MAGAZINE
MC
A RIGHT ROYAL APPOINTMENT
INSIDE Don’t Recycle – Upcycle
Get your bib on
Men get eating disorders too
• WORLD MENTAL HEALTH DAY SPECIAL • WORLD MENTAL HEALTH DAY SPECIAL •
Autumn 2017
MC
MAGAZINE
3 WELCOME 4 A RIGHT ROYAL APPOINTMENT 8 A DIFFERENT CORNER 14 STUDENT STRESS – TIPS FOR FRESHERS 16 IN CONVERSATION WITH MATT ASHTON 18 MEN GET EATING DISORDERS TOO 22 HAVE A LAUGH
27
I WOULDN’T LET MY KIDS MOVE
Tammy tells how she’s enjoying life more thanks to help from a specialist service for people diagnosed with a personality disorder.
23 WARMING AUTUMN SUPPER
22
24 GET BACK TO NETBALL
I NEEDED TO LAUGH
26 DON’T RECYCLE – UP CYCLE
How comedy can change your mood.
27 I HAVE A PERSONALITY DISORDER
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A DIFFERENT CORNER How the life of a Lancashire family has been transformed. MC magazine team: Managing Editor: Steve Murphy. Editor: Jackie Rankin.
30 WE’RE WORKING ON IT
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I COULDN’T SAY MY NAME
The actor who battled a lifelong stammer. Contributors: Myles Hodgson, Charlotte Hadfield, Jayne Moore. Editorial: Julie Crompton, Joanne Cunningham. Photography: Joel Goodman. Design: Jo Hadfield.
32 VOICE OF THE CHILD 34 A DAY IN THE LIFE 35 DOING IT FOR MY MUM
You can contact us at: communications@merseycare.nhs.uk MerseyCareNhsTrust Mersey_Care
ARE YOUR DETAILS UP TO DATE? If you’ve received this issue directly we’d like to be sure that the information we hold for you is 2
current and accurate. If you’ve changed your postal or email address, or your phone number, please email: membership@merseycare.nhs.uk or call 0151 471 2303. You can help us save costs by receiving your copy electronically. Please email communications@merseycare.nhs.uk.
WELCOME
It’s the season for getting out and kicking up some leaves.
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young mum is rekindling childhood memories by going out and playing netball, while others have thrown off inhibitions and learned to laugh again.
e’re all still grinning from the visit by a certain member of the Royal family to Mersey Care’s Life Rooms to see how a former library has become a place where people can start not just to live but to be fully alive (p4). Prince William told people on a confidence building course that helping others gives him confidence. Ensuring people have a voice is a recurring theme in this edition – from the therapist who helped a young actor overcome a stutter, to the nurse who is asking us all to be the ‘voice of the child’.
It’s the season when young people are making new memories; but university life can be daunting. Our feature gives tips on getting through the first few months.
It’s tempting to curl up and stay in - our autumn recipe comes from a dietician who can be found belting out a tune on his guitar after a warming supper! But one
If you’re struggling - whatever the reason don’t do it in silence, use your voice, talk to someone you trust. Have a great autumn
The MC editorial team. 3
A RIGHT
ROYAL
APPOINTMENT Crowds from the local community gives His Royal Highness a rousing send-off after his tour of facilities and services at Life Rooms Walton.
Word of Mersey Care’s Life Rooms and its capacity for helping people regain their lives has reached Royal circles… a year after its doors first opened HRH the Duke of Cambridge went along to find out more about the former library that has been transformed into a stunning community hub and home to Mersey Care’s Recovery College.
What a royal welcome! The Duke of Cambridge is greeted by the boys and girls of Northcote Primary School on his arrival at Life Rooms Walton.
His Royal Highness reveals to the Recovery College’s Confidence Building class how making people smile helps give him confidence.
4
The Prince explains to the Womens’ Addictions Group how much his wife, the Duchess of Cambridge, was looking forward to meeting them before being forced to withdraw from the trip due to severe morning sickness.
5
Julie Killen from the Cass Foundation shows the Duke the recently restored ‘Life Garden’ and explains its benefits for service users, carers, volunteers and Recovery College students.
M
ore than 16,000 people have experienced the first Life Rooms in Walton. A second centre has since opened in Scarisbrick Avenue Southport; and in a bid to support young people and the student population an association with Hugh Baird College will see a former church on Oriel Road, Bootle transformed into a third Life Rooms next year. The Duke became aware of the Life Rooms’ model and decided to see for himself the visionary approach to helping people ‘not just live but be fully alive’. He met members of a gardening group that has transformed the grounds into a ’life garden’ and heard from volunteers, staff and partners how a pathways service helps, advises and gives practical support to people who use the Life Rooms. Working in partnership with established employers is one of a number of ways Life Rooms is seeking to expand.
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The Duke’s ‘Heads Together’ campaign – run with his wife, the Duchess of Cambridge and brother, Prince Henry of Wales (Harry) – aims to end stigma.
He joked with students during a recovery college confidence building course “the last thing you want is someone like me turning up!” He revealed that helping others helped his own confidence, then shared with the group his commitment that mental health must be normalised. “The stigma must be smashed,” he said. Services like the Life Rooms he remarked, are needed right across the country. Michael Crilly, Mersey Care’s Director of Social Inclusion and Participation said “It was a great experience to be able to show the Duke how our model works. His visit is great affirmation of the common ground between Life Rooms and what he and the Duchess and Prince Harry are highlighting with their ‘Heads Together’ campaign. The Duke asked for more information on the Trust’s Zero Suicide approach to eliminate suicide among people in its care. Mersey Care is the first mental trust in the country to make such a commitment.
The Duke of Cambridge has been a high profile advocate for mental health issues, through the joint campaign 'Heads Together' run with his wife, the Duchess of Cambridge, and his brother, Prince Henry of Wales. headstogether.org.uk More information on Life Rooms can be found at liferooms.org
Suicide. Someone close to you could be about to snap... Friends, family members, neighbours and colleagues may appear to be strong on the outside but they may be crumbling within. Desperate for help but afraid to come forward due to fear, discrimination or ridicule. The aim of our Big Brew campaign is to shatter the stigma of suicide. By arranging your own Big Brew event and talking openly, candidly about mental health and depression, we can help people open up, sharing thoughts and showing support is available.
