Dementia

Dementia is a progressive and irreversible neurological disease characterised by cognitive and physical decline due to decreasing brain function which affects movement, memory, speech and mood.

Diagnosing Dementia

The Diagnostic and Statistical Manual of Diseases[1] (DSM-V) diagnoses dementia according to the following criteria:

A. Evidence of significant cognitive decline from a previous level of performance in one or more cognitive domains:

  • Learning and memory
  • Language
  • Executive function
  • Complex attention
  • Perceptual motor
  • Social cognition

B. The cognitive deficits interfere with independence in everyday activities. At a minimum, assistance should be required with complex instrumental activities of daily living, such as paying bills or managing medications.

C. The cognitive deficits do not occur exclusively during the course of delirium.               

D. The cognitive deficits are not better explained by another mental disorder (e.g., major depressive disorder or schizophrenia).

Types of Dementia – The Three Most Common Forms:

Alzheimer’s Disease

  • Alzheimer’s is the most common cause of dementia and is characterised by the build-up of plaques and tangles in the brain, causing the decline and death of healthy cells and neurons, resulting in the ‘shrinking’ of the brain. Memory loss is the main symptom of Alzheimer’s, but other symptoms of the illness include depression, delusions, mood swings and withdrawal.

Vascular Dementia:

  • This is the second most common form of dementia and is caused by limited blood flow to the brain due to damaged blood vessels, for example due to a stroke. The effects are most acute in terms of reduced cognitive speed and concentration, seen in issues with organisation, planning and communication.

Lewy Body dementia

  • This occurs when clumps of proteins called alpha synuclein (‘Lewy Bodies’) build up in the brain, resulting in confusion, delusions, hallucinations and parkinsonian behaviours such as reduced movement and gait changes. Sleep disturbances and changes in the autonomic nervous system are common, causing lower blood pressure, dizziness and incontinence. Memory loss is still present, but the decline is less rapid than that seen in Alzheimer’s.

Causes and Risk Factors

Age

  • Dementia is not a natural part of ageing, however the risk does increase with age, particularly once a person passes the age of 65. A factor in this is that ageing brings with it higher incidence of other health conditions that can increase the risk of dementia such as high blood pressure, reduced blood flow and stroke.

Genetics:

  • Certain genes play a role in increasing risk of dementia, for example the gene APOE4, involved in transporting fat and cholesterol in the bloodstream brings increased Alzheimer’s risk and is expressed in more than one in two individuals with Alzheimer’s[2]. However, genes only play a small role in causation of dementia and no one gene guarantees the development of the illness across generations.

Lifestyle and Environment  

  • Poor lifestyle choices such as smoking, and drinking increase the risk of dementia due to factors such as the high blood pressure and limited blood flow they can cause[3]. Poor diet including processed foods and lack of exercise also increase the risk, especially If this leads to cardiovascular issues such as high blood pressure and arterial cholesterol build up[4]. Environmental risk factors include air pollution which is linked to faster cognitive decline[5]

Treatments

Medication

There is no medication that can cure or completely stop dementia, but these medications do act to slow the process and reduce symptoms:

Acetylcholinesterase Inhibitors:

  • Acetylcholine is the main neurotransmitter in the nervous system, playing an important role in both physical and cognitive function. Individuals with dementia have a lack of acetylcholine, therefore this group of medications works to prevent enzymes breaking down this neurotransmitter, thus allowing for better communication between neurons. While these medications have been shown to be effective, they can have several adverse side effects including nausea, vomiting and insomnia[6].

Memantine Hydrochloride:

  • This medication works to block glutamate production which is often overproduced in those with dementia, causing cell decline and death[7]

Therapies

Cognitive Stimulation Therapy (CST):

  • This is a 14-session therapy course for mild to moderate dementia patients, most commonly delivered in groups and involves activities to stimulate social interaction and memory such as playing games, singing and discussing current news. Research shows CST can be as effective as medication (and avoids side effects)[8].

Life Story Work:

  • This involves working with the patient (and often their family) to reminisce on one’s life in a positive way to help take focus off the dementia. This can be done through a variety of mediums, including music, pictures and objects that take a person back to a happy time in their life.

