On The Level: June-July 2024

LEVEL Scotland’s magazine for people living with Bipolar Spring 2024

BIG Mood We asked Bipolar Scotland members to review the hit Channel 4 show.

NEW LOOK ISSUE!

bipolarscotland.org.uk

ON THE

Foreword / Spring 2024 Image: Vecteezy.com

Welcome to our exciting new-look On The Level!

In this issue, we’re taking a look at bipolar representation in the arts and media, with a special feature by Gillian Sheriff-Collins focusing on the connections between bipolar and creativity, and Bipolar Scotland members reviewing Channel 4’s new comedy-drama series Big Mood, starring Nicola Coughlan as a woman living with bipolar.

We’re also interested in how you feel about the world of work: as our development team begins putting together a toolkit which we hope will help employers support members of their workforce living with bipolar, we’d love to hear from you - see our Is It Working For You feature on page 20.

We turn the spotlight on volunteering this issue: meet our new Volunteer Development Officer Tom Robertson and hear a bit about how much Bipolar Scotland as an organisation depends on our volunteers.

In Research Corner, the University of Edinburgh’s research team investigate how new developments in wearable technology might be able to help people living with bipolar; our regular columnist David Carr, meanwhile, is reflecting on the negative aspects of being public about living with bipolar.

Finally, Victoria Reid looks into recent reports about dwindling numbers of psychiatrists in Scotland and asks what it means for the patients.

So, lots to get your teeth into! As ever, if you’d like to contribute a piece of writing to On The Level, please do get in touch by emailing kirstini@bipolarscotland.org.uk Our next edition will be out on Wednesday 31 July; we need all contributions in by Monday 15th July.

Kirstin Innes Editor

Contents

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David Carr ‘The Keyboard Whisperer’ talks about the perils of disclosure.

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Hear what some of our members have to say about Channel 4’s hit show!

Learn more about machine learning and Artificial Intelligence (AI) in Research Corner.

Edited by: Jamie Stewart and Kirstin Innes Please note that the views and opinions expressed in On the Level are not necessarily those of Bipolar Scotland.

Submissions: If you would like to submit a piece of writing, a photo or an idea to be considered for future issues of On the Level please get in touch with Kirstin Innes:kirstini@bipolarscotland.org.uk

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We would also love your feedback about On the Level, Send us an email or reach out to us on social media. You can find us on Instagram at: @bipolar_scotland and Facebook at /BipolarScotland1 ©Bipolar Scotland 2024 Scottish Charity No. SC021705 Company No. 163305

Image: Vecteezy.com

T: 0141 560 2050 E: info@bipolarscotland.org.uk bipolarscotland.org.uk

Is work working for you?

Maja Mitchell-Grigorjeva investigates...

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Noticeboard Self-Management Training Our latest online Self-Management Training course starts on Tuesday 18 June and there are still some spaces left! We’ve moved the time to an evening slot - the course will now run from 6.30-8.30pm on Tuesdays: 18th and 25th June, 2nd and 9th July.

The course can be done from your own home and are completely free to Bipolar Scotland members.

Working with our friendly, experienced facilitators, you can explore what bipolar means for you, learn new selfmanagement tools and strategies, begin to identify your triggers and learn to feel better able to plan for the future and take back control of your life.

Don’t just take our word for it, though!

Here are some thoughts from recent SMT participants:

Looking for men and shift workers!

The Circadian Mental Health Network and the James Lind Alliance are particularly interested in hearing from men and/ or shift workers who live with bipolar in their short survey about how your body clock impacts your mental health. This short survey will help shape the future direction of their research. You can find the survey at: https://www. circadianmentalhealth.org/ haveyoursay

“I learned a lot about myself on the course and have a couple of things to work on, but it was well overdue and I’m very hopeful that my life will improve as a result.”

“I am very pleased with the selfmanagement course: it has left me feeling like I have the tools to create the kind of life I want. Kerry and Hazel were so lovely as facilitators and were very knowledgeable and understanding…I also think the training has given me a greater awareness of the importance of having plans in place for if I ever do become unwell, so that I have as much control over my life as possible.”

To book a place on the upcoming course please email: training@bipolarscotland.org.uk before 4.30pm on Friday 14th June.

BOSS Study: call for participants Researchers at the University of Glasgow are looking for participants to take part in a study looking at the selfmanagement support needs and care experience of people living with and affected by bipolar. Participants should be over 18 and either have a diagnosis of bipolar or care for someone who does. Participation will involve either a one-on-one interview or a focus group session (participant’s choice), and these can be conducted either online or in person. Participants will receive a gift

Student Placement Lewis Wilson, who studies Access to Health And Social Care at Glasgow Kelvin College, has been working with Bipolar Scotland on a self-arranged placement with us for the past few months. At the end of his placement he wrote this short report on the organisation which we’re delighted to be able to share with you: “I have had the honour of being Bipolar Scotland’s first student placement allocation over the last ten weeks.

Throughout the few months I’ve been here I have had a chance to observe and participate in all of the pivotal work this charity does to support individuals across Scotland living with bipolar.

I now have a deeper understanding of the financial aspect of running a charity and how competitive it can be to attempt to fundraise operations. I now understand the incredible work this charity does with the help of volunteers, providing services like self-management training and peer support.

During my time at Bipolar Scotland, I have learned that the whole charity is like a well-oiled machine: if everyone is functioning then everyone works at their best. I have learned through my observation of multiple support groups just how important the volunteers at

token and all travel will be reimbursed.

