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Is Business Spending on Mental Health Worth it?

Is it Worth it for Businesses to Spend on Improving the Mental Health of Employees?

How Taking Care of Your Employees' Mental Health Can Give Back to the Business

By Dr Meetu Singh | December 2021

As a business owner, when it comes to envisioning a new venture sustainability and success, mental health and emotional wellness is not often even considered at the outset, much less focused upon. In this article, hope is to inform on how and why it ought to be.

Primarily, an understanding of the scale of the problem must be known and understood:

  • In 2020 a staggering 79% employees experience work-related stress, compared to 59% in 2018. (1)
  • Around 15% of people at work have symptoms of an existing mental health condition, at any given time. (2)
  • Annually, up to 300,000 people with mental health problems lose their jobs. (3)
  • Annual Cost to UK businesses due to mental illness is between £33 billion- £42 billion, due to staff turnover, sickness absences and presenteeism, latter defined as, when individuals are less productive due to poor mental health in work.
  • Every £1 spent on mental health of employees returns £5. (4)

It can therefore be stated with some confidence that it makes ethical sense that employers shoulder some responsibility of taking care of their workforce. The next question that comes up is, is a considered approach towards mental health and wellbeing required by law?

Employers have a ‘duty of care’. to do all they reasonably can to support employees health, safety and wellbeing. This includes, making sure the working environment is safe, protecting staff from discrimination, carrying out risk assessments to ensure they can dispose of their duties safely and effectively. (5)

 

What are the financial implications?

Do measures taken by businesses to improve mental health and wellness make business sense? On exploring the current research evidence, the following comes to light:

Better mental health support in the workplace can save UK businesses up to £8 billion per year. (6)

In another large study within a company with 500 employees, promoting wellbeing at work through personalised information and advice, a risk-assessment questionnaire, seminars, workshops and web-based materials will cost approximately £80/ employee/ year, therefore for all the employees to undergo the intervention, an initial investment of £40,000 will result in a net return of £347,722 in savings, mainly due to reduced presenteeism (lost productivity that occurs due to an employee working while ill) and absenteeism (missing work due to ill health). (7)

Spending £30.90 per employee for assessment, and a further £240.00 for the use of CBT to manage the problem, on screening and care management for those living with (or at risk of) depression in a company of 500 employees where two thirds are offered and accept the treatment, an investment of £20,676 results in a net profit of approximately £83,278 over a two-year period. (8)

A study in Geneva, found that every ¬1 invested in occupational health and safety generates a return of ¬2.20. So, health and wellness schemes not only save money, but they also lead to increased profitability. (9)

Healthy workers build a positive brand image in terms of public relations, talent acquisition and employee retention, boosting the morale and loyalty of those in the company, therefore reducing recruitment costs.

 

What can businesses do?

Are you left wondering, well the world is a tough place, how can the employers help that? To the relief of 1/3rd of the workforce who suffer and live with mental health challenges, businesses can make a significant difference to the quality of life at work, safety and general wellbeing of the employees as demonstrated by the studies above. This is what caring businesses can achieve with a relatively small investment:

 

Produce, implement and communicate a mental health at work plan with perhaps the following aspects:

 

Provide Good Working Conditions

Promote effective people management– A firm but gentle management style with empathy and understanding encouraged in the organisation, would go a long way in preventing work related stress. The work ought to be fairly and reasonably distributed in keeping with each persons capabilities and pace. Bullying and harassment, a major cause of stress at the workplace, needs to be dealt with swiftly and appropriately.

Healthy physical environment at work is more important than people think, well lighted, airy, non-cluttered and aesthetically pleasing offices provide a healthy environment as proven by the “hit” designs of Google (USA), Missing Link (South Africa) offices.

 

A Culture of Openness about Mental Health & Wellbeing

A culture of wellness can be cultivated without a great deal of spend, Mental health ought to be a topic people discuss openly without the stigma of being labelled or discriminated against. Encourage open and honest conversations about mental health.

 

Mental Health First Aid

Developing mental health awareness throughout the ranks. It must be understood that mental illness is just that, not weakness or something to be ashamed of, after all statistically speaking a third of the most successful people suffer from it.

Formal training- to be able to identify, bust the myths & learn the facts, how to support people with these issues is of paramount importance in this process.

 

Routine monitoring of employee mental health and wellbeing

Making monitoring of general mental health and wellbeing through open discussions with line managers, forums and questionnaires, will in the medium and long term be useful.

 

Workshops About Managing Stress and Anxiety

These can be valuable, regular grounding, mindfulness, relaxation and breathing exercises should and hopefully be deemed as important as physical exercise is to boost physical health. In the past, some of these practices have been branded part of the hippie movement. Again, time to change attitudes, right?

 

 

References

1. The 2020 UK workplace stress survey, Perkbox

2. Managing and supporting mental health at work: disclosure tools for managers, Dec. 2011

3. Thriving at Work: a review of mental health and employers, An independent review of mental health and employers by Lord Dennis Stevenson and Paul Farmer, Nov. 2017

4. Mental health and employers: refreshing the case for investment, Deloittes

5. Supporting mental health at work, ACAS

6. Briefing 40: Removing Barriers. The facts about mental health and employment. Sainsbury Centre for Mental Health. 2009

7. Mental Health Promotion and Mental Illness Prevention: The Economic Case. Knapp, M., McDaid, D., & Parsonage, M. 2011

8. Mental Health Promotion and Mental Illness Prevention: The Economic Case. Knapp, M., McDaid, D., & Parsonage, M. 2011

9. Calculating the International Return on Prevention for Companies: Costs and Benefits of Investments in Occupational Safety and Health International Social Security Association (ISSA)

 

For information or formal consultation about effective Mental Health at Work Strategic Plan, please contact us. Email us at contact@oaktreeconnect.co.uk.

