YOUR COMPLIMENTARY COPY
INSIDE More Tea Vicar?
Signs of Panic
The Bigger Picture
3 WELCOME 4 STREET LIFE 8 BEYOND THE BARRICADE 10 SEEING THE BIGGER PICTURE 13 MORE TEA VICAR?
BEYOND THE BARRICADE How one woman and her ukulele are bringing people together.
PANIC STATIONS The 20 year old who wants young men to talk more.
16 THE AUTISTIC CHOCOLATIER 18 PANIC! 20 STAY WELL FEEL GREAT 26 YOU DON’T BRING ME FLOWERS 28 THAT GREEN LIGHT 30 HAPPY 70TH BIRTHDAY NHS
FLING OUT YOUR FLIP FLOPS A podiatrist on getting your feet summer ready.
THE AUTISTIC CHOCOLATIER
Having Asperger’s helped Shane achieve his dream. MC magazine team: Managing Editor: Steve Murphy. Editor: Jackie Rankin.
Contributors: Graham Hignett, Mark Hudson. Editorial: Julie Crompton. Photography: Joel Goodman, Steve Murphy, Matt Russell. Design: Jo Hadfield.
32 INTRODUCING… COMMUNITY HEALTH SERVICES IN LIVERPOOL 34 A DAY IN THE LIFE 35 OUTSIDE THE BOX You can contact us at: firstname.lastname@example.org MerseyCareNHSFoundationTrust @Mersey_Care
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e were wondering which season would come out tops in a straw poll. For us at MC magazine spring, like no other, gives a sense of anticipation for things to come.
Church congregations may be declining but it seems some of us are turning to faith communities when we are at our lowest. We talk to the chaplain who is training vicars to better understand mental health.
Looking forward is crucial to wellbeing. But having a healthy mind can be hard if you have a physical illness. And vice versa. Health services are starting to put them on a par and treat people holistically – we look how this is happening on Merseyside.
Talking isn’t always easy. In our feature on panic we hear from a 20 year old who stayed silent for years before seeking help. Now he’s urging other young men to talk more openly.
We may need to go in hospital – but staying too long can undo the progress made. A new approach is making sure people go home safely at the right time.
Also in this issue, meet the ex-army chef who’s making pizzas and kebabs a healthy option, the actor who’s doing a gruelling awareness raising triathlon - and get expert advice on getting your feet summer ready (flip flop lovers beware).
Looking forward is crucial for wellbeing.
Read how actor Darren Connolly is facing up to a gruelling challenge to raise awareness of suicide. Page 21.
The MC editorial team.
STREET LIFE Actress Bhavna Limbachia talks about Coronation Street, dyslexia and growing up between cultures.
Picture Courtesy of ITV
Picture Courtesy of ITV
s crazy as it sounds, I knew I wanted to be an actress when I was four. I didn’t fully understand what it was, I just knew that I enjoyed making people laugh. Growing up in Preston in a single parent family with English not being my mother’s first language, becoming an actor seemed like an impossible ambition to fulfil. I was constantly being told by my extended family and career advisors in school that acting wasn’t a sensible profession for me to pursue, while at the same time being told that it was the only thing that I was any good at it. I wasn’t very academic but loved absolutely everything creative. I was growing up in a very creative family. With a career in acting apparently out of the question I suppose I settled and went on to study fashion and later gained a degree in Costume Design, I guess ultimately combining my two loves, fashion and the performing arts. In the 1980s with only three and then finally four television channels, sitting in front of the box was a real family event in our house. We loved watching J. R. Ewing in the hit American TV series Dallas. I had this real pang of excitement as we all sat and watched in shock at his appalling behaviour. I loved that he could do that, and I knew I wanted to do something other than make the family laugh by impersonating Cilla Black on Blind Date.
EVERYTHING ABOUT IT FRIGHTENED ME As I got older I just didn’t grow out of it. The more I worked backstage or behind the camera in costume, the more my desire to act grew. Even my dyslexia couldn’t stop me. Looking back now, everything about it frightened me. The thought of auditioning made me so anxious. Eventually I started taking acting classes locally in Preston in a mixed class of children and adults. I enjoyed it but in no time running around pretending to be a magic paintbrush didn’t quite fit with what I was eager to learn.
I auditioned for and got accepted into the Manchester School of Acting (MSA) and from there everything started to come together quite quickly.
It was so important to me to get the telling of Rana’s story right. Soon after joining MSA I signed with an acting agent and relatively quickly got auditions. I landed a high-profile role in a play at the Octagon Theatre in Bolton. A wonderful bitter sweet experience. Wonderful because I got to put into practice things I’d learned as well as learning so many new and valuable lessons. Personally however, I was lost. So many life changing things were all happening at the same time. My mother was involved in a road traffic accident and someone I thought of as a grandfather passed away in the space of three weeks. I worked so hard to push through, ‘the show must go on’, or so they say. I was broken. Such a hard and truly challenging time. Acting is the strangest and most wonderful job if, like me, you are someone who likes being other people and prying into other people’s lives. I also needed to get my head around the idea that it isn’t only about talent. When I was working in costume it
always was about your ability and skills. As an actor it was as much about your height, your weight, your age! I was once told that I was too pale.
YOU HOPE THE NEXT JOB WILL CHANGE YOUR LIFE In most professions you have an interview, you get offered the job and you work your way up the ladder, if you’re lucky. As an actor you audition, you might get cast, you do the job and then you start the same process all over again from the start. Constantly chasing the next job, hoping that it will be the one that changes your life. I did so many temping jobs in between acting work. Even when I landed a leading role in a BBC prime time sitcom, I had to go back to working as a receptionist for a sofa company once the acting job came to an end.
I WANT TO DO GOOD WORK I know that some actors say that they never once doubted their ability or their chances of becoming successful, but that certainly wasn’t me, I was constantly checking in with myself, my ability and my progress. That’s not a bad thing, because it kept me grounded. You do need to be sure that you really do want to do this thing. Some people would be happy with five minutes of fame; that really isn’t for me. I want to do good work, have a long career and have respect from the public and my peers. CONTINUED ON PAGE 6.
I feel lucky to have so many layers to my identity.
