Mental Health

Covid: ‘The horror of laying everyone off made me sick’

Early last year, the future looked bright for coach tour operator Robin Worsnop.

The chief executive of one the UK’s largest small group tour businesses was planning to add 30 staff to his 246-strong workforce as he prepared for the 2020 season.

But his world was about to crash.

When lockdown was imposed in March, he lost almost overnight his international visitor market – a core part of his business.

Mr Worsnop estimates that his company, Rabbie’s Tours, lost millions of pounds in revenues last year, with income down by more than 90% on 2019.

It forced him to confront the unthinkable – shutting down a UK-wide business he had built up from his Edinburgh base over decades.

‘Sleepless nights’

He openly admits that the pandemic took a heavy toll on his mental health.

“The month of March was the most harrowing of my business career as I faced the immediate prospect of saying goodbye to everything I had built up over 28 years,” he explains.

“The sleepless nights and stress and day-by-day reworking and reformulating business plan after business plan, based on a few words here and there from government ministers.

“It took an immense toll on my mental health and I lost 10kgs in that month alone.

“Admittedly I am now a better weight, but I also started chain-smoking.”

He said he had been in “the depths of despair” – but was kept going by his family and the team around him.

“The horror of laying everyone off and putting them in penury made me physically sick,” he said.

“But the support I got from both my management team and words of encouragement from many frontline team members convinced me I had to try and save Rabbie’s.”

Things were to improve as the UK government furlough scheme kicked in at the end of March 2020, allowing Rabbie’s to retain 190 staff.

But he says that the past year has been “incredibly challenging” for both him and his workforce, whom he describes as a “clan”.

‘Incredibly hard work’

“There have been some very dark days over the last year and motivation levels can be sapped very heavily.

“I know that I have suffered from these things so I can only imagine members of the team have been feeling the same way.”

However, Mr Worsnop remains optimistic about the future as restrictions are gradually lifted.

“I cannot say losing the millions of pounds we have over the last year has been enjoyable and we’ve got an awful lot of incredibly hard work to build back the business so it is financially robust again.

“But I look forward to doing that and making the business even greater than it was before.”

The lockdown has also been tough for managers like Simon Round, who runs the Huxley bar and restaurant in Edinburgh.

He spent a total of 10 months in furlough over the course of the pandemic, and only returned to his workplace full-time four weeks ago.

He says furlough came as a shock.

“I needed to keep active and fit to stay positive, as I live by myself and lockdown at times was really tough,” he said.

His employer, Signature Pubs, set up social media groups to help motivate Simon and his team to remain active.

‘Quite intense’

Staff were also encouraged to take part in quiz nights and post videos to the staff pages.

But returning to work also presented its own challenges.

“Myself and most of the team have gone from not seeing any people to serving hundreds of guests on a single day, so that alone can be quite intense.

“It’s also difficult for guests, who are having to get used to going out and about socialising again.”

Simon admits that he still facing challenges as he continues to re-acclimatise to his work environment.

“I personally have suffered with my mental health, and anxiety will come and go, but I tackle it by talking it out and staying active,” he explains.

“The best thing I have ever done is take up running and playing lots of golf – badly.

“Being around alcohol all the time can lead to you wanting to drink more yourself, and even though I do love a day/night out at the pub, the next day can sometimes be quite tough with anxiety.”

Companies and trade bodies across a range of sectors are already placing greater emphasis on mental health in the workplace for managers, as well as staff.

In tourism and hospitality, for example, there is growing concern that a crisis is looming, with many businesses still on government lifeline support, grants and loans.

Robert Allan, HR director of the Apex hotel chain, says measures to develop mental health support services are “a crucial component of the industry coming back strongly”.

He says companies should be “extremely mindful” that line managers, heads of department and supervisors may need support.

“Many will have been playing their part in supporting companies through the past few months, which in reality may add to their own challenges,” he says.

Hospitality Health, a charity which supports people working in the sector who are “experiencing tough times”, agrees that the pandemic has been hard on managers as well as staff.

Founder Gordon McIntyre explains: “Overnight they had to close the business and either make staff redundant or thankfully consider furlough, a better option at the time.

“The situation caused an immediate rise in stress, anxiety and in several cases depression.

“For staff it was the fear of the unknown. Would they keep their job? Would they be on a lesser income? What would things be like if and when they returned?

“And for the owners and managers, they had the sleepless nights of what to do with their staff, whose lives depended upon the income they provided.”

A lone robin

Covid: Seven ways to get through (and enjoy) Christmas on your own

Many of us have had to rip-up our Christmas plans this year – and for some that means spending the festive period alone.

We spoke to a couple of experts, a mental health charity and someone who spends Christmas on her own every year – and loves it – to find out what tips they would offer someone preparing to be on their own this Christmas Day.

