of major urban areas broke annual limits. Cutting this pollution means choking off diesel emissions and there is a wide range of effective measures available.

Creating zones in city centres where polluting cars are either banned or charged is important, while making cities safe for cycling and walking cuts traffic too.

Cleaner buses and taxis have an important role to play and change to the perverse taxes that encourage people to buy diesel over cleaner cars is needed. There is also some support for a revival of a scrappage scheme which saw dirty old bangers taken off the road.

The environment and transport departments were well aware of all this and proposed many of these measures internally, only for the Treasury to reject most of them, arguing they “would be politically very difficult, especially given the impacts on motorists”.

Motorists happen to be particularly badly exposed to air pollution, but the real political difficulty for the government is two humiliating legal defeats in two years where judges ruled its air pollution plans were so bad they were illegal.

Ministers have now been forced to come up with a third plan, but clean air zones and car tax changes take time to clean up the air. Yet the UK government is also in the slow lane when it comes to emergency measures.

When foul air descended on Paris in December, officials there swung into action. Public transport was made free and the number of cars allowed on roads was restricted, alternately barring those with odd and even licence plates. In the UK, during the same December smog, the government sent a few tweets.

At the root of the problem are diesel cars, which successive governments across Europe have utterly failed to ensure meet legal emissions limits when driving in real-world conditions on the road. The gaming of regulatory tests by carmakers was blown open by the Volkswagen scandal. The scandal of governments prioritising supposed driver freedom over the lungs and health of their citizens is only now playing out.

How do we fix air pollution? It"s simple but it needs political will

No more excuses. It"s time to change abortion laws in NSW and Queensland | Anna Livsey

Abortion laws in Queensland and New South Wales suck and right now is the time to change them. A survey this week found that Australians overwhelmingly believe that women should have unqualified access to abortion.

The Australian Electoral Study has been taken each election since 1969 by the Australian National University and this year found, among other things, that 65% of Australians believe women should be able to obtain an abortion readily when they want one, 26% believe women should be able to obtain an abortion only in special circumstances and 4% believe that a woman should not be able obtain an abortion under any circumstances.

This is the highest level of support ever.

But despite that, access to the procedure is severely restricted for women in Queensland and New South Wales, particularly poor women and those living in rural areas.

Say you live in Queensland, but outside the south-east corner. Your options for a surgical abortion look like this (the clinics that provide surgical abortions are marked in red).

Map based on Children by Choice’s list of Queensland abortion providers

As you can see, outside of the south-east corner of the state there are only two clinics that provide them. And to make matters worse, these clinics will close in February due to a lack of funding. This leaves women in central, far north or western Queensland having to travel hundreds, if not thousands, of kilometres to obtain an abortion, which can end up costing more than $ 1,000.

The situation is so dire in Queensland that one of the state’s leading pro-choice groups, Children by Choice, crowdfunds abortions. Last year the organisation raised more than $ 90,000 via grants, donations, and no-interest loans for clients who needed financial assistance. They also seek funds for individual cases via their Facebook page.

In New South Wales, women face a similar lack of options, with abortion providers concentrated in coastal areas and procedures almost exclusively performed in private clinics.

This situation exists in large part because of both states’ antiquated, regressive and now patently out of touch abortion laws, which criminalise the procedure except under certain circumstances.

These laws do not prevent abortions from happening though. It is widely accepted that between 10,000 and 14,000 take place in Queensland every year. The laws merely make life more difficult for women, particularly for those who already face disadvantage due to where they live, their socio-economic status and what kind of relationship they are in.

However, the wheels are in motion for things to change.

Currently there are bills before both the Queensland and NSW parliaments that seek to decriminalise the procedure, and in the case of New South Wales, enforce exclusion zones around abortion clinics so that anti-choice protesters cannot accost people at their entrances.

There has been a lot of pushback against the two proposals. See the submissions to the inquiry into MP Rob Pyne’s abortion law reform bill in Queensland for a taste. But the proposed changes are not extreme. They would put Queensland and New South Wales abortion law in line with the rest of Australia and with most European countries.

And change is possible. In the past two decades abortion has been decriminalised in Tasmania, Victoria and the ACT and just this year in Poland a popular protest prevented regressive abortion laws from being enacted by the country’s conservative government.

Changing the current laws is a step towards affording women in Queensland and New South Wales the same dignity, respect and access to safe options that many women around Australia, and the world, already enjoy.

And if the wishes, health, safety and bodily autonomy of women seeking abortions are not enough, the changes would now also reflect the wishes of the overwhelming majority of Australians.

No more excuses. It"s time to change abortion laws in NSW and Queensland | Anna Livsey