#leadersforleeds- Civic leadership for our City

December 11, 2012 2 Comments


As many of my readers will know, I’m terrifically interested in what goes on in my City of Leeds. The event held at the Civic Hall to encourage civic leadership across the City was a great chance to meet with people doing interesting things- from small social enterprises and community groups to the CEOs of our major institutions.

Integrating Health and Social Care

I work constantly to attempt to influence health and social care organisations to work more innovatively and to offer a more integrated experience for people using the services. After all, who cares about whether a service they receive is delivered by a local Trust, by the Council, by the Voluntary sector or if it’s delivered within community groups or social enterprises? When experiencing services, what matters is the quality of the experience, not the organisational structure behind it. So I was pleased to be able to meet with so many others who were representing large and small organisations who work for social impact in the City.

Health Inequality=Social Inequality

Rob Webster, who is CEO of one of our Trusts and a great Twitter follow to boot described the situation perfectly;

“For every mile you walk from North West Leeds heading South, the life expectancy of the residents drops by a year. Residents in South Leeds live 10 fewer years than residents in North West Leeds.”

One of the challenges for people interested in healthcare is that so much about health outcomes doesn’t depend on health intervention AT ALL. I know this sounds a bit strange, but we know that social inequality, access to green space, whether or not a parent reads to you as a child, an countless other factors are really important for health (and life) outcomes. So actually, people who care about health care have a responsibility to act on social inequality and to improve health outcomes in this way. This is great because it means that the creative possibilities for collaboration are extended across sectors- whether it’s a youth project, a local church, a small business offering employment, or any number of other possibilities, we can collaborate to drive up health outcomes and reduce social inequality.

Digital Health Centre of Excellence

My goal is to ensure Leeds is seen as a centre of excellence in the development and delivery of digital health and digitally-enabled social care. Many people I met agreed that this forms part of our civic future, because the people of Leeds need to have efficient and effective services despite a financial environment that ensures we have to think radically different. Because people recognise that we have to work together to make an impact on this. Because it’s a great way to develop the City’s economic outlook and provide jobs. Because we have some of the best hospitals and health services in the country. Because we have all the structural advantage of the NHS Information Centre and the NHS Commissioning Board. Because it’s the right thing to do.

Recently, the local Shadow Health and Wellbeing Board have crowd-sourced information about how digital products and social media can support people in the city who  use health and social care services- expect to see more of this as we move forward.

We have a vibrant digital sector, both within health care and in other digital fields (did you know that Grand Theft Auto was written in Leeds?) We already have great initiatives such as GoOn Leeds, Leeds Social Media Surgeries (TONIGHT at the Civic Hall from 6pm, by the way!), and the fabulous Leeds Digital Festival. Let’s make it even better.

Digital Conference and Hack v2

I’m already working towards the Digital Centre of Excellence, as are many other people all over the city. This year, we held the first Digital Health Conference and Hack, and we’re planning another one for next April. This time, we’re going to look at open source solutions in healthcare, described today by Dick Vinegar as “the future of Health IT”. We already have the excellent open source portal developed at Leeds Teaching Hospital Trust by Tony Shannon- there’s a lot more we can do with this agenda.

We also have several totally original digitally enabled health innovations going on locally- and I can’t wait to share more details with you. We’re hoping you’ll join us.

Filed under #sm4hwb, Conference, Leeds, Web 2.0 Tagged with , , , , , , , , , ,

An experiment in Social Media in Clinical OT practice Growing Together 3- Growing shoots

January 4, 2012 1 Comment


I’ve posted a couple of blogs about my experimental use of Social Media in Clinical OT practice (see part1 and part2). Today’s post discusses the first foray into the use of Social Media.

As I discussed in the first blogs, I visited other groups both within the city and more widely. During these visits, I took photos to share with our group members when we talked about what we could learn from other groups. These photos were also included in reports I made about the visits, which were uploaded to the Staffnet site discussed in the previous post. They made the reports more interesting, and also made my service users more likely to connect with the reports, when I printed them out to share with them a little like magazine articles.