1. It’s OK to be angry

If you’re really cross about your ruined plans, that’s OK. “We are in extraordinary circumstances and I think people have every right to be angry and disappointed and sad,” says Helen Russell, journalist and author of the book How to be Sad.

“We have to acknowledge and give space and sit with that sadness,” she says. “Suppressing the negative thoughts doesn’t work – they come back with a vengeance.” She says many people find change difficult, so don’t worry if you feel unsettled.

2. Change your expectations

“You may have been expecting a lovely big family Christmas, the picture-perfect Christmas, but unfortunately that’s not going to happen,” says Martha Mills, who spends Christmas on her own every year. She used to hate Christmas, but now can’t wait to have the day to herself. She wrote a helpful thread of tips on Twitter.

Accepting that this year’s festive period will be different is key, she says. She suggests changing the way you look at the day: “You can now rewrite the rules and plan something different.” Martha says she treats it as a “decadent” day of self-indulgence and self-care. So do what you like.

And if there are events or traditions that you can’t do this Christmas, it may help to think of them as paused rather than cancelled. Mind, the mental health charity, says “postpone them until next year, even if they happen in the summer”.

Make sure you have some nice food in and have some people you know you can video call or just text, and make sure you have some sort of agenda for the day
Martha Mills

3. Plan, plan, plan

Don’t wake up on Christmas Day not knowing what you are going to do. “I have to hold myself back from planning too soon,” Martha says. Planning the day out allows her to break it into bit-sized chunks. So plan what you are having for breakfast, set some time aside for reading, or a walk, or an afternoon film, or ringing relatives.

“Make sure you have some nice food in, have some people you know you can video call or just text, and make sure you have some sort of agenda for the day.”

Mind also recommends taking some time to make your home feel nicer. “This could be putting up Christmas decorations, or extra photographs.” It could be as simple as tidying up. And try to plan something nice to do after Christmas. “Having something to look forward to next year could make a real difference,” the charity says.

4. Do what makes you happy

Spend the day doing the things you enjoy. “This could be taking a morning jog, playing video games or doing puzzles,” the charity says. Equally it could be having a hot bath with a good book, or a lie-in wearing your favourite pyjamas.

If you haven’t got the pressures of travel or fitting in with other people, then you can simply focus on doing what makes you happy. Buy yourself a present or get something you’ve always wanted. And wrap it up to then unwrap later!

“Do what will make you feel good in terms of sensory things. I like to make sure I have a nice Christmas scented candle in. It is just being kind to yourself and being gentle with yourself,” Martha says.

5. Speak to other people

If there are people you’d like to speak to, you could arrange to talk over the phone or via video call. Or you could watch a film together, or do a quiz. British comedian Sarah Millican hosts a Christmas day chat on Twitter each year, which anyone can join, Mind says.

And if you are feeling isolated or down, try getting outside. Sophie Scott, professor of cognitive neuroscience at University College London, says getting outside, even if to only walk around the block, is “one of the best things you can do for your brain and your mood”.

Martha agrees. She says cheery cries of “merry Christmas” exchanged with strangers and dog walkers will help.

6. Eat what you want

If you love turkey – and can still get one from your local shop – then do it. If you hate the stuff, buy something else. There are no rules about what you should and shouldn’t eat, so get in some food you can look forward to eating.

“Plan to enjoy your favourite food or drink,” Mind says. It doesn’t even have to be dinner. “It could be a special breakfast or some interesting soft drinks. It could be a good excuse not to eat traditional Christmas food.”

“If you want to just have salad for lunch, or eat peanut butter out of the jar for breakfast, then do it,” adds Martha.

If you are having the worst day ever, you will go to bed that night and when you wake up Christmas Day will be over
Martha Mills

7. Don’t celebrate at all

Of course, you may decide not to mark Christmas at all this year. You could treat it as if it’s any other day. “This may feel easier than trying to celebrate alone,” Mind says. “It’s completely understandable if you feel this way”.

If you decide to skip it, the charity says you could let others know your plan. Say you’re happy to hear from them on Christmas Day but tell them “they can also support you by treating it like any other day and not mentioning Christmas”.

If you are planning to give gifts, exchange them in advance. And the charity advises staying off social media to avoid Christmassy posts, and trying to avoid adverts on TV or online.

“A lot of people get bogged down in thinking they are not going to enjoy it,” Martha says. “And that’s OK.” It’s important to realise Christmas Day is only one day – and it will quickly be over, she says.

“It is only 24 hours and it won’t last forever. If you are having the worst day ever, you will go to bed that night and when you wake up Christmas Day will be over.”

Fresh vegetables

Three pillars of mental health: Good sleep, exercise, raw fruits and veggies

Getting good quality sleep, exercising, and eating more raw fruits and vegetables predicts better mental health and well-being in young adults, a University of Otago study has found.

The study, published in Frontiers in Psychology, surveyed more than 1100 young adults from New Zealand and the United States about their sleep, physical activity, diet, and mental health.

