The Lost CinemaMovie lovers are to be given the chance to enjoy open air cinema in the grounds of Marlborough College.
Followers on the The Lost Cinema Facebook page are currently being polled to decide which film should be screened. Front-runners include The Breakfast Club, Bridget Jones’ Baby, Labyrinth, Dirty Dancing, and Top Gun.
The event will take place on Saturday, July 15 from 9.30pm.
Other events are taking place at Westonbirt School near Tetbury, St Michael’s Park in Cirencester, and Stanton House Hotel near Chippenham.
For more information, visit www.facebook.com/thelostcinema
Pewsey Fairy TrailFairy folk are heading to Pewsey, and visitors will be able to visit their tiny houses during the village’s first Fairy Trail.
Trees along the woodland walk called The Scotchel will be adorned with tiny doors and windows made by local children.
The trail will also feature a wishing well, art by local artists, and magical messages from the fairies.
The trail will be open to visitors between 11am and 3.30pm on Sunday, April 23. Attendance is free.
For more information, log on to www.facebook.com/PewseyFairyTrail
The third recital in this series at St Peter's Church in Marlborough was given (February 26) by the young British pianist, Adrian Oldland.
Adrian began his musical studies at the age of seven when he joined his local church choir and went on to gain a place at the Trinity Laban Conservatoire of Music where be completed both a B Mus and an M Mus, studying under Alexander Ardakov.
Since then Adrian has gone on to establish himself as an exciting and formidable performer on the concert platform, noted especially for his sensitive interpretations of the works of Robert Schumann. He has taken part in many master classes with distinguished pianists such as Peter Donohoe and William Howard, and currently enjoys a busy career, performing regularly across the UK and throughout Europe.
Adrian Oldland began his recital with two of Schumann’s eight ‘Novelletten’ or short stories written in 1838. No 1 begins with a march-like staccato theme which gives way several times to a more languid and expansive theme, full of sunshine, before returning triumphantly to the original theme - two very different moods in one piece, very reflective of Schumann’s own personality.
Clearly at ease with Schumann, Adrian made much of the contrasts, highlighting the plangent mood of the trio theme. No 8 is a much grander piece, but again, Adrian developed the marked contrast in mood which the piece exploits. It opens with a passionate statement heard above an outpouring of rippling semi-quavers.
This gives way to a jovial trio before returning with renewed urgency to the first theme before a second trio changes the mood again; contrasts that were very well articulated.
Then comes the last movement, which is almost the same the length as the remainder of the piece and with its own dramatic contrasts in mood, first languid and reflective and then forceful and masculine.
All human emotions seem to be encapsulated in this movement of frantic contrasts of both key and mood. The movement seems rather disjointed ('ramshackle' was the word Adrian used!) as if these short movements were put together randomly. However the movement does have some shape with a repeated use of the initial march theme.
Technically this was a ‘tour de force’. However, although the contrasts were clear, I thought there was insufficient ‘storm’ and grandeur in the louder sections.
Beethoven’s Sonata No 30 in E major completed the first half of the recital. This is a fine work - both personal and intimate. The first movement is all froth separated by more tranquil sections, while the second movement, a ‘prestissimo’, is more urgent and compelling. It was well played, but lacked some of the drama which the composition requires.
Finally came the third movement a gentle cantabile - one of the finest melodies that Beethoven ever produced. It is like a wistful sigh or a gentle yearning. This theme is then developed into a series of variations of varying character and complexity until the listener is returned to the serenity of the opening melody.
Technically Adrian’s playing was impressive, but was lacking in emotional intensity - the initial theme lacking in personal engagement and languor.
The second part of the concert was devoted entirely to one work: Franz Liszt’s ‘Apres une lecture du Dante’. This enormous work known is known as a ‘Fantasia quasi Sonata’ and was published in 1856 as part of the second volume of his ‘Annees de Pelerinage’.
The piece was inspired, as the name suggests, by the extended poem ‘The Divine Comedy’ completed in 1320 by the greatest of all Italian poets Dante Alighieri. As in the poem Liszt transports the listener on a journey towards eternal bliss through Hell and Purgatory until Paradise is finally gained.
Liszt begins the work in the key of D Minor and makes frequent use of the ‘Devil’s interval’, the augmented fourth. Both musical devices were used by many composers to portray the wailing of souls and the hopelessness of Hell. Slowly this turbulent work transforms into a brighter F sharp major key as we are drawn up towards the Heaven.
The work ends with a series of the massive chords in the key of D major - reflecting the reality of redemption as we bask in the glory of Paradise.
Like the poem which was its inspiration, this is a very profound work - technically and emotionally demanding. Adrian certainly rose to the technical challenge, but the performance was lacking in emotional punch. I remained unmoved by the horrors of Hell, and the rapturous description of Heaven lacked real conviction.
