Britain’s Bounce

Britain’s Bounce

“Britain’s got its bounce back” – is how we were invited by colleagues to join the Cambridge University Dance on Saturday 4 December 2021. Ballroom and Latin dance including tango and salsa are enjoyed by many during these events. No particular or expert skills are required.

“Any kind of is better than no dancing at all.” Barr

For more information https://www.cambridgedancers.org

Christmas Dance Event 10 December 2021 https://www.eventbrite.co.uk/e/xmas-special-festive-ballroom-social-dances-tickets-217436176457

Many children, families and medical colleagues are concerned about lack of normalcy, autonomy and liberty, and prefer contexts where these protective factors are available. Most governments that we and colleagues have liaised with do not mandate masks for sports including dance.

Dance is a unique way to connect with and integrate into communities and cultures, to build and maintain trust and positive relationships, to learn skills, exercise the brain and body, enjoy good music, manage stress or anxiety, relax, maintain calm and have fun. Dance is a protective factor for general health, mental health, general development, social risk and well-being for children and adults.

Dance also relates to trust. Learning about trust is essential for children. Read the inspiring true story or watch the movie “Take the Lead” based on the story of Pierre Dulaine, a Manhattan dance teacher, who changed the outcomes for children through dance. Once again, simple measures often affect outcome in profound manners for children. Measures must however be associated with evidence-based principles (principles based on good clinical evidence).

Many of our patients, after significant or repeated loss, report “my body or my heart, something tells me I have to dance to survive this dark time”, as reported by a 17 year old after losing more than one loved one in two months. Many report the same “urgent need” in terms of swimming in this context.

We all experience and manage loss, trauma and challenge differently, presenting with different needs at the time. “It is important to listen to your body, brain, spirit, heart – every cell that is verbal about moving forward must be heard”, as the same 17 year old reported. It is also important to never go it alone in dark times, to regularly meet with positive and supportive adults and peers to talk about concerns, plans or just spend time together. Many report “I want to withdraw from the world, just for a few moments, or for a while, so I dive into dance and music, it is an escape, a safe or healthy escape, that gives you a space to communicate without words”, as reported by a 14 year old child.

“Dance is the hidden language of the soul.” Graham

Dance is indeed a “healthy escape”; you can be surrounded by a group of people, yet be in your own world for the moment, or you can connect with others in a positive and light way “without talking about the heaviness”, as a child recently commented.

Everyone dances for a different reason.

“Dance, when you’re broken open. Dance, if you’ve torn the bandage off. Dance in the middle of the fighting.… Dance when you’re perfectly free.” Rumi

Many remarked on positive change in Britain since July 2021 and reported “there are no more chains, I feel I can dance”, “we are free, life has returned”, “I can hear music again”, “Britain is one of the frontrunners for normalcy and good evidence, because in July we stopped making face masks mandatory and we can breathe again, fear has been removed from our hearts and minds” and “we can’t expect good results if we don’t follow good evidence, and at last we are not following poor or inconsistent evidence any more”, as reported by a medical specialist.

However, unfortunately, this changes tomorrow, as announced yesterday. Many medical colleagues and legal colleagues are concerned considering increased rates of child abuse, domestic violence, general violence, drug and alcohol use (up to 500% or more in some cases – please see previous statistics published by the NSPCC as mentioned earlier) due to initiatives not based on good clinical evidence causing significant and chronic anxiety, frustration, anger and low mood. Many medical colleagues and professionals in the relevant field agree that this variant does not warrant these measures; “risk should be managed appropriately, after risk is assessed appropriately – this would be the same as admitting every child to hospital whilst assessing a child, this would translate into (more) negative prognoses for children”, as reported by a medical colleague.

We must however continue to dance.