In recent years I’ve been lucky enough to work on two really high-profile television shows; the hit BBC comedy, Citizen Khan in which I play Alia Khan and at the same time playing Rana Habeeb, in ITV’s Coronation Street. Such different shows,it often feels like I have two different professions. The style of the fast-paced sitcom and the continuing drama feel as though they are at both ends of the spectrum. Citizen Khan is filmed in front of a live studio audience and so in many ways it feels more like a theatrical event, with the additional awareness of what the camera can and can’t see. Because its success depends very much on the audience laughing the script would get changed regularly, evolving minute by minute. Demanding work but immediately gratifying. At Coronation Street you really don’t know if what you’ve done works until the show is aired, weeks later. The thing I’ve learned with both shows is that you need huge amounts of stamina
to keep going. I think everyone coming into a show like Coronation Street soon realises how much discipline is required to keep on top and do the scripts justice. We film everything out of order so you constantly need to remind yourself where you’ve just come from and what has just happened. It is really tough and definitely not for the faint hearted.
You need huge amounts of stamina to keep going. I try really hard to stay focused, optimistic, strong, courageous and hard working. I come from a single parent family and seeing my mother’s strength and courage while bringing up the family, constantly reminds me never to take anything for granted.
I never heard my mother complain even though communicating in another language was often very difficult. Witnessing what she went through, the sacrifices she made has given me the strength to pursue what I want in life, knowing that was not an option for her. My focus and work ethic come from a combination of my dyslexia and always being over prepared to compensate and wanting to make my mother proud. Coming from an Indian background, with one parent was really frowned upon in the Asian community back in the 1980s. Happily things have changed and moved forward since then, but the feelings I had growing up have never left me. I read an article in The Guardian written by Meera Syal that has really stuck with me and made me look at things in a slightly different light, she said, ‘Growing up between cultures is tough, until you realise it’s a creative blessing’ and it really is. I feel so lucky and proud to have so many layers to my identity. I am British born and bred and see myself as such. I am also so proud of my Indian heritage.
Having a support network and finding a work life balance is I think key to having a healthy mind. 100 DAYS OF HAPPY A trick I learned, was to write down ‘100 Days of Happy’, I’ve recorded mine on my Instagram. Every day for 100 days I made a note of something that made me happy that day. It doesn’t need to be anything big, something as simple as seeing a colourful flower or how blue the sky is. Doing this simple exercise always helps me stay present and living in the now; not looking back for me is so important. In Coronation Street, Rana is having trouble coming to terms with her sexuality and having difficulties with her parents accepting who she is. It was so important to me to get the telling of her story right. I wanted to accurately represent those people experiencing this huge thing with the utmost respect, the responsibility wasn’t lost on me, so, I got in touch with Matt Ogstan who runs the Naz and Matt Foundation, a charity he set up when his fiancé Naz sadly took his own life, as his family couldn’t accept his sexual orientation.
THERE’S NO STIGMA IN BEING WHO YOU ARE
Working at the level I do now is a privilege, it does however place huge mental and physical demands on you. The hours are long and the pressure of delivering the goods can be tough but to be honest as with most jobs, in the end, you have to work out how to take the rough with the smooth. Having a support network and finding a work life balance is, I think, key to having a healthy mind. You must try and stay true
to yourself. It is fine to be scared, fear isn’t always a negative thing. I always see fear as a different version of passion and let myself push through it. I’ve learned to enjoy the journey, good and bad and I always try to learn something from every experience. I’m a big fan of mindfulness. I really try to stay present and focus on an object in the room or use my senses like touch or smell to stay present.
The mission of the charity is to never let religion, any religion, get in the way of unconditional love between parents and their children. There are so many organisations who can help with this and I know how important it is to talk to people, to ask questions and to get help if you need it, there is absolutely no shame or stigma in being who you are or in asking for help. The thing I learned in telling this story and also in my own journey into becoming the actor that I always wanted to be is, never ever be afraid to ask for help or to seek out guidance. Every challenge has the potential to become an opportunity. @bhavnalimbachia.
REAL LIFE STORY
BEYOND THE BARRICADE
Ukulele players always appear to love life. Lindsey Stainthorpe is no exception. But her beloved uke plays another important role – as a coping strategy after a diagnosis of borderline personality disorder five years ago left her with depression.
t was a horrendous time. I was self-harming to cope. I was sectioned and spent four months in hospital after going into crisis while waiting for an appointment for mental health services. Taking up the uke forced me to go beyond what I thought I couldn’t change; to stop doing negative things, Just picking it up gave me a bit of space, a distraction from what was going on inside my head.”
Taking up the uke forced me to change my habits. Her recovery journals have been turned into songs she performs publicly. She became an advocate for others in the same situation and applied for funding from the People’s Lottery to run her Uke ‘n’ Chill project which brings together people in the same position. “It’s less of a class to learn ukulele, more a chance to chill in the company of people who are in the same boat, to talk, listen, sing and play if you want to.” “You’re given a journal to document your journey. It helps you with goal setting – it may be to get out of bed, brush your hair, things we take for granted that can be an uphill struggle when you’re unwell.” Uke ‘n’ Chill is running at the Life Rooms, in Walton.
FANCY A GO? You won’t be alone in taking up the uke – more than 250,000 are sold each year. Hundreds of ukulele clubs have sprung up across Britain over the past few years. The instrument’s rise in popularity could in part be down to London folk band Mumford and Sons.
Liferooms.org Tel: 0151 478 6556
DID YOU KNOW?
Just picking up my ukulele gave me a bit of space in my head.
The ukulele is originally from Portugal. The name is Hawaiian and means Jumping Fleas. Find a club near you: mightyukulele.co.uk
BIGGER PICTURE Whether in the pages of your morning paper or across social media illustrator Ella Byworth is drawing on her strengths to tackle taboos and shatter stigma. Working in the superfast paced offices of the Metro - The UK’s most read daily newspaper - her art and insights helps to illustrate unusual and challenging topics; encouraging people to keep an open mind and question ‘what is normal?’ Her work has been seen and appreciated by millions here she opens up about, her inspirations, her likes and dislikes and her love for illustration.
TEN QUESTIONS FOR ELLA 1.WHY DO YOU LOVE ILLUSTRATING?
3. WHAT DO YOU AIM FOR IN YOUR WORK?
It’s bite sized and unique. And it has a sense of fantasy about it – it’s not about a specific person, if you are the person it’s illustrating you can identify with it. Social media has really helped me build my collection of work and share it with
I try to make people question what is normal - and to represent everyone. People can feel ashamed because of religion or culture or for fear of coming across like a freak. We need to let them know that they’re not alone.