It was a very good concert, and it was refreshing to hear Adrian introduce the works at the beginning. However his demeanor and playing were a little stiff and short on emotional input especially in the Liszt. He has the potential to go far, and we wish him well.
NOTE: the recital advertised for Sunday, 26 March has had to be postponed. It will now take place on Sunday, 25 June and will feature the tri of Simon Watterton (piano), Anna Cashell (violin) and Ashok Klouda (cello).
The cover of the Wiltshire transformation plan for children & young people's mental health services A three part series on the treatment of children and young people's mental health problems - in Wiltshire and in the Marlborough area.
Does Wiltshire have a special problem with mental health issues among its children and young people? The county's rate for hospital admissions for mental health conditions (2014-15) was 57.7 per 100,000 0-17 year-olds - against the national average of 87.4. But the rate for self-harm admissions was above the national average: Wiltshire 478.3 - national average 398.8.
Of course much of the impact from anxiety, depression, suicidal thoughts, fear of exams, bullying, social media problems, shows itself and does harm long before children and young people reach the stage of a hospital admission. Early intervention is one of the keys to the new strategy for Child and Adolescent Mental Health Services (CAMHS) in Wiltshire.
Last month the Health Secretary told Parliament that a green paper aiming to 'transform' children and young people's mental health will be published before the end of this year. As is often the case, local health and social care providers are way ahead of the politicians.
New money from NHS England specifically targeted at CAMHS has already brought changes to Wiltshire. Among the improvements bearing fruit is the Improving Access to Psychological Therapies Programme (IAPTP) for children and young people, which began in 2011.
And Oxford Health are now offering a wider range of treatments and interventions. IAPTP also concentrates on training staff - something that will soon come under NHS Wiltshire's budget.
Another innovation has been the online counselling service for teenagers run by Kooth - with face to face access via web messaging available seven days a week - a format that is appealing to more and more teenagers.
The onyourmind.org.uk website, which is in the process of development, will give information about mental health services and will eventually include an online route to self-referral. And self-referral is one of the main pleas from older children.
A prime aim has been to build stronger links between CAMHS and schools. The main way this is being implemented is in Thrive Hubs at secondary schools. It began with six schools in the areas of most need and this is being increased to twelve - see map below.
Each hub has a named mental health practitioner at the school one-and-a-half days a week. The hub has a drop-in 'surgery', does group work, supports onward referrals, conducts one-to-one sessions, sets up peer mentoring and organises youth activities to build resilience.
The first six schools to get Thrive Hubs are named in black - the second six in blue (click on image to enlarge it)
Ian Tucker, headteacher at Chippenham's Abbeyfield School - one of the first tranche of hub schools - is very enthusiastic about its results: "Can I just reiterate the positivity and impact that the Thrive Hub project is having here at Abbeyfield for our students, their families and staff?"
No Thrive Hub yet in the Marlborough Area. But by April 2018 every secondary school will have a Thrive Hub with a named CAMHS practitioner.
Changes in Wiltshire's CAMHS over the next three years will be largely based on the joint Wiltshire CCG and Wiltshire Council 'Transformation Plan'. This is a very comprehensive document that is still at the consultation stage. It includes many worthy and many welcome ambitions, and it explains the ways in which much of the extra money will be spent to improve services.
Reducing waiting times, bringing services into the community, building up the capacity of services, easing transition to adult services, training mental health workers and teachers and helping parents understand the problems their children face - all take money and time.
There is one specific area Wiltshire lead commissioner is keen to improve: "We do need to improve support for children and young people with autism."
A step change in these services comes with the end on 31 March 2018 of Oxford Health's contract for Wiltshire's CAMHS. This contract will be replaced with a single new contractor to take over all CAMH services not just for Wiltshire - where it is being commissioned jointly by the Council and Wiltshire CCG - but also for Swindon and Bath & North East Somerset. Thus contracting one provider for the whole 'footprint' of the Sustainability and Transformation Plan (STP) for our area.
This contract went out to tender in November and the preferred bidder will be named soon. And the new provider will take over on 1 April 2018.
Wiltshire's share of the new contract will be £4,443,400 a year - which will just over half the total value of the seven year contract for the whole STP area. The contract will still rely on the involvement of the voluntary and community sector. This will include the Area Board Local Youth Networks as well as leisure centres and campus facilities.
There is one underlying feature of the new service - integration. The division between Council and NHS responsibilities will go. There will be "No more tiers", a single point of access for all referrals and not such a cliff-edge threshold to overcome before treatment can begin.
Another feature the new contractor must address is the empowerment of children and young people in designing and reviewing the service as it develops - something that is already happening in the county (as we reported in Part One of these reports.)
As ever with social care and health plans there is the matter of staffing. Is there a sufficient number of suitably trained staff available to meet the ambitions of the new service? The lead commissioner for Wiltshire who is working on the new contract told Marlborough.News: "What we are finding in Wiltshire is that Oxford Health have a good track record in attracting staff - they do not have many vacancies."