[1] American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596

[2] Safieh, M., Korczyn, A.D. & Michaelson, D.M. ApoE4: an emerging therapeutic target for Alzheimer’s disease. BMC Med 17, 64 (2019). https://doi.org/10.1186/s12916-019-1299-4

[3] Sahakian, B., Jones, G., Levy, R., Gray, J., & Warburton, D. A. V. I. D. (1989). The effects of nicotine on attention, information processing, and short-term memory in patients with dementia of the Alzheimer type. The British Journal of Psychiatry, 154(6), 797-800.

[4] Peters, R., Peters, J., Booth, A., & Anstey, K. J. (2020). Trajectory of blood pressure, body mass index, cholesterol and incident dementia: systematic review. The British Journal of Psychiatry, 216(1), 16-28.

[5] Peters, R., Ee, N., Peters, J., Booth, A., Mudway, I., & Anstey, K. J. (2019). Air pollution and dementia: a systematic review. Journal of Alzheimer’s Disease, 70(s1), S145-S163.

[6] Mohammad, D., Chan, P., Bradley, J., Lanctôt, K., & Herrmann, N. (2017). Acetylcholinesterase inhibitors for treating dementia symptoms-a safety evaluation. Expert opinion on drug safety, 16(9), 1009-1019.

[7] Wang, R., & Reddy, P. H. (2017). Role of Glutamate and NMDA Receptors in Alzheimer’s Disease. Journal of Alzheimer’s disease : JAD57(4), 1041–1048. https://doi.org/10.3233/JAD-160763

[8] Spector, A., Thorgrimsen, L., Woods, B. O. B., Royan, L., Davies, S., Butterworth, M., & Orrell, M. (2003). Efficacy of an evidence-based cognitive stimulation therapy programme for people with dementia: randomised controlled trial. The British Journal of Psychiatry, 183(3), 248-254.

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Bipolar

What is Bipolar Disorder?

Bipolar is a common mood disorder characterised by episodes of mania and depression that can suddenly come on and last for week or months:

  • Mania: This is manifested in extreme optimism, self-esteem and positivity which are part of an overwhelming sense of euphoria. This may seem like a positive mood change but the goal directed energy that comes with mania can cause irrational and inconsiderate behaviours such as reckless driving or misinformed investments. These are not ‘normal’ periods of happiness and involve uncontrollable delusions of grandeur and exhaustion from no sleep and hyperactivity. Given this heightening of emotions, an individual with bipolar may experience a period of psychosis too, during which they lose contact with reality, with delusions and hallucinations being common as well as incoherent speech.
  • Depression: This can be seen in extreme lows in mood, motivation, lethargy, and a general sense of hopelessness, which can often come immediately after a manic episode.

Types of Bipolar:

  • Bipolar I: This type of bipolar involves periods of mania, depression, and other negative moods. The mania is very acute, often accompanied by psychosis and has a very severe effect on daily functioning and often leads to hospitalisation.
  • Bipolar II: Like bipolar one, bipolar two still involves depressive and manic episodes which alternate but they are typically less severe. For example, individuals with bipolar two will experience brief episodes of hypomania which are less extreme than manic episodes. For most individuals with bipolar two, depressive episodes tend to be more difficult than the hypomanic episodes and are often equally as severe as in bipolar one.

Causes and Risk Factors:

  • Genetics: Being a relative of someone with bipolar can increase the risk of the disorder developing in others in the family by as much as 18 times[1]. As with other mental disorders, there is no one gene that causes bipolar and while there are high risk alleles, these are nonspecific in that that are also linked to depression and schizophrenia risk[2][3]
  • Environmental triggers: Adverse life experiences such as bereavement, relationship breakdown and childhood abuse increase vulnerability to bipolar[4][5]. Concussions and traumatic head injuries can also increase the risk of bipolar developing[6]
  • Neurotransmitter Levels: Abnormal levels of certain neurotransmitters in the brain such as noradrenaline, serotonin and dopamine can trigger bipolar behaviours such as mania and depression. For example, elevated levels of noradrenaline have been linked to manic episodes and low levels of noradrenaline are a factor in depressive episodes[7][8]

Diagnosis

Diagnosis of bipolar can be very difficult given the differences between bipolar one and two and the similarity of symptoms in other disorders such as anxiety, ADHD, and manic-depressive disorder. This unfortunately means clinicians may fail to diagnose a case of bipolar in a patient. Given these complexities and different treatments that are needed according to the behaviours presented, the International Classification of Diseases (ICD 10) makes different diagnoses according to which bipolar behaviours are being displayed by the individual, including:

