Writing and recovery: creative writing as a response to mental ill health

 

“You don’t put yourself into what you write, you find yourself there.”
Alan Bennett

Mental illness, for so long regarded as secondary to physical health, is now being taken more seriously. Media stories about loneliness, anxiety and depression have highlighted increasing concerns about mental ill health, and the issue has also been rising up the political agenda.

In 2017, a survey by the Mental Health Foundation found that only a small minority of people (13%) reported living with high levels of good mental health, and nearly two-thirds of people said that they had experienced a mental health problem.

Prescribed medication is one response to mental health problems, and it’s been reported that the NHS is prescribing record numbers of antidepressants.  But while psychiatric drugs can be of real value to patients, especially those whose condition is very severe, the mental health charity Mind has suggested that alternatives, such as physical exercise, talking therapies and arts therapies, are often more beneficial.

Last month, a conference at the University of Glasgow explored ways in which creative writing is being used to respond to mental ill health, and discussed what makes writing interventions helpful for coping and recovery.

Voices of experience: coping and recovery through writing

“Making and consuming art lifts our spirits and keeps us sane”.
Grayson Perry

Several speakers at the Glasgow conference testified to the effectiveness of writing in dealing with mental ill health and in finding a way to recovery.

In 2012, James Withey experienced a set of circumstances which brought him close to taking his own life. In the darkness of his depression, James felt that he might never recover. But after spending time at Maytree, the UK’s first “sanctuary for the suicidal”, he found that writing about what he was going through offered an antidote to the lies being spun by his depression.

He started a blog, and when he posted a letter to himself, beginning “Dear You.” James found that writing the letter gave him space to express his feelings and to listen to himself.

Before long, readers of James’s blog were responding with their own “Dear You” letters. The word spread that the letters offered a different perspective on recovery, and in some instances, had prevented suicide.

Today, The Recovery Letters project is still going strong, with a website, one published book and another in the pipeline. James is realistic about the project:

The letters are not a cure for a chronic illness, but they do provide support in helping sufferers of depression accept where they are.”

Policy positions: the view from Wales

“If poetry and the arts do anything, they can fortify your inner life, your inwardness.”
Seamus Heaney

Another speaker at the conference was Frances Williams, a PhD candidate at Manchester Metropolitan University, where she is studying arts and health. In her presentation, Frances explored some of the policy frameworks and public discourse surrounding the field of therapeutic writing in Wales.

She highlighted a recent report, Creative Health, The Arts, Health and Well-being, which  makes a case for the healing power of the arts in many different healthcare and community contexts.  In this report, a creative writing tutor explained some of the ways in which writing can help people experiencing bereavement, including keeping a journal, writing unsent letters, describing personal belongings and resolving unfinished conversations:

“Writing can be a valuable means of self-help, with the page as a listening friend, available any time of the day or night, hearing whatever the writer wants to say. The results of this can be powerful, and include people being able to return to work and adjust more effectively after their loss, acquiring skills for their own self-care which will serve them through the rest of their life.”

Frances also noted that the battle of priorities between impact and value-for-money has driven advocates of arts therapy programmes to defend them in terms of cost effectiveness and social value.

A mapping project by the Arts Council of Wales has taken this to heart, producing in 2018 an audit of the principal arts and health activities currently taking place in Wales.

Writing to the rescue

“By writing, I rescue myself”
William Carlos Williams

The Glasgow University conference underlined the health-giving properties of creative activities and the potential for creative writing to support people suffering with mental ill health. There was no pretence that writing offers a quick-fix solution. As James Withey noted, “…writing is just one element in a toolkit of responses to mental ill health.”

The All-Party Parliamentary Group on Arts, Health and Wellbeing fully supports this concept, and has recommended that policymakers recognise its importance:

“…the arts can make an invaluable contribution to a healthy and health-creating society. They offer a potential resource that should be embraced in health and social care systems which are under great pressure and in need of fresh thinking and cost-effective methods. Policy should work towards creative activity being part of all our lives.”


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Opportunity or necessity… what’s fuelling the growth in self-employment?

iStock_650068Small_BusinessManInMeadow

With unemployment reaching its lowest level since 1975, it may seem like the state of the labour market has improved in recent years. However, a closer look at the statistics suggests that this is not necessarily the case.

The strong performance in the labour market in part reflects the growth in self-employment, which has been a distinguishing feature of the labour market’s recovery since the last recession.

Growth in self-employment

There were almost 750,000 more self-employed in the UK workforce at the end of 2014 than at the start of the global financial crisis in 2008, representing a high proportion of the total net growth in jobs over this period. Self-employment accounts for over 15% of those in work in the UK – 4.8 million of a workforce of around 32 million. Between March 2008 and March 2017, self-employment accounted for almost a third of total employment growth.

The significance of the contribution of self-employment is highlighted in a recent article published in Regional Studies, which notes that of the 920,000 net new jobs created between quarter 1 of 2008 and quarter 2 of 2014, 693,000 were in self-employment.

