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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.