MC Magazine - Winter 19/20

YOUR COMPLIMENTARY COPY

MAGAZINE

MC

Winter 2020

I WILL SURVIVE

coping with stress

All change on allergies

Beat winter blues

Alcohol and brain injuries

MC

MAGAZINE

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INSIDE...

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AFTER THE EVENT Post traumatic stress disorder can affect anyone.

I THOUGHT I’D BECOME A MONSTER

3 WELCOME 4 I THOUGHT I’D BECOME A MONSTER 6 LOST IN MUSIC 8 MORE THAN A HANGOVER

The misunderstood condition that affects new parents.

11 AFTER THE EVENT

7LOST IN MUSIC

After suffering crippling anxiety Charlotte is on a high note.

Can music be truly therapeutic?

15 PUPPY LOVE 18 COVER FEATURE: WINNING THE STRESS BATTLE 22 STAY WELL THIS WINTER 26 ARE YOU SITTING COMFORTABLY? 28 ALL CHANGE FOR FOOD ALLERGIES

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THE HIDDEN TRUTH

Heavy drinking can cause brain injuries, yet they often go undetected. We talk to the specialist team helping vulnerable people to get the help they need.

MC magazine team: Managing Editor: Steve Murphy.

Editor: Jackie Rankin.

30 CAN YOU BE SOBER AND SOCIABLE?

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PUPPY LOVE Why a pet is therapeutic – and why it’s so painful when we lose them.

Contributors: Diane Cooke, Jo Henwood.

Editorial: Julie Crompton.

Photography: Rick Gem, Joel Goodman, Matt Goodfellow, Steve Murphy.

Freepix.com, Pixabay.

Design: Jo Hadfield.

32 PREVENTING SUICIDE – THE MAYOR SPEAKS OUT 34 DAY IN THE LIFE 35 MEET YOUR GOVERNOR You can contact us at: communications@merseycare.nhs.uk MerseyCareNHSFoundationTrust @Mersey_Care @MerseyCareNHSFT

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MEMBERSHIP AND GENERAL DATA PROTECTION REGULATION The GDPR is the General Data Protection Regulation, a European-wide law, which governs how organisations can collect, use and transfer personal data. It came into force on 25 May 2018 alongside the new Data Protection Act 2018. As a Foundation Trust, Mersey Care has a statutory requirement to develop and maintain a membership and it is necessary for us to process our members’ personal data to perform this task. Our members are drawn from the public, people who use our services or care for people who use our services and staff. We request and securely hold data on our members, which they provide when joining our membership.

The data we hold on our members enables us to show that we are representative of the community we provide services for, to keep members updated through our quarterly MC Magazine via email or post and to invite all members to the Annual General meeting. We also engage with all members advising when the election for governors will be taking place, giving members the opportunity to nominate themselves to become a governor and to vote in elections for the council of governors. Should you no longer wish to be a member of Mersey Care please email membership@merseycare.nhs.uk with your details or call 0151 471 2303 asking that your details be removed.

WELCOME D

id you make resolutions earlier in the year? We did, and already good intentions are slipping.

Why do we pile on the pressure?

Sometimes we have no choice – our feature looks at how actress Suranne Jones changed her lifestyle after buckling under extreme stress. We talk to a psychiatrist and realise that it happens to the best of us. And we offer ways to stay well when stress is unavoidable.

Getting a pet – or at least having one at hand – can be an antidote, as we found out when we met therapy dog Lily and some of those whose lives she touches.

In this issue we were also privileged to talk to people who have battled with the aftermath of a trauma.

We met a mum whose joy in giving birth was followed by terror and despair when

she developed obsessive compulsive disorder. Women are at most risk during or after pregnancy yet many are too ashamed to seek help. Find out more on page 4.

Dietitian Nina Halsall gives tips for staying upbeat and well through the darker months. Her recipe is perfect for a cosy night in.

For coeliacs like Jo Henwood dining out can end with a sick bucket – and there’s not a tequila in sight! We hear about changes to the law that will put an end to hidden allergens in food chains.

Finally back to resolutions – if yours involved giving up alcohol, a new book tells you how to keep your plan, and your friendships, going strong.

Embrace winter and enjoy this issue.

The MC editorial team.

It’s time to embrace winter.

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Nicky with Paul and baby Evie

I THOUGHT I’D BECOME A MONSTER

For Nicky, the joy of a healthy baby girl was replaced by distressing intrusive thoughts about harm coming to her daughter. MC Magazine explores maternal obsessive compulsive disorder (OCD), a common and debilitating anxiety disorder.

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lmost all of us have had unwanted thoughts or even sudden violent or offensive mental images. It could be ‘what if I drive into the central reservation’?

When people with OCD experience these intrusive thoughts or obsessions, they feel compelled to respond by performing repetitive actions, either physical or in their head, as a way of alleviating the anxiety and to prevent danger.

Recent studies suggest women are most at risk when they’re pregnant or after they’ve given birth. Their intrusive thoughts can often relate to the child. The mother may worry about her baby coming to accidental or deliberate harm, for instance dropping the baby down the stairs, or baby suffocating.

OCD can also affect fathers.

Libby Chamberlain is a psychologist with Mersey Care’s perinatal mental health team which works with mums (and dads) with this type of OCD.

“Having a new baby is a massive responsibility and the outside world can appear a dangerous place. The maternal brain is already programmed to the potential hazards to the newborn. There’s also lots of new advice to absorb. All this can lead to a pattern of increasingly anxious intrusive thoughts.

People may respond to the distress of these thoughts by developing compulsive mental or physical actions to try to alleviate their fear.

They can spend so much time performing these actions that they don’t have time to enjoy the baby.”

WHY MIGHT OCD DEVELOP OR WORSEN DURING PREGNANCY AND AFTER GIVING BIRTH? Experts say there could be several reasons; hormonal or biological influences, the impact of transitioning to a new role and an increased awareness of potential threat and responsibility as a parent to prevent danger to the child.

Getting early help is important. Parents can be referred by a health professional, or self refer, to talking therapies close to where they live. The perinatal mental health team works directly with people with moderate to severe complex perinatal mental health issues.

Says Libby: “The shame of having these thoughts can prevent people coming forward for help; it’s important they know it’s not them, it’s the condition. With help they can regain control of their thoughts so they can go back to enjoying their baby.”

GET HELP • If you think a friend or family member may have OCD, try talking to them about your concerns and suggest they get help • Talking therapy services in Sefton are provided by Access Sefton: insighthealthcare.org (search Access

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Sefton) and in Liverpool by Talk Liverpool: talkliverpool.nhs.uk

• Referrals to the perinatal mental health team are via a health professional e.g. GP, health visitor or midwife.

It’s important they know it’s not them it’s the condition…with help they can regain control and go back to enjoying their baby.

NICKY’S STORY “After a very long labour I was elated when Evie was born. The first few days were amazing, Paul my partner is great, we have a good home life, and everything was perfect.

I

was so excited to have her that even when she slept I’d stay awake. Looking back I didn’t give myself enough time to recover from the birth. I was breastfeeding and she was constantly hungry. After three days without sleep, exhaustion set in.

I started having thoughts about something bad happening to her. What if we had a car crash? What if I fell downstairs holding her?

SPECIAL FEATURE FIND OUT MORE • Maternal OCD, a charity founded by two mothers who experienced and recovered from extreme perinatal obsessive compulsive disorder: maternalocd.org • Stories of recovery, including an account of his own OCD by dad Ashley Curry on the Maternal OCD website • Fiona Challacombe’s Breaking Free from OCD • Dropping the Baby and Other Scary Thoughts by Karen Kleinman • Postnatal Depression by Michelle Cree, a supportive book to help new mums on their journey into motherhood.

