Black Mental Health Manifesto

"Concrete action is needed to improve mental healthcare for black communities otherwise generations will keep being “held back from achieving their full potential”, a new coalition has warned.

The group said it is calling for “positive change” to alter a system within which it said black people are being failed when they at their most vulnerable.

The coalition – which includes the Black Minds Matter charity, the Centre for Mental Health and Mind as well as smaller grass-roots organisations – has launched what it called the Black Mental Health Manifesto."

        continued ...

Individual

|

      INTERPERSONAL    :     SCIENCES               

HUMANISTIC  --------------------------------------  MECHANISTIC      

 SOCIOLOGY  :    POLITICAL 

|

Group

Mental Health / Illness - Parity of Esteem Holistic: Assessment, Planning, Intervention, Evaluation - Competency? Diagnosis of Psychoses	Physical health change/revision - WHEN? Objectivity of assessment / Cultural literacy
Black communities and Families Culture, History Radical future? Stigma, Stereotype Social determinants	Racism. Economic, Political determinants Poverty, Housing insecurity Statistics - Admissions / Recourse to MHA Incarceration, Injustice Mental Health Law - Mental Health Act CHANGE/REVISION - when? Coalition

Why 'Integrated Care' remains a Legacy Issue

Define 'integrated care'?

individual

|

INTERPERSONAL : SCIENCES

humanistic ----------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

|

group - population

Protect myself [You Government] Protect me* The individual need to  'do' something with this model,  not just think about it.  The personal sense (illusion) of doing, with yet another install of Wamp, Drupal ...	Complexity Systems Uncertainty Legacy - issues Evidence-Based Care?
*(I have a duty of care to protect my family and community and not become the next casualty.) Protect my loved ones and community	Evidence-Based Policy? The National Risk Register 2017 Is a tabletop exercise in pandemic  planning and response sufficient? The Political sense of thinking as 'doing'. (This is where the lamp is always on.) Tick here

See also:

'Desk-topping' i [ c/o BBC Radio 4 today 5 Feb. ]

Image source:
https://www.trident-crisis-solutions.co.uk/ (risk register)
https://www.bumc.bu.edu/ (tick box)

Conceptual Blending - Glocalisation

glocalize

MEANING:

verb tr.: To make a product or service available widely, but adapted for local markets.

ETYMOLOGY:

A blend of global and localize. Earliest documented use: 1989.

USAGE:

“Communications have also been glocalized. Facebook, the global power on the rise, is an expression of this.”
Uri Savir; Glocalization; Jerusalem Post (Israel); Feb 24, 2012.

Source:
A.Word.A.Day
with Anu Garg

This week’s theme
Portmanteau (blend words) 

I've been subscribed to A.Word.A.Day for many years and could not resist posting this word based on the current week's theme and musings...

• Conceptual blending
• Blended learning
• Blended family

Self care + Health care (the multidisciplinary team) + Social care (family/friends as carers) + State care = Blended care

Jones, P. (2012). Exploring several dimensions of local, global and glocal using the generic conceptual framework Hodges's model. The Journal Of Community Informatics. 8(3). Retrieved from http://ci-journal.net/index.php/ciej/article/view/876/

Jones P. (2014). Using a conceptual framework to explore the dimensions of recovery and their relationship to service user choice and self-determination. International Journal of Person Centered Medicine. Vol 3, No 4, (2013) pp.305-311.

Reflection is holistic...

individual

|

INTERPERSONAL : SCIENCES

humanistic -------------------------------------------  mechanistic

SOCIOLOGY : POLITICAL

|

group-population

"Reflection is holistic - it considers the whole,	where aspects within the experience  can only be viewed  within the context of the whole,
they exist in dialectical tension,	and cannot be reduced into parts or stages."

Johns, C. (1997). Becoming an effective practitioner through guided reflection (PhD Thesis). Open University, p.47.

"I kept your wild, cold, raw."

individual

|

INTERPERSONAL : SCIENCES

humanistic ---------------------------------------  mechanistic

SOCIOLOGY : POLITICAL

|

group


"You see, when 
I 
lived far away, you knew 
I was there, and I kept something for you,
even though you had never seen 
a polar bear or an ice floe . . .
I 
kept your wild, cold, raw. ...

When you see it whole,  you remember that  it’s not polar bears over there,	and snakes over here;
it’s one place,  one strange special place.	It comes as a  whole  or not at all."

  

Jeanette Winterson, Polar Bear
also cited by
Scott, L. (2015) The Four-Dimensional Human, Windmill Books. p.200.

