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equilibrium Haringey magazine for mental health

Summer 2008

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Issue30

Starwards ...Interview with

Marion Janner News on the Haringey

Mental Health Strategy talks to Equilibrium

Prozac... cont.

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Julie McNamara

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Contents

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Coming up in the next issue: Focus On Pets:

8-9

19 17

18

04

15

06

17

Copyright remains with all individual artists. All rights reserved. 2008

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Pets as therapy, and pets as friends. Gattuso on walking Barney and Maisy (great dane/border collie and bull mastiff) and Angela on her cat Polly. Trevor Rock on a very successful carers week, Ruth on bicycling, a review of the new Clarendon collection of inhouse poetry, focus on the Harington scheme and a review of the Clarendon music show on August 15th.

And with luck we’ll soon be downloadable from the Haringey website! www.haringey.gov.uk


equilibrium’s New Patron!!

contents 4-5 Marion Jenner An interview with the brainchild behind Starwards: much needed ward improvements.

7 Dr Liz Miller Congratulations to the new Mind champion 2008!

7 Poppy Shakespeare $Ă€OPEDVHGRQDSV\FKLDWULF ward in Whittington Hospital

8-9 Music Therapy 7KHEHQHĂ€WIRUDOOEHLW big or small

11 Obesity Anti-psychotic drugs side effects are weight gain

12-13 Pig tales A play about transgender

14 CBT v Prozac Talking Therapy versus medication and its side effects

15 Trip to Imperial War Museum Men’s group outing and what a fascinating time they had

15 Prisons and Mental Health Hospitals Prisons as psychiatric holding stations now that the majority of psychiatric hospitals are no longer

16 Mental Health Strategy for Haringey Equilibrium roving reporters went to the Launch

Dr Liz Miller, Mind champion of the year 2008, has agreed to be patron of EQUILIBRIUM. She has been wonderfully outspoken about her diagnosis of bipolar disorder and its effects on her career and her life. Her illness formed the catalyst for future campaigning, and she’s been instrumental in cofounding the Doctor’s Support Network, working for MDF – the Bipolar Organisation, is on the board of Stands to Reason and works in occupational health, as well as writing and blogging on mental health. Well done Liz on her award and we will hear from her in later issues.

editorial Summers here!... In this edition we look at music therapy at St Ann’s - the benefit of music for all be it big or small. Interview with Julie McNamara the writer of a fantastic play by the name of Pig Tales. Pumla’s written about prisons as psychiatric holding stations now that the majority of psychiatric hospitals are no longer. Marion Janner of Star Wards talks about her experience and what led her down to her brainchild. New patron! Congratulations to Liz Miller - Mind champion. Obesity issues - see the article on the correlation between antipsychotics and weight gain. Review of Poppy Shakespeare - recent TV drama.

contributions Wanted: contributions to Equilibrium! Please email us with your news, views, poems, photos, plus articles. Anonymity guaranteed if required.

contact us: Equilibrium, Clarendon Centre, Clarendon Road, London, N8 ODJ. 02084894856, email: equilibriumteam@hotmail.co.uk We DUHLQWKHRIÀFHRQ:HGQHVGD\PRUQLQJVEXW\RXFDQOHDYHD message at other times and we’ll get back to you.

the team Facilitator: Polly Mortimer. Editorial team: Pumla Kisosonkole, Angela, Gattuso, SB. Graphic designer: Anthony ParkĂŠ (www. parkegraphics.co.uk). The views expressed in Equilibrium are WKRVHRIWKHLQGLYLGXDODXWKRUVDQGGRQRWQHFHVVDULO\UHĂ HFW the opinions of the editorial team.

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Showcasing the Other Side Gallery

Correction: Denise Johnson’s name, the manager of the women’s football team, was left out of the recent article on football. equilibrium 3


Equilibrium teams interview with

Marion Janner the founder of

Star

Wards

I see that you have a dog. What are your views of having animals ie a dog coming into hospitals and being used as pet therapy in general? I’m probably tediously evangelical DERXWWKHEHQHÀWV that come from having pets on wards. There’s masses of academic and anecdotal evidence of what a difference it makes to patients, for lots of reasons, ranging from helping to normalise (humanise? animalise??) wards through to the sensory comfort of stroking furry creatures. There are heavier-duty psychological dynamics, such as feeling appreciated and accepted at a time when we can feel very underFRQÀGHQWDQGFDQ also feel subject to considerable negative judgment. Happily, an increasing number of wards are introducing animals, whether it’s resident guinea-pigs or dogs

accompanying their humans at work for the day. There was an interesting article in Mental Health Today recently about ‘equine therapy’ i.e. helping people’s recovery through contact with horses. And we’ve got some great photos on our website from the day when an animal handler went to Huntercombe Hospital Roehampton, with a snake, dog and something like a marmoset. (I’m sure that if it was not a marmoset, it was exactly like one.) What made you turn your experience into something positive where the majority of people wouldn’t have? I’m very lucky to happen to have a bunch of relevant experience for setting up Star Wards, including managing residential services (for people with learning disabilities) and running a social change campaign (against excessive imprisonment). But

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this is possibly not answering your real question, which sounds like it’s something about “What is it about you that made you embrace inpatient services rather than run as far away as possible from them?” There are a few aspects of

(believe me!) and so I’m a third generation campaigner. We’re compulsive campaigners!

my personality and background which have propelled me in this direction. Although somewhat battered by my illness, I’m a pretty optimistic person, with socialist and social worky tendencies which convince me that positive change is always possible. And I’ve got an unusual family

The whole issue of locked wards is very complicated and fraught. I’m not sure about the legal situation, but it is probably something like locked wards are legally acceptable for detained patients but would be legally challengeable for ‘informal’ or ‘voluntary’ patients. It would seem that as community

Did you know that you couldn’t have locked wards in psychiatric hospitals?