This study is the first stage in a larger project to develop self-management resources for people living with or affected by bipolar. It’s a collaboration between the University of Glasgow, Bipolar Scotland and NHS Greater Glasgow and Clyde.

To take part, please contact Dr Jamie Kirk on 0141 451 0885 or Professor Andrew Gumley on 0141 330 4852

Bipolar Scotland are and they’re integral to the survival and the flourishing of the charity.

Because of this enlightening experience that Jayne and her team have provided me with I will always remember Bipolar Scotland as being one of the turning points in my education. Thanks to this process I have never been surer that my calling in life is to help people. I have witnessed the very best of humanity, I have seen tears shed and the unwavering support shown in response, and I have seen the overwhelming sense of joy and community that can be at your disposal. I have been inspired by everyone at Bipolar Scotland’s attitudes, these are the people who have big dreams for the charity, but big dreams I have no doubt they will reach because these are the kind of people who will not stop working tirelessly to provide a safe space for as many people as possible.”

Lewis taking part in Bipolar Scotland’s staff away day in April

Image: Vecteezy.com

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THE KEYBOARD

Whisperer

by David Carr

Whisper it from the rooftops! The perils of disclosure. recently had the thrill of having an article published in The Herald.’

It drew on my lived experience of bipolar disorder and, inevitably, had something of the confessional to it. By putting my name on it, I was coming out to the world. I was comfortable with that.

But then, some words by Darren McGarvey gave me pause: “We decant our traumas into a rowdy and unforgiving public square where, once disclosed, they cannot be un-disclosed.”

I have always chosen to be open about my bipolar disorder. Arguably - too open. I refuse to feel any shame about my illness, and feel almost a duty to destigmatise, to educate.

However - you do have to put your own safety first - and I haven’t always done that.

I was thinking about safe spaces while talking with a young, trans friend who is only now making baby steps to being out with her gender identity. I was greatly affected by her description - ‘It’s like coming home.’ Put like that - wow. But being trans in a sometimes unaccepting world requires careful navigation. There are some people who you can be safe with, and some you can not.

Being out about a trans identity is only a thin analogy for bipolar disorder. They are each their own thing. Bipolar disorder is something most of us would rather do without. It’s something we can choose to hide. We can generally pick and choose

what spaces we feel safe to disclose in.

Do we disclose to friends, colleagues, dates? Each one of these decisions is fraught. But we have a choice.

I sometimes regret my openness. I fear becoming Mr Bipolar, with my label on my forehead, over-sharing my illness with anyone who will listen - or with those who won’t. Even in our brave new world of mental health candour - I have become cautious.

Proclaim it all you will - few will understand what bipolar disorder means.

At best you will be filed away as ‘another person with a mental health condition.’

But you will not advance the cause without further education - and you just might not have the bandwidth to constantly explain yourself.

A harsh lesson that life taught me is that it’s OK to be mentally ill - until you’re actually mentally ill. That is - people who may profess to care about mental illness in the abstract can still be somewhere between clueless and harmful when faced with the reality. This is especially true of bipolar disorder, which doesn’t fall into the ‘feeling a bit blue’ pattern that people are familiar with.

And the problem is writ large in the workplace. Even while employers increasingly profess that they value neurodiversity, there is still a gulf between intentions and reality. Well-intentioned diversity and inclusion policies can bring

about a forced openness. Those with lived experience are often singled out to take on the additional emotional labour of educating their colleagues.

Disclosing can expose your vulnerabilities.

Some people do stigmatise, do judge, do fail to understand. And even if they are doing no active harm,the negativity and lack of empathy can be wearing..

Being open about living with bipolar disorder, as I have done in my Herald article, and to a lesser extent am doing with this column - we’re all friends here can be to define yourself. I never set out to be a mental health writer. I love writing and share my work as widely as I can. I shamelessly crave an audience and ‘the thrill of the by-line.’ But with my writing on bipolar disorder - I increasingly choose to limit my audience.

I don’t want everything I say or do to be seen through the bipolar lens. I assert my right to choose my moment.

Now don’t get me wrong. I do still think that openness is good. My name is attached to my Herald piece, and I am proud of that. I will do my best to explain what living with bipolar disorder means, because I am - largely - in a mental space where I feel I can contribute. To borrow from Malcolm X: ‘If not me then who? If not now, then when?’

However - I can also be fragile and not very good at self care. Disclosure can be a liberating act. But it needs to be at a time and place of our choosing. I now feel cautious about shouting it from the rooftops. I reserve the right to only whisper.

“Disclosing can expose your vulnerabilities. Some people do stigmatise, do judge, do fail to understand.“ Image: Vecteezy.com

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TOUCHED

With Fire Exploring the link between creativity and bipolar

by Gillian Sheriff-Collins

Image: Vecteezy.com

he relationship between bipolar and creativity has a long history, and it is a connection which most people living with bipolar are anecdotally aware of.

Many notable artists, writers, poets, musicians and dancers have detailed their experiences with the creation of their art while living with bipolar. Charles Dickens, Edgar Allen Poe, Beethoven, Ernest Hemingway, Jackson Pollock, Edvard Munch, and Vincent Van Gogh are among the numerous historical figures that are thought to have had bipolar.

