Mental Health and Wellbeing Training Wellbeing Learning Objectives
Mental Health and Wellbeing Training Wellbeing
Learning Objectives Understand the definition of mental wellbeing Know the factors which contribute to mental wellbeing Be confident in measuring the wellbeing in ourselves and patients Be aware of the five evidence based steps to maintain wellbeing Recognise stress Understand how stress can affect mental wellbeing Be able to proactively help maintain mental wellbeing
What is wellbeing?
Definitions of Wellbeing Think about what is your definition? Happiness Life satisfaction Optimism Self-esteem Feeling in control Having a purpose in life A sense of belonging and support
Perspectives of Wellbeing The Hedonic Perspective – The Eudaimonic Perspective – The personal experience of happiness and life satisfaction Possessing positive psychological functioning, Good relationships with others and self-realisation. Positive relations with others, Independent, self-acceptance and competence. Self realisation and a focus on resources and strength, life meaning and purpose (Ryff and Snider 2008) or ‘FEELING GOOD’ Is it enough just to feel good? Pleasure attainment and pain avoidance (Kahneman et al 1999) or ‘FUNCTIONING WELL’
What Contributes to Mental Wellbeing Come from inside – a person’s attitude to life: • • • Direction – Have goals to look forward to Resilience – Find ways to bounce back Emotion – Take a positive approach Acceptance – Be comfortable with who you are Meaning – Be part of something bigger
Resilience Resilio = to jump back Definition = a person’s ability to handle pressure and bounce back from adversity How resilience is influenced: Development during childhood and adolescence External factors, for example relationships or having a faith Internal factors such as how the individual interprets events, manages emotions and regulates their behaviour
Mental Capital Encompasses a person’s cognitive and emotional resources. It includes their: Ability to think and work things out Level of flexibility and efficiency at learning Emotional intelligence (social skills and resilience in the face of stress)
What Negatively Contributes to Mental Wellbeing? • • • • Pressure at work Environment Family problems Job insecurity, threat of redundancy Financial hardships Relationship difficulties Bullying Discrimination Loneliness and isolation Lack of support with children rearing Managing long term conditions Caring for someone with a long term condition or disability Taking on too many commitments and feeling you don't have enough time to do everything Bereavement
Can We Measure Wellbeing?
Measuring the Wellbeing of the Nation The Office for National Statistics uses four questions to monitor personal well-being in the UK: On a scale of 1 to 10 (0 = not at all and 10 = completely) 1. Overall, how satisfied are you with your life nowadays? 2. Overall, to what extent do you feel the things you do in your life are worthwhile? 3. Overall, how happy did you feel yesterday? 4. Overall, how anxious did you feel yesterday?
The Warwick-Edinburgh Mental Well-being Scale 1. I’ve been feeling optimistic about the future a) None of the time (1 point) b) Rarely (2 points) c) Some of the time (3 points) d) Often (4 points) e) All of the time (5 points) 3. I've been feeling relaxed a) None of the time (1 point) b) Rarely (2 points) c) Some of the time (3 points) d) Often (4 points) e) All of the time (5 points) 2. I’ve been feeling useful a) None of the time (1 point) b) Rarely (2 points) c) Some of the time (3 points) d) Often (4 points) e) All of the time (5 points) 4. I’ve been feeling interested in other people a) None of the time (1 point) b) Rarely (2 points) c) Some of the time (3 points) d) Often (4 points) e) All of the time (5 points)
The Warwick-Edinburgh Mental Well-being Scale 5. I've had energy to spare a) None of the time (1 point) b) Rarely (2 points) c) Some of the time (3 points) d) Often (4 points) e) All of the time (5 points) 7. I've been thinking clearly a) None of the time (1 point) b) Rarely (2 points) c) Some of the time (3 points) d) Often (4 points) e) All of the time (5 points) 6. I’ve been dealing with problems well a) None of the time (1 point) b) Rarely (2 points) c) Some of the time (3 points) d) Often (4 points) e) All of the time (5 points) 8. I’ve been feeling good about myself a) None of the time (1 point) b) Rarely (2 points) c) Some of the time (3 points) d) Often (4 points) e) All of the time (5 points)
The Warwick-Edinburgh Mental Well-being Scale 9. I’ve been feeling close to other people a) None of the time (1 point) b) Rarely (2 points) c) Some of the time (3 points) d) Often (4 points) e) All of the time (5 points) 11. I’ve been able to make up my own mind about things a) None of the time (1 point) b) Rarely (2 points) c) Some of the time (3 points) d) Often (4 points) e) All of the time (5 points) 10. I've been feeling confident a) None of the time (1 point) b) Rarely (2 points) c) Some of the time (3 points) d) Often (4 points) e) All of the time (5 points) 12. I’ve been feeling loved a) None of the time (1 point) b) Rarely (2 points) c) Some of the time (3 points) d) Often (4 points) e) All of the time (5 points)
The Warwick-Edinburgh Mental Well-being Scale 13. I’ve been interested in new things a) None of the time (1 point) b) Rarely (2 points) c) Some of the time (3 points) d) Often (4 points) e) All of the time (5 points) What was your score? Wellbeing scores: 14. I've been feeling cheerful a) None of the time (1 point) b) Rarely (2 points) c) Some of the time (3 points) d) Often (4 points) e) All of the time (5 points) 0 -32 point - very low 32 -40 points - below average 40 -59 points - average 59 -70 points - above average
Recognising Stress
Recognising Stress Adapted from Nixon P. (1979) Practitioner.
