Getting closer to nature: good for our mental health and wellbeing

This week’s blog comes from Chur, which is Switzerland’s oldest city. People have been living here since 3,000BC. I have to say the city is situated in one of the most spectacular settings I have seen for a while. The Plessur and Rhine rivers meet in the city and the whole place is surrounded by high Alpine mountains. The old town in particular, is simply beautiful. Yesterday was very cold but it simply felt good to be outside walking in the winter sun. 

On Friday we took the Bernina Express to St Moritz, and then yesterday continued across to Chur through some of the most beautiful snow covered mountains and countryside I’ve seen in a while. The route is a UNESCO World Heritage Site. In total, the train crosses 196 bridges and through 55 tunnels. For much of the journey the train travels at a very sedate pace - a train equivalent of cruising a canal on a narrow boat. 

We are half way through a two-week holiday in continental Europe. We are travelling by train through England (well Blackpool to London), France, Italy and Switzerland and back home to Blackpool again. Last year we travelled from Blackpool to Istanbul by train. Jane and I enjoyed the slow pace of travel so much that we signed up for this trip on our return. We have not been disappointed. 

Apart from an overnight stay in Zurich last year, I haven’t been to Switzerland for many a year. It feels great to be back visiting once more. Next week we will be travelling the Swiss city of Basel on our way back home. Growing up, my parents would take us to Basel to see my mothers’ parents, often at this time of the year. I have some great memories of Christmas trees lit with real candles in little silver holders, proper snow, chocolate porridge, and once memorably, taking the night train from Victoria station in London. These family holidays were a brilliant part of my childhood.  

So far, this trip has lived up to our expectations and every place we have visited. has been a delight. Travelling by train, I feel much closer to the countryside we pass through. For me, there is a much greater sense of connectedness with the places we visit, that you don’t get by simply arriving somewhere on a plane. The journey itself becomes part of the experience and passing through some beautiful countryside, is a real tonic.

This trip has reminded me of how powerful connecting with nature can be. For me, and I’m sure for many others, being outside and connecting with nature has a positive impact on my mental health and wellbeing. There are other benefits too. Last week I read about little five-year old girl, Aurora. The story told of her making a ‘cake’ out of sand and mud, with mixed-in imaginary carrots, potatoes and meat. Somehow in the process, it was transformed into a ‘chocolate cake’. Aurora was making her cake while at her nursery school in Lahti, Finland.  

In this nursery, children are actively encouraged to literally get their hands dirty. The nursery is one of 43 day care centres across Finland that have been funded to increase children’s exposure to the microscopic diversity, such as bacteria and fungi, that can be found in nature. As well as being good for the child’s wellbeing, it can encourage a healthy immune system. I have long thought that the reason so many children have allergies today is that they are not exposed to microbes (what my mum might have referred to as ‘germs’) in our environment.

The first 1,000 days of a child’s life are crucial. It’s during this time that a child’s brain and body are most rapidly developing. Wrapping children up in ‘cotton wool’ to protect them from ‘germs’ is almost certainly not the best way of protecting a child from childhood and adult diseases and illnesses. We still apply the three-second rule in our house. If a piece of food falls onto the floor and can be picked up in three seconds, it’s safe to eat. Mind you, sometimes it can be a race against time if Dylan the dog is also in the kitchen!

Sadly, the UK is one of the least ‘nature connected’ countries in the world. Nepal is the most connected, and having visited there recently, I’m not surprised. Croatia and Bulgaria are the only European countries in the top 10 of a study which involved 61 countries. Having visited both these countries during our train holiday last year, again, I’m not surprised. Before I get back on our train again later this morning, can I just share that the number one research-based tip suggested by the Mental Health Foundation to protect and improve our mental health and wellbeing is ‘getting closer to nature’. Wherever you are, let’s all get out there and have some fun. 

Caring for the 18,000

After such a great week, I am almost hesitant to write this week’s blog. Among other things, I attended the NHS Providers conference in Manchester. It was a truly motivating week for me, but sadly for many others, up to 18,000 others in fact, this week will have been a real challenge. Last week, our Secretary of State for Health and Social Care, Wes Streeting, finally gave the go-ahead for a large number of redundancies across the NHS. The 50% reduction was first announced earlier this year, with many colleagues having endured months of uncertainty, as to whether they would have a job in the future.

It will have been a dreadful time for colleagues who potentially will be impacted. A Sword of Damocles doesn’t even begin to capture what they will have been going through. Wes stood on the stage at our conference last Wednesday and apologised that it had taken so long to get to this point. He apologised for the undeniable hurt that will have been caused by the delay. However, he said at least progress could now be made on reducing the numbers of people working in NHS England, the Department of Health and Social Care and in Integrated Care Systems.