Threshold and Conceptual Mobility: Hodges' model

threshold ramp

conceptual - inter(trans)disciplinary ramps

INTRA-INTERPERSONAL	SCIENCES
SOCIOLOGY	POLITICAL

Image source:
http://www.wheelchair-ramps.co.uk/d/

Hodges' model: Evidence-Based Integrated Healthcare - Policy, Mental Health & Research Funding

individual

|

INTERPERSONAL : SCIENCES

humanistic ---------------------------------------  mechanistic

SOCIOLOGY : POLITICAL

|

group

Mental health research 3% Quarter of all health costs	Medical Research...
2011-2014  33% rise in mental health related incidents dealt with by the police	Council.. £801.4 million for projects - mental health allocated £21.8 million Funding also via other bodies - National Inst. for Health Research

My source: Bennett, R. (2016) Research fund spends 3% on mental health. The Times, 25 March 2016. p.24.

Security of Tools for Community Care and Elsewhere: Take this 'one' with you...?

individual
|
INTERPERSONAL : SCIENCES
humanistic --------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
|
group

Image sources:

http://picphotos.net
http://www.ebay.co.uk
https://www.signkits.co.uk
https://i.pinimg.com

My source: Following some van, some where...

Let More Light In - Reflection

individual

INTERPERSONAL : SCIENCES

humanistic ------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

group

'total internal reflection'  ?	tungsten oxide  has a  high refractive  index
?	?

The researcher's cells use iron oxide and tungsten oxide to do the light-capturing. Iron oxide absorbs visible light and tungsten oxide absorbs ultraviolet. Also tungsten oxide has a high refractive index. This means that light finds it hard to escape once it is inside a piece of tungsten oxide because it is bounced back and forth by a phenomenon called total internal reflection, increasing the chance it will be absorbed. p.78.

Source:
Solar Cells: Tiny Balls of Fire, The Economist, June 28th-July 4th 2014, 411: 8893, 78-79.

Additional link:
HowTheLightGetsIn 2015
https://howthelightgetsin.org/hay

A "science for safety": getting the formula - and the grid right

The grid holds great fascination for me.

TRON LEGACY

It didn't start with The Grid in TRON, nor obviously TRON Legacy - even though the realisation is superb.

No, the first grid was in the cobbled back alley at my grandparent's house in St Helens. As a kid staying over in the summer I would take a spoon and the melting tar between the cobblestones was a syrupy invitation.

I must have got in trouble, as spoons were lost down the 'grid'.

In the here and now the "science for safety" report^* bears further consideration:

If healthcare is to significantly reduce patient harm, a holistic perspective is necessary to capture the requirements and needs related to the culture, workflow, and technology associated with caring for patients. In this paper, we relate the problem to other industries and how these industries have addressed safety. We identify the current gaps in today’s healthcare approach and describe the actions that can be taken, and the change in mental models that must be made by the global healthcare community, to continuously improve patient safety. p.3 [my emphasis]

The Formula 1 season beckons. The cars tested to the max are still to be tested in anger. They will soon, be ready - on the starting grid.

The "science for safety"
also needs a starting grid.

A conceptual framework recognisable and relevant to all.


^*Transforming Patient Safety: A Sector-Wide Systems Approach
Peter J Pronovost, Alan D Ravitz, Robert A Stoll, Susan B Kenned
https://www.imperial.ac.uk/media/imperial-college/institute-of-global-health-innovation/public/Patient-safety.pdf 

See also: How do you Balance and Elevate Holism and Patient Safety?

Image source:
https://www.artofvfx.com/tron-legacy-chris-harvey-superviseur-vfx-prime-focus/

How do you Balance and Elevate Holism and Patient Safety?

We have tended to focus on problems in isolation, one harm at a time, and our efforts have been simplistic and myopic.

To significantly reduce patient harm, we need to adopt a holistic, systematic approach that extends across cultural, technological and procedural boundaries - one that is based on the evidence of what works.
...
Taking its lead from developments in highway and airline safety, the report^* argues in favour of a holistic approach, integrated systems, comprehensive risk assessment and performance reporting, regulation and the creation of a "science for safety".
Darzi (2015).

What instruments does a "science for safety" need?

How can we balance procedure, patients, practice, drug delivery connections, cost, staffing and technology... How can we elevate care, competency, compassion, communication, commitment, courage and values between individual and group levels?

Having agreed and identified the essential sources of evidence (humanistic and mechanistic), how can we integrate them?

Ara Darzi (2015) Patient safety needs to be improved. Health Service Journal, 13 February. 125: 6434, p.18.

