It’s not all about location, location, location

One of the papers I read last week was published way back in 2012. I was looking for references I could use about choice, and how many of us have actual choices over important aspects of our life. Choice is possibly best described as being able to choose a preferred option from a range of distinctive alternatives. The paper was written in the context of choices people can make when actively trying to engage with the housing market. For example, how many homeless people choose to be or to remain homeless, and in terms of the basic need for shelter, they have no choice.

As Phil and Kirstie have pointed out over many years, choosing a house can be dependent on money, location, whether folk are upsizing or downsizing and lifestyle. When J and I bought our house, we had plenty of choices to think about, but there were also some limitations. I didn’t want to live in Wales again and J didn’t fancy Scotland, and after a brief flirtation with the thought of living on a narrow boat, we agreed to compromise.

We chose to buy our little house for five reasons. One, it was somewhere neither of us knew that we could discover in our new life together, two it is just a 10-minute walk from the beach, three, we can easily commute into Manchester, the Lake District and Lancashire, four, the house is like a Dr Who Tardis in that it looks like a small cottage from the outside, but inside it is a house with many rooms, and for much of the year, it is a sunshine-filled house. There are plenty of windows, big and small. In the summer, we tend to live in the end of the house that is nearly all glass, and in the winter, live in the other end of the house that has smaller more traditional windows, and a lovely log fire. The fifth reason is that it has an extra-large garden for our hens and goats to live in and me to potter. It suits us and does wonders for our sense of wellbeing.

The environment, in all its senses, can have a profound impact upon our mental health and wellbeing, good and bad. We can’t escape the environment, and it exists at spaces we call home, work, and even socially - the people we are around and the communities in which we live and are a part of. We know that young children who live in conditions of poverty, with poor housing, nutrition, and stimulation, are more at risk of mental health and behavioural problems. At the other end of the spectrum, and particularly with people living with dementia, the use of colour and simplicity in the home can soothe, signpost and reassure people with cognitive difficulties.

Where someone lives is not just about the house they reside in. Where the home is situated can also have an impact. We live on a fairly busy road and sometimes the traffic noise can be irritating and intrusive. Ours is a generally safe area, it seldom snows, there are plenty of green spaces and we are blessed with a wonderfully diverse community. We benefit from tourism and the attractions that draw people to holiday here. That said, there are pockets of extreme poverty close by, and unemployment levels are high. There is a thriving community grocery store/foodbank just up the street. Sadly, this continues to be very busy.

Now you might wonder why I am rambling on about the impact of the environment on our mental health and wellbeing? Well last week I was reminded of this connection in a couple of ways. The first followed a visit to Atherleigh Park, one of our inpatient and community services in Wigan. What a place. It was a purpose built, modern, spacious, light, airy and sunshine-filled environment. It was also one of the cleanest and uncluttered places I had come across in many a day. An air of calm pervaded the clinical areas, and it felt a very comfortable place to be. The design of Atherleigh Park, both promoted a sense of wellbeing and provided a great environment for contemporary mental health care.

I was hosted by the energetic, knowledgeable, and happy Head of Nursing and Quality, Natalie Molyneux. She had clearly embraced, and practised, the art of visible leadership. As we walked around the unit, she greeted colleagues and service users by name and knew something about each of them. I learned a lot and will definitely be returning very soon.

The second reminder arose from the publication, last week, of the NHS England-commissioned independent review into the care and treatment provided by GMMH, following failings within the Trust’s services, particularly the Adult Forensic Services. The review was commissioned following concerns by patients, their families, and colleagues, some of which were presented through the media, most notably a Panaroma programme based upon the findings of an undercover reporter. The report makes for a challenging read, and its publication will have impacted in many different ways upon all those working for our Trust and served by our Trust. Supporting our colleagues and services users was the number one priority last week, and being there for others will continue to be something we continue to do for some time yet.

Among other things, the report notes that the environment was not conducive to providing high quality mental health care, both from a physical and cultural point of view. Much work has been done to address these issues since the review was undertaken and there remains, of course, much more to be done. Meeting Natalie and her colleagues gave me the reassurance that we have many other folk who are willing, capable and passionate enough to really make a difference to the services we provide.