There has also been a rise in the share of female self-employed and those that work part-time, in addition to growth in a broader range of industries and occupations among the self-employed.

Recent ONS figures also show that the growth in self-employment between 2001 and 2016 has been driven mainly by those who have a degree (or equivalent), leading to the share of the self-employed with a degree or equivalent increasing from 19.3% in 2001 to 32.6% in 2016 as a share of total self-employed. As a share of total employment (self-employed and employed), the figures show that relatively highly-qualified individuals are becoming more concentrated in the self-employed.

Earnings growth?

The reasons for this growth has been the subject of much debate, particularly as research suggests many fail to earn a decent living. This recent analysis by the New Economics Foundation found that 54% of all self-employed people are not earning a decent living. It also found that the percentage of the labour force in ‘good jobs’ had decreased from 63% in 2011 to 61% in 2016, suggesting that the quality of jobs is perhaps declining.

Similarly, the ONS figures suggest that the self-employment labour market remains financially insecure for its workers. They show that the distribution of self-employed income appears centred around £240 a week, much lower than that for employees, which is centred around £400 a week.

And, according to a recent report from CIPD, their real incomes have fallen more since 2008 than those of employees.

Perhaps, then, the self-employment growth has been driven by necessity rather than choice due to a lack of opportunity in the full-time labour market.

However, the evidence suggests it is not this simple.

Despite the widening gap in earnings between the self-employed and employed, the self-employed continue to have higher levels of job satisfaction than employees. The ONS figures also indicate that self-employed workers were more likely to supplement their income from elsewhere.

This would suggest that choice probably plays a large part in self-employment.

‘Push’ or ‘pull’ effect

There has been much discussion over whether the growth in self-employment is predominantly a result of choice or necessity.

It is often seen as a sign of labour market weakness, with self-employment perceived as a ‘last resort’ where a regular job can’t be found. The evidence suggests that this motivation accounts for just a small proportion of the change, however, with most of the rise in self-employment appearing to be out of choice rather than necessity.

Indeed, the recent analysis in the Regional Studies article, which examined the extent to which self-employment was associated with local ‘push’ or ‘pull’ effects, found little or no suggestion of any net ‘recession-push’ effect on self-employment. It suggests that:

  • ‘pull’ factors are more significant in driving transitions into self-employment;
  • self-employed business ownership appears not to function as a significant alternative to unemployment where paid employment demand is weak; and
  • entrepreneurial activity prospers where local wages are higher and unemployment lower.

The uncertainty surrounding Brexit could also be having an effect as declining employer confidence has contributed to a growing number of short-term contracts – potentially making self-employment appear the better choice.

Final thoughts

As the CIPD report highlights, there are probably more opportunities for self-employment now than there were a decade ago. And the self-employed are more likely to value highly aspects of the work, such as its variety, and choice over their working hours and pay.

Across the range of job-related characteristics, it is shown that the self-employed are as satisfied or more satisfied with their working life than employees, resulting in higher levels of overall job satisfaction – a finding that is consistent both over time and from different data sources.

In a time where work-life balance is of increasing importance, it is perhaps no surprise that self-employment is the path of choice.


If you enjoyed reading this, you may also be interested in our previous blogs on the gig economy, ‘the self-employment boom’ and ‘olderpreneurs‘.

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Housing models for the future

Housing is one of the challenges of our time. The task for architects and designers is to create affordable, robust housing that can accommodate the needs of a rapidly growing, but also ageing population. And it’s not as easy as simply building. The demands and expectations on house builders to also be community builders and the architects of mental and physical wellbeing through design have led architects and designers to consider alternative ways to house us in the future. This includes innovative use of materials and construction methods, addressing the issue of financing through co-operative living models and using bespoke design to create lifetime homes which can be adapted to accommodate the changing needs of our population.

Large-scale development

One of the big challenges for urban areas is large-scale development strategies for designing and delivering housing to meet need. For developers and planners going forward there are a number of factors to consider: the type of investment introduced to an area; how the schemes fit with a wider development plan for the city; and the importance of engaging the community in any plans to develop or regenerate an area.

“Placemaking”, not just house building is central to large scale development discussions, emphasising to planners, architects and developers the fact that they are not just building houses, but creating communities. As a result, designers and developers should be mindful of their important role in community building, to build the right sort of homes in the right places, at affordable prices and with a legacy in mind. They should, create high quality, long lasting units, which will stand the test of time but that also can be easily adapted to accommodate people’s changing needs.

Alternative construction and design

Innovative models and options for future builds have been discussed for a number of years but they are becoming an increasingly mainstream way to build affordable housing that meets the current need, particularly of students and young professionals, and of older populations looking to downsize or move into assisted care accommodation.

Offsite manufacture or modular homes  Offsite manufacture of timber framed houses is becoming increasingly common, with the constituent pieces of the house manufactured off site, then transported to the site and constructed on a concrete block where foundations and services such as plumbing have already been created. Offsite housing can either be open panel, which requires the finishing such as bathroom and kitchen installation to be done on site, or closed panel which provide the entire section complete with decoration and flooring (this is becoming a common way to build cheap, efficient student housing).

