Prince Harry, mental health and the need for a more caring society | Letters

In my view, those who try to come up with totalising explanations of mental health are misguided (Letters, 20 April). It’s neither purely social nor purely individualistic, though effective help should start from actually listening to and honouring the individual case. Often in practice it does not, and I would agree with Professor Read that a biogenetic medical model is generally inappropriate and can actually be damaging. It also goes radically unacknowledged that there are various different types of bereavement, some of which are far more traumatic than others, and are not directly comparable. The effects of traumatic sudden bereavement experienced in childhood or adolescence can last for years and ultimately for a lifetime, as the princes have now highlighted. It is known that this type of bereavement can sometimes result in lasting shock followed by delayed grief years later, yet there is often little or no acknowledgment readily available, never mind any effective support.

On top of this, and especially in a culture of competition, the bereaved are often subjected to cutting comments, judgments and dismissals. Sometimes these are from those who claim to know what it’s like because their grandparent or cat has died, while sometimes they are from people in medical or authority positions whose callous judgmental ignorance can be devastating. Why does it require the intervention of princes to highlight the issue? At least they get taken seriously.
LE Collier
Cheltenham, Gloucestershire

• It seems to me that a potential key to improving psychological provision for common human grief and misery (Freud’s term) is not only more better-trained, organised professionals, but also a more compassionate and empathic caring society attuned to the emotional needs of others. Where many families are so economically impoverished, they barely have the inner resources, strength and resilience left to attend to each other’s mental pain and suffering. What chance this election gives us all an opportunity to change our minds about the material hardship and distress we are causing those most in need of help, so they can move on?
Ya’ir Z Klein
London

• Keith Farman asks whether bereavement is a mental illness. Before answering, note that Harry says he suffered from denying grief when his mother died, not from the grief itself. While grief is a normal reaction to loss that cannot be blamed on others or self, its first stage is usually denial, which may help deal with events following the loss and which I believe is an illness. However, as confidence recovers, fear should subside and a second stage of grief usually occurs when the rage or fear roused by the loss is normally expressed. This is not evidence of mental illness. Alison Sesi says children cannot yet express their feelings effectively. This should not be so. But they may not experience grief but the simpler hate, sadness, anxiety or rage. I suggest that when our species acquired verbal language, most societies came to believe in gods and devils. Though later religions used these to help sustain laws and customs, they do not exist. So mental illness has long been endemic.
George Talbot
Watford, Hertfordshire

• Professor Samuels never misses an opportunity to take a swipe at the evidence-based psychological therapy now available on the NHS. Prince Harry is at liberty to choose whatever sort of therapy he wishes and his comments, which seek to normalise and reduce the stigma attached to mental health problems, are very welcome. We don’t know what sort of therapy Prince Harry had, but scientific evidence suggests that had he attended eight to 12 sessions of cognitive behavioural therapy (CBT) at his local GP surgery for the traumatic bereavement he experienced, the outcome would have been a good one.
Hal Westergaard
(Cognitive behavioural therapist), Bath  

• It was with interest that I read Andrew Molodynski’s comments regarding ECT as a useful option for treatment resistant major depressive disorder (Shock treatment on increase again in NHS, 18 April). I have experienced this horrible illness along with anorexia for a number of years. I underwent a significant number of ECT treatments. Apart from some short-term memory loss, it is painless, and one is unconscious for a very short period. For me it was life-saving. I don’t  think I would be alive today without it. If the need arose I would willingly have it again. Although medical treatments may help the many symptoms of severe depression, it frequently returns time and time again.

The causes of this life-altering illness need to be untangled if treatments are to succeed. This is where psychologists/psychotherapy may have the answers. In an underfunded and understaffed mental health service, therapy can be difficult to access. I have been one of the fortunate ones. Let no one underestimate the distress of severe depression on the individual and their loved ones, and the challenges it presents to mental health staff. ECT is an important life-saving treatment for people like myself.
Sheila Cook
London

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Prince Harry, mental health and the need for a more caring society | Letters

If we hide our mental health issues, we make it easier for society to ignore us | Clare Allan

People with mental health issues are being expected to “prove it” as never before. Whether, as individuals, being assessed for disability benefits or, collectively, campaigning for services and adequate welfare provision, the pressure to demonstrate genuine need, to prove that one is “really disabled”, to quote the Tory MP George Freeman, is greater than ever.

The invisible nature of mental health problems, the fact that they do not show up on an x-ray, that no blood test can diagnose depression, underlies much of the discrimination people with mental health issues face. Humans are strongly predisposed to believe in what they can see. For many people, it is hard to accept that severe anxiety, for example, might incapacitate someone from leaving their house as genuinely as if they were suffering from a physical paralysis. The fact that the problem cannot be seen makes it easier to dismiss. They could, if they really wanted to; they’re just not trying hard enough; everyone gets stressed sometimes, and so on. Of course, the help a person with anxiety needs to enable them to leave the house will be different from that of a person with a physical disability, but that doesn’t make the need any less real.

In the year since my dog, Meg, lost her leg I have often had cause to reflect on the different challenges presented by visible and invisible health problems. For it doesn’t get much more visible than a missing leg, you would think – though I have twice been stopped by people wishing to inform me, in somewhat accusatory tones, that my dog is “limping”. “Well yes,” I reply. “She’s only got three legs.”