But he admits: "Nationally there is an issue around workforce that we need to address." For example, nationally the number of specialist mental health nurses has fallen by ten per cent in the last five year.
Locally they will need a workforce plan - seeing how to attract the necessary numbers of therapists and supervisors, how to retain staff and how to develop new roles.
They are working with Health Education England to refine the role of Psychological Wellbeing Practitioners who have experience of child health but do not necessarily have a degree in psychology. They can, for instance, provide high volume, low intensity interventions for children and young people with mild to moderate depression.
Another of the government's plans outlined by the Prime Minister is that the current CAMHS system across England should be 'reviewed' by the Care Quality Commission - ahead of that promised 'green paper'. When the review is complete, it will be interesting to see whether the plans for our area are ahead of the pack.
Part Three will be online soon: How Marlborough schools are responding to increased pressures of pupils' mental health issues
CASEBOOK TWO: Names have been changed throughout these accounts of CAMHS at work
Casebook One gave CAMHS a very positive report - not all experiences of CAMHS are the same:
Linda is a single mother living in Wiltshire with an eighteen year-old daughter (who we will call Frances) and another and older child. Frances has severe learning disability.
"Generally", says Linda, "she functions pretty much like your average 3-6 year-old." Two years ago Frances was hit by a series of losses - deaths and absences - over a very short period of time: "She couldn't understand her feelings, let alone articulate them."
Linda was called into school because teachers could not get Frances to do anything. One time she sat 'wailing in the corner'. Another time while she was supposed to be eating lunch, she was repeating over and over again a single plea: 'Sing to me and make me happy.'
Linda took her to their GP who referred Frances to CAMHS. How was CAMHS? "Useless". The initial appointment with a consultant was, by Linda's account, a disaster.
"I got the distinct impression she had no experience of dealing with learning disability. She directed every single question to me. Frances picked up on that straightaway. She has a heightened sense of that sort of thing and within a few seconds she wanted to get out. I said 'No'. The consultant carried on asking me awkward questions in front of my daughter."
"At the end the consultant said 'We can't deal with learning disability'. I thought that's not much help - and that was that. Some months later CAMHS rang me back for an update."
Linda has heard of other similar cases - and always there is no explanation as to why CAMHS cannot help.
After discussions with Frances' teacher and senior staff, she was saved by her school: "At the time they provided a private counselling service to come into school to help a couple of students. They probably couldn't do that now because of the cuts."
"My daughter is a million times better than she was. She's almost a different child."
Frances can stay at her special school till she is nineteen. Special needs funding lasts for three years beyond sixteen - so she will have used that funding up by the time she leaves the school. Linda hopes she can go to a farm college - she gets on well with animals and could get a certificate in horse studies and some work experience.
Linda is not at all happy that CAMHS will not help young people with a learning disability: "This is a huge chunk of society - and a vulnerable chunk. You could even say it's a human rights thing."
This case is now being reviewed.
Healthwatch Wiltshire's Young Listeners in actionA three part series on the treatment of children and young people's mental health problems - in Wiltshire and in the Marlborough area.
There is a growing awareness that child and adolescents' mental health is posing a problem of crisis proportions for health services and schools. Most importantly, as answers are being found, the children and young people themselves are being asked their views on the services and suggesting improvements.
Healthwatch Wiltshire, the independent organisation speaking for local people on health and care, has published a report on young people's views and worries.
They trained a number of young people to be Young Listeners - and hear first hand and without adult interventions (interference?) about children and young people's experience of Wiltshire's health and social care services.
When it came to mental health there were three clear areas of concern: lengthy waiting times for treatment, the problems when young people had to 'transition' to adult mental health care, and the need for continuity of care.
A student survey at St John's Academy highlighted ways to improve how early signs of mental health worries can better be treated - see Part Three of this series.
Other views have come from the recent Wiltshire Youth Summit on health and police issues (with representatives from all the county's secondary schools), from Wiltshire's Children in Care Council, from local user participation groups, from the Wiltshire Assembly of Youth, Wiltshire Council's Health and Wellbeing Pupil Survey and Council-led participation in workshops and surveys.
NHS figures show that nationally the number of children and young people with mental health problems attending A&E has increased over the past four years by 89 per cent. Even if that rise was from a relatively low base, it is an alarming statistic. Childline has seen calls about mental health issues rise by 36 per cent over the last four years.
Half of all mental health problems in adults start before the age of fifteen and three quarters before the age of eighteen. As one health professional told me, intervention when mental health problems first arise makes not only ethical, but economic sense.
After years and years as a fairly neglected or somewhat hidden part of the NHS, mental health services for young people are coming steadily closer to the top of the agenda. The Prime Minister has made it clear that young people's mental health is now a priority.
