Hello! - My name is Bob Houlston and I am the web master of this site. The photograph here was taken sometime ago but my smile remains the same. If I knew then what I know now I would have bought shares in lithium. ;) I have personal experience of receiving mental health services, both in an acute and community setting and I hope that I will be able to present, through this web site, some of the resources that a person who has an enduring mental illness would find useful. A wide variety of people use this web site and I hope that the information is organised in a way that makes it easy to find what you are looking for. However, I appreciate that for some people (particularly first time users) it may sometimes feel like you're suffering from information overload. For this reason I have developed a set of page jumps aimed at eight different groups of information. Simply select the link, from the vertical menu opposite, that comes closest to matching your requirement and let me guide you through some of the resources that I think will interest you most. People with bipolar disorder (or manic depression) are the target audience of this web site, so there is a lot of content here that will interest you if you are a member of this group. However, many people with a different psychiatric diagnosis and their carers may find the information here useful. Have a good look around and feel free to wander off into the conceptual hyperstructure if you like. Use CTRL + F to search each page. Be sure to tell your friends about this web site; give them a Flier.

The creation and management of this web site is part of my CPA - Care Programme Approach. I have frequently heard it said at various mental health forums that: "Nobody tells you anything!" People coping with mental illness, both sufferers and their families, often find it difficult to obtain reliable information about community resources and the options that may be open to them. My web site is intended to help fill this need with a one-stop shop approach to details of mental health resources for people living in Hertfordshire and indeed is relevant, in many instances, to the whole of the United Kingdom. It is very much under construction... Your input would be appreciated. Favourite URLs, contacts for me and/or advice of errors, broken links or any persistent malfunction of this web site are all helpful. I am especially keen to hear from you if you think any information on the site is out of date or inaccurate, or if you have found any broken links or other technical problems. All information you provide will be treated confidentially and your details will not be forwarded on to a third party without your permission. I hope you find whatever you wish for, both on this site and in life in general.......

Welcome and kind regards to all who visit here. Rest a while and say hello to other visitors via the Guestbook.



It would seem that you have stumbled upon my web site, probably through no fault of your own. I hope that this little corner of cyberspace will offer support information resources and a sense of community to those who are affected by mental illness. I cordially invite you to add a comment to the Guestbook and please feel free to take a look at the rest of my portal. There are pictures and treasures aplenty. I wanted to get this uploaded as soon as possible, so it's somewhat incomplete at the moment, but that should be fixed within a month. Oh, and remember to wear a Hard Hat here for the first few weeks, I am doing a lot of construction, so it may get a bit crazy at times. If you were looking for something else then AltaVista is that way

Take some time to browse my web site, I would value your opinion. Any issues that concern you e.g. benefits, medication or Mental Health Bill then this is your opportunity to communicate. You may contact me via my Guestbook. This gives you the option to leave an anonymous message or include your e-mail address for reply. Access is safe, quick and free. At last, a quality web site that does not require you to register, log-in/log-out, remember a password or jump through hoops. Gee, what a great concept ! ;~) Simplicity is the ultimate sophistication. Check back often as this new site grows and expands.

There is no "magna carta" where entitlements to mental health community resources are set out - but inconsistent and confusing rules, complex forms and no easy route to finding out what's free and what you'll have to pay for. This is the first ever web site to decode the system for users, carers and survivors - with no jargon. "Helping to break the link between disability and poverty." - Source: Online mental health reviews. This web site answers two questions. The first question is: "Why should I be interested in mental health community resources?" If you are determined to be oblivious to the issue of mental health community resources then this web site is probably not for you. The second question is: "How do I access mental health community resources?" If you were not convinced by the first answer you will not be interested in the second. Using my personal resources and initiative I have accumulated many benefit and concession items which I present to you here online. For those with an enduring mental illness my advice is to embrace the package of care that is offered by society.

It felt good to get all that off my chest! I know you came here seeking help or information and I will now turn my attention to you. I have used my personal experience and scoured the internet for the best information available about mental health community resources which I present in a format that may enhance your opportunity to access what is available. Forget the rumours and get the facts:

Introduction - Depending on the way in which mental health matters are defined then it would appear that 10% of the population, at any one time, can be said to be affected by some kind of mental distress issue. Would you know what community resources are available to anyone who has a mental illness, or to family, friends, neighbours and work mates who may be affected by one person's diagnosis? By not knowing about services in your community, you may come across difficulties in understanding procedures, finding information and support, or simply not knowing what is available and accessible to you. We all need to be able to access information and support locally. If you have an enduring mental illness then it is well recognised that Dacorum & St Albans is one of the most supportive areas in the United Kingdom. To take full advantage of the support offered, you and/or your carer may find the information on this web site useful.



Benefits & Concessions

Benefits Scandal ! Yes it's true, many patients are not claiming benefits to which they are entitled, through lack of information, confusion or even embarrassment. Low take up of disability benefits by people affected by mental illness is due to issues such as the perceived stigma of claiming benefits from the state and the complicated and confusing claiming process: "I found claiming benefits added more stress to my mental illness". Equally important are the misinformation and local mythology which prevail if there is no easy access to accurate information and trusted, expert advice. There is still a lot of old information around on benefits. People just don't know about some of the benefit changes which are positive and helpful. Expenses usually increase with illness at the very time when income, energy and resources decrease. Severe debt should never be seen as purely a financial issue. It affects families, work and in the worst case even peoples' mental health. Yet many people affected by mental illness who are in financial distress could be entitled to welfare benefits that would increase their weekly income and improve their quality of life. This is a problem easily resolved because the money is there waiting to be claimed. It is most unfortunate that some people affected by mental illness are faced with the extra stress and worry of money problems when they are most vulnerable - especially when help does exist, if only they knew about it. Everything becomes more difficult and expensive when you are poor. I believe that we are most fortunate to have a compassionate social security system that communicates: "Better to run the risk of possibly paying a few 'undeserving' cases rather than risking the virtual certainty of denying benefit to a few genuine cases." - Source: Social Security Booklet. Our welfare system has a fundamental requirement in that recipients of benefit must first make a claim, a good place to start is the CAB - Citizens Advice Bureau as listed in the telephone directory.

Benefit assessment changes urged by CAB - Thousands of sick and disabled people are being failed by the benefits system, denied money that is rightfully theirs and suffering prolonged hardship, distress and injustice, according to a new report from Citizens Advice.

It warns that there must be a quantum leap in the quality of decision-making if the Government's ambitious plans for welfare reform are to succeed.

The national charity says the process used to decide who qualifies for disability and incapacity benefits is deeply flawed, leading to so many wrong decisions to refuse or withdraw benefit that more than six in 10 are overturned on appeal.

What the doctor ordered? (PDF 107Kb) shows that much of the problem lies with the way medical assessments are carried out and the weight they are given when decisions on benefit are made. Over half a million such assessments were made last year.

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Citizens Advice says that Department For Work And Pensions (DWP) decision makers rely too heavily on the findings of these tests, rather than evidence from claimants' own GPs or other practitioners. This produces an unacceptable level of wrong decisions, with very harsh consequences for claimants.

Problems with medical assessments include inaccurate reports, doctors wrongly reporting what people have told them or underestimating the severity of people's disabilities. CAB clients report feeling humiliated, intimidated and rushed by examining doctors who are too often rude, insensitive, aggressive and dismissive. People with mental health difficulties fare particularly badly.

Those whose claim is stopped or refused face the choice of claiming jobseeker's allowance of £56.20 a week, or, if they decide to appeal, income support reduced by 20%. This means they can be left with as little as £45 a week to live on for several months while they wait for their appeal to be heard.

In one case a woman with severe mental health problems lost her benefit after an examining doctor said she "didn't look mental". She had to live on £39 a week for six months while awaiting an appeal. Another CAB client lived on reduced rate income support for two years and nine months while waiting for an appeal to be heard.

In a further case a woman was so intimidated by an examining doctor that she delayed three years before claiming help with her mobility needs. The CAB estimated she had lost a large amount of benefit to which she would have been entitled during this time.

Citizens Advice senior social policy officer John Wheatley said: "Getting benefit decisions right and getting them right first time is key to ensuring that vulnerable people get the money that is rightfully theirs and that public money is not wasted. The impact of wrong decisions can be devastating. People have to go through severe hardship when benefits they are entitled to are denied or withdrawn and they have to suffer the stress and long delay of taking their case to appeal. In some cases their health suffers. For many, particularly those with mental health difficulties, the prospect is too daunting and they are deterred from making an appeal even if they have a good case.

"Things have got to change. There has to be a vast improvement in the quality of medical assessments and decision making and this has to happen before the Government goes ahead with its welfare reform plans.

"The reform plans place new importance on the role of decision-making in the award of a new employment and support allowance. People who need continuing support because they cannot work through illness or disability and those who want to work and need support to do so will depend on accurate decisions being made and on receiving the right advice. Our evidence shows that the current system is not working either for the people claiming benefits or for the DWP and the quality of medical assessments and decision making is completely unacceptable."

Citizens Advice is calling for an urgent review of the decision making and appeals processes for all incapacity and disability benefits. It is also pressing for a change in the rules until the system is radically improved, so that people who lose their entitlement to disability or incapacity benefits following a review can stay on the benefit until the reconsideration and appeal process is completed.

The charity also wants to see a mental health champion appointed, to ensure the system deals better with cases involving people with mental health difficulties. 02 March 2006

DLA - are you missing out? Disability Living Allowance is a contribution towards the extra costs incurred by people with disabilities. Government sources indicate that less than 50% of people entitled to DLA actually make a claim. This may in part be due to its name. You don't have to be "disabled" to claim. It is based on care and mobility. Don't let the semantics put you off. "DLA is a most worthwhile benefit, it can lead to other benefits and concessions." Source: Employment Counsellor. DLA can enhance people's lives, awards range from a few pounds to substantial payments each week. If you have an enduring mental illness then Disability Living Allowance could be a most worthwhile benefit to claim.

You can claim Disability Living Allowance whether or not you work. It is not treated as income for the purpose of deciding whether you qualify for other means-tested benefits, such as Income Support, Tax Credits, Pension Credit, Council Tax Benefit or Housing Benefit. Disability Living Allowance does not depend on any income or savings you have and you do not have to have paid any National Insurance contributions to receive it.

DLA is a non means tested tax free benefit for those with an illness or disability, available up to age 65. For people under 16 there is a special claim pack. Claim packs are available from a local benefits office or by Freephone: 0800 882200. DLA covers two main areas of disabling illness, mobility and care. The rates vary according to the severity of the disability caused. This is the hard part of every application, to know what to write in which section in such a way that it is interpreted for you to receive the amount of money you are entitled to. There are few independent organizations that can truly help you overcome the complexity of completing a DLA application. Your local Citizens Advice Bureau or Social Services may have a specialist to help.