The Big w Bre
For more information and your FREE BIG BREW pack go to
www.merseycare.nhs.uk 7
A DIFFERENT
CORNER A
In the North West a specialist team works closely with the police and other partners to divert vulnerable people away from the courts and prison and give them the help they need to live ordinary lives.
We should all have the chance to live ordinary lives. 8
person with a learning disability commits a crime. What does society do? Send them to prison? The Government wants people with a learning disability, autism or both to live in their own community with the right care and support. How does this work when someone has or is at risk of committing a crime? Irene Byrne Watts is Director of Community Services in Mersey Care’s Specialist Learning Disabilities division. “We should all have the chance to live ordinary lives, with family, or in a home of our own, with friends and networks of people around us. However people with a learning disability can sometimes be vulnerable and open to exploitation.
They can be drawn in by others, coerced into committing crime. They can end up in prison or be placed in a secure hospital. We need to have a strong community infrastructure and the right support in place, to enable people and communities to stay safe.” Mersey Care’s Forensic Support Service has a decade of service in Lancashire, South Cumbria and Greater Manchester and has received national acclaim for its work. Clinical nurse specialists, together with a speech and language therapist and a clinical psychologist support service users and their families as well as providing education and training to partners.
LEFT: Debi and Simon (centre) with specialist learning disabilities nurse Andrew Jackson and Lancashire Police Early Action officer Claire Wall who supported their son Jordan (right).
The team steps in when a person has offended or is identified by police, probation or other services as being at risk of offending. Clinical Psychologist Jenni Crean says that gaining the person’s trust is a priority. “They may never have been formally assessed, and so understandably they might be reluctant to accept a label of learning disability, as there’s a stigma that comes with it. It’s up to us to convince them we’re there to help.”
We get to know the family and the community teams stay close to the person all the time, looking out for signs of problems and contacting us so we can respond quickly. Nicola McNamara is a speech and language therapist. The assessment tool she uses was developed to help identify communication difficulties, which can be an indicator of learning disability. “We often have to think outside the box to encourage people to engage in assessments. It can take time and lots of effort to build up a rapport with them.”
The team helps other services such as police and probation to understand the pattern of behaviour for someone with a learning disability. Specialist learning disabilities nurse Vicky Dunn: “It’s vital they know why someone behaves and communicates in a particular way as it can affect how they respond. The best results are where we have good relationships. “Safe means safe for everyone. We get to know the family, and community teams stay close to the person all the time, looking out for signs of problems and contacting us so we can respond quickly.” If someone is at real risk they may need to go into hospital. The team will work with hospital and community teams to make sure the person goes safely back to their normal life as soon as possible. What about people who have lived a large part of their lives in hospitals? They need to feel safe and have the right support, just in a different place. We get to know the person and work alongside them, so we are a familiar face when they move into the community. Change is hard for all of us, it’s how we as professionals manage the transition and support someone to live the life they deserve.”
People with a learning disability can be drawn in by others, coerced into committing crime. They can easily end up in prison. We have to have the right support to keep them and their communities safe.
National learning disability policy, called “Transforming Care” is about preventing admission to hospitals so that, like Jordan, people can stay in the community. Mersey Care learning disability experts are leading the development of a new service supporting vulnerable adults who come into contact with the criminal justice system, to prevent hospital admissions in the first place by offering the right support in the community, and providing families and partners with training and support.
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A DIFFERENT CORNER
I love it here... I feel more independent. Jordan.
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Debi and Simon are immensely proud of their son. At 23 Jordan’s just moved into his own flat and is loving life.
I
t’s a story that could have had a very different ending. Jordan was in trouble with the police; the family was in turmoil.
It wasn’t until he was 18 that he was diagnosed with autism. In the intervening years he struggled at school, relentlessly bullied. “It felt like we were sending him on a bus to the lion’s den,” said Debi. During the teenage years they found it harder to read their son’s moods. Debi: “He’d go out fine and come back completely different; he seemed to mimic the people he’d been with and sometimes that meant aggression. We knew he was buying people’s friendships and we found out he was being financially exploited.”
He was buying people’s friendships and we found out he was being financially exploited.
He needed protection and a sense of purpose. Specialist learning disabilities Nurse Andrew Jackson
During the past year Lancashire police became involved with the family. Early Action police officer Clare Wall knew there was something more to Jordan than met the eye. “It was a frustrating situation; the family bonds were being torn apart, yet although Jordan was committing crimes he always responded with respect when we challenged him. This was clearly a safeguarding issue for someone who was struggling with adulthood. I felt strongly that he had a learning disability and shouldn’t be criminalised. I desperately wanted to help him avoid prison but I needed help to scratch the surface.” Clare had worked with the forensic support service at Mersey Care before and asked nurse Andrew Jackson to assess Jordan. He drew on his 33 years’ experience to tap into the real Jordan.
Jordan became increasingly disruptive and impulsive. Holidays or evenings out were impossible, the couple couldn’t leave their son alone in the house.
Andrew and his team were surprised at the assessment results. “Our assessments showed clearly that Jordan had a learning disability which had never been picked up.
“We laid our lives bare to so many services over the years, telling them how we feared something awful would happen.” Debi recalls.
“He loves people - he saw himself as a local socialite - but his level of understanding was much more limited than it appeared. He’d copy what he heard and it fooled people into thinking he was more capable
than he actually was. He wouldn’t intend to offend but he was heading for a criminal conviction, he needed protection and a sense of purpose.” Clare agrees: “If Jordan had gone before a court he might be in prison now, with all the trauma and funding that it involves. Working with the forensic support team lets us divert vulnerable people away from the criminal justice system. It’s still policing, but in a different way.”
Their life has been transformed. It was felt Jordan needed a chance to live independently with professional support from carers. The team worked with the family and Jordan is now living a few miles away. He refers to his flat as ‘home’ and Debi and Simon enjoy visiting. When Clare last saw Debi both cried tears of relief and joy: “I’ve been a police officer for 20 years, but I had sleepless nights over Jordan. Their lives have been transformed. As a mum I know how that must feel.”
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TRUE LIFE
MY
NAME IS...