SIGNS AND SYMPTOMS OCD symptoms include: • obsessions – where an unwanted, intrusive and often distressing thought, image or urge repeatedly enters your mind • emotions – the obsession causes a feeling of intense anxiety or distress Psychiatrist Libby Chamberlan supported Nicky.

As I became increasingly sleep deprived, the thoughts became more intrusive and distressing.

What if someone sexually assaulted her?

I was having awful thoughts about my own baby. I couldn’t change her nappy or bathe her, I was in fear. What if sexual thoughts came into my head? I thought I had become a monster.

I’d stopped eating, I couldn’t talk. After 12 days I begged Paul to take me to A&E. I thought it would be better to kill myself – I didn’t want to die but I wanted the baby to be safe.

They were amazing; they assured me she wasn’t in danger. The mental health crisis team came out over the weekend and then the perinatal team quickly took over and diagnosed Perinatal OCD. Within a day I’d been assessed, prescribed medication,

allocated a care coordinator, and referred for psychology. They took me seriously, explaining that it’s the condition and that they’d help me.

Paul cared for Evie and I stayed with my mum – I had never experienced anything like this, the thoughts were overwhelming. Gradually I moved back home and I was able to slowly do more and more with my baby girl.

I’m so far on now – I wanted reassurance that I wasn’t bad, and I got it. There isn’t a quick fix, it’s gradual. You go through a period of having the thoughts, but the team helped me to recognise that my thoughts were part of the OCD and we worked together to manage it.

I’d say to someone in my situation “don’t wait, get help – talk to someone before making any decisions. It’s not you it’s the condition and you will get better”.

• compulsions – repetitive behaviours or mental acts that a person with OCD feels driven to perform as a result of the anxiety and distress caused by the obsession.

Maternal OCD usually (but not always) revolves around significant fear of harm coming to the infant, with worries frequently focused on accidentally or deliberately harming the child or the child becoming ill. Depending on the worries, this could involve compulsive behaviours such as cleaning, praying, rumination or avoidance of activities or even of spending time with the baby. In this way the thoughts and behaviours can interfere significantly with their wellbeing and their experiences of pregnancy and parenting. It is the extent of and response to the worries, rather than just having them that becomes the problem.

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Music is proving to reduce levels of depression and anxiety – and relieve pain.

LOST IN

MUSIC Music can affect us in so many ways. It can make us happy, or sad. It conjures up long forgotten memories. It sends us to sleep, wakes us up and helps us relive experiences. So it’s little wonder that harnessing the power of music has fascinated scientists and psychologists for decades.

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ut music is also proven to reduce levels of depression and anxiety, relieve pain and breakdown social and cultural barriers.

In hospitals and community healthcare settings listening to Iive music – and joining in – can improve the emotional wellbeing of patients.

Jess Ingham is Area Director for Music in Hospitals & Care, which works with 150 musicians at hospitals across the North West, including in dementia wards at Mersey Care’s Mossley Hill Hospital.

Musicians stay to chat afterwards, allowing people to express how the music has made them feel, or the memories it has evoked.

Jess says music is particularly powerful for dementia patients, helping them to focus, reminisce and engage with others.

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“It really is wonderful to see the impact a song like ‘Danny Boy’, that everyone knows, has on people.”

Caoimhe Daly, Occupational Therapist at Acorn Ward agrees.“We’ve found during and after concerts that patients’ agitation levels appear to reduce significantly and there is an overall calming feeling on the ward.”

Patients’ agitation levels appear to reduce significantly.

Jess also sees how live music helps communication between health and medical staff and patients. It simply brings everybody together.

Mersey Care Senior Recovery Learning Facilitator Iain Till has seen ‘profound and significant’ improvements in the wellbeing of some of the people taking part in music appreciation courses he runs at The Life Rooms.

“It’s fantastic to watch someone’s confidence grow. It builds self-esteem, helps to control anxiety and stops people feeling isolated because they’re part of something, it’s an entertaining distraction,” says singer songwriter Iain.

His 10 week ukulele course has not only proved popular, it’s also changing lives.

(Read Charlotte’s story on page 7).

“The ukulele is a tactile instrument and pretty easy to get around. Many people are embarrassed when they first start, but they soon overcome that and improve steadily over the weeks. It’s good to see everyone coming together and playing as a team.”

He says the course has also led to new friendships. “It is a totally bonding experience.”

• Find more on Music in Hospitals & Care: mihc.org.uk • Learn about courses at Life Rooms: liferooms.org

Charlotte plays the ukulele. Quite well actually.

She’s sometimes asked to lead the uke group at Southport Life Rooms. It doesn’t faze her.

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et six months ago even speaking to new people would have crushed the 34 year old. She’d suffered depression and lack of confidence since childhood and found it hard to give her trust. Teachers did their best but she struggled through school and college.

“I couldn’t open up to anyone. I put on a brave face and told people what I thought they wanted to hear, but I was in a bad place.”

Supported by Recovery College Manager Jackie Pearson, Charlotte gradually began to take part in courses and activities, including a beginners ukulele group. She flourished. “I realised other people there were in the same boat. It lifted my mood.

I started to have more up days than down days.”

But it was when tutor Iain Till was looking for someone to lead the group in his absence that Charlotte came into her own.

She walked past The Life Rooms many times, until her uncle suggested she went in.

She is now a volunteer, helping other people make the same journey she did… and hitting the same high note.

“I wanted help, I wanted a better future, but I couldn’t even speak when I first went. I was a nervous wreck.”

“I was so scared but I thought ‘why not?’

Two years ago I couldn’t speak, now I’m teaching people. I feel really good.”

REAL LIFE STORY I realised other people there were in the same boat.

RESOURCES • Meetup offers special interest groups near you – meetup.com • Making Music groups – makingmusic.org.uk • Life Rooms runs an ongoing timetable of courses in Bootle, Walton and Southport – liferooms.org

Life Rooms Ukulele group

Playing music lifted my mood.

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There’s sometimes a perception that the drinking is a lifestyle choice.

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Dr Catherine Shippen, Consultant Clinical Psychologist at Mersey Care’s Brain Injury Rehabilitation Unit.

MORE THAN A HANGOVER It’s a common sight in A&E – the clearly intoxicated patient, who is assessed, treated and discharged, yet comes back again and again.

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ut there’s more to this scenario than meets the eye. One in three people who drink to excess have alcohol related brain damage. It impairs their memory and decision making, and stops them sticking to programmes that could help them abstain. Family relationships break down when their loved one seemingly ignores all help.

One in three people who drink to excess have alcohol related brain damage.

keep up the treatment, they don’t keep up with appointments and lapse from programmes. They begin drinking again and end up back in A&E and the cycle continues.

“Because they appear normal there’s sometimes a perception that the drinking is a lifestyle choice, that the person is taking up valuable NHS time, yet doing little to help themselves.

They become stigmatised, excluded and exploited. The reality is that they don’t have insight into their situation.”

The challenge facing acute staff is to work out what the person needs during an often short hospital stay.

While many go home, some need more support.

Mersey Care’s Brain Injury Rehabilitation Unit’s specialist team assesses and treats complex patients on a sustained intensive programme to help them understand and manage their difficulties.

Both teams try to establish the triggers for someone’s drinking so they can find ways to meet not just their medical needs, but link with agencies to address housing, benefits and other aspects of their life that may have contributed to the problem.

CONTINUED OVER

Jenna Simons is an occupational therapist with Liverpool University Hospitals NHS Foundation Trust.

“These patients go through detoxifications, medications and discharge to community alcohol programmes. But because

the brain injury affects

their memory and

cognitive capacity to Jenna Simons occupational therapist .

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FEATURE

Bringing together different teams with complementary skills is changing the way these patients are supported.

Consultant liaison psychiatrist Dr Cecil Kullu

They work together to make other services more aware of the impact of an alcohol related brain injury and to highlight the need for more specialist community services. They also work closely with families to explain the reason for the person’s behaviour.