Custom build  Custom build projects are similar to self-build in that they give clients flexibility to select their own design and layout, However, custom build provides slightly more structure and certainty which can make it easier when considering elements like financing and planning applications. In essence, customers select the spec of their house in the same way they might make custom modifications to a car.

Build to rent  This model has been adapted from the United States, where build to rent is popular. The model is based on self-contained flats, with central and shared amenities, entrance and communal space. Designed to attract graduates and young professionals, these are being increasingly designed using a “user first” approach. Developers identify the sort of person they want to live in the development, identify what sort of things they might look for in a development, including floor type, furniture, layout, amenities, gadgets, and then build the development around that.

Dementia friendly – Building homes that are safe and affordable, but allow for independence in old age, is one of the major demands on house builders currently. Housing stock is seen as not suitable for current need, but building bespoke sites for people with illnesses like dementia has been seen as a bit of a niche previously. Virtual Reality (VR) is being used by some architects and developers to try to help them understand the needs and requirements of people with dementia and how they can build homes suitable for them to be able to live as independent and full lives as possible. Building dementia friendly homes not only means making them accessible and open plan, but also adapting the layout, adding signage where appropriate and if possible locating the homes within a wider community development. Dementia villages like those seen in Amsterdam are being used as the model for this.

Co-housing

Co- housing offers an alternative to communities in Scotland, and while lessons can be learned from elsewhere in Europe, where co- housing models have been successful, there are also pockets of good and emerging practice in the UK too. More traditional examples include Berlin, where almost 1 in 10 new homes follow the Baugruppe model, and Amsterdam (centraal wonen) where some of the oldest co-housing projects originate. In Denmark, 8% of households use co-housing models.

Co-housing provides the opportunity for groups of people to come together and form a community which is created and run by its residents. Each household has a self-contained, private home as well as shared community space. Residents come together to manage their community, share activities, and regularly eat together. A “Self-build Cooperative Group” is a joint venture between several private households who plan and build their own house together. Usually they are supported by an architect. Often co- housing groups are able to realise high-quality living space at prices below local market rates, although it is not really considered suitable for large-scale development within the current UK market.

Opportunities for a new way forward

Practitioners are often challenged to push the boundaries of design and building in their field. Looking to new models for future building design provides an opportunity to think creatively about alternative uses of materials and space and to consider options for construction, funding and investment in the built environment that challenge the norm. Learning lessons and exchanging ideas from elsewhere, architects and planners have the opportunity to come together to consider how the built environment in Scotland can help to create places  not just buildings  and how this can contribute positively to the wider wellbeing and happiness of people living in Scotland in the future.


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Maggie’s Centres: wellness through building design and the environment

In March 2017, the 20th Maggie’s Centre was opened in the grounds of Forth Valley Royal Hospital in Falkirk. Designed by architects Garbers & James, it is expected to receive 3000 visits in the first year.

Maggies Centre Forth Valley, Garbers and James

Maggie’s provides free practical, emotional and social support to people with cancer and their family and friends, following the ideas about cancer care originally laid out by Maggie Keswick Jencks and co-founded by her husband Charles, who is a landscape architect. Among Maggie’s beliefs about cancer treatment was the importance of environment to a person dealing with cancer.

She talked about the need for “thoughtful lighting, a view out to trees, birds and sky,” and the opportunity “to relax and talk away from home cares”. She talked about the need for a welcoming, reassuring space, as well as a place for privacy, where someone can take in information at their own pace. This is what Maggie’s centres today aspire to.

A number of high profile architects have designed Maggie’s Centres across the UK – from the late Zaha Hadid to Frank Gehry, Richard Rogers and Rem Koolhaas.

The Maggie’s Centre in Kirkcaldy, Zaha Hadid Architects

Promoting wellbeing through the natural environment and effective design

Drawing on research which considers the significant impact that environment can have on wellbeing, Maggie’s Centres are designed to be warm and communal, while at the same time being stimulating and inspiring. The interiors are comfortable and home-like. Landscape designers and architects are encouraged to work closely together from the beginning of a project as the interplay between outside and inside space, the built and the “natural” environment, is seen as an important one.

A building, while not wholly capable of curing illness, can act as “a secondary therapy”, encouraging wellness, rehabilitation and inspiring strength from those who move around it.”

Each of the centres incorporates an open kitchenette where patients can gather for a cup of tea, airy sitting rooms with access to gardens and other landscape features, and bountiful views. There are also private rooms for one-on-one consultations; here Maggie’s staff can advise patients on a range of issues relating to their condition, whether that is dietary planning, discussing treatment options (in a non-clinical setting) or delivering classes such as yoga.

Spaces to promote mental wellbeing as well as physical healing

Maggie’s Centres are also about offering spaces to people to help improve their mental wellbeing. As well as quiet tranquil spaces for reflection and meditation, there are also central areas, focused on encouraging the creation of a community between the people who use the centre. Wide-open spaces, high ceilings and large windows, with lots of opportunities to view the outside landscaping and allow natural light to enter are a key feature of many of the Maggie’s Centres.