Twins John Paul (left) and Kevin Cubbin are like peas in a pod, they have the same infectious grin. You could easily call one by the other’s name – and that’s what JP did for years when a childhood stutter got so bad he couldn’t say his own name.
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I’ll always have a stutter but now I see it as just a part of me.
T
hey have the bond that so often exists between twins sharing jokes, finishing each other’s sentences. JP’s stutter is barely noticeable. But before he sought help at 22 it blighted both their lives. “I relied on Kev to speak for me. I got most anxious saying my own name, so if people asked I’d say my name was Kevin – then they’d ask his name!”recalls JP. They laugh at the memory, but times have been tough. “At high school there was name calling, I got into fights, I lost my confidence. In year 8 I just stopped speaking. As I got older I’d avoid situations where I had to speak, I had panic attacks.” Ironically both JP and Kevin chose to study drama at Hugh Baird College. Surely not the best choice for someone with a stutter? “I’d be so far into the mind set of the character I wouldn’t stutter. But it began affecting my studies - I knew I had to get help,” says JP.
When he was referred to Sefton speech and language therapy service Kev went along too. But JP knew he had to do it for himself. Therapist Julie Cowen recalls meeting the twins: “JP was shaking, very withdrawn and reluctant to talk. The therapy is centred on what the person wants to achieve, so it’s important to set goals. JP wanted to stop relying on his brother and be able to manage studying and social situations. He wanted to not have a stutter but I reassured him no-one’s fluent all the time. We worked on breathing techniques to reduce anxiety and changing negative thoughts. I’m so proud of him, he worked hard and it’s paid off.” The twins have just graduated in musical theatre. JP is embarking on a Masters degree at Edge Hill University to follow his love of creating theatre. I’ll always have a stutter,” he says, “but now I see it as just a part of me.”
As I got older I’d avoid situations where I had to speak, I had panic attacks.
John Paul (left) and Kevin with speech and language therapist Julie Cowen.
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I FELT OUT OF MY DEPTH AT UNIVERSITY Fresher’s can be one of the best experiences of a new student’s life. It’s promoted as a time to party, get to know new people. If you’ve moved away, it means a new home, a different way of living. But it can also be an anxious time.
T
hird year student Charlotte writes for MC magazine about her fresher experience, and why she urges people to talk to someone if they need support. “I’d moved from Stockport to study at Liverpool University. I think people underestimate how overwhelming it can be to leave home for the first time. The reality didn’t really sink in until my mum and dad left and I sat surrounded by my belongings in a room that was completely unfamiliar. Despite feeling constantly nervous I threw myself into everything, going out with my new flatmates, joining societies. But I felt out of my depth. I couldn’t go a single day
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without getting upset and questioning whether I was capable of doing my degree. I ran up a £180 phone bill in the first few weeks from calling my mum.
I couldn’t go a day without getting upset. It wasn’t until the day I broke up for Christmas that I decided to get help. I spoke to a university counsellor about how anxious I’d been feeling. The session wasn’t long, but being able to talk to someone who wasn’t family (they probably missed me as much as I missed them), really put things into perspective.
Despite the constant debates I’d had with myself about staying or leaving my course I decided to go back for the new semester. I honestly believe that if I hadn’t spoken to someone that day about how I was feeling, I wouldn’t have returned to university and made the amazing friends that I now have. I’d advise anyone to do the same.” • Talk Liverpool provides face to face, telephone or online support to students or anyone registered with a Liverpool GP. Sessions for students run at Liverpool University, John Moores University and Hope University campuses.
STUDENT LIFE PROBLEMS HOMESICKNESS It’s not just you. Around 40 per cent of new students feel homesick during welcome week. Many worry that everyone else is settling better than them - some stay in their rooms because they find the crowds too overbearing.
EXAMS Exams are always stressful, because you are under pressure to do well. Some students cope more easily than others, but if you are having difficulty coping get advice and support.
COURSE CONCERNS You may lose confidence in your ability, and this might cause a crisis of doubt about whether you are on the right course of study.
MONEY AND HOUSING CONCERNS You suddenly have more responsibility than before for your own finances and accommodation.
SETTLING IN TIPS • Leave your door open while you’re unpacking in your room, or hang a friendly sign from it • Keep a stash of biscuits or teabags for group situations - you’ll instantly be loved! • Don’t be afraid to introduce yourself randomly to somebody you’re standing in line with or sat next to
Having trouble settling in? Talk to us Talk Liverpool is a free NHS talking therapy service for people registered with a Liverpool GP.
• Exchange numbers with people on your course and agree to go to lectures together this sets you up for academic as well as social success! • Listen to music to fill the silence • Wear comfy, familiar clothes • Do something familiar – read a favourite book or watch an old TV series
For more information call: 0151 228 2300 or go online at: talkliverpool.nhs.uk
• Make a drink in your favourite mug Find more tips at studentminds.org.uk National Union of Students also offers support at nus.org.uk
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IN CONVERSATION WITH...
MATT ASHTON DIRECTOR OF PUBLIC HEALTH SEFTON AND KNOWSLEY
A high visibility jacket hangs behind Matt Ashton’s desk. On the back emblazoned in reflective lettering ‘Director of Public Health’. It’s for ‘emergencies’ he tells us, thankfully he doesn’t wear it often. But there’s only one of that jacket …and its owner is in charge of keeping more than 420,000 people across Knowsley and Sefton healthy and happy – isn’t he? 16
We’re only on this planet once... we shouldn’t have a rubbish time.
Crosby beach
“
I may co-ordinate how we stay healthy and happy, but I do it with, for and through everyone else.” How does he see that happening? “There’s a saying ‘it takes a village to look after a village’. We can provide the services and activities, but public health is about us all looking out for our neighbours and our own communities – and expecting them to look after us.” We meet Matt in his office on the top floor of an office block in the middle of Huyton. The views are lovely, he can see across the city. But he knows that down on the ground leading a healthy life can be an uphill struggle. “People in Knowsley and Sefton have got healthier, which is great, but so has the rest of the country. It’s challenging, some people need more help than others. But we’re only on this planet once, we shouldn’t have a rubbish time, let’s all try to make it as nice as we can for ourselves and people around us.”
