Happy Holidays – to taking it slow with good cheer.

Happy Holidays – to taking it slow with good cheer. Wishing you a wonderful 2021.

MHB IP is ten years old at the end of next year, so if all goes well, we hope to have a #tango and #salsa #event on 31 December 2021 in #Cambridge, UK, in honour of Latin America.  Email us at admin@mentalhealthbus.co.uk if you want us to add you to the list.

To see what we’ve been up to or to join us ….

https://www.instagram.com/mentalhealthbusintprojects/ 

https://twitter.com/mentalhealthbus 

https://www.facebook.com/mentalhealthbus 

Warmest regards

Food for thought

Food for thought:

The immune system can be strengthened and maintained by simple measures such as:

1. Maintain a calm and positive mental state and environment (many would agree that management of anxiety to reduce anxiety is the most important factor)

2. Positive in person engagement with loved ones and peers (consider current local guidelines re social distancing)

3. Regular engagement in normative activities (please see earlier comments on normative activities)

4. Regular relaxation in fresh air with nature and / or animals (many report noticeable positive changes in blood pressure and general health when spending time with animals; animals are a life long (or sometimes 15 year long) responsibility, so opt for volunteering, animal rescue or pet sitting if you cannot make a longterm commitment to animals)

5. Regular exercise

6. Sufficient sleep

7. Adequate hydration

8. Healthy food options such as fresh fruit and vegetables

We have received many questions regarding which foods are ideal to support a healthy immune system and general health. We have asked our medical and para-medical colleagues, patients and their families what their favourite foods are to remain healthy.

We have only included thoughts from people who have reported that they have not presented with any symptoms of respiratory illness or any other infections in the last 12 months.

Favourites choices for:

Vit A: Eggs, oily fish such as salmon, tuna, sardines, anchovies and mackerel (once a week), fruit such as cantaloupe melon and mangoes, and vegetables such as carrots, spinach, butternut squash, broccoli, chilli peppers and tomatoes

Vit B1: Milk, some fortified breakfast cereals, yeast products (marmite is a favourite for many) and nuts such as peanuts (peanut butter is a favourite for many)

Vit B2: Milk, milk products, eggs, yeast extracts and some fortified breakfast cereals

Vit B3: Milk, eggs and meats such as chicken, pork or beef

Vit B6: Fortified cereals, bananas, nuts such as walnuts and hazelnuts (Nutella is a favourite for many), and meats such as turkey, chicken or beef

Vit B7: Yeast products, eggs, nuts such as peanuts, and green vegetables

Vit B12: Milk, dairy, fortified breakfast cereals, eggs, fish such as tuna, salmon, sardines and anchovies, and yeast products

Vit C: Kiwi, guava, citrus (oranges, lemons, satsumas, clementines, grapefruit), mangoes, papaya, black currants, strawberries, nectarines and vegetables such as sweet potatoes and broccoli

Vit D: Oily fish such as salmon, tuna, sardines, anchovies and mackerel, and eggs and milk

Vit E: Almonds, hazelnuts, peanuts, peanut butter, pine nuts (pesto is a favourite with pasta) and vegetables such as sweet potatoes

Vit K: Leafy vegetables such as spinach and broccoli (good with lemon, garlic and anchovies), eggs and dairy

Folate: Some breakfast cereals, milk, yoghurt, eggs, spinach (good on pizza or with fish), broccoli, green beans, peas and chickpeas

Calcium: Milk, cheddar cheese, yoghurt and sardines

Magnesium: Cocoa, pine nuts, cashew, hazelnuts and walnuts

Phosphorus: Milk, dairy (except butter), fish and nuts

Selenium: One or two brazil nuts per week (we usually recommend no more than one brazil nut per day), eggs and fish such as tuna or sardines

Iron: Fortified cereals, cocoa, nuts such as cashews, meat such as beef, and vegetables such as broccoli (a favourite for many is pasta with salmon, pine nuts and broccoli)

Zinc: Milk, milk products, eggs, oysters, cocoa and nuts such as pine nuts and cashews, as well as leafy vegetables such as spinach

Copper: Nuts such as cashews

Manganese: Fruit such as pineapple and vegetables such as spinach

Additional thoughts: Honey, bananas and yoghurt drinks with live cultures (such as Actimel) are healthy favourites and make excellent milkshakes for children and adults.