The locations also try as far as possible to provide a space free from noise and air pollution, while remaining close enough to oncology treatment centres to provide a localised base for the entire treatment plan of patients.

Fresh air, low levels of noise and exposure to sunlight and the natural environment, as well as designs that provide spaces that promote communal interaction to reduce feelings of isolation and loneliness, have all been shown to improve mental as well as physical wellbeing. In this way, the physical attributes and design of the Maggie’s buildings are helping to promote mental as well as physical wellbeing of patients and supplement the care being given by the cancer treatment centres located nearby.

Interior of the Maggie’s Centre in Manchester, Foster and Partners

Award-winning architecture and design

In 2017 Maggie’s Manchester was shortlisted for the Architects’ Journal Building of the Year award. And many of the individual centres have won regional design awards for their innovative use of space and incorporation of the natural environment into their designs.

A Maggie’s garden was also featured at the 2017 Chelsea Flower show, highlighting the importance of environment, and the role of the natural environment in rehabilitation and promoting wellness among those who are ill.

Final thoughts

How design and landscape can aid and empower patients is central to Maggie’s Centres. They are a prime example of how people can be encouraged to live and feel well through the design of buildings and the integration of the surrounding natural environment. These environments are the result of a complex set of natural and manmade factors, which interact with one another to promote a sense of wellness, strength and rehabilitation.

They demonstrate how the built environment can contribute to a holistic package of care – care for the whole person, not just their medical condition. Other health and social care providers can learn from them in terms of supporting the wellbeing of patients, carers and their families.


You can find out more about Maggie’s Centres though their website.

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Read more about innovative building design in our other blog articles.

Grandparents – the ‘hidden army’ of kinship carers

mamy and the little boy

By Heather Cameron

Tomorrow is the International Day of Older Persons, designated by the United Nations in order to recognise the important contributions made by older people, while raising awareness of the issues of ageing.

Today there are around 600 million people aged 60 years and over world-wide. A number that is set to double by 2025 and reach 2 billion by 2050.

With people living longer and healthier lives, it is not surprising older people are playing a considerably more active and increasingly important role in society. Not least when it comes to contributing to the care of their grandchildren.

Extent of kinship care

Kinship care – when children are brought up by relatives or family friends in the absence of their parents – has grown markedly in recent years.

It is estimated that between 200,000 and 300,000 grandparents and other relatives are raising children who are unable to live with their parents. Common reasons cited for this include abuse and neglect, parental illness or disability, parental substance misuse, domestic violence or death of a parent.

In examining the prevalence of kinship care, drawing on census data, a recent University of Bristol study found that there has been a 7% increase in the kinship child population in England since 2001 – more than three times that of the population growth rate of all children in England, which was 2% over the same time period.

The study also found that one in two (51%) children were growing up in households headed by grandparents.

Positive outcomes

With regard to the children in kinship care, research suggests that they do ‘significantly better than children in care’, both emotionally and academically.

Indeed, a recent study on the educational outcomes of looked after children found that children in long-term foster or kinship care made better progress than children in other care settings.

The largest kinship carer survey in the UK, conducted by Family Rights Group, also highlights the effectiveness of kinship care in preventing children entering or remaining within the care system, to the benefit of both the child and the public purse. The data found that 56% of children had come to live with the kinship carer straight from the parents’ home, with 27% having been in unrelated foster care.

The caring contribution of grandparents has also been shown to have made a material difference to maternal rates of employment.

And as 95% of children being raised in kinship care are not officially ‘looked after’, billions of pounds are saved each year on care costs.

But while benefiting the public purse, and despite evidence that kinship children have better outcomes, many kinship families face a financial burden. The University of Bristol study found that 40% of all children in kinship care in England were living in households located in the 20% of the poorest areas in England (an improvement of only 4% since 2001), and three quarters (76%) of kinship children were living in a deprived household.

Impact on grandparents

As there is no statutory requirement for local authorities to make provision for kinship carers and no automatic right to child benefit, many receive no formal support; leading to financial hardship, and the stress that comes with it.

Many kinship carers have had to give up work or reduce their working hours, either permanently or temporarily. And this is often their main source of income.

A study from Grandparents Plus on discrimination against kinship carers found that of the 77% of grandparents that have asked for professional help, only 33% received the help they needed. And 30% said they didn’t receive any support at all.

The study also found that, overall, kinship carers score ‘significantly below average’ when it comes to their wellbeing.

Other recent research has suggested that regular and occasional care for grandchildren can impact on the mental health of grandparents. The findings indicated that ten additional hours of childcare per month increases the probability of developing depressive symptoms by 3.0 and 3.2 percentage point for grandmothers and 5.4 to 5.9 percentage points for grandfathers.

Policies that substitute informal with formal childcare, it argued, could improve the mental wellbeing of grandparents.

