If we hide our mental health issues, we make it easier for society to ignore us | Clare Allan

People with mental health issues are being expected to “prove it” as never before. Whether, as individuals, being assessed for disability benefits or, collectively, campaigning for services and adequate welfare provision, the pressure to demonstrate genuine need, to prove that one is “really disabled”, to quote the Tory MP George Freeman, is greater than ever.

The invisible nature of mental health problems, the fact that they do not show up on an x-ray, that no blood test can diagnose depression, underlies much of the discrimination people with mental health issues face. Humans are strongly predisposed to believe in what they can see. For many people, it is hard to accept that severe anxiety, for example, might incapacitate someone from leaving their house as genuinely as if they were suffering from a physical paralysis. The fact that the problem cannot be seen makes it easier to dismiss. They could, if they really wanted to; they’re just not trying hard enough; everyone gets stressed sometimes, and so on. Of course, the help a person with anxiety needs to enable them to leave the house will be different from that of a person with a physical disability, but that doesn’t make the need any less real.

In the year since my dog, Meg, lost her leg I have often had cause to reflect on the different challenges presented by visible and invisible health problems. For it doesn’t get much more visible than a missing leg, you would think – though I have twice been stopped by people wishing to inform me, in somewhat accusatory tones, that my dog is “limping”. “Well yes,” I reply. “She’s only got three legs.”

The most obvious difference is that Meg has no option of going incognito. Her missing leg is a constant focus of comment and attention. As a dog, she enjoys the extra fuss but, as a human, I imagine it could rapidly become wearing. And there is the danger that one’s difference becomes the thing by which one is defined. Even with Meg, at the time of her amputation, I remember feeling – alongside concern as to how she would manage (remarkably well) – I didn’t want her to be the dog with three legs: I wanted Meg to be Meg.

Then there is the nature of the response, the feeling sorry for her (which I hate), the marginally better admiration (though what choice does she have other than to be “remarkably resilient”?), the need for an explanation: “What happened?”. In Meg’s case, the answer is far too long to fit comfortably into passing chat and, besides, it’s the fifth time I’ve been asked in a 30-minute walk. My favourite response, by far, is to ignore the missing leg altogether. There was a man I met on Hampstead Heath in London, coming in through the Kenwood gate, as Meg and I were leaving. “Wow!” he said, kneeling to embrace her. “What a beautiful, beautiful dog!” I could have hugged him.

It is these same concerns that lead many with mental health problems to choose not to disclose them. And to this I must myself plead guilty. For, though I’ve tried to be open about my own mental health, I confess I haven’t always been honest. I have occasionally cried off with a migraine, rather than admit I simply cannot face going out, or that I don’t trust myself to get through the evening without bursting into tears.

But while there are clearly advantages to having this option in some situations, it seems to me there are profound disadvantages, too. For the more we hide our difficulties, the more invisible they, and we, become. And the easier for those with an agenda – of cutting benefits, for example – to deny they exist at all.

If we hide our mental health issues, we make it easier for society to ignore us | Clare Allan

Young people’s mental health services need cash not empty promises | Clare Allan

It’s good to talk, and at the moment there’s a lot of talk about mental health and, in particular, about the mental health of young people.

I’m thinking, of course, of Theresa May’s recent speech, in which she announced a government green paper on children and young people’s mental health services, mental health first aid training for schools and a few other measures – to be funded apparently out of thin air – because mental health has been “a hidden injustice in this country” for far too long. From whom this injustice has been hidden was not specified.

BBC Radio 1, 1Xtra and Asian Network on Wednesday launched a year-long campaign “to encourage young people to explore issues surrounding their mental health”. My Mind and Me aims “to get young people talking about mental health, to reduce stigma around mental illness, and to raise awareness and understanding of mental health issues that affect young people”.

To assist them in this, they have partnered with the National Citizen Service (NCS) to create a group of “social action champions”, a group of young people from across the UK, who will work with the stations to help shape the campaign, sharing their own experience and leading discussions on “the key issues around mental health”.

Giving young people a platform to discuss these issues is certainly important. There is nothing more powerful than hearing directly from people about their experience, especially from people who are far too often stereotyped or simply ignored altogether. To hear an individual talk on their own terms and in their own words allows for a human-to-human connection that cuts through cliches and stereotypes. The result can be transforming. And as Ben Cooper, controller at Radio 1, 1Xtra and Asian Network, put it:“From prime ministers to our young listeners, we all recognise the need to change attitudes to mental health.”

It’s good to talk, but I cannot help feeling there is something of an elephant in the room. I confess that I listened to Theresa May’s speech, and much of the discussion that followed it, with my jaw hanging apishly open.

This government and the previous one have presided over the decimation of mental health services – “a car crash”, according to Prof Dame Sue Bailey, former president of the Royal College of Psychiatrists, speaking in 2014. She was just one of a chorus of voices, from patient groups to professional bodies, carers and mental health charities, all shouting the loudest, most urgent of warnings – it certainly wasn’t hidden from the government.

