Bondi fitness scheme turns the tide on treating mental illness

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medication, mental health issues, physical health, weight gain

Bondi fitness scheme turns the tide on treating mental illness

A groundbreaking “lifestyle medicine programme” developed on the surfers’ paradise of Bondi Beach in Australia will be used by the NHS to improve the scandalously neglected physical health of people with serious mental illness.

There are more than 300,000 people in England diagnosed with conditions such as schizophrenia, bipolar disorder and psychosis. But their antipsychotic medication, while reducing disturbing symptoms such as hearing voices and experiencing hallucinations, also causes rapid weight gain within two months of starting a course, precipitating diabetes and heart and circulatory diseases. Weight gain is often why some patients who stop taking their medication relapse and have to be sectioned and return to hospital.

In addition, many people with mental illness are heavy smokers, have chaotic lifestyles, take little exercise and have poor diets and it is hardly surprising that they die, on average, 15 to 20 years earlier than the general population. Gaps between those responsible for mental healthcare and physical wellbeing were revealed in the 2012 National Audit of Schizophrenia, a survey of 5,000 NHS patients with a diagnosis of schizophrenia. It found that only 29% received an adequate assessment of risk factors for cardio-metabolic disease (body mass index, smoking, blood pressure, blood glucose and cholesterol).

About five years ago, health workers in the Bondi Beach suburb of Sydney who were treating young people experiencing their first episode of serious mental illness, started to raise concerns about their patients’ rapid weight gain.

Professor Katherine Samaras, a diabetes and obesity specialist at the University of New South Wales, and one of the architects of the Bondi programme, told the Guardian that despite international expectations of a sunny climate and beach culture Bondi, Sydney (and Australia in general), shares first-world problems of inactivity and overeating calorie-rich foods. Antipsychotic medications also increase feelings of hunger and encourage inactivity, she says, thereby creating a potentially lethal mix.

As a result Keeping the Body in Mind, a multidisciplinary programme was devised, providing patients with vital life skills: what to eat, where to buy it, how to cook it, and how to exercise.

Each patient gets 12 weekly individual sessions with a dietitian and exercise physiologist, weekly group education sessions and access to a gym.

The “show how to cook/exercise/eat/shop” part of the programme was so popular, it was integrated with seeing the psychiatrist and mental health workers, which boosted attendance and engagement, says Samaras. “We have compiled a cookbook of recipes, to which the young people contributed to as well, with their favourite recipes.”

Pilot research presented at the international congress of endocrinology in Chicago earlier this month compared 16 young people who took part in the lifestyle intervention programme with a control group who received the usual care. Over the course of 12 weeks, the lifestyle intervention group gained an average of 1.2 kg, compared with 7.3 kg in the control group. Now the programme is undergoing a formal cost effectiveness analysis.

“Our programme was relatively cheap and of course this early investment in health offsets the cost of treating heart disease and diabetes,” says Samaras.

Some 60 young people aged 15-25 come through the Bondi model. It now forms part of the National Institute for Health and Care Excellence (Nice) guidelines on the care of young people with serious mental illness. And it is being piloted by the NHS in Worcester under the guise of Shape – the Supporting Health and Promoting Exercise – programme for young people with psychosis with a view to it being rolled out across the NHS.

The Bondi model dovetails with the introduction from April this year of physical health “MOTs” for seriously ill inpatients in every NHS mental health trust in England.

Dr Geraldine Strathdee, NHS England’s national director for mental health, describes the MOTs as the world’s largest ever initiative to improve the physical health of people with mental illness and a “clinical quality game changer”.

As part of the MOTs, trusts will be paid to ask patients about smoking status and diet, and monitor weight, blood pressure, glucose and cholesterol levels.

Mental health nurses, psychiatrists, health care assistants and psychologists will carry out the MOTs. This marks a sea change in the way psychiatric patients are treated. It is hoped this will prevent them from falling through the gaps in services historically divided under physical or mental health banners.

Back in Bondi Julio De Le Torre was 21 when he was diagnosed with bipolar disorder in 2012. He says the Keeping the Body In Mind programme helped him shed some 20kg he gained as a result of medications, enabling him to finish his degree and pursue a career in engineering. He is back on the surf and says: “I feel like a normal person now”.

Social workers need training to help them better understand self-harm

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autism, awareness, education, family, online support, physical health, self-harm, social workers, support, training, understanding, young people

Social workers need training to help them better understand self-harm

It is estimated that one in 12 young people have self-harmed at some point in their lives, according to charity YouthNet. The charity says 3,000 people aged 16 to 25 visit its digital support service TheSite.org every month after looking up self-harm on a search engine. Yet, despite these statistics, self-harm awareness training for social workers is not always as comprehensive as it could be.