Moving to the modern day, artists and creatives such as Stephen Fry, Selena Gomez, Mariah Carey, Catherine Zeta Jones, Demi Levato, Pete Wentz and Carrie Fisher have all openly shared their experiences of living with bipolar.

MARIAH CAREY

The fact that many high-profile celebrities and artists have been so transparent about their diagnosis and treatment in recent years has have played a significant role in moving towards heightening understanding and destigmatising bipolar.

Indeed, the controversial American musician and producer Kanye West has referred to the condition as his ‘superpower’.

However, it is important not to glamourise or romanticise the condition, as is sometimes the case in mainstream media.

Indeed, Van Gogh himself said “If I could have worked without this...disease, what things I might have done”.

WHAT IS THE RESEARCH BEHIND THE LINK? There have been a number of studies

around the potential link between creativity and bipolar over the last 10 years.

One study by the University of Glasgow found that both intelligence and creativity may be linked to bipolar via genetics. The research linked higher childhood IQ to an increased likelihood of experiencing bipolar in later life.

Danny Smith, now Chair of Psychiatry and Head of the Psychiatry Division at Edinburgh University, and Bipolar Scotland’s clinical advisor, said in The Guardian of the University of Glasgow study: “There is something about the genetics underlying the disorder that are advantageous. One possibility is that serious disorders of mood – such as bipolar disorder – are the price that human beings have had to pay for more adaptive traits such as intelligence, creativity and verbal proficiency.”

Another 2018 study has shown that university students who select a degree in the arts have a higher lifetime prevalence of bipolar than those in other disciplines. (MacCabe et al., 2018).

Furthermore, research published in the British Journal of Psychiatry suggested that people with bipolar often appear to have ‘enhanced access to vocabulary, memory and other cognitive resources.’[1] DOES MEDICATION CURTAIL CREATIVITY? One of the concerns among people living with bipolar is the idea of their medication somehow dulling or stunting creative output. While this is a valid consideration, the research points to effective management of symptoms in order to harness creativity while staying well.

Dan Winters, the hugely famous photographer described by National Geographic as ‘the Da Vinci of BIPOLAR SCOTLAND 08

contemporary photography’, has successfully found the balance between medication and creativity, citing his preference for a comprehensive approach to treatment: “… [my] medication regime..is a workable one, and I can still operate at a pretty high level of creativity without being in the danger zone.”[2]

CREATIVITY AS A TOOL FOR SELF MANAGEMENT The concept of ‘art therapy’ is not a new one, but many people benefit by leaning into their creativity as an effective tool in their selfmanagement armoury.

Writing, painting, dancing, making music, sewing, gardening, interior design, mindfulness and all forms of exercise and

movement are deemed positive activities which may help to manage symptoms in tandem with traditional treatments and a tailored medication regime.

One 2020 study showed that mindfulnessbased cognitive therapy had positive outcomes in managing mood and anxiety in those with bipolar disorder. (Mindfulnessbased cognitive therapy for bipolar disorder: A systematic review and metaanalysis, Xuan et al., 2020).

It seems that flexing your creative muscles, alongside being mindful of lifestyle factors such as protecting sleep patterns, and avoiding certain stresses or triggers, really can be useful in managing bipolar symptoms and staying well.

VIVIEN LEIGH Old-school Hollywood bombshell, Vivien Leigh, who is best known for her roles as Scarlett O’Hara in ‘Gone With the Wind” and Blanche DuBois in “A Streetcar Named Desire”, is thought to have had bipolar disorder.

The Oscar winning actress, had an incredibly successful acting career and played alongside greats such as Marlon Brando, Sir Laurence Olivier and Clark Gable.

STEPHEN FRY Generally regarded as a national treasure, Stephen Fry has been prolific in increasing awareness and understanding of the condition. His BBC documentary The Secret Life of the Manic Depressive shines a light on his experience, including his diagnosis at the age of 37.

PETE WENTZ Bassist for the award-winning American rock band Fall Out Boy, Pete Wentz, has spoken openly about his experience with the condition. In a 2015 interview he said of managing his symptoms: “Living with purpose and having a schedule with my family has brought me balance…just being able to talk through things, meditate and exercise has been helpful.”

Further reading: Touched With Fire by Kay Redfield Jamison Strictly Bipolar by Darian Leader 1] New Zeland Herald 2] Psychology Today

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RESEARCH CORNER Early Detection, Early Intervention: Can Wearables and Artificial Intelligence Improve Treatment for Bipolar?

By Dr Filippo Corponi

In this month’s Research Corner, Dr Filippo Corponi, a psychiatrist and PhD student at University of Edinburgh, explores how combining wearable devices and AI for bipolar management is a growing area of interest, and the challenges to this becoming a part of the bipolar treatment pathway.

Wearable devices (‘wearables’), such as smartwatches and fitness trackers, have become increasingly commonplace over the past decade. They come equipped with sensors to capture physiological data including activity levels, sleep patterns, heart rate variability, and sweat response of the wearer. Thanks to their unobtrusive and continuous data collection capabilities, wearables are emerging as powerful tools for monitoring various aspects of health and well-being, and are extending healthcare beyond the doctor’s office. The collection of daily data from wearable devices for this purpose is known as ‘personal sensing’.

Blood glucose management in diabetes and remote monitoring of Parkinson’s disease are the first applications of wearables recommended by the National Institute for Health and Care Excellence (NICE) in the UK. HOW MIGHT WEARABLES IMPROVE BIPOLAR MANAGEMENT AND TREATMENT? Episodes of bipolar feature disturbances in mood, sleep, and energy levels, which are reflected by changes in physiological data.

