1-in-4 in the City

I was delighted to be involved in the launch of the "1-in-4 in the City" anti-stigma campaign pilot launch in Cambridge on October 1st.




The campaign is called ‘Time to Change’. Rethink is leading an £8.1m England-wide anti-stigma social marketing campaign to raise awareness of mental health problems and reduce stigma and discrimination. This is one part of a bigger £18m programme funded by Comic Relief. The approach is focussed on getting people to talk about mental health. Time to Change hopes to:

• Create a 5% positive shift in attitudes towards mental health problems by 2012


• Achieve a 5% reduction in discrimination by 2012


• Increase the ability of 100,000 people with mental health problems to address discrimination


• Engage more than a quarter of a million people in physical activity


• Produce a powerful evidence base of ‘what works’.

For more information see tthe trust website and "time to change"

Suicide GP 'frustrated' at work

Nik's comment: sadly another example of the unheard voice of the depressed. The telling quote: "everything was perfectly normal". Absolutely nothing is perfectly normal when suffering clinical depression, and this need for education must be tackled urgently.

[source: BBC]

A GP who was "frustrated" at work died after taking an overdose of antidepressants and alcohol, an inquest in Cheshire found.
Dr Janet Wreglesworth, 43, a doctor in Chadderton, Oldham, committed suicide at the family home in Warrington.
Her husband Brian said there was "no indication of anything wrong" before her death, but said she was not enjoying part of her job.
Mr Wreglesworth later said he was "shocked" by the suicide verdict.
His wife was a GP at the Block Lane surgery, which had spent more than two years trying to find a new doctor to buy into the practice and a new practice manager.
Mr Wreglesworth told the inquest, at Cheshire Coroner's Court in Warrington, that his wife did not enjoy the business side of her work.

He said she often did not return home until very late at night after interviews for the jobs.
"She seemed frustrated at the slow process. She couldn't understand why other people couldn't be as committed," he said.
"She didn't like running the business side of things and she didn't like the interviewing process because she wanted to be a doctor - the thing that she was good at."
Mr Wreglesworth, 45, said when he last saw his wife they discussed finding a hotel for a Paris break they had booked.
"I kissed her goodbye. There was no indication of anything wrong."
Mr Wreglesworth found his wife's body when he got home from work on 19 February.
Tests found she had high concentrations of the antidepressant dosulepin and alcohol in her body.
'Absolutely devoted'
Dr Wreglesworth had also taken the drug citalopram, which she had been prescribed to treat depression, and paracetamol.
She had previously been treated for depression and had been drinking more, her husband said.
Cheshire coroner Dr Geoffrey Roberts recorded a verdict of suicide.
Mr Wreglesworth said after the hearing: "I'm shocked. It never occurred to me.
"None of it makes any sense. We'd just booked a holiday.
"She was adored by her patients. She was so kind and caring. Everything was perfectly normal."

Mental health bill 'will spiral'

[source: BBC]

The cost of caring for people with mental health disorders is expected to spiral, a report says.

This is due to a predicted rise in the number of people in England with dementia, the King's Fund study argues.

In total, it will cost £47bn a year, compared with £22.5bn in 2007, the think tank said.

The early detection of mental problems and prompt therapy could help the wider economy by keeping those affected in work, the report added.

Britain's ageing population means that diseases of old age are set to rocket in the next two decades, according to the King's Fund.

It is predicting a 61% rise - hundreds of thousands of extra cases a year.

This, coupled with inflation in healthcare costs, is almost completely responsible for the rise in the annual bill shared between the NHS and social care services.

Niall Dickson, the chief executive of the King's Fund, said: "The fact that we are living longer is cause for celebration, but it will mean that the health and social care systems will have to cope with a dramatic increase in the number of people suffering from dementia."

The incidence of other mental disorders, such as depression and schizophrenia, is expected to stay roughly the same, said the report.

In 1997, in addition to the £22.5bn directly spent by the NHS and social care providers, it is estimated that the mental disorders cost the economy an additional £26.1bn, as people affected were unable to work.

Hidden benefit

Researchers suggested that early diagnosis and treatment of more people with conditions such as depression could help reduce this.

As well as calling for increased detection and treatment of mental disorders, the King's Fund report also called on future governments to ensure that funding for services keeps pace with the likely increase.

A spokesman for the Department of Health said that it recognised dementia as a "significant health challenge" for society.

She added: "That is why we are determined to bring dementia out of the shadows and later this year we'll launch the first ever national strategy to improve the quality of life for people with dementia and their families."

Mental health charities welcomed the release of the report.

Mind chief executive Paul Farmer said: "This makes a robust economic case to invest more broadly in mental health because it's worth it."

And Andrew McCulloch, from the Mental Health Foundation, said: "The scale of the problem regarding old age and dementia is a serious worry."