That was my ‘however’. I cannot imagine that any one wants to hear that they may be losing their job. I have always been fortunate in being able to make my own career choices. Some decisions have been great, others less so. But I have always been able to control where I work and what it is I do. Not having that choice, like many others I’m sure, would be devasting. There is no good time to hear such news, but being so close to Christmas will add to the sense of worry and loss. And such it will be for many people; a loss of income, a pause to a career pathway, possible family disruption, and importantly a possible loss of their sense of self.

After such a good week, a week where I was inspired as to the possibilities beginning to emerge around transforming health care provision in the UK, this news felt inconceivably depressing. I have held many management leadership roles. Yes, I have worked in organisations that have downsized, and sometimes I have been responsible for such programmes. I like to think that such difficult times for those affected were managed well, putting people first in achieving what the organisation wanted or needed to do. How people have been treated doesn’t feel like this is the case here.

The theme of the conference last week was ‘Recharge’. I think it was meant to reflect the enormous changes facing the NHS, and the opportunities doing things differently might bring. Some of the sessions reflected this optimism. I was entranced by the possibilities that artificial intelligence (AI) might bring, different approaches to commissioning care and the lessons we can learn from international perspectives on neighbourhood health.

Ironically, one of the heavily promoted sessions was one on different perspectives of leadership. It was a facilitated conversation between Terence Stephenson and Victor Adebowale (both currently Chairs of NHS Providers, and NHS Confederation). They took us through what they thought makes for an effective manager and a great leader. I say ironically, because what they shared bore no resemblance to the reality of the leadership and management behaviours demonstrated by those responsible for the structural changes to the NHS.    

It doesn’t have to be like this. I once worked with a medical director called Umesh. At every Board meeting, he would remind us that happy staff made for happy patients. There is an element of truth in this. It doesn’t matter what role you play, whether you are close to the patient or in support of those who are, feeling good about what you do, and how you do it, will enhance the difference you can make. I just hope that those charged with actually delivering the widespread NHS redundancy programme, which will impact so many people, do so with humanity, care and compassion.

Not thinking about the morning after, but of 50 years ago

When I was a teenager, my world was one of sex, drugs and rock n’ roll. Well not drugs. I didn’t indulge then and have never since. Those years, somewhere between me being 15 and 16 were brilliant. Hedonistic for sure, but some of the happiest times of my life. I was just a little too late to be an authentic hippie, but in 1970, I believed I was. There was free love, long hair, the greatest music every made, the pill, and of course beads, bracelets and the ubiquitous Afghan coat. I think it would be fair to say I made the most of my life during that time.

However, responsible adulthood was just around the corner. As far as I know, despite the free love, and ‘easy come easy go’ relationships of that era, my first child entered the world in December 1975. It was time to settle down, I guess. Now there were two stories last week, which reminded me of that time. The first was the story that Gosport had seen the fourth highest rise in teenage pregnancies of all towns across England. For the first time in 14 years, teenage pregnancy rates have started to rise.

I must confess that I had never heard of Gosport and as far as I’m aware, have never met anyone from there. It is in Hampshire. It boasts several museums, including a submarine, a naval fire power, a diving and a Hovercraft museum. There is also an art gallery, and a 1642 Living History Village. As a later life commentator, I would have thought there was more than enough to keep the Gosport teenagers distracted and gainfully occupied. But come to think about it, museums didn’t feature much during my teenage years either.

The latest data from the Office for National Statistics on teenage pregnancies in the UK is for the year 2022. Although across England, there has been an overall rise in conception rates for both girls between 16-17 and for girls under 16 years of age, the actual rate remains below that of pre-pandemic levels. So, a good thing, as long as the rate doesn’t continue to rise. However, globally, teenage pregnancy is still a significant public health issue. Across the world, over 21 million pregnancies among 15-19 years olds occur each year.

There is much that can be done. In the UK, local authorities and health services must work more closely together. Together they have a responsibility to ensure young people have access to information and services that facilitate more informed choices about relationships and contraception. Which brings me to that second story.

This was the news that emergency contraception pills will be free for women to get from their local pharmacy. Last week this announcement was described as the ‘biggest change to sexual health services since the 1960s’. The emergency contraception pill, more commonly referred to as the ‘morning after pill’ is now free for women to pick up, without them having to see their GP or get an appointment at a sexual health clinic.