There are some totally independent advisors on DLA form completion, but they have bills to pay as well and therefore must charge for their help. But considering you stand to increase your income substantially, the fee could be worth it. *NOTE* Avoid anyone who either asks to keep your book or asks for regular weekly percentages of your benefit. This is illegal. You can appoint someone else to collect your money if it is difficult for you, but this is normally a family member or friend.

Suffering an enduring mental illness may lead to destitution and even premature death. However, with ££s in your account you are not "mentally ill" but merely eccentric! ;) DLA is a complicated benefit and requires specialist knowledge to fully understand how it applies to those with an enduring mental illness. Beware of allowing "professional" negative opinions dissuade you from claiming DLA. I believe that people who are ill should get more money rather than less. Here are some other opinions:

• "There is a disparity between those who receive the DLA and those who don't and yet even more importantly are those who don't even get to claim at all." Source: Day Centre Support Worker.

• "You should be able to enjoy the same standard of living as those without a mental illness. It is your right." Source: The Mayor of Watford October 2006.

• "You believe that it is your duty to claim the benefits to which you are entitled in order that you do not become a burden to the services e.g. hospitals, police, prisons..." Source: Employment Counsellor.

• "What's the worst thing that could happen if you claimed the DLA and didn't get it?... Nothing." Source: Community Psychiatric Nurse.

It is a good thing that in the 21^st Century our developed and prosperous country sees fit to provide for its vulnerable citizens. Modern society prides itself on being equal, just, compassionate and inclusive. Disability Living Allowance is not just for totally paralyzed people or those with severe mental disorders, it is for everybody who is disabled or has an enduring illness and in need of some assistance with care and / or mobility needs. It is meant to circumvent worsening of your health or doing things that might put you at risk. Retired people may claim Attendance Allowance instead of DLA. Freephone the Benefits Helpline on 0800 88 22 00 for more information.

Claiming Disability Living Allowance is not my field of expertise but it is my area of experience. When it comes to DLA you won't see any expensive television advertising campaigns encouraging you to "Pick it up, it's yours". You have to claim. I can only show you the door, you're the one who has to walk through it. If you have an enduring mental health issue then you will probably at some stage in your life require to claim benefits. Claiming DLA on mental health grounds is not like rocket science, it's more difficult. For adults experiencing an enduring mental illness I recommend the "Claiming DLA Guide" from welfare rights specialists Benefits & Work. It is used by claimants, carers, advice workers, solicitors, social workers, health workers, housing workers and disability organizations throughout the UK. Personal, non-commercial use allowed. Thank you to Benefits & Work for creating this valuable guide dated 2004: Down Load Guide

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Visit www.benefitsandwork.co.uk where you can access a recent guide on paying a membership subscription (recommended).

Freephone: 0800 882200 to have a Disability Living Allowance claim form sent to you. It is important that you give as much information as possible on the form. Your claim is usually decided on this information and the decision is made by a person who hasn't seen you.

DLA claims revolution - who will be the winners and losers? So far, it's a silent revolution. It's gone unannounced by the government and unnoticed by all the major benefits organizations. For some claimants, advice agencies and disability charities it will be a great step forward: some disabled clients will get better awards and some agencies will win extra funding and cooperate more effectively. But some claimants will lose out through lack of knowledge and some advice agencies and disability charities will lose funding as neighbours and rivals poach first their clients and then their welfare benefits funding. It isn't hard to imagine that in five years time paper based benefits claims will be all but unheard of - everything will be done online or via call centres. For many claimants with access to the internet, online transactions will be preferable to telephone conversations. For welfare benefits advice providers, the choice may be between offering support to people doing business with government departments online or watching their funding dry up. Source: www.benefitsandwork.co.uk Get online or get left behind.

1 in 3 people with mental health difficulties are in debt. As a mental health services user I am aware that some people miss out on their full benefits entitlement. To help address this issue I have created a leaflet, in an A4 format, for you to print and then display on your daycentre notice board. The leaflet is a précis of all the Disability Living Allowance information above. Down Load Leaflet

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Benefit Enquiry Line - For many psychiatric patients, the benefits system is "A precarious world where fact, lore and misinformation have become so intertwined that extracting a pristine truth is almost impossible." Source: - The Da Vinci Code by Dan Brown. To obtain authorative, general advice and information on all Social Security benefits Freephone: 0800 882200. Calls are anonymous but at your request they will send you literature and benefit claim forms. Also consider to contact your local CAB - Citizens Advice Bureau, 64 London Road, St Albans, Hertfordshire Tel: 01727 855269 / 811118. CAB, 19 Hillfield Road, Hemel Hempstead, Herts Tel: 01442 213368.

Cutting cinema costs via the Cinema Exhibitors' Association national card scheme can reduce the expense of a visit to see the latest films. Card holders will be able to get a free ticket for the person who accompanies them, every time they go to the cinema. To qualify for a card someone will need to meet one or more of the following criteria:

• Be in receipt of Disability Living Allowance
• Be a registered blind person

The CEA card is valid for three years and costs £5·50 to process. It can be used in the cinema of Odeon and other major chains as well as in local independent cinemas. For further information ask at your local cinema. If you have any difficulty, please contact at this address: The Card Network, The Technology Centre, Rossmore Business Park, Ellesmere Port, Cheshire CH65 3EN Tel: 0845 123 1295 or visit Web Site where participating cinemas are listed and you may print an application form.

The Medical Exemption Certificate, if appropriate, entitles the bearer to free prescriptions for certain conditions e.g. diabetes and thyroid problems. Ask your GP receptionist, NHS hospital or local pharmacy for a FP92A application form. Complete and sign parts 1 and 2 and then ask your GP or hospital doctor to complete and sign part 3. Send it to your local Health authority (your GP, NHS hospital doctor or local pharmacy can give you the address). To confirm your free prescription status Tel: 0845 4647 for advice.

Not entitled to free prescriptions? Pre-pay. You may find it cheaper to buy a pre-payment certificate (PPC) if you think you will have to get more than 5 items in 4 months or 14 items in 12 months. Buying a PPC; telephone 0845 850 0030 to find out the cost of a PPC and to pay by credit or debit card. Alternatively consider the NHS Low Income Scheme for help with prescription charges. You will need a HC1 form available from Post Offices, Social Security Offices or by Freephone: 0800 882200. Processing a claim usually takes 4 to 6 weeks.

Have you got the bus pass? Do you know about the bus pass? From April 2008 the national bus pass will give free off-peak bus travel anywhere in England for older and disabled people. This new scheme will widen the horizons of many people who currently only receive free travel within their own local authority area. Anyone who is over 60, or eligible disabled (including mental illness) will be able to travel between 9:30 am and 11:00 pm on weekdays and all day at weekends and on bank holidays. Any existing cards will be replaced by smartcards which will help reduce fraud, speed up boarding and enable authorities to claim reimbursement accurately.

Those with bipolar, claiming a free bus pass, may be confused by the application form. A spokesman for St Albans District Council said that people with mental illnesses fell into the category which included people with learning disabilities. He said the definition on the form was "someone who has a learning disability that is a state of arrested or incomplete development of mind, which includes significant impairment of intelligence and social functioning". Source: page 14, Herts Advertiser newspaper, 1 November 2007. Don't let the semantics put you off.

Some district councils are providing more generous schemes than the statuory minimum or are working with neighbouring councils to provide more generous schemes. You may have to pay a charge for the pass to get these extra benefits. Some councils are issuing tokens. These are all decisions made by your local council, not the bus companies. Due to the large number of areas in which the bus companies operate, there are many different schemes which the drivers and staff need to be aware of. However, they will be unable to answer queries about individual schemes so, if you have any questions or comments about a particular scheme, you will need to contact the relevant local authority.

Check it out at District Council Offices, St Peter's Street, St. Albans, Hertfordshire AL1 3JE Tel: 01727 866100 or 01727 819213/4. Dacorum Borough Council, Civic Centre, Hemel Hempstead, Herts Tel: 01442 228000 or 01442 228317.

The travel permit is better than American Express, try using a credit card on a bus and see how far it gets you! ;~)

p.s. National Mind has received a lot of calls from service users expressing concerns about local authorities cutting back on the concessionary bus fares they have previously offered people with mental health problems. If this is happening in your area please let National Mind know by contacting the Campaigns team on Tel: 020 8215 2424 or e-mail action@mind.org.uk as they need to know the extent of this problem. Source: Mind in Action, March 2008.

p.p.s. As you may be aware, from the 1^st April 2008, the government has decided that all concessionary pass holders will be able to have free bus travel right across the country. This means that your pass will be valid on all local buses not only in Hertfordshire, but all over England. There may be some restrictions regarding the time the free travel starts and ends and I would advise you to contact your local council for more details. You can make the most of this concession by travelling right across the bus network for free. Starting in Stevenage you could catch the 301 to Hemel Hempstead bus terminus, then travel to Aylesbury using the 500 service, then hop on to the Line 280 service and spend a day in Oxford, all without spending a penny! Plan your own routes using the online service of www.traveline.org.uk

p.p.p.s. From 1^st April 2008, the English National Concessionary Travel Scheme, allowing free travel to those over-60s and qualifying disabled people who have passes, will apply to off-peak journeys on almost all services described as bus. I hope to indicate where this is not the case as more information about exclusions becomes available. For journeys known as coach, those which stop frequently will be included in the scheme, but if the service requires pre-booking, a booking fee may still be charged. Most long-distance coach services are not included in the scheme, although coach operators such as National Express already have special fares for the over-60's so please check with the operator.

Hertfordshire Libraries offer free loan of music compact discs and no charge for overdue books plus other special concessions for those with a disability e.g. claimants of Disability Living Allowance. Pick up an information leaflet at your local branch.

The Dacorum Card is a free card that gives you discounts and priveleges at more than 180 local businesses and facilities, including sport & leisure, food & drink and many more! If you live in Dacorum and are receiving a means-tested benefit than you may be entitled to a Dacorum Card. Apply via Dacorum Borough Council, Civic Centre, Hemel Hempstead, Herts Tel: 01442 228000.

Low cost recycled furniture and "white goods" are offered at: Emmaus St Albans, Hill End Lane, St Albans, Hertfordshire AL4 0FE Tel: 01727 817297. Dacorum Paradise Furniture Project, Paradise Industrial Estate, Hemel Hempstead, Hertfordshire, HP2 4TQ Tel: 01442 241716 / 263197. Special concessions for those on certain benefits.