The most obvious difference is that Meg has no option of going incognito. Her missing leg is a constant focus of comment and attention. As a dog, she enjoys the extra fuss but, as a human, I imagine it could rapidly become wearing. And there is the danger that one’s difference becomes the thing by which one is defined. Even with Meg, at the time of her amputation, I remember feeling – alongside concern as to how she would manage (remarkably well) – I didn’t want her to be the dog with three legs: I wanted Meg to be Meg.

Then there is the nature of the response, the feeling sorry for her (which I hate), the marginally better admiration (though what choice does she have other than to be “remarkably resilient”?), the need for an explanation: “What happened?”. In Meg’s case, the answer is far too long to fit comfortably into passing chat and, besides, it’s the fifth time I’ve been asked in a 30-minute walk. My favourite response, by far, is to ignore the missing leg altogether. There was a man I met on Hampstead Heath in London, coming in through the Kenwood gate, as Meg and I were leaving. “Wow!” he said, kneeling to embrace her. “What a beautiful, beautiful dog!” I could have hugged him.

It is these same concerns that lead many with mental health problems to choose not to disclose them. And to this I must myself plead guilty. For, though I’ve tried to be open about my own mental health, I confess I haven’t always been honest. I have occasionally cried off with a migraine, rather than admit I simply cannot face going out, or that I don’t trust myself to get through the evening without bursting into tears.

But while there are clearly advantages to having this option in some situations, it seems to me there are profound disadvantages, too. For the more we hide our difficulties, the more invisible they, and we, become. And the easier for those with an agenda – of cutting benefits, for example – to deny they exist at all.

If we hide our mental health issues, we make it easier for society to ignore us | Clare Allan

Many do not want a fair society, it seems | Letters

The central argument of your leader column that “most people would like to live in a society that is fair, where merit is rewarded and every child has a similar chance of health and happiness” is very questionable (The class ceiling: entrenching disadvantage, stalling mobility, 26 January).

What we have witnessed during the last seven years is a wide range of social and economic policies with the prime purpose of reinforcing the belief that individuals are responsible for their own destiny.

This is reflected in policy failures to address increases in child poverty, child ill health and homelessness (Poverty is killing UK children, warns report, 26 January; Rise in rough sleeping for sixth year running, 26 January), as well as the chronic underfunding of social care and cuts to a wide range of national and local government services.

The cumulative impact is seen in how mega-inequalities are justified as “individual achievement”, in how little sympathy is afforded to refugee children and adults, and in how the homeless are kicked and urinated on.

Perhaps the worst psychological consequence – and the “success” of these policies – is how the most vulnerable blame themselves for failing to manage.

Your analysis should start from questioning the assumption underpinning the consensus for the “fair society” and recognising the need for comprehensive policies to address the wide range of inequalities, something lacking in current political debate from all parties.
Mike Stein
Emeritus professor, University of York

• How many landmark reports does it take to persuade governments that poverty in the UK is jeopardising children’s health? The 1970s Neuberger report on nutrition research recommended research done on the “cause of low birthweight and its associated handicaps”. The Black report of 1980 spelled out the wide nature of the problem and what should be done. The Winterton 1990-91 Commons select committee report on maternity services requested action on low birthweight and the inequality of health. The Acheson report of 1998 and that of Derek Wanless in 2005 echoed these sentiments, arguing for prevention and adoption of the principles laid out by the Black report of 1980. The Marmot review of health inequalities was published in 2010.

Do we have to beg for an end to this disregard of the evidence that links low incomes, high rents, freezing weather, debt and hunger to ill health and a shortened life?
Paul Nicolson
Taxpayers Against Poverty

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Many do not want a fair society, it seems | Letters

Without the power of kindness, our society will fall apart | George Monbiot

If there is an irrepressible human trait it’s the determination, against all odds, to reconnect. Though governments seek to atomise and rule, we will keep finding ways to come together. Our social brains forbid any other outcome. They urge us to reach out, even when the world seems hostile.

This is the conclusion I draw from touring England over the past few weeks, talking about loneliness and mental health. Everywhere I have been so far, I’ve come across the same, double-sided story: stark failures of government offset in part by the extraordinary force of human kindness.

First the bad news: reminders of the shocking state of our mental health services. I met people who had waited a year for treatment, only to be given the wrong therapy. I heard how the thresholds for treatment are repeatedly being raised, to ration services. I met one practitioner who had been told, as a result of the cuts, to recommend computerised cognitive behaviour therapy to her patients. In other words, instead of working with a therapist, people must sit at a screen, using a programme to try to address disorders likely to have been caused or exacerbated by social isolation. Why not just write these patients a prescription instructing them to bog off and die?At least then they wouldn’t have to wait a year to be told to consult their laptops. I heard of children profoundly damaged by abuse and neglect being sent to secure accommodation – imprisoned in other words – not for their own safety, or other people’s, but because there is nowhere else for them to go.

These are not isolated cases. It is a systemic problem. There has been no child and adolescent mental health survey in this country since 2004 (though one is now planned). Snapshot studies suggest something is going badly wrong: figures published last week, for example, suggest a near quadrupling in the past 10 years of girls admitted to hospital after cutting themselves. But there are no comprehensive figures. Imagine the outcry if the government had published no national figures on childhood cancer for 12 years, and was unable to tell you whether it was rising or falling.

Of children referred for treatment for mental health disorders, 60% do not receive it. The Guardian recently published a mother’s account of how her child had been treated. Despite a severe mental health disorder, it was only after the child attempted suicide that she received the care she needed. The treatment consisted of sending her to the other end of the country: the only available bed was 300 miles from home. You don’t need to be a psychotherapist to imagine what that might do to a distressed and vulnerable child. But when the beds don’t exist, the health service has no choice. Embarrassed into a semblance of action, the coalition government promised another £250m a year for children’s mental health. It will scarcely touch the sides.