Lead author Shay-Ruby Wickham, who completed the study as part of her Master of Science, says the research team found sleep quality, rather than sleep quantity, was the strongest predictor of mental health and well-being.

“This is surprising because sleep recommendations predominantly focus on quantity rather than quality. While we did see that both too little sleep — less than eight hours — and too much sleep — more than 12 hours — were associated with higher depressive symptoms and lower well-being, sleep quality significantly outranked sleep quantity in predicting mental health and well-being.

“This suggests that sleep quality should be promoted alongside sleep quantity as tools for improving mental health and well-being within young adults,” Ms Wickham says.

Along with quality sleep, exercising, and eating more raw fruits and vegetables — in that order — were three modifiable behaviours which correlated with better mental health and well-being in young adults.

Depressive symptoms were lowest for young adults who slept 9.7 hours per night, and feelings of well-being were highest for those who slept 8 hours per night.

Well-being was highest for young adults who ate 4.8 servings of raw fruit and vegetables per day; those who ate less than two servings, and also more than eight servings, reported lower feelings of well-being.

“Sleep, physical activity, and a healthy diet can be thought of as three pillars of health, which could contribute to promoting optimal well-being among young adults, a population where the prevalence of mental disorders is high and well-being is suboptimal,” Ms Wickham says.

Senior author, Associate Professor Tamlin Conner, of the Department of Psychology, says most prior research examines these health behaviours in isolation of each other.

“We showed that they are all important for predicting which young adults are flourishing versus suffering.”

She also stressed the study’s findings were correlations only.

“We didn’t manipulate sleep, activity, or diet to test their changes on mental health and well-being. Other research has done that and has found positive benefits. Our research suggests that a ‘whole health’ intervention prioritising sleep, exercise, and fruit and vegetable intake together, could be the next logical step in this research,” she says.

Story Source:

Materials provided by University of Otago.


Journal Reference:

  1. Shay-Ruby Wickham, Natasha A. Amarasekara, Adam Bartonicek, Tamlin S. Conner. The Big Three Health Behaviors and Mental Health and Well-Being Among Young Adults: A Cross-Sectional Investigation of Sleep, Exercise, and DietFrontiers in Psychology, 2020; 11 DOI: 10.3389/fpsyg.2020.579205
A sad man

NHS urges people with mental health worries to seek help

People with mental health worries are being urged to seek help in a new phase of the NHS’s Help Us Help You campaign.

Although mental health services have been running throughout the pandemic there was a marked dip in referrals despite evidence that coronavirus is making problems more common.

Now a new NHS campaign will encourage anyone suffering from anxiety, depression or other issues to come forward for assessment and treatment.

NHS talking therapies, also known as Improving Access to Psychological Therapies (IAPT), are a confidential service ran by fully trained experts.

People can access the service by visiting their GP or refer themselves online.

Claire Murdoch, NHS National Director for Mental Health said: “The NHS has been and continues to be here for the nation’s mental health. We know the impact that COVID and lockdown can have on people’s mental health and it has never been more important to seek help. We are proud to launch our first national campaign on mental health services today and encourage people to come forward for mental health care.

“People might feel nervous about burdening the NHS or getting exposed to the virus but remember we are here to help. Whether you are a new mum, an older person or struggling with work, please speak to your GP or self-refer online so we can get you the mental health support you need. No matter what age you are, these therapies help and are effective and we want you to come forward.’

In April 2020 only 57,814 referrals were made compared to 133,191 in April 2019.

The latest figures from July show that referrals are recovering, but are still down by 11% compared to last year.

Some people have experienced mental health issues for the first time during the pandemic and lockdown while others have seen them return.

Common anxiety problems seen include (but are not restricted to) panic attacks, social anxiety, obsessive-compulsive problems, generalised anxiety/worry, and post-traumatic stress disorder.

Emerging evidence suggests they are increasing due to the COVID-19 pandemic.

The Office of National Statistics (ONS) reported that almost one in five adults were likely to be experiencing some form of depression during the pandemic and almost one in eight developed moderate to severe depressive symptoms.

The ONS also found a marked increase in anxiety at the beginning of lockdown with almost half (49.6%) of people reporting high anxiety.

Not all those people who are feeling more anxious through the pandemic will go on to need professional support, but for those that do the NHS is here to help with talking therapies.

Professor David Clark, National Clinical and Informatics Advisor for the IAPT programme, said: “Talking therapies have been available through the NHS since 2008 and our programme is recognised worldwide for its scale, quality standards and effectiveness”.

“IAPT has transformed the treatment of adult anxiety disorders and depression since it was launched and is now being copied in other countries. The services have seen more than one million people in the last year.”

“COVID-19 has impacted us all in different ways and our mental health is just as important as our physical health. Talking therapies for anxiety and depression have been available throughout the pandemic and our services continue to be open to everyone who feels they might benefit from the invaluable help that psychological therapies can provide.”

