Channel 4 commissions documentary series The Maudsley

With one in four of us now suffering from a mental health problem, a new 4 x 60 series explores and demystifies the most profound decisions involved in treating the mentally ill.

The Maudsley (w/t) takes an in-depth and unprecedented look at mental health in Britain today, with exclusive access to a wide range of services, patients and staff at the South London and Maudsley NHS Foundation Trust (SLaM).

Key to the series, filmed over a year, is giving a voice to those who suffer with mental illness, from people with psychosis or manic depression to those with severe anxiety. For, although a growing number of us will experience mental illness in our lifetime, the stigma remains; it’s an unwanted label.

SLaM is the country’s best-known psychiatric trust and its services are unique, pioneering and often surprising. This is the most comprehensive access producers have ever had to any NHS mental health trust in the country.

Ralph Lee, Head of Factual at Channel 4 said: “Building on the success of last year’s 4Goes Madseason in bringing a fresh approach to mental health on television, we are delighted that the patients and staff of the Maudsley have trusted us to tell their stories for the first time.”

The series is produced by The Garden Productions (24 Hours in A&E, The Audience, Inside Claridges) and series directed by Dave Nath (Cutting Edge, The Year the Town Hall Shrank).

The Maudsley (w/t) will follow the lives of patients and their families, touching on a range of mental health conditions. Each of the four films tackles a different aspect of mental health – the big issues of today. Many people manage their illness with medication; others walk a daily tightrope with the possibility of relapsing at any time.

The cameras follow a community mental health team; the lion’s share of SLaM’s work takes place in a community setting, looking after more than 35,000 people with mental health issues.

Cameras are allowed in to Lambeth Hospital’s Triage ward for the first time. In a postcode with the highest rates of psychosis in Europe, this is the Accident and Emergency of mental health – where patients are at their most unwell. For the staff it’s all about risk management. The buck stops with psychiatrists like Dr Martin Baggaley who makes crucial decisions every day. Getting it wrong could have tragic consequences.

Anxiety has become the mental illness of our time, with seven million drug prescriptions issued every year. The Bethlem Royal Hospital’s national unit treats the most anxious people in the country – the top one per cent – and claims a success rate of three in four patients. Some are consumed by irrational fears they’ve caused a road accident in their sleep, harmed strangers or have intrusive thoughts.

The number of older people with mental health problems is estimated to increase by a third over the next 15 years to 4.3 million. Bereavement, stress and loneliness can contribute and some end up on the Maudsley Hospital’s Older Adults Ward. With a premium on bed space patients cannot stay on the ward forever but some lose the confidence to go back home and live an independent life.

It’s executive produced by Amy Flanagan and Jonathan Smith. Broadcast is scheduled for Autumn 2013.

Via http://www.channel4.com via Bridget

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Questions for carers to think about asking Health Professionals

This is an audio blog by Matthew who is a carer.

They are his thoughts and suggestions about questions that carers can ask health professionals about their cared for person.

It contains some really useful tips and advice.


PUTTING OUR MINDS TOGETHER TO MAKE A DIFFERENCE

A Themed Workshop for Carers

with

Andre Geel – Consultant Clinical Psychologist

 

&

Veronica Kamerling – Experienced Carer

Saturday 12th October 2013

9.00am – 4.30pm

The Fitzrovia Room, Park Crescent Conference Centre,

International Students House, 229 Great Portland Street London, W1W 5PN

Cost: £60.00 per person

Topics to be covered:

 

COMMUNICATION SKILLS – SEEING THINGS DIFFERENTLY

LOOKING AFTER YOURSELF – WAYS OF COPING

RECOVERY – TREATMENT & THERAPY

 

Responding to specifically relevant topics raised by carers and highly pertinent to anyone in a caring role, this workshop aims to teach new ways of thinking and behaving around old problems. It will highlight how change and looking after yourself can play a key role in promoting positive results in those you are caring for, and will utilize key concepts and techniques in current psychological thinking to achieve this.  You will leave with a series of practical skills and ideas on how to develop your own approach and techniques to help you manage those you are looking after.

