Supporting people with Severe Mental Illness who face food insecurity to access a nourishing meal

Sally Smith, Peer Lead for Research, Tees, Esk and Wear Valleys NHS Foundation Trust (TEWV)

I have met many wonderful and interesting people on the inside of a psychiatric ward. The immediacy and depth of connection between peers in there was an unexpected comfort in the most challenging of environments.

Illustration by Sally Smith

I remember lots of the stories shared in the smoking corners of gardens. We often reflected on how misunderstood we felt in the ward and in the world.

One young woman was desperate to stay on the ward as she knew that was the only way she was certain of ongoing access to food. Her cupboards empty, her benefits paused, she was terrified about discharge. I was unsure how much Dialectical Behavioural Therapy or anti-depressants would help: wouldn’t anyone feel miserable with no food or money?

I remember physical health checks on the ward being introduced. Being weighed and measured, compared to the graphs…. and yet being given medication that makes you want to eat sugar out of the bag, being locked on a ward with no way to exercise, offered beige food four times a day and feeling so damn lousy and desperate that motivation to even clean your teeth was a challenge.

It felt cruel and shaming. It certainly never helped me to change anything.

In my mind it is no surprise that the mortality gap for people with severe mental illness (SMI) continues to rise, the challenges and barriers around nutrition that people living with SMI face continue to go unseen. No amount of lessons on what makes a healthy plate will make avocado cost less than crisps, and no knowledge of a healthy Body Mass Index (BMI) will reduce the intense effects of psychiatric medication.

And perhaps this is more of an issue than ever with austerity and the cost-of-living crisis exacerbating people’s struggles.

Increasing accessibility of affordable healthy food to adults living with SMI in Middlesbrough

With this perspective in mind, I was delighted to join the team working on this National Institute for Health and Care Research (NIHR) Communities study as a peer researcher. With co-production and the voice of lived experience running throughout the project, we are seeking to develop practical solutions for people living with SMI who face food insecurity in Middlesbrough.

The project is a collaboration, bringing together lived experience with the best bits of Tees, Esk and Wear Valleys NHS Foundation Trust (TEWV), Teesside University and Middlesbrough Environmental City, a charity dedicated to promoting healthy and sustainable living.

Over a period of 16 weeks, we plan to co-design and co-develop a nutritious meal with surplus fresh ingredients from local Eco shops (social supermarkets) that would otherwise go to waste.

With the support of the food scientists at Teesside University, this will then be turned into a healthy ready meal and distributed back to Eco shops in Middlesbrough. Aiming to be an appetising, nourishing and accessible meal for local people battling severe mental illness, who for whatever reason may struggle to cook the fresh ingredients themselves.

Through the design and delivery group we are hopeful that there may be additional benefits for all participants and the collaborating organisations, for example:

• The opportunity to learn some cooking skills and explore recipes that are good to cook on a budget.
• The opportunity to develop peer relationships amongst the delivery group that support connection and foster hope for change.
• The opportunity for organisations to learn from one another’s strengths and take a fully bio-psycho-social lens on mental health difficulties.

We are currently in the recruitment phase for participants and a collaboration of this type has not been without substantial challenge. It is has not been easy to marry NHS language and expectations and academic protocols with how a community organisation runs. It has not always been easy to find middle ground between the clinical expertise and lived experience expertise. However, I look forward to sharing the progress we make as the delivery team becomes established.

 

Research published by the project team

This study published today explores food insecurity prevalence and the experiences of adults with Severe Mental Illness (SMI) living in Northern England.

This systematic review paper found that people with SMI are more likely to experience food insecurity.

Another recently published paper identified strategies to tackle food insecurity centred on making food banks more accessible and improving the quality of available food available.

Bitten by the blogging bug

Posted by Sarah Smith

On the 1st of October 2014 I started my PhD. I felt excited and happy at the prospect and keen to get started, although I was a little sad to be leaving the research group that had taken me under its wing again. I feel very fortunate to be in this position and know it’s in part due to them really. My first task is to move my ‘things’ to the PhD office, all the way next door! Two years’ worth of research work needs sorting and it takes me a while (most goes into recycling) but finally I am set up in my new office space. I meet new officemates and all seems well. I meet with my supervisor, we chat about my work and I head off back to my new desk to begin my journey as a PhD student. Student? [thoughtful pause].

Using the word ‘student’ to describe myself seems strange. I’ve worked in research for 10 years already and feel that at my age I’m too old to be even a mature student. It’s made even stranger by the fact that I’ve worked in the same University, department and corridor even up until only yesterday. My whole status has changed overnight. I start to waiver a little. But after a coffee break and chat with new officemates I feel this newly acquired student status could work out just fine.

My fear of blogging is actually that of the unknown

During the first week, after the usual student-related teething problems I start to join up to activities offered by my department, and workshops and reading groups. I have the time to attend these now. The daily pace is slower than my previous role, there seem to be fewer demands on my time, I get headspace, I can think, I get to read, a real luxury! Things are looking more and more on the up.

My first student outing is to attend the Qualitative Health Research Writing Group Network meeting where Jenni Remnant introduces me to the world of blogging, something I’ve heard other people doing but never dared myself. She really sells it to me, that it’s a great way to network, and collaborate even with other academics, some out of reach normally. Then she sets us a practical exercise, to write a blog. Panic ensues. I draw a blank. I’m only a PhD baby of a week old; I have nothing to blog about. I glance around the room and everyone else seems to ‘get it’, writing notes, chatting about their existing blogs with others. I admit ‘I’ve never written a blog, I’ve never even read one’ to which people repeat my words back to me ‘you’ve never read a blog?!’. Am I so out of touch? Am I cut out for this? More panic ensues.