Southport town centre
If you can do it for a month you’ve cracked it. That’s public health in action. He’s careful not to come across as blasé. “There’s no doubt that where we live, the lives we lead, our education, our job – it all affects our health. It can be a massive challenge but we can’t escape the fact that that feeling well, eating well, being out and about – makes you happier and more likely to fulfil your potential. Who wants to live longer but in pain and unable to manage during what should be the golden years?“ While people must make their own choices, his job is to help them make the connections between lifestyle and wellbeing, and give them the means to make a choice by getting messages and services that can help out there. For Matt personally, after work he likes to catch up with the family, go for a run, or have food and a drink with his wife and their friends.
Kirkby town centre
“I’m no different to anyone else. I know what’s best; I just don’t always want to do it. But neither do I want a life where I’m struggling to enjoy my life because I haven’t looked after myself. A friend of mine was complaining about having to start taking tablets for high blood pressure, whereas quitting smoking and having a couple of nice walks a week would probably do the trick.“ But in the end isn’t it up to the person? “Of course, it’s not a dictatorship. But people talk negatively about the nanny state. Is the idea of a nanny state really such a bad thing? After all, nanny was the person who in days gone by cared for you. We have to look after people, particularly in our communities, and through primary care while they are still well, so fewer people end up having to go into hospital.” It may be visionary says Matt, but in reality it’s every person taking a small step, doing one thing like cutting down on what they eat or drink, or smoke – getting a balance, and helping others to do the same. “If you can do it for a month you’ve cracked it. That’s public health in action…“
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Only young women get eating disorders. Right? Wrong. It’s thought that one in every four people in the UK with an eating disorder is a man. That’s roughly 400,000 men a year. Yet only one in 12 seek help.
MEN GET
EATING DISOR I
t’s changing though. Men receiving outpatient treatment in England have grown twice as fast as women in the last three years. But research and dedicated information to help men understand is still scant.* Body dissatisfaction, anxiety about appearance, excessive body checking and negative physical-self evaluation occur in both men and women, and are risk factors for developing an eating disorder. **
Men are beginning to speak out. BBC Wales sports journalist Steve James recently revealed his struggle with anorexia, while international rugby referee Nigel Owens revealed he suffers from bulimia. Mr Owens told Panorama’s Week In Week Out programme: “It’s a very secretive illness and men in particular find it very difficult to talk about it”.
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*
BBC Breakfast investigation 2016. **(Feldman & Meyer, 2007).
IT’S NOT A ‘FEMALE PROBLEM’ You can’t blame them; there’s a dearth of gender-appropriate information and resources for men. Liam Jones, psychological therapist with the eating disorders service at Mersey Care, says men need more information to stop them feeling like they have a female problem. “Men might think only women get eating disorders. The idea of them having a problem typically seen in women may mean that they are reluctant to acknowledge their difficulties, which may prevent them seeking help. It affects everyone and we need men to know that.” A range of factors can come together to make someone vulnerable. They may restrict their food and be low weight; or restrict their food but then eat a large
amount in a short time then find this distressing. Some people use food to help them feel better then they may gain weight. In both sexes, the issue is how the person relates to food and themselves; there is often an emphasis on their weight and the shape of their body. Trainee clinical psychologist Adam Welsh: “Both men and women feel societal pressures to look desirable. When they compare themselves to the ‘perfect’ images they see in the media both sexes can be left feeling as though they don’t measure up. Liverpool and Sefton eating disorder service offers psychological support for a range of disorders and weight management and surgery. CONTINUED ON P20
ORDERS TOO The advent of the metrosexual male, personified by David Beckham has made men much more body conscious.
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EATING DISORDERS
Trainee psychologist Adam Welsh (left) and therapist Liam Jones support men and women with eating disorder.
It’s a very secretive illness and men in particular find it very difficult to talk about it.
WHAT SETS IT APART? Liam explains: “Our approach is to avoid making the person’s experience overly clinical. Rather than solely focussing on weight as the primary criteria for entry to the service, the emphasis is on understanding their difficulties. We listen to their personal story, and through therapeutic process help them make sense of their experiences while finding a way to move forward with their lives. The eating disorder is one facet of who they are but it does not define them. To assume that it does misses the person entirely.” Liam is the only male therapist. Do men prefer to speak to another man? “We give them the choice and some do; but most are happy to see any therapist. We all adhere to the same client focused approach and adapt as people’s needs change.”
WE WANT MEN TO REALISE THEY’RE NOT ALONE The latest addition to the suite of therapies, compassion focussed therapy; described as ‘physiotherapy for the brain’, teaches the capacity for self soothing. Liam: “The distress of being shamefully alone is horrendous. It becomes all encompassing and has such a profound effect. I hope we’re helping to shape future perspectives so that men realise they’re not alone.”
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WHAT TO LOOK OUT FOR • Men of any age can develop an eating disorder but they are most likely to begin between 14 and 25 • Some personality types, including obsessive compulsive personalities, are much more susceptible to developing eating disorders • Eating disorders can be a coping mechanism, or an expression of, underlying emotional stress • Men who were overweight and/or teased about their size are often more at risk of developing an eating disorder. Bullying seems to be a common experience for adults as well as children
• Sufferers may participate in sports that demand a particular body build (thin or big). Runners or jockeys are at a higher risk of developing anorexia and bulimia, while footballers or weightlifters will focus on getting bigger. Wrestlers who try to shed pounds quickly before a bout so they can compete in a lower weight category seem to be at special risk. Body builders are at risk if they deplete body fat and fluid reserves to achieve high definition • A sufferer may have a job or profession that demands a certain look. Male models, actors, and entertainers seem to be at higher risk than the general population.
WHERE TO GET HELP Men Get Eating Disorders Too. A charity whose website is specific to men, with peer support and online chat sessions. The site also offers support and training for professionals. mengetedstoo.co.uk
NHS Choices: nhs.uk Beat: b-eat.co.uk
Welsh rugby union referee Nigel Owens has been battling bulimia since he was 18. He has recently revealed on television’s Panorama programme he made himself sick as recently as England’s two-week tour of Argentina last summer.
EATING DISORDERS
His battle began when he was trying to come to terms with his sexuality."My belly was hanging over the front of my trousers. There was no way these guys were going to fancy me looking like that, so I started making myself sick" he told television’s Panorama programme. “It takes you over and you feel there is nothing you can do. I would urge anyone suffering to do something - seek professional advice, tell people about it. Don’t hide it, don’t lie about it, that’s a great first step.”
