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Migraine Awareness Week 2019

September 3, 2019 13 comments

Those of you who weren’t reading or following my blog in the early days will probably be unaware that I used to do a series of ‘Dates To Note’ posts – if you’re interested they can be found in the menu above. These ran through 2013 into 2014 but I decided that they had run their course and, apart from a few reblogs – and a spoof –  there haven’t been many more since then. I have, however, decided to do a new one-off to recognise that this week (1st to the 7th September) is Migraine Awareness Week. I first posted about this in 2013 and have followed up on that a couple of times, but felt it was about time to do something new.

I’m sure many of you have experience of migraine, either yourself or with someone close to you. I was first diagnosed when I was 15 – to save you the maths, that was around 50 years ago. Since then I’ve had several migraines a year apart from one blissful period in my 20s when I went three years without one, and foolishly hoped I was somehow ‘cured.’ Not so. And the older I got, the more migraines I had and the longer they seemed to last! Five or six a year wasn’t uncommon, and they lingered for up to three days instead of just the one when they first started.

I hope you follow the link above, which takes you to the Awareness Week page on the Migraine Trust’s website. The Migraine Trust organises this week as a means of educating people about migraine, and their website has a lot of helpful information and links. Their headline statistics are frightening: every day in the UK there are 190,000 migraine attacks. The condition affects one in seven people, and is more prevalent than diabetes, epilepsy and asthma combined. In other words, it is a big issue! They have undertaken much research into the underlying causes of migraine, but their aim is ultimately to find a cure for this debilitating illness. This is especially important as only about half of those who suffer are actually diagnosed with the condition: if a cure could be found, that might encourage more people to seek help.

One of the things the Migraine Trust encourage you to do is to keep a diary of your migraines and share it with your doctor. I did this when I was first diagnosed with depression, as I seemed to be getting headaches and migraines all the time, and it was very helpful to see what pattern – if any – there was. In particular, the site might help those who say they have a migraine when it is actually a bad headache: believe me, there is a difference and you’ll know it if you’re a fellow sufferer! When I was running the Dates To Note series I always gave a link to the NHS website as this is a very good source of information, and their coverage of migraine is as good as everything else they do.

My diary showed that there was absolutely no pattern to my migraines, which often seemed to occur with no prior warning. Most of mine started the moment I woke up: there was no build up to them throughout the day, as some people experience. That made it difficult to assess, but we managed to find a tenuous link to late night tea and coffee, or eating, before some of my migraines. I cut these out on doctor’s advice, but was never convinced that this made any difference. Like most migraine sufferers I just shut myself away in a darkened room until it felt safe to open the curtains again. Medical science has yet to agree on a set of defined causes for the illness: whilst one of the causes is believed to be emotional factors, such as stress, mine have always been noticeably different from regular headaches, which tend to fall into the category of ‘tension headaches.’ Migraines are believed to be a result of chemical changes in the body affecting the genes, and the genetic effect can mean that they are passed through the generations within a family. My Mum used to suffer badly with migraine and it has always been believed in our family – and by doctors – that I inherited this from her.

So how can you explain the fact that I have had far fewer migraines since I retired? I now live a life which, as far as I can possibly make it, is free from stress and tension. And the frequency of migraines has dropped noticeably – go figure! Does this mean that what I have believed for around 50 years was wrong? Even if that is the case, I can’t really see how I could have changed my working life to remove stress factors, which were part and parcel of any job I had. But I do find it interesting that a reduction in the number and length of migraines since I retired may somehow be related to that major lifestyle change. It is nearly six years since I retired, and I can only recall seven or eight migraines in that time – when I would probably have endured something like 40 in a similar period whilst working. I can recommend retirement for a number of reasons – apart from having to be old to do it – but for me a dramatic reduction in migraine frequency is one of the biggest benefits!

If you’re a fellow sufferer you have my sympathy. If so, or you’d just like to know more, do take a few moments to look at the Migraine Trust’s website – here – as I’m sure it will be of interest and help to you.