Hospital Visits - If you are receiving Income Support and are a close relative of the patient, it is possible for you to claim your expenses when visiting your relative. You will either be paid a mileage rate if you use your own car, or if you save your bus tickets, the cost will be refunded. Taxi fares can only be refunded in extreme circumstances, e.g. you have had to visit in the middle of the night, or you cannot use public transport due to your own ill-health. Please speak to the nurse in charge of the ward to claim your expenses.

Useful Phrases - When completing benefit claim forms or being interviewed by benefit officials; "It is often useful to apply a liberal sprinkling of words such as; caring, support and health." Source: Support Worker. Here are some examples of useful phrases that can help to fill up those irksome blank white areas on a claim form: "I believe that leaving my employment has benefited my health. I accept the changes to my medication as prescribed by the doctors." Source: Community Psychiatric Nurse. "I require a caring, supportive environment that promotes my health. I trust that I have found it." Source: Social Worker. "The benefits help to take away the pressure for me to go to work." Source: Keyworker. Learn these phrases along with your National Insurance number. Fail to prepare... prepare to fail.

Council Tax - If you are unable / advised not to work, not receiving full Council Tax benefit and receiving a benefit such as Incapacity Benefit, or Disability Living Allowance at the middle or higher care rate, then hundreds or thousands of pounds in Council Tax can be saved per annum and previous years refunded. You do not have to reapply in future years. People who are "severely mentally impaired" are entitled to various concessions on their Council Tax charges. All councils operate this scheme through the 1992 Local Government Act. This defines severe mental impairment as having "severe impairment of intelligence and social functioning [however caused] which appears to be permanent". If you meet the criteria, telephone your Council Tax office to request an application form for Council Tax Discounts / Exemptions with regard to people that have a severe mental impairment. Source: MDF The Bipolar Organisation.

Let the experts do the work - Are you claiming all the benefits you are entitled to? Don't forget that Carers in Hertfordshire can refer you to the Hertfordshire County Council's Money Advice Unit for a full benefits check for you and/or the person you look after. The world of benefits is so complex, let the experts from the Money Advice Unit guide you through the maze and help with completing the long claim forms. If you would like to have a benefits check, Tel: 01992 586969.

Warm Front is a government sponsored heating initiative for those on benefits. When you join you can get access to free insulation, free energy-efficient bulbs and help if your boiler/heating fails to function. For more information Freephone: 0800 316 2808.

Direct Payments are means tested, cash payments, given to individuals by Adult Care Services to enable them to buy services they have been assessed as needing e.g. mental health care requirements. They can be made to disabled people aged 16 or over, to people with parental responsibility for disabled children, and to carers aged 16 or over in respect of carer services. The aim of a direct payment is to give more flexibility in how services are provided to people who are assessed as eligible for social services support. Providing money in lieu of social care services may give people greater choice and control over their lives, and enable them to make their own decisions about how their care is delivered. This is a relatively new and complex scheme that is not always fully understood by service users. For more information, advice and support, contact Hertfordshire County Council Adult Care Services, Tel: 01438 737400 or Leonard Cheshire Direct Payments Support Scheme, 10 Latchmore Court, Brand Street, Hitchin SG5 1HX Tel: 01462 439002.

Landmark for online registration. Hundreds of people have used an innovative online form that enables adults to notify Hertfordshire County Council of their disability quickly and easily. Adults w zxcz\ho register their disability online are entitled to a bus pass, a disabled rail card, reduction in the cost of a fishing licence and reduced admission charges for many leisure activities including cinemas, concerts and leisure centres. Adults who want to register their disability online can do so by visiting: www.hertsdirect.org/disabledregistration

ADMIT ONE FREE... The National Trust has introduced a scheme which offers a disabled person's assistant free entry to their properties. Find out more from Tel: 0870 458 4000.

If you have a low income, you can claim several benefits that can give you a basic amount to live on. To get them, you will need to pass a "means test", so you will have to give details of all your income and savings. If you live with a partner, civil partner, or your husband or wife, their income and savings are also taken into account when deciding if you can get these benefits. For more information contact your local Citizens' Advice Bureau listed in the telephone directory or contact the Benefits Helpline on Freephone 0800 88 22 00.

How to handle an interview under caution - If the Department for Work and Pensions (DWP) or your local council suspect you may have misled them about something to do with your benefits you might be asked to go to an 'interview under caution'. This could lead to them suspending your benefits and taking you to court. The AdviceNow Guide below looks at what happens if your council (which pays Housing Benefit and Council Tax Benefit) or the DWP (which pays most other benefits) invites you to an interview under caution. It may also be useful if another organisation such as the Inland Revenue (HMRC - which pays tax credits) wants to interview you under caution, but you will need to check that the information applies to you. The guide will take you through the process, explain what help you can get and suggest ways to help yourself.

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Carers

If you are a carer then investigate "The Carers' Assessment" as it may be of benefit to you. Contact your local Dacorum Community Mental Health Team, St Pauls Unit, Slippers Hill, Hemel Hempstead, Herts Tel: 01442 230326. Community Mental Health Centre, Edinburgh House, 82 - 90 London Road, St Albans, Herts AL1 1NG Tel: 01727 830031. Remember, you have needs too. Hertfordshire County Council is encouraging carers to claim the benefits they are entitled to including support and advice available to them. Carers can find out more by telephone: 01438 737400.

A recent survey by Carers UK has found that carer's are more likely to suffer poor health than the rest of the population and that mental illness is more common when carers cannot get a break from the demands of their role.

Financial worries were blamed as the cause of much distress and a large number of people had to cease work and became financially worse off in order to care, with a significant number of these carers having to cut back on food and struggling to pay essential bills.

The survey pointed to a lack of support and information for carers, particularly where money is concerned. Many of those entitled to benefits are not aware of their right to a carer's assessment, which is one of the main gateways to support.

A staggering £660 million in carers' benefits go unclaimed by some 300,000 carers. The Carers Rights Guide is produced by Carers UK and gives advice on support and benefits. To obtain a copy contact: Carers UK, 20 - 25 Glasshouse Yard, London EC1A 4JT Tel: 020 8880 8125.

Dacorum Carers Centre 20 - 22 High Street, Hemel Hempstead, Herts HP1 3AE Tel: 01442 253344.

Carers in Hertfordshire offer information about getting a break, support groups, money matters, managing the stresses and strains of caring, asking for a carers assessment, or if you simply need a listening ear then contact them at: Carers in Hertfordshire, The Red House, 119 Fore Street, Hertford SG14 1AX Tel: 01992 586969. Their newsletter is sent four times a year, free of charge. If there is something you would like to see in future newsletters or you have information or comments you would like to share with other carers, they would be happy to hear from you.

Need a break? Are you caring for someone at home who is elderly or has a disability? Do you worry about leaving the person alone and therefore rarely go out? Do you never have time to relax, time to shop without rushing, time to pursue your own interests or to visit friends? Crossroads is an organisation that can provide relief to the carer. If you would like to know more about the scheme contact: North and North West Herts Crossroads on Tel: 01462 455578.

Short Breaks for Carers is part of Turning Point. The nature of the break covers anything from spending time with a service user in the home to accompanying them on social/leisure activities in the community. This can also involve support to attend meetings with professionals, important appointments and day care services, where this gives a break to the carer. Contact: Short Breaks for Carers, Blue Box, Station Approach, Rickmansworth Road, Watford, Herts WD18 7FR Tel: 01923 211991.

St. Albans Mental Health Carers - Do you care for someone who has mental health difficulties? Then you are a carer. Carers groups meet regularly, daytime and evening, for support and information at Edinburgh House, 82 - 90 London Road, St Albans. Contact: Jo Cormack Tel: 01727 830031.

Carer's Tickets - Are you the main carer of a housebound person who is unable to visit Hertfordshire Libraries? Do you know?:

• You can borrow up to 24 items on the same ticket - 12 for yourself and 12 for the person you care for

• You can borrow items for up to 6 weeks and change items as often as you want

• You pay no fines or charges on books or sound recordings

• There are no fees to reserve items

Herftordshire Libraries understand that carers have busy and stressful lives. To apply for a carer's ticket please ask the staff.

'Get in touch' call to older carers. Social workers are encouraging parents and other older relatives of people with mental disabilities to get in touch as they can help. The county council adult care services department says it is unable to help about a quarter of carers over 70 as it does not know who they are.

Cabinet member Sally Newton said: "I realise that for some people admitting that they need help can be difficult but, being a carer myself, I also know how valuable additional support can be. There may be a whole range of services available to older carers that would make their lives easier. Our staff will discuss their situation with them and let them know how we can help - that is what we are here for. It is also important to put plans in place to avert crises of older carers becoming ill or maybe going into hospital suddenly, leaving someone at home in shock and coming into the system at a late stage. We do not want to wait until then before becoming involved. Older carers, or anyone speaking on their behalf, can get in contact with the team by calling its enquiry line on 01992 555444, which is open from 10am to 1pm Tuesday to Thursday.

Source: St. Albans & Harpenden Review Wednesday 27^th Feb 2008.



Creativity

It is often remarked (mostly by psychiatric patients) that mental illness often results in creativity. Here are a few of my personal accounts:



During the 1950s Hill End Psychiatric Hospital (which has now been converted into Highfield Park estate in St Albans as shown above) was considered a centre of expertise regarding treatments for disorders of the brain. It was a teaching hospital while I was a patient there. I have fond memories of fellow patients and the staff, some of whom I see occasionally. I am most grateful for the care I received. During my stay I spent many enjoyable hours in the hospital library where a creative writing group would meet. Here below is an example of my input to the group which to my pride and pleasure was actually published in the Hill End Hospital magazine:

HILL END LIBRARY
Paper cups standing still,
All along the window sill.
Mills & Boon in the rack,
Borrowed books that don't come back!

The Head Librarian laughed and giggled when she heard me read that out. Here are some more examples of my write-on creative literature:

THE JOURNEY IS MY DESTINATION
The windshield wipers swished sideways revealing the luminescence of lights in the dim foggy haze of motorway miles. I glanced at my wrist-watch, its interior light glowed 2am. I had no idea of my location other than I was sitting on the rear seat of a limousine next to a male psychiatric nurse who was there for my protection.

Sometimes it maybe helps to recollect the past to understand where one is now. Two hours previously my mental state had deteriorated to such an extent that I had telephoned my local psychiatric unit Albany Lodge for help. They advised me that they did not accept admissions during the night and in any case they were full to capacity so I should attend the nearest Accident and Emergency department at QEll Hospital, Welwyn Garden City where they had a psychiatric ward. I arrived at the QEll Hospital by taxi and a psychiatrist was summoned from his slumbers. After a brief but most thorough examination the psychiatrist advised me that I did in fact require hospital admission but unfortunately there were no beds available either at QEll, St Julian's or elsewhere locally. I was to be transferred to a hospital in another area.