FUTURE:

and crisis services develop and it’s increasingly only very ill people on wards, most wards are locked. There is a very simple way solution to the locked doors issue. Electronic swipe cards or fobs can be programmed to give each person the access they need and which is considered ‘safe’, including out of the ward. Quite a few wards have successfully introduced these.

friendly and caring approach were of course very important in my recovery. My VWURQJHVWDIÀQLW\ to St Ann’s is through weekly psychotherapy at the Halliwick Centre. Mentalisation Based Therapy was GHVLJQHGVSHFLÀFDOO\ for people with the personality disorder I’ve got, so I’m deeply appreciative to be getting such specialist input, on the NHS!

Why did you give the project the name Star Wards?

After your discharge from St Ann’s how did you settle back into the community?

I wanted something short, upbeat and memorable. The name just popped into my head and it felt quite humorous. Colleagues liked it so that was the clincher. Why do you love St Ann’s? Um, I’m not sure I love St Ann’s, but I love the staff! The ward staff have been wonderful to me on both my admissions there and their non-judgemental,

Your question reminds me that when I was sectioned three years ago, I was frustrated that the day I left, I had to wait over an hour for my ‘take-away’ medication. I felt terrible that this meant I couldn’t get LQWRWKHRIÀFHWLO after 10AM. Looking back, this seems ridiculous as I should have had a bit of transition time. Even a morning!

Finally, what do you think your greatest achievements have been in changing ward culture? It feels early to be talking about achievements let alone greatest ones, but what is very striking, and makes us very happy, is that involvement in Star Wards usually results in a considerable boost in morale among ward staff. This is of course valuable in itself (patients aren’t the only people on the ward with full sets’ of feelings!) and also essential to energise positive changes. In very practical terms, possibly the biggest tangible changes happening on our member wards are comedy evenings, *pets visiting or moving in, increased Internet access – and more spontaneous conversation and fun!

Our priorities now include trying to adapt our approach and/or what we provide for members to make it possible for particularly beleaguered wards to take part. The London Development Centre have funded us to run London Bridges to support the involvement of new wards. And the Star Wards’ team are now to be found in kaftans and beads as we prepare for our annual members’ get-together, the Star Wards Festival. Like Glastonbury but without the mud or drugs!

*See next issue for a focus on pets as therapy.

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From Foucault: Madness and Civilisation

“Johann Schenck cured a man ‘fallen into a profound melancholia’ by having him attend ‘concerts of musical instruments that particularly pleased him’; Wilhelm Albrecht also cured a delirious patient ‌by prescribing the performance of ‘a little song which awakened the sufferer, pleased him, excited him to laugh, and dispelled the paroxysm forever.’ ‌If music cured, it was by acting upon the whole human being, by penetrating the body as directly,as HIĂ€FDFLRXVO\DVLWGLGWKHVRXOÂŤ,WLVZLWKLQ WKHERG\LWVHOIIURPWKHQHUYRXVĂ€EHUWR the soul, that the music is recomposed, the harmonic structure of consonance restoring the harmonious functioning of the passions.â€? 18th century therapy.

Equilibrium went to see Hysteria

at Bart’s Hospital Great Hall - a VLWHVSHFLÀFSHUIRUPDQFHE\D%UD]LOLDQJURXSVSHFLDOL]LQJLQKLVWRULFWKHPHVWKLV time women’s incarceration in 19c mental asylums. The audience was seated along gender-split lines, and the production teetered along using the women as (un)willing participants, stars of the show or fellow inmates. It was ultimately rather arch and unaffecting and came close to ritual humiliation at times.

Jewellery making

ArtworksProject...

The jewellery project was something that interested me a while back‌but having said that, I was not too keen to go ahead, neither was I positive about my creativity, especially after doing a textile course that I found quite stressful. Surprisingly, few months later I started the course; initially there was a lot to remember, especially some terms related to jewellery. But, I was pleased to see the difference. The atmosphere in this group is relaxed, also the tutor, Alison, is friendly and at ease. She really built my FRQĂ€GHQFHHYHQPRUHHVSHFLDOO\ZKHQVKH says, “ you can do itâ€?. With Alison, I think \RXZLOOĂ€QGLWKDUGWREHOLHYHLQIDLOLQJDQG learn to doubt about yourself. SB

The products that are crafted and designed get all groups working together on the same project. The groups that are run at the Clarendon include printing, sewing and jewellery. A child of the parent from the group draws a picture that is close to their heart ,which the parent brings into his/ her group and collaborates with the other groups; the design of the child is printed and fabricated and made into jewellery. The design is of sentimental value to the FKLOGEHFDXVHWKH\DUHDEOHWRVHHĂ€UVW hand what their creation has developed. The design of the child is printed which is made into a whole range of products i.e. mugs, cards, posters, rings etc. Gattuso