But amid the rubble of a collapsing state, I kept stumbling into something wonderful. Performing with the musician Ewan McLennan, using music and the spoken word to explore these subjects, has brought me into contact with groups that restore my faith in the human spirit.

In Leeds we ate in a cafe run by the Real Junk Food Project, whose meals are made from waste or donated food. Seeing people of all ages, from all stations of life, who had never come together before, yakking away over dinner like old friends, I realised that the project is addressing not only the waste of food but also the waste of social opportunity. Breaking bread together: this is still the best and simplest way of reconnecting.

In Sheffield I met a man creating safe spaces for people experiencing manic or psychotic episodes: using woods, allotments and – if his project gets planning permission – cobb houses like hobbit holes to create a place of comfort for those whose minds are reeling. In Durham I saw how people whose poor mental health and isolation exclude them from work are being gently introduced to the social skills and creativity that might allow them to re-engage. In Bristol I met someone from the Happy City initiative, which is finding ways to measure wellbeing and discovering the best means of enhancing it.

Across the country, groups such as the Campaign to End Loneliness, Age UK, Independent Age, Community Network, Young Minds, the Transition Network, the Network of Wellbeing and the forthcoming Jo Cox Commisssion on Loneliness are trying to provide a coherent response to the troubled times that lead to troubled minds. Everywhere I look, I see the kind of enterprise and innovation with which business is credited, but which seems to be found most often in the voluntary sector.

But what has struck me with greatest force is this. At the end of every gig, we ask people in the audience to turn to someone they don’t know and say hello. I tell them they needn’t do any more than that, but they can keep talking if they wish. On the first night I made the mistake of mentioning the idea before we had wrapped up the show. That was all it took – the conversation flared up immediately, and it was a long time before I could direct people’s attention back to the stage. After every concert the talking has continued long into the night, in the venue’s bar or the nearest pub. It’s as if people have simply been waiting for permission to speak to the strangers who surround them.

Britain, according to government figures, is the loneliness capital of Europe, but even – or perhaps especially – here, the urge to connect is overwhelming. This reattachment, I believe, holds the key to both our psychological and political transformation. Connected, engaged and happy people do not allow themselves to be trampled into the dirt. It is when we are estranged both from each other and from our political environment that we are easiest to manipulate, as the rise of demagoguery in Europe and the US seems to attest.

Neither state provision nor community action is a substitute for the other: we need both. But the more effective community groups and voluntary initiatives become, the harder it is for governments to disregard their duties. By talking together, we find our voice.

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Without the power of kindness, our society will fall apart | George Monbiot

Neoliberalism is creating loneliness. That’s what’s wrenching society apart | George Monbiot

What greater indictment of a system could there be than an epidemic of mental illness? Yet plagues of anxiety, stress, depression, social phobia, eating disorders, self-harm and loneliness now strike people down all over the world. The latest, catastrophic figures for children’s mental health in England reflect a global crisis.

There are plenty of secondary reasons for this distress, but it seems to me that the underlying cause is everywhere the same: human beings, the ultrasocial mammals, whose brains are wired to respond to other people, are being peeled apart. Economic and technological change play a major role, but so does ideology. Though our wellbeing is inextricably linked to the lives of others, everywhere we are told that we will prosper through competitive self-interest and extreme individualism.

In Britain, men who have spent their entire lives in quadrangles – at school, at college, at the bar, in parliament – instruct us to stand on our own two feet. The education system becomes more brutally competitive by the year. Employment is a fight to the near-death with a multitude of other desperate people chasing ever fewer jobs. The modern overseers of the poor ascribe individual blame to economic circumstance. Endless competitions on television feed impossible aspirations as real opportunities contract.

Consumerism fills the social void. But far from curing the disease of isolation, it intensifies social comparison to the point at which, having consumed all else, we start to prey upon ourselves. Social media brings us together and drives us apart, allowing us precisely to quantify our social standing, and to see that other people have more friends and followers than we do.

As Rhiannon Lucy Cosslett has brilliantly documented, girls and young women routinely alter the photos they post to make themselves look smoother and slimmer. Some phones, using their “beauty” settings, do it for you without asking; now you can become your own thinspiration. Welcome to the post-Hobbesian dystopia: a war of everyone against themselves.

Social media brings us together and drives us apart, allowing us precisely to quantify our social standing

Is it any wonder, in these lonely inner worlds, in which touching has been replaced by retouching, that young women are drowning in mental distress? A recent survey in England suggests that one in four women between 16 and 24 have harmed themselves, and one in eight now suffer from post-traumatic stress disorder. Anxiety, depression, phobias or obsessive compulsive disorder affect 26% of women in this age group. This is what a public health crisis looks like.

If social rupture is not treated as seriously as broken limbs, it is because we cannot see it. But neuroscientists can. A series of fascinating papers suggest that social pain and physical pain are processed by the same neural circuits. This might explain why, in many languages, it is hard to describe the impact of breaking social bonds without the words we use to denote physical pain and injury. In both humans and other social mammals, social contact reduces physical pain. This is why we hug our children when they hurt themselves: affection is a powerful analgesic. Opioids relieve both physical agony and the distress of separation. Perhaps this explains the link between social isolation and drug addiction.