But Marjorie Wallace, from Sane, said: "We are concerned that the increasing need to channel resources into the treatment of dementia could force savings to be made elsewhere, in particular through cuts to psychiatric beds and inpatient care."

Putting a spring in your step

[source BBC]

There's nothing new about doctors recommending their patients take more exercise. But what kind?

You could pay a fortune for gym membership, or you could trudge down to your local swimming pool and spend the rest of the day smelling faintly of chlorine.

But the best exercise of all might be the easiest and the cheapest: a stroll in the park, or a country ramble.

The secret ingredient? Greenery. Those of us who live in towns and cities, and even some who live in the countryside, don't get enough of it.

The result for most of us is highly stressful; we get irritable and depressed, and even physically ill (because high levels of stress mean higher risk of things like heart disease and diabetes).

Yet put us in contact with trees and grass and levels of stress fall away.

Natural remedies

The notion that nature does you good is one of the themes of this year's Springwatch series on BBC 2.

Bill Oddie, one of the Springwatch presenters and an enthusiastic bird-watcher, suffers from depression. He has no doubt that contact with nature helps him.

"I know I'm really in trouble when I don't want to go outside and I can't bring myself to do it," he says.

"I've had three clinical depressions, which means going into hospital, and that's the stage where I know nothing's going to help.

"But when you get a downer, and lots of people suffer from this, there is no question, every self-help book, every doctor, every therapist will tell you: get out there in the fresh air, get yourself moving. It's to do with fitness, it's also to do with a meditational thing."

Scientific support for Bill's beliefs comes from Dr William Bird, who combines a career as a GP with a part-time role as health adviser to Natural England.

Last year he produced a report for Natural England and the RSPB arguing that contact with nature and green space has a positive effect on mental health, especially among children.

Some have gone further still. An American journalist, Richard Louv, author of Last Child in the Woods, coined the term "nature deficit disorder" (an echo of the medically-established condition, attention deficit disorder) to describe the deprivation, sometimes amounting to mental illness, of children who grow up without contact with the natural environment.

"Nature deficit disorder" is not a condition the medical profession recognises, though common sense suggests that children who take virtually no exercise and rarely get into the great outdoors are unlikely to be healthy and are missing out on a lot of pleasurable experiences.

Dr Bird is urging his fellow GPs to prescribe regular walks and exercise in green spaces for patients suffering from heart disease, depression, obesity and the like.

Referring patients to the natural environment rather than the pharmacist is a lot cheaper than conventional pills and prescriptions and, he argues, is likely to be just as effective in many cases.

But haven't we always known that contact with nature was good for us? Yes, says Dr Bird.

"But we kind of lost it when we got clever with our science. As soon as we got antibiotics and we got technical, we felt we didn't need all that green stuff.

"Now we've realised all that technical stuff can treat you, but we also need the greenness to provide a backdrop for preventing ill-health and for healing."

Happy feet

There's some evidence that patients themselves are willing to go along with the idea.

The results of a Mori poll, commissioned by Natural England and released exclusively to the BBC, show that 94% of us would be happy for our GP to provide outdoor exercise instead of prescription drugs, if he or she thought it would work.

Natural England has already established jointly with the British Heart Foundation a network of "walking the way to health" initiatives. Many areas now have "walk and talk" or "health walk" schemes, run by volunteers who encourage local people to gather regularly for walks ranging from gentle rambles to more demanding hikes.

Some GPs' practices are already prescribing exercise as an alternative to drugs.

The Culm Valley Integrated Centre for Health in Devon is one. A partnership of a dozen GPs, it occupies a splendid new architect-designed building, more like an old-fashioned cottage hospital than a conventional GP practice.

The Centre's symbol is "the Green Man", a kind of medieval nature spirit: outside the building is a herb garden; inside they offer complementary medicine as well as conventional clinical consultations.

We met one patient, Roger Cowley, who'd been suffering from obesity and depression and had been effectively confined to bed.

He's been given a "stepometer" that counts the number of paces he takes each day and receives help from Ruth Tucker, an exercise adviser working with GPs.

His eventual target is to take 10,000 steps a day, walking in the fields around his home. So far, he told me, he's up to 4,000 or 5,000.

"I think we've lost contact with our environment, and when you become de-rooted you become alienated, and that's part of becoming unhealthy," says Dr Michael Dixon, one of the partners.

"We know that the most sustainable treatment for depression is exercise, not anti-depressants: a year later people who take exercise are still improving, when with anti-depressants the effects are gone."

Other doctors may take some persuading to prescribe a walk in the country.

Natural England polled 70 GPs and nurses and found that 61% recommended that patients use green space, and 79% recommended walking informally.

But that still left a sizeable minority who didn't.