It takes you over and you feel there is nothing you can do.
REAL LIFE STORY
I KEEP
EATING EVEN IF MY
BODY’S IN PAIN Tony Brown knows about pain – he has undergone three lots of surgery for a broken foot and is only just beginning to walk again nine months later. But at 55 the pain of binge eating through depression has taken far more of a toll on his mind and body.
A
s a younger man he hovered around 14 stones. But binge eating and inactivity from his injury have seen Tony’s weight reach 26 stones. The father of two didn’t want to be photographed for this feature - the body he has now isn’t him, he explains. He can’t bear to look in a mirror and hates going out in case he catches a glimpse of himself in a shop window.
COMFORT Yet the binge eating that threatens his mind and body provides a perverse comfort when he’s at his lowest. “I’m ashamed to say I keep on eating even if my body’s in pain. I know all the rules, calorific content, eat less, exercise more… but when things are bad food can be the only thing that makes me feel normal again.”
Two suicide attempts have left him drained. “I had a family, a good income, holidays, but when you fall into that ‘black hole’ the pain is worse than any physical pain I’ve ever known. You think everyone will be better off without you.”
CONTROL Referral to the eating disorder service has seen Tony undergo therapy that he feels is giving him back some control and motivation. “The therapy is targeting the depression. I’m not cured but I’m more in control of my eating patterns. “It’s good having someone to talk to. It’s hard to discuss it with family and friends. With a physical problem people can see signs so they rally. But the stigma of mental health means that even when you’re at your most vulnerable and desperately need someone you trust to confide in you still hide the signs. It grieves me that stigma still exists. As compassionate human beings, we should be kicking it into touch, seeing mental health differently.”
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STAY WELL FEEL GREAT
I NEEDED TO
LAUGH AGAIN
There’s an old proverb: ‘What soap is to the body, laughter is to the soul.’ We visited a course that has helped people laugh again.
M
ari has just finished a Clowning Around course at Life Rooms Walton. I’ve suffered anxiety and stress off and on through my life; now I’m piecing myself together again. The clowning course is like a release; you can just act silly.” She gives us a song on her daughter’s old harmonica. Before we know it we’re clapping, stomping and grinning, proving the point that laughing really does make you feel better.
Fellow participant George agrees.”You lose your voice when you become ill. I’m actually shy, but I thought ‘I’m going to get the chance to laugh’ - I needed to laugh again. The course was like a bit of sunshine that carries on for the rest of the day. I even cycled home in my red nose, everyone was laughing at me – including myself! “Since I’ve done this and other courses I’ve started a job that’s demanding and further from home, but instead of hiding away I get involved.” Tutor Hanna says clowning gives people permission to let themselves go. “Putting on a red nose is like having a mask – it’s not you anymore. We draw on personal experiences to create a persona, use the characters to develop a simple plot and perform it at the end of the course. We hardly stopped laughing!”
Comedy courses run at Life Rooms. Go to liferooms.org or call 0151 478 6556.
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The course was like a bit of sunshine that carries on for the rest of the day.
STAY WELL FEEL GREAT WARMING AUTUMN RECIPE
SUPPERTIME Brian Johnson is lead for Sefton’s dietetic team, helping families in Sefton cook simple nutritious meals on a budget. I play guitar in a 17 piece big band and cooking this dish is an ideal supper before a gig, on a Saturday night. It’s quick and easy to prepare, is high in nutritional value – you get one of your five a day and plenty of fibre from the vegetables. And it’s full of flavour. ” WHAT YOU NEED
WHAT TO DO
For the meatballs: 500g (1lb 4oz) pork mince 1 egg, beaten 2 tbsp grated parmesan cheese 1 clove of garlic, crushed 1 tsp dried oregano 2 tbsp breadcrumbs Pinch of black pepper 300g pasta
• Place all meatball ingredients in a large bowl, mix well and shape into small balls
For the sauce: 1 onion, chopped 2 cloves garlic, crushed 1 tsp dried oregano 1 tsp low fat spread 1 tbsp oil 700g jar tomato passata • Serves four • Preparation time: 20 minutes • Cooking time: 30 minutes
• For the sauce blend chopped onions, oregano and garlic together • Heat the oil in a pan, add the blended mixture (not the meatballs yet) and cook for three minutes. Add the passata and cook for a further five minutes. Finally add the meatballs and cook all together for 15-20 minutes until the meatballs are cooked through • While they are cooking boil enough pasta for four people (follow instructions on the packet) and serve the meatballs on the pasta.
Enjoy!
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Netball’s more than just a game, it’s friendship, mutual support and getting out there and enjoying life.
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STAY WELL FEEL GREAT
GET YOUR BIB Going back to Netball
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etball was the love of Natalie Brown’s life. The 29 year old mum of two (pictured below back left) has happy memories of travelling country wide with her school and local team. Now her youngest child is in nursery she’s gone back to the game she loves. “It was a big part of my life. As a kid I loved putting on the kit. I remember the buzz of getting on the coach to go to tournaments. When you get older you lose that sense of enjoyment - life gets in the way. You can get a bit secluded when you have kids; your social life goes to pot! Being with people who you know are like you takes you right back!”
ON
England Netball Development Officer Louise Moss (back below right) from England Netball runs sessions across Merseyside. “There are so many women out there who loved netball and really miss the feeling it gave them. We start gently so they can pick up on the basics, including passing, footwork and shooting. It’s an easy pace and we finish with a friendly game. You don’t need special kit, just comfortable clothes. If you haven’t played before we’ll help you get started.” Feel the pace is too fast? Try walking netball – still netball but at a walking pace. Louise: “Walking netball really is something you can do regardless of age or fitness – I support a netball group in Widnes who are all over 70!”
Mindy Johnson (below centre) runs community sessions through Ambition Sefton drug and alcohol support service. A keen player herself she knows how invigorating playing can be. “It’s more than just a game, it’s friendship, mutual support and getting out there and enjoying life.”
You don’t need special kit, just comfortable clothes.
It’s thought the game’s history dates back to 1892 when people regarded it as the trendy new sport for women – today more than one million people play netball each week.