Pegler:“Curing Madness�

Jason

Initially, I found the book “Curing Madnessâ€? quite interesting, and share very much the writer views. Jason Pegler says it’s“vitally LPSRUWDQWWRKDYHDSV\FKLDWULVWWKDWWUHDW\RXDVDKXPDQEHLQJĂ€UVW and not a patient. Only then can you build up a rapport and start to help the patient to help themselvesâ€?. There were some very good aspects from the book related to mental health issues, also some aspect positives points to refer to. Although, there is some strong writing positiv and “i “inappropriate and irrelevant topicsâ€?. SB (available as a download from www.chipmunkapublishing.com)

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Doctor Liz Miller announced as

The Mind Champion of the Year Award, which is voted for by visitors to Mind’s website, honours those ZKRKDYHPDGHDVLJQLÀFDQWFRQWULEXWLRQWRFKDOOHQJLQJ discrimination against people with mental health problems.

Mind Champion 2008 Miller, a practising GP in London, has bipolar disorder J Liz and has written and spoken openly about her self management strategies, last year appearing on Stephen Fry’s documentary The Secret Life of a Manic Depressive. On receiving the accolade, Liz said: “I’m very touched to receive the award. It’s really important that we change attitudes about mental health, and a good starting point is changing attitudes within the medical profession. Through the Doctors’ Support Network we aim for doctors to learn to be kinder to themselves and others and to let

them know they’re not alone. Doctor’s get ill too - we’re only human after all.â€? Mind Chief Executive Paul Farmer said: “She is a fantastic role model and a worthy winner of this year’s Champion of the Year Award.â€? Mind Book of the Year went to Sunday Express Editor Martin Townsend for his book The Father I Had about life growing up with a father diagnosed with bipolar disorder. The Mind Awards are part of Mind Week, which this year focuses on debt and mental distress. Mind’s new report In the Red: Debt and Mental Health shows WKDWGHEWLVDVLJQLĂ€FDQWIDFWRULQ worsening our mental health and people living with mental health problems are almost 3 times more likely to be in debt.

thePoppy Shakespeare

film

is based in a psychiatric ward in Whittington hospital which is in the London borough of Islington. She was not very well groomed, and not looking after herself properly. One of the patients that had been discharged jumped off a bridge in Archway called ‘Suicide Bridge’. A new patient called Poppy Shakespeare came into the ward who looked like she came straight from the catwalk. She had very nice wavy black hair, a leopard skin coat, a red bag (which is this season must have) and make-up. She kept saying she was not suppose to be there because she is not mad. She didn’t want to be there because she has got a child. When Tony had to be seen by someone, she made herself look worse by putting cigarette ash under her eyes, and smearing chocolate on the groin of her trousers to make her look like she was bowel incontinent. The nurse asked for a urine sample, so Tony put tablets in a bottle of urine so that it would look like she was taking her medication. Patients were being discharged SUHPDWXUHO\EHFDXVHWKH\ZDQWHGWRSURYHWKDWWKHZDUGZDVEHLQJUXQHIĂ€FLHQWO\7KH patients p were concerned about a ‘big brother ‘style To get the solicitor to prove that she was not two way mirror. Unfortunately Poppy did not get her mad, she needed money; to get the money EHQHĂ€WV7KHĂ€OPZDVTXLWHDJRRGSRUWUD\DORIZKDW life is like in the mental health system. I found other she needed to prove that she was mad! patients patien very helpful when I was in Friern Barnet hospital. They introduced me to other people and VKRZHGPHDURXQG,HYHQJRWDFRXQFLOĂ DWZKLOHIROORZLQJWKHH[DPSOHRIDQRWKHUSDWLHQW And I made a lot of friends from the mental health system. Angela ngela

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Case Study

When

Words Aren’t

Enough The Barnet, (QÀHOGDQG Haringey Mental Health Trust’s Music Therapy Department provides therapeutic opportunities for many different people across the trust.

The practice of music therapy focuses on making a connection between therapist and client, generally using free musical improvisation. The process of making music together can establish a therapeutic and meaningful relationship. Sessions occur in the same place and at the same time each week. Many of the sessions are run in groups, though Music Therapists will also work with individuals, as well as carry out shortterm assessments. :KRPLJKWEHQHÀWIURP Music Therapy? Music Therapists work with many different people. The fundamental reason why someone might be referred

Clients who have participated in either group or individual music therapy during their hospital admission are given the opportunity to continue with music therapy for a further six sessions following discharge. Occasionally, if there is a space available and a client expresses a keen interest, Music Therapy can be extended, subject to periodic reviews. The client’s name has been changed in order to preserve FRQÀGHQWLDOO\ James is a young man in his ODWH·VZKRÀUVWEHFDPH unwell in his teens. He has experienced periods of recovery that enabled him to work, but these periods have been interrupted by relapses, which have led to hospital admissions. Many of our early sessions together focussed around supporting James in coming to terms with a longterm mental health issue. This brought up anxieties surrounding the stigma often

But what actually is Music Therapy? to music therapy is to help improve his or her health and well-being. Some of WKHVSHFLÀFUHDVRQVZK\D person might be referred to music therapy include: ‡7RLQFUHDVHPRWLYDWLRQ ‡7RH[SUHVVHPRWLRQV ‡7RGHYHORSVRFLDOVNLOOV ‡7RGHYHORSVHOIDZDUHQHVV ‡7RH[SORUHLPSRUWDQWDQG personal issues ‡7RRIIHUVXSSRUWGXULQJD GLIÀFXOWSHULRGLQOLIH