Young people's mental health services go by the NHS acronym of CAMHS - pronounced 'cams' and standing for Child and Adolescent Mental Health Services. And the latest figures show that nearly 3,000 children and young people were treated by CAMHS in Wiltshire in 2015-2016.
The lead commissioner for child and teenage mental health who works for Wiltshire Council and NHS Wiltshire told me: "Investment in CAMHS hasn't really kept up with demand - this is now being addressed."
NHS England has provided more funding. Funds available for Wiltshire's services increased from £5.7million in 2014-15 to £7million in 2016-17 - with increases continuing until 2020-21. The more CAMHS are improved - or 'transformed' - the more funding comes from NHS England in the form of transformation bonuses.
At present CAMH services for Wiltshire are provided by Oxford Health NHS Foundation Trust - available for 0-18 year olds who are referred by their GP, health visitor, school or hospital doctor. Several charities also work in this area - for instance Relate provides community and school based counselling.
However the two main tiers of the CAMHS are paid for and overseen by different organisations. The primary tier - catering for mild to moderate conditions - comes under Wiltshire Council and has about ten staff. There are also seven consultants providing emotional wellbeing support.
The specialist tier - catering for more severe cases - comes under Wiltshire Clinical Commissioning Group (so is from the NHS budget) and has about 66 staff.
Oxford Health have a CAMHS unit at Savernake Hospital as well as the eating disorders unit there. Another tier up, Oxford Health also run the 12-bed facility in Swindon - confusingly called Marlborough House - for in-patients from much of Wiltshire and Swindon.
This current organisational structure is described in a Wiltshire Council/CCG document as providing a 'patchy and incoherent service' and it is stretched: "Parts of the local CAMHS system are almost at gridlock with increasing pressure on GPs, primary and specialist CAMHS and A&E departments."
There are still problems with spotting young people's mental health problems and in dealing with them.
Emily Palmer - who has had first hand experience of CAMHS and wrote Scrambled Heads - A Children's Guide to Mental Health - did a straw poll of teachers via the internet. Ninety per cent said they had had no training in mental health and did not feel able or competent to help a student.
She says teachers often do not want to interfere - feeling they may be 'crying wolf'. When some teachers spot signs of anxiety or worse "There's a dilemma between breaking trust with students versus the duty of care - so they tend to avoid conversations about issues."
And a leading eating disorder charity (Beat) claims that nationally GPs are routinely failing to provide adequate care for patients - with just one in three referred for specialist assistance. Of 1,267 people questioned who had sought help for an eating disorder from their GP, 34 per cent said they did not think their doctor knew how to treat them.
Moves to provide a fit for purpose CAMH service in Wiltshire have already brought significant improvements. And next year there will be a step change in the service with a new contract for a single provider across all CAMHS services - to answer the challenge of turning CAMHS into a whole system rather than a series of providers.
Like commissioners across England, Wiltshire Council and the CCG will be under 'significant' scrutiny to make sure all the new money designated for improving CAMHS is really getting to the font line. It is there it is so badly needed to help children and young people ward off the mental health problems to which they are prone.
A recent letter from NHS leaders warning that local NHS bodies must meet the 'acid test' and prove where the money is going, shows they are worried new cash for mental health may not be properly used. They are demanding accountability and transparency for mental health spending.
Part Two will be online soon: Transforming CAMHS services for Wiltshire
CASEBOOK ONE: Names have been changed throughout these accounts of CAMHS at work
We will call her Anne. One of her two children - who we'll call Jill - is now sixteen. At primary school Jill was very disruptive, but at secondary she appeared to have calmed down. Then one day at school, when she was twelve, she tried to hang herself - and was automatically referred by the school to CAMHS.
"CAMHS", Anne says firmly, "were good." Her daughter was seen quite quickly. She was prescribed talking therapies. Then there was a gap while a new therapist was employed - and during that time she tried to kill herself again.
Although she got a bit better, Anne says: "Talking therapies were not really successful for her." She was discharged after five months.
Anxiety about school work and the pressures of school exams got the better of her again. They tried more talking therapy. It did not work. So she saw a psychiatrist who put her on medication and she is still on it. She has recently had another 'lot' added to her dosage: "And that seems to work".
Anne told me: "CAMHS were wonderful." They worked with the school to find ways to make things easier for Jill. And Anne has meetings at the school every six weeks.
Jill sat her GCSEs: "She didn't get the grades they'd predicted - ABs. But she got good grades - BCs. Better than we hoped. We were quite impressed because we didn't think she'd make it to the exams."
Now in the sixth form, she is finding the going very tough. She is getting a lot of support - a teaching assistant, who has a long experience in this area, sees her three times a week. "There's been no talk of suicide for the last two months - and her panic attacks have calmed down."