Of course there are positive impacts on grandparents too, many of whom find caring for grandchildren rewarding and who enjoy closer relationships with them, which can in turn have a positive effect on their health. As the research suggests:

the effect of grandchild care provision on grandparents’ health seems to depend on its intensity, the cultural context, as well as on its stability and change.”

Final thoughts

It is clear that grandparents play an increasingly vital role in family life. But it seems this role is in need of greater recognition and support, if society is to continue to benefit from this ‘hidden army’ of kinship carers.


If you enjoyed reading this, you may also be interested in our previous blog on the economic opportunities of an ageing society, published on last year’s International Day of Older Persons.

Follow us on Twitter to see what developments in public and social policy are interesting our research team.

Secure care in Scotland: measuring outcomes and sharing practice

By Rebecca Jackson

There are five centres which offer secure care in Scotland, with around 100 of Scotland’s most vulnerable children and young people placed within these units. Placements happen if they are deemed to be a risk to themselves, or others, within their communities, and it is felt that they can only be managed effectively within a secure care setting. These placements are arranged via the courts or the children’s hearing system.

 

National Secure Care Project

In 2014 the Scottish Government granted funding to the Centre for Youth and Criminal Justice (CYCJ) for a fixed term project to build on the work of the Securing our future initiative (SOFI) report in 2009. The SOFI report was a comprehensive analysis of the secure care estate in Scotland. It made recommendations for future practice in secure care and also suggested ways that the system could be made more efficient and young person centred. These included implementing and embedding the Getting It Right for Every Child approach and making full use of the Children’s Hearing and Early Years frameworks, including the SHANARRI indicators on well-being.

A scoping study was completed by CYCJ in 2015 which considered the current legislative and academic frameworks, as well as current practices of the 5 centres of secure care in Scotland. This followed the streamlining and takeover by Scotland Excel in 4 of the centres and Edinburgh City Council in the other.

The scoping study report, along with the project plan, highlights the aims and objectives of this new national programme:

  • identifying and promoting current best practice
  • identifying and exploring alternatives to secure care
  • building capacity within the secure care sector to draw comparisons and learn from the rest of the UK (and from each other)

Other key issues that the studies identified as needing to be addressed included:

Outcomes in secure care

One of the key issues raised by academics, policy makers and practitioners within secure care is the concept of outcomes. It’s been suggested that there is a need for both individual outcome targets for each child within secure care but also for a wider framework of general agreed outcomes to allow for better comparison between centres, which it is hoped will help raise standards of practice.

It is also recognised that long term, as well as the immediate, outcomes need to be assessed and researched. This ties in with the need for more emphasis on transitionary care and support. Although there is an expectation that local social workers will follow up on behalf of the secure care units, this isn’t always the case.

Key questions also have to be addressed from within the sector itself with regards to:

  • what are the aims of the centres
  • what exactly is meant by positive outcomes
  • what counts as an outcome
  • how can we look at a child or young person and say that a certain objective has been met, and can this be attributed to any one particular event, intervention or placement

These questions are not unique to the secure care sector but they do need addressed. Similarly there needs to be a wider acceptance that there are multiple outcomes and that these can be in terms of quality of life, process or change outcomes.

Sharing best practice and using staff as “knowledge brokers”

There is concern among practitioners and academics that, as a result of the changes to secure care provision implemented in 2014, secure care units are now reluctant to collaborate and share best practice.

The nature of the new secure care framework agreement means that, despite being referred to as a “secure care network”, the five centres are now in effect “in competition with one another” for individuals to be placed with them.

There is a risk that this constrains the sharing of best practice, ultimately reducing the collective standard of all five centres and therefore reducing the standard of care afforded to some young people. This was particularly highlighted in the 2015 CYCJ scoping report.

One of the key ways to share information and best practice is to allow the people who work within the centres, working with residents on a day to day basis, a platform to discuss and contribute to a wider discussion of best practice outside of their own individual centre.

Another potentially useful strategy would be to integrate approaches from traditional social work with regards to sharing ideas and information. This may also make it easier for social workers within and outside the secure care context to liaise with one another. Using staff members as “knowledge brokers” could be an efficient and effective way to allow staff to communicate best practice. Tools such as a digital platform, interactive app or online forum could help staff to share their experiences.

With the project scheduled to run until 2017, some of the issues highlighted here were discussed at an event hosted by CYCJ and WithScotland at the University of Strathclyde in April 2016. The hope is to increase collaboration and move the provision of care and creation of successful and useful outcomes frameworks forward as part of the wider National Secure Care Project.


Read more from our blog on supporting vulnerable children and young people across the UK:

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Mindfulness in schools: does it work?

by Stacey Dingwall

Over the last couple of years, the concept of being mindful has almost become a buzzword. However, mindfulness has actually been around since the 16th century, before being developed as a modern day western Buddhist practice from the 1970s.

Transform your life?