The service has been fully running throughout the pandemic with almost 95% of talking therapies delivered remotely from July 2020 through a digital platform or over the phone, allowing people to stay in contact and get support more flexibly and comfortably. Face to face appointments are also still available, and services have implemented new measures to limit infection risks.

Talking therapies are available to all adults in England and you will receive confidential support tailored to you. For those whose first language is not English, talking therapies can be delivered in your chosen language through multi-lingual therapists or through confidential translators.

Minister for Mental Health and Suicide Prevention Nadine Dorries said: “The last few months have been challenging for many of us, especially for those with pre-existing mental health issues, and the NHS and Mental Health Services have remained open to support those who need it.

“Talking therapies can be highly effective in helping people who are experiencing anxiety and depression, and I encourage anyone who is struggling to come forward to get the support they need. Do not suffer in silence, speak to your GP or self-refer online to access the support available.”

Paul Farmer, Chief Executive of Mind, said: “From illness or bereavement to loneliness due to lockdown, or concerns about job security and debt – Coronavirus has had a huge impact on the mental health of the nation. Mind’s research with 16,000 people showed that despite greater prevalence of mental health problems, people were less likely to ask for help because of being worried that their problems aren’t serious enough, they are concerned about placing greater pressure on the NHS, or that they might contract Coronavirus.

“The earlier people can receive support for their mental health, the more likely they are to benefit from treatment such as talking therapies. As we deal with the winter and the second wave, it’s more important than ever that people are aware of the support available to them and feel confident about seeking help. It’s also crucial that services continue to adapt to make sure that nobody falls through the gaps, for example, making sure people who need support over the phone or face to face are able to access it.”

The NHS is here to help. To find out more about talking therapies, you can visit the NHS website: nhs.uk/talk

Alone

NHS encourages children and young people to seek help as new data shows rise in mental health problems

England’s top children and young people’s mental health doctor is encouraging youngsters to seek help if they need it, as NHS Digital’s new survey shows there has been a rise in mental health problems in children and young people during the pandemic.

The survey shows one in six children and young people had a probable mental health disorder in July during the first wave, compared to one in nine in 2017.

NHS England’s Professor Prathiba Chitsabesan has said that it is entirely understandable that young people have concerns and anxieties given the impact and upheaval caused by the coronavirus outbreak.

And the NHS is stressing that children and young people, and those who care for them, should be reassured there are sources of help for anyone concerned with their mental health and is encouraging families to seek support, especially if symptoms are persistent and impacting on their everyday life.

Professor Prathiba Chitsabesan, NHS England Associate National Clinical Director for Children and Young People’s Mental Health, said: “As the whole country continues to find ways to live with the pandemic, many children and young people will be experiencing a range of feelings including anxiety, sadness and loneliness which are understandable responses to such an uncertain and stressful situation.

“Simple steps like getting enough sleep, talking to friends or family and ensuring your child has a simple routine can make a huge positive difference.

“And the NHS, children’s services, schools, colleges and the voluntary sector are working together to provide a range of support including 24/7 crisis support lines, face to face, telephone or digital appointments and support in schools so issues can be identified and help offered sooner.”

Professor Chitsabesan has previously issued a list of signs parents should look out for and where they can access help.

Signs that parents should look out for include:

  • You might find they are more upset or find it hard to manage their emotions
  • They may appear anxious or distressed
  • Increasing trouble with sleeping and eating
  • Appearing low in mood, withdrawn or tearful
  • Reporting worried or negative thoughts about themselves or their future
  • For younger children, there may be more regressed behaviour such as bed wetting or separation anxiety

If a parent is worried about their child’s mental health, they can help by:

  • Making time to talk to your child
  • Allow your child to talk about their feelings
  • Try to understand their problems and provide reassurance that you have heard them and are there to help
  • Help your child do positive activities including exercise
  • Try to keep a routine over the next few months
  • Look after your own mental health.

If someone is in a crisis, the NHS provides urgent mental health helplines offering 24-hour advice and support, or an assessment to help decide on the best course of care.

Rough sleeper

Rough sleepers in homeless hotspots to benefit from NHS mental health outreach

Towns with high rates of homelessness are set for investment in specialist mental health care, as part of NHS services for rough sleepers across the country.

The NHS-funded services in seven parts of the country will bring in new psychiatrists, psychologists and other experts to offer homeless people advice and treatment to tackle underlying mental ill health.

More than half of everyone sleeping on the streets lives with a mental health problem, while those affected by homelessness die, on average, around 30 years earlier than the general population.

Nearly four in five people living without a roof over their head experiencing childhood trauma, but vulnerable rough sleepers can often face a ‘revolving door’ where they receive treatment and support, only to end up back on the streets.