“Musicians don’t retire; they stop when there’s no more music in them.” L Armstrong

The BMJ (British Medical Journal) published an article regarding the amount of doctors who have taken early retirement during the pandemic which is very concerning. Medical doctors report that they are “losing hope that good evidence will lead”. We are now recruiting medical doctors who only want to see a limited amount of patients, and only low risk patients, per year, so that the music doesn’t stop unnecessarily for doctors willing, able and interested to continue to work. Please contact admin@cinaps.co.uk for more information. Doctors in any field are welcome. We often work with vulnerable children presenting with a wide range of medical problems. Referrals to CAMHS (Child and Adolescent Mental Health Services) in the NHS in the UK have increased from 100 per team to up to 1200 per team or more in some teams. Now is not a time to lose willing, able and interested doctors.

We must continue to dance, and we continue to dance by many steps, for example, by standing up for those without a voice, by looking after our own health to maintain our work and by asking questions. We often inform parents that curiosity, asking questions, is a sign of intelligence in a child, when children can’t stop asking questions, which is not just a way doctors reassure parents, it is true.

We too must ask the right questions, in the right way, to the right individuals at the right time. Psychiatry can be summed up by this sentence.

We often work in very high risk contexts, where we have only 3-5 minutes to do a physical examination, mental state examination and/or risk assessment. Success in most contexts, but especially in these contexts, depends on asking the right question or questions, in the right way, at the right time. The difference between success and failure in these contexts are very significant, and can change the outcome for the child.

One example. Working in a children’s prison we were informed by our mental health team that we cannot see one particular child, because he threatened that he would “kill the psychiatrist he sees”. He was on the ‘most dangerous’ list for children’s prisons, more or less 10 children in the UK at the time. The prison governors wanted the child to be seen to rule out eg serious medical problems, ADHD and depression, and to consider medication. The child remained in isolation most of the time, with limited contact with one or two adults. We (the child psychiatrist) agreed to meet with the child the next day. The assessment was brief, but effective. It is essential that children ‘feel’ and ‘believe’ that they are valued, respected and that professionals are honest and have as first priority their health, well-being, learning more about their concerns and goals, and children are experts at knowing what is real and what is not.

Further to the assessment, moments later in the prison yard, the child walked up to the child psychiatrist, leaning against the wall, saying “what’s up doc?” In that moment, the child’s status changed from ‘high risk’ to ‘low risk’ (as assessed by the prison) and the child was perceived differently by the adults and authorities around him. A world of opportunities in terms of support and care opened up for the child in that moment. The child asked if he has to see us again, that he would be happy to do this. He didn’t need to be seen again. He was removed from the ‘most dangerous’ list and professionals started positive engagement in terms of addressing his concerns and his goals. This child’s prognosis changed in a positive manner, further to these steps, and it started with one brief assessment.

When not to dance – when to sit one out for now. Please know that training, experience and expertise are required to engage in high risk contexts such as in children’s prisons, and with high risk children and complex presentations, and if you are not confident, based on extensive training and experience, that you can help a child and be successful in this role, that it is not the right timing for you as a professional to proceed, that you should rather request another doctor for the role (and request that this doctor provides training and support to the team). Children often get once chance in this context mentioned. If professionals fail, children are often blamed. One experience of a positive interaction with a professional or person with authority for a child, often the first positive experience with a professional or person with authority, can change a child’s path. This child’s ‘story’ changed from a clinical outcome perspective; he was no longer seen as ‘dangerous’ by medical and mental health professionals, but as a child presenting with difficulties requiring support. This translated into the clinical and social risk he posed to others (now and in the future), he was initially assessed as ‘high clinical and social risk to others’, and after a few weeks and months, ‘no high risk to others’, which was maintained long term. Simple, rather than complex solutions often change clinical outcomes for high risk children and risk for children in general, the general public and the community.

We must continue to ask questions in every context, not in frustration, anger or anxiety, but to learn and find evidence-based answers (evidence-based means ‘based on good clinical evidence only’ for most medical doctors). This is how we grow. We ask questions. This is how we protect the most vulnerable, by asking the right questions, finding the right answer, by good clinical evidence.