Wearables may therefore be particularly useful in this condition, complimenting current approaches which rely on intermittent inperson appointments and self-reported symptoms. For a person with bipolar, this could mean detecting early signs of a developing mood episode, such as changes in sleep, heart rate and the amount a person is moving. As patients sometimes may not be aware that an episode is underway, early, objective, detection enables timely access to treatment, thus minimizing disruption to a person’s life and improving outcomes. This new type of monitoring could enhance ordinary clinical observation, especially at a time when the mental health workforce is shrinking in the face of rising demand, in the UK and globally, and access to specialized care has reduced.

WHAT ARE THE TECHNICAL CHALLENGES WITH WEARABLES AND ARTIFICIAL INTELLIGENCE FOR BIPOLAR? One issue with using wearables in healthcare is the fact that processing and analysing large amount of data is very time-consuming and complicated. One solution to this is Artificial Intelligence (AI) - a a set of methods that enable computers to extract patterns and learn from large volumes of data. On the back of recent advances in AI techniques to analyse data from wearables, enthusiasm around healthcare personal sensing has grown. However, researchers have found that training an AI to detect the occurrence of bipolar episodes from physiological data is difficult. Some scepticism therefore crept in: will wearables eventually be counted among the undelivered promises in mental health care, as with psychiatric genomics and neuroimaging? Indeed, in both cases, decades of research have, as of today, failed to deliver any clinical decision-support tools, and wearables are yet to be implemented in the daily psychiatric practice. So what are the main challenges when it comes to combining wearables and AI detection of bipolar episodes?

CHALLENGE 1: HOW TO ‘LABEL’ LARGE AMOUNTS OF WEARABLE DATA Traditionally, AI learns from massive amounts of ‘labelled’ data. Simply put, this means data is presented to the AI with an explanation already attached –this data was collected from someone in a manic episode, but that data was collected from someone in a depressed episode. The AI can then learn what ‘manic episode’ data looks like compared to ‘euthymic’ or ‘depressed episode’ data and identify them in new data.

Attaching labels to data from wearable devices is resource-intensive and requires people with clinical experience such as doctors to do the labelling. This limits the amount of data available to train the AI, and ultimately the accuracy of the predictions that the AI can make.

A newer approach called “self-supervised learning” gets around this. It uses unlabeled data, which means the wearable data doesn’t need to be ‘explained’ before giving it to the AI. Here’s the trick: the AI is given incomplete data (like a missing puzzle piece) and has to guess the missing part. This method could help to solve the issue of limited amount of labelled wearable data from people with bipolar.

CHALLENGE 2: DETECTING PHYSIOLOGICAL CHANGES DUE TO A MOOD EPISODE IS DIFFICULT BETWEEN PEOPLE A second challenge is that our physiological functions are constantly changing dayto-day, and any changes from a bipolar mood episode might be relatively small and hard to detect. This ‘bipolar-related signal’ in wearable data is also very different between people, because bipolar episodes can manifest differently across patients and even within the same patient over time. Developing an AI that reliably detects different bipolar episodes across different people is difficult, and will need to include ‘tunable’ features to personalize the episode detection.

rate data when someone is asleep and moving less. Careful consideration needs to be given as to how to combine the different types of data in the best way to detect bipolar mood episodes.

WHERE DO WE GO FROM HERE? While the use of wearables for enhanced monitoring in bipolar is promising and the argument for it compelling, some technical challenges need to be overcome before this technology is rolled out. Preliminary research shows a good level of acceptability for wearables in people with mental health conditions, but we need more engagement with people with bipolar to make sure wearables are a feasible, and helpful, approach.

A CALL TO ACTION - WHAT DO YOU THINK? As a psychiatrist for the NHS and a PhD student at the University of Edinburgh, I appreciate the potential that personal sensing has to revolutionize how bipolar is managed, but I also identified areas which need further research. I am passionate about making a difference for people living with bipolar, and believe personal sensing is one way to do this.

That is why I am seeking your insights! If you have lived experience with bipolar, I would be grateful to hear your feedback, comments, or questions, about AI, wearables and personal sensing so that your views are reflected in my work. You can contact me via email: filippo.corponi@ed.ac.uk Research Corner is coordinated by researchers from the University of Edinburgh. If there is a topic you would like to find out more about, or if you have suggestions for this section, please get in touch! You can contact Amber Roguski at:amber.roguski@ed.ac.uk

CHALLENGE 3: WE NEED TO FIGURE OUT THE BEST WAY TO COMBINE DIFFERENT TYPES OF WEARABLE DATA Lastly, wearables record multiple types of physiological data, each having its own dynamics. For example, heart rate variability is unreliable when someone is moving around a lot, so it is better to look at heart

Image: Vecteezy.com

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BIG MOOD Arriving this spring onto Channel 4 with a huge marketing campaign, new series Big Mood stars Bridgerton’s Nicola Coughlan and Lydia West from It’s A Sin as best friends Maggie and Eddie, and promised a realistic, rounded depiction of life with bipolar. But what did people living with bipolar actually think of it? We asked Bipolar Scotland members to review the show.