2. IS ILLUSTRATION BETTER THAN PHOTOGRAPHY? Not better – but you can tailor illustration to the story you want to tell and portray things that could never be photographed - that models might feel awkward about doing. Where the content is explicit or the subject matter sensitive, illustration can be less confrontational yet still extremely effective.
4. WHERE DO YOU TAKE YOUR INSPIRATION FROM? I’m inspired by people I meet and their reactions to situations. And the emotions I’ve felt at the time. And colours and patterns…and travel. It freshens my mind I come back full of ideas! CONTINUED ON PAGE 12.
Ella’s illustrations tell stories photographs can’t always capture.
My ultimate goal is to be able to use my skills to help people to talk, escape, express. Creativity is good for the soul. 11
PROFILE ELLA... I was born in the UK but moved and lived in a little village called Geelong in Australia as a teenager. I came back to the UK for adventure, travel - and work. I believe you can learn a lot about life by travelling. Although I’d doodled and scribbled all my life – I’m 27 now – it was a hobby; work was graphic design. Then I was spotted on Instagram by Metro, newspaper. My boss gave me a chance and took me under his wing. It’s super fast paced! I’m also a picture researcher sourcing and editing photography for articles. I think my comfort zone is
5. WHAT SORT OF RESPONSE DO YOU GET ONLINE? I illustrated a blogger saying sorry to her friends for how her depression had affected their relationships – 680,000 people shared it which went a long way in getting that message out there. I’ve had hate mail from trolls on my images because they didn’t agree with what was written in the accompanying article.
6. WHAT DON’T YOU LIKE? Sometimes I don’t get a choice of what’s published, which can be challenging. But I’m also lucky enough to work with people who take promoting good health very seriously.
7. DO YOU THINK YOUR WORK HELPS CHALLENGE STIGMA AND OPEN UP CONVERSATION? I really hope so. Everyone has different perceptions of ‘normal’. I hope people can in some way relate to what I’ve pictured. If I can represent people who might feel like the ‘only one’ then I’d be happy.
8. WHO ARE YOUR INFLUENCES?
being out of my comfort zone!
Laura Callaghan, Eero Lampinen. You can see so much personality in their art. Of course you can’t ignore the messages Banksy sends through artwork.
9. WHAT’S YOUR GOAL? My ultimate goal is to be able to use my skills to help people to talk, escape, express creativity is good for the soul - I feel unfulfilled unless I’m being creative and helping someone else.
10. WHAT ADVICE WOULD YOU GIVE YOUR YOUNGER SELF? Sign up for workshops or evening classes or online tutorials. Get to know people who might be able to help you. Accept you’ll be working on your goals from the second you wake up to the moment your head hits the pillow. They say you have to be lucky but I believe luck is preparation meeting opportunity.
Ella is picture researcher and illustrator at Metro.co.uk. Follow her at: ellabyworth facebook.com/ellabyworth @ellabyworth
VICAR? More people than ever are turning to a faith community in times of mental anguish. Can they offer more than tea and sympathy?
Vicars, imams and other worship leaders are a source of support to people in need. But before we send them - like Dawn French’s famous sprout filled festive dash from one needy soul to another – should we not consider the impact of supporting someone with a mental health issue? Or is it simply even more tea vicar?
ersey Care chaplain Julian Raffay runs a bespoke training programme for faith leaders giving them the skills to deal with often heavy discussions.
“Mental health issues are massively on the increase. The NHS is excellent at caregiving, but the system is under pressure, statutory services are struggling to cope. I recently spoke to someone receiving enhanced care who didn’t know his nurse’s name. “People want a combination of psychotherapy and humanity. Care and love in equal measure. The root of many mental health crises is social problems, abuse, isolation and loneliness. The NHS can’t easily resolve those problems with a prescription.
Faith communities are rooted within communities – they do things with communities. They play an important role, but they need help to understand the nature of mental illness and the situations they are facing.”
People want Care and love in equal measure. He points to one church where the men’s group befriended a young man with learning disability, helping him
buy new clothes and smartening up his flat. “In effect they set up a management plan for him like a statutory agency would, but they did it through friendship.” The Diocese of Liverpool has taken the proverbial bull by the horns in establishing strategic mental health groups to support and equip leaders and congregations; but many churches feel they have a long way to go before describing themselves as mental health friendly, says Raffay. Most would welcome closer cooperation with mental health services.
People are still too embarrassed to ask ‘awkward’ questions about deep or suicidal thoughts.
“People are still too embarrassed to ask ‘awkward’ questions about deep or suicidal thoughts. We need to promote campaigns like the Big Brew – talking to someone you think may be low over a cuppa. They are going a long way to tackle stigma. The bigger challenge is to bring clinicians and faith community leaders together to share their skill sets – each to teach the other the things that make it unique – and to collaborate more.
Stress. Someone close to you could be about to snap...
“I know of a church-run arts centre for people with mental health problems. It was literally across the road from an NHS counselling service – yet neither organisation knew the other existed. The training, produced together with people who have lived experience of mental ill health and aptly entitled ‘Mental Health: Challenge or Opportunity?’ aims to challenge stigma and promotes understanding. “A five minute chat can result in unexpected revelations or discussions. Understanding the particular issues affecting someone is vital if we are to offer true meaningful support and also safeguard both parties”. Raffay urges us all to take simple training such as the 20 minute programme offered by the Zero Suicide Alliance. “We’re only human and we’re always more comfortable with people who are like ourselves, yet having the discussion with someone different can be enriching, it can open up a whole new area of life for everyone involved.”
Maybe it’s time to put the kettle on... Big Brew: merseycare.nhs.uk/getting-involved/ big-brew/ Zero Suicide Alliance training: zerosuicidealliance.com
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
REAL LIFE STORY
‘Chocolat’ - the mysterious tale of intolerance and the wind of change that comes with acceptance and kindness of people perceived as different, has proved the perfect backdrop for a new business idea by one man and his partner…
hane Quinn’s happiest childhood memories were watching his granddad, a chef,
make sumptuous cakes for customers. The little boy hoped that one day he too would design creations people would never forget. His sweet dream was hampered by years of depression and hospital admissions until he was diagnosed with Asperger’s syndrome and received specialist support. Now with the help of girlfriend Sue Dillon, Shane has launched an artisan chocolate-making business. Encouraged by growing awareness of Asperger’s among celebrities like Spring Watch presenter Chris Packham and motorcycle racer Guy Martin, the 43 year old has become proud to be on the autistic spectrum – so much so he’s called his venture Chocolatism.