To book a place on the above please contact:

Veronica Kamerling

T: 01256 704117

M: 07733 260 475

E: veronica@talktalkbusiness.net

www.eatingdisordersandcarers.co.uk

Flyer here: WORKSHOP OUTLINE FOR SATURDAY 12th OCTOBER 2013

Booking form here: BOOKING FORM FOR THE CARERS WORKSHOP SATURDAY 12th OCTOBER 2013


SLaM’s Family & Carers Event on 2 May – Empowering Family & Carers

SLaM is continuing their very successful Empowering Family and Carer Events. There will be 4 events this year with one specifically for Forensic Services. All events have a different theme with presentations based on this theme.

They are an opportunity for family members and carers to find out about how SLaM operates, what they can expect for themselves and their loved ones and how they can access these services. There are ‘surgeries’ for carers to meet professionals, get information about benefits, support services, medication, care and treatment and raise any concerns or complaints they have regarding the people they care for.

The first one will be on Thursday 2 May in Lambeth and the theme will be Welfare Benefits and Support Services. Please see poster attached for more information: SLAM153 – Empowering Family-Carers May 2013 and booking from here: Booking Form May 2013

Please help us to advertise this event by passing this on to Carers & Family members and also Service Users so they can pass it to their carers and include it in your newsletter or website and display the poster. Please note this event is for Carers and Family members only but we are always looking for staff to be involved in delivering the event.

For more information, to book a place or you want to find out how you can be involved in helping to deliver the event please contact

Angela.Mitchell@slam.nhs.uk  Tel: 020 3228 3722   Mob: 07837984608


Recovery College Co-Production Workshop – Service User Involvement: please note change in times

Dear All

The development of SLaM’s proposed Recovery College is, I’m happy to report, proceeding apace. The next stage in the development is to recruit potential facilitators (both staff and service users) to develop and run courses in a pilot scheme. I’m hoping that all of you working in involvement are able to ‘spread the word’.

As you may be aware, one of the primary purposes in the development of a Recovery College is to break down the destructive barriers between ‘them’ and ‘us’ that perpetuate stigma and exclusion – hence all of our courses will be co-developed and co-delivered by people with lived experience of mental illness together with mental health practitioners. The courses will cover these key areas:

  • Understanding mental health difficulties and treatment
  • Rebuilding your life
  • Developing knowledge and skills
  • Getting involved

Next month, we will be hosting a Co-Production Workshop, facilitated by our colleagues from the CNWL Recovery College. The purpose of this workshop is to explore in detail what is involved in co-production (we will then host a two-day train the trainers course sometime in May).

We are therefore looking for service users who think they may be interested in developing and delivering a course to come along to the workshop (although places are limited and will be allocated on a ‘first come’ basis). We are running the workshop twice:

  • Wed 24 April 10am-1pm
  • Mon 29 April 2pm-5pm

Both workshops will be held at Cambridge House, Addington Square, SE5. The audience will be a mix of staff and service users.

If you know of anyone who might be interested and who would like to come to one of these workshops please can they reply ASAP to tony.holmes@slam.nhs.uk – stating which date/s they would like/are able attend.

Regards

Tony Holmes

Social Inclusion and Recovery Volunteer

Tuesday, Wednesday and Thursday

South London and Maudsley NHS Foundation Trust and Maudsley Charity

Corporate OT | 1st Floor Admin | MaudsleyHospital | Denmark Hill | London | SE5 8AZ

Telephone: 020 3228 2175


Recovery College Co-Production Workshop – Service User Involvement

Dear All

The development of SLaM’s proposed Recovery College is, I’m happy to report, proceeding apace. The next stage in the development is to recruit potential facilitators (both staff and service users) to develop and run courses in a pilot scheme. I’m hoping that all of you working in involvement are able to ‘spread the word’.