Experiments summarised in the journal Physiology & Behaviour last month suggest that, given a choice of physical pain or isolation, social mammals will choose the former. Capuchin monkeys starved of both food and contact for 22 hours will rejoin their companions before eating. Children who experience emotional neglect, according to some findings, suffer worse mental health consequences than children suffering both emotional neglect and physical abuse: hideous as it is, violence involves attention and contact. Self-harm is often used as an attempt to alleviate distress: another indication that physical pain is not as bad as emotional pain. As the prison system knows only too well, one of the most effective forms of torture is solitary confinement.

It is not hard to see what the evolutionary reasons for social pain might be. Survival among social mammals is greatly enhanced when they are strongly bonded with the rest of the pack. It is the isolated and marginalised animals that are most likely to be picked off by predators, or to starve. Just as physical pain protects us from physical injury, emotional pain protects us from social injury. It drives us to reconnect. But many people find this almost impossible.

It’s unsurprising that social isolation is strongly associated with depression, suicide, anxiety, insomnia, fear and the perception of threat. It’s more surprising to discover the range of physical illnesses it causes or exacerbates. Dementia, high blood pressure, heart disease, strokes, lowered resistance to viruses, even accidents are more common among chronically lonely people. Loneliness has a comparable impact on physical health to smoking 15 cigarettes a day: it appears to raise the risk of early death by 26%. This is partly because it enhances production of the stress hormone cortisol, which suppresses the immune system.

Studies in both animals and humans suggest a reason for comfort eating: isolation reduces impulse control, leading to obesity. As those at the bottom of the socioeconomic ladder are the most likely to suffer from loneliness, might this provide one of the explanations for the strong link between low economic status and obesity?

Anyone can see that something far more important than most of the issues we fret about has gone wrong. So why are we engaging in this world-eating, self-consuming frenzy of environmental destruction and social dislocation, if all it produces is unbearable pain? Should this question not burn the lips of everyone in public life?

There are some wonderful charities doing what they can to fight this tide, some of which I am going to be working with as part of my loneliness project. But for every person they reach, several others are swept past.

This does not require a policy response. It requires something much bigger: the reappraisal of an entire worldview. Of all the fantasies human beings entertain, the idea that we can go it alone is the most absurd and perhaps the most dangerous. We stand together or we fall apart.

Neoliberalism is creating loneliness. That’s what’s wrenching society apart | George Monbiot

Increased Drug Screening Approaches – Easy Way of Harmonizing the Society

Increased Drug Screening Approaches – Easy Way of Harmonizing the Society

Your pool-peeing habits are pissing off the American Chemical Society

Do you love the smell of a chlorinated pool in the summertime? Unfortunately, urine for a surprise.

That nostalgia-inspiring aroma is actually a result of disinfection byproducts, or DBPs, created when people skip the bathroom and pee in the pool – and those DBPs are not good for you.

A new video produced by the American Chemical Society explains that when urine and other organic matter mix with the disinfectants we use in pools, they set off chemical reactions that produce compounds such as cyanogen chloride, chloroform, dichloramine, trichloramine and bromoform – AKA the unwanted DBPs.

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Chloramines can cause irritation to the skin, eyes and respiratory tract, according to the Centers for Disease Control and Prevention.

DBPs are also the result of dirt, sweat and lotion that swimmers bring into the pool, but urine accounts for about half of them, which is why the video calls using a toilet before diving in “your civic duty”.

The tricky art of pool chemistry has made international headlines this summer, thanks to the startling metamorphosis of Rio’s Olympic diving pool from azure to emerald.

Though Olympics officials have attributed the murky green waters to the accidental introduction of 160 liters of hydrogen peroxide into the pool, chances are there was a good amount of urine in there as well.

Seventeen percent of Americans admit to peeing in the pool, according to a 2009 survey by Water Quality and Health Council, but among elite athletes the number is probably much higher.

“Nearly 100% of elite competitive swimmers pee in the pool. Regularly,” Carly Geehr, a former member of the US swimming national team, wrote on Quora in 2012.

“Some deny it, some proudly embrace it, but everyone does.”

Among those in the latter camp are Olympians Michael Phelps and Ryan Lochte.

In 2012, Lochte responded to a question about peeing in the pool, saying: “Of course. We always do. I think there’s just something about getting into chlorine water that you just automatically go.”

Lochte went on to admit that he had befouled the pool during the London Olympics: “Not during the races, but I sure did before in warm-up.”

Phelps subsequently backed up his sometime rival, telling the Telegraph: “I think everybody pees in the pool. It’s kind of a normal thing to do for swimmers. When we’re in the water for two hours, we don’t really get out to pee.”

Such brazen pee-havior is unwelcome to Ernest R Blatchley III, a professor of engineering at Purdue University who studies DBPs.

“High-profile swimmers have a real opportunity to take a position of leadership and responsibility,” he told Chemical & Engineering News. The scientist urged swimmers “to practice commonsense hygiene”.

Your pool-peeing habits are pissing off the American Chemical Society

Our society can make us excess fat. Gastric surgery treats the signs, not the lead to

There is also an urgent issue to be solved. The obesity epidemic has grown to the level exactly where 24 per cent of men and 25 per cent of women are now clinically obese, feeding an explosion in diagnoses of type two diabetes. This condition now affects 2.9 million in the Uk, mainly in the above-40s, and can lead to organ harm, vascular ailment and blindness. Its effects are estimated to eat ten per cent of the NHS budget, or £9.5 billion per 12 months. Set against this background, providing a £5,000 operation far more extensively, even a single with important hazards, helps make sense.