Nushra Mansuri, professional officer (England), at the British Association of Social Workers (BASW), says while some social workers – such as those working in mental health – may be sensitive to the issue of self-harm, there needs to be more awareness of the problem within the profession and that self-harm training is patchy.

“Whatever client group you work with, it will be a feature – it [self-harm training] should be integral because you are working with people whose lives are in crisis – there is a high correlation between the people you work with and people with a propensity to hurt themselves,” she says.

“Social workers need a greater awareness of the issue and need to understand why people self-harm. I wouldn’t lump everyone together, but it can be the impact of trauma, it can be a cry for help, it gives someone, who may have had control taken away from them, a sense of control.”

What mistakes could a social worker who lacks awareness of the issue of self-harm make? “An untrained person may have a tendency to look at the superficial and not go beyond that,” Mansuri says. “A social worker may be out of their comfort zone and not be able to deal with it – dealing with someone’s raw pain is really hard.”

Mansuri adds that social work “doesn’t have all the answers” when it comes to self-harm and that more education is required. “There is an underestimation of the importance of looking at self-harm,” she says.

Jennifer McLeod, managing director of self-harm training provider Step Up! International, says in some regions self-harm training for social workers is inadequate.

“Social workers ought to be trained in spotting the signs; if they aren’t spotted, it could be fatal,” she says. “It’s about listening to what’s not being said, looking for physical signs and emotions – they [people who self harm] are generally hiding something.”

McLeod adds that well-trained social workers will broach the topic with the young people and their families. “There might be denial from parents and social workers will have to find ways of eliciting information from young people.”

McLeod says delegates at Step Up! International training courses are often in a state of panic about the issue as they are uncertain about how to deal with the problem or even broach the subject.

“Some professionals don’t feel confident about bringing up the issue directly, they daren’t ask about it as they think it might make it worse”, she says.

McLeod suspects self-harm is on the increase – and is being talked about more – because of the current economic climate.

“In addition to the emotional and biological changes [young people experience], there is the recession, labour market issues, parents being made redundant – parents may not be managing and may be economically struggling,” she says.

Caroline Hattersley, head of information, advice and advocacy at theNational Autistic Society (NAS), says people with autism face a “raft of challenges” that might make self-harm more likely.

“Autism does bring specific difficulties – we’d like to see more training on understanding autism and its relation to self harm,” she says. “The key is understanding the individual and understanding the underlying causes.” Lacking this understanding could lead to a social worker misinterpreting why someone is self-harming, Hattersley adds.

“The individual might not have done it before, they may be hitting their head because they may have communication difficulties and they’re trying to communicate a physical problem – you might miss an ear infection,” she says.

Hattersley acknowledges that it can be difficult for professionals to admit they are struggling with the issue of self-harm. NAS has set up Network Autism, a forum where professionals can read research, and discuss with each other, the issue of self-harm and how it relates to people with autism.

YouthNet’s chief executive Emma Thomas says all practitioners working with people who self-harm would benefit from a better understanding of the problem. She adds: “If social workers are more aware of services like TheSite.org, many more young people can be directed to safe, anonymous online support to complement the vital offline support they need.”

Americans ‘are sicker and die younger’ than people in other wealthy nations

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physical health

Americans ‘are sicker and die younger’ than people in other wealthy nations

America may be one of the richest countries in the world, but its people are less healthy and more likely to die early from disease or accidents than those in any other affluent country, a damning official US report has found.

Even the best-off Americans – those who have health insurance, a college education, a high income and healthy behaviour – are sicker than their peers in comparable countries, says the report by the US National Research Council and the Institute of Medicine.

“We were struck by the gravity of these findings,” said Steven H Woolf, professor of family medicine at Virginia Commonwealth University in Richmond and chair of the panel that wrote the report. “Americans are dying and suffering at rates that we know are unnecessary because people in other high-income countries are living longer lives and enjoying better health. What really concerns our panel is why, for decades, we have been slipping behind.” The report, US Health in International Perspective: Shorter Lives, Poorer Health, was commissioned by the National Institutes of Health. It compares the US with 16 affluent democracies, including Australia, Canada and Japan and many in Europe including Britain. There have been similar findings from the Commonwealth Fund over some years, but they have compared the US with only a handful of nations.

The new report looked in detail at data from the late 1990s to 2008. “Over this time period, we uncovered a strikingly consistent and pervasive pattern of higher mortality and inferior health in the United States, beginning at birth,” it said.

For many years, Americans have had a shorter life expectancy than people in almost all the comparator countries and for the past three decades the gap has been widening, particularly for women.