As you may be aware, one of the primary purposes in the development of a Recovery College is to break down the destructive barriers between ‘them’ and ‘us’ that perpetuate stigma and exclusion – hence all of our courses will be co-developed and co-delivered by people with lived experience of mental illness together with mental health practitioners. The courses will cover these key areas:

  • Understanding mental health difficulties and treatment
  • Rebuilding your life
  • Developing knowledge and skills
  • Getting involved

Next month, we will be hosting a Co-Production Workshop, facilitated by our colleagues from the CNWL Recovery College. The purpose of this workshop is to explore in detail what is involved in co-production (we will then host a two-day train the trainers course sometime in May).

We are therefore looking for service users who think they may be interested in developing and delivering a course to come along to the workshop (although places are limited and will be allocated on a ‘first come’ basis). We are running the workshop twice:

  • Wed 24 April 10am-1pm
  • Mon 29 April 2pm-5pm

Both workshops will be held at Cambridge House, Addington Square, SE5. The audience will be a mix of staff and service users.

If you know of anyone who might be interested and who would like to come to one of these workshops please can they reply ASAP to tony.holmes@slam.nhs.uk – stating which date/s they would like/are able attend.

Regards

Tony Holmes

Social Inclusion and Recovery Volunteer

Tuesday, Wednesday and Thursday

South London and Maudsley NHS Foundation Trust and Maudsley Charity

Corporate OT | 1st Floor Admin | MaudsleyHospital | Denmark Hill | London | SE5 8AZ

Telephone: 020 3228 2175


Insufficient evidence to suggest that exercise has a treatment effect on the symptoms of anxiety disorder

Anxiety disorders are identified by NICE clinical guidelines as a common mental health issue. The term refers to a range of disorders including generalised anxiety disorder, panic disorder, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), and social anxiety disorder. The typical treatment plan consists of medication and/or psychotherapy, however NICE acknowledges that access to psychological interventions is still limited, despite patient preference often being towards these non-pharmacological treatments.

While the potential benefits of exercise in depression have been widely explored and debated, the role of exercise in anxiety disorders has been less explored. Physical activity reduces feelings of stress and anxiety in healthy individuals, but it remains unclear to what extent it can benefit people with an anxiety disorder.

The authors of this new study therefore conducted a systematic review of the evidence surrounding the effect of exercise as a treatment for anxiety disorder.

Method

Evidence showing a positive impact of exercise on depression is increasing all the time

Evidence showing a positive impact of exercise on depression is increasing all the time

The authors were interested in randomised control trials (RCTs) in which exercise was used as an intervention for anxiety disorder. They conducted an extensive database and journal search, and also referred to bibliographies of included studies and related review articles, to identify relevant RCTs. Papers identified from the initial search were then assessed by 2 researchers according to relevance to topic and study design.

Data were then extracted from the selected papers, and effect sizes recorded or calculated (for some studies, but not others, these effect sizes are reported). The quality of included studies was assessed using Cochrane Collaboration rating systems.

Results

They identified 8 studies that were both relevant to the topic and appropriately controlled trials. Oddly one article is described as still ‘awaiting assessment’ but no explanation is given as to why. Considering only a handful of studies were identified for the review it seems a shame this study was not assessed as it may have been relevant!