“I was excited to hear about the show although I did worry. It took me a while to feel comfortable enough to actually sit down and watch it. What they got right: I thought it was really good at showing the ups and downs of bipolar, from the risk-taking and impulsive behaviour, the way we can spiral into excesses of sexuality, spending and alcohol/ drug use, to the depression and inability to function.

However, what really pulled me out of the series was the relationship Maggie had with her psychiatrist. Nobody I know with bipolar has that sort of direct access to a psychiatrist who is completely involved in their case and knows them that well. That’s just not reality in the country we live in.

I only see a psychiatrist once a year and it has never been the same person when I get my appointment. We just don’t have that continuity of care. I don’t see how someone like Maggie could afford that level of private psychiatry, so that soured things for me as I began to wonder if they’d done their homework. I felt that it was offering people an unrealistic depiction of how the system works or doesn’t. ” - S

“It was refreshing to watch bipolar representation on TV that wasn’t demonising us, and I did enjoy that they found the dark humour that can exist in the situation. I was also amazed by Nicola Coughlan’s range in the central role; she got the feel of the emotions so very spot on that I had to check that she didn’t actually have bipolar herself!

I don’t think it was marketed very well, though - all the trailers I saw really leaned into the zany hijinks side of the things she got up to when experiencing manic episodes, when the show itself went much darker. I appreciated that they were honest about the darkness, but the ending, although it was really well done, left me feeling anxious and upset at how bleak it was. I almost felt like it was re-stigmatising people with bipolar again; we can make friendships work and last!”

- Rachel

“I was expecting huge things from this much advertised series, especially because it tackled bipolar. The first episode was intriguing and promised to shine a light on a very complicated condition. I recognised myself in the character Nicola Coughlan portrayed.

The manic and depressive episodes and the swings between them. I was eager to journey further into the series, get to know Maggie and Eddie and the way their friendship worked.

As the series progressed I became increasingly bored with the portrayal of the condition I’ve had for 40+ years, however, I know there had to be a story to the series, so tried to see beyond my expectations and view it as a tv show instead of an opportunity to try to explain a much misunderstood mental illness. I found it far-fetched and, as it’s advertised as a “dark comedy”, laughs, even smiles, were few and far between.

I ended the series feeling disappointed.

I hope for better things from the next episodes.” - Tracey

Nicola Coughlan & Lydia West star in Big Mood.

Watch episodes on Channel 4 On Demand.

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The Patient’s Voice:

Psychiatrist Posts in Scotland

by Victoria Reid n her visit to the Bipolar Scotland office in Paisley in November, MSP Maree Todd, Minister for Social Care, Mental Wellbeing and Sport, gave a very positive account of the numbers currently employed in psychiatry. I was cheered by this, but also somewhat puzzled as it did not chime with what I have been witnessing at a grassroots level facilitating a Glasgow bipolar support group these last seven years. Yes, some of our participants do enjoy continuity of care and prompt access to a psychiatrist at times of crisis, but too often, they don’t.

Then, last month, an item on BBC Scotland’s news programme, The Nine, caught my attention. It highlighted the significant disparity between how consultancy vacancies are calculated officially and on the ground. Alan Robertson, chair of BMA Scotland’s consultants committee, explained how official workforce statistics from the Scottish Government exclude certain categories, namely ‘jobs that are temporarily filled by a locum; jobs not yet advertised; jobs that have remained vacant for so long that they’re no longer being advertised. […] None of these are being counted as a vacancy; but on the ground, they are vacancies.’ Regarding recruitment, he added, ‘psychiatry has been particularly badly hit.’

(The Nine, 18 April).

This issue has come to light thanks to the work of mental health activist Peter Todd.

Peter has been involved with Spirit Advocacy for a decade; he receives psychiatric and psychological support at New Craigs Hospital in Inverness; and gave evidence at the historical Child Abuse Inquiry into Cyril Smith and associates in 2019/20.

Peter is passionate about giving voice to patients in psychiatry; plugs the charity Vox

for its integrating of lived experience into political advocacy; and is pained by the lack of stability given to vulnerable people in need of psychiatric care by a system overdependent on locums, too centralised, and, without a viable long-term workforce vision.

I had the privilege to speak with Peter and learn more of his work at an Assembly meeting organised by the Mental Welfare Commission on 25 April. Peter’s Freedom of Information requests to health boards across the nation reveal broadly one in four (28%) of consultant psychiatrist posts to be vacant. There is no permanent psychiatrist is the health boards of Orkney, Shetland and the Western Isles, nor in a swathe of NHS Highland. Further, they show that currently 117 of the 162 posts currently vacant in Scotland are being filled by locums, i.e. one fifth of all consultant psychiatry staff in Scotland.

An overreliance on locums is bad. First and foremost, as many of us know, a revolving door of temporary psychiatrists does not give stability to patients. In psychiatry, more than in any other medical area, a good therapeutic relationship is essential and this is something established over time. A patient needs to know their notes will not be compromised or mislaid and that they will not have to recount time and again possibly traumatic events in order to get a stranger up to speed with their case. Two, the costs can be astronomical, taking up too much of a health board’s mental health budget, or causing an overspend. Strikingly, two locums in the Western Isles cost £1.2m a year (The Herald, 10 April). The NHS in Scotland as a whole spent nearly £30m on locum psychiatrists in 2022/23, an increase of 50% in 3 years (Daily Record, 15 April). Three, as Jim Crabb, from the Royal College of Psychiatry in Scotland points out, agency locum psychiatrists do not teach and train junior staff and so cannot lead and develop the team they work in; they simply plug the gap. Four, locums may be used as a means of masking the substantive recruitment crisis in psychiatry, and stopping those with power from addressing this critical issue meaningfully.