The US does badly in nine specific areas. It has the highest infant mortality rate of any wealthy country and also does poorly on other birth outcomes, such as low weight babies.

Deaths from injuries and homicides are far higher than elsewhere and a leading cause of death in children, adolescents and young adults. US adolescents have had the highest rate of pregnancies of affluent countries since the 1990s and are more likely to acquire sexually transmitted infections. The US has the second highest HIV rate and the highest incidence of Aids among the 17 countries.

Even taking out drunk driving, Americans lose more years of life to alcohol and other drugs than people in other affluent countries. The US has the highest obesity rate and, from age 20, one of the highest levels of type 2 diabetes. The death rate from heart disease is the second highest in the 17 countries. There is more lung disease and more deaths from it than in Europe and older people report more arthritis and other limitations on their activity than in Europe or Japan.

The US is, however, good at looking after the health of the most elderly. People who reach 75 are more likely to live longer, have lower death rates from stroke and cancer, better-controlled blood pressure and cholesterol levels and lower rates of smoking than elsewhere.

But death and disease take a huge toll on the younger American population, even though the US spends more on healthcare per capita than almost any other country in the world. Poverty, inequality, racial and ethnic differences and lack of health insurance are part of the story but not all. Even non-Hispanic white people with money and insurance who are not smokers or obese do less well than those in other countries.

Unless action is taken, the report says, the health of Americans will probably continue to fall behind. “The tragedy is not that the United States is losing a contest with other countries but that Americans are dying and suffering from illness and injury at rates that are demonstrably unnecessary. Superior health outcomes in other nations show that Americans also can enjoy better health,” says the report.

The US public is unaware of the issues, says the report. “I don’t think most parents know, on average, infants, children, and adolescents in the US die younger and have greater rates of illness and injury than youth in other countries,” said Woolf.

The report says the situation will not improve unless Americans wake up to the truth about their health and a public debate begins.

‘Catastrophic’ failings in schizophrenia care revealed

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early intervention, physical health, psychosis, schizophrenia, support, treatment

‘Catastrophic’ failings in schizophrenia care revealed

Care for people with schizophrenia and psychosis is falling “catastrophically short”, a report has found.

The Schizophrenia Commission said there were “shameful” standards of care on some acute mental health wards, which could make patients worse rather than better.

The commission, established by the mental health charity Rethink Mental Illness, has called for a radical overhaul of the care system. The report suggests that too much money is being spent on secure care – the most expensive form of care – and more should be invested in prevention and community support.

It expresses concern that early intervention treatment teams are being cut in some areas.

Researchers claim that very few sufferers get the recommended levels of care. The report states that there should be more widespread use of community-based “recovery houses” and a redirection of funding from secure units into early intervention services.

Professor Sir Robin Murray, chair of the commission, said: “We have spent the last year listening to expert professionals and more importantly, the experiences of people who have schizophrenia and psychosis and their families.

“The message that comes through loud and clear is that people are being badly let down by the system in every area of their lives.

“People with psychosis need to be given the hope that it is perfectly possible to live a fulfilling life after diagnosis. We have no doubt that this is achievable.”

Paul Jenkins, chief executive officer of the charity Rethink Mental Illness, added: “It’s been over 100 years since the term schizophrenia was first coined, but care and treatment are still nowhere near good enough.

“It is a scandal that in 2012 people with schizophrenia are dying 15-20 years earlier than the general population and that only 7% are able to get a job. Too many people are falling through the gaps in the system and ending up in prison or homeless.

“Developing ideal treatments might take time, but there are things which can be done today which could transform lives. More money does need to be spent – but the funding that already exists could also be used much more effectively.

“We wouldn’t accept this state of affairs for cancer, why should people with schizophrenia have to endure it?”

Schizophrenia affects more than 220,000 people in England and an estimated one in six people will experience some symptoms of psychosis at some stage in their lives, according to the report.

A Department of Health spokeswoman added: “This report highlights important areas for improvement and shows why we have put better treatment for those with mental health problems at the heart of the new mandate for the NHS.

“This includes plans to hold the NHS to account for improving health and reducing premature deaths in people with serious mental illness.

“We’re setting up pilot sites to improve access to psychological therapies for those who have a severe mental illness including schizophrenia. We are clear that people with mental health problems should be treated with the same high quality and dignified care as anyone else and we expect the NHS to make this happen.”

Andrew McCulloch, chief executive at the Mental Health Foundation, said: “GPs and other health professionals must do more to offer routine health assessments to people with severe mental health problems and address identified needs.