The reducing speed of the limousine alerted me. We were entering unfamiliar hospital grounds and I was swiftly presented to a doctor and a nurse for examination. During the questions and answers of this procedure the doctor remarked: "You appear to have a dry mouth. That is probably due to your medication. Nurse, a drink of water for this patient if you please." She spoke softly to me: "Would you like still or sparkling?"  It was then that I knew I was in a private hospital. ;~)

IT'S ONLY ROCK 'N' ROLL
Whilst gigging with a band in a club I was just a little high after unpleasant events at work previously that day. I could feel a certain adrenalin induced frisson when I took a guitar solo. As my playing progressed I became spontaneously creative and experimented with techniques that were beyond my usual repertoire. I took full advantage of the palette of my digital effects and a final glissando concluded my journey into sonic creativity. As the rapturous applause slowly subsided the drummer leaned back and exclaimed: "Every group needs a nutter!"  It's good to feel wanted, don't you think? ;)



Depression

Overcoming Depression - Helping you to get well. Depression is not something you can just "snap out of." It is thought to be caused by an imbalance of brain chemicals, along with other factors. Like any serious medical condition, depression needs to be treated. Source: www.depression.com

This resource will focus on self help for those suffering from depression.

What is depression? Many people use the word 'depressed' to describe feeling fed-up, sad or unhappy, but these feelings often pass within a few hours or a few days. Depression the illness, however, is different from this. When you have depression, these feelings are much stronger and last for a longer time. It is common to lose interest in things that you used to enjoy - even carrying out day-to-day activities can become very difficult. Depression can become so bad that the person suffering feels hopeless about the future and at times may think that life is not worth living.

Depression can also affect people in many other ways:

• Problems with sleep
• Feeling guilty
• Eating too much or too little
• Physical aches and pains
• Lack of energy or feeling very tired

What causes depression? The truth is nobody really knows what causes depression, but most people believe that depression is caused by a change in the level of certain chemicals in the brain. This change may be set off by stressful events, ill health, drinking too much alcohol, use of drugs and so on, However, for some people there is no obvious trigger.

Who gets depression? Depression is a common illness, and may affect as many as 1 in 4 people at some stage in their life. Depression can affect anyone regardless of age, gender or race.

How is depression treated? The good news is that there are treatments for depression that work well. In fact, nearly everyone can get over their depression with help. Depression can be treated in different ways. The most common ways are to use antidepressant tablets and/or talking to someone about your problems (as in 'counselling'). Talking about your feelings is often very hard, but your doctor and/or a trained counsellor or therapist can provide a lot of support. Additionally, if you feel that your depression is connected with a particular problem, sharing experiences with others in a similar situation (for example in a self-help group) may be both reassuring and helpful. Ask your doctor for information and advice about counselling services that are available.

Talking to someone is always useful and very worthwhile - you should never fee! uncomfortable about needing to talk things over. However, for some types of depression, talking about problems is not enough. Antidepressant medication may also be needed.

What you need to know about antidepressant medication - Antidepressants are not addictive and are not tranguillisers or sleeping tablets. You will be able to stop taking them when your doctor feels you are ready to, and they will help you to feel better more quickly than any other type of treatment. It usually takes a couple of weeks or so before the antidepressants have their full effects (perhaps a little longer for an elderly person). Always make sure that you take the full course of tablets, even when you start to feel better. It is important to take the tablets every day, as they do not work if you only take them when you feel you need to! Do not take any more tablets than have been prescribed for you and talk to your doctor about any concerns you may have. You may experience some side effects, but these do not usually last long. Check with your doctor about what to expect, so that they will not worry you if they occur. Don't stop taking the tablets once you start to feel better. It is important to continue taking them (usually for several months) after you feel better to ensure that you get well. Discuss with your doctor how long you should stay on the tablets.

Depression and anxiety - Anxiety is a condition in which patients often worry excessively and can experience physical effects such as the heart beating faster, a feeling of 'churning' in the stomach, feeling shaky and many other symptoms. Anxiety is very common and many people suffering from depression may also have symptoms of intense anxiety. However, depression and anxiety are not the same thing - depression is feeling that the very worst has happened and anxiety is fearing that the worst will happen. Counselling and/or antidepressants are also used to treat some anxiety states.

Recovering from depression - Most people who receive treatment from their doctor make a full recovery. To help yourself get well, eat properly, do some physical exercise and avoid alcohol as this can hamper your recovery. Use support from your family and friends to help you with your medication and to continue to talk things through. Some people recover from depression even stronger and better able to cope than before. Remember that you are not alone and that many other people go through the same thing.

Source: Neurolink leaflet. Practical solutions for anxiety & depression.



Driving

To drive or not to drive - Having a medical condition or disability does not necessarily mean you cannot or will not be allowed to drive. Whether you are a new or experienced driver - you must let the Driver and Vehicle Licensing Agency (DVLA) know about your medical condition or disability which is or may become likely to affect your fitness as a driver, unless you do not expect it to last for more than 3 months. Penalty for failure to comply is a fine of £1000. Psychiatric conditions which are notifiable:

• any mental ill-health condition (including depression)

• any psychiatric illness requiring hospital admission

The DVLA have produced a "M1" form for notifying them of relevant psychiatric conditions which you may download below, print off, complete and post to:

Drivers Medical Branch, DVLA, SWANSEA, SA99 1AT

Down Load "M1" Form PDF

You may require free reader software from Adobe

The mental health charity ReThink have produced a Driving and Mental Illness factsheet available by telephone: 020 8974 6814.



Employment & Training

Should I declare my disability? - This question causes concern for many disabled people who are applying for jobs. Under the Disability Discrimination Act, it is unlawful for employers to discriminate against disabled people in their recruitment and selection procedures. While it is not unlawful to ask questions about a person's health and disability on an application form or to issue a separate health questionnaire, it is unlawful to use the responses to discriminate against anyone. If you feel that you have been discriminated against when applying for a job, please tell a member of the Jobcentre staff. You may have a right to take a case to an employment tribunal. You must make your complaint within three months of the date of the incident that you are complaining about. When employers use application forms which are less than perfect, you may feel reluctant to tell them about your disability. In the end it's up to you, but you should remember the following points:

• If you are asked (in an interview or on an application form) whether you have a health condition or disability, answer in a straightforward way. Make the distinction between a health condition and a disability. If necessary, explain how your disability would affect you in a work environment - or say that it has no practical effect. Talk about your abilities and why you think you are the right person for the job.

• You must tell an employer about a disability if it might present a health and safety risk to yourself or other work colleagues.

• If you sign a declaration saying that you do not have a disability when in fact you do, this may affect your job at a later date.

Remember this web site is only a general guide and not a full and authoritative statement of the law. I have made every effort to make sure that the information on this web site is correct at the date shown below in the Conclusion at the end of this page. However, changes in the law make the web site become gradually less accurate. For up-to-date information please contact your local Jobcentre.

Way2Work - Have you experienced mental health or emotional problems? Do you want to find or stay in work, but not sure where to start? Way2Work is a voluntary and free programme, which can help you to find paid or unpaid work. An Employment Consultant will work with you on a one to one basis, providing advice and guidance which continues for a period of six months after entering employment or work placement. An Employment Consultant can also support you if you are already in work, advising on issues such as coping with stress and your rights in the workplace. For more information contact: Way2Work, Mind in Mid Herts, 137A Hatfield Road, St Albans, Herts AL1 4JX Tel: 01727 865070 or 894913.

Free vocational skills training may be available via DEA - Disability Employment Adviser at the JobCentre 54 - 56 Victoria Street, St Albans, Hertfordshire AL1 3HZ Tel: 01727 773900. JobCentre, 1 Waterhouse Street, Hemel Hempstead, Hertfordshire HP1 1EU Tel: 01442 426000.

Volunteer - Do you want a useful worthwhile voluntary job? Get yourself an occupation via CVS - Council for Voluntary Service (Volunteer Bureau) - 31 Catherine Street, St Albans, Hertfordhire AL3 5BJ Tel: 01727 852657. Volunteer Bureau Dacorum, 48 High Street, Hemel Hempstead, Hertfordshire Tel: 01442 247209 / 254227 / 253935. Volunteers are unpaid not because they are worthless but because they are priceless.

Seeking paid employment? Consider to contact Work Solutions (formerly Employment Direct), Disability Employment Training Consutancy, The Bury, Queensway, Hemel Hempstead, Hertfordshire HP1 1HR Tel: 01442 236533. The Shaw Trust offers free confidential benefits and employment counselling. Freephone: 0800 085 1001.

Paradise Project provides training for people with a physical or mental health disability. Subjects include; upholstery, woodwork, furniture restoration, administration skills, IT computer operator training. Enquiries via Paradise Project, Paradise Industrial Estate, Wood Lane, Hemel Hempstead, Hertfordshire, HP2 4TP Tel: 01442 413194. I recommend Paradise Project.

Self-Employment - There is a great deal of merit in considering self-employment if you feel you are self-managing your condition successfully. There are many exceptionally talented mental illness sufferers who have much to offer. Self-employment can give so much self-confidence and self worth - but if you think it is for you then I would say do lots of research and find a good mentor.

The Department For Work And Pensions may require details regarding activities of some benefit claimants with regard to part time work, voluntary work and study courses etc. To ensure you stay within the rules, so that your benefit is not affected, you can check your own situation by calling the Benefit Helpline anonymously on Freephone: 0800 882200.

An account of work experience with a mental health issue: I was employed for some years as an electro-mechanical inspector when I experienced a major bipolar mental illness requiring hospital treatment for nine months and prescribed lithium. Although I could have returned to my job I decided to resign and find an alternative employer with a fresh challenge for me. I did of course thank my ex-employer for having me and for all the months of sick pay I had received! ;)

I applied for another electro-mechanical inspector vacancy elsewhere but was rejected on the grounds that I had "insufficient experience". A few months later I applied to the same employer for a production line operator job and got it. I have always declared my mental health difficulty to employers because if I relapse I expect to be well cared for and on this occasion the interviewer's only concern was that I continued to diligently take my medication. After a week of successful employment I was asked if I would kindly transfer to the post of electro-mechanical inspector [the very post that personnel had deemed me unsuitable for] which I accepted. A few months later I heard that the personnel officer responsible for previously rejecting my employment application had been sacked. I could not possibly comment on the reason for her dismissal but I am sure you can draw your own conclusions...

I could go on like this with similar accounts of my employment whilst coping with a mental health issue but that would be so tedious... yawn... zzz... IMHO employers require to make a profit and if a potential employee has the appropriate skills then most disabilities, both mental and physical, will be catered for in order to realise that profit.