The new NHS-led teams will bring together doctors, nurses and other clinicians to co-ordinate treatment and support with other local organisations including councils.

The new services, are part of co-ordinated efforts to ensure that rough sleepers have better access to NHS mental health support – joining up care with existing outreach, accommodation, drug and alcohol and physical healthcare services.

In each area, outreach teams – comprising NHS and local authority staff – will identify rough sleepers in need of help, support them to access a GP and then on to the new expert psychiatric help.

Claire Murdoch, NHS national director for mental health said: “While the NHS cannot solve homelessness on its own, it is working hard to make sure rough sleepers have easy access to services that are built and designed around their needs – putting an end to the revolving door of trauma care.

“Many rough sleepers have been through incredibly traumatic experiences which can cause mental ill health or exacerbate problems – often impacting on the type of support they need and this is about stopping people slipping through the net.”

The mental health care will sit alongside existing support for rough sleepers, including for example,  one to one support from a specified caseworker who can help with everything from housing advice to attending NHS appointments – and will keep in contact with the patient for as long as is required

The first wave of funding is worth almost £12 million over the next five years and will be used to build and scale up comprehensive services across:

  • Birmingham
  • Brighton
  • Hull
  • Lincoln
  • Lambeth
  • Luton
  • Haringey

At least 20 areas with high levels of rough sleeping will be expected to have set up new teams by 2023/24 as part of a wider national roll-out – backed by £30 million as part of the NHS Long Term Plan.

The new money will be directed at towns, cities as well more rural areas most impacted by rough sleeping.

Areas must already be working in partnership to address rough sleeping and ensure mental health services are accessible for rough sleepers.

Dominic Williamson, St Mungo’s Executive Director of Policy and Strategy at St Mungo’s, said: “In 2018, 726 people died while sleeping rough or in emergency accommodation, with many affected by a range of physical, mental health and substance use problems. This is a public health crisis and the NHS has a key role to play in tackling these issues and supporting people’s recovery from homelessness.

“As a result we are pleased to see investment in these specialist services for people who are homeless. We particularly welcome the promises to join-up provision between mental health, substance use and housing – to ensure no one is denied the treatment and support they need. We hope these services will save lives and ensure more people recover from homelessness and rebuild their lives.

“We hope that services seize this opportunity to do things differently, and that this is just the start of a renewed effort to truly join up health and housing, to ensure everyone sleeping rough gets the support they need.”

The programme will in part be based on a scheme in London which also included a crisis café for homeless people to visit and receive mental health support when needed. The service in Camberwell has been running since 1991 and includes rehab services, substances abuses services and mental health provision.

Barber

Training for barbers to spot warning signs of mental health problems

Community initiatives including mental health first aid training for barbers, and counselling for bereaved relatives, are set to benefit from a £10 million funding boost.

A dedicated support package has been provided to local NHS, public health teams and voluntary organisations across England to strengthen suicide prevention plans and provide practical and emotional support to friends and family who have lost a loved one to suicide.

The funding will be used to set up tailored projects to care for people in high-risk and vulnerable groups such as those who self-harm, middle-aged men and hospital patients with mental health illnesses.

The majority of the money – £8 million – has been allocated to bolster suicide prevention initiatives across 30 local areas, including 15 new projects, during the 2020/21 financial year. The remainder is earmarked to provide bereavement support for people after a relative or friend’s suicide.

Support will range from one-to-one sessions with trained volunteers or counsellors, group support or signposting to specialist mental health services.

Local and grassroots initiatives will also include suicide prevention training programmes, awareness campaigns, some specialist support services for the most vulnerable people at risk of suicide and phone, video and online support.

Funding is also allocated for suicide bereavement support services, including bereavement liaison officers who will provide practical and emotional support for families and loved ones impacted by suicide.

These services, usually provided by local voluntary and community sector organisations, are a key component of local suicide prevention pathways.

Claire Murdoch, NHS national director for mental health, said: “Every death by suicide is a tragedy for the person, their family and friends – with countless lives devastated as a result, which is why we continue to expand access to mental health care, including offering help from different and convenient community locations, and are working around the clock to support people through the Coronavirus pandemic and beyond.

The pandemic has turned lives upside down for many people and this funding will support our mission to ensure appropriate suicide prevention programmes as well as suicide bereavement support services are available right across the country. I would urge anyone concerned about their mental health to come forward for help as the NHS is here for you.”

Mental health and suicide prevention Minister, Nadine Dorries said: “Suicides are truly devastating and those left behind can suffer indescribable pain and grief. It is vital those coming to terms with a loss have access to the right types of support.

“We want everybody experiencing mental health problems to be able to get the help they need before they reach crisis point and these new initiatives will provide vital support networks in the heart of our communities.

“The NHS is there for everyone who needs it and this funding delivers our NHS Long Term Plan commitment, providing support to communities across the country and strengthening suicide prevention plans and support services.”