“Some people with severe mental health problems experience a chaotic lifestyle, self-neglect, poor diet and high levels of smoking, all of which significantly increase risk of physical health problems, including cardiovascular disease.

“However, this level of mortality cannot be simply attributed to lifestyle – this could be seen as victim blaming. Social inequality clearly plays a major role.

“The commission’s report points out that about 45% of people who receive a diagnosis of schizophrenia recover after one or more episodes.

“Rates of recovery will only improve when we refocus resources on to the early stages of illness, give people hope, and help them to self-manage their condition better, instead of spending all of our resources downstream.”

How One Charity Is Tackling Complex Mental Health Problems Using The Simple Power Of Reading

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books, Children, confidence, dementia, literature, mental health issues, MS, physical health, reading, relaxation, symptoms

How One Charity Is Tackling Complex Mental Health Problems Using The Simple Power Of Reading

It is, as one member of the Reader Organisation puts it to me, like watching a dozen tiny miracles.

Sat around a kitchen table in a mental health ward in central London, five patients are munching biscuits and taking turns to read out loud from Great Expectations.

We pause after the scene where Pip meets Miss Havisham sat alone in her cobwebbed bedroom.

Lucy, a London woman in her 30s who looks far older after years battling alcoholism, speaks first.

“It’s like me when I was drinking, that is” she tells the group with a nervous chuckle.

“I couldn’t let go of who I was. Couldn’t move on.”

We pick up the story again until Pip is humiliated by Estella, runs away and kicks a wall in frustration.

Ryan, a Scotsman with big, bunched shoulders says in an intense, slow voice that he felt exactly the same way as Pip that morning talking to his doctor.

“You can feel patronized at every stage in life, especially when you’ve got a mental illness,” he says.

“Doctors, people in shops, your children’s school teachers…” he flares up momentarily, getting angry as he tells the anecdote, then relaxes so we can carry on the story.

Up until this point Jan, a softly-spoken woman in her late 50s who has suffered for years with manic depression has remained politely quiet.

But at the group’s request she takes a turn to read in a beautiful, expressive voice which everyone compliments afterwards. She ends with a smile and begins happily nattering about how much she loves Dickens, before catching herself.

“I can’t believe I just started a conversation!” she says, blushing.

For ten years, the Reader Organisation has been helping some of the most vulnerable people in society feel better by carefully harnessing the power of reading.

In schools, care homes, psychiatric wards and local libraries across the UK, sessions held by one of over 40 trained facilitators provide a haven for troubled kids, elderly people battling dementia and people with a range of mental illness, from depression and schizophrenia to drug addiction.

The format of the sessions is very simple. Taking it in turns to read, the facilitator and the group work through a novel or short story, pausing at key moments to share their thoughts about the story and how it makes them feel. Then they end with a poem.

There is no attempt to ‘analyse’ the texts in any academic sense, just to empathize with the characters and debate the plotlines. But then there is no ‘dumbing down’ either – the reading list is resolutely classic, from Shakespeare to Steinbeck to Wordsworth and the Romantics.

The therapeutic benefits are two-fold. First as Jane Davis, the charity’s founder and a former literature tutor, puts it: “there is something about reading aloud, something rhythmical, comforting, childlike and secure that either directly or indirectly addresses that inner weather we all experience. That’s why people love it.”

The second, particularly for people suffering from mental health problems like those I meet in London, is the opportunity to share how they are feeling with others through a form of displacement.

The characters in Great Expectations or Shakespeare or any of the texts the Reader Organisation use function as vessels – or as Dr Kathryn Naylor, an Associate Specialist in Forensic Psychiatry at Ashworth Hospital puts it: “a way of expressing emotions without having to say what’s really upsetting you.”

Naylor treats men who are mentally disordered offenders, and has been using The Reader Organisation as a supplementary exercise with her patients (“it’s not therapy it’s therapeutic” she explains) for many years.

The results, she says, can be amazing.

“We had a man with us in his early 40s with paranoid schizophrenia, who was very suspicious of other people’s motives. He found it very hard to talk to people and had bad social anxiety.

“He started coming to the reading group and just sitting in the corner and listening. This happened for about 3 months, when eventually one day at the end of a session he suddenly said: ‘can I read the next page?’.

“We saw that as an incredible breakthrough, being able to read in front of other people. That was accompanied by him engaging in cognitive behavourial therapy, looking at some of the underlying reasons for his paranoia and mental illness.

“The group brought about real progress for him. He has since left the hospital. Prior to the group he felt he couldn’t even leave the ward.”

The Reader Organisation wasn’t founded with the aim of helping people’s mental health. Instead, it was born out of Jane’s belief that the great works of literature should be accessible to all, no matter their background.

