Glenn Westrop, AHP Clinical Fellow, NHS Improvement
Reflections on my journey up to and after the Equally Well UK launch, why you need to be involved!
I write this blog, a first for me, to summarise my reflections from attending the Equally Well UK launch. It covers why I will continue to support and drive Equally Well UK to tackle the inequalities people with mental health conditions face to have good physical health.
As an Occupational Therapist who has worked in mental health services for 18 years, physical health and more strongly, holistic approaches to health and wellbeing have been of great interest to me. However, I find myself still asking questions as to how people spend their day meaningfully? What skills do people need to develop to achieve this? What does an individual want to, need to or have to do? Finally, how could I use my skills to assist a person to develop and maintain good health and wellbeing? All these points have a clear link to achieving maximum physical health and wellbeing.
The services I have worked in created challenges not only for me but for the people I worked alongside. What does a mental health team assess and what interventions are offered to promote good physical health and avoid poor physical health? What is the team’s stance on the prevention of poor physical health?
I found myself starting to think about initial assessments and needs assessments, the main ways to assess and understand people’s needs. How can these maintain a focus on mental state assessment and gather more information about a person’s physical health needs both currently and in the future? I do understand that as a mental health service we should be in the right place to protect individuals and others from immediate harm, but how do we embed further prevention activities and proactive support to avoid the development and worsening of physical health needs? How often do we work with people exploring the longer term, how often do we really pause and see the whole person; their lives and hopes for the future? Indeed, how do current systems help us all to take this view? After all we have a whole person sitting in front of us. They deserve the right support, advice and treatment to live long, fulfilling lives.
I recall completing needs assessments where we discussed smoking, alcohol and illicit drug use. I think mainly because of the impacts these were likely to have on an individual’s mental state; not on their overall health. I may have also commented on whether someone was ‘slim’ or appeared ‘overweight’ and documented whether they had any other physical health or long-term conditions. How many of you reading this blog have also fallen into this position, not on purpose but due to the boundaries and expectations of services? Sometimes this was broken down into a long list of ailments. How did I share with people the likely challenges they may face on their journey and what might help, not just about their mental health but also their physical health? Did the care plans I endeavoured to produce collaboratively address these needs and assist an individual to have equal health?
I do recall thinking to myself how I could work more effectively with individuals to promote healthy eating and to increase their activity in a meaningful way. I knew it wasn’t as simple as advising these things or talking about them, change would not miraculously happen.
I recall working with a patient who bought pasties and cans of coke on a daily basis. Unsurprisingly, he was overweight and there were increasing concerns regarding his physical health. This was easily assessed. Delivering interventions took longer, together we explored his anxiety. He struggled to access his community, but getting to the local shop was manageable. His motivation and cognitive skills fluctuated as did his planning to eat and live more healthily. He also wanted to improve his cooking skills. We tried different foods and stocked an emergency food cupboard. We also developed some ‘go to’ recipes, which we practised. Somehow though, this was seen at times in isolation and not part of improving his physical health? A physical health check in the clinic room was where all the important activities happened for this individual.
I hope this story and the questions posed in the blog will enable you to think differently when meeting someone within your busy life as a clinician and endeavouring to improve their physical health and wellbeing.
Fast forward to the Equally Well UK launch on the 13 September: the complexities around achieving Equal Health for people with mental health conditions were clearly articulated. I felt saddened and shocked by the Experts by Experience’s stories, where professionals had not taken a whole person approach and had not understood their part in assisting people to achieve equal health. I had heard similar stories before, but I wonder if I had really and truly listened? Had I asked meaningful questions about people’s physical AND mental health and found out what was important to them?
The Charter for Equal Health called us all to action, with many organisations joining and committing to the movement by making pledges. We all have a part to play in addressing this huge health inequality and I am so glad to be playing just a small but significant part in the next steps of Equally Well UK. Please reflect on the questions posed in this blog, either by yourself or in your team, when you have a moment. Will you join me and make the commitment to people with mental health conditions being Equally Well in the UK. I hope so.
Please follow @EquallyWellUK and check out the website for more information