Dr Catherine Shippen, consultant clinical psychologist at the Brain Injury Centre says by the time they are diagnosed both the person and those around them are often at crisis point. It’s a challenge for staff as recovery can be slow, but they’re determined that people should have the chance to reach their full potential.

“Families are angry and frustrated; they’ve tried everything, yet the person appears unwilling to change. Explaining the impact of the brain injury, particularly memory loss and lack of insight, can help.”

Referral numbers are rising – and the team is seeing a big increase in people as young as 30. Dr Shippen calls for more awareness of alcohol related brain injuries.

“We talk a lot about liver damage from alcohol abuse, but few people are aware that drinking heavily for a long time can cause a brain injury.”

• Alcohol Change has a fact sheet: Alcohol related brain damage: what is it?

Alcoholchange.co.uk

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Consultant liaison psychiatrist Dr Cecil Kullu says the condition can dramatically reduce life expectancy. “Alcohol affects all the organs.

Because the brain damage prevents people seeking help, they often go on to develop serious alcohol related problems such as strokes and cancers. It’s very sad”.

He says bringing together different teams with complementary skills is changing the way these patients are supported.

Alcohol affects all the organs.

“For example, having the expertise of an occupational therapist to identify problems in the way someone functions that might indicate a brain injury is invaluable. It means people get the right treatment and the best chance.”

SIGNS AND SYMPTOMS Cognitive and memory problems include: • memory loss

• erratic behaviour and mood swings • difficulty concentrating.

• difficulty in familiar tasks • problems processing new information • poor choices and decision making

Physical problems include: • damage to the liver, stomach and pancreas

• depression and irritability

• pins and needles or numbness in arms and legs

• poor judgement and loss of inhibition

• slow wide stumbling gait

• problems with language, remembering words or the names of friends and family, or problems like forgetting the end of a sentence halfway through

• poor temperature control, muscle weakness and disturbed sleep patterns.

For more information go to alcoholchange.co.uk or NHS.uk

PTSD FEATURE

A song, a smell or a photograph are powerful reminders of times gone by.

They can give comfort, make us smile.

But when that memory is painful we shut it out – or do we?

AFTER THE EVENT Peter Owens was 21 when he was caught up in the Hillsborough football disaster. The trauma he experienced in the years afterwards took him to the brink of suicide.

T

herapist Jane Walker supports people like Peter, who have post traumatic stress disorder. (PTSD) Although it’s often associated with the armed forces community, the condition can affect anyone.

Symptoms vary but include: avoiding situations that remind you of the incident, a need to constantly check that you’re not in danger, being easily startled, recurrent upsetting dreams and self blame.

PTSD happens when someone has experienced a situation where they felt a threat to life or intense danger to themselves or someone else. Road traffic accidents, childhood abuse, life threatening illness and traumatic life events can all leave people with flashbacks, nightmares, intrusive thoughts that never go away.

Jane, a high intensive therapist with Talk Liverpool, uses trauma focussed therapy to give people an alternative way of understanding and normalising their reactions.

“When we experience severe trauma we try to block it out, to repress it. But that memory gets stuck in your mind, then is triggered by music, something on TV, a news item maybe.

With PTSD the memory comes back not in the past, but – often terrifyingly – as if it’s happening now.”

“People who have escaped a major incident or near death experience, or watched a horrific event and survived may have massive guilt. They may feel they shouldn’t have survived, or done more to help others. They may become convinced the event will happen again.

“When the memories are unbearably painful people block them out and for years they can present a front that everything is OK. But it doesn’t work – they have nightmares, flashbacks, often triggered by sounds or smells, happening

when they least expect it and re-traumatising them. Flashbacks take you right back and focus on the scariest bits. You have no sense of reality. It’s incredibly distressing.”

“In trauma focussed therapy we look at the person’s memory of their trauma, and their beliefs about their experience. We work with them to find a new way of thinking about what has happened, and help reduce feelings such as guilt and anxiety that the memories evoke.”

Jane doesn’t promise an easy ride and successful therapy requires commitment from the client, says Jane. “It will only work if someone sticks with it, but it happens in a controlled environment and it gets easier.

We can’t erase the memory but we can help them process it and learn to cope with it.

They’ll still have the memory but it’ll be in the past.”

Read Peter’s story on page 12.

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REAL LIFE STORY

PETER’S

STORY

MY FAMILY BEGGED ME TO GET HELP

PTSD? Talk to us

PTSD is an anxiety disorder caused by traumatic life events.

Need help?

You can refer yourself online by visiting talkliverpool.nhs.uk or calling 0151 228 2300, alternatively you can be referred by your GP or another health professional.

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ack in 1989 when he and his friend joined the queue at the Leppings Lane entrance of Hillsborough football ground for the Liverpool match against Nottingham Forest Peter Owens was young and high on life.

In the horrific events that followed, one that claimed 96 lives, he pulled some people from the crowds but was unable to reach others.

Peter was only slightly injured – on the outside.

“I remember a social worker coming to the house afterwards. I didn’t say a word. I thought if I didn’t talk about it I couldn’t be affected.

My family always knew something was wrong. Deep down, I knew too.

“Thoughts would come into my head that would stop me in my tracks. It was as if it was happening again rather than a memory.

The song ‘Eternal Flame’ by The Bangles was a big trigger. It was the first song I heard on the way back home after Hillsborough – I’d constantly worry in case it was played somewhere. I’d look for exits in case it came on and I had to get out.”

Peter turned to alcohol to blot out the thoughts. I was drinking to forget but everyone around was affected. “My family begged me to get help. But this was my baggage; surely it was a sign of weakness if I told people I had all this stuff going on in my head and mind?”

One night in work things came to a head.

“I was in work one night, by myself. The thoughts kept coming, I couldn’t remember the last time I’d had a night’s sleep. I thought ‘I’m hurting people I love. I could hang myself from a door here and no-one would find me for a while’. But then I thought about my kids – they mean everything to me. I’d lost my own dad at 14. Plus I was too much of a coward.

“It made me realise if I didn’t sort myself out, I could potentially push away everyone who cared about me”.

The call to Talk Liverpool was the first time he’d openly admitted to needing help.

Embarrassed (he broke down during his telephone assessment), and consumed by anxiety he’s also open about his scepticism.

“When I saw that the therapist was around the same age as my daughter I wanted to turn round and leave. I thought ‘how can I open up to someone so young?’, but I was completely wrong.“ Therapist Jane Walker diagnosed post traumatic stress disorder (PTSD) and suggested cognitive behavioural therapy.

She warned the therapy would involve Peter reliving his experience over and over again.

“I dreaded it, I’d come out with my chest feeling crushed, like I’d been punched in the stomach. It was exhausting but a massive relief.”

Jane invited Peter to write a script of his experience to record and play out.

“It was the hardest thing I’ve ever done.

I went back there, explaining why things happened the way they did. Jane was responding, not judging, just offering an alternative way of thinking about it. She told me that I couldn’t have done any more than I did.

“Dealing with that script was the point when I knew the therapy was working.

I’ve come way further than I ever thought I could. The thoughts are still there and they still scare me, but Jane taught me to think about them in a different way, as a life experience, in the past. To believe I can cope.

What I also believe is that she saved me...”

POST TRAUMATIC STRESS Support for you

• Help yourself – our self help guide on PTSD can be read online, downloaded or watched as a video.

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PTSD FEATURE

WHEN

TRAUMA

FOLLOWS

ILLNESS

Coming close to death through a medical illness can cause its own PTSD like symptoms. In fact, new research estimates that it occurs in up to a quarter of cases.* Here and over the page we reveal how near death experiences have affected people’s lives.