Dr Singh is the consultant psychiatrist with a special interest in neuropsychiatry.  Having seen and treated hundreds of patients with ADHD, in London and Birmingham and with masters in Neuropsychiatry, she is well known as an expert in this field. 

Contact: 
Email – clinicadmin@oaktreeconnect.co.uk
Telephone – 020 39277699
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Informative Video About Fear & how to tackle isolation during COVID-19 Outbreak, Dr Francesca Mantia Conaty

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COVID-19: Looking for the Positives & Appreciating the Gift of Time

COVID-19: Looking for the Positives and Appreciating the Gift of Time

A Challenging and Unexpected Event Can Be Seen As An Opportunity to Prioritise Your Mental Health

By Farzana Rahim | March 2020

The current coronavirus pandemic has been frenetic and a scary time for all. At Oaktree Connect, we urge you to at stay home as suggested by the government. However, this period of time does not have to be all doom and gloom! For most of us, our day to day lives are very busy and we are always on the go. How many of us have thought ‘I don’t have time’?. If you find no positives in this situation, take this as one of them: you have been given the gift of time. In this post, read on for tips on how to fill your new-found time.

It can be very stressful constantly trying to stay up to date with the news and scrolling through social media. Therefore, it may be wise to take breaks from hearing about the pandemic so try to have a tech-free hour! In current times, we are so immersed by technology. Challenge yourself to try something new for an hour.

Exercise is really important whilst we are trying to practice social distancing. Research shows that exercise has benefits for physical well-being as well as mental health. Exercise has been proven to help with decreasing symptoms of depression and anxiety through the release of endorphins.

If you love learning and want to feel productive, stimulate your brain by taking an online course. There are many free online courses in a variety of subjects with just a google search, there is no doubt that something will spark your interest.

Cook something new! Personally, this is something that I have been doing. I am not a great cook, but I have found cooking to be very therapeutic and it has helped me to feel productive. I recently and successfully made pizza from scratch and this has inspired me to explore more recipes. Let us know below if you have recently tried a new recipe!

Have you been meaning to unwind but until now you haven’t been able to? This is the perfect time to have a movie marathon. Let us know your favourite movies below.

Stay in touch with loved ones. Is there a friend who you haven’t spoken to in a while? Why not call, text or video call them? This is a perfect time to reconnect or strengthen social bonds with those who are dearest to us.

Structure your day. Time can seem never ending as there is so much of it at the moment. It can be good for your mental health if you like to have structure and stability. Chunk your time into work and social time to make sure your day is well rounded.

Self-isolation, although tough it doesn’t have to be boring and unproductive. If the above activities are something you have been doing recently, let us know in the comments as we would love to hear from you. Alternatively, if you have further suggestions, we would also love to hear from you too! For now, stay safe. Stay strong.

Farzana Rahim, Oaktree Clinic Administrator

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Dear Mum: A Story by an Oaktree Patient with Depression

Dear Mum

A Story By An Oaktree Patient With Depression Based on Their Own Experiences


Trigger warnings: Suicide, eating disorders, body hatred, assault, abuse, alcohol abuse.

The content of this story may be emotionally challenging. Discretion advised.

Through persistent denial of the looming, black “ bellied thunderhead of his shadow, she had tried to keep still “ as still and as quiet as a bunny in a bush – for one move, one rustle, one hitched breath and he’d see her. She didn’t want to look at him. She knew she shouldn’t through years of learning that one look was enough. Calypso Barbie when they first met. 

“Hello, Penelope, my name is depression did Santa bring you lots of nice things today?” 

A blood stain on her summer dress, the sixth form exit button, Lady Macbeth, gin. And now, famished through the weight gain, through the medication, through the doctors and a cauliflower for dinner.

“Why, Penelope, you know we really shouldn t keep meeting like this.”

She stared down at that pathetic cauliflower before her and felt her foot slip, the brambles in the bush snapped and seemed to cackle, she caught her wrist on a thorn and everything that she had been hiding from billowed in the air and fell upon her like a 50-mile-wide, black parachute. 

“What’s the matter? Are you not enjoying your cauliflower?” 

Through time and familiar sights and smells one can sometimes run but where is there to go when the innocuous cauliflower is no longer just a cauliflower and produce turns trigger.

“No, I’m not.”

“Well now,” he said. She felt a familiar hand rest lightly upon her shoulder as he bent down and whispered in her ear with that intoxicating purr she both missed and loathed. 

“What a pity.”

 

Dear mum,

Please forgive me, please don’t blame yourself, I know you may not understand, and this is selfish.

 

In placing a heavy chess board between herself and her mother, chequered with life and death (was her mother white or black? Is death white or is death black?). He once again accompanied her to therapy and split a gut at the comedy. 

“TRIGGERS,” he bellowed, clutching his stomach, “Why this fellow should do stand up.” 

He went with her on long walks. 

“Gosh, isn’t nature ugly. Look at that fat ox over there, trying to better himself.” 

He sat with her when she tried to read. 

“I wrote this book, you know,” he said, leaning over her shoulder, “Silvia Plath, pure plagiarist.” 

He kicked things about her room when she tried to tidy, he sprinkled soiled cat litter on her food, he tucked her in at night and kissed her forehead, he stroked her hair in the mornings. She lay with him, lovingly cradled in the crook of his arm. He listened to her, he smoked cigars and watched her from across the room. “You will always be someone to me, Penelope.”

 

Dear mum,

I don’t want to ruin your life and hate that you might not now ever have a merry Christmas or that you’ll forever live in dread of my birthday, a day in remembrance of a life given and then thrown away. But I hope that you will come to see, in time, that all the other days are actually all the better. You’re a great mum.