Olive oil with garlic and onions make a good and healthy start to any dish, as most reported.

Mushrooms are also a healthy favourite for many in pastas or on pizza.

Salads with rocket, leeks, fennel and fish are a favourite for many French families.

Chillies and avocado are also healthy options and Mexican food is a favourite for many.

Desserts: Greek yoghurts with berries such as raspberries, blueberries, blackberries, cherries, and honey. Dark hot chocolate drinks or sauces with spices such as ginger, turmeric and cinnamon over fruit including berries, figs, apples, apricots and pears, or in pancakes.

General information:

Please know that this list only includes ‘favourite items’ of people who we have liaised with in the last few months, there are many more food choices available in every category.

Remember some vitamins or minerals are best absorbed when taken with certain food types such as with fats or orange juice, and some foods or drinks such as tea or wine reduce absorption such as tannins or caffeine, so avoid combinations where absorption is reduced if you can.

Some food choices such as grapefruit cannot be taken with certain medications, your pharmacist will be able to advise you. We always recommend that care is taken when new medications or food choices are introduced, please speak to your GP if you have concerns. We usually recommended ‘go low and slow’ with anything new, and have access to emergency facilities, in our work with children and families. Many doctors, nurses and pharmacists recommend for instance that you remain within 3 minutes of the office with emergency facilities after you have received vaccines or started a new medication for at least 20 minutes, and for some a bit longer.

Balance is key. Healthy fats such as olive oil, proteins and carbohydrates are essential for most bodily functions. Many food choices including herbs and spices are good for health, however, if you consume high amounts, health benefits change to health risks. Moderation is key.

Enjoy your favourite food such as chocolate, but in moderation, and ideally choose healthy options such as dark chocolate possibly with nuts and berries. Enjoy your favourite drinks such as coffee and tea, but try to limit intake to two cups per day.

Drink 1-2 litres of water or decaffeinated and unsweetened tea per day (camomile or thyme and peppermint ice teas are a favourite for some). Hydration is essential for nearly all physiological functions in the body.

We usually recommend that vitamins and minerals are received through food choices, rather than tablets or capsules, unless specific medical indications exist and medical recommendations from your doctor include medication or supplements.

We recommend that you always follow medical advice given to you by professionals including medical doctors, nurses, pharmacists and dieticians. No two people are the same and medical conditions such as Diabetes Mellitus or Ischaemic Heart Disease will likely mean that you likely have to alter your diet significantly to ensure reduced risk and improved health, which often means avoiding some food types in total. Discuss options with your treating doctor or medical team.

If you have medical problems or symptoms or if you are worried about your health, we would recommend that you book an appointment to speak to your GP without delay. The pandemic is not a good reason to postpone contacting your health service if you have concerns, even if your concerns appear ‘not serious’. Health professionals will advise you on next steps specifically detailed for your unique circumstances.

Please know that some doctors who offer services to the NHS report that they have not been less busy in decades, please therefore do not assume that your concerns are not important during this time. Health and mental health is important and prevention is key, therefore please liaise with your medical professional without delay if you have concerns for you or your family.

The content of our websites and social media accounts is intended for general information purposes only. These pages do not constitute any form of consultative or diagnostic tool or process, and is no substitute for assessment and recommendations by a medical doctor. The assessment, diagnosis and treatment of mental health or general health difficulties, particularly in children, but also in many adults, is a complex and specialised process and should only be undertaken by qualified mental health or medical professionals with appropriate training and sufficient experience.

#food #nutrition #fats #carbohydrates #proteins #fruit #vegetables #children #immunesystem #health #vitamins #minerals #COVID19 #calm #anxiety #dessert #animals #nature #bloodpressure #exercise #sleep #hydration #GP #HealthServices #balance #moderation

Deprivation of liberty

Deprivation of liberty

Deprivation of liberty significantly increases bio-psycho-social risk for many adults and young people; negatively affecting behaviour, thoughts, beliefs, emotions, physical health and social risk with negative consequences for the immune system, general health and mental health, increasing morbidity and mortality. 