“Books did something for me that helped me have a different kind of life to the one I was heading for,” she explains.

“I had been a 12-year-old run away. Someone who at a young age had been using drugs and drinking a lot. I was disturbed teenager who had a shoddy education, so when I got my degree and even my PHD I still very strongly had a sense of myself as not being properly educated.

To end up as a university lecturer, she says, felt amazing.

“But I couldn’t help thinking that out there in the wide world was someone like me in a bus shelter who needed to find the same things I’d found.”

After 15 years teaching the canon to bored undergraduates mainly from comfortable middle class homes at the University of Liverpool, Jane finally found an opportunity to try out her theory. In 2002, she was given a £500 budget to set up a reading scheme under the university’s new objective of ‘widening participation’. It would prove to be not just a turning point in her life, but go on to change many others.

“It was a one off, 5 week summer project. The idea was take some books I thought was great out of the university and out into places you wouldn’t expect to find a lot of readers. I recruited a lot of the people in that first group through friends who worked in community work. They weren’t very literate, so I just read to them.

“It was fantastic. It was like meeting up with people from my childhood – the ones I used to meet in the pub where I worked – but instead of serving up beer and vodka I was serving up Shakespeare. People loved it and realised that this was what I wanted to do. I did one more year at the university and kept the group up in my own time. Then I handed my notice in.”

The first few years were a struggle as Jane tried to find funding for a project that didn’t give anyone qualifications or get them into work. But it was as she gathered feedback from participants that Jane realised the true potential of her inclusive, accessible approach to sharing literature – not to educate, but to heal.

“We were frantically trying to gather evidence so that at the end of our year we could justify the project continuing. So we began asking the people attending the group: ‘what’s it done for you?’

“The responses were astonishing. People would say: ‘I’ve got MS, and when I come here for two hours a week I seem to get into such a state of relaxation I become unaware of my symptoms’, or ‘I have chronic pain but I forget about it here because I’m so immersed in the reading.’

“We knew that a number of the people attending had serious mental or physical health issues, but these were powerful and surprising moments. As well as giving people the confidence to read Shakespeare, we were making them feel better too.

“A woman said: ‘I’m bipolar and I’ve been bipolar for 30 years and I’ve tried everything to get better, but this is brilliant. It should be available on the NHS.’”

These early responses would send Davis’ project on a whole new trajectory, and change her entire outlook on what the Reader Organisation could achieve.

“I’d never thought of it in those terms before. But if one in four of us have mental health issues, it must really be more like two in one, because they’ll be a lot of people out there like me who have had mental health problems but didn’t bother going to see a doctor about it.

“Now I don’t think of ‘healthy’ and ‘unhealthy’ as two separate states, I think they’re on a continuum. I realised that what was true for me as young adult – that I love reading because it makes me feel great – could be true for anyone with a little help.”

If this all sounds rather anecdotal, there is a weight of academic evidence to support The Reader Organisation’s claims too.

A study carried out by the University of Liverpool in 2011 looked at the long term affects of participating in Get Into Reading, The Reader Organisation’s flagship program, on older people living with dementia.

They found that regular attendance was effective at improving the memory and concentration of patients, and had a positive long term impact on reducing symptoms such as delusion, anxiety and irritability. It concluded: “the Get Into Reading model should be extended to all care homes.”

Today, the Reader Organisation has just celebrated its tenth anniversary. It now runs 100 weekly reading group in its original home of Wirral alone, and has teams set up in ten different boroughs of London and areas of South Wales, Belfast, Durham and Glasgow – as well as sister projects in Denmark and Australia.

Speaking to anyone involved, from the nurses and volunteers who facilitate the groups to the readers themselves, what comes through is the overwhelming potential everyone feels the scheme has.

“There are a lot of areas of life where what we do could work,” Jane tells me when I ask about the future.

“The army for example. Veterans. People with post-traumatic stress – why not?”

Give it another ten years, and perhaps we’ll no longer see reading as simply as a source of pleasure or a route to education but a way to tackle diseases of both the body and mind.

To learn more about The Reader Organisation check out their website.

Darren Eadie: Life after football – depression and panic attacks

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Depression, panic attacks, physical health

Darren Eadie: Life after football – depression and panic attacks

One minute, Darren Eadie was the Premier League footballer who Martin O’Neill had paid out £3.5m to bring to Leicester City. The next, he was lying in a hospital bed, his arm covering his face, trying to take in a surgeon’s words that his career was over.