Sue and Shane begin what is a delicate and skilled process...
“I wanted a name that brought together chocolate and autism,” he smiles. “What we are also trying to say is having a disability shouldn’t hold you back from doing what you want to do. I honestly think my Asperger’s is a positive thing because some of its characteristics, such as fastidious attention to detail, have really helped me make a hobby into a proper business.” Samples of Shane and Sue’s exquisitely crafted products were used by the National Autistic Society at a campaign event graced by Sophie, Countess of Wessex. Shane: “I’ve had some very difficult times that have affected my mental health over many years. I find making chocolates relieves stress, is creative and ultimately very fulfilling.”
Mersey Care support worker Dawn Williams said: “I’m just so proud of Shane, his recovery story is one of the most positive stories I’ve ever seen.”
I find making chocolates relieves stress.
and share a sample of their creations
Shane was supported to develop his idea by Citizens Advice Sefton’s mental health advisor Holly Penny who put him in touch with Southport Life Rooms, where he was supported by Alt Valley Community Trust and Merseyside Enterprise Hub. www.chocolatism.uk @chocolatismUK www.facebook.com/chololatismuk
Panic – that feeling when you realise you’re miles from home and you’ve left the iron on. You’re about to make a speech and your mind goes blank. It’s our natural response to stressful or dangerous situations. However, for some people, feelings of anxiety, stress and panic happen regularly and at any time.
panic attack is no fun. It’s a rush of intense mental and physical symptoms. The lack of control can make you feel faint, or worse that you’re having a heart attack – even that you’re about to die.
VICIOUS CIRCLE Your reaction is to escape the situation and avoid it happening again. Before you know it you’re declining invitations, avoiding being in public or leaving home. It’s a vicious circle. Panic affects all kinds of people. Model Kate Moss has suffered attacks since childhood, mainly when she’s in stressful
situations. La La Land star Emma Stone’s extreme attacks caused agoraphobia in her early years.
Around one in 10 of us will experience a panic attack at some point in life, according to the Royal College of Psychiatrists. Colin Grimes psychological wellbeing practitioner with Talk Liverpool explains what panic is and how talking therapy can help. “Panic is a perceived threat that you’re in danger. Fight or flight – the acute stress response - has been around since cavemen but if you can’t manage the feelings it can have a massive impact on your life. People may try to escape by avoiding the things that cause the panic, but then another trigger begins. If the cycle isn’t broken their world becomes very small.
DIFFERENT TRIGGERS Colin says therapy can help people to understand their trigger and develop their own coping strategies. “There are lots of different triggers. Some people panic when they’re under pressure or in a particular place. One of the most common is supermarkets, people may stop going out altogether because of the fear of an attack. Avoidance makes it worse.
Actress Emma Stone had extreme panic attacks in her early years.
WHAT DOES THE THERAPY DO?
“Talking can help people to understand that they aren’t in danger, it normalises the feelings, helps people become aware of thoughts or situations that bring on panic and offers coping strategies. “We suggest small steps that challenge the fear. So if going out makes you panic we’d help you get to the point where you can wait until the strength of the feelings halve then maybe go to the front door, or the car. Anxiety levels may rise but at some point they’ll reduce.” But he makes it clear there’s no magic wand. “A person has to engage and follow the plan. Goal setting and homework play a key part, helping you build on your good work and make progress. Family and friends can be a huge help. Everyone benefits; relationships improve, family life is better.”
Model Kate Moss has suffered panic attacks since childhood.
SIGNS OF PANIC... • An overwhelming sense of fear, apprehension and anxiety • pounding heartbeat • feeling faint • sweating • nausea • chest pains • feeling unable to breathe • shaky limbs or feeling like your legs are turning to jelly • feeling like you’re not connected to your body • thinking you’re having a heart attack or that you’re going to die.
WHAT TO DO... The next time you feel a panic attack coming on, try the following: • don’t fight the attack and stay where you are, if possible • breathe slowly and deeply • remind yourself that the attack will pass • focus on positive, peaceful and relaxing images • remember it isn’t life threatening. Source: NHS choices – nhs.uk
Therapy can help people to understand their trigger and develop their own coping strategies.
READ OUR PANIC SELF HELP GUIDE AT MERSEYCARE.NHS.UK 19
REAL LIFE STORY
PANIC STATIONS Jack’s panic attacks left him unable to go on trains, or even walk into a station without feeling he might collapse.
was always shy - I struggled at school, but I joined the army cadets and it brought me out of my shell. I loved all the outdoor things, I was happier. But then I got a problem with my back and had to leave. I went right back to how I was and as I got older it got worse. I wanted to tell someone but I couldn’t. Some days were fine, but little things can throw you off balance. I knew the signs, I’d start to fidget, get out of breath, my chest felt heavy. My senses would become heightened to the point where I thought I’d collapse. It’s an internal battle with yourself. I kept busy to stop the feelings. I became reliant on beta blockers and anti depressants – I hated it but it reduced the feelings a bit. I started to remove myself from anything that triggered it. My fear of trains stopped me from socialising. It was a safety mechanism but it affected my whole life.
I knew I had to get help. My GP had suggested Talk Liverpool twice before, but I just didn’t believe it could help. I couldn’t have been more wrong. Rhea my therapist is amazing. She genuinely listened and understood. I started to trust what she said – that the feelings would only get to a point then pass – that nothing terrible would happen. It’s hard – you have to be honest with yourself. But it helped me get my life back. I don’t take the beta blockers now – I keep a few handy just in case but really I don’t need them. I can tell the signs when people I know are suffering like I did and not talking about it. There are more mental health problems among lads than you’d think. They won’t speak out because it’s too scary. We need to talk to each other more. Talk Liverpool is for people who live in Liverpool or are registered with a Liverpool GP.