Lockdown, stay at home and shelter in place are associated with significantly increased social risks for many such as relating to domestic violence (80% increase), child abuse (30-65% increase), economic challenges, poverty and unemployment (the World Bank estimates that an additional 88-115 million people will fall into extreme poverty in 2020, 150 million in 2021), along with an inability to access clean water or food (89% increase, resulting in 12 000 deaths per day, exceeding 10 000 deaths a day recorded from COVID-19 in April 2020) and social isolation (87% of Young Minds respondents) in most countries (see reports from Childline, NSPCC, Young Minds, United Nations, UNICEF, NCMEC, Oxfam, The Trussell Trust, Stop UK Hunger, England’s Children’s Commissioner and the WHO, recently published).  These increased social risks, frequently associated with a high mortality rate, also significantly and negatively affect the immune system, general health and mental health, which affect clinical health outcomes in every culture. 

Deprivation of liberty affects behaviour for many which contributes to social risk, general health and mental health in most cultures.  Consider statistics illustrating significantly increased figures reported by organisations such as the UN, UNICEF, WHO, NSPCC, Alcohol Change UK, England’s Children’s Commissioner and RCPCH in the UK in recent months relating to aggression, violence (300% increase in one study in February 2020), alcohol abuse (400% increase), along with child abuse, suspected child sexual exploitation (90% increase reported by NCMEC, US) and non-engagement in hospital activities required to maintain or protect health (93% increase).  Public Health England identified a drop in Emergency Department visits, particularly by children.  UNICEF and the WHO reported that children in many countries were not receiving necessary childhood vaccinations before the pandemic, and the pandemic and restrictive initiatives have increased these concerns markedly; this has a worldwide impact relating to serious infectious diseases.  These are significant risk factors that negatively impact on the immune system, general and mental health for every nation.

Deprivation of liberty has direct effects on thoughts and beliefs for many that negatively impact on the immune system, general health and mental health.  Statements starting with “I can’t” and ending with “so there is no point” are frequent and relevant.  One young person recently reported “I can’t leave home, because we are weak and this flu is scary, we will get sick if we leave home, what is the point of caring” and “the world is not safe for us”.  Thoughts affect immediate and long term clinical outcome directly and significantly.  What the mind believes often transpires; many evidence-based therapies are based on this principle.  

Deprivation of liberty in any context causes high levels of stress and chronic anxiety within many or most individuals.  Emotions such as anger, hostility, panic, low mood, hopelessness and depression are also frequently observed.  Negative experiences and emotions such as chronic anxiety are risk factors that significantly and negatively impact on the immune system, which cause increased susceptibility to infections and a poorer general health prognosis through increased morbidity and mortality.  Chronic anxiety also affects mental health morbidity and mortality in children and adults.  We have observed a significant increase in referrals relating to tic, anxiety and mood disorders of children of all ages during the last few months and the profile of referral has changed; children with no previous concern or family history are presenting for the first time.  

We have also observed an increase in referrals relating to possible ADHD (Attention Deficit Hyperactivity Disorder) and ASD (Autism Spectrum Disorder); however, in our experience, 30-60% of all ADHD and ASD referrals or caseloads typically do not present with ADHD or ASD, but rather with mood or anxiety disorders or histories of trauma or abuse.  Children with ADHD and ASD often present similar to children with anxiety disorders, such as PTSD, or depression, along with child abuse or trauma (differential diagnoses), and preliminary diagnoses or diagnoses are often made by professionals with limited training in Child Psychiatry.  Children with mental health problems often present differently compared to adults.  Paediatricians often report that they have had no training in child psychiatry to differentiate between eg anxiety disorders, ADHD or ASD.  Misdiagnosed children often wait 6-8 years before receiving appropriate treatment.  This is of particular concern to us in the context of the pandemic. 

Mental health morbidity is markedly increased for many in the context of deprivation of liberty.  Consider statistics illustrating increased figures reported by organisations such as Young Minds, Samaritans and MIND in recent months relating to increased mental health problems in adults (80% increase) and young people (75% increase) with relevant mental health histories and an increase in mental health presentations in young people with no previous mental health problems (55% increase).  10% of adults presented with suicidal ideation within the first week of lockdown and 2% attempted suicide or self-harmed.  Research indicates that living or feeling alone along with feelings of hopelessness are significant risk factors for suicide.  MIND reports that 33% of young people with mental health difficulties self-harmed to cope during lockdown, which is a significant risk factor associated with suicide.  These numbers are likely to be underestimated.  The NCMD reports 25 child suicides in the first 56 days of lockdown.  In 48% of the 25 post-lockdown deaths, factors related to COVID-19 or lockdown were thought to have contributed to the deaths.  Mental health problems, associated with its own morbidity and mortality, also significantly affects the immune system and clinical outcome relating to general health. 