 

Picked up by the nerve strings, the pickup – or rather the drag down – is merely preliminary and he rarely bothers with it himself. In his tricky subterfuge, he recruits his cabinet to break her so he can play the hero.

First, there comes the woman, with her taunting beauty and her words spoken so sweetly – a vacuum in and of themselves – with a sinister distractedness, she prods at the flaws on Penelope’s face. 

Did Satan spit you out? You’re just so ugly.” 

The ever-self-destructive profligate, stinking of vodka and poking Penelope with a gnawed toothbrush.

You’re hungry. Here, you can take it out again afterwards.”

The fearless musketeer and his watchful python.

“What’s the matter, Penelope? Why I think you’re having a heart attack, you’re choking, you can’t breathe.”

The hag of the haunted house. 

“Do you remember, do you remember, do you remember?”

The petulant child.

“That therapist is a hateful brute!”

And the old man and his wild and frenzied raven, who give her sticky thoughts – thoughts that stick to everything, so that she can blindly appreciate nothing. They make her teeter and question, gulp sulphuric pus in wondering – am I? Should I? Will I? Did they? Is that true? With each one of them a kettle weight, the descent is perpetuated by a heavy thought process, until he catches her like a dark prince and the mind begins to melt as if doused in acid, seeping through the eyes. “I’m not crying, my mind is melting” into a world of HE.

HE is the solitude of a dripping tap, the mould eating the plaster, the cockroaches, the infestation. HE is the old man weeping in a broken chair, his mind melting. HE is the girl who opens her legs and immediately feels the need to apologise, her mind melting. HE is the waste that chokes the seahorse and dirties the plumage of the noble swan, HE is the bullet that fells the proud stag, the warm needle in the shivering vein. It is HE, who suckles the breast of every man, girl and abandoned child as the mosquito does blood, who has made her face no longer a face – her eyes do not tear, her eyes her mother will no longer meet, her eyes now the red of picked-at sores. Each organ slows to its final pulsing beat – from tissue to turning leaf and she will soon to be dust.

 

Dear mum,

I’m frightened, I’m frightened of it and I’m frightened of the battle, the same battle I must keep fighting as his numbers grow while mine diminish. Will I ever be able to turn my back? It is said that Abraham Lincoln used to storm through the woods with a shotgun in his hand on every successive assault.

 

Two weeks have now passed, and he comes to show her what her life is. She sees herself lying on the bed asleep, or awake dreaming, lying amongst his allies who will never leave her to ensure that she will never leave him. She sees the old hag tormenting the mouse that was her rationality. She sees the fluttering fawn, once her feather of happiness, chained to her self-destruction and covered in cigarette burns. Her beautiful insecurity blows a kiss at the squawking raven as the beloved pet of her fear is snaked around the chandelier and watches her sleep with eyes meaner than cat piss. Linen in anarchy and waste scattered like blasted brick, are swathed beneath the hovering wraiths of her dreams. Above, they twirl and float as the ballerina floats – but their skin has now taken the form of their bones and the residual, oscillating ribbons of putrid hope left to rot, smell of sewage and nicotine.

He scoffed in the face of dreams.

“Dreams,” he’d say, “Dreams are like lily pads for the croaking toad. But one must plop back into the pond to sustain oneself and SNAP comes the cunning water snake. It is better to learn to hide than to fool oneself and forget what is lurking.”

So she let them die. Dreams die a slow death, and they let one know it for the lingering stench.

 

Dear mum,

I do not feel like a person because I am so afraid of people. Does a zebra fear the zebra as it does a lion? Why is it that when I look at a person s face, they seem less human to me? Why is it that a woman is ugly when she whispers but a man is oh so beautiful? Men do not whisper to me I left the reading and the man thanked me for coming. If he hadn’t thanked me for coming, I’d have said he hates me. But he did thank me for coming and so I say, he hates me. I was in a lift with a boy, when we got to his floor, he walked out too fast. Do you understand, mum? Does this help a little?

 

“So,” he says. He stands behind her with his hand on her shoulder. The slick black of his cane slices through the periphery of her vison. “How are we doing on the food front?”

“Good. I’m on two weeks.”

“Not a morsel?”

“No, nothing.”

“And your mum?”

“Great, said I look thinner every day.”

“Good,” his voice is warm with stoic pride as he gives her shoulder a gentle squeeze. “You’ve done very well. If you’re sure this is how you want to go about things. There are easier ways.”

“I know,” she answers and swallows down the modicum of doubt once again blossoming, as persistent as the dandelion, in her throat and chest and stomach. “But I’m a coward and I don’t want to hurt anyone. I don’t want her to find me, and I can’t get the note right. It’s better this way.”

“Very well, let’s be off then.”

The gym is empty, there’s no one there, no merciless humming of machines, no jousted joints. He leans languidly against the treadmill and adjusts the speed every two minutes, until she’s on 6mph and can feel her feet and trainers infuse into one static mass. It crawls upwards, ankles now frighteningly numb, then the knees begin to lose pressure.

“I hate it here,” he scoffs. Disgust etched on his face with a hard grimace, he observes the room from beneath the velvet rim of his top hat as if afraid to expose his eyes to the pungency. The place REEKS of endorphins.

Endorphins are good for people.

“Endorphins are a lie!” He snaps and fixes her with a hard, penetrating stare that seems to manifest as a ringworm in her gut. “You feeling anything yet? Chest pains?”

“I feel sick.”

“Right stop!” He slams his hand down on the stop button and yanks her backwards by her elbow. His grasp is hard and violent, and yet his face remains impassive as he drags her weak and stumbling to the door.