Anne stresses the help given by her other child, who is two years younger than Jill, has been "Fantastic - he's been brilliant with her. The times she won't talk to me, she'll talk to him." He has had help from his school and been supported by Young Carers Wiltshire.
Anne is very positive about the changes coming to CAMHS. She is especially hopeful that parents will be able to refer children to CAMHS - up to now referrals are mainly by a GP or teachers. And she favours self-referral too. She wants more schools to sign-up to having CAMHS staff on the premises.
The Tri-Force Dog unit wants volunteers to help develop and train potential police dogs of the future.
The unit, which is made up of Wiltshire, Gloucester and Avon & Somerset dog handlers, is looking for people to foster puppies.
Sometimes, they may also need assistance in homing one of the potential specialist search dogs before it goes on a training course. These dogs would be aged between six and 18 months and normally be a Spaniel or Labrador breed.
Volunteers to provide weekend and holiday cover for puppy walkers will also be needed.
Police Dog Instructor Gary Isom said: "As a puppy fosterer, the puppy would live with you at home from seven weeks old. Under normal circumstances, the puppy would remain with you for at least six months and would then be allocated to a handler between six and 12 months old."
"Obviously the puppies are incredibly cute when they are very young and I am sure there will be thousands of people that would love to give them a home, but you must be able to answer 'yes' to a set of questions, and only serious applicants with experience in training dogs will be considered."
"The early months in the development of these puppies are the most crucial and can bring a real challenge - it will require a great deal of commitment and time from yourself and your family."
"The puppies are highly driven and are not the type of dogs that are happy to sleep all day. They therefore need lots of regular training, exercise and stimulation and cannot be left alone for excessive periods of time. Ideally, they need someone who is at home, or works from home to give them 24/7 supervision in the early weeks.”
To become a puppy walker, you need to answer YES to the following questions:
* Do you have experience or a very keen interest in training dogs?
* Are you able to live with a large, strong dog for at least 12 months?
* Are you physically capable of walking and controlling a large, energetic dog on a lead?
* Do you have access to a vehicle for safe transportation of the dog?
* Do you have a suitable home environment to allow a dog crate to be allocated?
* Are you able to provide a secure garden area?
* Are you able to attend regular training sessions?
* Do you have lots of spare time to introduce the dog to as many new environments & experiences as possible?
* Are you able to ensure that someone would be at home with the puppy 24/7 in the early weeks?
All puppy walkers will be under the supervision of Police Dog Training Instructors who will teach, assist and guide you in the development of your puppy over the months.
They should - please - include examples of their previous experience in training dogs.
Junkyard photo by Manuel HarlanJunkyard reminds us that we need to fight for places to play.
Sometime in the mid-eighties (I’m guessing the spring or summer of 1985) my parents took me to Bowood House, near Calne, where I spent an incredible couple of hours at my first adventure playground.
Rather than swings, and roundabouts, and slides there were tall wooden structures to surmount, cargo nets to scramble up, and what I recall was called a death slide, but which health and safety now demands is called a zip wire.
Back at school, I could not wait to tell my friends. “Lockleaze has got a Vench” said one mate. And so, the following Saturday, we set off – he and his brother on their BMXs, me on a racer (my parents disapproved of the brakeless BMX), five or so minutes door-to-door.
What I found was underwhelming: ramshackle structures of badly nailed wood, and tyres attached to lengths of rope. Occupying the playground were some older kids, who smoked, and swore, and were reluctant to let outsiders play. Did I, I wonder now, meet the real-life inspirations for Fiz and her friends?
This, then, is the world of Junkyard by Bafta award-winning Jack Thorne, whose Harry Potter and the Cursed Child brought the story of the boy wizard to the stage. Lockleaze, though, is no Hogwarts.
It’s the summer of 1979, and optimistic degree-educated hippy Rick, inspired by the Adventure Play movement, comes to Bristol’s Lockleaze estate to work with the secondary school’s most troubled children in building a playground.
At first he is mocked, but one by one his small army of swearing, smoking teenage recruits grow. We meet feisty Fiz – in whom Rick sees leadership qualities – and her pregnant sister ‘Dirty’ Debbie. The father of Debbie’s baby might be skinhead Ginger, or Higgy, or someone else entirely, but not the fragile Talc, who harbours not-so-discreet desires for Fiz.
The playground is built, and the friends evolve from dismissive to becoming fiercely defensive of it, mounting moonlit patrols to ward off vandals and school authorities, who want to build a maths block on the site.
Junkyard is fast-paced and witty, with much of the action taking place around the playground, which in The Best of Us has a song of its own: “This is a spider, this is a ship, this is the thing where we do dip the dip, we haven’t quite worked out what this bit is, but we promise you it is the biz,” the cast sing, in a ballad that recurs throughout the play.
Elsewhere in the song, the playground becomes a metaphor for the lives of the young people “it’s broken and s**t and it doesn’t fit, as broken and s**t as we know we are.” Oh yes, in Junkyard, everybody swears. Even the headmaster.