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teve Murphy (above and left) is head of communications at Mersey Care NHS Foundation Trust and was recently ordained into the Church of England. He was diagnosed with Guillain-Barre Syndrome in March 2019 and is still suffering PTSD. “It began one evening with numbness in my arms and legs. The next day at work I had no strength. I was walking like the Tin Man; I couldn’t even hold a pen. Colleagues took me to A&E where they immediately suspected Guillain-Barre a rare and potentially life threatening condition.

“They wanted to start treatment immediately.

I thought it was a massive overreaction. It was only when I was taken to a high dependency ward at Aintree Hospital and sized up for a ventilator that I realised how serious things were.

“They told me my immune system was attacking my body and destroying nerve pathways. They feared it could move quickly to my heart and lungs. I became tremendously weak, vulnerable and dependent. My sense of self disappeared very quickly.

“Things slowly stabilised, and I was discharged from hospital but a few weeks later, I had horrible feelings of depression and hyper-alertness.

I was like an emotional meerkat, constantly on the look out for danger. I lost confidence, found myself crying for no reason and I’d wake up shouting from really vivid nightmares of being attacked or chased.

*www.mdedge.com/psychiatry/article/138435/depression/illness-induced-ptsd-common-understudied

Doctors told me I had medical PTSD. It seems that my physical illness had upset the chemistry of my brain. As it caught up with my physical illness my brain was realising the threat that my body had been under.

“PTSD sucks the joy out of everything. I’d spent four years training for ordination for the church. The ceremony at the cathedral was to be a joyous occasion, yet thanks to this illness it was the last place I wanted to be.

I wanted to curl up and hide.

“My GP recommended anti-depressants and I’ve found that using distraction techniques and where possible avoiding crowds and noisy environments to be helpful. So is being able to open up and share my feelings with friends and family.

“People say I look fine, but I’m not on the inside. I’m waiting for cognitive behavioural therapy; I do believe it will be useful. Overall I’m in a much better place now, I have a lot to be thankful for but I’m still not through it yet. I’ll get there though. I’m determined to get back to being me.”

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PTSD FEATURE

I WAS SO ANXIOUS AFTER CANCER Business woman Annette Hurst was diagnosed with breast cancer at 38 and suffered PTSD-like symptoms for six months during and after treatment.

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ut of the blue in 2003 I was told the small crease of skin on my breast was in fact cancer, and I needed a mastectomy and chemotherapy. The chemotherapy treatment was gruelling, and I was often hospitalised unable to eat or drink.

The experience was both debilitating and isolating. I couldn’t concentrate on anything and small things such as leaving the house were a struggle. I was so anxious.”

Part way through my treatment a psychiatrist friend recommended a medication used for anxiety disorders which really helped me through the rest of the chemotherapy. Also, I had a fantastic counsellor who helped me cope with the anxiety and uncertainty of a cancer diagnosis.

The cancer returned in 2010, but this time I didn’t have any anxious feelings. I felt more able to make decisions. By then, I’d already had seven operations, chemo and radiotherapy and, after doing extensive scientific research, I declined more drug treatment. I couldn’t go to that dark place again.

I decided to take my chance and in doing so took back control of my life. With the love and support of my family and friends I haven’t looked back.”

PTSD SIGNS AND SYMPTOMS

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Many people feel grief-stricken, depressed, anxious, guilty and angry after a traumatic experience.

As well as these understandable emotional reactions, there are three main types of symptoms:

happen both as a ‘flashback’ in the day and as nightmares when you are asleep. Ordinary things can trigger off flashbacks. For instance, if you had a car crash in the rain, a rainy day might start a flashback.

FLASHBACKS AND NIGHTMARES

AVOIDANCE AND NUMBING

You find yourself re-living the event, again and again. This can

It can be just too upsetting to re-live your experience over and over again – so you distract yourself.

You avoid places and people that remind you of the trauma, and try not to talk about it.

BEING ‘ON GUARD’ You find that you stay alert all the time, as if you are looking out for danger. You can’t relax. This is called ‘hypervigilance’. You feel anxious and find it hard to sleep.

Source: Royal College of Psychiatrists - rcpsych.ac.uk

FEATURE

PUPPY

LOVE Could the answer to staying healthy have four legs and a wet nose? We look at the psychological benefits of pets – and the importance of grieving for a lost pet.

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THE

riter Diane Cooke recently lost her pet dog to cancer.

She talks about the effect it has had on the family.

best

therapist

“Lola the loveable Labrador was something of a celebrity. She was named after The Kinks’ famous hit of the same name, which talked about gender confusion, because when we saw her at the kennels we thought she was a boy.

She chose us as a family. She came racing up, leaving her slumbering siblings behind, and leapt on my son, licking his face as if he was the one. Who could possibly reject such adoration?

At the time, 10 years ago, we were a bereaved family after losing my husband and children’s father, and Lola hauled us out of our collective grief and made us laugh.

Like the time when I was a slimming club consultant – she gnawed her way through a box of chocolate cereal bars, taking the wrappers off each one and scoffing the lot – all 10 boxes of them. The fall out was indescribable.

We called Lola the empathy dog because whenever we were feeling down, she’d wrap herself around us, or place her

has fur &

FOUR LEGS

Losing Lola the labrador left a hole in her family’s lives

I still put my hand out and expect her to nuzzle it. head on our laps, just staring at us with those huge brown eyes.

Lola welcomed everyone who came to our house. As teenagers suffering angst or boyfriend problems sobbed away, she would sit patiently with her head on their shoulder, or lap, or drape herself around

their necks, waiting for the tears to subside so she’d receive a grateful cuddle.

Lola was diagnosed with a nasal carcinoma and outlived her prognosis by 18 months.

She died at home, peacefully, but hung on for two days until my daughter arrived from London, after a mad dash to see her one last time. She died in our arms within 15 minutes of her arrival.

The hole left in our lives is immense. When I arrive home I feel her absence like a stab to the heart. As I write this, I put my hand down and expect her to nuzzle it, but nothing, and at times I feel overwhelmed by the loss of a friend, companion, exercise buddy and canine comedian.”

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REAL LIFE STORY

MY DOG CAME TO MY WEDDING Mersey Care psychologist Lianne Franks understands first hand the importance of the pet/human relationship.

Mum to ‘fur baby’ Sonny, a Jack Russell cross, the rescue pet is such an important member of the family that he attended her wedding.

L

ianne says a lot of research has been conducted into the benefits of having a pet – the social interaction, unconditional love, exercise and the fact that it is a non-judgemental relationship make pet ownership important for many, particularly those who are alone or suffering with psychological conditions.

Evidence also suggests that having a pet can improve depression.

She says a pet can have even more significance for people with autism for example, especially when the pet dies. “They can

find it difficult to form human relationships, so are significantly impacted when a pet dies,” she says.

That’s why it’s vital to go through the grieving process when a pet dies in the same way as if a human had died.

“A pet has often been with us through many experiences in our lives and has become a part of the family. When we minimise that grief we’re not going through the necessary process of resolving it and that’s detrimental to wellbeing.

The grief of losing a pet can also trigger past grief associated with the loss of a loved one,” she says.

Currently, employers do not allow time off for pet bereavement, it must be taken as sick or annual leave, but Lianne believes that needs to change.

“This is where I feel the stress of losing a pet is minimised. It’s not taken seriously enough. Losing an animal can be just as traumatic as losing a person. We’re all different and should be treated as such.”

HOW YOUR PET KEEPS YOU HEALTHY AND SANE They keep you active. Research shows that older adults who own a dog have a lower body mass index, make fewer visits to the doctor and do more exercise. Also, the stronger your bond with your pooch, the more likely you are to walk and spend longer walking.

A pet helps your heart. American researchers found it’s not just the exercise associated with having a pet that helps you – the stress relief and companionship also have very physical benefits.

They make you sociable. A four legged friend gets you talking to other people and prevents the social isolation that can increase your chances of dying early.