Later, he would be hit by a depression so deep that it left him driving around the country lanes of his native Norfolk, so traumatised that he had to stop and call his wife out to come and rescue him. The same illness left him unable to go into the sea with his children on holiday, or to complete a birthday meal with his wife when the panic which was regularly seizing him took over once again. But to begin with, it was only the little things that hit Eadie as he went through the motions of packing up his life and career in a bag, at the Leicester City training ground.

“Everybody says you hang your boots up when your career is finished,” Eadie says now. “But you actually take them down.”

His story, which asks questions of whether football does enough to help those players who are thrown out before they are ready, begins in the bed of a private hospital in Leicester in 2003, where Eadie was trying to shake off the effects of an anaesthetic, after his third operation in one year on his left knee. It was surgery carried out to find out the effects of what had been the last roll of the dice – pioneering surgery, carried out on Eadie in Sweden 12 months earlier by the surgeon Lars Peterson, whose technique was to re-grow part of the cartilage in a lab, then inject it back into his knee via three grafts. It was a relatively new operation but it had worked before and it would do so again, notably when Manchester United’s Ole Gunnar Solskjaer needed help.

Eadie had encountered problems with his knee before but had always overcome them. A crunching tackle by Scott Parker, 40 minutes into Leicester’s game at Charlton on 1 April 2001 was different, leaving him sidelined for months and unable to get back playing. He never would get back. The knee never felt right after the Swedish surgery. When running one day he felt “something go” in it and it emerged that one of the grafts had fallen out of place. A repair took place, Eadie went back to the gym, but he felt the same problem. All three grafts had fallen out and that was when more exploratory surgery – in the Leicester hospital – brought him to his moment of truth with the surgeon and Leicester physio Dave Rennie.

“I just knew by the look on their faces that the news wasn’t good but the words ‘I’d advise you that it would be in your best interests to give football up’ were shattering,” Eadie says.

His wife, Kelly, was told by Rennie that she should get to the hospital as soon as she could. She immediately knew that the situation was not good. “I can remember walking in and seeing Darren lying on the bed with his arm covering his face,” she recalls. “It was a massive blow for him, knowing that his football career was over, and it affected all his family too, as our family life was also based around Darren’s footballing career.”

Eadie’s first instinct was panic. He was a top Premier League footballer at the time, earning good money. “When I got home and spoke to all my family on the phone, I wasn’t sure what to do. My first thoughts were that money would be an issue and I’d have to sell everything to get by. It was unrealistic to be driving around in a Porsche any more. Everybody did their best to keep my spirits up, but the unknown was frightening.” He recalls his final day at Leicester when he said his goodbyes, collected his belongings and walked into the boot room to take that pair of his down off the peg.

“That was probably the worst moment,” he says. “Being told in a hospital environment wasn’t great but going to gather my football bits together, knowing I was going to leave, was the hardest moment.” It was after selling up in Leicester and moving back to the family home in Norwich, that he was finally confronted with the enormity of what lay in front of him.

“At first I was OK. It was nice being back among family and friends. I just thought I’d be able to sit around and do my own thing. But things started to change. People I’d started to trust in life let me down. In football and inside the changing room, everybody is pretty much in the same boat and same position in life. You all trust each other and the camaraderie in the team brings everybody closer.

“On the outside, things are different and you soon realise that you can’t trust everybody. I was involved in a couple of business ventures that didn’t work out. People that I thought had my best interests at heart didn’t. It is hard when the only thing you know is football. I would go into Norwich and walk around and see everybody else was happy and it depressed me even more. It was a vicious circle. Then the panic attacks started and it was completely debilitating. I’d end up having to call Kelly to come and get me. It was really scary and it paralysed me at times. It would happen up to three times a day, and cause pain in my arms and other places in my body.”

The news that his mother had been diagnosed with breast cancer – and had been made redundant – was another blow. “That was devastating, of course. Thankfully, she has had an operation and treatment and is making a great recovery. But… depression is a very lonely place, even with all the support around you. It’s only in your head. I can remember driving one day in the country lanes around Norfolk and not being able to go any further. I had to phone Kelly up to come and get me.” Had he considered taking his own life? No, he says. That is something he could not put his family through.

His wife lived through the depression too. “It was like looking after another child,” Kelly says. “I didn’t really have anybody to seek guidance from. It was very lonely and it certainly put pressure on our marriage. I didn’t realise depression could make you so physically ill at times.

“What Darren was going through shocked me, and at times it made me feel numb. I wanted to run away but I was the one keeping the family together. I needed help how to deal with the illness. Football ruled our lives when Darren played. He told me one day in the middle of all this that he could never see himself being happy again. He wasn’t able to go running for four years after he finished football. He couldn’t even go out in the garden and play with our son, Taylor. Even on holiday in Cornwall he wasn’t able to go in the sea with the kids.”