Panic attack? Talk to us
Talk Liverpool is a free NHS talking therapy service. You can be referred to Talk Liverpool by your GP or another health professional. You can also self refer. Go to talkliverpool.nhs.uk
REAL LIFE STORY
HOW TO SAVE A LIFE NHS worker Sue Ormesher went to the aid of a woman climbing over a motorway bridge safety barrier, but as reality hit that she was planning to jump Sue was scared how to react.
ou think to yourself ‘will what I say make her more agitated – or even worse to take her life’? It was incredibly distressing; we talked to her while the emergency services came and breathed a sigh of relief when she came down from the bridge. Sue has since taken the Zero Suicide Alliance online suicide awareness training. “I wish I’d taken it before I wouldn’t have been so nervous. It only takes 20 minutes and it reassures you that what you say to someone won’t make them take their life, it can make them realise someone cares and could change the outcome.”
IT’S TIME TO TALK SUICIDE
arren Connolly, the Manchester based actor best known for his roles in Peaky Blinders and Sons of Liberty, has also represented Great Britain in the Biathlon (skiing and shooting). Now he’s taking on a new challenge – the gruelling Lanzarote Iron Man, a 2.2 mile swim, 112 mile bike ride and a Marathon through rough terrain – and all in baking temperatures and strong winds at 8,500 feet. Yet it’s not his toughest challenge. That was battling depression after the death of his mum from suicide when Darren was just 19. He’s raising awareness of mental illness and fundraising for MindEd, a charity set up by businessman Steve Mallen after his son Edward took his life three years ago at 18.
After my mum died I cried before going to sleep and I cried when I woke up. I thought what did my mum go through? The whole family was affected long afterwards. This will be a tough challenge but it’s nothing to the challenge someone with depression or anxiety some people are going through every day.”
I want to raise money not just to prevent suicide but for the people left behind.
Actor Darren Connolly is no stranger to tough challenges.
You can donate to MindEd at Darren’s mydonate page: mydonate.bt.com/fundraisers/darrenconnolly1 themindEdtrust.org Because ONE life lost is ONE too many
It can make a person realise someone cares...
SUICIDE IS NOT INEVITABLE, IT IS PREVENTABLE
Because ONE life lost is ONE too many
STAY WELL FEEL GREAT
KEBAB Life Rooms chef Anthony Muldowney was introduced to this recipe by a Greek Cypriot chef while on an army peacekeeping tour. “It brings back fond memories of generous and welcoming locals. Sun, sand sea and no worries!”
WHAT TO DO • Spray the diced chicken with oil. Season with salt and pepper, add garlic, herbs and spices and put in the fridge for one hour • Pre heat the oven to 190Oc. Peel and cut the potatoes into chips and put in a sauce pan with cold salted water. Bring to the boil, simmer for six minutes, drain, spray with fry light and oven bake for 25 minutes • Add tzatziki ingredients together and mix well • Push the skewer through a pepper, then chicken, then onion and repeat until the skewer is two thirds full. Grill until the chicken is cooked through, rotating regularly • Place the tzatziki, chips and chicken kebab in a warm pitta with a mixed salad.
Cooking time: 25 minutes Makes: six kebabs Preheat oven to 190Oc WHAT YOU NEED For the kebab 6 large chicken thighs (diced) ½ each large red, yellow and green pepper (diced) 1 medium white onion large (diced) 1 tsp cumin 2 cloves garlic (crushed) 2 tsp oregano 2 tsp paprika Salt and pepper 6 skewers
For the tzatziki 250g fat free greek yogurt 1/3 of a cucumber (grated) ½ the juice of a lemon 1 garlic clove (crushed) 2 tsp mint sauce salt and pepper Healthy chips 4 white potatoes Fry light spray oil salt pepper Mixed salad to garnish
CHEF’S TIP: If you prefer you can simply cook the chicken onions and peppers in a frying pan with a little fry light spray. Chicken leg meat has a stronger flavour and is much cheaper than breast meat.
Tel: 0151 478 6556
The preparation takes a bit more time and effort but you’re getting the food you like without the bad stuff.”
An army chef from 16 Anthony met his wife Joanne in Cyprus - he was on tour, she was a holiday rep. He was fulfilling a childhood dream and while cooking in tents for 250 soldiers in the desert heat fifteen hours a day was exhausting, he loved army life. It was a desire to be a hands on dad that prompted Anthony to return to civilian life. He is passionate about the concept of linking food to mental wellbeing and excited that his new role offers the chance to pass that on.
The high streets are peppered with takeaways. I enjoy fast food but when it becomes your staple diet it becomes a bad thing. How will he get that across to people for whom healthy eating is low priority? If you bought a Ferrari you would use the best fuel and oil to make it last. I won’t preach though – I can’t, I do junk food too. Just not all the time.“ He will use his innate understanding of the specific issues faced by ex service men and women when a veteran wellbeing programme begins later this year. “They struggle to share their experiences in traditional environments. We want to create somewhere they feel safe to be open and among people like them. My experiences have taught me that everyone has their own battles, it’s all relative.”
Photo: Matt Russell
The first thing you notice about ex army chef Anthony Muldowney is his readiness to confess his love of food – even the fast sort! Diets aren’t really his thing. He’d rather find new less unhealthy ways to cook things he enjoys.
Anthony is a fan of Gino D’Campo’s recipes.
WHAT’S YOUR TASTE? • Gino D’Campo or Delia Smith? Gino. I have two signed books in my collection. • Fast food or slow cooker? Slow. Greek food is simple and tasty, slow cooking methods means you can use cheaper cuts of meat • Lap tray or table? On our kitchen island, we eat and talk about everybody’s day • High tea or cosy supper? Supper at home with a movie eating some healthy junk food! • Breakfast or brunch Brunch unless my stomach doesn’t play ball!
STAY WELL FEEL GREAT
FEET SUMMER READY?
Have you put your boots and socks back in your winter cupboard and reached for the flip flops?
efore you head for the beach take heed from a podiatrist. Much as we love our flip flops they’re the route to all kinds of painful foot problems. Head Podiatrist for Sefton Community service Sue Keech says the main problem comes not from the strap between your toes, but from not having a strap around your heel. “Flip flops make your feet and back work really hard so by the end of the day they’re fatigued and you can develop back problems. Your toes become clawed from trying to hold on.” Her advice? “Choose flip flops with an ankle strap.” Sue’s the bearer of more bad news for ladies who love trimmed, polished nails. “We see so many nail infections caused by wearing polish and cutting nails too short. Polish seals the nail, breaks down keratin which is the main ingredient of nails, causing a fungus to grow. Cutting nails too short is the main cause of ingrowing toenails which are really painful. If you get one bathe your feet in salt water and put on a dry dressing – no creams or TCP! Sue (pictured bottom centre) says she hadn’t realised how important looking after your feet is to your general health until she became a podiatrist 17 years ago. It’s a highly specialist role, the team treats people with diabetes related issues, musculoskeletal problems caused by poor gait and pressure sores from being immobile.