 

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World Mental Health Day 2018

October 10, 2018 17 comments

It has been a few months since my last post on mental health and it seems right to post today, to mark World Mental Health Day (WMHD). This day has been celebrated – if that is the correct word – since 1992, and is co-ordinated by the World Federation for Mental Health (WFMH). This year’s theme is ‘Young People and Mental Health in a Changing World’ – you may have seen the logo:

On their website, the WFMH explain the reasons for this choice of theme:

“Imagine growing up in our world today. Constantly battling the effects of human rights violations, wars and violence in the home, schools and businesses. Young people are spending most of their day on the internet – experiencing cyber crimes, cyber bullying, and playing violent video games. Suicide and substance abuse numbers have been steadily rising, LGBTQ youth are feeling alone and persecuted for being true to themselves and young adults are at the age when serious mental illnesses can occur and yet they are taught little to nothing about mental illness and wellbeing…..We want to bring attention to the issues our youth and young adults are facing in our world today and begin the conversation around what they need in order to grow up healthy, happy and resilient.”

Here in the UK the Education Policy Institute (EPI) published the results of its recent survey at the weekend, and although news coverage didn’t mention its relevance to the WMHD theme I don’t think the timing was a coincidence. The EPI undertook Freedom of Information requests from 60 providers of Child and Adolescent Mental Health Services (CAMHS) and from local authorities, and received 54 provider responses, so I think it safe to describe the study as comprehensive. Their headline finding is that referrals to CAMHS have increased by 26% over the past five years. Based on data from 50 of the respondents there were more than 264,000 referrals of under-18s in 2017/18. Having worked a lot with our CAMH services during my years in the NHS I find this figure horrifying: the service was already overrun with referrals, and is now under even more pressure. And we should never lose sight of the fact that every single one of these referrals represents a child (or children) and family which is being torn apart by their problems. It’s heartbreaking.

There is a good report on the study here on the BBC’s website: it makes for interesting reading. Interesting, but very scary and worrying. Some 27 local authorities (out of 111) reported that they had ceased to provide services for the mental health and wellbeing of children and young people in the past eight years. Over and above the loss of those related services, far too many – more than 20% – of provider referrals were refused treatment as not meeting required criteria. In effect, the children and young people weren’t considered sufficiently unwell!

The BBC report quotes the official Department of Health position: “We are transforming mental health services for children and young people with an additional £1.4bn and are on track to ensure that 70,000 more children a year have specialist mental health care by 2020-21.

“We are improving access to mental health services through schools with a brand new dedicated workforce, as well as piloting a four-week waiting time standard in some areas, so we can better understand how to reduce waiting times.

“We are completely committed to achieving parity between physical and mental health as part of our long-term plan for the NHS, backed by an additional £20.5bn of funding per year by 2023-24.”

This is being followed up by a speech today by the Prime Minister, in which she is fleshing out some of these commitments. For the first time we are to have a minister with specific responsibility for suicide prevention, and £1.8m is to be provided to the Samaritans to enable them to continue their helpline for four years. For children and young people, the government is promising more support in schools, bringing in new mental health support teams and offering help in measuring students’ health, including their mental wellbeing. There will also be a new annual progress report each year on WMHD. This is all being announced at a global summit on mental health being held in London, attended by representatives from around fifty countries. I wonder what, if anything apart from the usual platitudes, will come out of this, and what the composition of that attendance is – does it, for example, include large countries who are really in a position to make a difference? We can but hope so.

Of course, any government initiatives on mental health are welcome, but please forgive me for being a little cynical about this: the government has been making noises about improving mental health services – both for children and adults – for quite a while now. But, as I covered in my piece Mental Health Matters in September 2016, there doesn’t seem to be any certainty of service commissioners making this additional funding available to the providers for whom it is intended. To date, there has been a lack of joined up thinking about mental health treatment, and drastic changes are needed. And then there is the question of whether this funding exists at all. Remember that Vote Leave promise of making an extra £350m per week available for the NHS if we left the EU? Well, the latest official figures suggest that, rather than making that saving, Brexit is actually losing us more than £500m per week, and that is before we even jump off the cliff! And we also need to consider the haemorrhage of staff the NHS is already suffering pre-Brexit, a position which doesn’t seem likely to improve if the government continues to bury its head in the sand over the disastrous effects of losing freedom of movement across the EU. Even if that funding were somehow to materialise from some magic money tree – which I very much doubt – where are all these new specialist staff going to come from? Even if the money was already being provided – which it isn’t – there is no way that all of the specialist staff required could be recruited and trained in time to meet the government’s stated aim. In short: it’s as valid as a promise to give us all a pet unicorn.