  • F31.2: Bipolar affective disorder, current episode manic with psychotic symptoms: “The patient is currently manic, with psychotic symptoms and has had at least one other affective episode (hypomanic, manic, depressive, or mixed) in the past.”[9]
  • F31.4: Bipolar affective disorder, current episode severe depression without psychotic symptoms: “The patient is currently depressed, as in severe depressive episode without psychotic symptoms (F32.2), and has had at least one authenticated hypomanic, manic, or mixed affective episode in the past.”[10]

Treatments

Treatments are key as those with bipolar are at high risk of self-harm and suicide especially during manic and depressive episodes[11]. Medication is commonly used, as well as cognitive behavioural therapy:

  • Mood stabilisers can be very effective, especially in stopping a manic episode and reducing suicide risk. Lithium salts are the most commonly used mood stabiliser for bipolar and can be continued to be used as a long-term solution, but this comes with a number of health risks such as thyroid dysfunction and chronic kidney disease[12]. These potential negative health risks need to be weighed against the long-term benefit of mood stabilisation that lithium can offer, as well as the withdrawal from it that can increase risk of another manic episode occurring, especially if done abruptly[13].
  • Antipsychotics: These are effective in treating mania symptoms such as hallucinations and delusions and are commonly used in addition to lithium, or as an alternative if the patient is not responsive to lithium[14]. However, antipsychotics can also bring negative side effects such as increased risk of heart disease and strokes[15].
  • Antidepressants: Selective serotonin reuptake inhibitors (SSRIs) have been used as an antidepressant for bipolar. However, their efficacy is very mixed, with research finding they can increase risk of a manic episode but are effective in treating depression in those with bipolar II[16]
  • Cognitive Behavioural Therapy (CBT): CBT is typically paired with medication and while it is not suited to deal with an acute manic episode, it can help the client to process the anxiety that may come from the fallout of a manic episode, such as financial issues or damaged social relationships[17]. CBT can also help the individual overcome depressive episodes through techniques such as stress management, thus reducing rates of relapse[18][19]

[1] Smoller, J. W., & Finn, C. T. (2003, November). Family, twin, and adoption studies of bipolar disorder. In American Journal of Medical Genetics Part C: Seminars in Medical Genetics (Vol. 123, No. 1, pp. 48-58). Hoboken: Wiley Subscription Services, Inc., A Wiley Company.

[2] Green, E. K., Grozeva, D., Jones, I., Jones, L., Kirov, G., Caesar, S., Gordon-Smith, K., Fraser, C., Forty, L., Russell, E., Hamshere, M. L., Moskvina, V., Nikolov, I., Farmer, A., McGuffin, P., Wellcome Trust Case Control Consortium, Holmans, P. A., Owen, M. J., O’Donovan, M. C., & Craddock, N. (2010). The bipolar disorder risk allele at CACNA1C also confers risk of recurrent major depression and of schizophrenia. Molecular psychiatry15(10), 1016–1022. https://doi.org/10.1038/mp.2009.49

[3] Gordovez, F.J.A., McMahon, F.J. The genetics of bipolar disorder. Mol Psychiatry 25, 544–559 (2020). https://doi.org/10.1038/s41380-019-0634-7

[4] Garno, J. L., Goldberg, J. F., Ramirez, P. M., & Ritzler, B. A. (2005). Impact of childhood abuse on the clinical course of bipolar disorder. The British Journal of Psychiatry186(2), 121-125.

[5] Hosang, G. M., Korszun, A., Jones, L., Jones, I., McGuffin, P., & Farmer, A. E. (2012). Life-event specificity: bipolar disorder compared with unipolar depression. The British Journal of Psychiatry201(6), 458-465.

[6] Mortensen, P. B., Mors, O., Frydenberg, M., & Ewald, H. (2003). Head injury as a risk factor for bipolar affective disorder. Journal of affective disorders76(1-3), 79-83.

[7] Kurita, M., Nishino, S., Numata, Y., Okubo, Y., & Sato, T. (2015). The noradrenaline metabolite MHPG is a candidate biomarker between the depressive, remission, and manic states in bipolar disorder I: two long-term naturalistic case reports. Neuropsychiatric Disease and Treatment11, 353.

