Friday, 30 December 2011

We are rubbish at looking after carers!

This post, by me, first appeared on Scots Gazette on 29 November

The sad death of footballer Gary Speed has thrown mental ill health into the spotlight again.  As I write I do not know what led to the death of a popular young man by his own hand at the tragically early age of 42. However, it highlights the battles many suffer from illnesses such as depression and the desperate challenges faced by their families and loved ones.

I want to consider the issue of those who suffer mental ill health and their carers.  I want to talk about how important they are, how important it is to look after them and how – when it comes to carers – the mental health authorities are all talk and could do better!

Something like a fifth of the population suffers from mental illness and it is estimated that in the UK there are 1.5 million caring for relatives suffering in this way or from dementia.

Carers are a desperately important part of the support medical care given to those with mental illness to allow their recovery or put them in a position where they can cope with their everyday lives.  The mental health authorities in Scotland have recognised the importance of an informal network of unpaid carers as a crucial part of the delivery of care and that they be” respected in their role and experience receive appropriate information and advice and have their views taken into account.” Which is apparently part of one of ten Millan guiding principles which went towards forming the Mental health (Care and Treatment) (Scotland) Act 2003.

Carers also face a tough situation.  Sure they come in all shapes and sizes and face an almost infinite variety of different situations across a broad spectrum of severity.  However, they all face certain things in common.  Carers all report feeling emotions of hopelessness, fear, guilt and isolation.  Often they find themselves utterly alone and overwhelmed by a situation they feel inadequate to deal with.  There is also plenty of evidence now that their physical health often suffers as well.

Caring is a tough gig and it is important.  But talking to carers they all, consistently, complain of being kept outside the loop.  They feel they are not well communicated with about their loved ones condition. They feel, despite the fact that they know them and their moods best, their views and observations are not listened to and, perhaps worst of all, they feel there is almost no information and support for them.

One carer said to me, “the mental health profession is just a bit rubbish when it comes to looking after carers!”

This is a view many professionals working with carers sadly share as well.   I’m told by some people working with carers that the principles of working with carers in Scotland have not yet been truly implemented.  And I’ve no reason to think England and Wales is doing any better.
More needs to be done.

To this end I want to praise the work done by Edinburgh Carers Council (ECC).  They recognise the need to look after and support carers.  They need the support and ultimately this aids the recovery of the original loved one and patient.  And this is more than a one hit.

As the medical model of looking after mental illnesses has moved from complete recovery to finding a way of living a satisfying and contributing life, so that ongoing support has to adapt for carers.

The ECC are developing programmes that support carers on an ongoing basis.  One programme I have come across is known as WRAP (wellness recovery action plan).  It has been adapted for carers and is about supporting them and equipping them to support themselves.  It aims to give carers a range of strategies and routines which are about looking after themselves.  Eating properly and getting rest and exercise is part of it.  Making time for yourself and having routines to recuperate are also important.  This is about leisure and doing some of the things you love.  If you are not making a life for yourself you will rapidly become useless to your loved one you care for.  It is also about self esteem and feeling supported; and it’s about giving access to information and practical support to navigate the mental health authorities, to participate in care and get answers and support when you need it.  The idea is improved physical and mental well being, less guilt, more energy and improved relationships which all means being a better carer.

It is just one programme but it is giving real and practical support to carers of those with mental health problems in Edinburgh today.

My plea is therefore this:
We need more of this for carers of all types.

The mental health authorities, who do a tough job and many great things, need to be better in practice at looking after carers rather than just talking about it in reports.

And, in these times of austerity, I can imagine programmes like this could be in the frontline for being cut-back.  My plea is that they are vital and ultimately better value in saved resources and medication bills as a result of the support carers give the mentally ill on their journeys to recovery and coping.

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