^*Transforming Patient Safety: A Sector-Wide Systems Approach
Peter J Pronovost, Alan D Ravitz, Robert A Stoll, Susan B Kennedy
https://www.imperial.ac.uk/media/imperial-college/institute-of-global-health-innovation/public/Patient-safety.pdf

Social Care is dry in January

I bought The Times today and on the front page is the news from University of Oxford:

Dehydration ‘common’ among patients admitted from care homes:
http://www.ox.ac.uk/news/2015-01-16-dehydration-%E2%80%98common%E2%80%99-among-patients-admitted-care-homes

When nursing and residential homes are struggling to manage an individual's care and look to refer to mental health services (usually) they know they need to asked the 'question'. This is about physical health: does the resident have an infection, are they eating and crucially drinking, are they in pain, constipated. ...

Although the headline augers badly and points to an ongoing (politically) 'inflammatory' problem within the sector, there is a great deal of compassion out there.

A resident's marked emotional distress and torment can upon investigation become a matter of how to also manage the staff's distress as they try to meet the individual's care needs. The latter does not help the former and amongst other things points to an educational need. This is especially so, if residents are to be able to continue to 'age' in their new 'home' with the additional complex needs that might follow.

Fluid balance used to be an element of basic nursing care.

Now of course - social care is not nursing care.

It is not always 'basic' either.

Peter's penchant for boxes...?

Although the number of posts using Hodges' model may suggest I'm obsessed with putting things in boxes and I am extolling you to do the same, please note; this is not the case [well not entirely ;-) ].

The model recognises the common need to make sense of things, hence our tendency to dichotomise, categorise, to seek meaning and order. The model makes explicit 'four basic boxes', but then invites us to transcend them by testing each one, subjecting the four domains to reflection. Five domains, taking in the spiritual also.

Given a situation, a context, a patient, or carer, or student ... we can ask what are the facts, what are the issues and how are they linked? Mentally we can consider what important concepts are missing?

It is not for me to provide all these concepts. I may|should|must also listen, observe and liaise in order to identify them. The solution is about teamwork, partnership and collaboration.

Yes, the 'boxes' really are there. The disciplinary divides do still exist. In h2cm they are integral to the structure of the model. But as we progress in applying the model we seek to blur, if not erase the boundaries. To achieve holistic and integrated care we need to collapse the boxes. It seems something more than interdisciplinary and interprofessional is needed to connect and integrate what are frequently neglected knowledge (care) domains and content.

I should be able to explain some of this in my review of Prof. Carel's book 'Illness'.

simplicity - complexity and Content Types

Without activating any content related modules Drupal 8 beta 4 is pretty stark. That's not a criticism. There are just two content types listed: article and basic page as per the screen dump below. The fact is Drupal is providing an easel and that's exactly what you need even before we get to the palette and canvas. As for other content types, there is a Book, Comment and Forum in core as additional options a checkbox away. There are many other contributed content types that could be added depending on your purpose.

Drupal 8 add content: Article and Basic Page

That's the challenge; using existing resources, stretching them as far as possible. In a book like Drupal for Education and E-Learning you can see even without dedicated learning resources, even with generic content types it is possible to create complex learning environments. Add this to experience of  distance learning - e-learning in the raw - that includes library access, databases, reading, discussion, peer review ... (and for our cohort another residential) and there's plenty to learn from.

In reality content is brittle, usually you can't just stretch it. Imagination and control in the form of flow and rules can work wonders. What is glued together - can be broken apart. It's educational chemistry: learning.

Reuse when possible. Be, active-reactive: responsive.

Is this a desktop I see before me, or is it a smartphone? 

So the screen image above is quite an invitation. I'm sure I've posted about his before: what else should be listed?

two cultures? mental health care_physical care : health care_social care : Hodges' model axes

Val Scura

 
C P Snow The Two Cultures
http://www.newstatesman.com/cultural-capital/2013/01/c-p-snow-two-cultures

My source:
Robbins, T. (2014) On the straight and narrow, FT Weekend, Travel, 6-7 December. p.8.

Val Scura - image source:
http://www.proguide.it/index.php/2011/02/23/valscura-sassongher/?lang=en
©Francesco Tremolada

Agnostic qualities in Hodges' model

In the previous post I highlighted "Holistic approaches to learning are agnostic as to method." 

I added that there would be more to follow as Hodges' model can be viewed as agnostic on several levels. The following is taken from a paper on Hodges' model and its application in forensic nursing:

Hodges’ model claims to be person-centred and situated (Jones, 2008). What exactly does this mean for forensic nursing? The utility of Hodges’ model lies in it being agnostic. By ‘agnostic’ this means that the model is not dependent upon, dedicated to, sanctioned by, or owned by any particular discipline (even nursing). It was not designed with a particular media, clinical setting, situation or organization in mind. It is true, however, that the model was formulated within academia and health and social care, being taught and applied by community mental health nurses, learning disability and health visiting students. Apart from the history and universality of the model’s cruciform structure and its inherent 2 x 2 matrix form [often referred to as a Johari window (Luft and Ingham, 1955)], the model is also culturally neutral. This is an essential requirement to reflect and enact nursing values and codes of conduct (Nursing and Midwifery Council, 2008).