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attached to mental health problems, in particular, whether to tell friends and how to explain periods of unemployment. When faced with these challenges, simple questions from friends such as “Hi, I haven’t seen you for a while, how have you been?”, can be a great source of anxiety. Through improvising music together and talking, James


has been able to address some of these anxieties and increase his selfFRQĂ€GHQFH)RUH[DPSOHLQ earlier sessions, James was reluctant to try instruments he had never played before. (Clients need no prior musical experience to take part in Music Therapy).

combination of music and being able to talk about things is the perfect combination for me. If I was just talking, then all the stuff that I couldn’t express through talking, it would be just there. I think I’m more balanced now than I’ve ever been.’

Through engaging in shared music-making, where he was able to experience the connections between our music and feel listened to and understood, James has begun to move more freely around the Music Therapy space and try new instruments and different ways of playing. This increased level of FRQĂ€GHQFHZLWKLQWKH0XVLF Therapy space has enabled him to try new things in other areas of his life.

James recently completed a college course and passed his exam and has come to regard our Music Therapy sessions as playing a vital role in the continued management of his mental health.

As our sessions have progressed, James has been able to explore a number of different issues. He has come to regard the Music Therapy space as a safe place to be where he is able to share his thoughts and feelings without fear of judgement or rejection. These are some of James’s thoughts about our sessions: ‘I think if I didn’t have this session, I would be just trying to do everything on my own again. It gives me WLPHWRUHĂ HFWRQERWK sides...being admitted and being ill, and then life and society and home and stuff like that. It’s helped me in so many different ways. I feel that being able to express things through music has allowed me to express stuff that I can’t talk about... I think a

M Alleyne, BEH MHT Music Therapist If you would like more information about the Music Therapy Service for BEH MHT, please contact the department at St Ann’s Hospital on 0208 442 6844/6637. For more general information about music therapy, go to www.bsmt.org “It is the best! A way of releasing the tempest.� “When you play it’s like going somewhere you haven’t been before.� “When I am in a manic episode, music is the only way I can communicate� “In music therapy you can explore certain aspects of your life that may have hindered you or stopped you from doing things in the past.� “Playing freely can help to relax that mental anguish that you might be going through at the time.�

BOOKS on music therapy Music therapy – An art beyond words, Leslie Bunt published by Routledge

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Greener Haringey‌ The Harington Scheme is a brilliant organisaWLRQIRUSHRSOHZLWKOHDUQLQJGLVDELOLWLHVGLIÀculties in West Haringey. It also offers NVQ and pre-NVQ training in Horticulture to those with basic skill needs and disadvantages. Additional support is offered in literacy, numeracy, job searching, life skills and work

experience. There are also supported work placements, and ways into further education and training. Additionally Harington Gardeners is a supported employment project which operates as a garden maintenance company. The Day Service provision offers horticulture of a therapeutic nature to adults with a learning disability or mental health support needs. There is also an Entry to Employment (E2E) course aimed at young people 18-24 who need support to enter mainstream training and education. The Harington Scheme has won a lot of medals at Chelsea Flower Show etc . Further info: Joanna Baxter or Michelle Besant: 8347 8860 info@harington.org.uk www.harington.org.uk

Forked stick From the Guardian Guide 17 May ‘Club meds’ A timely article on the use of prescription drugs in movies and the recreational consequences‌Indiscriminate and dangerous pill popping and the results feature in many Hollywood movies and TV – from House (the +XJK/DXULHĂ€JXUHLVDGGLFWHGWR9LFRGLQ  Desperate Housewives (Ritalin munching), Juno (Adderall – an amphetamine based ADHD med) – selling among teens, to Darjeeling Limited (Indian pharms) and the Simpsons (Focussyn). â€˜â€Śno higher power is telling writers and directors to stop making med users appear cool.’ Which is not good. www.guardian.co.uk

www.foyer.net interesting organisation helping homeless young people. Their StrongMinded campaign aims to help support pport thos those with mental ment health ealth issues in Foye Foyers.

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Books Equilibrium recommend this issue: Madness and Civilisation – Michel Foucault – groundbreaking book tracing the history, SKLORVRSK\DQGHFRQRPLFVRIœFRQÀQHPHQW of the mad’ from the leper colonies of Paris in medieval times via Ships of Fools to workhouses and asylums. Routledge

Cycling back to Happiness – Bernie Friend (8.99 Pen Press). Challenging North Sea cycle route of 6,000 km taken by the author to try and rid himself of a life limiting paranoia/ neurosis. ‘this book is a riveting account of one person’s journey and a heart –warmLQJUHDIĂ€UPDWLRQWKDWRUGLQDU\SHRSOHDUH basically good and compassionate the world over.’ (Michael Stenning – London Cyclist June/July 2008)