Her birthday meal, when the two of them went out together, is one of the moments she remembers. “Halfway through, Darren started to get really upset and panicked. I had to quickly get him out of the restaurant and pay myself. It wasn’t the birthday that I expected but the bigger picture was more serious.” Eadie knew he needed to seek help. “I saw doctors and other people as well. Everybody was really good with me, especially Leon McKenzie, the former player, who had been through a similar experience.”

But the help that came from within the game was not all it could have been, he says. “I was disappointed with the help that came from within the game. I spoke with Professional Footballers’ Association chairman, Clarke Carlisle, who was great, but overall I found the PFA disappointing. When Gary Speed died, the PFA said they would be sending out leaflets to all ex-players about life after football, but nothing ever came through my door. I found myself waiting every day for it to arrive. There needs to be a place sportspeople can go to sort their heads out. Treat the early stages of depression and it could stop the addictions like gambling, drink, drugs starting. People start these when they are feeling at a low.”

Like most people fighting depression, it was the solace of his family which helped most, although Eadie was astonished to discover so many others had been through the experience. “People have a perception about footballers being egotistical big-heads. Don’t get me wrong, there are some of them, as in any walk of life, but most of them are not like that and depression is not an exclusive club. Wealth, race, age, gender – it can affect anybody at any time. It really is so important to talk and seek help. You will be amazed at the response.”

Eadie has made it through and today finds himself in a better place. He works in local radio, enabling him to keep a close eye on his former teams Norwich and Leicester, and also for Sky Sports and other media. He has established a charity website – www.sellebrity.org.uk – auctioning celebrities’ clothes and other items they no longer need. Beneficiaries include the Prince’s Trust, of which he is an ambassador. He has also been involved in an enterprise to launch a new energy drink, EQ8, made from natural ingredients.

Where the future is concerned, it is still “one step at a time for me, so early on,” Eadie says. But he has found focus. “I want to be just as successful in something else as I was at football. I am now working with some lovely people and I’m determined to make it all a success for them as well as myself. Things like this make you better and stronger.” The last few years have been long but now he can really say that he has taken those boots down.

Almost half of unpaid carers risking their health, survey shows

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Cancer, carers, healthcare, mental health issues, physical health

Almost half of unpaid carers risking their health, survey shows

Nearly half of unpaid carers in the UK are jeopardising their health due to a lack of support, according to a survey.

Carried out by Carers Week, a group of eight charities including Age UK, Carers UK and Macmillan Cancer Support, the survey found that 40% of carers had put off receiving medical treatment because of the pressures of their role.

In addition, 87% of the 3,400 carers surveyed said caring had been detrimental to their mental health, while 83% said they had suffered physical health problems. Another 36% said they had sustained injuries such as back pain and insomnia while caring for sick or disabled friends or family.

Helen Clarke, Carers Week manager, said the government had to do more to support Britain’s 6.4 million carers – both practically and financially. She called for more sustainable social care funding, better signposting for support services and regular health checks for carers.

“It’s a scandal that carers can’t get the time or support they need to look after themselves, which could be jeopardising their health as a result. Carers are feeling the strain of a woefully underfunded system and still we’re seeing more cuts. Unpaid carers save the government a fortune – £119bn a year – yet they’re let down in return. It is time for urgent action to tackle the crisis in social care.”

Another survey conducted by the Association of Directors of Adult Social Services last week revealed that social care budgets had been cut by £1.89bn in the last two years, and suffered a drop of 6% last year at a time when pressure from rising numbers of older and disabled adults continues to grow, at around 3% each year.

The Department of Health said it was responding to the carers issue via £400m in extra funding to the NHS for carers’ breaks until 2015.

Tracy Sloan, a carer for 20 years to her son Phillip, who has severe cerebral palsy, said she was diagnosed with cancer after missing a regular screening appointment. But once she had begun receiving treatment, there was still little time for recovery.

“Looking after Phillip is so full on, that it just didn’t occur to me to keep an eye on my own health,” she said. “I was really shocked when I discovered I had cancer and needed an operation. I came home from hospital exhausted, emotional and fragile. I really needed the chance to rest but instead I had to deal with Phillip’s demands too, and that took its toll on my recovery.”

Carers Week, which also includes the Carers Trust, Independent Age, Marie Curie Cancer Care, the MS Society and Parkinson’s UK, said that Tracy’s experience is not an isolated one.