In New York City, a radical prevention agenda has been launched, which includes bettering meals choices and portion sizes in dining establishments, hospitals and schools, media campaigns to market wholesome eating, better dietary details on menus and direct interventions for newborns and infants to inspire breastfeeding.

The Access to Nutrition Index, a partnership funded by the Bill &amp Melinda Gates Basis and the Wellcome Believe in, has started out to place strain on the largest foods companies to supply much better nutrition alternatives to their clients. The three-year evaluation judges firms this kind of as Nestle, Unilever and Coca-Cola on how healthier goods are formulated, made much more accessible to shoppers, and marketed appropriately.

Our accessibility to workout amenities in the Uk is terrible. We need to make it easy, totally free and inviting for as numerous folks as attainable to be physically active, not just those Folks with the income and time to go to the fitness center or individuals who occur to reside near to scarce swimming pools and other locally run facilities.

Cycling is harmful not just in London but in many towns and cities all around the Uk, in which the auto is nevertheless king. Fewer and fewer youngsters walk to college, and workplace buildings are even now designed to inspire sedentary functioning and avoidance of stairs.

To give a single instance, the Wellcome Trust funded investigator Pedro Hallal has convinced the Brazilian government to offer free gyms and workout classes in 2,000 cities and towns across the nation. They are entirely totally free of charge and targeted at the most in require, generally the poorest in society.

The evidence from Brazil exhibits that accumulated bodily exercise all through adolescence (regardless of timing) protects towards bodyweight acquire in early adulthood. Encouraging the habit of obtaining to school “actively” (i.e. by strolling or cycling) has prolonged-lasting result on commuting alternatives for grownups. The total programme cost a fraction of what is being invested on healthcare in Brazil to tackle obesity and connected illnesses.

The United kingdom should be taking much more of a lead internationally than we are. We can find out from tasks about the planet that ambitious public well being interventions, particularly in young children and adolescents, can have weight problems successfully. In the brief run, there may be a situation for reaching much more frequently for the surgeon’s scalpel. In the longer phrase, we need to place it away.

Dr Jimmy Whitworth is the head of population well being at the Wellcome Believe in

Our society can make us excess fat. Gastric surgery treats the signs, not the lead to

A healthier society is just as significantly about neighborhood as healthcare

A colleague in the States was telling me about a meeting he’d had with a campaigner from the Jamaica Plain neighbourhood in Boston. “She pointed out to me: ‘This town has significantly increased amounts of cancer than the rest of the state, notably amongst ladies. What would it mean to develop a cancer-free of charge, toxin-free of charge economic climate?’ When she stated that, a lot of bells rang in my head.”

They rang in my head as well. Over the previous handful of months, the Reside Much better Challenge has brought stories of inspirational tasks about the world developing foods, managing waste, saving and generating vitality in new ways. This kind of issues are normally imagined of as environmental, or sustainability initiatives. But how different may items seem if we were to reimagine them as public overall health initiatives?

When you believe about it, practically almost everything we want to do to create far more resilient, reduce-carbon communities would also aid develop cancer-free, healthier communities. Whether or not it is creating community renewable power firms, beginning urban food production tasks, marketing cycling, retrofitting houses, they all promote public well being. One particular could even argue that nearby currencies this kind of as the Bristol Pound, diversifying and strengthening regional economies and enabling community investment, must also be noticed as public wellness initiatives.

In the world of public wellness this conversation is currently taking area. In March this year, the Lancet published the exceptional Manifesto for Planetary Well being, calling for “a social movement to assistance collective public overall health action at all levels of society – personal, neighborhood, nationwide, regional, worldwide, and planetary. Our aim is to reply to the threats we face: threats to human overall health and wellbeing, threats to the sustainability of our civilisation, and threats to the all-natural and human-produced techniques that assistance us.”

I spoke to Martin McKee, professor of public overall health at the London School of Hygiene and Tropical Medication and 1 of the authors of the manifesto. He mentioned: “Individuals men and women who want to promote a healthier, safer, higher-high quality setting as nicely as the health of the population have significantly in typical. We ought to be operating together in some coalition of the inclined to try out and make the globe a better place.”

For David Pencheon, director of the NHS Sustainable Development Unit, this coming collectively is previously occurring, just not nevertheless at the scale necessary: “Hospitals could be wellness-improving civic structures … could they supply vitality via district neighborhood heating systems, biomass, mixed heat and energy? Could they offer allotments, could they supply green spaces, could they provide areas the place folks could truly see what it looks like to dwell healthier lives? Could they have great meals shops in the concourses, could they have honest trade coffee in the concourses? All of individuals issues sound really visionary. But really every single 1 of these issues is occurring now, but sporadically in isolated examples”.

Some NHS trusts have begun, or linked to, foods expanding projects, and are taking daring methods about renewable vitality. Some are doing work with “green fitness center” initiatives, and what’s referred to as “social prescribing”, in which men and women are prescribed environmental conservation or horticultural operate. Nottinghamshire Healthcare Believe in have altered their meals procurement so they now source 90% of fruit, vegetables and meat from inside of thirty miles of the hospital, an injection of £2m into the local economic climate every single year.

Islington council in London, together with NHS Islington, have started out a Seasonal Health Intervention Network (Shine) which seeks to decrease fuel poverty, seasonal deaths and hospital emissions, providing tips on energy efficiency and finances. It has led to the thousands of participants conserving £455,000 from their power payments. The Houghton-le-Spring Major Care Centre in Sunderland, a state-of-the-art ecological developing, combines well being and social care services, with an emphasis on workout and health.