The US Obesity Scandal New Scientist 8.3.08

2/3 of Americans are overweight, half of whom DUHFODVVLĂ€HGDVREHVH$ORQJZLWKVN\URFNHWLQJ Ă€JXUHVFRPHLQFUHDVHVLQGLDEHWHVKHDUWSURElems and deaths. One culprit is rarely mentioned : the broad range of psychiatric drugs that can cause substantial weight gain. These include: ‘antidepressants’ (amitriptyline, doxepin and imipramine), ‘mood stabilisers’ (lithium and valproate) and ‘antipsychotics’ (including clozapine, olanzapine and chlorpromazine). A sixth of patients taking olanzapine gain at least 30 kgs. Reasons for weight gain are poorly understood – some psych drugs may impair the nervous system’s control of energy intake, leading to food craving, whereas others, like SSRIs , may alter a patient’s metabolic rate. Doctors are increasingly prescribing multiple psychiatric drugs for the same patient at the same time, even though many effects of doing so have not been investigated. IN 2004 32.6 million Americans bought outpatient prescriptions for antidepressants, stimulants, antipsychotics and tranquillisers, up from 21 million in 1997. Overall 1:6 Americans take at least one psychotropic drug. Rising obesLW\LQWHHQDJHUVDQGHYHQ\RXQJFKLOGUHQFRLQFLGHVZLWKDĂ€YHIROGLQFUHDVHLQ prescriptions of antipsychotic drugs in these age groups‌. American culture is very eager to label negative feelings and problems as evidence that a person is mentally LOO²DQGWRSXVKGUXJVDVDTXLFNĂ€['RFWRUVRIWHQIDLO to warn patients that the drugs they prescribe may increase their appetites, and people labelled mentally ill often learn to attribute all their problems – including eating more – to their psychological disorder.

One culprit is rarely mentioned: the broad range of psychiatric drugs that can cause substantial weight gain.

Every one considering taking these drugs needs to be able to make an informed choice ‌ and drug companies must disclose the extent of the weight gain that their drugs cause and educate the public about the risks.. Adapted from an article The pills that make us fat NS 08.03.08 by Paula J Caplan. Essential advice: never alter your medication without seeking help from your GP.

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PigTales

interview

Where did you get the idea from to direct this play?

The play was reviewed in the last issue and performed at the Courtyard Theatre Hoxton by Julie McNamara

Julie: I didn’t direct it. Jessica Higgs is the Director. I wrote the play and performed in it. It was commissioned by Oval House Theatre and Jackson’s Lane for Xposure Festival of Disability Arts. The theme they wanted was: Body, Identity and Culture. Pig Tales was my response to that theme. I didn’t want to go with the obvious themes around disability as WKHà DZHGERG\,ZDQWHGWR write about how we disable people by writing our dreams and dark desires across the landscape of their life. And how we treat difference as a contamination. It was inspired by my relationship with my father because he had always wanted a son and treated me as a boy until I was of school age. Did you have to do a lot of research with people with altered gender?

Julie: I did a lot of research into current medical thinking around transgender issues, because I have been through the mental health system Interview with Julie McNamara myself and one of the labels I have acquired along the way is: Gender Dysphoria. I don’t believe any of the labels I have been given. They serve to support the shrinks who play with them, not the people who have to wear Interview by Angela them!

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Did you get support to direct this play? I didn’t direct the play (please see above) Julie: I was funded by Oval +RXVHWKHDWUHIRUWKHÀUVW version, which was then picked up by South West Trust in the NHS and then the Mental Health Commission in New Zealand. So the production travelled abroad constantly before getting a wider audience in the UK. I was funded by the Arts Council for this recent tour of the UK. Have you or the people you researched had depression or any other mental illness? Could you tell us about it if so? Julie: This country depresses me constantly. Does that count? I have been given a variety of psychiatric labels over the years, most of which I disagree with. But a psychiatric history is the most disabling thing you have to live with. It follows you around in your records for the rest of your life, impacts on your visa for travels abroad, your insurance, your mortgage, your employment chances and your eligibility for fostering or adoption. I believe that our current mental health system is designed to contain and control, not to heal people in crisis. It is the most unimaginative response to people in psychic pain you could dream up. No further research needed.


Did you get a lot of response from people who are altered gender? Julie: People who are transgendered don’t usually think of themselves as altered gender, rather that they are aligning the body with their true selves. I have had great responses from Trans people coming to the show and also one or two grief stricken reactions from people who felt pained by the accuracy of the doctor’s treatments delivered to the character onstage. Do you think that the topic of altered gender is no longer taboo? Julie: Just look at the VWDWLVWLFVRIYLROHQFHLQÁLFWHG upon Trans people and tell me that there is no longer a taboo. Why are they still operating on intersex children under the age of two at Great Ormond Street hospital? Is that because we need to carve those children up to conform to our notions of what it is to be ‘normal’? There are huge taboos confronted within the play. Why do we still favour male children in Ireland – and many cultures across the world? Why do we treat people we ‘other’ with such fear and violate both their bodies and their human rights? Why do we think the mental health system is the place to treat somebody who wants to align their physical body with their true inner identity?