And between 2010 and 2015 funding for Child and Adolescent Mental Health Services (Camhs) was slashed by £50m, despite massively increasing demand.

Even setting aside both of those things, consider how, as a society, we are failing our young people.

However inconvenient the fact may be, mental health is not some discrete entity. The mental wellbeing of young people cannot be considered in isolation from the issues that affect their lives: the education system, benefits, housing, employment practices. In all these areas, the needs of young people have been trampled on over and over again by the boots of political expediency. And now they are supposed to believe we care about their mental wellbeing.

It may be that My Mind and Me is going to address these issues and I very much hope it does.

In 2016, winners of Radio 1’s Teen Awards, which included a mental health category, were invited to meet the Duke and Duchess of Cambridge, who praised their “inspirational work”. All fine, except that mental health problems have repeatedly been shown to be most prevalent in those countries with the highest levels of financial and social inequality.

And I know it seems churlish to point that out, but it would really be the bitterest of ironies if raising awareness of mental health issues became a means of avoiding confronting the factors that contribute to them.

Young people’s mental health services need cash not empty promises | Clare Allan

Give us a garden and we can cultivate our own hope and wellbeing | Clare Allan

The therapeutic rewards of gardening have been recognised by charities such as Freedom from Torture, which use it to support rehabilitate victims. Photograph: Alexey Stiop/Alamy

This is the season of abundance, when the garden is at its fullest. Flowers are in bloom and the grass is pushing through so quick that half an hour right after mowing it you seem to be back the place you started out.

This 12 months, for the first time, I am trying to develop my own veg. An try that has so far proved wildly effective, which is to say that the beds have gone wild with an virtually indecent profusion of lettuce and kale and spinach and some red leafed issue – I can’t now remember what it was, nor regardless of whether you’re meant to cook it.

I am a complete horticultural novice but you can not plant so much as a plug of curly leaved parsley without feeling a connection not only to the earth but to the a great number of generations who have worked the land ahead of you. To plant and to tend and to harvest what you expand is to feel an elemental sense of belonging that is deeply therapeutic.

My friend and gardening mentor agrees. Originally from Malaysia, Tash has lived in the United kingdom for much more than 25 many years because he initial arrived, aged 16. His ancestors had been also immigrants, travelling from the rice fields of south-eastern China to settle in what was then Malaya. “It is very practically about placing down roots,” he tells me. “It truly is no coincidence that so numerous individuals who have allotments in London originally come from somewhere else, from Turkey for instance, or Bangladesh.”

The charity Freedom From Torture (formerly the Health-related Basis for the Care of the Victims of Torture) has been using gardening as a form of therapy and rehabilitation for a lot more than 20 many years. Mary Raphaely, co ordinator of its Natural Growth Project says that customers can locate “an preliminary spark of hope” in nature.

A venture consumer, Suleyman, agrees, “To get started with I attempted antidepressants. But nothing at all seemed to hold the recollections away. Almost everything was darkness – and I hated the city, the place I felt confined and unable to communicate or do anything at all. Then I came here and every little thing seemed acquainted. I am always at 1 with the earth. If the garden seems very good, I feel excellent. When the soil sleeps, I sleep. Apart from these things you have, these snails and slugs which have been new to me, there is no evil in the backyard”.

The mental overall health charity Mind is also trying to harness the therapeutic electrical power of nature with its EcoMinds programme. Between 2009 and 2013, EcoMinds funded 130 projects across England with routines which includes gardening, meals expanding and environmental conservation. Over 12,000 folks participated and a lot more than seven out of ten reported a “important increase” in mental wellbeing. Last October, it launched Ecotherapy Performs, a national campaign focusing on well being and wellbeing boards with proof of the effectiveness of ecotherapy.

I consider this kind of schemes have incredible possible for strengthening the psychological and physical wellbeing of participants. When I feel of the 18 months I spent sitting in the common space of an inner-city day hospital, with a dead plant in the corner, smoking and drinking tea and envision rather paying them outdoors, not shut off from the planet but an active portion of it, feeling the rhythms of the earth, at one particular with the seasons, hands covered in soil, it does seem to be to me a more promising environment in which to seek to recover. An environment that can wordlessly provide exercise, community, a sense of goal, hope.

Due to the fact if gardening backlinks us into the past, to those who have dug the earth prior to, inevitably it factors to the future too. Once again and yet again, in that straightforward act of planting, I express my belief in the promise of tomorrow.

Give us a garden and we can cultivate our own hope and wellbeing | Clare Allan

How I took Basildon hospital out of specific measures | Clare Panniker

A nurse advised the well being secretary earlier this 12 months that workers at Basildon hospital now felt listened to when they raised worries. Photograph: Steve Meddle / Rex Features

There have been cheers – and tears – of joy final week when I broke the information to colleagues at Basildon hospital that we had been eliminated from specific measures. The announcement follows a “excellent” rating from the NHS regulator, and marks the starting of a new chapter for the hospital.