Service users wanted to be involved. They wanted reports like these relating to their project. In response to service users asking if we could take photos of our progress, and to enable the participants in the group to share this progress as they wished, I took photos with my smartphone.  Initially, we only shared the photographs during the tea break with each other, but then I considered the use of a photo sharing social networking site in order to share the photos more widely with family and friends of group members. We talked about how to do this, and settled on using FlickR, a free social media tool for sharing photographs. This would mean they could share their progress with others, all that was required was internet access.

As health service employees we have a duty of care for everybody that uses our services, including protecting their data. Mindful of our Information Governance issues, this was cleared by our IG department, and clear boundaries set for the use of cameras to record progress. Consent forms were developed to capture informed consent from service users before they were photographed. Part of  gaining the informed consent was to discuss what we could do with the pictures  and what kind of boundaries I was operating under in terms of what information would be photographed. We made sure that the majority of the photos we took didn’t have “patient identifiable information” on them (faces, distinctive tattoos) because this made the Information Governance issues much easier to handle, and it made our service users comfortable with the process. Of course, if people didn’t wish to be photographed, we would respect their wishes.

We started to take more pictures, uploading them to the FlickR site we had set up.

As we developed the project and they became more comfortable with what was happening, they did ask to be photographed on occasion. One particularly memorable photo was of a young man holding a crop of onions he was proud of harvesting! Because of our informed consent proceedure, the subjects of the photos (if identifiabe) got a second chance to decline their permission for publication on FlickR, but if they agreed, my clinical reasoning was that it was okay to publish.

Disabled people and people with mental health issues are often socially excluded, and I felt that including the photos within the larger social network was a way to combat some of that exclusion, in our own small way. We had set up a group that was non-stigmatising- it didn’t carry “health” branding, and our group members had as much right to occupy the virtual space as any other community group. Had we encountered any adverse comments or increase in social difficulty for the group members as a result of this, we could have taken alternative action. But we didn’t.

Sometimes, the things which matter in a therapeutic group are not the things we carefully plan for. Within this group, the wildlife that we saw around us became a real hot topic of conversation, and this was another great opportunity to take pictures to share.

We also had a regular visitor in the form of our Allotment cat.

Many people with disabilities and mental health issues don’t have pets because they fear they either cannot afford to look after them, or they have lifestyles which mean they wouldn’t be able to offer the care they feel the animals need. This was the case for several of our group participants. However, they all felt very affectionate about the Allotment cat, and he seemed to return their affection. He would visit during every group, and was inevitably fed and offered a saucer of milk by the group. He would then make his way from knee to knee, offering every group member the opportunity to give him a stroke or two. Who knows what effect this affection has on a person with limited social skills?

At this point, I felt I needed to learn more about Social Media, in order to really maximise how we used it within the group; so I attended a local Social Media Surgery. I am immensely grateful for the help I received there. I felt encouraged to venture further into the realms of social media.

What are your views about using photo sharing social media with mental health service users? Please share in the comments.

To find out our next steps, watch out for my next post.

Filed under Digital Inclusion, FlickR, Occupational Therapy, Recovery, Social Inclusion, Social Isolation, Social Media Surgery, Stigma Tagged with , , , , , , , ,

Leeds Social Media Surgery #leedssms

February 4, 2010 1 Comment


  1.  Fantastic night at the second Leeds social media surgery last Tuesday (02/02/10). As usual, learned so much from the fantastic surgeons there, ( including @dysconnection, @dsugden) but as always, for every question answered I have a host of new questions…..
    • Why do some people use social media rather than connect with other individuals face to face or on the telephone?
    • How realistic is the fear of this in some health professionsls?
    • What are the digital needs of people with severe mental health problems
    • What digital technology could be useful on a ward?
    • How do I make staff “get it”? – hook them to buy in?
    • Where are the institutions online that have positive anti-bullying stances?
    • What evidence is there of growing peer led support online?
    • What evaluation tools could help show that this positively affects state of mind?
    • Everything used has to consider ease of use, and what to do in the event of withdrawal of permissions- can a developer write a code that helps to withdraw photos that consent is withdrawn for?

Any help with these most recent questions would be appreciated- over to you!