But how might communities themselves try out to initiate this kind of an technique when it is not coming from their wellness providers? A single illustration is underway in Devon, led by transition town Totnes. Caring Town Totnes is an initiative functioning to carry folks from across the spectrum of care, wellbeing and public health collectively in the face of the austerity cuts. Their Totnes Welfare Conference in October 2013 brought collectively people from across the community involved in care, and was followed by a nicely-attended wellness and welfare day. They are now searching to develop a local community hub and seeing this various strategy as a catalyst for new livelihoods, new social enterprises, new models of social investment, peer-to-peer lending, skill sharing, and linking to wider financial localisation operate in the town. As David Pencheon says: “It is definitely clear that public wellness is by far the very best investment we could make in regional, meaningful, resilient, sustainable communities in which it is just a much greater spot to reside.”

My aim is set the very same bells ringing in your head as the conversation in Jamaica Plain set ringing in mine. At its root, this calls for some joined-up contemplating. For instance, it no longer tends to make sense to search at food procurement in isolation from how a hospital’s grounds are managed, who manages them, what’s taking place in the wider neighborhood in terms of neighborhood foods, social prescribing inside the hospital and so on. We need to have to join these issues up. The positive aspects of performing so could tackle more concerns simultaneously than we may well have ever believed attainable. Public healthcare as the catalyst for a local financial revolution? Why not?

Rob Hopkins is co-founder of the Transition Network and Transition Town Totnes. You can go through a lot more of his pondering on this topic right here.

Interested in obtaining out far more about how you can dwell much better? Take a search at this month’s Dwell Much better Challenge right here.

The Reside Better Challenge is funded by Unilever its emphasis is sustainable living. All material is editorially independent except for pieces labelled advertisement attribute. Discover out much more right here.

A healthier society is just as significantly about neighborhood as healthcare

Alzheimer"s Society champions Dementia Pleasant Communities

Sponsored by Lloyds Banking Group and supported by the Telegraph – the panel of judges included Telegraph editor Chris Evans, and Jeremy Hughes, chief executive of the Alzheimer’s Society – the awards recognise communities, organisations and folks who have aided to make their neighbourhood or workplace more dementia-pleasant.

The Sporting Memories Network, which supports local community-primarily based projects that tap into people’s passion for sport, was also singled out for an award.

A full list of winners will be offered from 21 Could at alzheimers.org.uk/dementiafriendlyawards

Alzheimer"s Society champions Dementia Pleasant Communities

Bail hostel with mental overall health staff helps residents integrate into society

St Joseph’s approved premises runs rehabilitation actions and programmes focusing on cooking, budgeting and benefits. Photograph: Don McPhee

When Barry learned he had to move into a probation-run hostel following leaving prison, he was not satisfied.

“I was really angry. My view was that I would completed my sentence so why could not I go straight back to civvy existence?” he recalls. “I just didn’t see the level of it. In fact, however, I’ve come on leaps and bounds. No way could I have sat and talked like this to strangers when I acquired right here seven months in the past.”

Barry’s property considering that completing his 5-12 months jail sentence has been St Joseph’s accredited premises in Eccles, Better Manchester. Formerly identified as bail hostels, these locations now specialise in functioning with offenders deemed a large risk to the public and likely to benefit from a gradual reintroduction into society after prison.

Amongst the UK’s authorized premises, nevertheless, St Joseph’s may be exclusive – fairly potentially the only 1 to have an on-web site mental well being group. Beneath a partnership that dates back at least a decade, the Greater Manchester West NHS believe in posts two local community psychiatric nurses (CPNs), plus a help worker, at the probation service-run hostel. They aid support its 29 male residents, several of whom have enduring diagnosed mental health issues.

In frequent with other accredited premises, residents are referred to St Joseph’s as a issue of their licence and are strictly supervised, with curfews and typical drug and alcohol testing. Breaking the principles – some of which are personalised dependent on people’s offending historical past – could result in a return to custody.

There are also rehabilitation activities: university, occupation clubs, art courses, bodily activities, excursions and programmes focusing on abilities such as cooking, budgeting and advantages. Some consider area outdoors the centre to aid develop self-confidence and re-integrate residents into society.

The mental well being assistance slots in alongside this. Adam Clayton, CPN group leader, says: “Us being here helps make sense because inside of accepted premises there are a comparatively substantial quantity of residents with understanding troubles or psychological well being troubles – and coming out of prison is a big and stressful adjust. Being here implies we can reply a lot more quickly than a neighborhood psychological health staff could. In partnership with probation, we can decide what people’s care demands are and look at how that may effect on chance management – as effectively as offering support to them at a time of enhanced vulnerability.”

When an inmate is referred to St Joseph’s, Clayton’s team members make contact with their counterparts within the jail to find out about the person, just before going to the prisoner to carry out their very own assessment. The place an offender with psychological overall health requirements is topic to multi-agency chance-planning meetings – as a lot of substantial-threat inmates are – the CPNs also attend the sessions and share appropriate details.

When inmates arrive at the hostel, the CPNs supply a familiar encounter and can talk to them about their anxiousness. Residents then have speedy access to CPNs and psychiatrists if they require – who attend in emergencies as properly as operating twice-weekly clinics.