On the 17th of March, along with almost 400 other people, I attended the Transform Your Life event at Glasgow’s Trades Hall. The event was organised by the Kadampa Meditation Centre (KMC) in Glasgow, a Buddhist temple which opened in 2013 with the aim of providing a space for people to learn how to meditate and practise Buddhism.

The talk was delivered by Gen Dao, a senior Kadampa teacher who has been ordained for over 20 years, teaching at centres in America and Australia before taking up her current post as principle teacher at KMC Liverpool. Its focus was on equipping attendants with the ability to cope with everyday stresses and anxieties, by applying some simple meditation and mindfulness techniques.

After demonstrating a basic breathing technique, Gen Dao opened her talk by commenting on how prevalent mindfulness has become, noting that it is now used as a management technique and as a means of selling women’s magazines. She spoke about the benefits of using mindfulness not only on a personal level, but also how actively improving your mind can awaken the potential to bring benefit to others. Mindfulness, she explained, was essentially just remembering to breathe, and trying to focus on experiencing only positive states of mind.

The remainder of Gen Dao’s talk concentrated on the importance of mastering the ability to ‘oppose’ negative thoughts, and making the decision to be content and happy, without the intervention of others. Also highlighted was the need to strive for ‘patient acceptance’, or the ability to give up on the feeling that things in your life should be different – instead, we should learn how to view our feelings from a more detached perspective, and not identify with painful feelings, or “bad weather” in the mind.

Speaking to Gen Dao after the talk, I raised the point that, although not a physical pursuit, mindfulness is something that you have to train in, and learning to adapt to a new way of thinking is something that could take some time. Essentially, adopting a mindful outlook could mean changing the habits of a lifetime.

Mindfulness in the classroom

This could explain why some schools are now incorporating mindfulness exercises into classes, in order to prepare young people for the future. Last July, BBC News reported on the first large-scale trial of mindfulness exercises in schools across the UK conducted by the Wellcome Trust, during which researchers will look at whether introducing mindfulness at an early age can help build psychological resilience. The exercises, which will include deep breathing and a practice called ‘thought buses’ in which participants will be taught to see their thoughts as buses that they can either get on or allow to pass by, are designed to show children how to live in the present and eventually, equip them with the ability to solve problems while under stress.

The study will involve around 6,000 children and young people; a considerably larger amount than have taken part in previous evaluations of the impact of mindfulness in schools. While the existing evidence is currently described as limited, these smaller studies have indicated that mindfulness interventions with children and young people do have some success in generating lower stress levels and a greater sense of wellbeing among participants. These findings are important, given that a recent survey of school leaders by the Association of School and College Leaders found that 55% of respondents reported a significant increase in the number of young people in their schools who are dealing with anxiety and stress.

Case study: Mindfulness in Schools Project

The Mindfulness in Schools Project (MiSP) was founded in 2007 by former teachers Richard Burnett and Chris Cullen. Having experienced the benefits of mindfulness themselves, they developed “.B”, a 9-week course that aims to make mindfulness accessible, and fun, for secondary school pupils. The course, which has also been adapted for younger children as Paws B, is now being taught in twelve countries, including the UK. Teachers and pupils who have used the programme report on its ability to restore calm to a class after break, for example, or to calm pupils down at times of particular stress, such as exams or performances. It has also been suggested that the programme can help to improve pupils’ ability to concentrate.

Critics of the impact of mindfulness in the classroom argue that these results cannot be relied on, due to the experiments taking place outside of the boundaries of a randomised controlled trial. They also point to the possibility that participants’ ability to concentrate may only have improved due to their being informed that this is what the exercises are designed to do. Richard Burnett has openly recognised the limits of mindfulness himself, emphasising that it cannot replace the fact that some people require medication and clinical care to deal with their condition, and is more effective in smaller groups supervised by medically trained professionals. Trainers delivering the programme are also open about the fact that mindfulness is not something that will work for every child. What it can do, however, is provide a reminder to breathe when things get too much – something that can surely only be a positive for everyone.

If you enjoyed this post you may be interested in our previous commentary on mental health issues:

Overworked and under-resourced – ‘mission impossible’ for social workers?

By Heather Cameron

A year on from my previous blog on the emotional pressures facing social workers, have the headlines improved any?

Going by a new Guardian survey of social workers, it would seem that the answer is a resounding no.

The Social Lives Survey revealed that while the majority of social workers enjoy their job, two-thirds say they can’t focus on what really matters and only a quarter feel their workload is manageable. Almost 80% work overtime every day, and 86% don’t get paid for doing so.

Heavy and increasingly complex caseloads was the most common reason given for stress among social workers in last year’s Community Care survey.

Unmanageable caseloads

Unison surveyed social work staff from across the UK about their work at the end of a day in April 2014. Just over half (52%) said their caseload size was affected by covering for staff shortages and nearly three quarters highlighted that there was no formal system in place to help manage their caseloads and ensure they are at a safe level. A significant minority (42%) noted that they left work with serious concerns, the main reason for which was being unable to complete paperwork, followed by being unable to speak to other agencies or professionals involved.