[8] Wiste, A. K., Arango, V., Ellis, S. P., Mann, J. J., & Underwood, M. D. (2008). Norepinephrine and serotonin imbalance in the locus coeruleus in bipolar disorder. Bipolar disorders10(3), 349-359.

[9] International Statistical Classification of Diseases and Related Health Problems (10th ed,; 5th Revision; ICD-10; World Health Organization, 2016).

[10] International Statistical Classification of Diseases and Related Health Problems (10th ed,; Fifth Revision; ICD-10; World Health Organization, 2016).

[11] Jamison, K. R. (2019). Suicide and bipolar disorder. The Science of Mental Health, 115-119.

[12] Volkmann, C., Bschor, T., & Köhler, S. (2020). Lithium Treatment Over the Lifespan in Bipolar Disorders. Frontiers in psychiatry11, 377. https://doi.org/10.3389/fpsyt.2020.00377

[13] Tondo, L., Alda, M., Bauer, M. et al. Clinical use of lithium salts: guide for users and prescribers. Int J Bipolar Disord 7, 16 (2019). https://doi.org/10.1186/s40345-019-0151-2

[14] Geddes, J. R., & Miklowitz, D. J. (2013). Treatment of bipolar disorder. The lancet381(9878), 1672-1682.

[15] Citrome, L., Collins, J. M., Nordstrom, B. L., Rosen, E. J., Baker, R., Nadkarni, A., & Kalsekar, I. (2013). Incidence of cardiovascular outcomes and diabetes mellitus among users of second-generation antipsychotics. The Journal of clinical psychiatry74(12), 8870.

[16] Gitlin, M.J. Antidepressants in bipolar depression: an enduring controversy. Int J Bipolar Disord 6, 25 (2018). https://doi.org/10.1186/s40345-018-0133-9

[17] Palmier‐Claus, J., Wright, K., Mansell, W., Bowe, S., Lobban, F., Tyler, E., … & Jones, S. (2020). A guide to behavioural experiments in bipolar disorder. Clinical Psychology & Psychotherapy27(2), 159-167.

[18] Geddes, J. R., & Miklowitz, D. J. (2013). Treatment of bipolar disorder. The lancet381(9878), 1672-1682.

[19] Colom, F., & Vieta, E. (2004). A perspective on the use of psychoeducation, cognitive‐behavioral therapy and interpersonal therapy for bipolar patients. Bipolar Disorders6(6), 480-486.

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Climate Change

Climate Change and Mental Health

The UK is currently facing the most severe storms for thirty years, cutting off power to thousands, destroying homes and infrastructure and triggering the first use of a government danger of death warning from flying debris. Storms, floods, and unpredictable seasonal weather are all evidence of climate change in the UK, and these can have a significantly adverse effect on our mental health.

Climate Change and Mental Illness:

Climate change can be both a chronic and acute mental stressor. The constant (chronic) stress it can cause individuals stems from the existential threat of rising sea levels, more extreme temperatures, and the ultimate threat to earths habitability that these changes pose. This causes mental stress, recognised recently in a new set of terms including ‘ecoanxiety’, ‘Eco guilt’ and ‘ecological grief’[1][2]. Those who suffer from chronic mental strain due to environmental change do not necessarily live in places consistently affected by adverse weather, as it is the awareness of global changes that causes the chronic stress. 

Acute stress can occur for those who directly suffer from the results of climate change. This can come in the form of sudden natural changes, disasters and weather conditions but can also be long lasting concerns such as the threat to farming and agriculture. In the UK, flooding in particular is a recurring, often yearly event which has been shown to cause significant psychological distress, especially if the individual has to be evacuated from their home[3]. This is in line with research across the globe that shows that individuals that live in areas that experience regular adverse weather are more likely to develop mental illnesses such as PTSD, anxiety, and substance abuse issues[4].

Solutions:

Because of the sheer scale of climate change, we can feel it is out of our control and we are helpless to change it, causing feelings of apathy and subsequent mental illness. However, there are small steps we can all take to reduce its negative impact on our mental wellbeing:

  • Don’t feel guilty: Environmental concerns are valid and justified, and they are not going away so they need to be managed and overcome.
  • Reduce your carbon footprint: Making lifestyle changes such as driving and flying less helps the environment but also reduces your climate change stress and offers an outlet for the frustration you may feel.
  • Reach out to others: Environmental groups are places where you can share concerns and be part of bigger environmental projects; these can also be online communities and can overcome the sense of helplessness that climate change may be causing.
  • Mindfulness: Climate change can be overwhelming but practicing mindfulness, being present and breathing exercises can help[5].
  • Seek professional help if needed: There is an increasing professional awareness of these issues and in some places, you can access climate-aware therapy which is specifically designed to address your environmental concerns[6].