Peter is frustrated by political mud-slinging and point-scoring instead of solution-finding for a situation that is dire for many; his campaigning efforts are a-political/pan-political. He has a number of proposals to bolster recruitment

and retention in rural areas, particularly the Highlands and Islands. There is a major need, in Peter’s view, for more creative, proactive recruitment. Strategic workforce planning must urgently be improved. Health boards should be better audited and scrutinised to ensure that limited funds are being optimally used. In September, Peter will take this project to the Scottish Parliament’s Petitions Committee with a view to pushing these proposals and also raising some questions, e.g. why is the number of locums used going up? (MSP Rhoda Grant put a question to the new First Minister regarding locums on 9 May.) His work led to a flurry of media interest, with articles appearing in the John O’Groat Journal (11 Jan; 10 May), The Herald (6 Jan; 10, 17 & 18 April), The Telegraph (4 April), The Times (4 April), The Daily Record (4 April, 15 April), The Guardian (21 April), Stornoway Gazette (27 April) and even The Madras Tribune (21 April). There were also radio features on Care Radio, MFR and its sister stations Northsound, Tay FM, and Greatest Hits Radio for Dumfries & Galloway.

He believes that what has captured the imagination of the press on these issues is that the patient’s voice is at the forefront.

So many patients are not given a voice. So many of us need more stability in our care.

BIPOLAR SCOTLAND 16

Jamie’s Diary Hello everyone, I seem to have found some of that missing spark l spoke about in the last issue.

As predicted, life for me functions on a pendulum and l am on the up swing.

It’s been a busy couple of months, l have a job as a peer support worker, it is extremely rewarding and l have a great team l am truly blessed. I am currently writing this and working on the design of this very issue at the same time. We have so many talented people who write on here and l am blessed to be part of this.

My life is full of talking about mental health and its impact, but in truth mental health is secondary to what is underneath and that is people. Speaking of people, I lost an old and dear friend last week, I am not speaking of this causally, I am struggling with this. We used to work together - years ago, we lost touch over the years, we lived far apart and we both left a job that wasn’t good for either of us. When the news of his passing hit me, it hit me like a truck.

I think back to the days we had together and at 42, I realise how much I looked up to him.

I am always trying to embrace life as it happens, but in an effort to do that, Ironically, I let so much slip through my fingers.

There are people who light up your life, there are people who are patient with you when you are young and unwell. That was my friend, I truly wish he could have met a more (slightly) balanced me. We never fell out, never had a cross word and I will miss him forever.

Your light, kindness and warmth I will try and take with me. I always thought we had more time. Growing up, l didn’t have a CPN, l had a supportive family but l was guided by friends.

We didn’t share the same condition but we had fun and l needed that more than anything.

Being around people and laughing, sharing stories’, that was what life was all about for me. People see what they want to see, with me. I always seem to be social and happy but it takes a lot to get me ready to do things, l have a job, family, friends and l manage this condition. I live with limitations, but l give 100% to everything l do.

I just find it difficult keeping up with people, That is one thing I wish I could change. But I do enjoy what I am able to do! I love my job I love Graphic Design, I feel so fulfilled, Things haven’t really changed, I have always taken

time away, not to hide but to recharge, it is hard to explain that to some people but I appreciate they try and understand.

I have no big ambitions or plans for world domination, I like the little things in life and that is all I really need, a sit in the sun, a nice walk, a hug, little moments make me happy.

I often wonder what my life would have been like without mental health problems, would l have met the people l met? Things would have been completely different but not necessarily better, l feel blessed in so many ways. Life has been varied as a life should be, it may have been more balanced without bipolar but not richer, and not as interesting.

Getting out and walking every morning has kept me well, I just love it. Whether I feel like superman or I am limping along, it always makes me feel better. I think about periods of my life of inactivity and very little exercise and I see what a benefit it is, it really keeps me grounded. Whatever you are able to do big or small, a little exercise is great. To be honest sometimes I am full of energy and vitality, sometimes I feel amazing.

I must apologise if my last few entry’s – I haven’t been myself. My job opportunities ahead of me and designing On a Level are things I am very much looking forward to continuing, I get down, but I never stay down!

You can be extraordinary without even realising it, If you think about how many times you have been up then down then up and down again, and kept going, that is fantastic. As we embrace the summer months l ask you enjoy what you can. As the sun beats down on me, l will take a big breath and be grateful for everything l have.

I think l have created an image of classic music in my headphones or something profound in my headphones as l sunbathe but it will probably be The Vengaboys!

Surfs up, Much Love,

Image: Vecteezy.com

BIPOLAR SCOTLAND 18

IS WORK

working for you?

Bipolar Scotland’s Impact and Development Manager, Maja Mitchell-Grigorjeva, investigates how the world of work does and doesn’t work for people living with bipolar

Work is a common theme that comes up during conversations within our peer support services. For many people, work can be an important part of what keeps them well. It provides structure and routine, social contact, opportunities for learning and growth, a sense of purpose and, importantly, an income. For people with bipolar, it’s not always so positive.