Conclusion: Stigma, if it really exists at all, is usually inverted. Mental illness is not a determining issue when it comes to employment. It is skills training that will enhance a potential employee's job prospects. Let's face it, if you have got what an employer needs then you are no longer considered to be a nutter... you're merely eccentric! ;) Don't work too hard, take it easy.

p.s. One of the best things you can have on your CV is that you enjoy playing musical instruments both on your own and with other people. Think about it...

The Power to Work Project is a 26 week programme for those in receipt of Incapacity Benefit or other associated benefits such as Income Support or Credits of National Insurance contributions for reasons of incapacity e.g. mental health conditions. A variety of skills training and support is offered at: Careers Development Group, 1st floor, 62 The Parade, Watford, Herts WD17 1AZ Tel: 01923 222128.



Medication

Maudsley Mental Health Medication Helpline - If you want immediate advice on any mental health medication call the Mental Health Medication Helpline at the Maudsley Hospital. The helpline provides independent advice and information about mental health drugs. The helpline is staffed by experienced mental health pharmacists and provides independent advice and information about drugs to patients and carers. Tel: 020 7919 2999 or 0203 228 6000. Opening hours: 11 am to 5 pm Monday to Friday, excluding Bank Holidays.

Keep taking the tablets. "To stop taking psychiatric medication without medical supervision may have serious consequences for your health." Source: Psychiatric Nurse. "If you should forget to take your medication at the appropriate time then wait until next scheduled dose to continue your treatment. This will maintain the continuation of your medication without the risk of overdose." Source: Occupational Therapist. "Lithium is a wonder drug that has revolutionised psychiatric medicine but in order for it to work the patient has to take it." Source: Hospital Library Book. Beware of possibly well meant but ignorant and potentially harmful comments such as: "Lithium is a placebo, you don't have to take it." Source: Care Assistant.

Response Curve



Increasing the dose of an antidepressant without medical supervision may result in a decrease of benefit if the medication response curve is not considered. With reference to the graph above it can be seen that an increase in the dose may be detrimental to the mood and may even make one feel worse than before treatment. A substantial increase in dose may be required to elevate the mood more but unfortunately this could result in unacceptable side effects. The finer details of the reponse curve may vary between patients. All adjustments to the dose should be authorized by the prescribing doctor. "Do not exceed the stated dose." Source: Pharmacist. "Not many GPs know about the response curve." Source: Mind.

Always remember that there are lies, damn lies and statistics. If you torture data sufficiently, it will confess to almost anything.

Self-Medication - I am most fortunate to have attended the self-management course hosted at Herts Mind Network. The issue of self-medication was thoroughly discussed. I was able to implement this knowledge recently which I believe empowered me to avoid an admission to hospital. I feel a lot better now. Thank you Herts Mind Network. God bless. Yours sincerely, Bob Houlston. Contact Herts Mind Network via Tel: 01442 215117.

Self-Management Tip - Some psychiatric patients find it difficult to remember to take their medication dilligently. I use an alarm clock set to ring at the appropriate hour. This reminds me to take my tablets at the prescribed time and helps me to avoid a relapse. During these uncertain days of NHS cutbacks I believe it is crucial that I self-manage my illness as essential support may not be available during a future crisis. I welcome the NHS cutbacks. I think the NHS cutbacks are second to none. The NHS cutbacks give me an incentive... an incentive not to be ill. :(

Always read the Patient Information leaflet that comes with your medications and never ever throw them away. If you didn't get a PI leaflet, you may request one. Some doctors tend to take a dim view of patients who know too much about medications, so tread lightly when and where appropriate. Diagnosing yourself from a web site is like defending yourself in court, you suddenly have a fool for a doctor. Don't be a cyberchondriac, thinking you have every disease you see a web site about, or that you'll get every side effect from every medication. Anyone with a history of mental illness who needs advice on appropriate psychiatric medication needs to be discussing that with a doctor and not getting your information from some stupid web site. Get off your computer and start making appointments!

A support worker in a daycentre sometime ago asked me: "Bob, do you believe that your medication makes you well?" I replied: "No I don't. No doctor has ever required of me to believe that my medication makes me well, they merely insist that I take it. It is not necessary for me to believe." My illness feels like a psychological issue but it is apparently a dysfunction of my brain.

I believe that my bipolar affective disorder is predominantly a genetic issue. My lithium medication appears to enhance the functioning of my brain so it is a good thing that I take it. After all, why should I settle for what I was born with?

Lithium is a wonder drug that has revolutionised psychiatric medicine. As a mental health services user I am aware that sometimes it can be bewildering to source reliable, jargon-free, information about medications. To help address this issue I have created a leaflet, in an A4 format, for you to print and then display on your daycentre notice board. Down Load Leaflet

To read the leaflet you may require free reader software from Adobe.



Survival

Survival On A Psychiatric Ward - NHS psychiatric wards are notorious for their shortage of bath plugs. Always carry a bath plug with you in case you are admitted. You can make new friends by lending it out to fellow patients.

If you wake up in the middle of the night on a NHS psychiatric ward ask for a warm milky drink. The staff are trained to provide this service. Requests for cups of tea or coffee may be curtly refused especially when you consider that caffeine inhibits sleep whilst warm milk is beneficial. If preparing a warm milky drink at home I find that a microwaveable mug of milk heated at 800W E full power for 1½ minutes and then stirred, works well for me.

No coins to telephone a friend then dial: 0800 REVERSE where REVERSE = 7383773 for a reverse charge call.

Self-Management - I have found self-management to be beneficial to the stability of my mental health. I believe that a "toolkit" of advice helps me to avoid repeat hospital admissions. To access more information try this suggested reading: Overcoming Mood Swings by Jan Scott (ISBN 978-1-84119-017-4) A self-help guide using Cognitive Behavioral Techniques.

MIND is the leading national mental health charity. Contact your local branch for advice and information regarding housing support, befriending schemes, groups and clubs etc. Mind in Mid Herts, 137A Hatfield Road, St Albans, Hertfordshire AL1 4JX Tel: 01727 865070 or 894913. Herts Mind Network, 139 Leighton Buzzard Road, Hemel Hempstead, Hertfordshire HP1 1HN Tel: 01442 215117.

CALM - Campaign Against Living Miserably is an initiative by the Department of Health to help alleviate suffering caused by suicidal thoughts / mental illness / drug dependency. The CALM campaign is targeted at men in the age range 15 to 35 years, but the helpline is open to anyone. Everyone who calls will receive an equal service regardless of age, gender, cultural background or sexuality. Originally based in Manchester it is now available nationwide 5.00pm to 3.00am. If you need to speak to a counsellor Freephone: 0800 585858. I have found this telephone number most useful to me so I thought I would pass it on. Remember, calls to CALM on a landline are free, confidential and anonymous and they don't show up on landline telephone bills.

NHS Helpline - If you are feeling distressed or need urgent help, contact the Mental Health Information Line: Freephone 0800 616171. Provided by Coventry Healthcare NHS Trust.

Mental Health Helpline provided by Hertfordshire Partnership Foundation Trust (HPFT) is available to all their service users and carers who need it. Offering advice and telephone support from mental health professionals, outside normal working hours, it is available via Tel: 01438 843322. Hours of opening: 5:00pm - 9:00am Mondays to Fridays, 24 hours round the clock at weekends and on Bank Holidays. During normal weekday working hours service users needing advice should call their local community mental health team.

For a long time, service users and carers have said that they needed a number to call when mental health services are closed. The good news is that HPFT has responded and set up a new out-of-hours help line. A trained mental health professional will answer your call. If it cannot be taken immediately, you will be able to leave a message on an answerphone. The mental health professional should call you back within an hour. If your first language is not English, staff will be able to arrange for an interpreter to translate for you.

The helpline is essentially a telephone advice and support service. For example, you may want to know more about medication or local services or you may need some support if you are not feeling well or if you are worried about someone you care for or need more help as a carer. However, if you are having a crisis or an emergency when you telephone, the helpline staff will make sure you receive the help you need.

In every society, there will be poor people: the mentally ill and the drug addicted, the historically disadvantaged who do not understand the prevailing system, the feckless who are not interested in getting out of bed in the morning. Another, larger group rises and falls according to luck and circumstance, doing its best to get by. Whether you are above or below the poverty line, if you have an enduring mental illness then community resources won't make you well but they may well enhance your well being.

Restring a spare guitar for left handed use. The concentration required to play it helps to calm me down when high.

PALS - Patient Advice Liaison Service aims to resolve patient concerns, give patients the chance to make suggestions on improving local services and provide them with information on health services. PALS will liaise with staff, managers and other organizations to help solve problems and can also advise patients and their families about the best local or national support groups. Before you lose your temper over an unresolved issue please consider that some NHS staff work twelve hour shifts. The NHS is as much mine as it is anybody else's. I feel that it is my duty to do what the doctor says. If I find something wrong I speak up. In the absence of a satisfactory response I make a fuss, PALS is a good place to start. Contact: PALS, Charter House, near Parkway, Welwyn Garden City, Herts AL8 6JL Tel: 01707 361281. I have had some personal challenges that I won't bother you with, nevertheless, on the rare occasion it is needed a well crafted letter to PALS is worth a score of fruitless forgotten telephone calls to harassed and/or exhausted frontline staff. I believe that I have been well cared for, make sure you are too... Write on! ;)

"If you're going to have a mental illness then manic depression is the one to have, at the end of it all you're pretty much the same as when you started. All the others go from bad to worse." - Source: Psychiatrist. Manic depression or bipolar affective disorder could be described as: "A severe mental illness involving the presence of mental disease, which severely and adversely affects a person's mood or behaviour and which severely restricts their social functioning, or their awareness of their immediate environment." - Source: Social Security Booklet. "There is no doubt that manic depression is one of the most serious and disabling illnesses that mankind is subject to. The World Health Organisation ranks it in the top ten disabling conditions. Nevertheless, I regularly meet people with manic depression who have learnt to manage their illness effectively and found satisfying relationships and creative roles." - Source: Consultant Psychiatrist. Bipolar children are like a bird with a broken wing, but together we can make them fly again.

Promote Dental Hygiene Campaign - Depressed mental patients' possible self neglect regarding poor dental hygiene leading to gum recession and eventual loss of teeth is a worthwhile campaign issue. This campaign is I believe achieveable, non political, of timeless value, virtually free and of benefit to many psychiatric patients. I am presently pursuing this campaign via my web site, the mental health forums I attend and talking to anybody who will listen. You can make a difference; join the campaign now by protecting your teeth from gum recession and propagating the knowledge. Toothbrushes are available, to patients in National Health Service psychiatric hospitals, on request to the staff.