The funding will help to deliver the commitment set out in the NHS Long Term Plan that by 2023/24 every region and system across the country will benefit from the current suicide prevention programme and have suicide bereavement support services.

Hamish Elvidge, chair of The Support after Suicide Partnership, said: “There are over 5,000 suicides in England every year and each one has a huge impact on the families, carers, friends and colleagues left behind. Their lives are turned upside down, with feelings of loss, guilt, disbelief and rejection.

“The Support after Suicide Partnership believes that everyone bereaved or affected by suicide should be offered timely and appropriate support and is working closely with the NHS and our members to establish support services in every area of the country. These services, provided mostly by local, voluntary organisations, offer emotional and practical support, which will help people cope with their loss and start to rebuild their lives.”

Case studies

  • Recognising that men spend more time with their barber than their GP, local organisations in Greater Manchester have commissioned the Lions Barber Collective charity to offer free training for barbers in the area. They have developed an initiative – BarberTalk – which gives barbers the skills to recognise the signs that someone may be struggling with their mental health and how to help clients get the support they need. From 10 September to 10 October, 40 barbers will be given training online as part of this project. They will be added to the Lions Barber Collective ‘Locate a Lion’ map and listed on Greater Manchester’s Shining A Light On Suicide website.
  • In the South West, the funding will be used to expand the Hope Project which covers Bristol, South Gloucestershire and North Somerset. The project provides support to men aged 30 to 64 who are experiencing psychological distress, in debt or financial difficulties, dealing with housing or employment issues as well as those who have recently self-harmed, and are not in touch with other mental health services. Over the last 12 months, the project has supported more than 250 men, significantly more than the original target of 180.
  • In the South East, an enhanced bereavement support service will be launched this month to ensure anyone living anywhere in Sussex who has been affected by a family member or friend taking their own life will receive emotional and practical support from a dedicated bereavement liaison officer and the opportunity to access counselling.  The new enhanced service will have a Single point of access, a triage service, a bereavement liaison and counselling service based in each of its three local authority areas and a Sussex wide Children’s and Young People’s bereavement service.
Bored at school

Top NHS doctor issues advice for children going back to school

NHS England’s top doctor for children and young people’s mental health has urged parents to be alert to signs that children could be experiencing anxiety, distress or low mood as some pupils return to school on Monday (1 June).

Lockdown will have increased pressure on many mums, dads and their children, with young people unable to see friends, Professor Prathiba Chitsabesan said.

However, the return to school may cause anxiety for some pupils heading back to the classroom after months away – and those who would like to return but remain stuck at home feeling left out or isolated.

Professor Chitsabesan stressed that NHS mental health services remain available for children and young people. We are working in partnership with schools and other services to support children and their families.

Parents can also take simple steps to help sons or daughters who might be struggling to deal with the loneliness and uncertainty of lockdown or fears about returning to school.

Professor Prathiba Chitsabesan, NHS England Associate National Clinical Director for Children and Young People’s Mental Health, said: “Children and young people may be experiencing a variety of feelings in response to the coronavirus pandemic, including anxiety, distress and low mood, and it is important to understand that these are normal responses to an abnormal situation.”

“The NHS offers a large amount of mental health support for children and young people, and if a child needs urgent mental health support or advice, check nhs.uk for services in your area, including 24/7 crisis support.”

NHS England has issued advice on what parents should look out for and steps that they can take to look after their child’s mental health, based on advice from clinicians and first-hand experience from patients and parents.

Signs that parents should look out for include:

  • You might find they are more upset or find it hard to manage their emotions
  • They may appear anxious or distressed
  • Increasing trouble with sleeping and eating
  • Appearing low in mood, withdrawn or tearful
  • Reporting worried or negative thoughts about themselves or their future
  • For younger children, there may be more bed wetting.

If a parent is worried about their child’s mental health, they can help by:

  • Making time to talk to your child
  • Allow your child to talk about their feelings
  • Try to understand their problems and provide reassurance that you have heard them and are there to help
  • Help your child do positive activities
  • Try to keep a routine over the next few weeks
  • Look after your own mental health.

Parents should contact NHS 111 online or a GP immediately if they notice any physical injuries on a child, such as deep cuts or burns.

Advice is also available from Rise Above, a website created with young people, and from MindEd – a free educational resource for parents and professionals working with children.

Claire Murdoch, NHS England National Mental Health Director said: “We know that children and young people’s lives have been disrupted during these uncertain times, and some may be suffering from anxiety as schools reopen.

“The NHS is open for business as usual and has adapted to the coronavirus crisis through offering flexible options including phone and video consultations and online support.”

Tom Madders, Campaigns Director at YoungMinds said:”School can provide routine, structure and a chance for children to connect and learn, which can all be positive for mental health – but for some children, returning will be a confusing and overwhelming experience, especially if the environment feels different to how it was before. Some children who aren’t yet returning to school may also be struggling with social isolation or uncertainty about what the future holds.

