A personal reflection for World Mental Health Day 2013

The theme for this year’s World Mental Health Day is ‘Mental Health and Older Adults’. There is also a lot of work developing about ‘Parity of Esteem’ – valuing mental health equally with physical health.

I want to share a personal reflection that highlights, for me, just how important it is for us to think about the whole person – mentally, emotionally and physically – in the way we design, plan and deliver services.

My Dad. In December 2004 he was a fit, active and intelligent man making plans for his retirement – a move back to his roots in Yorkshire, walking in his beloved Dales, time with his Grandchildren. Then he fell down the stairs. We don’t know what caused his fall. We do know he had a fractured C1 and C2 (broken neck) and 16 fractures in his skull, a massive traumatic head injury.

He had fantastic care in the neuro high dependency unit at the John Radcliffe in Oxford. Part of his brain, left frontal lobe, was removed and we watched and waited. His recovery was slow. Watching and helping someone relearn how to speak, to move their arms and legs, to start to walk is hard and frustrating. But he was making progress. He knew who I was and everyday he was a little bit better.

After many months he went home and started to rebuild his life. His behaviour was a bit odd, his cognitive functioning a bit impaired but he was alive. He got back to work.

In January 2006, he was hit by a car. A dark evening, walking the dog, crossing the road. Did he look? It wasn’t anyone’s fault, an accident.

Fantastic emergency care. He had broken almost everything – shattered left leg, collarbone, left arm, right ankle, every rib which also pierced his lungs. 33 hours starved of oxygen because his lungs were full of blood and he had broken his neck again.

His body fixed itself, slowly. His behaviours were more extreme than they had been but he was alive. Eventually he was discharged home. This time he couldn’t get back to work. One leg was significantly shorter than the other and he was physically in pain most of the time. But he was at home and alive.

August 2008 Dad’s house was on the market and the estate agent called with some prospective buyers. Dad never missed an appointment. He didn’t answer the phone. The neighbours hadn’t seen Dad coming and going for a couple of days. Together they all knocked and then they kicked the back door in. Dad was in bed. He didn’t really know where he was but he knew he didn’t want to go back in to Hospital.

The Ambulance crew convinced him he really did need to go to hospital. The neighbour went with him and called me. I drove home non-stop from the South of France. I arrived in the Medical Assessment Unit looked at him and knew he had had a stroke. I was told it was too early to diagnose that. He had been there for nearly 2 days.
When I opened his post at home I discovered he had already exchanged contracts on a house in the next village to me. The good news is that I wouldn’t be doing 300 mile round trips, the bad news I had to complete the process without power of attorney!

The Hospital told me it wouldn’t be possible to transfer Dad to my local hospital. My local hospital and GP told me it was possible and he was transferred about a week later. He was diagnosed with a stroke when he arrived at my local hospital. He had a massive blood transfusion as he was severely anaemic and had lost lots of blood from his stomach ulcer. They put him on a drip and encouraged him to drink a lot as he was severely dehydrated. Dad had Physio and OT assessments and they started planning with him and me about his goals to go home – a new home that he wouldn’t know or recognise.

Dad moved in to his new home and he’s been there ever since. He doesn’t go out much because walking is hard and conversation is difficult. The Ladies from the Church call on him, his neighbours chat and the staff at the Co-op and the Chemist keep an eye on him.

Dad is very frail and I know he’s probably depressed. But he is at home and, for the most part, independent.

Dad saw a Psychiatrist after his first brain injury. He’s never had any further support for his mental health because, as he tells anyone who asks in passing, “I’m fine”.  I know he’s not.

For this World Mental Health Day I’d like all of to think about the huge role our communities, neighbours, networks and groups all play in helping us to stay well. I’d love everyone who works in the NHS to think about how they are putting mental health in parity with looking after people’s physical health.

In line with our vision and values, NHS England is using World Mental Health Day to highlight the importance of tackling the stigma that surrounds mental health.  To support this, NHS England staff are invited to support the Time to Change campaign.

Olivia Butterworth

Olivia Butterworth is Head of Public Participation for NHS England and NHS Improvement.

She ensures the NHS works with citizens and communities to have a voice that influences the development, design and delivery of our health and care services.
Olivia is the national lead for the People and Communities workstream of the Primary Care Networks programme and was named in the HSJs Top 50 Innovators and the Top 50 Integrators in 2014. In 2018 she was named as one of the Top 70 NHS Stars.

She has a background in Community Development and education with a passion for empowering people to be their own change.

Olivia has worked with a wide and diverse range of voluntary sector organisations, both in paid and voluntary roles, providing support with organisational development, developing services, engagement, involvement and fundraising. Olivia is very proud to be a Trustee of Manchester based LGBT Foundation and a Non-Executive Director of Local Care Direct.

You can follow her on Twitter @LiviBF


  1. Anne says:

    Thanks for sharing your story- personal stories always help inform what’s happening & what needs to happen. We all have a mental health just you can’t always see when it’s broken & we need to get better @ seeing it.

  2. Liz England says:

    Thank you for sharing you and your father’s story with us Olivia. Almost in tears reading it. My experiences are nowhere near as difficult as yours but a family member of mine has a number of serious long term conditions, had some fairly big procedures in hospital and is slowly deteriorating physically. I think they are depressed (I am a GP interested in Mental Health) but more to the point, other family members do too. If they have noticed it must be fairly obvious…but they won’t seek help. Their generation don’t ‘do’ depression or talk about it. Their GP has never asked about it and they certainly wouldn’t go to see them with it. They attend various out patient clinics but the clinics don’t do mental health. The staff are all lovely people who are working hard and trying to do their best but I guess my point is that no one is looking at their entire health or seeing them as a person- each just sees a little bit related to whatever their speciality is, so they only see a walking collection of diseases. I think the Time to Change campaign is one way that we can tackle this. To make it OK for people of all ages and backgrounds to feel they can talk about their feelings. I think as healthcare professionals we should all be thinking about how we tackle this. It shouldn’t be down to one person to ask ‘how are you feeling in yourself?’ Maybe some mental health first aid training should be made mandatory- like CPR and manual handling!?

  3. Ben Heubl says:

    Hi there,

    I think mental eHealth is one of the few areas that holds immediate potential to be released. Think of it, if you connect a suicidal person with a care taker, via a whatever e-health channel, it impacts immediately, mainly because its urgent. Its simply amazing that only a few people understand the entire extent of the opportunity. Basically, you can go throughout the entire list of helpline service sub-sectors, where mental eHealth can be applied. You start at drug addiction, over psychological support of pregnant women to treatment of stressed police personnel, it offers endless potential. What do you think, Olivia? Where do you see the greatest potential. Please get in touch if you can.