What jobs have you done in the entertainment business? Julie: I started off in theatre in the Eighties as an actor and deviser of plays before KDYLQJP\ÀUVWEUHDNGRZQ – which I now consider as a breakthrough! I have since emerged from the Disability Arts sector, where I have ranted and raved on stage as a Performance poet for many years. I now write plays about madness, about the chaos of emotional extremes. I work to close the false divide between those of us who are seeking and those providing help in the ‘caring’ services. Emotional extremes, psychic sensitivities and vulnerability are all part of the human condition, part of what it is to be human. Why are we trying to medicate and obliterate difference? Don’t get me wrong, I have used medication to hold me when I have been in the darkest of places, in emotional hell. But I don’t want to be sectioned, locked up and chemically controlled without trial or jury. Why haven’t we got more crisis houses in the community to support people when they are in pain? I’ve heard that you also do music. What kind of music do you do? Julie: My family are Liverpool Irish and so Irish traditional and folk music have had a big LQÁXHQFHRQPH,XVHGWR write songs with a folk style

but have moved more into ballads and blues nowadays. My last CD ‘Fly Like an Eagle’ was a memorial to Emma Humphries who spent ten years in jail for killing the man who led a gang rape against her. She changed the face of the British judicial system by challenging the courts. Nowadays a woman can use the defence of provocation in court, thanks to Emma. But sadly she died of heart failure at thirty thanks to the high doses of psychotropic medication she was administered. She always told me she was going to come back as an eagle, so I wrote her a song to give her VDIHÁLJKW Is there going to be a sequel? Julie: It’s here already! ‘Pig’s Sister’ was written two years ago, commissioned by Theatre Workshop, Edinburgh. It’s been through a re-write and I’m planning to produce it next year. It’s about a bitter feud between two old dears in a care home, who choose very different pathways in response to the bad luck they’ve been dealt. They’re brought together by the death of the nurse on duty. At the moment I am obsessed with another play. I’m working on a piece called: ‘Crossings’, it’s the meeting of three women ghosts born a hundred years apart, in the hull of a ghost ship.

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CBT v PROZAC CBT – Cognitive Behaviour Treatment, a natural approach, to do with how one lives one’s life. In medicine the one that is easily quoted is PROZAC. When we say or hear “depression� we have any number of images of the condition, from suicidal to simply feeling constantly down. The descriptive colour used for this is usually ‘black’, and in music its ‘blue’. Overall, it’s the downturn in the Human Condition. Straight off, a very effective treatment has been CBT –Cognitive Behaviour Treatment, a natural approach, to do with how one lives one’s life. In medicine the one that is easily quoted is PROZAC. PROZAC has moved on from 30 odd years ago when the popular treatment of a yet unaccepted condition was to prescribe a vitamin pill without any chemical mind altering qualities (placebo). This was largely disputed in the 60s after trials where people found that they were being given medication

for the sake of it rather than for its healing SRZHUV,WRSHQHGWKHĂ RRGJDWHVDERXW WKHHIĂ€FDF\RIH[LVWLQJPHGLFLQH7KHUH are those in healthcare and those in the pharmaceutical profession, both with very strong opposing views. One lot have people literally screaming ‘mental health – keep away’, whilst the other lot are trying to cure it along the lines of painkillers, or ‘illness attackers’. Professionals from psychiatrists to therapists are split as to whether the mental health area should be just to calm a situation (the placebo effect) or whether to look for actual cures : and do these actually exist? Can they exist given the nature of the exercise?

by Pumla

Gattuso on Prozac I have been prescribed Prozac for several years now. The second attempt of administrating Prozac a few years before this second stint was for depression. I am on the second stint and this time it is for PMT . Before e Prozac ffor PMT I just felt absolutely terrible with the different drugs I was taking they did nott do anyt anything for me. Now I am on Prozac for PMT I feel much more lively. Is it because that it is com combined with Sodium Valproate? I believe so. Gattuso

PS. David Healy (Prof of Psychiatry at Cardiff Uni): ‘Some people will be shocked to discover that Prozac has been prescribed for decades when..it barely works. However, the real story is HYHQZRUVH)LUVWWKHĂ€QGLQJVDUHQRWQHZDQGLWLVQRWRQO\WKH3UR]DFJURXSRIDQLWGHSUHVVDQWVWKDWZHVKRXOGEHFRQFHUQHGDERXWVHFRQGWKHĂ€QGLQJVSRLQWWRDJHQHUDOPHGLFDO LQDELOLW\WRXQGHUVWDQGHYLGHQFHDQGĂ€QDOO\WKH\UHYHDOWKHGDUNVLGHRIFRPSDQ\PDUNHWing, and the role of regulators.’

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Trip to the Imperial War Museum &KDUOLH FHQWUHRIĂ€FHU WRRNWKH men from Clarendon on a trip to the Imperial War Museum.

Mark Francis and Charlie and Liam

This museum is near Elephant and Castle. Entry is free, but donations are welcome. Programmes could be purchased. Liam went to the trip and gave me an account. ‘There were lots of bombs, tanks, aeroplanes. There were exhibitions on trenches and child evacuees. The children were fostered out, sent to the country and farms. It was an interesting day out. The museum was not too big, you could see everything in one day. It did not glorify wars; it just presented the facts. There was nothing on United Nations. There shouldn’t be so much war because children are dying in places like Palestine and Israel. People should boycott oil from Iran. The war in Iraq has been going on far too long.’

Prisons and Mental Health Hospitals P “We thought we had closed our mental health hospitals but here we are holding so many people in prison who cannot be effectively treated� Peter Selby, former Bishop to H M Prisons.

in the 21st century a man of the Cloth is bringing yet another humanitarian angle to all the situations. The task of looking into prisons has fallen , interestingly, on to a former bishop.

