A Hopeful Resurrection, Contemplating Suicide and Saying Goodbye

 With so many colleagues on holiday last week (and next) it has been a week for taking stock, getting all those things done that have slipped down the 'must do list' in favour of addressing the latest crisis or meeting yet one more demand generated by others. That said, the week felt, for the most part, a relentless task orientated one with little time (or energy) left for blue sky thinking.

So I was glad to get to the weekend (a long one) and enjoy a chance to step of the merry-go-round for a few days. Whilst the weather yesterday was pretty mixed it didn’t prevent me from going out to the annual Bolton Food and Drink Fair. This year’s event appeared bigger than ever. It really was so good to see so many people crowding the Town Hall Square and the surrounding streets. The last few times I have been into Bolton it’s been dead, no noise, no action and not attractive at all. This weekend has clearly provided a boost and I hope it will be the start of Boltons resurrection so that once more Bolton will become a place to shop, visit and enjoy at a weekend.

This week I came across a newly published research study that examined the relationship between physical illness and suicide. The report, Hidden data provide new insights into life at the end: the truth about suicide was published by DEMOS. DEMOS are a highly regarded independent think-tank focused on power and politics. During 2011, DEMOS focused on five programmes: Family and Society; Public Services and Welfare; Violence and Extremism; Public Interest and Political Economy

And as the report notes, suicide continues to be an extremely important public health issue here in the UK. In the UK there is one death by suicide every two hours. Nearly four times more men than women die from suicide. Although over the last decade the overall rate of suicide has fallen, in the last two years there has been an increase. Indeed, data included in the Coalition Government’s recently published Consultation on Preventing Suicide in England suggest that the 20 per cent reduction target set by the previous Labour Governments National Suicide Prevention Strategy is unlikely to be achieved. Suicide rates tend to rise during periods of high unemployment or economic uncertainty. Some of the key risk factors for suicide are well known and include gender, unemployment, drug abuse and mental illness, the latter being considered as the most significant risk factors.

Of course this is not new. In 1897, Emile Durkheim, the French sociologist, published what at the time was a paradigmatic shifting thesis on the prevailing view of suicide. He described four subtypes of suicide: Egoistic; Altruistic; Anomic; and Fatalistic. For me it is the egoistic and anomic subtypes that are of most interest – both deal with the individual sense of self and self in relation to others, and perhaps more particularly the impact of perceived expectations of others on self.

Durkheim established through his work that generally suicide rates are higher in men than women, for those who are not married, or for people without children, for soldiers rather than civilians, and are higher in Scandinavian countries. This new study by DEMOS adds to our understanding of suicide and is definitely worth a read by all those interested in this aspect of mental health care and the care of people with long term conditions.

Friday was both the end of the working week, and unfortunately the end of a fabulous relationship. Lunch was spent saying goodbye to a wonderful colleague and friend who was moving on to a different place. Although I found lunch a very sad occasion, I was reminded that like all good relationships that involve hard work, there had also been plenty of fun along the way as well.

And fun it was yesterday – my grand niece was staying for a sleep over and although she is only four, sometimes she behaves as if she was 40 - and she certainly reminds me I am 56! When I asked her if she wanted to have some music on as she ate her dinner, without hesitation and in all seriousness she said she would rather like to listen to Coldplay! So that’s what we played and in truth, it was lovely to hear such fine music again.

Strategic Thinking in Cheshire and Cello gets a new Soul Mate

Monday wasn’t the best day of the week for me. It was the start of what turned out to be an exhausting week, and the day ended with unexpectedly finding one of my female colleagues (and friend) had taken up smoking again. So I was more than interested in reading a piece in yesterdays Telegraph newspaper reporting on some recent research involving women’s belief about the seriousness of lung cancer. Lung cancer is the cancer that kills most women in Britain. The survey revealed that most women thought that 40% of sufferers would live for 5 years after diagnosis, whereas the real figure was only 9%. Smoking remains the biggest cause of lung cancer. That so many women are still smoking is amazing. This study appeared to suggest an almost state of denial being adopted by many women of the consequences of their choice to smoke.

And smoking was still on the agenda by Thursday when I drove to Cheshire to work with a group of mental health service providers on helping them to think more strategically about where they wanted to be. I went to work with the Executive part of their Trust Board. Two of this group smoked, and the time spent together was definitely punctuated by many so called ‘therapeutic smoking breaks’. While all staff are banned from smoking on any part of the Trust premises service users are allowed to smoke in designated areas. This approach sparked an interesting side debate about what message this sent in terms of promoting health and wellbeing across the Trust.

However, it was a lovely venue to hold a retreat and the group worked well over the two days in developing their understanding of the difference between strategic thinking and strategic planning – the latter activity was one they were very good at doing. Unnervingly (for me) it was my analysis of the mental health world that was up for scrutiny – presenting an expert veiw in this kind of context is always a difficult situation to find oneself in. The conversations were, however very interesting. And as a group, they reached a consensus over what the strategic direction and intent was, only late on in the afternoon. But they got there and that made the second day a very productive one.

For me it was a real privilege to work with such an interesting and informed group of practitioners. Some definite opportunities for further collaborative work between the Trust and the School were identified. Driving back on Friday afternoon, although very tired, I felt in a very good place, and once again thought how fortunate I am to have such opportunities. It has made me more determined to try and ensure that others have similar opportunities to both grow and develop personally and contribute to the development of the services we prepare others to work within.