Let’s continue to dance. Even when the music stops, let’s continue to dance.

This is a good example of continuing to dance. Medical colleagues in the UK, but also in other countries agree with Ms Lois Perry:

https://www.mirror.co.uk/news/politics/face-masks-instil-fear-division-25571052.amp

https://apple.news/Alfm8VfZ5TU-tCAeX4U_zaw

World Health Organisation:  “At present there is only limited and inconsistent scientific evidence to support the effectiveness of masking healthy people in the community to prevent infection with respiratory viruses, including SARS-CoV-2”  More details at https://apps.who.int/iris/rest/bitstreams/1319378/retrieve and https://www.who.int/news-room/q-a-detail/coronavirus-disease-covid-19-masks and https://www.who.int/publications/i/item/advice-on-the-use-of-masks-in-the-community-during-home-care-and-in-healthcare-settings-in-the-context-of-the-novel-coronavirus-(2019-ncov)-outbreak

Let’s move forward following only good evidence. The dance is better this way, it’s easier to move forward and change the outcome in a positive manner. Let’s continue to dance as a team in one direction – forward (or anti-clockwise, as in many dances) – in one direction as a group, as nations, to avoid unnecessary stumbling blocks, delays, collisions or harm and increased bio-psycho-social risk for the general public.

#Britain #Cambridge #Sports #Dance #Event #Tango #Salsa #Ballroom #music #enjoy #fun #relax #calm #swim #GoodEvidence #Recruitment #Doctors #Retirement #ChildPsychiatrist #CAMHS #WaitingLists #children #prisons

Gentle France

Gentle France

“Gentleness is a divine trait; nothing as strong as gentleness, nothing so gentle as real strength.” R Sockman

A 14 year old boy sits down next to a 80 year old woman sitting alone on a park bench in the village. He asks her what she bought. She shows him her vegetables that she bought at the market. She tells him what she will cook tonight, that it will keep her strong, and that it tastes very good. He smiles. She asks about his skateboard. He shows her the wheels. Until today, they had never met. These are the experiences France offers every day, and in every corner, from what we have observed or from what has been reported to us. Powerful protective factors can be found in this brief example.

Individuals of all ages like to connect with individuals of all ages; eye contact is made, smiles are shared, brief enquiries regarding health, comments regarding the weather (usually pointing out how good it is), simple acts of respect and validation. Interactions are often brief, but always or usually meaningful. Individuals stop, make eye contact, and greet each other as they enter an establishment, or as they are handed their coffee. Strangers stop to greet you, wish you a good breakfast and comment on the good weather.

Calm, focussing on plenty and patience (and offering or receiving someone’s full attention) are part of the tradition in France from what we have observed over 20 years.

“From serenity comes gentleness, comes lasting strength.” P Brown

France has highlighted the importance of focussing on child protection concerns in recent months during the pandemic. France has considered good evidence in relation to practical, academic and theoretical challenges. Many charities in France look after those without a voice.

Most comment that they feel ‘home’ and ‘accepted’ in France, even after their initial arrival. France is a place where many feel welcome. Camaraderie (often working together with common goals eg protecting children), liberty and equality are evident in France.

Liberté, Egalité, Fraternité are not mere words in France, but experienced. Most people leave France with one main lesson, that everyone from every walk of life eats the same excellent quality of food, and that you can have the best meal of your life for 3 euros. Months or years can be spent discussing the bread and the butter. Simple things are treasured and expert skills are valued in these domains. Many report “airlines can learn from France’s approach to food”. Attention to detail, relating to all matters, including quality of bread or butter, makes all the difference and translates into quality of life, strength and success. People are inspired by skills, enjoyable food, beauty, by tidy parks and colourful gardens.