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Pets stop you getting low. A study found that pet-owners over the age of 60 living alone were four times less likely to develop clinical depression compared with people who didn’t have pets.

They reduce stress. A group of people with high blood pressure and high stress jobs had their reactions to stress measured by researchers.

Some bought a pet and when the measurements were taken again six months later pet owners had less of a physical response to stress compared with those without a four legged friend.

Blue Cross Pet Bereavement and Loss: bluecross.org.uk Pets as Therapy: petsastherapy.org

It’s not just dogs, any pet can help you stay well.

HOW YOUR PET KEEPS YOU HEALTHY AND SANE

SHE KNOWS HOW TO MAKE

PEOPLE FEEL BETTER Lily with owners Doug and Lynne Love.

Lily is well loved by patients in Clock View Hospital, in Liverpool. Doug recalls: During one visit a patient was quite agitated. He saw Lily, stopped and clicked his fingers.

She ran over, began licking his hand and he instantly became calm again.

“It’s the same when patients are anxious when they’re having tests. She seems to sense they need her and hops up on their knee so they can stroke her – they forget about the tests!”

When Doug and Lynne Love’s miniature schnauzer Lily was offered as a rescue dog by a family in Portsmouth a decade ago, the couple felt she’d be perfect for their first foray into pet therapy. They were right.

She seems to sense they need her and hops up on their knee so they can stroke her.

The couple have been taking Lily to visit patients at Clock View’s dementia and psychiatric intensive care wards since the hospital opened.

The pint sized pooch is a hit with the nursing teams too, some even change their day off so they get to see her! Doug says:“Patients tell us how much they miss their own pets while they’re in hospital – Lily just seems to know how to make them feel better.”

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WINNING THE

STRESS BATTLE 18

By Diane Cooke

FEATURE

None of us are immune from stress. Not even celebrities. But can you live with stress and still stay well?

We ask an expert.

K

I look back and go ‘wow’. I’m not surprised it affected me along the way.

eeping calm and carrying on is not always an option, as actress Suranne Jones discovered when intense pressures in her work and private life caused her to break down.

All that time she was taking on challenging, often dark roles. “Betrayal! Murder!

Paedophilia!” is how she summarised what looked, from the outside, like a flawless professional run from 2015 to 2018.

Suranne, 40, had to take time off before taking on the lead role in the BBC One biopic of Anne Lister, in the period drama Gentleman Jack.

She was fantastic as the lead in the BBC noir Doctor Foster, the story of a small town GP made vengeful by the discovery of her husband’s infidelity. Then she was a mother who’d lost a daughter in Lennie James’ award winning drama Save Me, and after that another mother whose daughter had been abused in a West End production of Bryony Lavery’s Frozen. Amid all this, she won a BAFTA for the first series of Doctor Foster and filmed a second, featuring more betrayal.

“With every new job now, I’ll consider the psychological side… the content, which I maybe didn’t do before. I’ll need to know that I can live in that place for a period of time.

“The inner light, the inner confidence, can go out of all of us… and if you lose it personally, that inner thing, you can’t put it out professionally – because that’s where it all comes from, inside you.”

Manchester born Suranne Jones – real name Sarah – had married, had a baby and lost her mum Jenny to vascular dementia, all in the space of two years.

“I look back and go ‘wow’. I’m not surprised it affected me along the way. Something had to give.”

And so it did. She collapsed backstage at Frozen and was forced to pull out of the production.

With every new job now, I’ll consider the psychological side... the content, which I maybe didn’t do before. I’ll need to know that I can live in that place for a period of time.

Actress Suranne Jones Suranne played demanding roles such as the vengeful wife in the BBC drama Doctor Foster.

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At the time, the former Coronation Street star, blamed the play’s dark plot but has since revealed she never allowed herself to grieve her mother’s death.

She ‘put all the bad stuff to one side’ and threw herself into work. Then she began to feel ‘edgy and nervous’.

Describing how she couldn’t converse properly, Suranne said being in the theatre only heightened her anxiety and panic.

She didn’t want to take time off for fear of becoming a headline.

You try to resist what’s happening.

Keep working.... in the end something gives.

“That solution could be medication or therapy. But it could be debt or housing advice in a church hall to sort out money or benefits. It might be rediscovering something you used to enjoy to regain motivation, or finding a social group so you feel less isolated”.

Suranne Jones took time off, did yoga, had therapy, quit Instagram and finally returned to TV work, on the BBC Gentleman Jack series in May 2019.

She has ruled out a return to theatre for the time being.

“Go back to emotionally draining myself in a very dark auditorium? Probably not yet,” she said.

• Series 2 of Gentleman Jack is expected back on our screens in 2021.

“You try to resist what’s happening. Keep working. Keep doing the trick of going round as Suranne not Sarah. And in the end something gives. I think that’s what happened,” she explained.

Community consultant psychiatrist Kate Wood says identifying the cause of the stress is essential to find the right solution.

“Stress is a very general term for a multitude of symptoms and sometimes people are looking for a pill that will fix it rather than finding out the cause and working out what’s needed.

“Is it a reaction to a stressful situation – illness, job loss, debt, bereavement? Is it isolation and loneliness? Or is a past trauma affecting your ability to cope with the stresses of life?

“We try to tease out the underlying reason, highlight what it is that’s keeping you stressed and help you find the best and most empowering solution.”

NEED SUPPORT? • Help yourself – our self help guide on stress can be read online, downloaded or watched as a video.

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STRESS

Support for you

STAYING WELL THROUGH

STRESS

The fact is stress kills. Prolonged stress has been linked to heart disease, depression and diabetes.

Here are some tips on how to combat it.

Psychiatrist Kate Wood says self help – or self soothing as it’s sometimes called – is also important to combat stress. “Some patients are sceptical when I suggest guided meditation, but everyone can do it. If you’re disciplined and set five minutes aside it can really help.

“Exercise is a known antidote to stress.

And if you struggle to sleep a hot bath and a milky drink before bed will set you up for a good night’s rest.”

TIPS EAT WELL When we’re overwhelmed, it’s easy to reach for a quick fix in the form of sugar rich food and drink. This gives us an instant spike in serotonin, the body’s feel good chemical, but it won’t last – and neither will the fast rise in your blood glucose levels, which also gives you a temporary high.

EXERCISE HELPS

TRY TO GET ENOUGH SLEEP

If you can’t afford to visit a gym, or have responsibilities that keep you at home, there are plenty of free home based workouts that can be squeezed into a few minutes.

When you are stressed, your sleep often suffers. But staying up late is counterproductive. Cognitive Behavioural Therapy can help address anxiety and improve the quality of your sleep.

SEEK PROFESSIONAL HELP

YOUR SUPPORT NETWORK

Your first port of call should be your GP. “We all have stress in our lives,” says Dr Zoe Norris, a GP, “but the definition of anxiety as a disease is different from stress.”

If patients come to her complaining of stress, she will ask them whether they have been having palpitations, panic attacks or long term sleep disturbances. These could all be indicators that they were struggling with an anxiety disorder.

“If you feel overwhelmed, it’s usually a combination of work and home life factors.

Develop your support structures. Look at your relationships, who are your potential allies? It may be family or friends. When people open up, they’re often overwhelmed by how much support is available to them.

Instead, opt for complex carbohydrates such as porridge or wholegrain bread, which will give you the energy you need to face a difficult day.

Taking 10 minutes to eat lunch away from your desk will reduce stress levels.

Talk Liverpool is a NHS free talking therapy service for people with a Liverpool GP. Go to talkliverpool.nhs.uk

YOUR JOB DOES NOT DEFINE YOU Ask yourself the question: what do you really care about? Strip your workload down to the essentials. Many things that we do in the workplace to endear ourselves to our bosses or appear more proactive than our colleagues are pointless.

To avoid burnout, remember you don’t have to spend every hour in productive or fruitful labour. There are other dimensions of life, and selfhood that are worth believing in.