“Why did you stop me?”

Because, turning to face her and cocking his head in mock perplexity which makes her shiver. “You’re going to faint, and a fainting spell will only work against us. On to the next.”

He takes her to the city centre, his cane tap tap taps against the cobbles – it sounds like the beating of a rusty heart. They sit by the fountain and the ice-cold marble travels up her spine, from arse to aorta.

You’ll get piles,” her aunty Beth used to say. The bottom of the sleeping fountain is peppered with coins, clutching the dedicate little wishes of children. In the daytime they glimmer and twinkle like rebellious stars, but in the dark they lie in the murky water dead and dirty and useless. There are no stars in the sky tonight. Drunks stumble about beneath, laughing coarsely like syphilis-infested libertines.

“Well now,” he says, “If your heart won’t do the dirty work, perhaps someone else’s will. Now, make yourself look vulnerable.” He straightens her back and overbearingly lifts her chin with his fingers.

“In case you haven’t noticed, I am vulnerable.”

“No, you’re too hard in the face.” Leaning in close, he winks with the dark luminosity of an onyx and murmurs behind a wayward grin: “Sweet little girls are much more fun to strangle.”

 

Dear mum,

I know I shouldn t do this, I don’t want to hurt you. I tried, I promise I really tried but I can see nothing and feel everything while empty and the still silence thunders and I can’t catch my breath while I sleep. The man sits there, before the girl without a gun to her head so he’ll just talk to fill the time. There is wanting to die and then there is dying, is there? The man sits there, before a withering mess who wants to die but is not dead and is therefore, as he declares, contradicting herself. Then he leans back in his chair oh so pleased with himself for isn’t he clever? Check mate. I am contradicting myself? Of course, I’m contradicting myself! By definition, the suicidal mind is a contradictory mind. A mind that has found a way to deny the very nature of its being, the most primitive and potent instinct engrained into us since the beginning of man, self-preservation, survival. So yes, well done, alert Sweden, I AM contradicting myself. I am choking on my contradictions. For example, do you know how frightening it is to feel nothing?

 

So, she tries to smile and cross her legs like some languorous starlet or the silk-clad concubine. She tries translucence, amiability, panting puppy, sex kitten, lucid and gagging for it, pissed and pleasantly puzzled, but, despite her best efforts, she remains unnoticed. In an indolent oblivion they move past and around her as merely blurred outlines and they can no more see her than she can see them.

“Unfortunately,” he declares, to her relief, “I don t think you are going to get anything out of this lot. Nothing but horny little boys, Eros without an aim for his arrow and abandoned old dogs! Not a psycho in sight, the bold-eyed slatterns. Don’t worry,” he adds, slipping his hand into hers, their fingers entwine like slithering smoke, “You will always be beautiful to me, Penelope.”

They arrive back at Penelope’s house and walk up the back stairs.

“Penelope,” he says suddenly, breaking the silence. His voice is quiet and serious, equal parts assertion and interest. “How do you feel about South Africa?”

“Why?” She answers. She is devastated and baffled to need to use the bathroom, why is her body still working? She looks down at her shoes, they shrivel with every step to the tiny toes of a toddler. “These shoes don’t know where they are going,” she thinks.

“Well, you know sharks have an excellent success rate. SLOBS!” They find Penelope’s room still and quiet, permeated only by the occasional, tepid murmurings of a room asleep. Even the Raven, usually blabbering on with the hardy vigilance of a tomcat, was snoozing upon the old man s shoulder.

“Slobs,” Depression reiterates through gritted teeth, “Don’t I do enough! Oh, Penelope, why so glum? We can try again tomorrow.”

“How about you just go away,” she answers. She sits down on the edge of her bed. Her eyes, limp and painfully hooded, are blunted with the inertia of being open.

“Why would you want that? I mean, look at all these wonderful books I have allowed you to keep. Have I not been very good to you?” He wanders over to the book shelf and begins picking them out one by one: “wrote this one,” flings it over his shoulder, “oh, and this one too and this one, why, you’ve got some of my best works here. Ahhh, No Longer Human, I must say Dazai was a pleasure to work with.”

“Don’t say that,” she snaps. In that moment he sickens her. His callousness sickens her. His unabashed vulgarity starts to fill her with a formidable revulsion that begins to steam through her body, until, eventually, it groans and starts to clatter and clang against its russet tracks, breaking down somewhere around her left leg.

“Oh, and why ever not?”

“Because he killed himself.”

“I know,” he says, half turning, still with Dazai s book in his hand, and throwing her that salacious wink she could neither resist nor bare to look at.

“Well, it’s in very poor taste, even for you.”

“Poor taste? What other option was there? Of course, there’s always therapy,” he retches and spits the word out as if coughing up phlegm. “But does the artist live longer through the latter?”

“It depends on how you look at it.”

“It depends on nothing. Therapy aims to untangle the web, but without its web, how will the spider eat? Intriguing little creature, the spider. Most will see one, scream in revulsion and pounce to a nearby perch. They wait for it to scurry away and yet they can never quite stop staring at it. No web, no spider. Imagine that. Look at him over there, with his slippery snake can you imagine a world without him? A world without fear?”

 

Dear Mum,

I can’t see anymore. I have two friends, one is a god to me and the other makes me laugh, but I can’t see anymore.

 

“Can you imagine a world without crippling insecurity, pain and bladesmith memories that sharpen their knives upon the bone?”

 

Dear Mum,

I love you.

 

“No planned, well devised, bordering meticulous schemes to destroy oneself?”

 

Dear Mum,

I hate you.

 

“No questions, no answers, rose petals in the place of blood?”

 

Dear Mum,

I’m sorry

 

“A world without ME?”

 

Dear Mum,

I love you.