We have spoken to people who have shared stories of being unfairly dismissed as a result of their bipolar diagnosis, feeling pressured to leave their job due to high levels of sickness absences and dealing with unsupportive employers who are not willing to make reasonable adjustments. Many people with bipolar face stigma at work, and fear being open about their mental health. There’s also the shame, embarrassment and lack of understanding that can come from returning to work and facing colleagues and managers after a bipolar episode.

In 2022, the Bipolar Commission surveyed more than 7000 people with bipolar in the UK and found that:

· 63% felt they had lost their job due to bipolar · 44% hadn’t applied for a promotion due to bipolar · 35% felt they’d been overlooked for a promotion because of their bipolar

Source: Bipolar Minds Matter Report, November 2022 Bipolar Minds Matter report, November 2022 We also know that there are many people who live with bipolar and are incredibly successful in their jobs. Our Peer Workers at Bipolar Scotland are all examples of how the insight and knowledge gained from living with bipolar can be an asset and a strength. There’s a side of bipolar that can sometimes help people in feeling productive and inspired in the workplace.

Bipolar Scotland want to dispel the myth that people living with bipolar are unreliable, or less able, than their colleagues without bipolar.

We want to challenge employers to reconsider the adjustments they may need to make to ensure a person with bipolar can remain in work. Often, these adjustments are minimal to the organisation but can make a massive difference to the employee.

We also want to ask employers to see the person, not the illness. No two people with bipolar will have exactly the same experiences or need exactly the same adjustments.

look like at work and, most importantly, what employers can do that actually helps.

In March this year, Sam Christie (one of our Peer Workers) and I prepared and delivered a presentation to more than 240 people at an Employers Networking event. Sam was able to share her lived experience of working with bipolar, and we were able to speak about what bipolar is, what it might

If you would like to share your story of working with bipolar, or share your ideas for how people with bipolar can be better supported in the workplace, we want to hear from you. Please get in touch on Majam@bipolarscotland.org.uk

Bipolar Scotland are in the early stages of developing a new project that aims to support people with bipolar who may be experiencing challenges at work as a result of stigma or discrimination, as well as developing training to help employers feel better informed and able to support their employees.

Image: Vecteezy.com

BIPOLAR SCOTLAND 20

SPOTLIGHT ON:

VOLUNTEERING Introducing Tom Robertson, Bipolar Scotland’s new Volunteer Development Officer!

What brought you to Bipolar Scotland?

Firstly, my experience with bipolar drew me towards Bipolar Scotland. I have three direct family members that live with bipolar - either bipolar type 1 or schizo-affective bipolar-type. So I have seen how these forms of the condition can impact people I love and care for and what bipolar’s effect can also mean for their support networks - family and friends.

When I read up about the peer support, self-management training and support groups set up and run by Bipolar Scotland staff and volunteers I was reminded of the positive impact of support like this on my family members with the condition.

And of the ripple effect that good support has had on their children, partners and siblings.

Secondly, my obsession with volunteering.

I caught the volunteering bug at a young age when, still at school, I helped run a before-school sports club for SEN pupils. I have been in the charity and volunteering sector continuously since then. In my previous role with Alzheimer’s Society I was the Volunteer Development Coordinator for the South West of England. So the role of Volunteer Development Officer at Bipolar Scotland spoke to my enjoyment of engaging with volunteers!

Thirdly, and by no means least: my partner works in bipolar research and she kindly made me aware of the Volunteer Development Officer vacancy - so big thank you to her :)

Image: Vecteezy.com

What do you see as your role here?

I am responsible for most aspects of the volunteering journey at Bipolar Scotland. Before a volunteer has even taken on a role, I make sure we are set up as best we can for volunteers to get involved. From their application, through their interview and induction, ongoing engagement and support, celebrating and recognising volunteer contributions to Bipolar Scotland and the people we support and even making sure that when the time comes, that volunteers can leave positively. I also provide support and guidance to Bipolar Scotland members of staff who manage and engage with volunteers.

I will also be responsible for the role management of Group Facilitator volunteers and also developing and setting up new support groups across Scotland. Making sure that people living with bipolar across Scotland can access groups in order to support them in being able to live a good life.

How does the organisation currently engage with volunteers?

There are currently around 40 Bipolar Scotland volunteers carrying out a few different and interesting roles.

We have Group Facilitator Volunteers, who facilitate support groups across Scotland in both face-to-face and online sessions providing group peer support to people living with Bipolar and their families and friends. Likewise, we have Peer Support Volunteers who provide 1:1 peer support for people living with Bipolar. We also have digital volunteers who provide support with the

website and digital design and fundraising volunteers who help to raise vital funds. And of course we have our board of trustees, volunteers who carry out the role of critical friends, discussing organisational progress with the leadership team.

What are Bipolar Scotland’s ambitions for our volunteer programme?

Coming into the role I am excited to get engaging with and hear from the existing Bipolar Scotland volunteers. So over the coming months I am looking to chat with and provide a space for discussion with and between volunteers to learn from them and their experiences to see how we can move forward together.

Having had some great initial discussions with the Bipolar Scotland team, we want to make the volunteering experience at Bipolar Scotland the best it can be! We plan to apply best practice from the volunteer charter (see the Volunteer Scotland website for more details), aiming for Volunteer Friendly accreditation and making sure we are engaging with, celebrating and recognising the vital support, time and effort volunteers at Bipolar Scotland provide.