SO WHAT SHOULD WE DO TO CARE FOR OUR FEET THIS SUMMER? • Feed your feet with a non lanolin based moisturiser – you’ll find hard skin disappears gradually • Don’t use corn plasters – they contain salicylic acid which makes the plaster slide about and cause more skin damage • Look after your general health which will keep your circulation working and your feet in good shape.
Shop for shoes in the afternoon. Feet swell as the day goes on so if shoes fit in the afternoon you can be assured they will always be comfortable. More tips at NHS Choices: nhs.uk
“Walking is a man’s best medicine”, said Hippocrates over 2,000 years ago. Since then study after study has shown walking helps you physically and mentally.
f you go from sitting at your desk at work to sitting on your couch at home a short walk could mean some big health benefits. An Indiana University study of desk bound workers found that blood flow in the main artery in the legs was impaired by as much as half after just one hour.
I make myself go even if the weather is bad - once you’re out there it’s energising. Stanford researchers found that walking even increases creativity levels during the walk and shortly after. And a University of East Anglia study found that a more active commute to work can be associated with the same psychological benefits as things like a raise in income or starting a new relationship. The Life Rooms Southport Liferooms.org Tel: 01704 383198
STAND UP, SIT DOWN, KEEP MOVING
Donna (pictured above right) joined a walking group run by Southport Life Rooms to become more healthy; but it’s also helping her connect with other people.
Sitting too long is bad for your health. But standing or walking for even five minutes in every hour can make a difference new research says.
“I needed to push myself, but walking by yourself isn’t much fun. It felt uncomfortable at first I didn’t know anyone but once everyone gets talking you feel better. I make myself go even if the weather is bad because once you’re out there it’s energising.
Professor Stuart Biddle who helped set up national guidelines in England to reduce sitting says that essentially the body is shutting down while sitting and there is little muscle activity. “Sitting needs breaking up. A common sense approach would be five minutes in every hour.”
Find a group in your area at: walkingforhealth.org.uk
Tips to reduce sitting time at work and home: • stand up at work meetings and coffee breaks • walk to a colleague’s desk instead of phoning or emailing • stand or walk while on the phone • use the stairs as much as possible
The link between illness and sitting first emerged in the 1950s, when researchers found London bus drivers were twice as likely to have heart attacks as their bus conductor colleagues. For more go to NHS Choices: nhs.uk
• stand up and move during TV advert breaks • do gardening and DIY • do any type of of housework.
BRING ME FLOWERS When IT consultant Kate underwent surgery for a back problem she was inundated with flowers and get well cards.
et there were none during the ten years she’d spent in and out of hospital with mental health. “People didn’t know how to handle it – they just stayed away.” While the profile of mental health is on the rise thanks to celebrities like actor Stephen Fry and author Matt Haig and the young Royals, those with mental health issues still feel physical health problems are much more socially ‘acceptable’. The Royal College of Psychiatrists has launched a range of ‘get well soon’ cards specifically for people who are unwell with mental ill health. The cards designed in collaboration with service users, carers, psychiatrists simply say: “Thinking of you at this time. Hope things improve soon.” TV star Tricia Goddard is supporting the campaign. She recalls her own experience
When I had to have a mastectomy… people commented on how brave I was. No-one has ever told me how brave I am to endure all these years of mental ill health. Sally, member of the Royal College of Psychiatrists’ Service User Recovery Forum
of “feeling invisible because people avoid you. It rubs salt into a wound, which sometimes takes a long time to heal. A card can help you deal with the pain; whether the hurt is in your heart or your head.” Consultant Psychiatrist Dr Arun Chidambaram says health professionals should look across boundaries and treat both mental and physical health problems at the same time. “In the past if someone turned up at A&E with a physical injury, but showing signs of mental distress they might be treated for their physical symptoms. Equally we in mental health can rely sometimes heavily on general hospitals to manage physical health symptoms.
Dr Arun Chidambaram
We’ve made great progress in the way we think and do things. We have mental health liaison nurses in A&E and we are finding ways to support people on our wards who have a physical health problem. But there’s still scope to increase the access and the experience of receiving care for people with both mental health and physical health issues.” This different way of thinking – which puts the Trust at the forefront of development, includes recruiting a new ‘breed’ of healthcare worker– a physician associate with a ‘mixed’ skill set who takes a holistic approach, caring for the physical wellbeing of patients while they are on acute mental health wards. They can give pain relief, conduct basic tests and procedures such as IV fluids. The concept was developed in America to give staff more time with patients. Dr Chidambaram “Being physically unwell can worsen someone’s mental condition and lead to longer hospital stays. For the patient, having someone who sees them every day and can do things to make them feel physically better, all contributes to recovery and getting out of hospital quicker. Every contact counts and this is the type of contact everyone should have.” Meet the Trailblazers page 27. RCP cards come in two striking and colourful designs. Inside the greeting reads: “Thinking of you at this time. Hope things improve soon.”
MEET THE TRAILBLAZERS Mary-Anne (left) and Kimberley are physician associates.
ary-Anne Feely found herself doing ‘textbook‘ stuff after graduating in Anatomy. During a spell as a sexual health advisory clinic worker she realised she wanted a role with patient interaction. She and orthotics graduate Kimberley McGhie (pictured right) took up a place on a two year postgraduate physician associate course sponsored by Mersey Care, followed by six months mental health training on a ward.
Now the pair are trailblazing the role – Mary-Anne at Rathbone Low Secure Unit and Kimberley at Broadoak Unit. Mary-Anne: “We act as a link between clinicians, dieticians, therapists and the service user for that person’s overall wellbeing. Being based in one place means we’ll have time to get to know people, see how they are each day and pick up on any issues. It’s little things like helping them keep appointments which often goes by the board when someone is unwell.”
Kimberley sees the role as one of ‘listening to people’s stories and gaining the trust’ of people who don’t always understand the impact of being physically unwell on their mental health. “Communication is really important and that takes time. People value someone explaining why they might feel unwell and what can be done to help. That’s where we come in.”