 

“Do you think it would be a better place?”

“So we should all just be miserable. For the sake of the so-called spider?”

He approaches and crouches down before her – his long fingers entwine around the tip of his cane as his dark eyes gleam within the hollow shadows of his face.

“It depends on how you look at it,” he answers. There’s an undertone of mocking in the forlorn resonance of his words, in his voice coated in silk and sugar. With the tranquil stillness of a lily pond, he smiles the lazy, slow smile of a prince, of the insatiable wolf, of the devil courting.

They sit in silence for a while. She keeps her head down, he bores into her. She is thick, she is sloppy, she is a viscous blob of distilled meaning.

“You want me to die,” she whispers. She feels her throat tighten and close over the word die – that serrated, final word that can mean one of a million different things while thought, definition and meaning flap about inside her skull like bats with broken wings.

“Do I? I don’t recall telling you to die. I recall you wanting to die and, as always, I have offered my unflinching support. But, don t confuse things, Penelope. Death at the hands of oneself is the purest choice a person can make and, contrary to consensus, is totally detached from one’s afflictions. I am what you make of me.”

“I hate you.”

“No, you don’t,” he calmly asserts. “I only want what is best for you. I want you to be who you are.” He shoots his hand out and pinches her chin between his fingers. Locked in a struggle of submission and fear and a cloying need, their hard indent forces her eyes up to meet his. “And I am a part of who you are.”

Her self-destruction, draped across a chair and holding an empty bottle close to her chest as if it contains a love letter from captain Morgan himself, snores a resonating grumble from the depths of her gullet. Depression sneers over at her with searing contempt and with one giant swoop of his cane, bonks her on the head shouting: “GET UP! We’re leaving.” Suddenly the room leaps awake with feigned alacrity as the insidious glitter in the eyes of his flock is replaced by an embarrassed submission that never fails to surprise Penelope, the fire breathing dragons now doe-eyed and wheezy.

“Are you going?” she asks.

“Must, I’m afraid, got a meeting with a chap in Canary Warf. You know, there’s nothing like the newly bankrupt to keep me feeling young.”

“But I’ll be back tomorrow,” he coos and smiles down at her. It’s a warm smile, a tender smile, but a smile written in cypher that speaks of the interspersing paradox hidden beneath. “You will always be special to me, Penelope.”

After he leaves, she sits listening for the tender tweeting of a wagtail outside her window, the one she sees every morning. It probably isn’t the same one every morning, but she likes to believe it is – and has named it James Brown for its funny little wiggle. But delicate little birds are not accustomed to singing in the dark and are often replaced by the lonesome cawing of a distant fox. Delicate little birds that can shit on the head of an unsuspecting child, replaced by the ruthless fox, howling like a banshee, that was also the charming and irreverent Basil Brush from her childhood and teacher to the lost little prince.

 

Dear Mum,

I suppose things are not always what they seem and the things we see are like clouds in the sky, lured by shifting currents of air. The trees are bare. They have given the last of their bounty to the earth and remind me of emaciated orphans, naked and waiting. I can’t see the clouds, but I know they are there for the sky is black – thick and heavy, its velvet veil seems so impenetrable even the wind can’t billow its weight. I don’t think I’ll ever see through that sky. But then, as I sit in quiet submission to the vast desolation above and the good in me labours to breathe, suddenly the sky reveals an imperfection. Blown by a distant wind like the metamorphosing wind that pursues the caterpillar – that thick, imposing curtain becomes merely a gossamer wisp of smoke, unfurling before a lone star- or is it Venus? Was it always there? I’m not sure, it doesn’t matter I suppose, it’s there regardless. Perhaps if I hadn’t looked closely at the sky just now, I wouldn’t have noticed it at all- a hopeful wink amidst the waves of shifting darkness, there incomparable merely waiting for a wind to shine its shoes.

 


A Patient has been having treatment with us at Oaktree and written an account of her experience. She would like to be a published writer and has agreed to share her story with us. The sketch is also by the Patient. [Note: Patient’s name has been edited due to privacy]

What happens during a TMS treatment for depression?

What happens during a TMS treatment?

Repetitive Transcranial Magnetic Stimulation Is A Highly Effective Treatment for Treatment-Resistant Depression and Other Disorders

By Michael Swift | January 2019

It’s one of the most common questions we get asked. Of course, patients want to know what will happen before, during and after a TMS treatment.

Our experienced and caring practitioners will guide you through the whole process and be by your side every step of the way, but here is a quick guide on what to expect.

A Full Assessment with Oaktree

When a patient first calls, we offer advice on what TMS can achieve as a treatment, guidance on costs and the usual length of a course of treatment. If the patient would like more information and advice, one of our consultants will then arrange a free call with them to discuss if TMS will be an effective form of treatment for them and, if so, how TMS could work for them.

If they would like to go ahead, we invite them in for a face-to-face mental health assessment and the chance to see the TMS equipment for themselves. The consultant psychiatrist will assess the current and past issues and background to come to a diagnosis. If TMS is considered an appropriate treatment for them then they will talk through everything that happens during treatment, including the sounds and procedures, so that they know exactly what to expect. From there, we create a bespoke care plan and discuss the treatment options with them.

As TMS does not affect you physically, no physical assessment or investments are needed and, once the patient has signed the consent form and is happy to go ahead with TMS as their preferred choice, the treatment can begin immediately.

 

The treatment: relax, talk or listen to music

We invite patients into the therapy room, where they can relax in the treatment chair. It is similar to a dentist’s chair. Patients will be asked to wear a cap over their head and we lightly mark this cap to indicate the area of the brain that requires treatment. We then carefully lower the coil over the patient’s head ready to start. The coil looks like a large figure-of-eight plastic paddle and it very lightly touches the scalp. We use Magstim TMS systems, the pioneers of the technology.