[1] Palinkas, L. A., & Wong, M. (2020). Global climate change and mental health. Current Opinion in Psychology32, 12-16.

[2] Cianconi, P., Betrò, S., & Janiri, L. (2020). The impact of climate change on mental health: a systematic descriptive review. Frontiers in psychiatry, 74.

[3] Trombley, J., Chalupka, S., & Anderko, L. (2017). Climate change and mental health. AJN The American Journal of Nursing117(4), 44-52.

[4] Cianconi, P., Betrò, S., & Janiri, L. (2020). The impact of climate change on mental health: a systematic descriptive review. Frontiers in psychiatry, 74.

[5] Panno, A., Giacomantonio, M., Carrus, G., Maricchiolo, F., Pirchio, S., & Mannetti, L. (2018). Mindfulness, Pro-environmental Behavior, and Belief in Climate Change: The Mediating Role of Social Dominance. Environment and Behavior50(8), 864–888. https://doi.org/10.1177/0013916517718887

[6] Bednarek, S. (2019). Is there a therapy for climate-change anxiety. Therapy Today30(5), 36-39.

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Bullying in the workplace

Rates and Impact of Workplace Bullying

Workplace bullying affects approximately one in ten workers, with research typically finding rates are generally slightly higher for women compared to men[1][2]. Furthermore, research has unfortunately revealed that sexual and gender minority individuals are at higher risk of being bullied in the workplace[3]

Personal Impacts: 

  • Those with prior mental illness are more likely to suffer from workplace bullying, which often leads to the condition worsening[4]
  • Workplace bullying increases the risk of developing a mental illness such as depression, anxiety, insomnia, and an increased suicide risk[5]
  • Workplace bullying increases the risk of physical illnesses such as acute tiredness and pain (fibromyalgia) and cardiovascular issues[6]

Financial Impacts:

  • Loss of productivity and absenteeism: The stress, isolation, and anxiety that workplace bullying causes not only results in significant mental strain for the individual but also means those suffering are less able to work productively. This leads to loss of productivity due to absenteeism and presenteeism
  • Turnover of staff and reputation damage: Staff turnover due to individuals leaving costs companies significant amounts of money and this comes with reputation damage if the individual is leaving due to workplace bullying.

What is being done to help victims and reduce rates of workplace bullying?

  • ‘Bullying’ is not illegal in UK workplace, however workplace harassment is illegal according to the Equality Act of 2010. Harassment is when someone behaves towards you in an undesirable or intrusive way, causing feelings of humiliation and intimidation. Whether the perpetrator does this purposefully is not relevant. Harassment can be classed as unlawful discrimination if perpetrated on the basis of on gender, sexuality, age, religion, race or disability. Legal action can be taken against the perpetrator of harassment.
  • For sexual and gender minorities there has been an increase in more inclusive company policies in terms of equal treatment in the employment process and awareness raising and education for staff. This is key as studies show that the presence of other sexual and gender minority individuals and more accepting work environments are linked to less incidence of workplace bullying and increased job satisfaction for sexual and gender minorities[7]
  • More legal progress is needed in terms of the whistleblowing process as bullying, harassment and discrimination are not covered by the whistleblowing law in the UK (unless your case is in the public interest). This acts as a barrier to reporting abuse as workers who make complaints when they see colleagues being abused or harassed still face fears of losing their jobs.

What can you do if you are being bullied at work?