Walking netball really is something you can do regardless of age or fitness – I support a group whose members are all over 70!
England netball: englandnetball.co.uk Ambition Sefton netball programme runs at Netherton Park Neighbourhood Centre, Chester Avenue Netherton L30 1QW: To find out more call Mindy Johnson on 0151 944 5334.
Netball Development Officer Louise Moss
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STAY WELL FEEL GREAT
Upcycle: reuse
(discarded objects or material) in such a way as to create a product of higher quality or value than the original.
DON’T RECYCLE
UPCYCLE B efore you put that old table or chair into the tip think about upcycling it. You’ll not only save the planet, it can make you feel better. Technical instructors Tracy Charnock and Christine Talbot lead courses to help men living in a high secure mental health hospital.
Using your hands to create something is very therapeutic.
Upcycling not only can save the planet but can make you feel better.
“Everyone has tips – someone suggested using an elastic band around the paint tin to get rid of excess paint. One patient has a sister who is interested in upcycling, it’s driven him on to finish his piece and given them something in common.”
Furniture is sourced from Emmaus, a charity that supports people to work their way out of homelessness, providing meaningful work as well as a stable home for as long as someone needs it. Tracy says this is an important aspect of the programme. “Sourcing our pieces from a charity that resonates with the men makes it all the more fulfilling. They can support others and make donated items into something to be proud of.” If you have a piece you’d like to donate, contact Christine on 0151 473 4346.
“We wanted to help the men gain skills that will help them when they leave to either furnish a home or gain work in painting or upholstery. Using your hands to create something is very therapeutic; there’s a real sense of achievement when you take a battered old 1940s chair that is wonderfully detailed and you paint and upholster it so it looks beautiful, yet keeping and enhancing the features that you don’t get with modern furniture”says Christine. An old cabinet has become a sought after piece of furniture.
Tracy Charnock and Christine Talbot with some of the pieces that have been transformed.
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I JUST KNEW
I WAS SAD
Personality Disorder affects one in 20 of us. Yet it’s a much misunderstood condition. We talk to experts about what it is, and why they’ve launched a dedicated therapy service on Merseyside. 27
TAMMY’S
STORY “I’d never heard of personality disorder, I just knew I was sad. It started after I had the second of my three children and suffered post natal depression. I became overly possessive. I’d hit out at anyone who challenged my way of thinking.
Tammy
I have the same life issues but I deal with them in a different way. The term personality disorder is sometimes used disparagingly, yet few of us really understand what it is, or what it’s like to live with. Events in our lives can shape the very fabric of our personality.
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ersey Care psychotherapist Richard Curtis explains:
We each cope differently with emotional experiences and relationships, but someone with personality disorder will often struggle with how they think about themselves and others. It’s not an uncommon condition – if we all went before a psychiatrist one in 20 of us would be diagnosed with a personality disorder of some sort.
WHY DOES IT HAPPEN? “Trauma is often the root cause. Difficulties in childhood often have an impact on someone’s personal development and how they relate to others. They blame themselves, it can be crippling. “There are different types of disorder and the difficulties are as unique as
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we are. One person may have mood swings, while someone else will be mistrustful or easily feel abandoned or rejected. Most people tell us they feel very alone and not understood.
COPING SKILLS COME UNDER PRESSURE “It’s at times of stress and strain, when our coping skills come under pressure, that emotions can be overwhelming and relationships suffer. For some people the only way to manage this is through self-destructive behaviour such as alcohol or drug abuse or self harm, or through unhealthy relationships. “It can sometimes be lifelong, but don’t despair. Things won’t change overnight, but research shows that nine out of 10 people who undergo treatment are well 10 years later.”
I
think the need to protect the people I loved comes from an irrational fear of being abandoned. When I was nine my beloved nan died; it affected me really badly. It grew into an obsession with keeping my kids safe. Even when they were old enough I wouldn’t let them go to parties. If they didn’t reply to texts I’d threaten to go and find them. Although I had counselling the fear of losing people took a hold. I developed a fear of contamination. I had panic attacks and had to have hand gel with me constantly. It was ruining my life.
I CRIED EVERY NIGHT Before getting help I cried every night. After spending so long not knowing what was wrong it was relief to get a diagnosis. I was offered a place on the psychotherapy service’s Rotunda group programme. It isn’t easy, they have strict rules, I sometimes felt uncomfortable, but hearing other people’s views on your situation makes you feel better, you become more mindful. You think ‘did I really see things like that’? It’s been almost three years and I’m now in the transition group for people who have been through the programme; I also volunteer for the service. I have all the same life issues but I deal with them in a different way. I’ve married Leanne my partner of 14 years; she’s stuck with me through everything. And I have a granddaughter who I love to bits. I went to a wedding with my mum recently and she told me how proud she was. It was good to hear. It’s hard to think back without getting tearful, but I understand now it’s part of my life. You have to put in to get out - I just didn’t know that.”
UNDER
ONE ROOF The psychotherapy service at community and mental health trust Mersey Care runs one of the few dedicated specialised services for people diagnosed with a personality disorder.
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ith a main hub in Waterloo - just a mile from the sea and home to Anthony Gormley’s Iron Men - and two satellite clinics in Liverpool, the personality disorder hub has the full range of tailored services under one roof – clinical lead Dr Simon Graham says the Trust has responded to a growing body of evidence that this sort of approach is needed. “Even within mental health services personality disorder is often poorly served. Conventional psychiatric care doesn’t always work. All the evidence points to avoiding the need for visits to A&E or inpatients stays in acute hospitals in favour of specialised care. We’re empowering people to be in control, supported by professionals and their peers. Being located in one place allows us to develop our expertise and create therapeutic communities.” An expansion of the service will see a specialist team of nurses offering intensive support to 40 people with the
most complex needs and training other mental health professionals; The hub is set to open till 10pm each night and at weekends. Crisis support will be available and the long term plan is to have inpatient care on site for people who need it. As a transition from therapy and in preparation for discharge service users can join a transition group that meets monthly for two years and offers less intensive support. People registered with the service who are in crisis can telephone or visit the hub; the long term plan is to have an inpatient crisis service. Simon is proud of the breadth and depth of the programmes which offer up to three years of therapy. “Service users are actively involved in running group sessions; they take responsibility for themselves and each other, challenging one another to try to break with old destructive patterns and cope with difficulties in new ways.” For more information go to: merseycare.nhs.uk
We’re empowering people to be in control supported by professionals and peers.