Many children and adults who presented with neurodevelopmental or mental health problems before the pandemic now present with decreased impairment and distress, due to recommendations to remain at home and subsequent non-engagement in challenging, social and normative activities within the public and community; this does not encourage recovery or maintenance of positive progress. 

An indirect effect on the immune system via multiple pathways has been illustrated in this section, however, a direct effect is also relevant and important for many; most systems in the human body including the endocrine, haematological, cardiovascular, respiratory, gastrointestinal and neurological system can be directly affected by deprivation of liberty.  This is emphasised and repeated because it affects susceptibility or resistance to infections and subsequent prognosis in terms of morbidity and mortality; degree of illness, associated complications, recovery times and outcomes during the pandemic.  

General health morbidity is also affected by direct effects on general health, not relating to indirect pathways such as via chronic anxiety and the immune system, for many, although these are major factors.  Confinement or the impression of confinement or ‘being trapped’ often leads to agitation.  Agitation is not necessarily associated with anxiety, particularly as a medical or psychiatric term.  Agitation is often associated with irritability and restlessness, and is often seen in psychiatry units, emergency departments and care facilities secondary to eg head injuries.  Concerns in this context can extend to, but are not limited to, increased blood pressure, heart rate and respiratory rate, poor attention, concentration and memory, as well as chronic headaches, digestive problems, fatigue, lethargy, loss of appetite, weight loss, insomnia, muscle and joint pain.  General health and mental health morbidity and mortality can be affected directly and indirectly by these presentations, which contribute to clinical outcome during this pandemic. 

As illustrated, deprivation of liberty in any context therefore increases social risk, mental health risk and general health risk for many, and can be associated with very strong messages to the mind and body for every individual, high and low risk groups, which can significantly and negatively affect prognosis.  Doctors in every medical discipline will be aware of these risks.  There are important evidence-based clinical, ethical and legal reasons why liberty should be considered and safeguarded where possible for every individual. 

Initiatives that prevent chronic anxiety, support the immune system and prevent harm are essential if health is to be protected for the general public in the context of this pandemic.  Initiatives should protect, not harm, and this needs to be evaluated and weighed on a regular basis. The outcomes of deprivation of liberty for vulnerable and at risk children and individuals, along with the general public, relating to serious mental health, physical health and social risks, are of significant concern, not only in the UK, but worldwide, as per recent statistics published.

A systemic approach is important; relevant evidence-based bio-psycho-social risk and protective factors should considered.  A systemic approach implies that all things are connected and that every factor must be considered.  Deprivation of liberty is one of the risk factors that can cause the most stress and chronic anxiety for many, and clinical outcome can be significantly affected for most in this context. 

#COVID19 #liberty #confinement #trapped #risk #behaviour #thoughts #beliefs #feelings #emotions #ImmuneSystem #ImmuneResponse #health #outcomes #prognosis #susceptibility #complications #recovery #morbidity #mortality #culture #ADHD #ASD #mentalhealth #anxiety #PTSD #calm #agitation #depression #anger #hopelessness #violence #endocrine #haematological #cardiovascular #respiratory #gastrointestinal #neurological #irritability #restlessness #bloodpressure #heartrate #respiratoryrate #attention #concentration #memory, as well as chronic #headaches #digestive #fatigue #lethargy #appetite #weight #insomnia #musclepain #jointpain #protect #FirstDoNoHarm #Childline #NSPCC #YoungMinds #UN #UNICEF #Oxfam #WHO #Samaritans #MIND

Simple initiatives can support the immune system for children and adults.

Calm, lack of stress or lack of chronic anxiety supports and strengthens the immune system, and contributes to improved general health; resistance to infections, decreased complications, improved recovery times and prognosis, which is supported by longstanding well established evidence-based research.

Simple initiatives can support the immune system, such as regular:

1. Calm and positive mental state

2. Calm and positive environment

3. Laughter, fun, enjoyment

4. Positive engagement with loved ones, supportive seniors or peers

5. Engagement in normative activities (details mentioned)

6. Relaxation in fresh air with nature and/or animals

7. Exercise

8. Sufficient sleep

9. Hydration

10. Health food options such as fresh fruit and vegetables.

#GlobalHealthPlan #Systemic #covid19 #coronavirus #Health #FirstDoNoHarm #calm #stress #anxiety #prognosis #immunesystem #resistance #complications #recovery #laughter #normalcy #relaxation #nature #animals #exercise #sleep #hydration #food

Simple initiatives can positively impact on mental state.

