We all want recovery, don’t we? Recovery from illness, from the things holding us back, from doubt and fear. Recovery itself is something embodied by hope. The potential for recovery means that there is always hope.
At the Asia Pacific International Mental Health Conference—Recovered Futures, in October 2016 this year, some great things were being done. Keynote speaker Dr Manaan Kar Ray, Consultant Psychiatrist at Fulbourn Hospital, Cambridge and Clinical Director of the Adult Services Cambridgeshire and Peterborough NHS had some interesting things to say.
He said, without risk there can be no recovery.
His talk, Force is Incompatible With a Vision of Recovery, spoke of simple things that they were doing that made a difference. You can’t treat anything in 3 days but what you can do is capture hope. Promoting dignity by eliminating force in mental health (imagine that) is a deliberately provocative idea. And it rests back into, practices of simplicity, the heart of what we do, or is done to or with us.
What Does Recovery With Risk Look Like?
For example, his hospital looked afresh at their practice of morning medication rounds which typically was waking the patient, perhaps a shake of their shoulders, and speaking to them about taking their medication. Imagine for a moment how this feels. In a way it is constrained, you don’t have a choice, it’s not a nice way to wake up and you can’t really complain. You may resist, as we do, in a passive or resentful way, or be thankful to a degree perhaps, but it is a little harder to be thankful. Being thankful would be a great outcome to start the day but its hard to see in this situation how we may be inclined to start the day that way. We are reminded of our helplessness in an institutional situation over which we do not have not much or little control, and now we are not thankful! Not good.
So what they did was change. “Why don’t we go in with a cup of tea?” So they did. And then say “Would you like 10 minutes to get ready?” and “then we will bring your medication in ready for you”. What a difference it made to the start of the day. Surprisingly, it met with some resistance from some nurses who had been there a long time. Indignantly they said that they don’t themselves get a cup of tea handed to them when they get up in the morning, and resented at least initially the provision of this service and generosity to patients!
Yet, as you may well know, and I know, the little things in how we start the day, whether I am thankful for the day, whether I get up and stretch and walk to the deck and be thankful, whatever works for you this day or this week, influence the foot I get off to on the day. I might write a list, or not. I might go for a walk first thing. I might get into things. I might not. I might meditate this week first thing. Each are ways that pace or shape the mood.
In the afternoon, they would ask “What was good about your day?” to patients. And people could get things off their chest if needed. These things say “I care about you” and it transforms the way people feel, and decreases physical intervention (restraint).
In their practice, they looked at responses to patients. “Did you really have to say no, or is no just the easy answer?” Saying “Wait just one minute” can be the longest minute. So they looked at these small things. I could really sense the difference this would make to me if I was in the confines of an institution/hospital, and how much I would appreciate it.
What are the restrictions that you or others make for yourself? And how can you be kind to yourself? So I will remind myself here, as I am writing to you, I am really writing to myself to, “Owen, be thankful for the day. Get up out of bed and walk to the deck and repeat those words. Be thankful for the day.” It’s a nice idea, but you you know what, I am going to treat myself to a lie in. Oh, I like that.
Cup of tea anyone?