Many now report “France is a place where we can find normal, breathe, we can exhale, we can find calm”. Markets provide a world of experiences in every small village. Conversations started, treasures found, stories shared and moments made. Lives are sustained and made worth while by simple things and precious moments. Restaurants are open and Jazz live concerts continue. Spirits soar as the audience enjoys the talent. Communities come together to connect and enjoy together, with evidence-based safeguards, such as regularly washing hands and remaining calm and positive. Simple evidence-based initiatives, decisions and priorities relating to protective factors, promote and sustain immune systems, general health, mental health, development and well-being.

“In this world there is nothing softer or thinner than water. But to compel the hard and unyielding, it has no equal. That the weak overcomes the strong, that the hard gives way to the gentle, this everyone knows, but no one acts accordingly.” Lao-Tzu

Patients, children and families, medical and mental health colleagues often contact us to ask us “where do I find some normal to protect my (or our) health”. Normalcy, autonomy, liberty are evidence-based protective factors for health, mental health, development and well-being. Other examples of protective factors are provided above, such as being part of a community, support networks, friendly conversation, enjoyment and calm.

Medical doctors use the phrase ‘evidence-based’ when good or very good clinical evidence supports the statement or initiative.

We have been asked to write about bio-psycho-social protective factors for health, mental health, development, well-being and success. Health, mental health, appropriate development and well-being are some of the building blocks for success and victory with goals. We have liaised with several organisations, visited many places, and provided lists for several months. We know our colleagues are asked the same questions.

Simple evidence-based protective factors can change the course of individuals’ health, mental health and development. Let’s work together to focus on good clinical evidence.

#health #gentleness #strength #beauty #positive #QualityOfLife #SimpleThings #calm #enjoy #success #victory #France #Liberté, #Egalité, #Fraternité #children #Jazz #LiveMusic #travel #airlines #food

Italy’s Roar

Italy’s Roar:

Every country or area in a country has their own sounds, smells, tastes, traditions, colours, cultures, styles or narratives. Everyone perceives and enjoys these connections differently.

We usually wake up in Italy with the sound of roaring laughter. Children, young people as well as adults of all ages laughing together, often not long after sunrise.

We can learn from Italy’s laughter. Laughter, togetherness and enjoyment, as separate items, but also together, benefit general health and mental health to very a significant degree.

We can also learn from Italy’s focus on beauty, children, communities and food. Everyone, from the fisherman to the mega yacht owner eats the same quality food – excellent food (see recent tweet regarding fish market / shop in Genoa – wait to see fresh fish prepared in the old traditional way – worth a trip – but go early).

Much energy is spent on making the environment or setting beautiful, which gives powerful messages. Music is played, table cloths and candles are ready – “making things beautiful is how we look after yourselves and each other – it means we care”.

We are inspired by Italy’s and Genoa’s many outreach projects for vulnerable individuals – the focus is often on education, learning skills and being part of a healthy community. In Cape Town in the 1990’s – all mental health patients well enough, in one of the main mental health hospitals, were taught a trade or skill such as planting vegetables or basic farming skills, so that when they are discharged (often after months or years), they have opportunities of employment, which help to contribute to a sense of achievement, meaning and being part of a community, which help with confidence and relationships, general health and mental health. These factors, from education to employment, also lead to less poverty and less crime. Most things are connected and the solutions are seldom complicated; solutions often start with education and empowerment – sustainable solutions leading to independence. Giving is not giving unless the goal is sustainable independence.

Simple things often make the greatest difference for adults and children with health or without health difficulties.

We are frequently asked what our thoughts are regarding happiness, general health, mental health, mental state and children – for vulnerable children and adults – and also for privileged and healthy children and adults. The answers are not different.

We will share some thoughts regarding these topics and the effects of for instance music, food, the environment, cognitions, emotions, behaviours and physiological changes such as breathing in future postings. Medical doctors, surgeons, professional athletes and many others use these simple techniques to achieve goals and to inspire or maintain calm or a positive mood.