If a resident’s mental wellness deteriorates even though at St Joseph’s, Clayton’s group would carry out an evaluation. In some instances they may possibly be taken to hospital, voluntarily or through a sectioning buy. Out-of-hrs emergency mental healthcare is provided by means of the same NHS trust’s crisis group.

Clayton says: “Our evaluation could inform regardless of whether someone’s recalled to custody but if it really is purely about psychological wellness our aim would be that it ought to be managed inside the context of current mental wellness solutions, and not always by restricting someone’s liberty.

“If someone is recalled to prison even though – and if their mental health is an situation – we have robust hyperlinks with our colleagues inside of prisons. We inform them if there is a concern about self-harm or a risk of suicide, so they know what needs choosing up. This partnership functions both techniques.”

The crew also aims to support residents to remain well and integrate into society. The support employee runs self-assurance-constructing sessions such as budgeting, buying, gardening and employing the health club. A flexible technique is necessary, with lots of person support in some instances.

Barry, an agoraphobic who barely left his home for the 15 years ahead of he went to prison, and suffers from serious social phobia, does not like groups and prefers to invest his time cleaning to maintain his mind busy. Understanding that structured appointments stress him out and preserve him awake at evening, Clayton rather engineers possibility meetings in the hallways or on the stairs whilst he is cleansing.

The CPNs also identify residents’ demands for moving on – specifically for people whose bodily or mental needs suggest they might need rehab or supported accommodation. After referrals are made they website link people with community psychological well being support in their new location. In the case of Barry – quickly to leave for an independent tenancy – the local community team is aware of his problems with formal appointments so can try to be as flexible as possible.

“I believe there should be much more spots like this,” says Barry. “If I would have gone straight house from prison I would have even now been the very same individual and would have stayed inside the whole time. Now I go for walks to clear my head. This area has aided me to get out and in other methods I do not yet know.”

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Bail hostel with mental overall health staff helps residents integrate into society

Human casualties of an unequal society | @guardianletters

Steve Mort, head of the college exactly where Ann Maguire was fatally stabbed, rejected the use of metal detectors in schools. Photograph: Christopher Furlong/Getty Photographs

Polly Toynbee is correct that profiteering from residential childcare is at the excessive finish of outsourcing (Now troubled young children are an investment chance, 13 Might). It is also the at sharp finish of social inequalities.

Proportionately, twelve times more youngsters in the most disadvantaged 10% of little neighbourhoods are currently being looked after in care than in the most advantaged ten%. As social inequality in childhood is predicted to expand, this gap will increase also. Inequalities in kid safeguarding interventions are not just about parenting skills, just as well being inequalities are not just about life-style selections. Care-house earnings reflect the human casualties of an unequal society.
Paul Bywaters
Professor of social perform, Coventry University

• I am confident I can’t be the only a single who contrasted Norman Lamb’s response to the publicity of abuse in an Essex residential care property – when he suggested higher use of CCTV monitoring – with that of Steve Mort, head of Corpus Christi Catholic college in Leeds, where the fatal stabbing of Ann Maguire occurred, who rejected calls for metal detectors in schools (Report, 29 April).

Lamb, the minister for care and support, stressed there have been hazards in relying solely upon CCTV to guard towards abuses. He explained relying on this measure to develop a excellent culture and compassionate care could fail entirely.

However, the emphasis on both surveillance or believe in-primarily based approaches is important. Techniques based mostly on surveillance reinforce unhelpful electrical power differentials and are frequently applied when believe in has not been established or has broken down. Risk-free and compassionate spaces require to be co-created with mutual respect and cooperation (Steve Onyet, between other individuals, has written and spoken about this.) Psychologically wholesome environments support folks to turn into and give the very best they can. We have a selection.
Gillian Bowden
Clinical psychologist, Norfolk

Human casualties of an unequal society | @guardianletters

Are we utilizing antidepressants to paper more than the cracks of a fractured society?

The probabilities are that you know someone who takes antidepressants. Or possibly you take them your self. If so, you are in very good firm. Far more than 50m prescriptions for antidepressants are written in the Uk every 12 months and, despite the fact that the not all of the capsules will be swallowed – taking into account repeat prescriptions and failure to collect from pharmacies – the figure is still staggeringly high.

There is a constructive side to the 50m statistic, although. It suggests that as the stigma has decreased, folks have become more inclined to ask for aid. And, for a lot of, antidepressants operate. Nonetheless, while specialists are quick to acknowledge the benefits – which can be lifestyle-saving – many express concern about our growing dependence.

“Prescription ranges have gone through the roof,” says Dr Matthijs Muijen, head of psychological health at WHO Europe. “On the demand side, men and women know antidepressants operate. I would even argue there is a degree of fashion about antidepressants. On the provide side, antidepressants have grow to be less expensive and more effortlessly obtainable. Doctors now know it’s effortless and ‘good’ to prescribe.”

Important to arguments around antidepressant use are inquiries about what constitutes “typical” sadness and in which the boundary lies among this and clinical depression. There is no reduce-and-dried response, and this ambivalence all around the use of antidepressants looks to be characteristic of these taking them. “It’s not excellent, but I just make use of the sources obtainable,” is a characteristic response.

Lisa Cunningham, 45, was signed off on sick leave and prescribed Prozac after suffering troubles at function. Quickly afterwards, she was attacked, leaving her with facial injuries and even deeper depression. For nearly eleven many years, Lisa remained on medicine, turning into steadily far more withdrawn, till she barely left the residence.