We read Charles Dickens’ works about conditions in mental health institutions and prisons in the 18th century and, probably, if read out of context the descriptions of the inmates and what was happening could be interchangeable. Mental health institutions having quite a big claim on space – land, accommodation etc, being populated not unlike Boarding Schools – were well known for their strict regimes and of course, HQIRUFHGFRQÀQHPHQW3HRSOHZKRFRPPLW FULPHVVKRXOGEHFRQÀQHGDZD\IURPVRFLHW\ as also, in practice, should people not mentally well – for their own good.

And he asks that pertinent question whether any institution in question is holding people for treatment or as a deterrent? So it seems that the debate still continues as to whether mental health is served by either service. In a hospital, people are given treatment and medication to get better.

Maybe it was the question of space and VWDIĂ€QJZKLFKPHDQWWKDWWKHWZRFRXOG be run along the same lines and eventually contain the same kinds of inmates! Now

In a prison people are given punishment for their past sin(s) to make them better citizens. How, in mental health does a “getting better� system then work when some people are born like that and it’s a permanent state? Should mental health be criminally marginalized?!

by Pumla equilibrium 15


Mental Health Strategy Consultation Equilibrium went to the launch of the Mental Health Strategy Consultation Event for Haringey in April at the Cypriot Centre, Wood Green. It was a really good event – with breakaway groups (Equi went to the rehab and recovery group) and an amazingly delicious lunch (moussaka, salad, and garlic chicken among the delights). Equi met Fiona McKeown (BEH mental health trust) and Andrew Law from Tulip who were full of good ideas and inspiUDWLRQV/RWVRILGHDVà HZDURXQGRXUJURXS on recovery and its essentials – from hope - to small steps – to individual attention – to befriending - to sheltered and non sheltered work and activities etc. Simon and Stuart from ÀOOHGXVLQHORTXHQWO\RQWDEOHWHQQLVDQG biking, as well as their 684 newsletter. * See nest issue for table tennis article. The brief of the day was multifarious – What would services need to do differently? Do we work effectively with pan-Haringey organisations such as faith groups and community groups? What skills will staff need in the future? Where do we want services provided? What will services look like in the future? Two representatives from the Emilia project summed up the whole debate by reminding the room that service users and ex service users were not symptom carriers but PEOPLE. Seconded by Equi – when in receipt of mental health services, it is all too easy to be seen as a receptacle for strong pills, and containment, and not as a human being. Wellbeing featured strongly – as it should

on everyone’s agenda - and so did culturally sensitive services and stigma reduction. Evidence – based psychological therapies, advocacy, choice, individual needs audits, social networks of family and friends, personalisation and understanding of the underlying reasons for mental distress – all these were aired as very important on the voyage to improve support.

There are 7 goals: 1. 2. 3. 4. 5.

Improved health and emotional wellbeing Improved quality of life Making a positive contribution Increased choice and control Freedom from discrimination or harassment 6. Economic wellbeing 7. Maintaining personal dignity and respect All admirable! There’s a useful booklet called Improving Adults’ Wellbeing - A summary of Haringey’s Wellbeing Strategic Framework for 2007-2010 – available in many languages and large print, audio and Braille from Freepost RLXS-XZGT8*5-+DULQJH\&RXQFLOWKà RRU5LYHU3DUN House, 225 High Road, N22 8HQ. It is also available online at: www.haringey.gov.uk/wellbeing_framework.htm/ www.haringey.gov.uk/ the_well-being_plan_easy_read.pdf

Bibliotherapy... Trevor Rock and Polly Mortimer from the Clarendon and Equilibrium went to a fabulous training with Jane Davis from Get into Reading (see last Equilibrium issue). A small group of trainees got together and learnt the technique from Jane – basically taking a book (often quite ‘tough’ classics) and reading it out loud with the group – many people taking turns- and discussing along the way. She has pioneered her groups in the Liverpool area in lots of social settings, from Alzheimer care homes to homeless shelters, and has seen marvellous transformations in people who come to the group. At the training were a psychotherapist, a Mind worker, a retired teacher, a few librarians, an ex-service user and someone who wanted to help their sister with mental distress.

Bibliotherapy continued... It was an inspirational day –and the main emerging merging theme heme was one of simplicity. It’s fantastic to harness the power of literature (the sam ame me can app pply pp ply to all the arts) and see the transforming effects. More details:www.getintoread ding.org org. Trevor org

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This play was created and formed by David Woods and John Haynes at the Barbican on Saturday 8 March 2008.

YES YES YES

There were two men on the stage wearing blue skull caps and pyjamas. It started off with a man coming out of a large cardboard box, a hammer FDPHRXWÀUVW7KHQKHVPDVKHGYHU\ODUJHSLHFH RILFH7KHQKHVDLG´,¡YHEURNHQWKHLFH¾:KLFK ZDVYHU\IXQQ\DQGJRWDUHVSRQVHIURPWKH audience.

This play wasn’t like a story, it was made up of ORWVRIYHU\IXQQ\VKRUWVNHWFKHV7KHPDWHULDOZDV YHU\RULJLQDODQGLQWHOOLJHQW/RZEXGJHWSURSV were used but we still got our monies worth. There was a circus sketch of a human plate lying on an ironing board, with a large piece of meat on his reviewed by Angela tummy and then a lion came to eat it. There was another sketch where he had water WKURZQRYHUKLPEXWKHGLGQRWVHHPWRPLQG $QGKHKDGHYHU\WKLQJEXWWKHNLWFKHQVLQNLQKLV underpants. It ended with one of them scantily clad one in blue pyjamas running around the Barbican, then outside along the main road and WKHQWRWKH(LIIHO7RZHUWKH6WDWXHRI/LEHUW\DQG the Taj Mahal, and yes,yes,yes they did get a lot of strange looks, ha,ha,ha! This play was a good HIIRUWLWZDVYHU\RULJLQDODQGIXQQ\,WZDVDOVR exciting and unpredictable.