Many medical colleagues, professionals, patients and families report that they currently “find it challenging to be calm, positive or hopeful or go on with life during this time” and have asked for general thoughts. We recommend that you speak to your GP if you have concerns about yourself or anyone else without delay – getting a general check up or screen in terms of general health and mental health has never been a better idea than now during this time. If you have the ‘all clear’ from your GP – there are many options to consider to move forward – different approaches will work for different people.

Many children and colleagues report that there is nothing more important than having a dream, a goal, a plan – and moving towards it – slowly – whilst enjoying every step of the way.

Where to start – some thoughts:

Step 1 – Be inspired – find a topic or interest that moves or inspires you – that you are very enthusiastic about – it might be Italy, food, sailing, surfing, tango, salsa, working with animals, playing the saxophone, speaking French, horse riding, performance driving, motorcars, travelling, gardening, photography – anything. If at first you cannot think of anything go on an explore adventure phase – read books, magazines, visit forums or webpages, arrange experiences such as sailing or golfing or spending time in nature or with animals – enjoy the explore phase to find something that moves you… there is no rush and ‘pressure’ will sometimes prevent you from reaching this goal or delay the process. Think about what you enjoyed when younger or what you would like to remember as part of your life when you are older. Try to avoid ‘tick box’ items or ‘what looks good on paper or to friends’ – you have to be moved by it – you alone – for yourself. This might be the second most important stage. You can start step 1 at any age.

Life’s blows cannot break a person whose spirit is warmed at the fire of enthusiasm. Paele

Step 2 – Spend time reading or researching this topic – enjoy every moment. You do not have to leave your home for this stage. Do not rush this stage.

Step 3 – Surround yourself with items related to the topic – a theme – for instance if your topic is Italy find suitable music, food, clothing or images. Do not rush this stage.

I have overcome nightmares due to my dreams. Salk

Step 4 – Pause – ensure you are enjoying the previous stages. Dream. There is no rush. Take it slow. Life is a game of inches. Slow progress is often good and sustainable progress. These 4 stages are protective factors for general and mental health, and positives in a life and should be enjoyable and relaxing.

He who has a why to live can bear almost any how. Nietzsche

Step 5 – Prep – start the preparation phase. Think about what you would like to achieve, what you hope to gain from it, why, how it will look like, feel like, as much detail as possible, think about when you want to achieve the first phase or the goal and how. Take it slow – achievable is good. This stage, if completed effectively, will guide and aid the next stage, as the foundation for where the house (plan) will be developed and built.

Everything worthwhile in life takes hard work. Diamonds are only chunks of coal who stuck to their jobs. Smith

Step 6 – Plan – start drawing up a plan – on paper. Read and research thoroughly. Consider risks, weather patterns, training, tools and equipment required. Speak to people with similar interests, professionals and experts. You might meet interesting people. This is the most important stage. Ask for second or third opinions regarding your drawn up plan and goals, as well as thoughts on your progress. This stage is lengthy, as it often takes a long time to develop a good plan, based on information gathered, and to complete required training, learn skills and collect tools. Enjoy this stage. Don’t rush it – rushing this stage will mean a less likely chance of success or achieving your goals.

There is no shortcuts to any place worth going. Sills

Step 7 – Jump – believe in yourself knowing you have prepared and planned well, that you have people at hand to ask for advice if need be, a safety net, and that you will enjoy the ‘getting to the destination’ as much as you have enjoyed the first 6 steps and the destination itself. Don’t give up. Adapt and adjust your sails. Know you should and will never stop learning.

Hold on, hold fast, hold out, patience is genius. Comte de Buffon

There is never a rush – as long as you keep moving forward slowly. Remember good and sustainable progress is often 3 steps forward, 1-2 steps back – that is how we learn, that is how we grow and achieve our goals.

Nothing great is created suddenly. Epictetus

Every one of these 7 steps are protective factors for general health and mental health.

#Italy #Genoa #laughter #children #community #enjoy #health #happiness #positive #calm #skills #education #MentalHealth #goals #dreams #progress #persistence #perseverance #success