Many mental patients lose their teeth because they are predisposed to self neglect. When ill and left to my own devices I tend to self neglect. Good dental hygiene is important for healthy teeth and gums. A dental hygienist has advised me that some people need help with brushing their teeth. An electric toothbrush may be appropriate providing it is used gently. I use the Oral-B Professional Care 7000 electric toothbrush (Which? best buy) powered by Braun, available from Boots or Superdrug on special offer for just £33 (was £45) and replacement FlexiSoft brushheads only cost £3·50 each. It removes plaque efficiently. I love it! :) p.s. Remember to floss. I use Oral-B Essential Floss twice a week together with Oral-B, or Listerine, mouth rinse available from Superdrug and Boots. Helps me to do more to keep my teeth and gums healthy.

My professional patient duties are:

• Diligently take my medication
• Drink plenty of water to flush out medication toxins
• Maintain my dental hygiene

Issues such as a dishevelled appearance are relatively trivial and will be resolved with time.

Interestingly I attended a ViewPoint meeting recently and dental hygiene was raised as an issue. The comment was that there needs to be an enhanced promotion of personal and dental hygiene to allow people to be more acceptable in society. Often it is easy to correct a dishevelled appearance but it takes a lot longer, if ever, to repair damaged teeth and gums. Prevention is better than cure. For many psychiatric patients, who are fortunate enough to receive help, their mental health will improve significantly. Upon recovery you will be thankful that you persevered with your dental hygiene régime. Be true to your teeth or they'll be false to you.

You are not alone. It helps to know that others have lived with mental health difficulties. Previously, people did not have as many ways to get help as they do today. In the past ten years there have been huge improvements in the treatment options for mental health. Today, some mental illnesses are considered as treatable. Instead of hiding the disorder, many people have chosen to share their experiences with the public through books, personal appearances, and even films. Finding out about others who have successfully coped may be one of the best ways to gain confidence in your own ability to manage illness. You can see how others experienced anger, alcoholism, drug abuse, and other self-destructive behaviours and perhaps identify with their struggles. Most importantly, you may see how getting treatment for mental illness gave them a chance to lead more normal lives.

Although you may feel too shy or embarrassed to tell certain friends and loved ones you have a mental illness, doing so will eventually become a natural part of recovery. Once treatment takes effect and you are having some success, it may be easier to tell certain friends and your employer about the disorder. Understanding that your moods and behaviours result from mental illness can help them become supportive of your needs. For many people, fortunate enough to have employment, their recovery is often enhanced by the virtuous circle of opportunities and benefits that an occupation provides.

Reverse stress by playing a musical instrument. A groundbreaking study published in the February 2005 issue of the international research journal Medical Science Monitor shows for the first time that playing a musical instrument can reverse multiple components of the human stress response on the genomic level. "In simple terms, using a unique combination of the latest genomic technologies, we showed for the very first time that we could turn off the DNA-based switches that literally turn on components of human stress response," said Muhammad A. Sharaf, Ph.D., Senior Staff Scientist at Applied Biosystems. The study's principal investigator, Barry Bittman, M.D. of the Mind-Body Wellness Center in Meadville, PA, USA, says; "These unique findings not only shed new light on the value of active music participation, but also extend our understanding of individualised human biological stress responses on an unprecedented level. One possible explanation relates to the degree of active engagement in a calming expressive activity in contrast to merely settling down to relax and read. With ongoing research, recreational music making could potentially serve as a rational stress reduction activity along with other lifestyle strategies that include healthy nutrition and exercise."

Join the Herts Mind Network music playing group on Wednesdays 1:00pm to 3:00pm.

What is the first sign of madness? Hairs on the palms of the hands. What is the second sign of madness? Looking for them! ;) That is a popular school playground joke but for a fellow patient at a psychiatric day hospital it was a severely harsh lesson. He had attempted suicide by throwing himself in front of an approaching car causing his palms to abrade against the road. A skin graft from his legs resulted in hairs growing on the palms of his hands. He was keen that other people should understand his story which is why I present it here. He was an inspiration in the manner that he coped with his situation. He said to me: "Don't do what I did, go and get help." So if you are suicidal go and get help e.g. present yourself to your GP or an A+E. Modern medications have relatively few side effects and can improve your mood. "We can help you make a full recovery but if you damage yourself, well..." Source: Psychiatrist. Regarding the success of the NHS to treat patients it is apparent that: "They get it right most of the time." Source: Advocacy Counsellor.

Alcohol - Until recently, most people believed that the brain had finished developing by the late teen years. We now know that this is wrong. The brain is actually still developing during these years and even into young adulthood. Protect their brain and their future - the earlier your kids start drinking, the more likely they are to abuse it. Talk to your kids about the dangers of underage drinking.

Say no to that joint my friend. The Home Office is responding to new research evidence from Holland which links cannabis with an increased risk of mental illness e.g. schizophrenia. "Development of psychosis harm from the use of cannabis is four times higher for the 10% of the population predisposed to it." Source: Professor Jim Van-Oss of Maastricht University. Mental health charities have welcomed moves to promote a review of information and to bring attention to higher strengths of cannabis known as skunk. "More and more people with mental health difficulties are using cannabis and we can see a direct link between cannabis and their problems." Source: Mental Health Community. Hash, bhang, black, blast, reefer, joint, blow, dope, ganga, grass, marijuana call it what you will cannabis is not as benign as previously thought. "Don't take cannabis." Source: Psychiatrist.

Coping strategies may include:

• Only drink decaffeinated coffee, rather than regular, to enhance ability to sleep.

• Leave radio on when going out (not television as it may be a fire risk) so that your home will seem more friendly when you return.

• Use a telephone answering machine to screen incoming calls thereby minimising stress levels.

• Learn deep relaxation techniques. Apply at local day centre for classes.

• Listen to relaxing music e.g. Classic FM 100·0 - 101·9 MHz 2pm - 3pm or 7pm - 9pm most days.

• Listen to relaxing music to aid commencement of sleep e.g. use cassette / CD / MP3 player.

• When I am hypomanic I tend at times to snigger. Whilst at work a colleague was annoyed at this and retorted "What are you laughing at?!" Subsequently I wore my headphone radio to provide the excuse of an amusing programme.

Deep Relaxation Technique #1. - This has been a most beneficial complement to the other treatments I have received e.g. art therapy, drama therapy and medication. NHS day centres run weekly sessions. The ideal number of participating clients in a deep relaxation group is from five to twelve with seven being the optimum. I lie on my back with a pillow for support under my knees which relieves tension. I use a blanket to keep myself warm, especially my feet. I do not aim to fall asleep. I am fully alert throughout the deep relaxation session. It took me six months to acquire the skills I now use to calm myself, whilst fully awake, everyday. I am most grateful to my psychiatrist and community psychiatric nurse for insisting that I should persevere with learning the deep relaxation techniques and to the occupational therapists who instructed me. It is generally recognised that 20 minutes of deep relaxation is worth 2 hours of sleep.

Deep Relaxation Technique #2. - Brief account of full body relaxation exercise: Sit in a chair, preferably with the head supported, and relax. Deal with all of the worries that occupy you at that moment. If you can not solve them, then put them aside in an imaginary box. If possible, take a warm shower before you begin to get you more relaxed. Be sure that you will not have to go to the bathroom during the time that you will be trying this technique so use the bathroom beforehand. Unplugging the phone would be a good idea also. Starting with the feet, tense them and relax them slowly. Continue with the calves, thighs, hips, stomach, chest, arms, neck and face. Go over this a few times until you feel completely relaxed. Breathe deeply and slowly throughout this and try to become "aware" of the breath entering and leaving your body. The objective is to remain fully awake and alert throughout this exercise. Stay in the relaxed state for about 20 minutes. Adopt this excercise as part of your daily routine to achieve the optimum benefit. You may use calming music which can act as the timer for when to cease the exercise. Ideally you should attend relaxation classes e.g. held at NHS Mental Health Day Centres. Apply at your local Community Mental Health Centre. Relaxation is a progressive skill that can be learned and improved with time and practise. Be prepared that when you first go into deep relaxation unexpected things may happen e.g. twitching, strange thoughts, feelings of distress, crying etc. therefore it is wise at first to attend classes where there is support if these events are likely to upset you. Ideally there should be a qualified Psychiatric Nurse or Registered Mental Nurse on call. I believe that regular application of deep relaxation techniques has enhanced the quality of my life. Deep relaxation techniques are a complement to my medication and not a substitute. I use Deep Relaxation Techniques purely for the benefit of my health.

Deep Relaxation Technique #3. - It has been brought to my attention that some people use Deep Relaxation Techniques in the pursuit of: Divine Light, Bhuddist Trance, Yogic Flying and Astral Projection etc. If you are interested in the cosmic application of Deep Relaxation Techniques and would like to learn more then a good place to start is The Collective Unconscious.

The Expert Patient Programme is a new government initiative to help people living with long term conditions to maintain their health and improve their quality of life through self management courses. It is free and locally held. The course complements existing health care programmes and treatments. Contact: The Expert Patient Programme, 99 Waverley Road, St Albans, Herts AL3 5TL.

Cooking for one. Sadly, many psychiatric patients eventually find themselves living alone. Here is a quick and useful recipe ideal for bedsit preparation.
Scambled Egg
2 large eggs
6 tablespoons milk
½ oz butter or margarine
1 tomato
2 slices buttered toast

Put a stop to the rumours about microwave scrambled egg not being as nice as when it's made on the hob. This recipe is just as delicious and it's much quicker too. Serves 1. Beat together 2 large eggs and 6 tablespoons of milk in a microwaveable bowl. Add butter and season to taste. Put in the microwave and cook on HIGH for 60 seconds. Stir and return to the microwave and cook on HIGH for a further 60 seconds. If you prefer your eggs more firm, cook on HIGH for a further 10 secs. Serve on buttered toast with sliced tomato on the side. Source: Lizzie

Hearing Voices - When I was under great emotional stress and had a major mental breakdown a cynical voice impinged itself onto my mind yet I was alone. Was it an hallucination? It matters not to me as I shouted at it in my mind in a most forceful manner. This was most effective in banishing the rogue spirit.

Whilst on a psychiatric ward I declined the medication that I was required to take. The ward doctor was summoned immediately: "You see, when I prescribe medication for a patient it goes in him. It can go in you the easy way or it can go in you the hard way but it will go in you." I withdrew to consider his words when I heard a voice: "Nurse, is that syringe ready?" Since that day, some twenty years ago, I have been taking my medication the easy way.

Free Flu Jabs - In recently released Department of Health guidance, carers are included in the priority groups of people who are entitled to a free vaccination against flu. So if you want to avoid the aches, pains and fevers of flu and the difficulties it brings to your caring role, book a flu jab at your surgery. During the course of my recent medication review the nurse practitioner enquired if I had taken advantage of the flu vaccination. She explained that influenza can affect mental health. I've had my flu jab, have you had yours? Stay well.