We have our eyes on 2025 when we are hoping to start putting together our new strategy prior to A Time to Move Forward is completed in 2026 - this is certainly something we want volunteers to participate and engage in as much as possible.

What are the benefits of volunteering?

Hopefully, most people know that volunteering can provide fantastic benefits for individuals in terms of satisfaction, learning new skills and experiences, making a positive difference, helping to support mental wellbeing, collaborating with others and reducing isolation - this goes for both volunteers and the people they engage with - which is great!

Volunteering has far wider benefits as well.

As I see it, volunteers founded Bipolar Scotland with Dr Thomas in 1992, they make up our board of trustees and they are a core part of how we support, inform and empower people with the condition, and their families and friends across the country. Throughout Bipolar Scotland’s 30+ years and all the people and communities that we as an organisation have engaged with, supported and empowered, this has happened precisely because of volunteers.

For me that speaks volumes about the wide reaching benefits and power of volunteering for the people we support!

Got any questions, or interested in joining our volunteer team? Get in touch: info@bipolarscotland.org.uk

BIPOLAR SCOTLAND 22

BIPOLAR SUPPORT GROUPS ACROSS SCOTLAND We run online and in-person peer support groups across Scotland - friendly, safe spaces for anyone living with or affected by bipolar.

Here’s a full list of all of our groups running during June and July. Why not talk to people who get it?

To access an online support group visit bipolarscotland.org.uk/support-groups, click on the relevant calendar entry to RSVP, and you’ll be emailed a link you can use to join the group at the appointed meeting time.

SCOTLAND-WIDE (all online) BIPOLAR BLETHER: for anyone living with or affected by bipolar in Scotland, Sunday 2 June & Sunday 7 July, 3-4pm 18-30: for anyone aged 18-30 affected by bipolar in Scotland, Wednesdays 12 & 26 June, 10 & 24 July, 7-8pm FRIENDS AND FAMILY: for carers and loved ones, Monday 17 June & Monday 15 July, 7-8pm

REGIONAL AYRSHIRE & DUNDEE • Ayrshire and Dundee online group: Tuesday 4 June, Tuesday 2 July, 7-8pm • Dundee in-person (Dundee Volunteer and Voluntary Action, 10 Constitution Rd, Dundee, DD1 1LL): Thursday 4 June, Thursday 4 July, 7-8pm BORDERS • Borders online group: Wednesday 5 & 19 June, Wednesday 3 & 17 July, 7-8pm FIFE • Fife online group: Tuesday 25 June and Tuesday 23 July, 7-8pm FORTH VALLEY • Forth Valley online group: Tuesday 11 June and Tuesday 9 July, 7-8pm HIGHLANDS & ISLANDS • Highlands & Islands online group: Thursday 20 June and Thursday 18 July, 7-8pm

• Glasgow West in-person (Partick Trinity Church, 20 Lawrence St, Partick, Glasgow G11 5HG): Wednesday 26 June & Wednesday 24 July, 7-9pm.

• Glasgow West online: Sunday 9 June & Sunday 14 July, 7-8pm NORTH LANARKSHIRE • North Lanarkshire in-person (Coatbridge Community Centre, 9 Old Monkland Rd, Coatbridge ML5 5EA): Monday 10 June, Monday 8 July, 7-9pm PAISLEY • Paisley in-person (Methodist Central Hall, 2 Gauze St, Paisley PA1 1EP), Monday 24 June & Monday 22 July, 6-8pm • Paisley online, 6-7pm, Monday 10 June & Monday 8 July • West Lothian in-person group (Bathgate Community Centre, Lindsay House, South Bridge Street, Bathgate, West Lothian EH48 1TS): Thursday 13 June & Thursday 11 July, 7-9pm

• Highlands in-person (Cafe 1668, 86 Church St, Inverness IV1 1EP): Thursday 6 June & Thursday 4 July, 7-9pm GLASGOW • Glasgow City in-person: (Premier Inn Glasgow City, 187 George St, Glasgow G1 1YU), Wednesday 12 June & Wednesday 10 July, 7-9pm.

• Glasgow City online: Sunday 23 July & Sunday 28 July, 7-8pm BIPOLAR SCOTLAND 24

OVER TO YOU: A space for our members’ creative writing. If you’d like to submit a poem, short story or piece of writing, please email us on info@bipolarscotland.org.uk with the subject line On The Level submission

Life within limits!

by Colette MacFayden

Life has its limits, and you must obey

Sit in the chair and just be still

Or else you will be stressed

It is good for you to just relax

To watch your time and demands on you

Don’t plan every minute full of tasks

And always take time to relax!

Take a breath each day and learn to chill

I find it hard to live within limits There are always things to do See family and friends and just enjoy life The demands are endless on you But life has its limits, and you must obey

It is the only thing you can do If you are not careful you will be ill So take a breath and just be still!

Image: Vecteezy.com

BIPOLAR SCOTLAND 26

Want to get in touch with us?

Bipolar Scotland is based at: Studio 40, Sir James Clark Building Abbey Mill Business Centre Seedhill Road Paisley, PA1 1TJ You can contact us by phone between 9.30am – 3:30 pm, Monday to Thursday, on: 0141 560 2050, or by email on info@bipolarscotland.org.uk We’re also on Instagram: (@bipolar_scotland), Facebook: (bipolarscotland1) and X/Twitter: (BipolarScotland).

Charity Number: SC021705 Company Number: 163306 bipolarscotland.org.uk