Music plays an important part in Junkyard, but songs are delivered naturally and honestly, rather than with West End musical flamboyance, with accompaniment provided by a stripped-down three piece ska band of bass, guitar and drums.
The mainly young cast takes the audience on an anarchic emotional rollercoaster, from despair to joyful exuberance and back again, frequently breaking the fourth wall to include the crowd in the action, but never to such great effect as when Fiz stands at the front of the stage and closes the performance with: “We’ve been junk, you’ve been lovely, thanks for coming to watch us play.”
The Vench, we’re reminded, is nearly 40 years old. Now run by a social enterprise, the roughly-hewn wood has been replaced by sanded, varnished, health and safety-pleasing structures. A fitting legacy, you’d think, to the play pioneers, but, tellingly, the name of The Vench’s Facebook page is Save Lockleaze Adventure Playground.
The Vench and playgrounds like it are constantly at risk from politicians who have forgotten the value of play. In 2014, Wiltshire Council cut the number of youth workers from 144 to 25. That number is now down to seven – for 100,000 children.
In Marlborough, the future of our 1970s Youth Centre – saved from total closure by a handful of community champions, but providing nothing like the services to young people it did five years ago – remains in limbo. Devotion, a hangout for youngsters, could close if more volunteers are not found.
Junkyard, as well as being a thoroughly entertaining two-and-a-half hours of theatre, reminds us that we need to fight for places to play.
Junkyard is at Bristol Old Vic until March 18, then tours until April 29.
St John's Academy: healthy mind, healthy lifeThe last in a three part series of reports on the treatment of children and young people's mental health problems - in Wiltshire and in the Marlborough area.
One former pupil of St John's Academy we spoke to said they had found CAMHS "Brilliant - with its friendly waiting room and willingness to suit your timetable - very different to what was available at school. But when I needed more serious help there was a huge gap - going to a hospital felt like a big step up. It's scary - lots of long names and corridors."
Attitudes in secondary schools are changing - and schools will, as we have seen, be at the centre of the new CAMHS regime for Wiltshire. I met with St John's Academy's Assistant Vice Principal in charge of safeguarding, Miss Maeve McNeill, and with the school's part-time counsellor, Rona Muller, to discuss mental health issues - especially anxiety and panic attacks.
At St John's they were very open and keen to discuss the issues. Why did they think there was such an increase in pupils wanting help? "Twenty years ago there just weren't so many issues. Now there's a greater awareness of the issues and discussion in the media and on social media."
"Much of it is anxiety - quite often at a low level. There's a lot of tension in the world and they pick up on it. They're connected all the time to 24-hour news - they will know instantly that something has happened - and they worry more about what they hear or read. There may be family tensions too. It's an intense time of life. But teenage years are hard enough without these kind of issues."
There are worries too about achievement and exams - these may be internal school or parental pressures to excel or they may be pressures they put on themselves when they realise they need good results to get a good job or move into further education.
Wiltshire's lead commissioner for CAMHS had identified for me a further and interesting cause of the rise in teenage mental health issues: lack of sleep. Whether it is chatting via social media, watching television in their bedrooms or playing computer games, sleep time is being lost.
The Marlborough area is not yet on Wiltshire's programme for secondary school Thrive Hubs. But St John's Academy has Rona Muller, and can also call on two part-time mentors. She has her own room, which was included in the design for the new school buildings: "We're very lucky that it is a very nice room - conducive to counselling!"
Rona Muller sees students during the school day - the average is about five one hour sessions and she swops appointments around so students do not miss the same lessons again and again. Appointment times are delivered in envelopes - for privacy: "We do respect students - we're very discreet."
A poster for an the online services designed for teenagersSt John's are also lucky to have the area's CAMHS unit so close by - at Savernake Hospital. Sometimes CAMHS staff from Savernake Hospital work with pupils in the school and sometimes go to their home: "It's a very bespoke service and they now work more closely with schools."
Since September, teachers have seen an improvement in the service provided at Savernake. Before there had been too much 'bouncing back' of students who did not meet the CAMHS severity threshold: "There's especially been an improvement in turn-around time - it's down now to two or so weeks from referral to being seen."
There are still, of course, varying degrees of 'awkwardness' about mental health problems: "The key to being successful with our young people is knowing them as individuals." Only then can open discussions between teacher and student take place.
While year seven students at St John's - in their first year at secondary school - have a separate regime, students up to year eleven are in mixed age tutor groups and see their own tutor every morning. Sixth formers are grouped together. These arrangements make mentoring schemes easy to arrange.
St John's Academy has found an innovative away to help students at the early intervention level. Currently there is not the time or the resources in school to address all the needs of those suffering panic attacks or anxiety - conditions that do not automatically qualify for CAMHS treatment.