“If you’re worried about how your child is coping, trust your instinct and reach out for help. The YoungMinds Parents Helpline can provide advice and support to any parent or carer who’s concerned about their child’s mental health, and you can also talk to your GP, your child’s school or NHS mental health services.”

Minister for Mental Health, Nadine Dorries said: “As many children start to return to school, it’s vital we continue to give them the support they need to maintain their mental health and wellbeing and deal with any feelings of uncertainty or worry they may be experiencing.

“The NHS remains there for those who need it and our mental health services are adapting to best support families and children as we all get used to these changes in routine. We also recently provided over £9 million to leading mental health charities to help them expand and reach those most in need.

“I urge any families and children in need of guidance and advice or crisis support to contact their GP or visit the NHS website.”

Children and young people with disabilities including those with autism spectrum disorder, learning disabilities and ADHD may find the impact of coronavirus particularly difficult to manage. It is important to explain change and manage any anxiety and distress they may be experiencing.

Seek immediate advice if they are already in contact with specialist health and social care services or contact your GP. The National Autistic Society have helpful advice on their website on how to deal with this uncertain time with the coronavirus.

Teachers who have a concern over a pupil should visit their local NHS Children and Young People’s Mental Health Services website which has phone numbers so you can get in touch directly for detailed advice.

Army veteran

Helping our heroes: NHS urges veterans to get help despite coronavirus outbreak

As the nation gears up to mark the 75th anniversary of VE Day, the NHS wants all those who have served their country to know that dedicated help and support is still available despite the coronavirus outbreak.

The NHS has also today payed tribute to the many veterans who are working as ‘hidden heroes’ in the NHS’s efforts to tackle the virus.

To date the world-leading services have improved the lives of thousands of former services personnel supporting their physical and mental health needs for those who struggle with civilian life, some of whose stories are set out below.

While a growing number of veterans have been referred for help year-on-year, latest data indicates a drop in the number of people reaching out to specialist services in April.

But despite the coronavirus outbreak help is still available and has been adapted to offer more digital services, including video consultations with psychotherapists and support by phone, in response to social distancing rules and travel restrictions in place.

The NHS lead for armed forces’ health has today issued a timely call urging veterans to seek help as dedicated services remain open for business.

Kate Davies CBE, Director of Armed Forces at NHS England and NHS Improvement, said: “This weekend’s VE Day commemorations are a reminder of the remarkable difference our armed forces have made to our country throughout history and the contribution they continue to make today on the NHS frontline in the fight against coronavirus.

“At a time when we are facing significant uncertainty and long periods of isolation which can be particularly worrying, it has never been more important for veterans to reach out if they need support– help is available – with new digital offers which ex-personnel are already benefiting from.”

The NHS is committed to making sure that every veteran gets the best possible support for their physical and mental health with dedicated services available for those who struggle with civilian life including targeted mental health services for veterans.

These include the NHS Veterans’ Mental Health Transition, Intervention and Liaison Service (TILS), which identifies and treats mental health needs early, and the NHS Veterans’ Mental Health Complex Treatment Service (CTS), which gives intensive support to those with military-related complex mental health concerns not improved by earlier care and treatment.

Since the TILS service was launched in April 2017 it has had over 11,000 referrals up to May 2020, while there have been almost 1,500 CTS referrals in total up to April 2020.

Both offer local community-based support ranging from therapeutic treatment for complex challenges or trauma, to help meeting wider needs that can have an impact on mental health, such as physical health, employment, housing, finances, social relationships and drug and alcohol misuse.

Plate of white fish

Eating Well for Mental Health

From a young age, we’re taught that eating well helps us look and feel our physical best. What we’re not always told is that good nutrition significantly affects our mental health, too. A healthy, well-balanced diet can help us think clearly and feel more alert. It can also improve concentration and attention span.

Conversely, an inadequate diet can lead to fatigue, impaired decision-making, and can slow down reaction time. In fact, a poor diet can actually aggravate, and may even lead to, stress and depression.

Maxine Barish-Wreden, M.D., a complementary and integrative medicine physician with Sutter Medical Foundation, says one of the biggest health impairments is society’s reliance on processed foods. These foods are high in flours and sugar and train the brain to crave more of them, rather than nutrient-rich foods such as fruits and vegetables.

“A lot of the processed foods we eat are highly addictive and stimulate the dopamine centres in our brain, which are associated with pleasure and reward,” Dr. Barish-Wreden says. “In order to stop craving unhealthy foods, you’ve got to stop eating those foods. You actually start to change the physiology in the brain when you pull added sugars and refined carbohydrates from your diet.”