Chronic anxiety or stress is a well established evidence-based and significant risk factor for mental health and general health; lowers the immune response, significantly increasing susceptibility to infections and worsening prognosis.

Simple initiatives can positively impact on mental state. Consider your immediate environment and be creative regarding your options. Many children and adults comment on their favourite activities in this context, effective strategies to precipitate and maintain calm:

1. Regular time in nature or in the garden or tending or enjoying indoor plants.

2. Planting a fruit or vegetable garden, learning as you go.

3. Quality time with pets and animals.

4. Learning about new food types and experimenting with new recipes on your own or with your family.

5. Enjoying a drawn out meal in a pleasant setting, such as outside, or with a certain theme such as Italian.

6. Creating a calm environment with good music.

7. Reading a relaxing and good book or magazine.

8. Enjoying a favourite hobby such as birdwatching, fishing, swimming or learning about sailing.

9. Learning a new skill such as salsa, ballroom dancing or yoga (with the help of online experts or old movies).

10. Watching relaxing movies.

Balance and boundaries are important to maintain a calm mental state.

It is important to stay up to date with current governmental advice regarding health and travel, however, it is essential that you arrange regular ‘time outs’ where you only focus on positive and relaxing themes.

#covid19 #coronavirus #Health #calm #anxiety #stress #risk #immunesystem #prognosis #simple #strategies #timeouts #positive #animals #nature #balance #boundaries

Protecting high and low risk groups equally is essential.

We cannot cause harm to one group to protect another group.  Please consider recent statistics published relating to lockdown and increased risk and harm in the context of the general public and vulnerable children (WHO, Unicef, NSPCC, Children’s Commissioner’s report England, NCMEC, MIND, Samaritans, Young Minds and Oxfam).  

High risk individuals in the context of covid-19 (due to eg age, compromised immune systems or underlying medical problems), require different protocols to facilitate equal protection.

It is essential to protect high risk and low risk groups equally and ensure that both groups have access to risk reducing and protective tools and initiatives from a bio-psycho-social context.  Normalcy and liberty are important and evidence-based protective factors for both groups.  Different risk groups can be provided equal protection, but this cannot occur by applying uniform, indiscriminate or ‘blanket’ measures to the general public. 

Doctors have been protecting high and low risk groups equally in many contexts and medical domains for several decades in Health.  

Significant fear, stress, chronic anxiety, negativity and hostility have been reported in the context of debates relating to covid-19.  Most medical doctors would agree that these markedly increased chronic anxiety and panic are likely to lead to significant harm and increased clinical morbidity. 

Initiatives, approaches and debates to protect the public, especially when associated with increased chronic anxiety or in the context of deprivation of liberty, must be considered, weighed and reviewed regularly to prevent harm.

Further to recent liaison with a contact in Asia, we were informed that their approach has remained more or less consistent since January; the public has been educated and asked to be responsible and take steps to protect health for self and others (respecting normalcy, liberty and autonomy), strategies did not include threats or mandatory stay at home, curfews or lockdown initiatives, and a sense of calm and camaraderie continued.  Statistics, research, medical training and experience support this approach.   

#covid19 #calm #protect #children #protectivefactors #FirstDoNoHarm

Transparency is essential during medical and mental health crises.

Transparency is required regarding initiatives and information relating to COVID-19.  The high and ongoing anxiety, panic, hostility and conflict reported within the public in many countries, regarding different debate topics relating to COVID-19, will likely not contribute to reduced risk, it will likely contribute to increased immediate and long term risk and harm; as is supported by longstanding well established evidence-based research. 

The public has to be informed of relevant statistics to reduce panic and chronic anxiety.  Dr Michael Ryan, Executive Director, WHO Health Emergencies Programmes, stated on 5 October 2020, that “our current best estimates tell us about 10% of the global population may have been infected by this virus”.  The WHO reports a global population of 7.6 billion, therefore more or less 760 million have been infected, with 1 034 837 deaths at the time and an infection mortality rate of more or less 0.136%.  These figures have to be published widely and explained in a clinically relevant context to reduce anxiety for the general public. 