It was the students themselves - in a recent survey - who asked for help with these mental health issues. And it was Wiltshire Council's area Youth Facilitator, Helen Bradbury, who canvassed students and suggested the school apply through the Area Board for a grant from Local Youth Network funding to run a pilot programme of weekly 'mindfulness' sessions.
The sessions with a specialist practitioner will teach techniques and exercises to calm the mind and through self-awareness help students manage their stress and anxiety. The school will support this with an hour a week of one-to-one work with the practitioner.
During the pilot, the school will evaluate the effectiveness of the programme subjectively, with a questionnaire at the beginning and end of the programme.
St John's asked for a grant of £5,000. In January, the Marlborough Area Board approved a grant of £3,500 to fund the pilot for the rest of the academic year - with £500 of the grant put for a proper evaluation of the pilot. And they wanted this work to become part of the school's budget and spread to other schools in the Academy Trust.
St John's reckons that about five per cent of their students need some attention for mental health issues. That equates to about one student in every class.
Wiltshire's lead commissioner for CAMHS explains: "Locally, the bulk of the CAMHS caseload is made up of teenagers - mainly anxiety, low mood and depression." The problems are not so serious or numerous at primary school level - but early intervention is the watchword.
Marlborough St Mary's Primary school is still operating on its two sites - and due to move together into the new school in September. At the moment they do not employ a counsellor.
Headteacher Anne Schwodler told Marlborough.News: "CAMHS offer a very useful service but along with everyone else have very limited funds to cope with the increasing demand for mental health services and it is therefore sometimes quite difficult to get support when it is needed."
The number of pupils who need support for emotional problems has been rising, but it is difficult to give a percentage as the level of need varies widely: "We have children in Key Stage 1 and Key Stage 2 - pupils between five and seven years old - who need some support with emotional needs for a variety of reasons."
"We have trained Emotional Literacy Support Assistants on both sites who work with children one-to-one or in small groups to support children with emotional issues."
One of the Prime Minister's plans is to offer every secondary school in the country mental health first aid training over three years. With 'early intervention' the watchword on the lips of politicians and commissioners, it might be advantageous if this was extended to primary schools as well.
In development: part of the home page of the new On Your Mind website
CASEBOOK THREE: Names have been changed throughout these accounts of CAMHS at work
A third parent who lives in Wiltshire but outside the Marlborough area and has shared her experiences with Marlborough.News, confirms that CAMHS do not always cope well with pre-existing conditions that turn into or come to include a definable mental health problem.
We will call her Jenny: she sees her teenage son's depression, anxiety and suicidal thoughts as quite separate from his ongoing autism and aspergers: "I just couldn't get through to them how he needed handling differently due to the autism, but that it wasn't necessarily the main cause."
"The CAMHS were lovely people. I did find the young girl we spoke to a bit unsure of how to approach a child with autism. She did keep saying that some of the negative feelings were caused by the autism, but did not say how to help him."
"Six sessions were nowhere near enough to get a testosterone filled austistic teenager with anger and suicidal issues back to 'normal'. It wasn't even long enough really for them even to get to know each other, to form a trust."
"He also," Jenny says, "lies." He will lie to create the easiest path: "His keyworker knows this and we have spoken quite often about it. But in six sessions the CAMHS worker just did not know him well enough to help him."
"He is still bad now, last week we went back to the doctor and he has pretty much demanded more sessions, but it's the school that has to implement this and I don't think they have the clout to get it done. The doctor did say she would write to the school if it helped - but that my son needed help and needed it now."
At the February meeting of the Marlborough Area Poverty Action Group (MAPG), a Marlborough man, who experienced homelessness for several years, and who is now planning to develop a project aimed at helping other homeless people in the local area, outlined just how difficult life on the streets can be.
Becoming homeless is a devastating experience which can happen very quickly to young and old alike. A broken relationship, a loss of employment, unmanageable debt - and everything familiar can disappear almost overnight.
There has been a 134 per cent rise in homelessness since 2010 and an estimated 4,134 people sleep rough in England on any given night (homeless.org.uk). For many the sudden change in environment causes havoc with mental and physical health and the experience can be so disorientating that seeking help is almost impossible. When help is sought it is often fragmented and difficult to access.
His talk highlighted difficulties in decision-making and communication abilities, which can occur when people are cold, tired, hungry and angry. Many people want to help the homeless, but sometimes the help on offer is difficult to engage with. A harsh environment can alienate individuals from other people to the point where the individual may look at life much differently to a normal person.
His project, being planned in conjunction with Gloucester and Cheltenham University, hopes to bridge this communication gap through the experiences of those who have suffered homelessness.
For this reason it is being developed in collaboration with seasoned and hardy homeless people who have had time to adapt to their environment. It is primarily aimed at helping the inexperienced or vulnerable such as under 18’s, and men and women with no experience of homelessness to gain access to appropriate help as quickly as possible in order to survive the early stages of homelessness.
