Maintaining Health Partners

The Whole Ward

Do you have the patience to wait until your mud settles and the water is clear? Can you remain unmoving until the right action arises by itself?

Lao Tzu (c.604-531B.C.)

The Projecto A three-year project o Funded by the Maudsley Charity o Promoting health, well-being and community

amongst staff and patients o On a PICU, an acute psychiatric ward and moving

on to communityo A team of 5 therapists and 4 volunteers

o Ward and community-based holistic therapies, meditation and breathing for staff and patients o Teaching sessions for ward staff

Photograph of therapists

The project also offers:herb teas, raw organic vegetables and fruit

and encourages:healthy habits such as drinking water regularly and using outdoor space

Past – not only purges, vomits, blisters and bleeding

Valentine Greatraks – the ‘stroker’ who healed patients by touch - 1666

Dr Edward Tyson – used hot baths and nutritious food to build physical health for the Bedlam inmates - 1680

Royal therapy: In 1789 Dr Robert Jones advised the physicians attending King George III to ‘invigorate the body and afford every consolation to the mind’ of their Royal patient..

Background and Past Interventions

Community-base 1998-2008 Mental health project from a church community centre - linking with CMHT referrals; various funders

National Smoking Ban response2008 Invitation from OT department 20 weeks-long pilot on 2 separate male/female acute wards3 hr daily therapy sessions - Acupuncture, Homeopathy, Chi Kung, Yoga, Reflexology, Indian Head Massage and Massage

A vision for a healthy ward

Inspiring InfluencesBelief in:

Holistic approaches Equality of access

The benefits that people experiencing therapies articulate

The people we work withLaing, Soteria and Steiner

One Flew Over The Cuckoos Nest

Visiting a psychiatric ward when 14 and also when pregnant

The presentWHO Traditional Medicine Strategy 2014-2023

Strategic direction 1: Capitalise on the potential contribution of T&CM to improve health services and health outcomes. Mindful of the traditions and customs of peoples and communities, Member States should consider how T&CM, including self-health care, might support disease prevention or treatment, health maintenance and health promotion consistent with evidence on quality, safety and effectiveness, in line with patient choice and expectations.

Strategic actions for partners and stakeholders 1. Promote mutual respect, collaboration and understanding between conventional and T&CM practitioners. 2. Promote international communication among practitioner communities regarding integrative models. Strategic objectives, strategic directions and strategic actions 55 WHO Traditional Medicine Strategy 3. Promote research on the cost-effectiveness of integrating T&CM approaches. 4. Promote continuing education, evaluation, evidence and research into T&CM practices.

Implementing the Strategy

The goals for the WHO Traditional Medicine Strategy 2014-2023 are to support Member States in: 1. Harnessing the potential contribution of T&CM to health, wellness and people-centred health care; 2. Promoting safe and effective use of T&CM through the regulation, evaluation and integration of T&CM products, practices and practitioners into health systems, as appropriate.

The Royal College of Psychiatrists, College Centre for Quality Improvement publication Standards for Assessment/Triage Services – 4th EditionNovember 2014 states,

‘All patients have access to local complementary therapies, delivered by trained practitioners, in accordance with local policy and procedures’U51.6 3

NAPICU 2014 National Minimum Standards No reference to Complementary Therapies although it mentions WRAP - Wellness Recovery Action Plan – which enables people to recognise their own triggers and design their own routes to recovery

The present

The aims, delivery and evaluation of the project: o increasing positive interaction between staff

and patientso improving feelings of health and well-being o encouraging techniques that enable self-

awareness, self-management and choice

Deliveryo The context

o One therapy a day 4 days a week Group: Chi Kung; Yoga; Breathing and MeditationIndividual: Massage; Indian Head Massage

o Herb teas, water, organic raw veg/fruit

o Teaching sessions focusing on HPAA (hypothalamus pituitary adrenal axis/ stress response)

o Developing the work

Evaluationo Staff and patient surveysAdapted from Warwick Edinburgh Mental Wellbeing Scale o PEDICo Data collected by ward Incidents of violence and

aggressiono Staff and patient commentso Six-monthly reportso EPJS

SurveyPatients Staff

April- Sept 2014 Oct- March 20150%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Graph 10- Taking part in the comple-mentary therapy sessions has made me

feel more relaxed

Strongly AgreeAgreeNeutral

April- Sept 2014 Oct- March 20150%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Graph 20- Taking part in the complementary therapy sessions makes me feel more relaxed

Strongly AgreeAgreeNeutral

Patients Staff

April- Sept 2014 Oct- March 20150%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Graph 13- Taking part in the comple-mentary therapy sessions has increased

my feelings of happiness

Strongly AgreeAgreeNeutral

April- Sept 2014 Oct- March 20150%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Graph 22- Taking part in the comple-mentary therapy sessions increases my

feelings of happiness

Strongly AgreeAgreeNeutralDisagree

Patients

April- Sept 2014 Oct- March 20150%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Graph 12- Taking part in the complementary therapy sessions has helped me to feel better about myself

DisagreeNeutralStrongly AgreeAgree

Staff

April- Sept 2014 Oct- March 20150%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Graph 17- The introduction of complementary therapies makes the atmosphere more positive on the ward

Strongly AgreeAgreeNeutralStrongly Disagree

Strengths, Weaknesses, Opportunities, Threats

• Strengths – it’s taking place, holistic, non-denominational, positive feedback, offers choice, timely and unique, new habits, responds to other cultures

• Weaknesses - time-limited, a ‘project’ misunderstood,

• Opportunities - to explore doing things differently, to make a change, to change a culture, to embed practice, zeitgeist

• Threats - funding, institutionalisation, trends

Chi Kung

An opportunity to experience a taster session of one of the therapies we offer

The futureA vision for holistic therapies on psychiatric wards and for

patients in the community o Immediate future - prevention of a giant pilot projecto Embedding within wards and wider staff/patient communityo Commitment in practice as well as in writing to real choices –

not just lip serviceo Parity of regard and respect for other systems of

understanding healtho Preventing institutionalisationo Resourcing new systems of research and establishing

agreement on the evidence base for complementary therapies