This initiative builds upon the recent introduction in many thousands of pharmacies of contraceptive advice services, consultations and repeat prescriptions without women needing to have a doctor’s appointment. Indeed, Jane’s youngest daughter now gets her contraceptive pill from Boots (there are other pharmacies) where assistants check her blood pressure and general health, before handing over the prescription; something she is well pleased with. She trusts them as health professionals, and her Boots is just a 10-minute walk from her apartment. As we are with our pharmacy team. They know us and we know them too. Over time, they build an important informal knowledge base that if used appropriately, really will help the left shift to neighbourhood and community care.

Whilst this new initiative is aimed at all women of childbearing age, young people under 16 years old will need to be assessed using the Gillick competence and Fraser Guidelines. I refreshed my understanding of these guidelines; you can too here. 

Thankfully, I think the Gillick and Fraser guidelines provide a solid foundation for young people seeking help around contraception and pregnancy, particularly where they don’t want to, or feel able to involve their parents. As in Gosport, getting this information out there and to young people will make the difference. A national awareness raising campaign has been kicked off, and this sensibly makes use of the social media channels many young people and young adults might use.

Just as a slight throwback to my youth, this ageing hippy is currently awaiting delivery of an all-black Afghan coat – I just hope it doesn’t smell as bad as my original 1970 one!

The Wizard of Oz, well his rainstick at least!

This week’s blog was inspired (not sure that is the right word) by a question from my youngest sister. She lives in Australia, which she has done for many years. My sister had been having a nostalgic conversation with her daughter and the subject of where a gift I had given to our mum came up.

Apparently, many years ago, I had bought my mum a rainstick. She had admired one I had and so I gave her one similar. I think I bought my rainstick in Australia. I’m not sure when though. My first trip there was in 2001, and that seems the most likely occasion – more of which in a moment. However, it appears that I told my mum the one I had bought for her came from the Lake District. So, the question from my sister was ‘why the Lake District?’. This simple question sparked off a whole lot of memories.

For those who don’t know, a rainstick is a long hollow tube about 1 metre long. They are usually made from bamboo or cactus and contain rice or tiny stones. When the rainstick is turned, the rice or stones fall to the other end of the tube. As they brush against any internal protrusions, they make a soothing sound that sounds like gentle rain falling. Rainsticks can be found all across the world including in Peru, Chile, Africa, India and Australia. In each of these countries, rainsticks have often been associated with folklore customs connected to bringing rain during times of drought.

The reason I think I would have bought my rainstick in Australia is because the aboriginal people have used them as rituals for centuries in various ceremonies, usually to do with growing food. They also use them in their story telling about the aboriginal connection with nature and as part of their ancestorial traditions, something I was introduced to on that first trip.

That first trip was to Adelaide. It is a city I have visited twice. On the first occasion, it was to present three papers at the Contesting conversations in mental health practice, education research and policy conference. My papers looked at the being and doing of mental health nursing; a re-reading of mental health care in the UK; and exploring whether team working was best caught or taught. I have continued to explore the underlying themes to these papers; ideas which helped shape my academic career. They continue to do so today.

Since that first trip, I have been fortunate to return to Australia on a further seven occasions. I have presented my research in Canberra, Melbourne, Sydney, Cairns, plus twice in Brisbane, my sister’s home city. However, one of my favourite trips was to Alice Springs in 2006. At the time, I didn’t write about that trip. Mainly because I only started writing and posting this weekly blog in 2009! However, I did refer to it in a blog I wrote about the trip, back in 2010. Have a look here.

As well as presenting a couple of papers at the conference, my long-term fellow author and collaborator Professor Sue McAndrew, we also submitted a poster. We hadn’t done one of these before, and carrying a large, printed conference poster in its own cardboard tube was akin to bringing back a rainstick in your cabin luggage. Very difficult. Unbeknown to us, there was a ‘best poster’ competition. There was prize money. I think about AUS$ 400 for the best poster. We won for our poster on whether mental health nurses are ‘prepared’ to work with folk who had experienced childhood sexual abuse.

As nurse educationalists, we were concerned as to whether we truly ‘prepared’ nurses, in terms of skills and knowledge, (as well as ‘comfortableness’) to work with those who had been abused in childhood. The evidence appeared to suggest we didn’t on both counts. Thankfully, today things have changed, and I’m proud of the contribution we were able to make to these changes.

Rainsticks in the Lake District? Well at one time, I used to walk and climb all over the Lake District. That said, I have no idea where I would have found a rainstick for sale. I’m glad I did, and my mum got her gift. However, and somewhat spookily, Prof Sue’s Christmas present to Jane and I this year was a weekend hotel stay near Windermere, in the Lake District. On one of our walks while we were there, we walked into Windermere town centre and lo and behold there were at least three shops selling ‘authentic’ rainsticks. Thank you, Sarah, for prompting the memories.