A spokeswoman for the DH said: “Carers make an invaluable contribution to society and it’s vital that we support them to look after their health and wellbeing. We know how important it is for carers to be able to take a break from their caring responsibilities, to protect their own physical and mental health. That is why we have provided £400m additional funding to the NHS until 2015 for carers’ breaks, and why we’ve given the NHS the clearest ever direction to make carers a priority.

“We also want to place the rights of carers on a much firmer footing, so that the law recognises carers’ rights and their role in caring for others.”

According to Carers UK, 1 million carers – one in six UK carers – are forced to give up or cut back work to provide care, which can mean a significant drop in income. They said carers clocked up an average of 27 hours a week.

Angela Eagle, minister of state for pensions and ageing society has said the government would introduce reforms that would enable carers working for more than 20 hours a week to build up an entitlement to a basic state pension.

Scandal of mental illness: only 25% of people in need get help

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anxiety, cbt, Children, Depression, mental health issues, physical health, stress, Therapy

Scandal of mental illness: only 25% of people in need get help

The “scandalous” scale of the NHS‘s neglect of mental illness has been described in a report which suggests only a quarter of those who need treatment are getting it.

The report claims that millions of pounds are being wasted by not addressing the real cause of many people’s health problems. Nearly half of all the ill-health suffered by people of working age has a psychological root and is profoundly disabling, says the report from a team of economists, psychologists, doctors and NHS managers, published by the London School of Economics.

Talking therapies such as cognitive behaviour therapy relieves anxiety and depression in 40% of those treated, says the Mental Heath Policy Group led by Lord Layard. But despite government funding to train more therapists, availability is patchy with some NHS commissioners not spending the money as intended, and services for children being cut in some areas. “It is a real scandal that we have 6 million people with depression or crippling anxiety conditions and 700,000 children with problem behaviours, anxiety or depression,” says the report. “Yet three quarters of each group get no treatment.”

Layard added: “Mental health is so central to the health of individuals and of society that it needs its own cabinet minister … The under-treatment of people suffering from mental illnesses is the most glaring case of health inequality in the NHS … Despite the existence of cost-effective treatments it receives only 13% of NHS expenditure. If local NHS commissioners want to improve their budgets, they should all be expanding their provision of psychological therapy.”

A third of families have a member suffering a mental illness, the authors found. The report says mental health problems account for nearly half of absenteeism at work and a similar proportion of people on incapacity benefits.

In 2008, Layard and others won the argument that treating anxiety and depression saved the NHS money. A programme called Improving Access to Psychological Therapy (IAPT) was set up to train thousands more therapists.

Official figures, however, show that too few people are getting treatment across the country. There were 6.1 million with treatable anxiety or depression in England but only 131,000, or 2.1%, entered talking therapy in the last quarter of 2011.

There are stark differences between primary care trusts. Walsall did best, with 6.4% of depressed and anxious people in talking therapy, followed by Swindon with 5.8% and Northumberland with 5.5%.

But Hillingdon, west London had only 0.1% in treatment – 17 out of 29,000. Barnet and Enfield, both in north London, had 0.3% and 0.4% respectively.

Layard said commissioners were wrong “if they think ‘why don’t we cut a bit of that [talking therapies]’ when they are spending money on infinitely lower priority conditions. Depression is 50% more disabling than conditions like angina, arthritis, asthma or diabetes.” Even including those on medication, treatment only reaches a quarter of those in need.

Commissioners needed to understand that treating people with mental illness saves money, the report says. Layard pointed to a survey at two London hospitals which found that half the patients sent for an appointment with a consultant had physically inexplicable symptoms, such as chest and head pains for which there was no organic explanation. “These are people with somatic symptoms as a result of mental stress,” he said.

In the long term he said he would like to see psychologists and therapists working alongside physical medicine doctors in the acute sector, to help determine the real cause of people’s apparently inexplicable symptoms.

Dr Andrew McCulloch, chief executive of the Mental Health Foundation, said the report showed mental health remained a poor relation to physical health for the NHS. “The government has rightly committed to a parity of esteem between physical health and mental health in the health and social care bill, and surely they must now deliver on what they have promised.”

Dr Clare Gerada, the chair of the Royal College of GPs, applauded the efforts of Layard and his colleagues to increase the availability of talking therapies.

“We live in a stressful society and the number of patients with mental health problems presenting to GPs is on an upward spiral,” she said. “GPs face tremendous challenges in caring for patients with mental health problems in primary care and we welcome any development which will help us improve their care.”

The care services minister, Paul Burstow, said: “Mental ill-health costs £105bn per year and I have always been clear that it should be treated as seriously as physical health problems … the coalition government is investing £400m to make sure talking therapies are available to people of all ages who need them. This investment is already delivering remarkable results.”

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NHS is’failing’ mental health patients