Dr Simon Graham.
WHAT TO LOOK OUT FOR • A person has difficulty relating to others and usually shows patterns of behaviour most people would regard as odd and eccentric. Others may describe them as living in a fantasy world of their own • Someone struggles to regulate their feelings and often swings between positive and negative views of others. This can lead to patterns of behaviour others describe as dramatic, unpredictable and disturbing • They struggle with persistent and overwhelming feelings of fear and anxiety, appear painfully shy, socially inhibited and extremely sensitive to rejection. The person may want to be close to others, but lack confidence to form a close relationship. If you or someone you know would like help or advice contact your GP.
FIND OUT MORE NHS Choices – nhs.uk MIND – mind.org.uk Rethink – rethink.org
Psychotherapist Richard Curtis. Source: nhs choices
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WE’RE WORKING ON IT Work is a huge part of our lives. What if you don’t work? Can’t get work or had to give up? Where do you go for help that doesn’t just focus on getting you back to work quickly without addressing the real issues?
S
Sometimes it’s about going back to the start. Social Worker Clare Rotheram leads Liverpool’s Life Rooms Pathways Advisor team, a unique service that identifies the support people need – then stay at their side while they find it. At the beginning that may be a million miles away from simply going back to work or finding a job.
PEOPLE ASK ‘WHAT DO YOU DO?’ “In our society work is seen as part of your identity – the first thing we ask when we meet people is ‘what do you do?’ Not having that can have a significant impact on wellbeing.”
IT’S HARD TO SAY YOU’RE NOT COPING Speaking to a Pathways Advisor may be the first time someone has spoken out. “The idea of saying ‘I’m not coping’ is often too big to contemplate, so people put on a brave face while inside they’re distressed. It’s a recipe for a crisis,” says Clare. Not having work or losing your job can exacerbate poor mental health. A Royal College of Psychology report on work and mental health says people unemployed for more than 12 weeks are between four and ten times more likely to suffer from depression and anxiety. Work is all too often the root of the problem. The RCP says workplaces can contribute to or exacerbate mental ill health.
Clare:“If your workload is increasing and you don’t feel supported or listened to it doesn’t make you a less resilient person, but it can change your perception of your personal value, you can start to fear becoming unemployable. Not being able to function in work can lead to little slips, without support, the situation can become more formalised in spite of your trying to keep it to yourself. The situation is compounded till it all becomes too big to navigate on your own.”
HOW DOES PATHWAYS HELP? “Our ethos is that people are people regardless of their situation. We’re not a clinical service but our advisors have compassion and understanding. They’ll ask about your goals and help you find ways to reach them in your time in your way. “It may be that you have anxiety and managing that is your first goal rather than getting straight back to work or finding a job. It could be getting housing or money advice; enrolling on a course run by our recovery college, or advice on volunteering.
WE’LL BE THERE WITH YOU. “We also refer to partners who specialise in the type of help you may need, but we know that going from one place to another for help can be a step too far when you’re unwell, so we bring the experts to our building and we’ll offer to go with you to your appointment. It’s just that extra bit of support to give you confidence.
Clare Rotheram leads the Pathways Programme at Life Rooms.
“Giving people strength when they feel vulnerable is often all they need. To know there’s somewhere they can go to. In reality they’re doing it, we just listen, understand and offer help.”
We listen, understand and offer help.
GET IN TOUCH You can make an appointment to see a Pathways Advisor by calling the Life Rooms Walton on 0151 478 6556 or Southport 01704 383 198. Alternatively, just drop-in to Life Rooms on Evered Avenue or Scarisbrick Avenue Southport and an advisor will make time to see you as soon as possible. Email: Pathways.advisor@merseycare.nhs.uk
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I FINISHED MY SHIFT AND DIDN’T GO BACK TO WORK After 32 years working in the cold storage industry Alan is used to handling pressure. Then one day it got too much…
“
Work was changing, new regimes brought more pressure and less compassion. After all that time you’d think I’d be ok but I was getting emotional for no reason, you feel inside like you’re falling apart. I got antidepressants from my GP but they were a low dose; I’m a big fella, they worked for a while, but then one day it just happened…I cracked, I let out almost a primal scream in front of my boss. I finished my shift and didn’t go back.” Almost a year later Alan’s back at work on a phased return. He’s not sure how his future will pan out but what happened in between has changed his views on life, work and mental health forever.
“I was going to Clock View Hospital to have my tablets reviewed but that week I ended up in A&E, I’d hit rock bottom. I wanted to kill myself; it was an escape clause.
I knew I had to help myself, but it’s difficult to make decisions when it feels like there’s a washing machine going round in your head. It drains you of energy, then your sleep pattern goes and you hit a brick wall. On a visit to his GP Alan picked up a Mersey Care Recovery College prospectus. And signed up for the Journeys through Film course. “I didn’t know what to expect, but I enjoyed it. I went along to more courses, I felt relaxed, I started to get my confidence back – the peer support workers running the courses understand. They’ve been there.” But work was looming in the background. “I knew I had to tackle it I just didn’t know how. I was invited onto the Pathways programme and met Claire Scott my
I was getting emotional for no reason, you feel inside like you’re falling apart. advisor. She’s helped me work out what I want. They’ve asked Remploy to liaise with my employer to make sure I have what I need to stay well. “I owe a lot of my recovery to the Life Rooms. They really can help you climb out of the hole and up the ladder. Medication has a place but this should be the first place GPs send people to. “I’m not sure what the future holds for me, but I’m sure I want to help other people know that with the right help you can get better.”
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We need to give children the skills to overcome a crisis.
INTRODUCING...
THE VOICE OF THE CHILD 32
When a family is affected by a mental health or substance misuse issue, who listens to the child? We talk to the nurse who supports families to get better together.