Doyle, M., Jones, P. (2013). Hodges’ Health Career Model and its role and potential application in forensic mental health nursing. Journal of Psychiatric and Mental Health Nursing. 20, 7, 631-640.
http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2850.2012.01961.x/abstract

Book: Teaching Crowds - Learning and Social Media

This book is available as an open access pdf. Here is an extract from chapter 2 on Social Learning Theories.

Holistic approaches to learning are agnostic as to method. Drawing from connectivist and older models, they valorize diversity and the socially distributed cognition afforded by the read-write Web and other publishing models, accepting that every learning experience is unique, and every learner’s needs are different. Connectivist approaches, for all their extensive reliance on networks of people engaging socially, are at heart focused on the individual—specifically, the individual’s learning. Holistic models embrace the fact that it is sometimes more important that a group learns, rather than an individual, especially in collectivist cultures (Potgieter et al., 2006). Holistic models recognize that, sometimes, guidance is what is most needed, that people can learn without direct engagement with others and, even that transmittive instructionist models of teaching have a place. p.61.

In the next post I will explain the emphasis placed in the quote.


Jon Dron and Terry Anderson (2014) Teaching Crowds: Learning and Social Media, AU Press.

My source:
ITFORUM mailing list 
http://listserv.lt.unt.edu/mailman/listinfo/

Health in the Round - A paper Griffiths et al. ...

The quote below from Griffiths et al. highlights what might be described as health in the round. As the authors address: the rapid growth of online social networking for health, health care systems are experiencing an inescapable increase in complexity - they contrast disease-centred health care with patient-centred. In so doing they distinguish the mechanistic tendencies in health care systems with the humanistic. For me reading this section of the paper was a circumnavigation of health and social care domains of Hodges' model:

Good communication between doctors and patients has been widely recognised by professional bodies in North America (AAMC, 1999) and Europe (GMC, 2009) as essential to the delivery of health care and appears to contribute to healing (Street, Makoul, Arora, & Epstein, 2009). Stewart (2001) has argued for a shift away from disease-centred biomedicine to a more holistic patient-centred alternative. This approach encompasses: exploring the patient’s reason for consulting; developing an understanding of their context; finding common ground in problem characterisation and management; supporting health promotion; and enabling the doctor-patient relationship to continue (Stewart et al., 2003). Patient-centred practice reflects (Bensing, 2000) a set of social and political ideas about the nature of the doctor patient relationship (Mead & Bower, 2000), which, it could be argued, forms a complex system (Situngkir, 2004). p.2237.

Griffiths, F., Cave, J., Boardman, F., Ren, J., Pawlikowska, T., Ball, R., Clarke, A., Cohen, A. (2012). Social networks - The future for health care delivery. Social Science & Medicine. 75: 2233-2241.

A World Record for Health Care: The 4 minute reflection

Of all the things that can be done within 4 minutes one of the most significant in the history of sport is undoubtedly who would be the first to run a mile in under four minutes:

In health care four minutes is both an age and an instant in someone's health career.

If we took four minutes to reflect upon a person's care across the care domains what difference might that make?

Just one minute per care domain to help deliver - personalised care, self-care, carer support, integration, health promotion and how to stay well. ...

In healthcare we are constantly seeking GOLD.

Wherever you are have an amazing Olympics!

Public health: Whole society, whole government - whole medicine

The Health Service Journal isn't cheap so here every issue as a subscriber is a valuable resource.

In a September issue (1st) there were some really good opinion pieces and articles. One by Graham Burgess (p.17) concerned the coherence of public health. He started with the struggle that has been public health in England for the past 50 years; it has failed to define the problem to be solved.

Things may be set to change with the shift to local government that helps define public health on a social level, not just as a medical preoccupation - a distraction in fact from the disease health service perspective.

The word holistic that we all band-about was brought into stark relief by Mr Burgess as he nailed some w-holistic ecologies in referring to the 'whole of society' and 'whole of government' approaches necessary to build on the finding by the National Audit Office that only 15-20% of the inequalities in mortality rates can be directly influenced by health sector interventions.

There is a need to look further field than the supposed macrocosm that is the NHS: physical health - mental health.

Mental health is a whole world so frequently set apart from 'medicine'. Mental health contains a range of services that all shout: 'I am Cinderella!' So, Mr Burgess both frames the public health line up; and as I see it highlights the holistic scope of what are crucial and still emerging concerns. Still emerging ...? Well in the sense of having new - local authority - legs and thus endowed - how much further can public health run - and what tools are needed?

NAO Department of Health:
Tackling inequalities in life expectancy in areas with the worst health and deprivation