Stress and Depression

Sugar and processed foods can lead to inflammation throughout the body and brain, which may contribute to mood disorders, including anxiety and depression. When we’re feeling stressed or depressed, it’s often processed foods we reach for in search of a quick pick-me-up. During busy or difficult periods, a cup of coffee stands in for a complete breakfast and fresh fruits and vegetables are replaced with high-fat, high-calorie fast food. When feeling down, a pint of ice cream becomes dinner (or you skip dinner altogether).

According to the American Dietetic Association, people tend to either eat too much or too little when depressed or under stress. Eat too much and you find yourself dealing with sluggishness and weight gain. Eat too little and the resulting exhaustion makes this a hard habit to break. In either case, a poor diet during periods of stress and depression only makes matters worse. This cycle is a vicious one, but it can be overcome.

To boost your mental health, focus on eating plenty of fruits and vegetables along with foods rich in omega-3 fatty acids, such as salmon. Dark green leafy vegetables, in particular, are brain protective. Nuts, seeds and legumes, such as beans and lentils, are also excellent brain foods. Dr. Barish-Wreden says a healthy diet can be more effective for treating depression than prescription medications.

“Studies have shown a reduction in depression of 40 to 60 per cent when people are eating the right foods, which is a better outcome than most drugs,” Dr. Barish-Wreden says.

A Healthy Gut

Researchers continue to prove the old adage that you are what you eat, most recently by exploring the strong connection between our intestines and brain. Our guts and brain are physically linked via the vagus nerve, and the two are able to send messages to one another. While the gut is able to influence emotional behaviour in the brain, the brain can also alter the type of bacteria living in the gut.

According to the American Psychological Association, gut bacteria produce an array of neurochemicals that the brain uses for the regulation of physiological and mental processes, including mood. It’s believed 95 per cent of the body’s supply of serotonin, a mood stabilizer, is produced by gut bacteria. Stress is thought to suppress beneficial gut bacteria.

Failing to keep the bacteria in our guts happy with a healthy diet can lead to depression, says Dr. Barish-Wreden. Depression can take hold when the gut is inflamed by processed foods such as sugar and flours, even whole grain flours. To remedy this, Dr. Barish-Wreden says people need to scrap their poor dietary habits.

“Reducing flour and sugar helps create a new microbiome of healthy bacteria. Adding fresh fruits, fibre, fish and fermented foods will also help your gut bacteria truly thrive,” she says.

Mindful Eating

Paying attention to how you feel when you eat, and what you eat, is one of the first steps in making sure you’re getting well-balanced meals and snacks. Since many of us don’t pay close attention to our eating habits, nutritionists recommend keeping a food journal. Documenting what, where and when you eat is a great way to gain insight into your patterns.

If you find you overeat when stressed, it may be helpful to stop what you’re doing when the urge to eat arises and to write down your feelings. By doing this, you may discover what’s really bothering you. If you undereat, it may help to schedule five or six smaller meals instead of three large ones.

Learn more about mindful and emotional eating.

Sometimes, stress and depression are severe and can’t be managed alone. For some, eating disorders develop. If you find it hard to control your eating habits, whether you’re eating too much or too little, your health may be in jeopardy. If this is the case, you should seek professional counselling. Asking for help is never a sign of weakness or failure, especially in situations too difficult to handle alone.

Brain Food

Your brain and nervous system depend on nutrition to build new proteins, cells and tissues. In order to function effectively, your body requires a variety of carbohydrates, proteins and minerals. To get all the nutrients that improve mental functioning, nutritionists suggest eating meals and snacks that include a variety of foods, instead of eating the same meals each day.

Here are the top three foods to incorporate into a healthy mental diet:

  • Complex carbohydrates — such as brown rice and starchy vegetables can give you energy. Quinoa, millet, beets and sweet potatoes have more nutritional value and will keep you satisfied longer than the simple carbohydrates found in sugar and candy.
  • Lean proteins — also lend energy that allows your body to think and react quickly. Good sources of protein include chicken, meat, fish, eggs, soybeans, nuts and seeds.
  • Fatty acids — are crucial for the proper function of your brain and nervous system. You can find them in fish, meat, eggs, nuts and flaxseeds.

Healthy Eating Tips

  • Steer clear of processed snack foods, such as potato chips, which can impair your ability to concentrate. Pass up sugar-filled snacks, such as candy and soft drinks, which lead to ups and downs in energy levels.
  • Consume plenty of healthy fats, such as olive oil, coconut oil and avocado. This will support your brain function.
  • Have a healthy snack when hunger strikes, such as fruit, nuts, hard-boiled eggs, baked sweet potatoes or edamame. This will give you more energy than packaged products.
  • Develop a healthy shopping list and stick to it.
  • Don’t shop while hungry, since you’ll be more apt to make unhealthy impulse purchases.
  • Think about where and when you eat. Don’t eat in front of the television, which can be distracting and cause you to overeat. Instead, find a place to sit, relax and really notice what you’re eating. Chew slowly. Savour the taste and texture.