Sadly, I fear that this is all a very long way short of what the WFMH describes in its objectives for this year’s WMHD. The figures I have quoted relate to the more serious cases which require specialist treatment, but there are far greater numbers of young people who are affected by the issues set out in the WMHF statement: how are they going to get the help they need in current circumstances? So much needs to be done, but do we have the resources and the desire to make this happen? I’d love to be proved wrong, but I’m not sure that we do. Of course, I know there are no easy answers to this, but I hope today will be a starting point for us to review our priorities as a society. If we don’t give our children and young people the best possible start in life we are failing them. I hope the Government has the will, money and resources to deliver on today’s announcement. It will be interesting to see how much they will have achieved by the time their first annual report comes round next 10 October, and whether they will have done enough to confound my doubts.

A Political Football

November 23, 2016 9 comments

A couple of months ago I wrote in my post Mental Health Matters about the way the Clinical Commissioning Groups (CCGs) were diverting the ring-fenced funding they had been given for mental health services into other treatments, against the express instruction of the government. To date, this post has received 38 ‘likes,’ the most for any of my posts, so this must have struck a chord with many people. Just for clarification, I’m using the phrase ‘many people’ in its true sense, not in the way Donald Trump uses it to tell the UK government that it should appoint a racist buffoon as its US Ambassador.

But I digress (it was too easy a target!). Last Friday The Times newspaper ran a front page story headed ‘Nine health secretaries attack government for failing mentally ill.’ The piece related to this letter which the paper carried on the same day:

Copyright Times Newspapers

Copyright Times Newspapers

It refers to this as ‘an unprecedented intervention,’ coming, as it did, from former Secretaries of State for Health from across the UK political spectrum. It goes on to say “the decision…to speak out reflects wider concern that people with mental illnesses are neglected in a way that would never be accepted for patients with cancer or other physical conditions.” I agree wholeheartedly with this, but nevertheless this letter causes me serious concern. Not so much in the letter itself which, taken at face value, is fine, but more in the motivation of those who signed it. In effect, the letter is challenging the government to deliver on promises made – it is making a political statement in a political game, and is using mental health as the football in that game.

But is the government really to blame in this case? Don’t get me wrong, I am not a supporter of our government and the direction it is taking, but as my previous post showed, they had been making the money available, but the CCGs were choosing to ignore its purpose and use it to commission other services instead. As I also said in that piece, the CCGs were created by the wholesale changes made by the government in 2010, despite the fact that this had not been mentioned in any election manifesto, as they would supposedly be a more informed group to commission services. The Health Secretary who brought in these changes was Andrew Lansley, who is one of the signatories of the letter to The Times. Either the man is totally lacking in self-awareness or he is now getting his revenge for being sacked from the job and being ‘promoted upstairs’ to the House of Lords when even the then Prime Minister could no longer make excuses for his monumental incompetence. This Times cartoon from that time sums him up perfectly:

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Blaming solely the government for the failure of support and funding for mental health services is wrong. The CCGs should also be in the firing line – arguably, at the front of it. The only thing letters like this will achieve is to provoke a political argument and, while that goes on, nothing will be done to give the additional support to mental health services that they so desperately need. It could be argued that the outcome of this letter might be that the government will tell the Department of Health to investigate how funds are being spent on the commissioning of services. For all I know they will already have done that after the report two months ago – and in any event, oversight of the CCGs and how they commission services is a regular part of the DoH’s responsibilities. Either way, we don’t need any more debate, and a letter from a bunch of people who can be too easily dismissed as being self-interested isn’t the answer. Mental health services in the UK have been under-funded for decades, and the CCGs need to recognise this. I don’t envy their decisions, as to allocate money to one service means taking it from another. But it is a question of priorities: they have been given money for mental health treatments and have chosen to use it for other services instead. This is wrong, and they should be called to account for it and required to invest in better mental health services.

The NHS in general, and mental health services in particular, have been kicked around for far too long. Turning them into a political football won’t do anything to improve that. As long as this situation continues, I fear for the future of mental health services in this country. We need someone in a position of influence to lead action on this, not write politically-motivated letters to newspapers.

 

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