Then I start to think rationally and realise that my fear of blogging is actually that of the unknown and that I might do something I shouldn’t and once I do it’s out there in the ether. I’m reassured that as a first time blogger I can submit my blog, editors read it and will bounce it back to me if they think it or parts are not suitable for the public domain [sigh] I feel more comfortable about the idea now. But still, what do I blog about. Apparently anything, but it still seems daunting. I decide to embrace it and write a blog, but I’ll start tomorrow, then I’ll start the next day and it doesn’t happen, until I’m gently persuaded once more.

So today is the day, blog writing day. I open a blank word document and write ‘Blog’ at the top, the cursor blinking at me expectantly, and I have no idea what to write. Then I think back to where the blogging story began, the Qualitative Health Research Writing Group Network, and I remember my blog-writing fear, and I realise I’ve partly conquered that fear by even opening a Word document and being willing. I recall Sally Brown’s presentation at the meeting and a quote plays back through my head ‘don’t get it right, get it written’. And so I start typing, and typing. And the rest is history….

52 weeks in public health research, part 46

Posted by Amelia Lake, Mark Welford, Sarah Smith, and Shelina Visram

From Amelia Lake: My office mate Duika Burges Watson (@debedub) doing her daily handstand #yogaintheoffice

From Mark Welford: Discussing blogging with Lisa Briggs and Kirsty Metcalfe from the Graduate Research School at Teesside University (@TeesUniResearch). They wanted to know all about the inner workings of a research related blog with a view to entering the blogosphere.

From Sarah Smith: Meta-analysis masterclass courtesy of the Centre for Reviews and Dissemination (CRD) York where I've been on the Systematic Reviewing course this week.

From Shelina Visram: Fieldwork for the HYPER! (Hearing Young People’s views on Energy drinks: Research) study is now underway. The focus groups with schoolchildren include a fun sorting exercise to explore perceived differences between energy drinks, soft drinks and sports drinks.

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A reminder from the Fuse blog group:

Each Thursday of 2014 we’ll try and post around four pictures on the Fuse blog that capture our weeks in public health research, from the awe-inspiring to the everyday and mundane. Given that more of the latter than the former exists in most of our lives, we foresee problems compiling 208 images worth posting on our own. So this is going to have to be a group project. Send an image (or images) with a sentence or two describing what aspect of your week in public health research they sum up and we’ll post them as soon as we can. You don’t have to send four together – we can mix and match images from different people in the same week.

Normal rules apply: images you made yourself are best; if you use someone else’s image please check you’re allowed to first; if anyone’s identifiable in an image, make sure they’re happy for it to be posted; nothing rude; nothing that breaks research confidentiality etc.

Email your posts to m.welford@tees.ac.uk or contact any member of the Fuse blog group.

52 weeks in public health research, part 45

Posted by Sarah Smith, Amelia Lake, David Hunter, and Mark Welford

From Sarah Smith: I attended the Public Health England work, health and wellbeing workshop on Monday in Manchester. This is Sam Haskell, Health and Work Lead from PHE, who used the Fuse logo in his presentation!

From Amelia Lake: I am grateful for the front of pack labelling which illustrate just how high in saturated fats & fats this prepared pizza is. Clear information is so important in terms of public health nutrition.

From David Hunter: Earlier this week I was involved in a Health Summit held at the Lindisfarne Centre in Durham to discuss and debate the challenges facing governance for health. We had a reception and dinner at the Castle on the first night and the event was attended by around 30 invited participants from across Europe, mainly from the UK. Partly organised to launch our WHO Collaborating Centre on Complex Systems Research, Knowledge and Action. Pictured are the speakers from the event.

From Mark Welford: Boxed, labelled and ready to go. We (the staff, students and researchers) at Teesside University's Health and Social Care Institute (HSCI) are moving offices from Parkside West to the much more central Constantine Building.   

Teesside University was originally founded as Constantine College and was officially opened by the Prince of Wales, the future King Edward VIII, on 2 July 1930. Below is a photo of two plaques that can be found on the wall of the Constantine Building.  Although you can't really see it clearly in the photo, the one above commemorates the fact that the college was a gift from local shipping magnate Joseph Constantine and his family and the one below marks the date when the college was officially opened.
    

The college became a polytechnic in 1969; and in 1992, the Privy Council gave approval to 14 higher education institutions, including Teesside, to become new universities.

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A reminder from the Fuse blog group:

Each Thursday of 2014 we’ll try and post around four pictures on the Fuse blog that capture our weeks in public health research, from the awe-inspiring to the everyday and mundane. Given that more of the latter than the former exists in most of our lives, we foresee problems compiling 208 images worth posting on our own. So this is going to have to be a group project. Send an image (or images) with a sentence or two describing what aspect of your week in public health research they sum up and we’ll post them as soon as we can. You don’t have to send four together – we can mix and match images from different people in the same week.

Normal rules apply: images you made yourself are best; if you use someone else’s image please check you’re allowed to first; if anyone’s identifiable in an image, make sure they’re happy for it to be posted; nothing rude; nothing that breaks research confidentiality etc.

Email your posts to m.welford@tees.ac.uk or contact any member of the Fuse blog group.