Yesterday, my youngest brother arrived. He and his family were to spend Saturday and today here before returning to the lost city of London. His two children were a delight and in turn, delighted Cello, who as always, is always up for as much attention as he can get. By late afternoon, my brothers daughter had formed a real bond with Cello and they were inseparable.

The children went to bed asking for the 100th time when were they going to get a dog. I certainly don’t envy my brother the drive back to London!

Sitting in the seat of the armchair anthropologist once more

Last week was hectic! The first day back from work came and went at an almost bewildering speed.

The oasis of calm on Monday was a PhD viva – the second time for the student and this time such a better experience for all. There is something very special in spending that couple of hours having a conversation with someone passionate enough about a particular question that they spend three, four or more years studying it. And for me, once that door has closed and the viva starts, the outside world cannot intrude – it is an almost self-indulgent activity. For this candidate it was a successful conclusion to five years work, allowing a welcome return to his family and friends.

My new office, started on Saturday, was welcoming but not complete – somehow it didn’t quite work for me. It was Tuesday before I began to feel a creative certainty over what to do – chairs were exchanged, pictures placed on walls and at a stroke the room delivered on its promised magic. What I had been missing for a while now was a space that would allow me to think, write and converse with others. By the time I had got to Tuesday going home time, I felt I was getting somewhere, and the new office was starting to feel like a place to centre ones thoughts in. Just as well perhaps, as it took me two hours to get home that night.

The riots, sparked by a death of a young man in London had spread north. Starting in Salford, the dissent and mindless wanton destruction quickly spread to Manchester city centre. The result (coupled with an accident on the M60) was gridlock and the inevitable long journey home. All comparisons are odious, and I was particularly put out by the way in which the media kept cross referencing the behaviour of rioters in Manchester with the street protests there were in Thatcher’s early years. It was strange watching the old archive films of the anti Thatcher protests on the news programmes, and for me, a little sad.

Later on in the week I started the task of preparing for a two day workshop next week aimed at trying to consider what the future holds for mental health care providers and service users in the North West. My approach to such tasks is to search for, download and print off, everything I can find to read on the question being addressed. It is an activity akin to that sense one gets with the ethnographic immersion into the field that typifies the work of anthropologists. In this case it is a form of anthropology, sometimes called armchair anthropology that sees the ‘anthropologist’ using and relying upon the work of others to provide the ‘data’ for analysis. For me it is an approach that inspires huge amounts of creative analytical thought.

It was Edward Tylor who is considered to be the greatest armchair anthropologist. Tylor’s first and only field trip was to Mexico in 1856. He never traveled anywhere again to collect data, although he continued to study the customs and beliefs of many different tribal communities, both existing and prehistoric. His work, Researches into the Early History of Mankind and the Development of Civilization, published in 1865 was based entirely on the studies and information collected by others. His most influential work however was, Primitive Culture published in 1871. This work set the foundations for what we know today as cultural anthropology.

This week, I have trawled my way through over 45 separate pieces of policy, governmental guidance, white and green papers to try and gain a sense of where it is we have come from and where it might be we are going to in terms of new directions for mental health care. It is a process that involves first deconstructing the [policy] rhetoric in order to be able to re-construct a new view of a possible future.

In dealing with all the day to day turbulence of change that has characterised much of my work over the past six months, I had forgotten what a pleasure it is to sit in the seat of the armchair anthropologist once more. Now I have a new creative space, it is a seat I intend to occupy a lot more in the future.

Two Weeks and 100s of Emails Later - it’s back to work!

Well the last two weeks have been a wonderful break. The sunshine, sea and isolation of Scotland were fantastic, a real tonic and totally relaxing. Last week was more unreliable weather wise but there were plenty of sunshine filled days nevertheless – but it was a week of chores and getting things done that are more difficult to do during the weekend.

The tree surgeon came for his annual visit – trees are lovely things but certainly need looking after. Cello went for his regular check up, as always an absolute star and of course loves being the centre of attention. I spent an hour or two choosing new shelves for my office at work, and thought I am possibly becoming too much of a grumpy old man to tolerate IKEA any more. But many thanks to our caretakers who took the flat packs out of my car and up to the new office. Jennie and I have swopped offices in preparation for the new enlarged School and although I am sure it was a pain to organise my thanks also go to Jennie and colleagues for getting things sorted while I was away.

Yesterday I called in and assembled the book cases – I really am becoming a grumpy and impatient old man, who should stick to buying ready assembled furniture. I abandoned the project after a few hours, and I guess it will take me some late evenings this week to get things sorted and comfortable.

Following on from a conversation I had a few weeks ago at a wedding reception I was invited to go and meet some colleagues at a mental health service in the West of what our new NHS SHA Cluster refers to as the NHS North. Whilst some might some think this a strange thing to do on holiday, it was partly business as well as pleasure. The morning was very bright and the sun shone. It was gorgeous walking around the grounds of a relatively unspoilt and slight old fashioned mental health hospital. Someone clearly had spent time, love and care on the grounds, and the space and quietness was soothing.

Today I will have to turn on my outlook account and start to look at the emails – 100’s, but hopefully, many of these will have already been looked at and responded to by colleagues – so it will be more a case of me catching up. A bit like Cello, who has been trying every night for the last two weeks, to catch Henry our resident hedgehog - every night he waits for Henry to walk across the front lawn, at which point he becomes beside himself with excitement - until last night Henry has always disappeared by the time Cello has gone out for his last walk - but last night he hadn't and Cello managed to catch him - Henry of course rolled into a ball leaving Cello completely flummoxed! Just as well...

...and now I am off to enjoy the last few hours of my holiday.