Hawaii’s government circulated a fast facts sheet to the public stating that illness due to COVID-19 is usually mild, especially for healthy children and young adults, and that most people recover from COVID-19 without needing special treatment.  We observed that this initiative contributed to significant calm within Hawaii. 

It is essential for good clinical outcomes that individuals believe that it is possible and probable to remain healthy or recover without complications if they follow medical advice, which, considering evidence-based research, has to include risk reducing behaviours (eg washing hands before touching the face) and protective factors for the immune system, general and mental health (eg relating to advocating calm, normalcy, liberty and autonomy to make informed and educated decisions regarding own health).  

Clinical outcome is often affected most by simple measures to prevent harm and to protect.  Simple protective measures cannot be neglected in initiatives to safeguard the public.  

Decisions in the context of the pandemic will have consequences for years to come in many communities and countries, therefore transparency, diligence, clinical responsibility (considering that this is a clinical crisis) and accountability are required.

https://www.bmj.com/content/371/bmj.m4425

#BritishMedicalJournal #BMJ #FirstDoNoHarm #covid19 #transparency

Global Health Plan

Global health plan:

A global health crisis requires a global health plan; a systemic, evidence-based, consistent approach is required with a focus on risk management in the context of respiratory infections (eg hand washing before touching the face or eating) and protective factors that support and strengthen the immune system and contribute to general and mental health (eg calm, normalcy, liberty and autonomy, giving individuals with capacity to make good decisions the responsibility and tools to act responsibly).  

Relevant evidence-based bio-psycho-social risk and protective factors have to be identified, considered and weighed during risk assessments and risk management plans by clinicians with clinical experience in complex and high risk contexts.  Every country is different and biological, psychological, cultural and social contexts vary vastly within many countries.  Culture and social environment must be considered.  Photographs available on our social media links illustrate various living quarters for children; many individuals live 10 per room, do not have plumbing, clean water and do not eat if they do not leave home.  The latter is true for many families in nearly every country including the UK (please see recent reports by The Trussell Trust) and the USA.  Living arrangements and lifestyles are of course different in Hong Kong and Korea or Canada and New Zealand or London, Leicester (in lockdown until recently) and Wales.  

We have to consider the clinical and social outcomes of initiatives put in place to protect the public in every country and context.  

General health, mental health and social risk outcomes secondary to this pandemic and secondary to relevant initiatives put in place to protect in one country, will affect all countries; a global and systemic approach is therefore important.  Consider the relevance of childhood immunisations or vaccines, for example.  Equal, considered and consistent protection in communities and countries should be a treatment goal. 

It is essential that a global health plan prevents harm, protects and is simple, generalisable and evidence-based, not indiscriminate, prescriptive, dictatorial or micro-managing, but rather providing all responsible adults with tools (such as information and education) to make good decisions for themselves, their families and communities in every bio-psycho-social context.  This is the clinically safest approach, considering a systemic and evidence-based view, and is congruent with relevant laws and ethics relating to health, liberty and children. 

Give people the tools, including information and education, and let every adult make responsible decisions for self and others.  This approach has good clinical outcomes in many or most medical fields in all cultural contexts.  Deprivation of liberty has devastating immediate and long term consequences for the immune system, general health and mental health for the general public, as per evidence-based research.   

Let’s work together to protect the most vulnerable in every age group.

#covid19 #lockdown #GlobalHealthPlan #culture #mentalhealth #children #social

A systemic approach is key to affect positive change in most medical domains.

Leadership observed in many countries in Asia during our travels was inspiring; we observed no delays, debates, uncertainty or chaos, we mainly observed clarity, consistency and congruency amongst the public, governmental officials and health professionals.  Messages within recommendations were evidence-based, brief, clear, informative, consistent, helpful to the public and instilled calm.  Governmental officials and health staff appeared clear regarding protocols and policies, and appeared to follow policies diligently; the public appeared to follow their lead.  The public did not present as confused or anxious, but as positive and confident regarding next steps.  The public appeared educated regarding risk and appeared to trust health professionals and government officials, who led by example.  We observed a sense of camaraderie and working together within the public, government and health systems.  These strategies contribute to good clinical outcomes, as per evidence-based research. 