Filed under Digital Inclusion, Leeds, Occupational Therapy, Recovery, Reflection, Social Inclusion, Social Media, Social Media, Social Media Surgery, Society, Web 2.0 Tagged with , , , , , , ,

Thoughts on how we’re gonna use all this new tech…

November 16, 2009 Leave a comment


I see the blogosphere is starting to consider digital differences as well as digital exclusion, please see
http://sarahhartley.wordpress.com/2009/11/13/musings-on-the-week-a-north-south-social-media-divide/

I agree with posts in the above blog, that the people who were at the #leedssms were focussed on how to use the technologies, for the benefit of our service users and to promote our individual activism/vocations. Meeting individuals such as @dysconnection, who are truely like minds, is such a benefit when I work in an institution where not many people “get it”- and there is no way I would waste our brief time to hammer out the issues with self-congratulation.

It’s a week tomorrow since the #leedssms and it has given me some time to reflect on how social networking can be used from within mental health services.

Today, I was doing some training which considered psychological theories of attachment. These are based around the developmental process we all go through. Where we experience consistancy in our caregivers, we develop a “secure attachment” i.e. we can predict that our emotions can be named, attended to appropriately, and consequently we learn to regulate our own emotions as we develop. Many people with mental health issues may have grown up without a secure attachment figure in their caregiver- they may have been ignored, say, or dismissed as they attempt to get their physical and emotional needs met. This results in an “insecure attachment”- where because they lack the ability to self-regulate, they continue to display the emotion, escalating in intensity until the (physical or social) environment changes and regulates them.

We were considering the fact that many of our service users may have experienced insecure attachments during their childhood and the implications on this of our constant efforts in th ehealth service to move them on- to get them off our books, discharged, or sent off to a third sector agency- as soon as we considered the risks to be manageable. We had a discussion about the function of the old-style psychiatrists, who were attached to the old institutions. The “old guard” acted as attachment fgures for their service users- although someone was discharged and went back to their usual life, the door was left open for them to come back and re-connect, either at a time of crisis, or change, or even celebration. Some individuals would return just once a year to report on how they were getting on. This mirrors the developmental process of attachment, where children reduce their “clinginess” as they become confident that their caregiver is still there (why Peekaboo is such an important game cross-culturally). They became free to explore the other identities and possibilities of their life beyond that of “mental health services user”, because it was safe to do so.

Now, we have become focussed on community integration, a laudable aim in many ways. However, there remins the issue of attachment. If a service user has been ignored, rejected, dismissed and consequently failed to develop secure attachments in childhood, they are tasked with developing this skill as adults. Unfortunately, if we have insecure attachments, we are likely to seek out further environments that mirror our previous experience, i.e. further experiences of invalidation. This means that the mental health workers could be the only secure attachment figures in an individual’s life. What does it do to that dynamic when the worker is so focussed on discharge- at which point we remove all contact with the service user? It reinforces the experience of abandonment , of rejection, of being worthless. It confirms that other people cannot be trusted, that we only ever have conditional relationships.

I am not arguing for the return to the big old institutions- I wholeheartedly believe in social inclusion. But consider the use of social netwroking to develop attachment beyond an admission…..how would it change the experience of our service users to know they could continue to “check in” with their workers and peers, who may be the people they have shared with in groups- mirroring the family dynamics and allowing the possibility of developmental process…..

It’s my hunch that this could be revolutionary- within the mental health service we always will have people who require long term, continuous, intensive input. But these are a minority group. We have a lot more people who I believe would benefit from being able to keep that lifeline….for where or when they feel things are getting on top. If there was an easily accessible way of these people accessing mental health first aid- this would surely impact on their need to use more intensive and more expensive services. This digital service could comprise workers from statutory and voluntary sectors, and would lend itself to a huge degree of service user involvement. And compared to our primary mental health care at the moment, cheaper to deliver. Most importantly, the whole thing just intuitively feels like the right next step

I’m so excited by this, and this piece is a snapshot of my thinking… now, I have to work out where to go with this.

Filed under Attachment theory, Digital Inclusion, Recovery, Reflection, Social Inclusion, Social Media, Social Media Surgery, Web 2.0 Tagged with , , , , , , , , , ,

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