The patient will hear a series of loud clicking noises and a light tapping on their head under the coil but it is completely non-invasive and pain-free.

During treatment patients need to remain still but they can listen to music, watch a TV show, or have a chat with the clinician. It is completely up to them how they’d like to spend that time. Many use the time to catch up on some rest.

Once the treatment is finished, which varies from a few minutes to half an hour depending on their care plan, they are free to go about their day as normal including driving or returning to work.

Oaktree TMS Treatment Results

Incredible results

TMS is a very simple treatment that can achieve incredible results. Treatment times vary from patient to patient but we often see results in just three weeks of daily TMS sessions.

TMS can be easily be incorporated into a patient’s day with very little disruption and – most importantly – it really works.

Michael Swift, Therapist

Have a look at some of our testimonials here.

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SCHIZOPHRENIA – A Poem

SCHIZOPHRENIA - A Poem

Schizophrenia is not the most understood of mental disorders. Oftentimes it is confused with Split Personality Disorder, when in reality it’s less cinematic and a lot more traumatic. Below is a poem inspired by the condition written by our psychology trainee, Anjili Gogna.

The sounds of voices, the unpredictable noises
Leaving me confused but people tell me there’s no excuse
The deterioration of my health
Has encouraged me to find help

Nobody understands what it is
Questions rise like tides in me too
A never-ending cycle of pain and despair
I wonder, does anyone care?

The thoughts that trouble me, is that man here to kill me,
Or complete apathy, to the world and creation,
This scares me and adds to my frustration,
I turn to highs and drink to forget about my life on the brink

Some call it a mental disorder, some are plain harsher
Everyone seems against me, ridiculing me or worse pitying me
Leaving me very lonely and sad and completely mad
Is this the madness everyone talks about only that?

Recently, I came across some help,
Finally, someone could offer more than just resent,
For once they called me a person with schizophrenia,
Offered me medicine, talked with me rather than show hysteria,
This helped manage my thoughts and the annoying voices just disappeared.

Now the day has arrived that I will make a brave entrance,
Into this world that is new to me, I feel safe, it feels right
The sight is clearer, possibilities are brighter
There’s a sense of relief, gone is the despair
Now behold, at last I am on the repair

Anjili Gogna, Psychology trainee

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Mental Fitness: How to Beat Stress

Mental Fitness: How to Beat Stress

We all know what stress is, but it can be hard to put into words. For one, there is no agreed definition. Stress is an overwhelming feeling in response to a situation or events that put us under pressure. Stress is also the effects on our bodies of these pressures.

In a recent poll by the Mental Health Foundation, three out of four felt so overwhelmed by stress that we were unable to cope in the last 12 months. Overeating and eating unhealthy food were the top coping strategies and were used by almost half of the respondents. One in three used alcohol to cope, and one in eight started or increased smoking.

All stress, however, is not the same. There is good stress, which motivates us to do our best at the things that matter. Small doses of good stress, for example in preparation for an exam, can help in keeping our focus and enthusiasm towards whatever we are trying to achieve. But beyond a healthy amount of stress, both health and performance deteriorate.
Here is a two-step strategy to keep stress under control.

 

Step 1: Recognise when stress stops being helpful

Learn your early warning signs. These are the first signs that you might be experiencing more than just good stress. Examples include:

  • Physical exhaustion
  • Forgetfulness
  • Difficulty concentrating
  • Procrastination
  • Restless sleep
  • Avoidance of people or situations
  • Overeating or loss of appetite
  • Relying on junk food and alcohol
  • Not feeling your normal self
  • Feeling ineffective
  • Physical symptoms without a physical cause
  • Irritability and tearfulness
  • Difficulty relaxing
  • Low self-esteem

Step 2: Improve your coping skills

Prevention is better than cure. Once you notice the first signs of stress, take action:

  • Identify the underlying causes
  • Focus on what matters the most
  • Take a step back and look at the bigger picture
  • Talk to supportive friends and family
  • Eat healthily, reduce smoking, alcohol, and caffeine
  • Take time out
  • Smile and laugh
  • Practice regularly mindfulness and relaxation
  • Take a deep breath
  • Exercise
  • Be kind to yourself

Dr Nick Zygouris, Chartered Clinical Psychologist

Talking Autism: MYTHS EXPOSED

Talking Autism: Myths exposed

Dr Anupama Iyer | Child & Adolescent Psychiatrist I January 2025

‘People often assume that Connor must be amazing with art or music. He’s very bright but in a very unique way. He struggles to understand the world the way we can, but sees and senses so many things that other people don’t.’  Father of Connor, 9 years old with autism

In this current day and age, autism awareness is growing exponentially. However, there are still many common misconceptions about autism held by many, which can cause issues with autism being recognised and hinders support being provided to the people who do suffer from autism in a variety of ways.

Here, we want to shed some light on these misconceptions and most commonly held myths with the hope to be able to change thinking and attitudes towards this neurodevelopmental disorder.

Myth 1: AUTISM IS LINKED TO VACCINES

Possibly the biggest and most damaging misconception is the claim proposed by Andrew Wakefield, that the Measles, Mumps and Rubella (MMR) vaccine causes autism. This fraudulent claim led to the public disgracing of Dr Wakefield for a number of reasons and his claim was repeatedly disproven in subsequent years in many high quality research studies that proved there was no link between vaccinations and autism.

Myth 2: AUTISM IS A DISEASE

Contrary to popular belief, autism is not a disease. It is a developmental disorder characterized by differences in communication, behavior, and social interaction. Viewing autism as a disease implies that it needs to be cured, which can be harmful and misleading. Instead, it’s important to recognize and respect the unique perspectives and strengths of autistic individuals.