What are the Signs and Symptoms of Stress? Feelings • Moodiness • Irritability or short temper • Agitation, inability to relax • Feeling overwhelmed • Sense of loneliness and isolation • General unhappiness Thoughts • Memory problems • Inability to concentrate • Poor judgement • Seeing only the negative • Anxious or racing thoughts • Constant worrying Behaviour • Eating more or less • Sleeping too much or too little • Withdrawal • Procrastinating or neglecting • responsibilities • Use of alcohol, cigarettes or drugs for • relaxation • Nervous habits (e. g. nail biting, pacing) Physical • Aches and pains • Diarrhoea or constipation • Nausea, dizziness • Chest pain, rapid heartbeat • Loss of libido • Frequent colds
Questions which may pick up Stress in Ourselves and Colleagues and Patients • • Are you able to sleep properly without any worries going through your mind? Do you feel impatient or irritable at minor problems? Is concentrating difficult due to worrying about things? Is making a decision difficult? Are you drinking or smoking more? Are you not enjoying food so much? Do you feel unable to relax because you feel that something always needs to be done? Do you feel tense, nauseated or sweaty? Do you have a 'knot' in your stomach a dry mouth or a thumping heart? How did you do?
Promote Life Style Habits Check the Intake of Caffeine
Promote Life Style Habits Encourage to eat healthily • Protects wellbeing • Prevents some mental illnesses • Associated with good mental health How do you feel when you’ve been overindulging?
Promote Life Style Habits Promote regular exercise as: ü It releases endorphins ü It provides structure and purpose ü Exposure to sunlight directly boosts mood
Promote Life Style Habits Help the patient to get adequate sleep 1. Maintain a regular routine. 2. Create a restful sleeping environment. 3. Have a comfortable bed. 4. Regular moderate exercise. 5. Avoid caffeine. 6. Avoid over-indulgence. 7. Stop smoking. 8. Relax before bed. 9. Worry time. 10. Don't worry in bed.
Promote Relaxation • Meditation • Mindfulness • Relaxation exercises Let’s try relaxing…
Maintaining Wellbeing
How Can we Help to Maintain Wellbeing? No specific guidance from NICE for primary care Group work How can your practice (as a whole) promote wellbeing? Be Creative • Provide relevant information • Allow prompt access • Know what your patients want • Provide group support • Promote physical activity • Consider the patient’s experience
Remember to ask yourself: How do I know when I am Stressed? What are things I can do to support my mental wellbeing? What’s in your stress container? Helpful coping strategies – a working tap lets the stress out Unhelpful coping strategies – a blocked tap means water fills the container and overflows If the container overflows, problems develop – ‘emotional snapping’ Stress flows into the container
How to Stay in Wellbeing CREDIT: • Commit to developing your own mental wellbeing toolbox; it can be useful to develop a daily/weekly planner which includes working hours and relaxation time. • Recognise when you might be starting to struggle and what may be causing it. • Experiment and find the best coping strategies for you whilst working at home; think about your workspace, taking regular breaks, when you feel you are most productive. • Develop skills to maintain your mental wellbeing and remember to look after your physical health: sleep, diet and exercise. • Identify where your stressors may be and take action to address these. • Talk to someone early on if you need to; it is really important to make sure that you don’t feel socially isolated when having to physically distance from others. Don’t forget to find a way of measuring and reviewing how well you are doing and celebrate achievements. You may want to end each day by writing down three positive things that have happened that day. This can help to improve your wellbeing.