Similarly, in May 2012 the British Association of Social Workers published the findings of its State of social work survey which indicated that 77% of the social workers surveyed said their caseloads were unmanageable. One child protection social worker said “the team I work in currently is working at dangerous caseload levels in terms of child protection work”.

The emotional impact of the challenges of social work were highlighted by a number of respondents, as one mental health social worker described:

It makes me so sad that this job seems only to be possible if you sacrifice your own health and wellbeing

The subsequent inquiry into the state of social work report by the All Parliamentary Working Group at the end of 2013 also emphasised the extent of stress among social workers who are overloaded and under-resourced. It heard from a local authority social worker who said:

 “the more cases we have, the more corners we have to cut, and the more corners we have to cut the more we have significant numbers of children for whom we haven’t had the time to do a thorough assessment”.

Another social worker said that as a result of budget cuts, “the conditions for child-centred practice and safe working are being eroded”.

Impact of austerity

A little over two years on from the inquiry, it would seem there is no let up on the impact of austerity on the social work profession.

A huge majority (92%) of social workers who took part in the Guardian’s survey highlighted that spending cuts are affecting services and putting more pressure on care professionals. And it was felt by 88% of respondents that social work isn’t as high on the political agenda as other public services.

With further cuts to hit local authorities from April this year, following the government’s announcement of a 6.7% funding cut for councils, things may get worse before they get better.

To help offset the impact on social care, local authorities will be able to raise an extra £2 billion through a 2% Council Tax precept and the £1.5 billion Better Care Fund.

Nevertheless, it has been argued that this will not be enough to address the immediate social care crisis or to prevent an estimated £3.5 billion funding shortfall by the end of the decade.

‘Bad press’

As well as spending cuts increasing pressure on social workers, the negative perception of the profession was also raised by the Guardian’s survey:

“The government and media need to stop portraying social workers as child-snatchers and do-gooders. They should sometimes focus on the lives we have saved and positively changed.”

It was suggested that newspapers should also focus on the pressures put on social workers rather than always on when things go wrong, and the government should be supportive of the role and address the lack of recognition and support at the national level.

Way forward?

Perhaps the rest of the UK should be looking to Wales for good practice, where the happiest social workers reside.

In Wales there are lower caseloads, more support from managers and better integration with health. According to one social worker, “it’s a better place to be a social worker. Social work is recognised and valued; in England I don’t think it is.”

Social services in Wales have also been more protected from cuts than elsewhere. And you don’t see the same negative language about social workers in Wales as you do in some parts of the media in England, according to the Welsh Government’s minister for Health and Social Services.


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Further reading: if you liked this blog post, you might also want to read Heather’s other article on engaging fathers with social work.

Costs and benefits of the National Living Wage

English money

By Heather Cameron

Britain’s bosses have been urged by the government to prepare early for the introduction of the National Living Wage (NLW) in April next year.

Firms are advised to follow four simple steps:

  • know the correct rate of pay – £7.20 per hour for staff aged 25 and over
  • find out which staff are eligible for the new rate
  • update the company payroll in time for 1 April 2016
  • communicate the changes to staff as soon as possible

Support

This push coincides with a new poll revealing that 93% of bosses support the Living Wage initiative, with a majority believing it will boost productivity and retain staff.

This is supported by new research by the University of Strathclyde and the Living Wage Foundation (LWF), which uses real-life case studies and evidence from employees working for accredited Living Wage employers. It suggests that paying staff a living wage leads to many business benefits – such as staff retention, more efficient business processes, improved absenteeism and better staff performance.

Potential benefits

Many of the findings highlighted relate to research on the London Living Wage (LLW). Among these include:

  • 50.3% of employees receiving the LLW registered above average scores for psychological wellbeing, a sign of good morale, compared to just 33.9% of non-LLW employees studied
  • an average 25% reduction in staff turnover was reported for organisations moving to the LLW
  • and 70% of employers studied reported reputational benefits through increased consumer awareness of their commitment to being an ethical employer

Estimates show that 4.5 million employees will see a rise in their wages as a result of the introduction of the NLW in 2016, with a further 2.6 million gaining from spillovers. By 2020, 6 million employees are predicted to have received a pay increase.

Up to one in four workers are expected to experience a significant positive impact from the NLW. If the result is indeed a happier workforce, perhaps the knock-on effect for businesses will be improved productivity.

There will however be variation across different parts of the UK and across different households, depending on how the NLW interacts with the tax and benefit system (it should be noted that many estimates were made prior to the u-turn on welfare reform). And let’s not forget that the NLW is not for all as under-25s will not be eligible.

Costs to employers

The impact on employees and therefore employment generally, will also depend on the actions firms take to prepare for the NLW in order to mitigate costs.

Indeed, the research from Strathclyde and LWF recognises that implementing the NLW will inevitably involve initial costs to businesses and could represent an issue for some companies more than others.

According to the Federation for Small Businesses, a negative impact on business is expected by 38% of small employers, with many expected to slow their hiring and raise prices.