Cunningham’s story has a optimistic outcome: following being referred to a volunteering scheme by her GP she acquired involved in a gardening undertaking which led to a complete-time job. She then felt able to cease taking her medication. “Antidepressants did a essential occupation and I definitely feel I had clinical depression,” Cunningham says. “But I was a nervous, anxious kid.” She explains that whilst developing up, she was subjected to bodily aggression from men and women close to her, “so it was virtually inevitable I would get depression. Searching back, it would possibly have been far better if I’d had some sort of psychotherapy in college.”

For Darren Ellis, forty, lifestyle occasions and mental overall health have been similarly linked. Ellis lost his father at 16 and at the time was not presented any assistance. Ellis’s depression and anxiousness created and he was prescribed medicine right after medicine. None of the drugs worked and he twice attempted to take his personal daily life. It was only this year that he was in a position to get the one-to-1 cognitive-behavioural treatment (CBT) that, he says, is finally assisting him to recover.

Ellis believes items could have been diverse that the depression could have been prevented. “I’m certain I could have averted taking medication if I’d had therapy instantly,” he says. “I was confident – the life and soul of a celebration – till my dad died.”

The website link between life events and depression is of course not disputed, but it is of specific relevance now. A report by The Wellness and Social Care Information Centre exposed that in many places in the Uk – like Barnsley, Durham, Middlesbrough, Redcar, Salford and Sunderland – approximately one particular in six adults are prescribed antidepressants. By comparison, in affluent Kensington &amp Chelsea, it is one particular in 21.

Since the economic downturn started, Mind has reported a dramatic rise in the number of people calling its mobile phone line. “There are clear hyperlinks amongst unemployment and depression,” says Sophie Corlett, Mind’s director of external relations. “Following six months, one in 7 unemployed guys will create mental-health troubles. People are falling into debt and there’s a reciprocal partnership among debt and mental health.”

While virtually everybody with expertise of antidepressants reports locating them beneficial, numerous could have created use of option varieties of aid. “We know that folks go to the medical professional due to the fact they’re feeling reduced, and the reasons may possibly be domestic violence, debt, bereavement, marriage breakup, problems from past trauma,” says Corlett. “Some of these are practical and could have sensible solutions, whilst some are deep-rooted psychological concerns that need to have dealing with. Antidepressants are not often the response.”

For mild to moderate depression, unless of course it is persistent, the Nationwide Institute for Health and Care Excellence (Great) does not advise medication as a initial resort. Nonetheless, despite the government’s investment in the Improving Entry to Psychological Therapies programme, in some components of the nation individuals wait months for entry to CBT or equivalent treatment options. Likewise, it does not appear that people’s prescriptions are always reviewed each 6 months, as Wonderful suggests.

There are a lot of problems with prescribing antidepressants when there could be an alternative resolution. Antidepressants have side-results that we are only just discovering and, though rates have dropped as patents expire, the price to the NHS is nonetheless enormous.

It is unattainable to gauge whether we live in a much more nerve-racking age than that of our grandparents. What is specific is that attitudes and entry to drugs have changed. On stability, this is a very good issue. But as the economic system continues to flounder, the number of folks struggling with mental-wellness issues is most likely to boost, nearly undoubtedly top to the writing of nevertheless much more prescriptions.

“My worry is that we are medicalising all types of sadness in the belief that antidepressants are a risk-free drug that you just prescribe,” says Muijen.

Mind has named for precise study to be carried out into how several folks are taking antidepressants, how prolonged they get them for and whether they are getting any other treatment. It is a severe issue, Corlett says, that this data does not exist. Antidepressants are a vital instrument. But if, in several circumstances, we are just papering more than cracks, we should, as a society, face up to the depth of the problem.

Are we utilizing antidepressants to paper more than the cracks of a fractured society?

Hospital records of 47 million NHS individuals obtained by insurance coverage society

Much less than a week soon after the NHS was forced to postpone its enormous GP and hospital record-sharing strategy, it has emerged that a major insurance physique bought far more than a decade’s well worth of hospital information covering 47 million patients which, it was claimed, is to be employed to assist insurers refine their premiums.

The Staple Inn Actuarial Society mentioned that information covering all hospital in-patient stays between 1997 and 2010 was utilized to track patients’ health-related histories, recognized by date of birth and postcode, in accordance to the Daily Telegraph.

The information have been then reportedly combined with details from credit ratings agencies and employed to advise insurance coverage firms, resulting in enhanced premiums for most consumers beneath the age of 50.

The newly formed Health &amp Social Care Info Centre (HSCIC), which collects nationwide wellness and social care information, explained that the information referred to by the Staple Inn Actuarial Society had been supplied by a predecessor body, the NHS Info Centre.

It insisted that the records had been not used to analyse individual insurance coverage premiums but to analyse common variances in crucial illness.

“The newly formed HSCIC can now only supply HES [hospital episode statistics] information to organisations that are hunting to increase the way they are run for the benefit of their sufferers,” it stated in a statement. “This information is totally protected and does not recognize men and women.” The news comes at a time of heightened sensitivity about patient record confidentiality after the postponement of the NHS’s massive care.information scheme. The task, which would be the 1st time that the complete healthcare background of the nation had been digitised and stored in a single area, has been place on hold for 6 months.

Advocates say that sharing data will make medical advances less difficult and in the long run save lives because it will allow researchers to investigate drug side results or the overall performance of hospital surgical units by monitoring the effect on sufferers.

Nevertheless, privacy professionals warn there will be no way for the public to function out who has their health care information or to what use their information will be put.

Hospital records of 47 million NHS individuals obtained by insurance coverage society