Five ways - Grounding Tool Take time out to ground yourself in surroundings List 5 things you can see 4 things you can feel 3 things you can hear 2 things you can smell 1 thing you can taste Try taking time to do this everyday it’s a quick exercise to take you out of rising stress
Five Evidence Based Steps to Maintain Wellbeing Daily activities: 1. 2. 3. 4. 5. Connect with others Get active Be aware of yourself and the world Keep learning Give to others
Connect Now, more than ever, we need to ensure we are connecting with the people around us. The places we would normally connect with others, like the workplace, restaurants or gyms are no longer as accessible. Try to think of ways you can still socially connect with others, using video calling rather than audio so that you can see people. There are lots of virtual classes being set up and faith and community events online. Reach out to family and friends
Take Notice Be observant, look for something beautiful or remark on something unusual. Savour the moment and adjust to the changes happening, if you are using remote meetings or video calls, take notice of those that you are talking to. Enjoy the time that you have and allow yourself to relax. If you are finding it difficult to manage your emotions and the current uncertainty, a useful technique is a grounding exercise based on our senses use the grounding tool
Be Active Take some exercise time to go for a walk, run or cycle ride. Even a 10 minute stroll can really help Consider taking 5 minutes to stretch at work Take a walk in your lunch break Why not put on some music and dance around your living room, join an online class or even do some stretches while you are watching TV? Housework, gardening and DIY also count. Exercising makes you feel good so it is important to think of ways that you can still do this.
Keep Learning Don’t be afraid to try something new, rediscover an old hobby or sign up for a course; there are lots of free courses online. Learn to play an instrument or how to cook your favourite food. Learn a new language or set a challenge you will enjoy. Learning new things will make you more confident, as well as being fun to do. It may be that you have put off doing something and now you have the time and opportunity to embrace learning something you have been putting off.
Give Do something nice for a friend, colleague or loved one. It may be that you send them a message, phone or video call them or send a card. If you are able to, maybe think about volunteering some of your time, join an online community group or even just thank someone. Look out as well as in. A small random act of kindness not only fulfils us but pays it forward for others
Following the Outbreak of Coronavirus (Covid 19) we are More aware of life’s uncertainties Influencing our actions and future plans It is causing a heightened sense of anxiety Many people are worried re and fearful of what will happen Social distancing and working from home may mean we feel more alone It is essential we stay in charge of own stress Stay connected and support our peers and colleagues
Useful websites: Sources of support https: //www. rcn. org. uk/get-help/member-supportservices/counselling-service https: //www. bma. org. uk/advice/work-lifesupport/your-wellbeing/bma-counselling-anddoctor-advisor-service https: //www. samaritans. org/ General self-help https: //www. nhs. uk/conditions/stress-anxiety-depression/ www. mind. org. uk https: //web. ntw. nhs. uk/selfhelp/ https: //www. cci. health. wa. gov. au/Resources/Overview Mental health in the workplace https: //www. rcpsych. ac. uk/usefulresources/workandmentalhealth/worker. asp x https: //www. mentalhealth. org. uk/our-work/mental-health-workplace https: //publichealthmatters. blog. gov. uk/2018/01/30/is-lack-of-sleep-affectingyour-work/ https: //wellbeing. bitc. org. uk/tools-impact-stories/toolkits Compassion, mindfulness and reflective practice https: //www. skillsyouneed. com/ps/reflective-practice. html http: //selfcompassion. org/ http: //www. mindfulhealth. co. uk/mindfulness-meditationaudio-with-karunavira/ http: //franticworld. com/ https: //www. som. org. uk/ www. cwmt. org. uk
References Kahneman, D. et al 1999 Wellbeing the Foundations of Hedonic Psychology New York Russell Sage Foundation Ryff, C. D. and Singer B. H. 2008 Know Thyself and become what you are Journal of Happiness Studies 9 13 -39
- Slides: 39