The main internal options are to contact your manager or speak to somebody in your HR department. When doing this, be factual about your experiences and firm about how you feel about the situation. Employers have a legal duty of care which should include policies on how to deal with workplace bullying. However, you may feel uncomfortable about approaching your manager as they may not take the abuse seriously or even openly allow it, or they may be the perpetrator themselves, often passing off abusive behaviours as part of their managing style. Furthermore, HR departments can be neglectful as they often care more about the company reputation rather than the wellbeing of employees. Companies across the UK are increasing their measures to ensure worker welfare, especially since the advent of the pandemic. However, if you are suffering from workplace bullying and do not feel comfortable about discussing it internally, there are many places where you can seek help and advice:

BULLIESOUT:

Email: mail@bulliesout.com

Telephone: 02920 492 169

Acas Helpline:
Telephone: 0300 123 1100

Equality Advisory Support Service (EASS)

Telephone: 0808 800 0082


[1] Sansone, R. A., & Sansone, L. A. (2015). Workplace bullying: a tale of adverse consequences. Innovations in clinical neuroscience12(1-2), 32–37.

[2] Rosander, M., Salin, D., Viita, L., & Blomberg, S. (2020). Gender matters: workplace bullying, gender, and mental health. Frontiers in psychology11, 2683.

[3] Hollis, L. P., & McCalla, S. A. (2013). Bullied back in the closet: Disengagement of LGBT employees facing workplace bullying. Journal of Psychological Issues in Organizational Culture4(2), 6-16.g

[4] Rosander, M., Salin, D., Viita, L., & Blomberg, S. (2020). Gender matters: workplace bullying, gender, and mental health. Frontiers in psychology11, 2683.

[5] Sansone, R. A., & Sansone, L. A. (2015). Workplace bullying: a tale of adverse consequences. Innovations in clinical neuroscience12(1-2), 32–37.

[6] Sansone, R. A., & Sansone, L. A. (2015). Workplace bullying: a tale of adverse consequences. Innovations in clinical neuroscience12(1-2), 32–37.

[7] Richard A Prayson, MD, MEd, J Jordi Rowe, MD, LGBTQ Inclusivity and Language in the Workplace, Critical Values, Volume 12, Issue 2, April 2019, Pages 28–30, https://doi.org/10.1093/crival/vaz004

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Mental health and intervention for BAME people

Mental Illness and Intervention for BAME Individuals

The Issue

Research has shown that Black, Asian and minority ethnic (BAME) individuals have a higher risk of developing mental illness compared to their white counterparts, especially since the beginning of the Covid-19 pandemic (Proto, E., & Quintana-Domeque, C., 2020). This vulnerability can be heightened further by carrying multiple marginalised identities such as being a sexual or gender minority in addition to belonging to an ethnic minority group (Rehman et al. 2021). This is known as intersectionality which both makes mental illness more likely due to layers of marginalisation and can also create more barriers to discussing mental health and accessing professional help. Unfortunately, there are several issues with mainstream mental healthcare services in terms of appropriately and effectively accommodating for BAME individuals. Research on NHS mental health services has shown that: 

Mainstream services often do not understand the nuances of BAME culture:

  • For example, the pressures and expectations from family to succeed in education, stemming from cultural belief systems (Arday 2018). Awareness of these pressures is key to understanding and addressing some of the causal factors behind mental illness for BAME individuals.

Culture clashes between client and therapist:

Therapists are in a position of power and responsibility, which can often lead to a power relationship between client and therapist (Arday 2018). From this, discrimination, stereotyping and microaggressions towards the client become common, often done unconsciously. This can make the client feel belittled and neglected, often worsening their already fragile mental state. Cultural understandings of mental illness are also likely to make diagnosis difficult as some symptoms of mental illness may not be seen as such in non-western cultures. For example, in some African cultures, hallucinations are not a sign of mental illness and are often seen as positive spiritual experiences, whereas western diagnostic manuals see hallucinations as a symptom of schizophrenia. Differences like these can make diagnosis and intervention difficult. These factors have understandably led to a desire for a therapist or counsellor from the same ethnic background, language, and culture as there is evidently a lack of diversity in service providers, an issue that needs to be addressed.

The Wellbeing for Us Solution

  • Our online care helps to reduce the power relationship experienced in services as it removes the practice environment can be intimidating and impersonal.
  • We have a diverse group of advisors from a variety of backgrounds, cultures and languages who are educated on and experienced with BAME clients. We also offer the client a choice to be matched with an advisor from a similar background to themselves.
  • The workshops and group support we offer creates a space where we can bring those from similar ethnic and cultural backgrounds together to discuss their mental health. Seeing another individual from a similar background who is willing to open up about their mental health can be very empowering and key in recovery, especially in cultures where discussion of mental health is not encouraged, and mental illness is stigmatised.