Music Matters Equilibrium listened to a fascinating edition of Music Matters (Radio 3) with Tom Service recently – available on the Listen Again facility. He visited various groups including SMART in West London where they made music with Nordoff Robbins trainers and Grove Road music listening group in Bristol. Participants spoke of ‘grey clouds lifting and fog clearing’ as a result of involvement with music. He talked to Timothy Dowling leader of Grove Road and Professor Paul Robertson about what music exists for – it is a sort of self medication – a complex internal expression of oneself.

Haydn was the greatest antidepressant and that GPs should prescribe music on the NHS. Some do and more should! There is a unique course Music for health at the Royal Northern College of Music for graduates. He also talked about projects for children with Asperger’s syndrome and the Chelsea Mental Health Centre where music helps those with personality disorders and ‘schizophrenia’. The Archive programme (Mar 1) can be listened to on www.bbc.co.uk/ radio3 then follow links to Music Matters. There are also a lot of useful www sites given, including www.lahf.com (London Arts Forum) and www.apmt.org. (Association of Music Therapists).

equilibrium 17


in brief

news

Triumph! Eleanor Longden talked to Claire Campbell in the Daily Mail Femail section (February 2008) about her experiences with voice hearing, how she was hospitalised as a student, unlistened to and overmedicated, and 6 stone overweight as a result of the side effects of the drugs. She was bullied by fellow students when she went back to uni, and the voices worsened - probably another side effect of the medication. Finally she found Pat Bracken, inspired Bradford psychiatrist, who talked to her about the meaning of the voices – not to see them as a symptom of mental illness, but start

ORRNLQJDWWKHPDVDPHDQVRIÀQGing out about herself. She gradually reduced the medication until she stopped completely. She learnt to challenge the most threatening voice, refusing to do what it told her and telling herself it was no more than a symbol of her own internalised anger. One by one the voices disappeared until she was only occasionally hearing one. She’s now studying for a doctorate in clinical psychology and working with teenagers dealing with sudden onset psychosis. www.dailymail.co.uk/femail

From the New Scientist: Blood test to measure mood: Uni of Indiana have created a blood test to discriminate between highs and lows in bipolar disorder using gene expression patterns. So far the mood prediction test has had only 70-80 % accuracy. Apparently enzyme level measures will prove more practical. Not sure what use these will be put to – apart from further medicalisation of mood.

Prozac... The Great Debate:

c

New Scientist 2008

Lets hear it for the placebo effect! From the Guardian 29.2.08 ‘Expectation has been shown to be a key factor in the success of any counselling or psychotherapeutic approach; why not in every aspect of medicine? The placebo effect, mediated by intention, expectation and suggestion, enables and potentiates the person’s natural healing capabilities – and is arguably the mechanism by which many ‘complementary’ approaches work. What a wonderful thing placebo is – no side effects and works successfully a third of the time.’ Dr Ann Williamson

Motley Music A motley collection of music by people who’ve experienced depression, bipolar disorder, paranoia, guilt, rejection, frustration etc – ie most of us! Listen with care…. 1.Twisted – Annie Ross 2.Institutionalized – Suicidal Tendencies 3.Psychotic Reaction – The Count Five 4.Paranoid – Black Sabbath 5.Mind playing tricks on me – The Geto Boys 6.Take Pills – Panda Bear 7.4.48 Psychosis – Tindersticks 8.House on the Hill – Kevin Coyne 9.The Letter – Kristin Hersh 10.Mr Whisper – Dory Previn Dorian Lynskey – The Guardian 29.2.08 Playlist recommended by readers

equilibrium 18


Gallery23

Other Side Gallery artists. Clockwise from top left: Bonzo Been there before Gina Bold Black tortoise Eloise Untitled 1 Joseph De-Hann Atrium Geoff Mack Lilies David Barend Koekkoek Landscape Sam Heywood Ripe banana Steven Jackson Death in the clouds tmb Vander Bueno Photograph 2 Mike Hawthorne 51

Upcoming exhibition of Other Side photographers: 18th Aug-30 Sept. Our Space Gallery 12 Old St. EC1V 9BE

equilibrium 19 equili


Richmond Fellowship Employment Service Haringey

Forthcoming book from Clarendon!

CAREER OPPORTUNITIES AND WORK EXPERIENCE FAIR 16TH SEPTEMBER 2008 - 11 – 3PM @ The West Indian Cultural Centre, Clarendon Road, London N8 0DJ Come along to our event, where we will be showcasing local jobs for local people. There will also be a chance to meet with a variety local employers, training providers, and tap into great volunteering opportunities. We will have a Disability Employment Adviser (DEA), who will be available to give advice. Free CV advice Information, Advice and Guidance (IAG) This event is FREE Contact details: 020 8889 2378 Email:haringeyes@richmondfellowship.org.uk Richmond Fellowship is a national organisation that supports people who have been disadvantaged by mental ill health.


Equilibrium - Summer 2008