The project aims to be an easily accessible survival guide for those on the streets.
With a working title of “The Lamp” or thelamp.org.uk it will offer life saving advice, tips, first aid, a directory of useful numbers and provide information on where to get food/shelter/free showers/medical help/the side effects of drugs/what drugs to avoid and much more.
Most importantly it contains information that is vital to getting the help each individual needs quickly.
Printed in an easy to carry book, the initiative will also come with online services including a dedicated website, mobile app and low cost mobile device text bulletin services.
An aerial view of High St from St Peters ChurchThe name might be boring, but a recently-published document gives a fascinating snapshot of life in Marlborough and the surrounding villages (including Ramsbury and Aldbourne, but excluding Burbage and Great Bedwyn, which fall under Pewsey).
A Joint Strategic Assessment has been conducted for each of the 17 local areas (most centred around market towns or large villages) in Wiltshire.
Looking at areas over which Wiltshire Council - which compiled the statistics - has influence, it compares the quality of life in a community to its county neighbours.
Here are some of the findings:
- The Marlborough Community has an estimated population of 18,120 people, 21 percent of whom are aged 0-17, 57 percent of whom are of working age that’s 18-64, and 22 percent of whom are 65 or over.
- Life expectancy is slightly higher than the Wiltshire average: 82 for men (against 81 county-wide) and 85 (against a county average of 84) for women.
- According to the report, although four percent of Wiltshire residents live in some of the most deprived areas in the UK none of them are in Marlborough.
Health, wellbeing and leisure
- Our children are, by and large, a healthier-than-average bunch: 22 percent of 10-11 year olds are overweight or obese, compared to 33 percent county-wide. That’s still one-in-five junior school kids who could stand to lose some weight, though.
- In 2014/15 92 percent of five year olds in the Marlborough area had received their second dose of MMR jabs. While this might sound impressive, it needs to be around the county average of 95 percent to reduce the risk of a measles outbreak – and that’s making health officials nervous.
- On top of that, only 36 percent of people at particular risk from the impact of flu received a vaccination shot in 2015-16.
- Fifty-nine percent of infants in the Marlborough area were partially or totally breastfed at 6 to 8 weeks – four percent higher than the Wiltshire average.
Children and young people
- Seven percent of children and young people live in low-income households – lower than the Wiltshire average of 10.6 percent.
- In 2015, the percentage of children achieving level 4 or above in reading, writing and maths at the end of primary school was higher in the Marlborough area (85 percent) than across Wiltshire as a whole (80 percent).
- And in the same year, the percentage of young people achieving five r more GCSEs including English and Maths at A* to C was 64 percent, compared to a county average of 61 percent.
- In 2015-16 the rate of reported anti-social behaviour in the Marlborough area was eight reports per 1,000 people – lower than the county average of 19 per 1,000.
- In the same year, the rate of reported domestic abuse in the area was four incidents per 1,000 people, against a county average of seven per 1,000.
- Is the percentage of households in socially rented accommodation higher or lower than the county average? Have a guess. It’s higher: 17.3 percent against a county average of 14.7 percent.
- The average house price in Wiltshire is £230,000. Guess what it is in Marlborough? £315,000.
- Guess how many affordable homes were built in the Marlborough area between 2013 and 2016. Six. SIX! No wonder there are currently 54 families waiting on the social housing register.
- Four percent of A roads and two percent of B roads were identified as requiring treatment in 2015-16, against a Wiltshire average of three percent (A roads) and four percent (B roads). This will prompt a lot of readers to ask at what point is a road ‘identified as requiring treatment’?
- Average daily traffic in the area has increased by two percent since 2007.
- The usage of car parks owned by Wiltshire Council in the Marlborough Area is 69.8 percent – higher than the county average of 52.9 percent.
- The largest two employment sectors in Marlborough are education and retail – thank you St John’s, Marlborough College, and our High Street traders!
- 0.6 percent of working age adults in the Marlborough area receive Jobseekers Allowance - slightly lower than the Wiltshire average of 0.8 percent and a third of the UK average (1.8 percent).
- One percent of 18 to 24 year olds in the Marlborough area receive Jobseekers Allowance - which is lower than the Wiltshire (1.7 percent) and England (2.5 percent) averages.
- 5.3 percent of the local population area employed in the arts, entertainment and recreation sector.
- Forty percent of residents in the Marlborough area are members of the local libraries – which, surprisingly, is one percent lower than the county average.
- 53,067 library visits were recorded in the Marlborough area in 2015-16.
- There are 835 listed buildings and 17 venues hosting cultural programmes in the Marlborough area.
For ease of reading we’ve been selective with the statistics we’ve reproduced. You can view all the stats online at http://wiltshirejsa.org.uk/community-area/marlborough/