It has been estimated that the NLW may lead to an increase in the unemployment rate by 0.2% points in 2020; resulting in around 60,000 more people unemployed and total hours worked per week across the economy around 4 million lower.

Businesses may also look to employ those under the age of 25 who won’t be eligible for the NLW. This could particularly impact on those sectors with a high proportion of lower paid employees, such as social care – a sector that is already under financial pressure.

The roll out of the Living Wage has certainly raised concern over potential costs for councils, which are having to deal with increasing budget cuts. The Local Government Association (LGA) has estimated that the NLW could cost local authorities £1bn a year by 2020/21.

So while increasing wages for low paid workers may seem like a no-brainer in the bid to help reduce in-work poverty, the full impact on employees, employers and therefore the economy, remains uncertain. Only time will tell what the true impact of the NLW will be.


Further reading: if you liked this blog post, you might also want to read our previous blog on the Living Wage

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Child neglect, wellbeing and resilience – adopting an art’s based approach (Seminar highlights)

upset boy against a wall

By Rebecca Jackson

‘Neglect is a complex issue but art can help, so let it’. That was one of the key messages to come out of a seminar session held at Strathclyde University last week.

The seminar is one of a series of four, looking at how arts-based techniques can be used in research and practice when interacting with neglected children. The session also considered how the arts can be used as a tool to promote resilience among vulnerable and neglected children by building self esteem, a sense of self worth, providing an outlet for emotion and supporting self efficacy.

The interactive seminar drew on a range of topics and sources. Academics from the Universities of Stirling and Dundee led the discussions and delegates included practitioners from psychology, social work, education and social research.

Lack of value placed on the arts

Some general themes to emerge from discussions included:

  • The lack of value placed on the arts as a form of assessment and interaction with children in a professional setting.
  • The over-emphasis on outcomes and funding which means that more ‘fun’ resources and methods are overlooked for more cost or time efficient ones, rather than the ones which work best for each individual child.
  • Children quite easily and quite quickly, between the ages of 10-14 go from being ‘neglected, vulnerable children’ in the eyes of society to ‘problem or troublesome children’.
  • The need to clarify what is meant by successful outcomes and the sense that outcomes have to be quantifiable, with one participant commenting:

    “I am required to produce reports and look for evidence in facts and figures, when in reality, getting a child who has suffered neglect to feel self-worth, or to say they have had fun could and should be a major indicator of the success of a scheme. That is difficult to evidence to other people who don’t know that child.”

Discussions from the day were captured by a graphic designer (Rebecca Jackson, 2015)

Discussions from the day were captured by a graphic designer (Rebecca Jackson, 2015)

Benefits of arts-based interventions

Some of the more art-specific observations from those who use it in their practice highlighted:

  • That removing children from feeling as though they are the centre of attention can be helpful in engaging them – baking, building things from Lego and drawing or colouring can help with this:

    “One-to-one interviews can be very intimidating for children, often they can cause them to close up more as they feel there is pressure and judgement from adults. Blending art activities with standard practice creates a better environment for a child and addresses some of that power imbalance which they are often acutely aware of.”

  • Distancing the child from their story, through analogies, creative writing or storytelling can also help them to open up:

    “I will quite often say, if you had a friend who…. or if there was a character in a story who…. how do you think they would feel? what would you tell them to do? who could they talk to about it? Just giving that little bit of hypothetical distance can really help a child to open up. The story creates an extra level of safety for them”

  • Resources are a big barrier:

    “I work in an office – that’s where I hold my meetings – where can I find a space to bake a cake with a child?”

  • Making full use of the community and its resources – and having the guts to ask for something if you want it:

    “You will be surprised and amazed by people’s generosity if you just ask”

  • Relationships will always be key, and arts-based practice can help encourage and shorten the time it takes for practitioners to build these relationships.

    “Quite often it is one key person, who engages with that child, who the child trusts and feels safe and comfortable around, that can make the biggest difference to that child’s progress”

Future questions

This seminar session was designed as a way to introduce arts based practices in cases of child neglect and vulnerable children and to identify some of the key strategic barriers to its use in practice in Scotland (and the UK more widely). In many ways it raised more questions than it answered.

The subsequent sessions, to be held in early 2016 at the University of Strathclyde and the University of Stirling, will use these discussions to address how academics, practitioners and policy-makers can create a strong collective voice to encourage training in, and promotion of, arts-based practice in Scotland.


Scottish Universities Insight Institute seminar series:Child neglect, wellbeing and resilience: adopting an arts-based approach

Seminar 1: Research methodologies and arts based approaches to resilience and neglect (26th October 2015)

Who was speaking?

  • Professor Brigid Daniel, School of Applied Social Studies, University of Stirling
  • Cheryl Burgess, Research Fellow, University of Stirling
  • Jane Scott, Business Development, WithScotland
  • Dr Susan Elsley, Independent Researcher and associate of CRFR at University of Edinburgh
  • Professor Divya Jindal-Snape, Education, Inclusion and Life Transitions, University of Dundee