Myth 3: PEOPLE WITH AUTISM LACK EMPATHY

A prevalent myth is that people with autism lack empathy, which is simply untrue. While individuals with autism may process emotions differently, many are deeply empathetic. They may express their empathy in ways that are not immediately recognizable to others, but that does not diminish their capacity for understanding and sharing the feelings of others.

 

Myth 4: AUTISM IS A CHILDHOOD CONDITION

Autism, a lifelong developmental condition, affects individuals in unique ways. While many people commonly associate autism with children, it’s important to recognise that there are actually more adults than children living with autism, particularly in the UK. This highlights the necessity for ongoing support and understanding throughout a person’s life.

Research indicates that with the right support, individuals with autism can experience significant improvements in various areas of their lives. This support can include specialized educational programs, therapeutic interventions, and community resources tailored to the needs of autistic individuals.

One of the areas where individuals with autism can see positive change is in language and communication skills. With appropriate interventions, such as speech therapy and communication devices, many people with autism can enhance their ability to express themselves and understand others. This improvement can lead to better social interactions and a higher quality of life.

Anxiety is a common challenge for many individuals with autism. However, research suggests that with the right strategies and support, anxiety can be effectively managed. Techniques such as cognitive-behavioral therapy, mindfulness practices, and sensory integration therapy have been shown to help calm anxiety and improve overall well-being.

While autism is indeed a lifelong condition, the potential for positive outcomes exists at every stage of life with the right support. 

Supporting individuals with autism is a community effort, and by fostering an inclusive environment, we can help create opportunities for everyone to thrive.

Myth 5: AUTISTIC PEOPLE HAVE SPECIAL TALENTS

Many parents of individuals with autism and those with autism are asked this extremely frustrating question and often come across as condescending. It’s important to remember that having autism does not automatically equate to possessing extraordinary abilities. Just like neurotypical individuals, people with autism have a wide range of strengths and weaknesses. Recognising and celebrating these strengths is essential in promoting a more inclusive and understanding society.

There is some truth in the fact that people with autism can have higher abilities in certain functions. 

Research indicates that about 28% of individuals with autism exhibit specific abilities that stand out significantly. These abilities, often referred to as “islets of ability,” can manifest in various forms:

  • Mathematical Skills: Some individuals with autism have an exceptional ability to solve complex mathematical problems, often with little to no formal training.

  • Artistic Talent: Many autistic individuals possess extraordinary artistic skills, creating intricate and imaginative works of art.

  • Memory: Enhanced memory abilities, such as the ability to recall vast amounts of information quickly and accurately, are also common.

  • Musical Talent: Some may have perfect pitch or the ability to play instruments by ear without sheet music.

Myth 6: AUTISTIC PEOPLE HAVE LEARNING DIFFICULTIES

Many autistic people are very able and independent, with the right support and a suitable environment most will do very well in a variety of area of work and leisure.

One common misconception is that individuals with autism who take longer to process information do not understand it. This is not the case. In fact, the unique cognitive processes of autistic individuals can bring about distinct strengths and advantages.

Some autistic people may require additional time to process information, which is a reflection of their unique neurological wiring, not their level of comprehension. This slower processing time allows for thorough analysis and a deep understanding of the information at hand. By taking the time to process in their own way, autistic individuals can often uncover insights that might be overlooked by others.

Strengths of Autistic Individuals

The strengths of autistic individuals can be significant and varied. Among these strengths are:

  • Attention to Detail: Many autistic people have an exceptional eye for detail, which can be advantageous in fields that require precision and accuracy, such as coding, engineering, and quality control.

  • Pattern Recognition: A remarkable ability to recognise patterns is another common trait. This skill can be particularly beneficial in data analysis, mathematics, and scientific research, where identifying patterns is crucial.

  • Focus and Persistence: Autistic individuals often exhibit a strong ability to focus intensely on tasks, allowing them to work on projects for extended periods without losing concentration. This can lead to high-quality work and innovative solutions.

Myth 7: AUTISTIC PEOPLE ARE ANTI-SOCIAL

Autistic people may need extra support with social skills or interact differently with the world around them, but most autistic people enjoy having relationships.

Those with autism express their difficulties in different ways. Some are quiet and shy or avoid social situations, others speak too much and struggle to have normal two-way conversations. Implicit communication can be confusing for autistic people and things such as body language, tone of voice and sarcasm can be difficult for them to read. These challenges can make it difficult to make friends, build relationships or get on at work; things neurotypical individuals often take for granted.

Taking time to get to know autistic people and understand their differences in an environment where they are happy makes all the difference

Myth 8: ONLY BOYS ARE AUTISTIC

Although autism is significantly more prevalent in boys than in girls, it maybe a matter of it not being recognised in girls as much. Girls are more likely to ‘mask’ their autism features, and are more likely to learn the skills to interact with the rest of the world more than the boys. This can mean that girls with autism are diagnosed much later in life than boys.

Myth 9: AUTISM IS CAUSED BY BAD PARENTING

Autism is a developmental disorder and definitely not caused by bad parenting. Research has proved that parenting is not to blame for the causation at all. However, parenting style can certainly equip an autistic child with the tools to better cope with the world and affect their behaviours in the future and throughout life. But it is not the root cause of autistic behaviour.

Conclusion

We need not look at autism as a terrible disorder with a low ceiling of promise, but as a marvelous opportunity to look at the world through a different lens and walk in different shoes. If you or someone close to you needs support for mental health issues, please do not delay seeking out help. There are people who can help you.

Dr Iyer is a child and adolescent and learning disability psychiatrist with a special interest in autism.   