Xtras

The library on the Harperbury site holds a specialist collection on mental health: books, pamphlets, government publications and videos on psychiatry and mental health and other health-related topics. Contact: Library & Information Services, Postgraduate Centre, Harperbury, Harper Lane, Radlett WD7 9HQ Tel: 01923 427205.

NHS Direct is a professional 24 hour advice and health information service. Most useful for a wide range of concerns and access to local support groups. Calls are charged at local rate. Tel: 0845 4647.

Are you ready to stop smoking? There are free NHS Stop Smoking Services now in St Albans and all of Hertfordshire. Freephone: 0800 389 3 998. Don't give up giving up.

DISH - Disability Information Service for Hertfordshire is a single access point for many disability information issues. DISH exists to provide information and support on all aspects of disabled living which will enable disabled people to access services and other entitlements and thus exercise more control over their lives. Freephone 0800 181067.

Day Centres - If we judge a society by the way it treats its mentally ill then let us continue to invest in quality day centres and vocational skills training units both NHS and voluntary sectors. There are many fine day centres, NHS and voluntary, offering a range of activities and information for mental health services users, survivors and respite for carers. Day centres often offer a gateway to vocational skills training units. Enquiries for NHS day centres via the receptionist at your doctor's surgery, local library or Dacorum Community Mental Health Team, St Pauls Unit, Slippers Hill, Hemel Hempstead, Herts Tel: 01442 230326. Community Mental Health Centre, Edinburgh House, 82 - 90 London Road, St Albans, Herts AL1 1NG Tel: 01727 830031. Or contact voluntary sector day centres direct: Trinity Day Centre, Trinity United Reformed Church, Beaconsfield Road, St Albans, Hertfordshire AL1 3RD Tel: 01727 838671. Therapeutic Day Centre, Community Meeting Point Harpenden, Unit 5, 16 - 18 Bowers Parade, Harpenden, Herts AL5 2SH Tel: 01582 763204. Investigate local branches of MIND in telephone directory. Most day centres, both NHS and voluntary sector, will require a health care staff referral.

Open Door Club is a friendly environment to meet and chat with fellow service users every Tuesday 10:30am to 12:00pm at Friends Meeting House, 12 Southdown Road, Harpenden, Herts. Tel: 01582 764593.

POhWER - The advocacy agency. This organisation is also known as People of Hertfordshire Want Equal Rights. "Our Mission is to give power to your voice." POhWER now incorporates Equal Voice (Stevenage and North Herts) and Advocacy Now (St Albans). POhWER, 551 Lonsdale Road, Stevenage, Herts SG1 5DZ Tel: 01438 740162.

EarthWorks is a horticlutural project for people of all abilities. Current activities include heavy and light gardening, building work and conservation. Contact details: 16 Gombards, St. Albans, Hertfordshire AL3 5NW Tel: 01727 847311.

Alzheimer's Society - St Albans, located at 22 Catherine Street, St Albans, Hertfordshire Tel: 01727 812035. Alzheimer's Society, Lord Alexander House, Waterhouse Street, Hemel Hempstead, Hertfordshire Tel: 01442 260088.

Camphill St Albans - Camphill St Albans provides a social network of support for people with mental health problems, learning difficulties and other special needs. Camphill St Albans, 76 Sandridge Road, St Albans, Herts AL1 4AR Tel: 01727 811228.

ViewPoint - "Difficulties facing mental health services users include stress, benefits trap, stigma, isolation and side effects of medications." - Newsletter Sept 2004. Would you like to help improve mental health services in the county? Then ViewPoint would like to hear from you. ViewPoint exists to empower and support people who use or have used mental health services to be part of the decision making process. This is not about the world that we inherited from our forefathers, it is about the world we have borrowed from our grandchildren... For more information contact: View Point, 62b Bridge Road East, Welwyn Garden City, Herts AL7 1JU Tel: 01707 328014. I recommend ViewPoint.

The ViewPoint Hertfordshire remit includes: Abbots Langley Amwell Ashwell Baldock Bedmond Berkhamsted Bishop's Stortford Bishops Stortford Borehamwood Bovingdon Braughing Bricket Wood Brookmans Park Broxbourne Buntingford Bushey Cheshunt Chorleywood Codicote Colney Heath Cuffley Dane End Elstree Essendon Flamstead Goff's Oak Goffs Oak Harpenden Hatfield Hemel Hempstead Hertford Hinxworth Hitchin Hoddesdon Hunsdon Kimpton Kings Langley Knebworth Letchworth London Colney Markyate Oxhey Park Street Potters Bar Radlett Redbourn Rickmansworth Royston St. Albans Saint Albans Sawbridgeworth Shenley South Mimms Standon Stanstead Abbots Stevenage Tring Waltham Cross Ware Watford Watton At Stone Welwyn WGC Welwyn Garden City Wheathampstead Whitwell

Dynamic prosumers are welcome. The exact cause of most mental disorders remains elusive. Many theories are proposed, ranging from the psychological to the biomedical. Conventional wisdom considers that there may be a genetic chemical imbalance component involved. "You can't think your way out of it." Source: Psychiatrist. It is apparent that some patients are vulnerable and by default our mental health community resources are susceptible to adjustment from fiscal and logistical responsibilities e.g. witness the subliminal shifting sands of diverse opportunities at daycentres and training units. We need to be proactive in order to benefit from the package of care delivered, realise self fulfillment and enhance the effectiveness of mental health community resources. Hertfordshire Partnership Trust has ambitious plans for service user involvement. They are looking for knowledgeable and enthusiastic Service users to create a Service User's Council that will help Hertfordshire Partnership Trust develop mental health services that are more service user focused. Payment of £10 per hour is offered. More information via Jo Burnham, Service User and Carer Involvement Lead, Mental Health Services, Hertfordshire Partnership Trust, 99 Waverley Road, St Albans, Herts AL3 5TL Tel: 01727 897761

"Mental Health is a Cinderella service." That is a most unfortunate tired old cliché, it is important that we don't talk the service down. Inverted stigma and mentalist discrimination attitudes are passé. Career candidates requiring a vibrant, exciting environment with opportunities for advancement would do well to consider a future working in the mental health services.

Advance Directive is an advance statement enabling a person, who may be receiving mental health services in the future to leave instructions about their care and treatment in anticipation of a time when they are no longer capable of making these decisions during times of illness. Your Advance Directive can include requests from you, directives (refusals) of certain types of treatment and a reflection of your wishes and preferences e.g. who you want informed of your care. You may also want to inform the medical staff of what has worked well for you in the past with regard to your care. To obtain an Advance Directive contact: Medical Records Department, Albany Lodge, Church Crescent, St Albans, Herts AL3 5JF Tel: 01727 834330.

Turning Point is a national organisation that supports people who have severe mental health difficulties. It aims to work with people who may have experienced difficulties engaging with other services, or who have slipped through the net of traditional social care due to their complex needs. Turning Point includes support for those who are at risk of losing their tenancy as a result of a mental health problem, learning disability or substance abuse. Contact local branch: The Centre, 139 Leighton Buzzard Road, Hemel Hempstead, Hertfordshire HP1 1HN Tel: 01442 262573 / 212800.

EastForward is the newsletter of NIMHE Eastern - one of eight development centres of the National Institute for Mental Health in England. NIMHE is part of the NHS Modernisation Agency. Their aim is to support and facilitate local activity to develop statutory and non-statutory mental health services in Bedfordshire, Cambridgeshire, Essex, Hertfordshire, Norfolk and Suffolk. If you would like to be added to the mailing list contact: Valerie Lofthouse Tel: 01206 287593.

The Bereavement Network aims to help anyone in the St Albans City and District to have access to free bereavement support. All support will be given by trained volunteers who will respect your confidence. Contact: St Albans City & District Bereavement Network, PO Box 671, St Albans, Herts AL1 3ZX Tel: 10am to 12pm or 1pm to 3pm on 01727 841841.

Nurse Practitioner - There is a new kind of nurse working at GP surgeries across the land. She has a wealth of practical commonsense experience, legible handwriting and is competent to deal with medication reviews, daycentre referrals, flu jabs etc. Witness her credo; "Prevention is better than cure." Although the nurse practitioner is not a fully qualified doctor she delivers a most useful service and relieves patient pressure from GPs. I only see doctors when I have to.

ICE - A friend told me about a scheme whereby you put your next of kin's name and number in your mobile phone in case you have an emergency. It's called ICE, and it's a brilliant yet simple idea launched by an East Anglian ambulance paramedic, Bob Brotchie, in 2005. You enter the acronym ICE - short for "in case of emergency" - into your mobile phone's contact book alongside the number of someone who should be contacted in an emergency. In the event of need the emergency services will know immediately whom to call, saving lots of wasted time.

We are all aware of the shocking suicide statistics of young men with a mental health issue as documented recently in the BBC Radio 4 programme All In The Mind which is usually broadcast on Tuesdays at 9:00pm and repeated on Wednesdays at 4:30pm. Questions on this issue and content of the programme in general may be raised in confidence via the Action Line on Freephone 0800 044 044.

Funding - Are you a local group run by people with experience of mental health problems? Are you trying to bring about better mental health services or to improve people's attitudes to mental health issues? Do you need money for your running costs like rent, bills and travel? If so then read on! Comic Relief is offering small grants (of up to £5,000) to support user-led mental health groups who can help people with mental health problems to get their voices heard and campaign for change. For more information download:(comic-relief.pdf 29Kb). Or contact: UK Grants Team, Comic Relief, 5th Floor, 89 Albert Embankment, London SE1 7TP Tel: 020 7820 5555.

To read the PDF you may require free reader software from Adobe

Pension - Am I entitled to the basic state pension even though I have not always worked? Your contribution record will be credited as having been paid, making you eligible for the basic state pension, if you received any of the following when you were not earning:

• Invalid Care Allowance.
• Disability Working Allowance
• Jobseeker's Allowance.
• Incapacity Benefit
• Severe Disablement Allowance

Plan for the future with the help of a DWP pension forecast. This could be most useful if you expect to be out of employment and on benefits for a prolonged period of time. Tel: 0845 3000 168.

For free advice on pensions including help with problems contact: The Office of the Pensions Advisory Service (OPAS), 11 Belgrave Road, London SW1V 1RB Tel: 0845 601 2923.

Mental health legislation is extremely powerful. It allows the state to deprive people of their liberty purely because of their medical condition. I believe that any compromise of a person's rights and freedom should be balanced by safeguards. People with mental health difficulties should have the right to help when they ask for it. Patients should only be detained against their will if it will benefit their health. They should have access to an advocate and their carers and family should be involved.