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hantelle Carey is an experienced paediatric nurse and Mersey Care’s Named Nurse for Safeguarding Children. “Difficult times happen to us all, but sometimes the voice of the child gets lost. We need to support children and families to build resilience and have the skills to overcome a crisis together.” Chantelle shares a case of a mum who was receiving care from one of Mersey Care’s community mental health teams. “It emerged that her son’s behaviour was contributing to the problem. He was involved in crime, when she tried to talk to him he would become aggressive and she became anxious – it was clear they both needed help.” A family support worker was allocated to work with the family. Mersey Care’s Early Intervention Team supported the son to manage his aggression and involved him in support groups and activities to help divert him away from crime.
“It doesn’t matter if we’re involved with the parent first, or the child – we always ‘Think Family’; how can we help the whole family? By getting involved early and listening to their lived experience we can offer support.”
IT’S EVERYONE’S BUSINESS Chantelle works closely with children’s agencies, including health and social care partners, sharing information about the child and family to give those helping them a better picture. “People worry that telling someone will lead to the child being taken away, but speaking up helps us identify what sort of support is needed “We never think of someone as a bad parent, we focus on the strengths of the family while identifying what they need early on to stop the situation escalating and becoming a crisis.
It doesn’t matter if we’re involved with the parent first, or the child – we always think how we can help the whole family.
“We all have a duty to be the voice of the child – safeguarding really is everyone’s business.”
If you see something you’re not happy about act and act now! See something untoward? Think it’s unacceptable? Don’t turn a blind eye. Don’t keep it to yourself. Act. And act now. If you think a child is at risk of harm or abuse call your children’s social care service: Liverpool: 0151 233 3700 Sefton: 03451400845 Knowsley: 0151 443 2600 Wirral: 0151 606 2008
Safeguarding is everybody’s business merseycare.nhs.uk/contact-us/see-think-act 33
A DAY IN THE LIFE...
JACQUI HART AND LAURA CHAFFER
SUPPORT WORKERS ALBERT WARD, BROADOAK ADULT MENTAL HEALTH INPATIENT UNIT
listening and supporting is so rewarding - I know I’m in the right job.
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JACQUI: Today we said goodbye to a man who arrived a few weeks ago with no possessions and very scared. I’ve spent time finding out what he needed and reassuring him. He looked like a different person when he left. Another patient was unsettled and wanted to read to calm down but he had no glasses, so I found him some. It’s the little things. Our ward is for men who need to come into hospital because their mental health has deteriorated. We joke about the lengths I go to trying to create a lovely welcoming feel for new patients – I put two fresh towels folded like a hotel room with shower gel on top! I’m new and still learning but listening and supporting is so rewarding I know I’m in the right job.
LAURA: I had a breakthrough today. A patient I’ve been supporting wouldn’t speak to anyone. I’ve been sitting with him and chatting; today I asked how old he was - he just said ‘forever 21’. Now he’s talking to his doctors, it’s made me smile all day. People ask me why I’ve chosen to work here. I love the hospital environment. It’s challenging but building up a rapport with patients means you can pick up on how someone is feeling and pass it on so they get the help they need. The support from colleagues is incredible, the team will always make time to listen to you and hear how you feel. I’ve never worked anywhere else where that’s happened.
COUNCIL OF GOVENORS
DOING IT FOR
MY MUM
Media Company Managing Director Jayne Moore is a public governor for Mersey Care. Her inspiration for her involvement is her mum, Sally, who for the past nine years has been living with vascular dementia. It is Jayne’s experience on this journey that shapes her thinking when standing as a governor.
Jayne Moore manages publicity for the ADHD Foundation Umbrella project.
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While my mum is now very settled in a full time nursing home, there was a time just after my daughter Georgia was born, that mum’s condition escalated and we had no idea what to do. We did what all good families do, we moved mum in to live with us.
Jayne is also a trustee of St George’s Hall and MD of successful communications agency Jayne Moore Media, operating in Liverpool city centre and her work for clients across a number of sectors brings learning to her role with Mersey Care.
The effects on my young family meant that rather than enjoying the first years of being parents, we were caring for my mum who had complex needs and it was probably the most challenging few years of my life.
Over the years, I have worked on the suicide reduction strategy for CALM or raising awareness of child and adolescent mental health, through the work done for the ADHD Foundation, addressing stigma and media reporting on challenging topics is at the heart of my job.
The intervention of other family members and care from Mossley Hill hospital’s Acorn Unit was transformative for my mum. I now understand that what is best for mum is consistent care and she has that now.”
It’s vital we support carers. Being a carer for someone full time can create mental health issues, it is vital that we support carers in the same way that we support patients, which is why projects like the
Life Rooms is so incredible. My governor training visits were enlightening, the thread that runs through Mersey Care is the passion of its people, I find that so inspiring. When people hear I am in PR they think it’s all parties and prosecco, and yes that is a small part of the job. The bit that I am most rewarded by is when you see the MAN DOWN campaign or ADHD’s Umbrella Project take off and go viral, raising awareness for difficult issues like mental health. Don’t get me wrong we have a healthy balance, one day it’s the fun of Albert Dock’s Pirate Festival and the next the ADHD Foundation’s 10th Anniversary Conference is our priority, so it is never dull in my office!”
Meet our new Governors at merseycare.nhs.uk
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BREATHE EASY WE’RE SMOKE FREE
All our sites are smoke free. To create a healthier environment for everyone, smoking including e-cigarettes is not allowed anywhere on any site. This includes all wards, grounds and vehicles. You can find out more at merseycare.nhs.uk or by speaking to your consultant, care coordinator or named nurse. If you would like any help to stop smoking visit: nhs.uk/smokefree or phone 0300 123 1044 (free). Staff can speak to occupational health on 0151 471 2451.
Thank you for not smoking
Contact Details
MerseyCareNHSFoundationTrust
Got some news you’d like to share?
Mersey Care NHS Foundation Trust, V7 Building, Kings Business Park, Prescot, Merseyside L34 1PJ
Contact us at the following address.
Telephone: 0151 473 0303 Email: communications@merseycare.nhs.uk
MC MAGAZINE is published by Mersey Care NHS Foundation Trust and produced by the communications team, Mersey Care NHS Foundation Trust, V7 Building, Kings Business Park, Prescot, Merseyside L34 1PJ T: 0151 473 0303 E: communications@merseycare.nhs.uk W: merseycare.nhs.uk. MC MAGAZINE is available in other formats on request. Please pass on for others to read and recycle.