References:

Proto, E., & Quintana-Domeque, C. (2020). COVID-19 and Mental Health Deterioration among BAME Groups in the UK.

Rehman, Z., Jaspal, R., & Fish, J. (2021). Service Provider Perspectives of Minority Stress among Black, Asian and Minority Ethnic Lesbian, Gay and Bisexual People in the UK. Journal of homosexuality68(14), 2551–2573. https://doi.org/10.1080/00918369.2020.1804256

Arday, J. (2018). Understanding mental health: what are the issues for black and ethnic minority students at university?. Social Sciences7(10), 196.

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Mental Health Issues and Intervention

LGBTQIA+ students are between 3-6 times more likely than their heterosexual counterparts to develop a mental illness, significantly increasing risk of self-harm and suicide amongst this population[1]

The Current Issues with Mainstream Services:

 

Barriers to services:

LGBTQIA+ individuals experience several unique barriers to accessing in person mental health services such as those provided by the NHS. One of these is the dual stigma carried by being both a sexual and/or gender minority and having a mental illness. This can be heightened if the individual is not ‘out’ about their sexuality or gender and feels uncomfortable about disclosing this to a professional. This is due to the discrimination that they expect from the practitioner, stemming from the prejudice LGBTQIA+ individuals experience in wider society and employment. This anticipated discrimination is added to by a lack of inclusion and outreach for LGBTQIA+ individuals from mainstream services, leading to reduced awareness and an assumption that they can’t be effectively catered for. These barriers serve to prolong mental illnesses and can lead to deteriorating mental health for an already vulnerable group.

Negative Experiences within services:

Unfortunately, studies have shown sexual and gender minorities experience discrimination within mental health services such as therapists not taking cases seriously and assuming clients are heterosexual and cisgender. This lack of awareness and understanding was highlighted in a recent study on NHS services revealing that 64% of LGBTQIA+ individuals felt mental health professionals lacked knowledge about sexual and gender minority issues and 43% felt practitioners did not understand or have the capability to address their needs[2]

How Wellbeing For Us overcomes these issues:

At Wellbeing for Us, our advisers are specially trained to be understanding and effective in promoting the mental wellbeing of sexual and gender minority students. This is important not only in making sure intervention is effective but through promoting these specialised services through universities, LGBTQIA+ students can be made aware that they can be accommodated for if they are experiencing mental strain. This is key as it overcomes the barrier faced in mainstream services caused by lack of outreach and inclusion of sexual and gender minorities.

Furthermore, by offering an online service such as wellbeingforus.com, LGBTQIA+ students aren’t exposed to the negative experiences of pursuing and using mainstream in person care, which is typically structured around heterosexuality, for example the use of gender binary pronouns and restrooms. By getting directly to a trained advisor through Wellbeing for Us, vulnerable LGBTQIA+ students can avoid these potentially triggering environments which can have a negative effect on their already fragile mental state.

[1] Gnan, G. H., Rahman, Q., Ussher, G., Baker, D., West, E., & Rimes, K. A. (2019). General and LGBTQ-specific factors associated with mental health and suicide risk among LGBTQ students. Journal of Youth Studies22(10), 1393-1408.

[2] McCann, E., & Sharek, D. (2014). Survey of lesbian, gay, bisexual, and transgender people's experiences of mental health services in Ireland. International journal of mental health nursing23(2), 118-127.

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COP26

For us, it has become evermore apparent that our future is linked with protecting, sustaining and aiding our natural environment. That is why we are honoured to have been invited to the UN Climate Change Conference UK 2021.

“What a privilege to be invited for our valid input in the future of remote working and remote therapy. It is truly an honour to be invited and to be a part of this global campaign”.

One of the key things that we can do to help the natural environment that surrounds us is to reduce our carbon footprint.

One of the key aspects of our company is that we not only help the environment by reducing our own carbon footprint but we also help our users’ footprints as well.

How do we reduce our carbon footprint?

Travel.

Environmentally speaking, travelling is generally regarded as one of the largest contributors to a person’s carbon footprint. This includes travelling to work, school, the gym and even to your therapy sessions.

One of the biggest environmental benefits of providing access to our services remotely is removing the need to travel in the first place!

By providing our multiple services digitally, not only can you access mental health advice and support at a time convenient to you but you are helping to reduce your own, others and our company’s carbon footprint.