Contact
Email – clinicadmin@oaktreeconnect.co.uk
Telephone – 020 39277699
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Christmas Charity Fundraiser – Gatsby Night

        Hello all,   As we enter the joyous New Year, we look retrospectively at the positive moments that 2017 offered to us. One such moment was the Gatsby Christmas Charity Fundraiser, held here at the Oaktree clinic on the evening of the 1st of December. This was held with the aim of setting up a pro bono fund to subsidise our psychological and psychiatric services for young adults and children who have difficulties fulfilling the financial commitment of receiving care. Here at The Oaktree Clinic, we believe that every person has the right to high quality care, regardless of race, gender and socioeconomic status.   Attracting an attendance of approximately 80 people, along with the help of our generous guests, we raised a total of 1200GBP, a massive step towards helping our close-knit community. The efforts of the Oaktree staff resulted in a very successful raffle and auction. The selection of 7 different prizes in the raffle and multiple pieces of elegant artwork proved to be in high demand.   Alongside some lovely appetisers, we got the pleasure of listening to two very talented singers: Titine Lavoix and Rhea Deshpande. Drawing all the guests to one room with only their voices, their talents clearly encapsulated the attention of all the guests, singing various numbers from the early 20th century era.   Later on, after some more food and drinks, it seemed like the energy of the guests began to bubble over. The power of dance allowed everyone some release. Two instructors from Smooth Salsa Dance Company held an interactive Salsa workshop, a hit with the majority of the guests, by the end, could differentiate their right and left feet!   We would like to thank all the guests who attended and all who donated to help make this event a success. Also thanks to Dr Meetu Singh, Dr Minnie Joseph and the Oaktree staff for setting up and carrying out a successful event. Thanks should also go out to the plethora of companies, businesses and the two artists: Alexander Rhys, Patt, John Hill, Mezzo Company, Hair Boutique, and Sky Clinic who donated cash sums, vouchers, and artwork for the benefit of our cause.   Artist Biography   Pat Short: I design and create highly stylised, organic stoneware pieces. My work is influenced by my passion for the natural world and a desire to create pieces that reflect the beauty of forests, stream and oceans. I trained as a Cartographer and discovered clay later in life when I took some amazing classes at the Midlands Art Centre in Birmingham.   http://www.studiopottery.co.uk/profile/Pat/Short       Alexander Rhys: Alexander Rhys is based between Birmingham and London, UK. His work has been sold and published in New York, London, Los Angeles ,Chicago and Amsterdam . Alexander Rhys studied Fine Art at Bath Spa University, UK, where he explored the role of Art in Therapy. His unique works manipulate acrylics with the aim to take the viewer on a journey of finding the ordinary, extraordinary. Rhys’ global and diverse clients include outdoor advertising giants Clear Channel and leading Kenyan hip-hop artist Octopizzio   Alexander Rhys launched his online gallery and store to provide the opportunity for people to enjoy and purchase his work. Alexander Rhys is proud to be supported by the Prince’s Trust. Alexander Rhys offers a bespoke commissioning service. If you find a piece of work on Instagram or in the Gallery that you would like to inspire a bespoke commission, please email hello@alexanderrhys.com.  
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‘Trash Talk’ On the Pitch – Why Do They Do It?

'Trash Talk' On the Pitch - Why Do They Do it?

Athletes strive to reach their ultimate potential and sometimes even pursue super human targets, attempting to master their own bodies. Testing the boundaries of physical selves, putting themselves through the gauntlet everyday to reach the pinnacle of their individual performance and beyond. The notion of the ‘perfect’ athlete seems to be a chimera in the world of sports for coaches.

An individual fully synergising the multitude of different facets that construe ‘perfection’ is a rarity. Both physical prowess and a superior level of mental strength is needed, but the latter overlooked by many. The willpower, resilience and mental stability of athletes are tested day in and day out, in training and during competitions.

However, the expectation that one can be totally in control of their thoughts and cognitive processes at all times may become unreasonable, even impossible. This effort can then extend to an urge to control the behaviour of others.

The battle between the competing athletes can then begin on two fronts, physical and psychological. One of such ‘psychological warfare’ strategies, which is alarmingly common, to gain a mental edge during competition, is ‘trash talk’. Both players and spectators at all levels of sport use this dubious strategy. Some examples of ‘trash talk’,

“I’m just looking around to see who’s gonna finish second.” Larry Bird (1968-NFL)

“I’m not worried about the Sacramento Queens. Write it down. Take a picture.”- Shaquille O’Neal (2003-NBA)

“Float like a butterfly and sting like a bee…his hands can’t hit what his eyes can’t see.”- Muhammed Ali (Boxer)

Trash talk has been shown to drastically impact on performance, its effect seems to increase exponentially when players are losing as they feel that they have no control over the situation. Their focus shifts from “winning” to attaining a personal victory by satisfying their impulse of retaliation. A lack of respect seems to be a frequent trigger, causing heated exchanges on the pitch and a resultant change in performance.

HOW TO DEAL WITH TRASH TALK

There are a number of strategies one can employ to deal with and prepare for trash talkers.

  • Mental imagery: visualising yourself in situations where you are resilient and calm.
  • Self-talk (motivational affirmations e.g. mantras).
  • Meditation: Clearing your head and maintain peace within yourself.

All elicit positive results, helping individuals tune out negative thoughts (doubts, worries, insecurities) and external stressors (fans and opponents).

Athletes with an understanding of this psychological battle, with well-developed skills in their ability to remain focused will retain composure in the face of trash talk. They fully immerse into their performance, remaining unperturbed by the words of their opponents and WIN.

Author: Varun Deshpande, Psychology Assistant, The Oaktree Clinic

HEM LIFE