We observed no Police or Military involvement or threats in the context of the pandemic during our travels in Asia. The public was educated in terms of risk and protective factors, and asked to make responsible decisions for themselves and their community. We observed no restriction, severe or otherwise, associated with deprivation of liberty or threat in general towards the public; this, from what we observed, contributed significantly to calm within the community.  Calm, lack of stress or lack of chronic anxiety supports and strengthens the immune system, and contributes to improved general health; resistance to infections, decreased complications, improved recovery times and prognosis, which is supported by longstanding well established evidence-based research.  

Most doctors would agree that ‘forcing’ an adult to do anything, in any context or health discipline, is very seldom, if ever, effective.  A systemic approach is essential.  Quality of communication is key.  Language used is key.  Consider Newton’s third law; a force in one direction promotes a force in the opposite direction of equal strength.  This is relevant in all cultural contexts.  As one doctor reflected “forcing anyone to do anything has never worked if you consider world history, it only serves to create chaos and disaster.”  Most doctors would agree that neglecting a systemic approach, by ‘putting an individual in a corner’, where there is no choice, is a sure measure to increase risk significantly; social, psychological and biological risk.  It is an approach that is seldom effective and often leads to significantly increased risk and harm.  Exceptions do exist, although clear evidence-based clinical indications or legal reasons are required and laws such as the Mental Health Act protect individuals in this context. 

The general systemic approach, quality of communication and language used in much of Asia, as observed, inspired calm, a positive environment and hope within the public, which affect clinical outcome significantly, as per evidence-based research.  These are significant protective factors for general and mental health, and initiatives that protect, support and strengthen the immune system significantly and in more than one way.  These are also evidence-based initiatives for crisis, risk or emergency management in Medicine and Health.  Current statistics also support this approach in these nations.

Let’s work together to protect our most vulnerable. A consistent, evidence-based, systemic approach is essential to achieve good clinical outcomes.

Thank you to the leaders of nations and international organisations who have raised concerns regarding systemic risk and protective factors for children and communities. You are shaping our tomorrow for our children.

#calm #lockdown #leadership #covid19 #systemic #WorldHealthOrganization #risk #ThankYou #education #camaraderie #recovery #complications #prognosis #communication #messaging #evidence #Newton #culture #doctors #laws #language #ImmuneSystem #children #communities #future #ChildProtection

 

A global health crisis requires a global health plan.

A global health crisis requires a global health plan; a consistent, evidence-based and systemic approach with a focus on risk factors and protective factors that support the immune system, general health and mental health, eg calm, normalcy, liberty and autonomy.

It is essential that medical professionals with appropriate and different clinical training, clinical experience and cultural as well as educational backgrounds work together and share expertise to agree on a global health plan without delay. A global health crisis requires a global health approach.

It is essential for a good clinical outcome that clinical recommendations or initiatives include evidence-based protective factors, which include protecting, supporting and strengthening the immune system through initiatives relating to normalcy, liberty, autonomy and avoiding chronic anxiety and high levels of stress.  

First do no harm is an essential focus for good clinical outcomes; this will ensure protection, improved prognosis and decisions in accordance with ethics and human rights laws.  Ensure that all recommendations adhere to this principle.

It is essential that one person or party (with one person responsible) takes the clinical lead and the clinical responsibility in medical crises, this avoids debates and delays.  There is little place in a health crisis for debates or delays, politics or negative emotions; clinical training, experience and research support this approach.  Medical emergencies should be clinically led by a clinician with training in emergency management; with appropriate experience to consider systemic risks and protective factors in high risk and complex contexts and to finalise or amend systemic risk management or action plans without delays.  Medical emergencies require a focus on clinical presentations and relevant systemic bio-psycho-social risk and protective factors, which must be weighed and balanced throughout emergency management by doctors with relevant clinical experience.  

Clinical experience refers to medically trained doctors and specialists who have extensive experience in clinical assessment and treatment, through direct face to face contact with patients, in various high risk and complex settings, including emergencies, ideally in more than one medical domain.  

Leaders with clinical training and clinical experience are essential for good clinical outcomes during clinical assessments, treatment and emergencies. 

Let’s work together to protect our children and communities.

#covid19 #GlobalHealthPlan #ImmuneSystem #Together #evidence #risk #protect #children #communities #doctors #calm, #normalcy, #liberty and #autonomy #outcomes