Remote working employees.

Fun fact: Wellbeingforus does not have an office space. (This is another one of our biggest environmental benefits.)

As many of us will know, offices are not known for being environmentally focused. More often than we would like to admit, we waste a substantial amount of energy leaving our workspaces on and well lit, even when we have clocked out.

By working remotely, overall we are releasing less carbon emissions than if we had an office.

Also, we are reducing the need to travel too!

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Bullying

Bullying is repeated behaviour that hurts someone else in a physical, emotional or mental way. There are many different ways in which someone can be bullied, some of them being obvious like name calling or hitting someone, and some of them can be subtle, like spreading rumours or overly criticising someone. 

Bullying can include:
Being called names or teased.
Hitting, kicking or shoving someone.
Threatening or intimidating someone.
Humiliating someone in front of others.
Spreading rumours about someone.
Stealing someone’s possessions.
Posting horrible or mean comments or images of someone online.
Sending nasty texts or messages online.

It’s important to know that if you are being bullied it is not your fault. 

What can you do?

Different strategies work for different situations, but there are still a multitude of things that you can do if you are being bullied.

Try to avoid the bully – There’s no need to bunk off school or hide, but if you can try to avoid being alone in areas where your bully may be. 
Take a different route to your classes or to school.
Walk to school with a friend or a family member.
Leave through a different school exit.

Try not to react – If you can, try not to show the bully that their behaviour is affecting you. Reacting to the bully, especially with anger, can cause the situation to get worse.

Tell someone you trust – No matter what anyone says, do not ever be afraid to tell someone else what is going on or ask for help. 
Tell a close friend.
Tell a parent or family member.
Tell a trusted teacher.

Keep a diary or a record – Keeping a diary or a record of any incidents or messages can be incredibly useful in supporting what you say. It can also help provide adults with the evidence they need to stop it.

Be cyber-savvy – Remember, it’s important to keep your personal information safe. This can include making your social accounts private, checking your privacy settings and blocking or deleting others.

Nobody deserves to be bullied we are here to support you.

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Bullying Prevention

When we think about bullying, we typically think about the playground bullies from our schooldays. Unfortunately, bullying is something that is not always left behind on the school playground. Bullying can also be experienced in the place of work.

What is workplace bullying?

Workplace bullying is defined as repeated, unreasonable actions of individuals (or a group) directed towards an employee (or a group of employees), which are intended to intimidate, degrade, humiliate, or undermine; or which create a risk to the health or safety of the employee(s). It is a systematic campaign of interpersonal destruction that can jeopardise your health, your career and your confidence. It is often surprisingly to do with power and control in terms of popularity and access to information. Workers that are often doing a good job and have high integrity and authenticity find themselves being singled out by less able staff members who tend to operate in groups as the employee that is singled out becomes more and more of a threat as each day passes.

What are the signs of bullying in the workplace?

Bullying in the workplace can be both obvious and subtle, there are many types of bullying and the following list has been provided to give an idea of ways bullying may happen within the workplace.

Verbal aggression.
Yelling.
Humiliating someone.
Being overly critical.
Setting impossible expectations or deadlines.
Ignoring emails and messages.
Excluding someone from meetings or social work gatherings.
Intentionally withholding information or giving someone the wrong information.
Using someone else as a scapegoat.
Taking credit for someone else’s ideas.
Purposefully preventing career advancement.
Spreading rumours.
Calling someone derogatory names.
Putting down or negatively remarking about someone’s work.
Undermining or deliberately impeding someone else’s work.
Belittling someone’s opinions.
Denying holiday or annual leave.
Purposefully asking someone to come in on their day off.
Intimidating someone.
Threatening physical abuse.
Physical abuse.

Bullying within the workplace can affect our health in a physical, emotional and mental way and can create a toxic and unproductive workplace environment.

What should you do if you’re being bullied?

Calmly tell the person that his or her behaviour is unacceptable and ask them to stop.
Keep copies of any letters, e-mails, messages etc.. you have received from this person.
Keep an informed diary or journal of any incidents or events.
Report the bullying to your manager or the person outlined in your company’s complaints procedure as set out in your contract or handbook.
Seek legal advice.

How can we help? We offer one to one advice and workshops to support and offer advice to effectively tackle this ever such growing problem across the UK.

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