Computers for the Disabled is a registered charity, run solely by volunteers. They aim to help disabled people communicate on the internet and participate in electronic activities by recycling computers and accessories e.g. digital cameras. By providing disabled people with extremely low cost computers, the charity is giving them an alternative means of keeping in touch. For more information Tel: 01268 284834.

Computer Club - Monday and Thursday from 2:30 - 4:30pm at the Bill Salmon Centre, Town Centre, Hatfield. Drop-in free computer access including games, word processing, internet, desk top publishing etc. There is always support and guidance available.

Computer Courses - (with Oaklands College) - Wednesday pm. Basic computing and CLAIT. More information via Mind in Mid Herts, Tel: 01727 865070.

Drop-in - every Tuesday 10am - 12pm at the Free Church Hall, Church Road, Welwyn Garden City - for people facing issues such as bereavement, stress and mental health problems.

What is meant by disability? A disability is a restriction or lack of ability to perform an activity in the manner or within a range considered normal for a human being. A handicap is the disadvantage resulting from an individual form of disability within a specific environment. A person is disabled if:

• They have a mental or physical impairment.
• This has an adverse effect in their ability to carry out normal day to day activities.
• The adverse effect is substantial.
• The adverse effect is long-term (meaning it has lasted for 12 months or is likely to last for more than 12 months or for the rest of their life).

Disability Discrimination Act 1995

Survivors Speak Out was founded in 1986 by a group of mental health service users and workers. The use of the term survivors was chosen to portray a positive image of people in distress and people whose experience differs from, or who dissent from, society's norms. People who use the statutory mental health services are often referred to as patients or users. People who use the voluntary mental health services are often referred to as clients or particularly as members if they have joined the organisation and have voting rights. Some users of mental health services often feel stigmatised and stereotyped by society. The language that people choose can compound this prejudice. Some users find the term 'mental illnes' offensive and as a result may prefer the phrases 'mental distress', 'emotional distress', 'mental health problems' or 'mental health difficulties'. Please be aware of the words you use. Although I am not too fussed about any labels that are applied to me I do believe it is important how we define ourselves.

The Lions Message in a Bottle is a simple idea that encourages people to keep their basic personal and medical details in a common place where they can easily be found in an emergency. The information is kept in a bottle. The bottle is kept in the fridge, where the emergency services will expect to find it in the event of being called to your home. They will know you have a bottle by two labels. One is fixed on the inside of the front door or the main entrance to your home and the other to the door of your fridge. Health Centres, Doctors' Surgeries and Chemists should have free supplies of bottles in this scheme. If you have difficulty please contact your Local Lions Club or Tel: 0121 441 4544.

Disabled people "suffer healthcare gap". An investigation into healthcare given to people with mental health problems and learning disabilities shows they often get worse treatment than others. The Disability Rights Commission (DRC) - which examined eight million health records - says the government could face legal action unless things change. The study concentrated on primary care in England and Wales, which will soon fall under new equality laws. The government says it has already started acting on the report. The 18-month investigation shows that people with learning disabilities and mental health problems are more likely to have a major illness, to develop a serious health condition younger and to die sooner than the rest of the population. Such people were less likely to have routine tests and screening to pick up signs of a problem in its early stages. "Lazy fatalism." The DRC also found that people with learning disabilities and mental health problems face "real barriers" when accessing services. "The acid test of a national health service is not whether it works for those who are generally healthy, but whether it benefits those with the greatest risk," said DRC chairman, Bert Massie 10/04/2007.

Books on Prescription - This new scheme in Hertfordshire follows the model of others which have recently started across the UK to help the many of us who experience emotional or psychological problems at some time in our lives. Recent research has shown that medicines do not always need to be the first choice of treatment. If you choose to use the scheme, your GP or another health professional can prescribe a self-help book from your local library. This will give you information about your condition and suggest ways to help you manage it. The books have all been recommended by experts and offer one way of treating patients with health problems such as anxiety, depression, stress or eating disorders.

Your doctor will suggest the best book for you and will give you a "prescription" which you can take to your local library to get the book. If you are not a member of the library you will be asked to join when you take your prescription in. It is very simple and free to join and you will then be able to use the whole range of library services, inluding internet access. The library staff will be pleased to help you and will provide your book in confidence. If you feel the book has not helped and you still have difficulties or distress you should return to your GP/health professional who will give you more help. For further information or to use the scheme ask at your local library, or Tel: 01438 737333 or 01923 471333 or check the Web Site.

Open Door Nightshelter is a direct access organization offering temporary accommodation to homeless people. The address is 8 Bricket Road, St Albans, Herts Tel: 01727 859113.

Dacorum & District Mental Health Support Group - Meet on the first Thursday of the month at the Berkhamsted Day Centre, (behind the Social Services building) Manor Street, Berkhamsted, 7:45pm to 10:00pm. For more information Tel: 01442 215117.

SMS Text Messaging Service for Hertfordshire Partnership Trust users. A text message reminder for service users to attend appointments. Please ask at reception of The Community Mental Health Centre, 82 - 90 London Road, St Albans, Herts AL1 1NG Tel: 01727 830031 for a consent form.

Older people across England are being left housebound and disabled by a lack of footcare services according to Feet for Purpose, a major new report from Age Concern. One in three people over 65 - over two million older people in England - cannot cut their own nails. Increasingly nail cutting and other footcare services are being withdrawn or restricted by the NHS. Although nail cutting may sound trivial, lack of even the most basic footcare frequently leads to complications that can result in dangerous falls, severe restrictions on mobility and social isolation. Find out about the Feet for Purpose campaign via Freephone: 0800 00 99 66. Alternatively, if you would like to find out whether your local Age Concern runs a foot care clinic please Tel: 020 8679 1609.

What is a SCAM? - Scheming Crafty Aggressive Malicious. A scam is a scheme to con someone out of their cash. Many scams take the form of bogus and fraudulent offers sent by post, telephone or e-mail. Every year, three million people fall victim to scams, losing an average of £850 each. Fake lottery and prize draw wins, bogus psychic preditions, get-rich-quick investment cons and 'miracle' health cures are just some of the tricks scammers try. Though anyone can fall for a scam, the elderly and vulnerable are more likely to be targeted. Anyone who thinks they have been the victim of a scam, or suspects a scam is being attempted, can contact Consumer Direct on Tel: 08454 04 05 06 for clear, practical advice. For free copies of more information Freephone: 0800 389 3158.

The St Albans Exercise Referral Scheme (ERS) is a 12 - 24 week programme of physical activity to help improve a variety of medical conditions including mental illness. Being more physically active can relieve tension and stress, reduce depression and anxiety. The ERS enables Health Professionals to refer patients, who meet the criteria, to qualified exercise professionals for an appropriate personalised programme of physical activity. For more information please contact St Albans Arts, Sport & Health Development Team on Tel: 01727 827667.

My mission is access for all to mental health community resources information via free internet distribution - working for our community. This web site was inspired by my Community Psychiatric Nurse who remarked how useful it would be to have one place to go for information on mental health benefits and concessions. I believe that eventually there will be a mental health survival guide network covering the United Kingdom. I have made a small step towards this goal by helping a service user in Watford create his own web page. Whilst encouraged by my success to date, I am driven by my vision for the future. Tell your friends! Give a Flier.

Legal stuff applies - All expressions in this communication are personal, non-commercial opinions of the author (not aware of violating © Copyright but will delete if brought to attention) and do not represent a commitment. This web site is independent of the statutory services. This is not a commercial web site and is intended solely for informational purposes and not a substitute for medical evaluation, treatment or consultation. Individuals with medical or personal problems are strongly urged to seek advice from physicians or mental health professionals. Users interested in medical advice or treatment must consult a licensed practitioner. No doctor-patient relationship is created through the use of this web site. Commercial advertisements appear on this web site only in exchange for services.

All content within Mental Health Survival Guide is provided for general information only and should not be treated as a substitute for the medical advice of your own doctor or any other health care professional. I am not responsible or liable for any diagnosis made by a user based on the content of the Mental Health Survival Guide website. I am not liable for the contents of any external internet sites listed, nor do I endorse any commercial product or service mentioned or advised on any of the pages of the site. Always consult your own GP if you're in any way concerned about your health.

I am neither responsible for any action that you do take, or that you do not take, as a result of the contents of this web site.

No part of this work may be reproduced or transmitted in any form or by any means (photocopying, electronic, recording or otherwise), except for personal, non-commercial use.

This web site does not discriminate against ANY browser. The Viewable With Any Browser Campaign is an effort to promote a web that is not designed for one specific browser. "Anyone who slaps a 'this page is best viewed with Browser X' label on a Web page appears to be yearning for the bad old days, before the web, when you had very little chance of reading a document written on another computer, another word processor, or another network." - Tim Berners-Lee in Technology Review, July 1996.

Apology - Some people with no social or moral values have been excessively spamming me through the e-mail form that used to be on this page. The junk e-mail I am now receiving is so copious and invidious that I feel compelled to suspend reader feedback via the e-mail form until I figure out a resolution to the problem. I can assure you that I am extremely upset by this, as my readers represent the heart and soul of this site. Please bear with me and keep checking back. In the meantime you are most welcome to submit your comments via the Guestbook. Once again, my sincere apologies.

Conclusion - This document is neither finished, nor is it even all that current. It reflects my thinking during the Spring of 2008, which is the last time that I had the luxury of spending three months thinking about these kinds of things. The world changes rapidly; in some ways this document is now hopelessly out of date. In other ways, though, it still retains some valuable insights (at least, in my humble opinion). You'll have to be the judge, as the reader, because I have neither the time nor the inclination these days to try to keep this document updated. So this is definitely probably the last you'll hear from me for a while. This text is still largely the same text I wrote that Spring, with occasional grammatical and spelling fixes. Caveat emptor!

But does this mental health web site make me an authority? No. If I've an overall message here, it's check things for yourself. Don't trust a site just because it's telling you what you want to believe. Don't believe me without evaluating my arguments and checking the references I provide either, (I'm as likely to make mistakes as anyone else). Look into the claims yourself, discover both sides of the argument and make your own mind up. The truth deserves nothing less.

The past was grim but with the developments of the 21^st Century there are bright prospects for many psychiatric patients. I would like to take this opportunity to thank the people, both professionals and volunteers, who encouraged me to take advantage of the treatments offered that have enhanced my generally good health.

If you are planning on leaving please remember to sign my Guestbook. Thanks!... Now that's what I call interaction. I enjoy receiving e-mails and telephone calls from visitors to my web site so do feel free to use the contact details below. Good luck & stay well.

Best wishes, Bob Houlston

Tel: St Albans 01727 851809.