Main findings

  • Group exercise versus no exercise (1 RCT): both groups improved, but no significant difference between groups on a quality of life measure at both 20 weeks (programme duration) and 32 weeks (follow-up period).
  • Exercise versus placebo pill (1 RCT): exercise group (10 week programme of running) showed significantly greater improvement in scores on 6 out of 9 anxiety and depression scales.
  • Exercise versus antidepressant (Clomipramine) (1 RCT): antidepressant group showed significantly greater improvement in scores on 5 out of 9 anxiety and depression scales.
  • Exercise (10 weeks of “aerobic exercise”) and antidepressant medication (Paroxetine) combined versus “relaxation” and placebo pill combined (1 RCT): exercise/antidepressant group showed significantly greater improvement on the Clinical Global Impression scale.
  • Exercise (10 weeks of “aerobic exercise”) and placebo pill combined versus “relaxation” and placebo pill (1 RCT): no significant difference between groups
  • Group CBT and walking exercise (8 week programme) combined versus group CBT and “educational sessions” combined (1 RCT): CBT/exercise group showed significantly greater improvement on depression scale, but no significant difference between groups on the anxiety and stress scales.
  • Exercise, occupational therapy and lifestyle changes (16 week programme) combined versus standard GP care (1 RCT): at 20 weeks and at a 10 month follow-up those in the exercise/occupational therapy/lifestyle changes group had significantly greater improvement in scores on Beck Anxiety Inventory and fewer panic attacks.
  • Three RCTs then compared different types of exercise. No significant differences were found between aerobic and non-aerobic exercise (1 RCT), or between walking and jogging (1 RCT). The third RCT found a significantly greater reduction in panic attack rate and panic symptoms after one session of moderate-hard exercise compared to one session of very light exercise.

There is considerable variation across studies in the treatments studied and the specific anxiety diagnoses included in the sample

There was considerable variation across the included RCTs in the treatments studied and the specific anxiety diagnoses included in the study population

Strengths of the review

As the authors highlight, the strengths of this review include the extensive search for relevant literature and the systematic appraisal of research quality of included studies.

Limitations of the review

Research to date is limited. There is considerable variation across studies in the treatments studied and the specific anxiety diagnoses included in the sample. No meta-analysis could be conducted due to this heterogeneity, and as the authors note no assessment of publication bias could be conducted. As the authors also highlight, many of the studies had methodological issues and relatively short duration of follow-up. Unfortunately reporting of results in the review is often unclear and details about individual studies are limited.

Discussion

The authors conclude:

It seems that exercise shows a treatment effect beyond the placebo effect. Although it appears that the antianxiety effects of exercise are lesser than antidepressants for clinical anxiety disorders, it can still be beneficial as an adjunctive treatment.

As it stands there is not enough evidence to suggest exercise has a treatment effect on symptoms of anxiety disorder

As it stands there is not enough evidence to suggest exercise has a treatment effect on symptoms of anxiety disorder

However I think we need to be cautious with these conclusions. The comparison to placebo is based on just one study finding. Additionally there were only two studies including exercise as a stand-alone treatment, and these found contradictory results. Other trials assessed exercise combined with other interventions, so conclusions cannot be drawn regarding the unique effect of exercise from these studies. Consequently the authors’ conclusion that exercise “can still be beneficial as an adjunctive treatment” has not actually been tested in the studies discussed. Meanwhile antidepressants and CBT have a large evidence base for treatment of anxiety disorders, and indeed as the authors conclude antidepressants led to a greater improvement in anxiety symptoms when compared to exercise in one of the studies reported here.

Better controlled trials with appropriate control comparisons are needed. As it stands there is not enough evidence to suggest exercise has a treatment effect on symptoms of anxiety disorder.

However, while the evidence for a treatment effect of exercise in anxiety disorders is currently lacking, us woodland elves still love to keep active! Exercise is good for your physical health and mental wellbeing. Keeping active is a great way to keep a healthy heart and mind!

Link

Jayakody K, Gunadasa S, Hosker C. Exercise for anxiety disorders: systematic review. Br J Sports Med. 2013 Jan 7. [Epub ahead of print] [PubMed abstract]

#RT from http://www.thementalelf.net

Emailable link to article here: http://www.thementalelf.net/mental-health-conditions/anxiety-disorders/insufficient-evidence-to-suggest-that-exercise-has-a-treatment-effect-on-the-symptoms-of-anxiety-disorder/