Tips adapted from information published in The Guardian September 2019.

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STAY WELL FEEL GREAT

STEP THROUGH

WINTER

There’s no denying it – feeling great in winter isn’t easy. Sun kissed skin and al fresco dining are distant memories. It’s easy to let your mood dip. We asked dietician Nina Halsall to come up with steps to keep our minds and bodies vibrant until spring…

WHY IS IT HARDER TO FEEL GOOD IN WINTER?

WHAT DO YOU MEAN BY MINDFUL?

We change our behaviour. We’re less motivated to go out, or do physical activity – and more tempted to eat high carb, high calorie foods. We might put on weight.

Winter sunlight doesn’t contain enough type B ultraviolet light (UVB) for our bodies to make vitamin D, which can contribute to low mood. But don’t despair we can get our quota from food sources (oily fish, red meat and eggs) or from supplements.

Mindfulness runs across all aspects of life.

It’s about living in the moment. Mindful eating involves learning to recognise the signals your body sends to your brain when you’re hungry or full. Doing this will then help you avoid eating as a response to being upset, stressed or bored. When you cook choose something you like and take time preparing it. When the dish is ready switch off all distractions such as your tv or phone and fully focus on the smell, appearance and taste of your meal.

You’ll notice the flavours and enjoy the experience of simply eating and being.

MY RESOLUTIONS ARE SO HARD TO KEEP UP. WHAT’S THE ANSWER? Avoid setting yourself up for failure!

Be kind to yourself and don’t make things worse by setting restrictions and unrealistic short term goals. Focus on a long term positive goal. Challenge yourself each month by trying something new – it could be a new activity or trying different recipe ideas.

WHAT ELSE CAN I DO? Stay active. It might mean changing an outdoor activity to an indoor one but I personally love wrapping up warm and going for a frosty walk round the park.

Once you’re out it’s so refreshing!

HOW DO I SHIFT THE WEIGHT I’VE PUT ON? Think of the weight you’ve put on following the festive season as similar to holiday weight. Once you go back to your usual routine your weight should go back to normal. Being mindful about what you choose to eat can really help.

• Our self help guide Food for Thought is available online, by download or you can watch a video: merseycare.nhs.uk

HOW TO EAT MINDFULLY • Shop mindfully: write a list • Think about what you want to eat and take some time to prepare it • Sit at the table to eat • Turn off the TV and put your phone away • Take time to taste and smell your food.

Try Nina’s healthy salmon teriyaki recipe on page 25.

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Avoid setting yourself up for failure!

Be kind to yourself... focus on a long term positive goal.

Nina Halsall is a Mersey Care community dietitian in Liverpool.

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STAY WELL FEEL GREAT

Lots of other things affect our mood but we feel content when we’re full.

Cook something you like then take time to enjoy it, says Nina.

MAKE A

FRESH START Cooking with colourful fresh ingredients are not just for summer – it will keep you feeling upbeat and energised through the colder months. Dietitian Nina Halsall’s version of teriyaki salmon is full of nutritional goodness, easy to make and looks and tastes delicious.

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RECIPE

SALMON

TERIYAKI INGREDIENTS:

(serves 4)

• 4 salmon fillets • 100ml of reduced salt soy sauce • 1 lemon • 4 tbsp. clear honey • 2 cloves of garlic (crushed) • 1 tbsp. lazy ginger paste • 1 tbsp. sesame oil • 600g rice noodles • 200g baby corn • 200g tender stem broccoli • chopped chilli, spring onion and sesame seeds to season.

METHOD: 1. Heat oil in two pans on a medium heat 2. Combine soy, honey, garlic, lemon and ginger with 100ml water and mix well 3. Place the salmon in the pan (skin down) and marinate with the mixture 4. In a separate pan stir-fry the broccoli and baby sweet corn for 10 minutes 5. Once the salmon has cooked for 5 minutes and is nearly light pink all the way through, flip it over for the top side to go golden brown 6. Add the rice noodles to the pan with the vegetables and a splash of soy sauce, heat for 3 minutes until cooked through 7. Place the noodles on a dish, with the salmon on top and the vegetables at the side, poor any extra sauce over the top then garnish with chopped chilli, spring onion and sesame seeds.

Add a squeeze of lemon to finish.

NUTRITIONAL INFO (per portion) • Calories: 473kcal • Protein: 29g • Fat: 15g • Carbohydrate: 57g.

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SITTING

COMFORTABLY? THEN I’LL BEGIN 26

STAY WELL FEEL GREAT

There will always be dark days, but so many of us have lived through them.

Jenny Bridgman is a priest, mum and storyteller. She blogs about her life, including her struggles with her own mental health. Here, she shares her thoughts with MC Magazine.

T

here are a fair few clouds around at the moment. The school run is wet and cold. The mornings are dark and even by noon the daylight is barely breaking through.

So many of us are battling with the incessant demands of just keeping going.

As a Church of England priest, I believe in the power of story. I’m also a mum and as all parents know, stories profoundly shape how we view the world.

I‘m used to writing and speaking and sharing stories: it goes with the territory.

But recently I chose to tell the story of my mental health. I wrote of my battle with postnatal depression and suicidal thoughts and I published it on my blog.

People contacted me, publicly and privately, to say that they too had walked the confused and lonely path of feeling suicidal. Many were outwardly successful and happy. They all knew the agony of not wanting to die, yet at the same time feeling unable to go on with life. Others had family members and friends who had faced this battle. All of them said they valued my honesty.

What I realised from this is that I have a platform from which to speak with integrity.

I could have presented a polished and professional façade. Perhaps this would inspire a little confidence. Or I could write and speak as I am: a priest who walks the darkest of journeys with others, a mum who is constantly juggling the demands of raising three young children – a human being who struggles under clouds of depression and anxiety.

I have chosen to be public about my brokenness. The more of us who can tell stories about the dark clouds over our heads, the more glimmers of hope we might find shining through them. There will always be dark days, but so many of us have lived through them. Perhaps a little more honest story sharing from all of us would help some sun to shine through those dark clouds.

Jenny Bridgman blogs at jennybridgman.wordpress.com GET HELP MIND: mind.org NHS: nhs.uk Samaritans: Call 116 123 or go to Samaritans.org

SIGNS... that you or someone you know might have postnatal depression include: • a persistent feeling of sadness and low mood • lack of enjoyment and loss of interest in the wider world • lack of energy and feeling tired all the time • trouble sleeping at night and feeling sleepy during the day • difficulty bonding with your baby • withdrawing from contact with other people • problems concentrating and making decisions • frightening thoughts – for example, about hurting your baby.

Many women do not realise they have postnatal depression, because it can develop gradually.

Source: nhs.org

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In 2016 teenager Natasha Ednan-Laperouse died on board a flight after suffering an allergic reaction to sesame which had been, unlabelled, in a Pret a Manger baguette she had bought at the airport. Thanks to the tireless campaigning of her parents, Natasha’s Law comes into effect in 2021. Food businesses will have to clearly label all the ingredients on foods that are prepared and packed on the same premises from which they are sold.

Is it enough?

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REAL LIFE STORY

ALL CHANGE FOR FOOD ALLERGIES Eating out can be a minefield for people with a food allergy. Will new labelling laws make a difference? Writer and coeliac Jo Henwood shares her experience.

Oh mum!

Here you are, staying in a student flat, and it’s you who needs the sick bucket!

S

taying with my daughter in London, we had not been out on the town, downing Tequila shots and dancing till dawn. We had been to a civilised restaurant, with a clearly labelled menu, which had even been accredited by a national charity which supports people with my condition.

I am a coeliac. Intolerant to gluten, a protein found in wheat, rye and barley, I have to follow a strict gluten free diet otherwise I am sick, have diarrhoea and feel unwell for about three days.