I’M WAITING FOR IT... THAT
GREEN LIGHT Research shows that staying in hospital too long can have dire consequences on someone’s wellbeing – and their life. Sarah spent 10 years in and out of mental health wards.
Someone messaged me on Facebook from high school recently asking what I’d been up to. Do I say ‘life’s passed me by’? The problem with being in hospital for a long time is that the only people you’re around are other people who are ill. I first went in when I was 17. My mum had died about six months earlier. I’d had a bit of a messed up childhood. By the time I was 13 I was really depressed. By 17 I was self-harming and suicidal. I’ve lost count of how many times I’ve been in - I stopped counting at 15. There’s a part of me that’s thankful that I was admitted. They kept me safe until my crisis had passed. But you forget what life is like outside. It took away my youth. I should have been out with my friends and at college.
You spend so much time with people who are in very dark places. You’re both drowning and trying to save each other.
I had a dog – I absolutely loved that dog – but there was nobody there to take care of him when I was in hospital. The longer you stay, the more the outside world stops being a real place. When you have to face it on your own it can be overwhelming – it crushes you. I’ve lost so much. Because I wasn’t around I lost my
tenancy. I had a dog – I absolutely loved that dog – but there was nobody there to take care of him when I was in hospital. I know there are times when you need to be in hospital, but you need to be discharged when you’ve recovered. You’re stronger then, you’re in a good place. If you’re kept in for too long, well the cycle moves on. You dip again, you lose your strength, your ability to cope. You’re discharged eventually but you know it won’t be long until you’re back. I’d say ’let me go when I’m ready, not when the system’s ready – when I am’. You can watch Sarah’s full real life story on Mersey Care’s YouTube channel. Sarah is played by actress Vickie Gates (pictured here.)
Every morning at 9am the men and women on Mersey Care’s Intermediate Care Unit at Aintree hospital are visited by a nurse and advised what will be happening that day – it could be therapy to help them make meals when they go home – or support to get their mobility back that is easily lost after illness or injury.
ither way they’ll know exactly the plan – and so will everyone on the ward. It’s known as Red to Green. On the ward’s patient board is a red dot. By 3pm that day the team aims to have discussed every patient’s needs and acted on it, hopefully replacing the red dot with a green one to prove they’ve helped that patient take a step closer to their goal of recovery and going home safely. It’s happening in mental health wards too, as part of a wider plan to help people leave hospital when it’s right for the patient, not the system. The approach has already been held up as a national example of good practice in Parliament. Michelle Fanning is Head of Clinical Operations with the Trust. “Being in hospital takes you away from your normal life. If someone’s medically ready for discharge but for some reason stays longer, they can actually become less well. They can get infections, they start to lose their confidence, we helped them build up their health and wellbeing as well as their independence. You can see their mood change. It’s not right that someone should be sitting round for days waiting for scan results, or a prescription to be dispensed, so we make sure all that happens well ahead of discharge. Sometimes the circumstances are outside our control but our view is that every day is vital –
It’s making a huge difference to people’s lives – I’m proud as punch. we want every day possible to be a green day.” Naomi Morgan, Inpatient Lead Nurse at Worcester Health and Care Trust agrees: “It’s heartbreaking to see someone who has got so well waiting on your ward, go full circle and then they’ve broken down again, they’ve become unwell, back to where they were. You feel it’s your fault, that you haven’t identified the barriers to them going home.” Pat McGuinness, Deputy Director of Integration said the approach also helps staff. “They can focus on what’s important to the person they are caring for; and resources are deployed where they’re needed most.” Isn’t it another way of overcoming what some describe as ‘bed blocking’? And what about patient safety?
Michelle Fanning: “Red to Green is not about discharge at any cost. Safety is everything. We want to support someone in whatever they choose, but it has to be safely implemented.” The team at Aintree has joined forces with Sefton’s Community Integrated Care Team, Urgent Care and the Community Therapies team to form ICRAS (Integrated Community re-enablement assessment services.) Michelle: “Integrating all the services means that when someone is ready to be discharged, we’ve already liaised with our community nurses and therapists to create a robust plan for what the person needs to continue their recovery at home. We ask ourselves, if I was in the last 1000 days of my life, would I be prepared to waste three of them waiting for test results, medication to be dispensed or transport to get home? It’s making a huge difference to people’s lives – I’m proud as punch.”
We want every day possible to be a green day.
I’m 85 and I live on my own. I go to social
support. They came out for around a
clubs and shopping with my son in law but
month to help me settle back in. It was all
I fell and went to the intermediate care ward
the same things I had in hospital but I was
for rehabilitation. I was ready for home after
able to sleep in my own bed and get back
seven weeks, I was a bit nervous but they
into my old routine.”
reassured me I’d still have the same
I’LL BE UNTIL THE DAY I DIE 30
As the National Health Service turns 70 a family with a legacy of working in the NHS talks of the highs, lows, challenges and joys of a life of service…
ita Davis worked in an office until she was 21 because her family didn’t want her to go into nursing. “It’s all I can remember ever wanting to do. I loved everything about it.”
After training in London and Edinburgh she became a general nurse in 1964, working at Belfast’s Royal Victoria Hospital at the height of the troubles. As a psychiatric nurse she met and married Dennis, a former farmer who’d gone into nursing ‘out of necessity’. “As a soldier I’d been stationed in Northern Ireland. I was from a farming family so I stayed to become a farmer, but it was a
struggle making ends meet. I saw an advert for student nurses at the local psychiatric hospital – and that was the start of a wonderful career.’ The 87 year old former nursing officer has since turned his memories into a book. “In 1956 I earned £23 a month for a 48 hour week. Psychiatric wards were overcrowded with four nurses caring for 48 patients; toilet and bathing facilities were spartan.”
change and moved north to Southport, working at a new innovative child psychiatric unit, then Greaves Hall Hospital. Rita, now 75, worked in mental health hospitals across Southport and Liverpool, graduating in Health Studies, retiring at 70. She recalls only happy memories of their combined 82 years of service.
This institutional approach to mental health changed in the late 50s with more emphasis on rehabilitation. Dennis embraced the
There’s a sense of camaraderie in nursing.