It was the knowledge of one particular couple, whom I met two months right after I was appointed as chief executive of the NHS basis believe in in September 2012, that really drove us to enhance. They had been the mothers and fathers of a 10-year-old woman who had died simply because of our failings.

Soon after the youthful patient suffered an epileptic fit, medical professionals were unable to give her the anti-seizure medication she necessary since our stock was out of date. To make issues worse, there had been no senior staff on duty to treat her simply because it was five.30pm and consultants have been on call but not on site right after 5pm.

As I am a mother of three, their story struck a personalized chord. I was appalled by the standard of our care and by no means needed any other dad and mom to be so let down by the hospital. This was the catalyst for a modify in culture that was extended overdue. Only by recognising and acknowledging exactly where things had been going incorrect could we begin to put them right.

Following a 2nd serious incident in October 2012, the Care Top quality Commission (CQC) severely criticised the leadership and culture of the children’s services. Meanwhile, in a survey, half the hospital’s employees said they would not advocate it to their buddies and family members.

The organisation required to place compassion, care, openness, transparency and learning at its core. These are worthy aims but, to translate them into action, the hospital’s bosses had to be a lot more visible. We went out on to the wards to hear the views of patients and employees at 1st hand. We invited individuals to share their experiences, excellent and poor, at our board meetings.

We changed our structures to place physicians and nurses at the heart of management and determination-making, guaranteeing security that was our top priority. We overhauled governance processes to make certain we realized from severe incidents.

We employed 200 much more clinical employees and put wonderful emphasis on delivering the greatest care 24 hrs a day, seven days a week, with consultants’ rotas guaranteeing senior cover out of hours. Recruiting much more everlasting employees has enabled the trust to lessen investing on agency workers.

But in the wake of the Francis Report into the devastating failings at Mid Staffs, the spotlight on trusts this kind of as Basildon had become even a lot more extreme. The government asked the NHS medical director, Sir Bruce Keogh, to inspect trusts that have been deemed to be among the worst-executing in the country. Regardless of all our improvements, we were dealt a huge blow when the wellness secretary, Jeremy Hunt, announced last July that we were a single of 11 trusts to be place into particular measures.

It was disappointing, as our turnaround was under way. Morale was improving, employees have been raising issues and we have been listening and altering.

We caught to our path and, during their 2nd go to in November 2013, Keogh’s inspection team endorsed our transformation, saying they would be happy for their friends or family to be handled at Basildon hospital.

Following a CQC inspection in March, we received our “excellent” rating final week. Our maternity care was the initial in the nation to be rated “exceptional”. Professor Sir Mike Richards, chief inspector of hospitals, advisable to Keep track of, the regulator of basis trusts, that we should be the very first to be taken out of unique measures.

The well being secretary praised our turnaround in parliament. He quoted a nurse whom he had met on his visit earlier this 12 months, who said the difference at Basildon hospital was that workers now felt listened to when they raised concerns.

Our task is far from full – like all NHS trusts, we have to proceed improving services despite a substantial reduction in funding. But for now it truly is wonderful to see patients, politicians and media speaking about Basildon hospital for all the right reasons. And I am determined to keep listening.

• Clare Panniker is chief executive of Basildon and Thurrock University Hospitals NHS Foundation Trust

How I took Basildon hospital out of specific measures | Clare Panniker

Clare Dimmer obituary

Clare Dimmer founded the charity Breast Cancer United kingdom and grew to become its chair

My colleague Clare Dimmer has died aged 58. When she was diagnosed with breast cancer, twenty many years in the past, she made the decision not only to fight the disease but also to tackle its leads to. Her conviction that fewer of us would need to endure this horrible illness if our daily merchandise and setting were totally free from hazardous chemical compounds drove her passion to make the world a safer, more healthy location.

Even though undergoing gruelling medical therapies, with a stoicism that unfailingly drew admiration, she grew to become a established campaigner for breast cancer prevention. In 1995, with a group of close friends, she set up the charity Breast Cancer Uk and in 2007 she grew to become its chair. In 2011, the charity successfully worked to create an EU ban on the use of the chemical bisphenol-A in making babies’ bottles, and it continues to campaign for the substance to be eliminated from all meals and drinks packaging.

She was born Clare Cole in Southampton and was brought up in the small Hampshire village of Otterbourne. She went to Otterbourne major college, Toynbee college, Eastleigh, and Eastleigh technical college. At 19, she met Kevin Dimmer and, a tiny above a yr later on, they have been married. They purchased their initial household home collectively in the village of Denmead and continued to reside in the location. Until finally the birth of their two daughters, Alannah and Zöe, Clare worked as a secretary/PA, latterly at Plessey electronics in Havant.

Clare brought generosity of spirit, persistence, humour and determination not only to her campaign work, but also to her hobbies of cycling, walking, badminton and singing. She would uncover any excuse to have a get together and celebrate daily life.

Clare is survived by Kevin, Alannah and Zöe, her mom, Pam, her sisters, Jane and Pippa, and her brother, Jonathan.

Clare Dimmer obituary