And that evening, despite everything, I had been ‘glutened’. We had chosen a well known chain of restaurants which, at the time, was accredited by Coeliac UK. The informed waiter had gone through the menu with me, highlighting only two items which were unsuitable for my diet.

I avoided them and ordered. Four hours later, I was vomiting and knew why.

A follow up email exchange to the restaurant indicated that they were very sorry that I had been ill but assured me that everything I had eaten contained no gluten. The charity were similarly sorry but assured me that they had contacted the restaurant and nothing was amiss.

Until eight months later. Impressively I received an email from the charity which said that they had been made aware of some ‘ingredients changes within [the restaurant’s] supply chain’ and that whilst

Menus don’t always tell the full story says Jo Henwood.

they undertake a review of this, the restaurant had ‘temporarily suspended their GF accreditation.’

Since then I have been ‘glutened’ at least twice in my home town and once on a visit to Glasgow. I always email the restaurant and invariably they assure me my meal was gluten free. Persistence usually results in the discovery of a fault in the supply chain – the butcher supplying the sausage meat, whoever makes up the burger or the lamb meatballs – and sometimes, but not always, I am offered some form of compensation.

Improvements to food labelling laws are great. But everyone who works in the catering industry needs to check, double check and triple check that things haven’t changed.

Improvements to food labelling laws are great. But everyone who works in the catering industry needs to check, double check and triple check that things haven’t changed. Every time there is a new delivery, read the label, if the packaging has changed check the contents haven’t as well, if your menus change, check again.

For more information about coeliac disease visit the charity Coeliac UK at coeliac.org.uk Twitter @Coeliac_UK

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BOOK REVIEW

CAN YOU BE SOBER AND SOCIABLE? Flic Everett ‘bobbed through life supported by a gently flowing current of booze.’ Age, the menopause and a realisation that drinking alcohol was no longer enjoyable she quit.

H

owever the tricky part wasn’t being sober – it was having to explain it to friends and family. Everett’s book ‘How To Be Sober and Keep Your Friends’ makes you feel she’s there with you, sip by sip.

It may take Dutch courage and daiquiri just to press ‘buy’ on Amazon – but if you’re even thinking about it, it’s because you want to do something about your own or someone else’s drinking habit.

You (or they) are not alone. Almost a quarter of adults in England and Scotland regularly drink over the Chief Medical Officer’s low risk guidelines and 27 per cent binge drink on their heaviest drinking days.

There’s no shortage of factual guidance on cutting down or giving up alcohol. Trouble is it’s emotionless.

Fact sheets don’t hit the spot like a botanic gin and tonic.

That’s where this book comes into its own. Everett gets inside your head, pre-empting your next hurdle.

She takes all the arguments for drinking, then gives a compelling ’ah yes but…’ and an alternative to get the same buzz, but without the downside.

There’s a chapter for every challenge – going out, staying in, with friends, alone. It talks about the fear of meeting people armed only with a soda; of dating sober, ‘having to struggle through the small talk, worry about what they think of you, then – oh God – sex with a new person… would anyone ever form a relationship at all, if it weren’t for alcohol’?”

The humour is a huge help. You don’t want to become, in Everett’s words ‘your old headmistress with toothache’. But if you want to change your drinking habits, this book is the literary equivalent of a couple of glasses while you’re getting ready... it gets you in the mood.

Review by Jackie Rankin.

ALCOHOL AND YOU Support for you

• Our self help guide – Alcohol and You is available online, to download merseycare.nhs.uk

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Published in 2019 by Quadrille. ISBN 978 1 78713 422 5

THINGS TO TRY • If you drink to blot out problems try to figure out what you’re avoiding.

Make a list / grit your teeth and work out what the foundations of the problem are • If you really struggle to say no, just say you’re on antibiotics …While not normally advocating fibs, it can be easier when you’re in a large group of keen drinkers • Don’t do rounds – just say you’re saving money, so you can be in charge of your own drinks.

IS THIS YOU? You may need help if: • you often feel the need to have a drink • you get into trouble because of your drinking • other people warn you about how much you’re drinking • you think your drinking is causing you problems.

A good place to start is with a GP. Try to be accurate and honest about how much you drink and any problems it may be causing you.

Source: drinkaware.co.uk/advice

GET HELP • Drinkline is the national alcohol helpline – call 0300 123 1110 (weekdays 9am to 8pm, weekends 11am to 4pm).

• Alcoholics Anonymous (AA) is a free self-help group. Its ‘12 step’ programme involves getting sober with the help of regular support groups – aa.org • NHS UK has links to organisations that can help – nhs.uk

STAY WELL FEEL GREAT

IT’S IN YOUR

HANDS

Are you a thorough hand washer?

Or a dribble under the tap and run type?

I

f you could see the germs on your hands you’d probably spend far more time washing them. Blood, raw meat and body fluids all stay around if you don’t do the whole hand washing thing properly says district nurse Kat Brownlie.

“You wouldn’t intentionally give someone food poisoning, flu or diarrhoea, yet if you don’t wash your hands there’s a chance you might. It’s an invisible risk.”

What is proper hand washing?

Kat who leads the team of nurses from Everton Health Centre in Liverpool says soap and water is the way to go. “Antibacterial gel is only effective on clean hands, washing is the only sure way to kill bacteria. And you should moisturise to stop your hands from cracking.”

HERE’S OUR ‘HANDY’ GUIDE:

You should wash your hands:

• spend at least 20 seconds (the time it takes to sing Happy Birthday twice)

• after using the toilet or changing a nappy

• wet your hands with water and apply enough soap to cover them • rub your hands together. Use one hand to rub the back of the other and clean in between your fingers.

Rub the back of your fingers against your palms • rub your thumbs using your other hand • rub the tips of your fingers on the palm of each hand

• before and after handling raw foods like meat and vegetables (spinach is a particular culprit) • before eating or handling food • after blowing your nose, sneezing or coughing • before and after treating a cut or wound • after touching animals, including pets, their food and after cleaning cages.

CAN ARGUING BE GOOD FOR YOU?

but there are ways you can feel like spring is (hopefully) not too far away.

• Wind down your car windows when you’re travelling • Have a pedicure ready for flip flop time!

• Open your bedroom window (make sure you don’t leave it open while you’re out!)

• Wear lighter colours – whites, creams

• rinse your hands with water and dry with a disposable towel. Use the towel to turn off the tap.

We spend more time indoors in winter – that means more time together... and the risk of more arguing. But if you do it right it can make things better. Susan Quilliam, Relate author of Stop Arguing Start Talking, says we all have an arguing style. Want to know yours? Take the survey on the website. The book claims to help you break free of old patterns

IT MAY BE WINTER OUTSIDE...

• Where flowers bloom so does hope – buy a bunch of tulips or a bowl of hyacinths.

of behaviour and bring discussion rather than confrontation back into your relationships.

You can talk to a Relate Counsellor for free with the charity’s live chat service or by email with its Message a Counsellor. relate.org.uk

31

ZERO SUICIDE

Steve Rotheram

32

As Liverpool prepares to host the Zero Suicide international congress in spring, MC Magazine talks to Metro Mayor Steve Rotheram about his ambition for Liverpool to be the UK’s first suicide safe city region.

TELL US ABOUT YOUR VISION?

HAVE YOU BEEN AFFECTED PERSONALLY?

This is the first time a UK city has hosted the congress so we’re very excited. We want to be the most progressive city region in the country in reducing the number of people who take their own lives. We did it with smoking cessation. Liverpool was the first UK city to become smoke free. We’ll try to do it again.

Yes, it happened to someone I’d socialised with for years. You’d never have known that the person’s life was so bad; I’m sure there were signs but I didn’t see them. I wish I’d known more.

WHAT’S DRIVING THE MOVEMENT? The catalyst has been the Zero Suicide Alliance, a group

of like minded organisations from across the spectrum, who all want to eradicate suicide from our communities.