FROM THE CRADLE TO THE GRAVE –
HAPPY 70TH BIRTHDAY NHS The war had not long ended when Health secretary Aneurin Bevan launched the NHS, a hugely ambitious plan to bring good healthcare to all.
or the first time, hospitals, doctors, nurses, pharmacists, opticians and dentists would be brought together under one umbrella organisation, to provide services that are free for all at the point of delivery. The service was to be based on clinical need not ability to pay, and financed entirely from taxes. Since then diseases such as polio and diphtheria have been eradicated, the NHS has pioneered treatments like the world’s first liver, heart and lung transplant and more recently bionic eyes to restore sight. The 1959 Mental Health Act established that community care should be prioritised and that
patients with mental ill health should not be considered any different from other types of sick people. Today genetics are playing a major role in preventing disease, but it all started in 1952 when two Cambridge University scientists, described the structure of a chemical called deoxyribonucleic acid (DNA) in Nature magazine. • The nation is gearing up to mark 70 years of the NHS with events across the country. To find out how to get involved in your area go to nhs70.nhs.uk or look on your local NHS organisation’s website.
DID YOU KNOW... the NHS shares its birthday with the first supermarket, opened by the London Cooperative Society, and the first post war Olympic Games, known as the 'Austerity Games' because rationing was still in force in Britain.
For Mersey Care events go to merseycare.nhs.uk
Speech and language therapist Clare Grace provides vital support for patients like Phil Jamieson, whose speech has been affected by a stroke. The team supports people with dementia, multiple sclerosis, motor neurone disease and head injuries, and those with eating and drinking disorders.
COMMUNITY HEALTH SERVICES IN LIVERPOOL
Being physically well affects your mental wellbeing. If you live in Liverpool your physical health services, previously provided by Liverpool Community Health NHS Trust are now being offered by Mersey Care.
ur community teams help people to be more independent and live longer, healthier lives. Personalised care packages developed with our partners, support people to maintain their independence. Our staff include nurses, community matrons, health visitors, dietitians, podiatrists, physiotherapists, occupational therapists and speech and language therapists. Services also include dental health care, therapies, medicines management and a nutrition and dietetics service. Thriving partnerships with colleagues across the NHS, social care, education, charities and local government, help us provide services such as health education, school nurse services and sexual health services.
We support people in their own homes and at locations across the city, including health centres, clinics and four walk-in centres. We work closely with patients’ families and carers to understand their wider needs and help them better understand how to prevent and detect problems early, and about self-care. You can find details of all these services at merseycare.nhs.uk
Improving people’s dental health is a key service, particularly for people in areas of high deprivation, or those who can’t access high street dentists. In her 33 years’ service dentist and Clinical Director Nicola Marshall has treated several generations of the same family.
Our community teams help people to be more independent and live longer.
We support people in their own homes and at locations across the city.
Community physiotherapist Niamh Hansberry supports people to recover from serious illness, like Kathy Jackson who became ill with sepsis. After months in intensive care and a hip replacement, Niamh is guiding Kathy through therapy to help her become mobile.
A DAY IN THE LIFE...
I’m often the first person patients and families see.
LUSU SMEE RECEPTIONIST
BROADOAK (ACUTE MENTAL HEALTH) UNIT Our wards are for people who need to come into hospital because they are too unwell to stay at home. I’m on reception so I’m often the first person patients and families see.
came here through an agency two years ago and I can honestly say I’ve never once felt like I didn’t want to come to work. Every day is different. A lot of people are scared when they come here; they don’t know what to expect. It’s so rewarding to think that what you do can affect what happens next. A couple of weeks ago a family member came in distraught and anxious because his wife had been admitted. He mentioned he was really cold, so I offered him a cup of tea. I listened to what he had to say
and he seemed better afterwards. When his wife got discharged and they were leaving he stopped to say he appreciated the support. Our reception can be very busy. You need to be able to respond quickly whether it’s phones ringing, people at the counter, staff needing information or alarms going off. I’m naturally calm, so that helps. I’ve just completed suicide awareness e-learning training; it helps you to talk to someone who thinks their life is not worth living.
You don’t always get to know that what you’ve done makes a difference, but today I got the chance to say goodbye to a man who’d come in a few weeks before and shared with me how bad he was feeling. I managed to get staff from our access team to see him. He came back with his dog and he was smiling. It made me happy. The agency offered me two job options - here or a hotel. I think I made the right choice…
COUNCIL OF GOVERNORS
THINKING Sara Finlayson started work as a clinical psychologist in the late 1980s. “People with severe mental illness still lived in asylums with long dark corridors and dormitories. I was 21, but looked about 12. All I knew about these people were their labels – I was shocked and scared. But I loved talking to patients back then; I still do.
I believed we could better help people progress out of hospital.
OUTSIDE THE BOX
worked in some very deprived areas and I quickly realised that so many of their problems were related to the environment and that unless systems that supported them changed, recovery would always be difficult. When I moved to Liverpool in the 1990s I had a caseload of 50 patients. Some had been on the wards for years; I realised the best way to help so many people was to try to influence colleagues to think about people’s environments and experiences, and the profound effect external factors could have on their sense of wellbeing, values and symptoms. If we understood someone’s behaviour and symptoms from their perspective rather than merely that of a label, I believed we could better help people progress out of hospital, and avoid relapse and readmission.
To learn more about our council of governors, go to merseycare.nhs.uk
So when we were planning a new low secure unit at Rathbone Hospital 15 years ago we brought in architects who thought ‘outside the box’ – a bit like psychologists do. Having opening windows for people in a secure mental health unit was unheard of. They designed windows that opened in a way that was secure but gave patients fresh air whenever they chose; the design is now used nationally. We learnt a lot about how to make people’s living spaces conducive to recovery and it’s now a fundamental part of new builds. If we are to improve things for patients we need a supported staff group and a functioning ‘system’. Staff work so hard to preserve their patient’s identity, and to understand what recovery truly means for that person. Sometimes working with people experiencing distressing symptoms and behaviour linked to previous trauma, is very difficult. Being compassionate can mean putting their own issues on hold. As a governor I want to represent them, to speak up for them. I could never have done that at 21, but I can do it now...”
Because ONE life lost is ONE too many
IT’S TIME TO TALK...
SUICIDE Over the course of a year 6,188* people died by suicide in the UK, that’s nearly 17 people EVERY day.
Because ONE life lost is ONE too many *
Save a life, take the training. Find out what you can do at zerosuicidealliance.com
Source Samaritans Suicide Statistics Report 2017
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