Save a life...

Take the TRAINING at zerosuicidealliance.com

WHAT HAS THE ZSA DONE? The online training package they’ve developed is fantastic. It only takes 20 minutes and it teaches you how to spot the signs and gives you the language and confidence to talk openly and ask the awkward questions that need to be asked if you think someone may be thinking of taking their life. It’s really gaining momentum. 450,000 people have already taken the training and we’re aiming for a million. It’s a fantastic gift.

WHY ZERO? I asked that question myself when I talked to Joe Rafferty Chief Executive at Mersey Care and others from the Alliance. He said ‘if we don’t start with zero then what? Is one life expendable’?

It’s an aspiration, and yes it will be challenging.

But if even one life is saved as result it will have been worthwhile. St Helens has the highest suicide rate in the country. You have to ask yourself is this ok? The answer will always be no.

WHY IS IT IMPORTANT FOR BUSINESSES TO GET INVOLVED? They’re ideally placed to network and spread the word across a huge community. Most businesses want the best for their staff, not least because it’s good for the business. It’s our job to help them, to bring them together and find out about best practice; the things they’re already doing to support their employees’ mental health. We’re developing a Fair and

THE WORD FROM THE WORKSHOP

• We put out a message inviting staff to take the ZSA training – the same day a colleague who I’d had a one to one with just weeks before asked to see me and confided that his wife had recently taken her own life. He appreciated us giving importance to suicide by having the training • A colleague in my small tech business was clearly distressed but kept saying he was fine. Rather than take him into a meeting room I suggested we talk from home over a video game. He was able to open up about his depression in complete confidence and I could offer him support. It’s about finding ways that work for you and your staff

Ethical Business Charter. Taking the ZSA training will be a condition of that.

WHY DO WE TALK SO MUCH ABOUT MEN AND SUICIDE? It’s the biggest killer of men between the ages of 20 and 45. Suicide affects everyone but women are much more emotionally aware.

They talk about their feelings. We need to make it the same for blokes. At one time men wouldn’t talk about prostate cancer – last year I spoke to plenty of men about getting the test. They’re not embarrassed any more.

We need to do the same with mental health, encouraging them to ask for help instead of becoming so desperate that the only way out is suicide.

WHERE WILL YOU START? We’ve already started. The Zero Suicide Alliance is running workshops bringing businesses together to take the training and identifying best practice, finding out what ethical businesses do to make their workforce happy. Most businesses want the best for their staff - after all they are the business. But we’ve heard some stories of staff opening up after being offered the training. (See feedback from the workshops below).

WHO CAN GET INVOLVED? Everyone. There’s no limit. We need to get this buzzing! zerosuicidealliance.com

• A staff member had come for an absence review meeting. He’d received the email about the training just before we met. He told me he was going to give a false reason for his absence but felt that he now felt he could be honest about his substance misuse. We appreciated knowing what was going on in his life so we could help him • It’s little things like sitting side by side with someone when they’re talking about sensitive issues • We often devolve responsibility for a discussion with a staff member about a personal issue to a colleague with some common ground; they can bring more to the conversation and have a positive impact.

Comments from attendees at the ZSA business workshops

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A DAY IN THE LIFE...

I always say ’you might not want this help right now but I’m here whenever you’re ready’.

I’ve always been fascinated by how people have ended up in the criminal justice system – what’s gone on behind the scenes. I know now that there’s almost always a trauma usually in childhood.

T

here are so many factors that go together to make someone commit a crime and my job allows me to look for what makes them vulnerable and to deal with the person as a whole. That way we can improve their wellbeing and reduce the likelihood of them coming into contact with the criminal justice system again.

I see people in police custody and court.

Spending a night in a cell can make everything feel so much worse, but we can empower them by introducing them to services and support they may not be aware of.

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GRACE HATTON SUPPORT PRACTITIONER CRIMINAL JUSTICE LIAISON AND DIVERSION TEAM

I always say ’you might not want this help right now but I’m here whenever you’re ready’ – and it’s lovely when they reach out down the line.

A lady who has been coming to one of our women’s drop in clinics came in again today. Six months ago she wouldn’t make eye contact, her anxiety levels were through the roof and she was addicted to alcohol. Now she’s relaxed, she rarely drinks and she’s looking to become a volunteer. It’s rewarding to think that she might see us as playing a part in her recovery.

Once of the scariest parts of my job is speaking before a judge – it’s daunting, but I keep in mind that my sharing information with them about someone’s circumstances might result in a sentence that includes treatment for say a mental health or drug or alcohol problem. Having that has the potential to change someone’s life.

I love my job and I work with an amazing team. I go home knowing I’ve done the best I can – and that someone knows where I am if they need support.

To find out more about working at Mersey Care go to our YouTube channel.

For job opportunities visit jobs.merseycare.nhs.uk.

GOVERNOR PROFILE

HITTING THE

GROUND RUNNING TASHI THORNLEY

Service User Governor

I

remember becoming a student rep – and the realisation that you were accountable. But it was my passion.

I wanted to make the positive changes students told me they wanted, like water fountains in the 24 hour library which we worked hard and got.

They struggled to afford study books, so I set up a second hand book shop. They also asked for a way of acknowledging tutors so we set up an awards programme and called it the Golden Robes – it’s still going strong today.

COME AND

I always believed from being a student that there’s no point in being negative and complaining about something we feel isn’t right – for me it’s about coming up with a solution.

I love running – my idols were Kelly Holmes and Paula Radcliffe. But my mental health hasn’t been too good and I’ve spent a lot of time in hospital.

I was diagnosed with borderline personality disorder in 2103. It’s a horrible diagnosis.

It’s quite new and people don’t know what it is so there’s a lot of stigma. I think service users should be involved in developing our services.

My care has really helped me become recovery focussed. It was a community mental health nurse who recommended I put myself forward for the governor role to work on behalf of other service users.

JOIN US

Our next members’ event will take place at Golden Miller Suite, Aintree Racecourse, Ormskirk Road Liverpool L9 5AS on Friday 28 February 2020 from 12.30pm to 3.30pm. If you would like to attend this event RSVP to Christy.Ryder@merseycare.nhs.uk or call 0151 473 2921.

Being an elected representative means working hard for the people you represent, but I’m looking forward to it! Getting people engaged is my passion. I won’t shy away, no matter how I feel. I have a responsibility.

My care has really helped me become recovery focussed.

To learn more about our Council of Governors, go to merseycare.nhs.uk

Find out more about our membership and governors at: Website: merseycare.nhs.uk. Phone: 0151 471 2303 or 0151 473 2778 Email: membership@merseycare.nhs.uk Write to: Alison Bacon, Mersey Care NHS Foundation Trust, V7 Building, Kings Business Park, Prescot, Liverpool L34 1PJ.

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Because ONE life lost is ONE too many

SAVE A LIFE TAKE THE TRAINING Because over the course of a year 6,188* people died by suicide in the UK, that’s nearly 17 people EVERY day.

Take the training at zerosuicidealliance.com source: Samaritans

*

Contact details Got some news you’d like to share?

Contact us at the following address.

MerseyCareNHSFoundationTrust

Because ONE life lost is ONE too many

Mersey Care NHS Foundation Trust, V7 Building, Kings Business Park, Prescot, Merseyside L34 1PJ Telephone: 0151 473 0303 Email: communications@merseycare.nhs.uk

@MerseyCareNHSFT

MC MAGAZINE is published by Mersey Care NHS Foundation Trust and produced by the communications team, Mersey Care NHS Foundation Trust, V7 Building, Kings Business Park, Prescot, Merseyside L34 1PJ T: 0151 473 0303 E: communications@merseycare.nhs.uk W: merseycare.nhs.uk. MC MAGAZINE is available in other formats on request. Please pass on for others to read and recycle.