An informal conversation and guide to the sometimes confusing world of volunteering.

Panorama's Broken by Battle showed the impact of PTSD on soldiers struggling to adapt to civilian life

This week the BBC's Panorama programme screened Broken by Battle, a documentary about the impact of PTSD on ex-servicemen. At TimeBank this is something we are very familiar with through our work on the Shoulder to Shoulder programme which supports veterans with PTSD.

Those who leave the Armed Forces with mental health problems can struggle to access the support they need to make a successful transition into civilian life. They are vulnerable to homelessness and unemployment, and may experience problems with anger management, intense loneliness, lack of direction, relationship problems, physical health issues, alcohol/substance dependency and increasing vulnerability to a range of social difficulties.

We know from our work with ex-servicemen and women living with mental health problems in the community that this is a largely hidden problem. In many cases ex-servicemen and women will not present to their GPs, mental health services, veterans or mainstream charities – they slip off the radar and are hard to reach. To address this we believe there needs to be more partnership work between GPs, statutory mental health services, veterans charities and the mainstream voluntary and community sector. There also needs to be resourcing to help identify where veterans are - and in particular those with mental health problems.

A 2012 study by King’s College London Centre for Military Health Research found that reservists were twice as likely to have symptoms of mental health problems as their counterparts who did not deploy. A 2006 study by the Royal British Legion found that veterans in the 16-44 age group had a much higher level of mental health problems than the same group in the general population.

Anger management and violence are a particular problem for this group.  Recent research in the Lancet, funded by the Ministry of Defence, highlighted the fact that younger members of the armed forces are more likely to commit violent offences than the rest of the population: in particular those under-30, where one in five had committed a violent offence. The 2012 King’s College London Centre research also found that soldiers involved in direct combat were also twice as likely to admit hitting someone at the end of the tour, with a third of the victims being someone in the family.

Family members of territorials, reservists and ex-Service personnel do not always receive the support they need to manage and understand the needs of their partners, and the unique challenges they, the families, face. In the most recent survey by the Army Families Federation (Annual Survey 2012), 30% of respondents said they have or had mental health problems, with a similar percentage unhappy with the support families and family members received from their GP.

TimeBank’s Shoulder to Shoulder programme for ex-service men and women recovering from PTSD and other mental health issues recognises these challenges and works with veterans  to make positive changes. In an external evaluation of our Shoulder to Shoulder programme by Órla Cronin Research they describe how having a volunteer mentor made them feel less isolated and brought new trust and hope for the future.

The evaluation found that many service veterans were in a state of crisis in their lives, with complex and multi-faceted problems including financial hardship, homelessness, alcohol dependency, physical health problems and mental health problems including depression, anxiety, panic attacks and agoraphobia.

Mentoring helped to alleviate their stress and isolation and helped them overcome daily challenges like taking public transport, budgeting and exercising. Some were able to start training and job hunting. Their ability to think optimistically about the future, both in setting goals, and in taking small steps towards those goals, improved over the course of the project. 

The project is the first peer mentoring project in the UK which supports ex-service men and women who are suffering from mental health issues in this way. If you'd like to know more about Shoulder to Shoulder, take a look here.

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Can exercise improve your mental health?

During Shoulder to Shoulder mentor training sessions, we teach our volunteers the Five Ways to Wellbeing recommended by Mind and the Mental Health Foundation to help maintain good mental health: ConnectBe activeKeep learningGive… and Take notice.

Recently we've been focussing on getting active. We all know that exercise is good for you, but most people tend to focus on physical health benefits – level of fitness, reduced risk of chronic illnesses, weight – so what are the benefits for your mental health?  

Physical activity has been shown to boost confidence, improve body-image, self-esteem and self-worth, and can act as both prevention and treatment for various mental health problems including depression and anxiety.

Exercise decreases the stress hormones such as cortisol and increases endorphins.  Endorphins are the body’s natural feel good chemicals, and when they are released through exercise, your mood is boosted naturally. Exercise also releases adrenaline, serotonin, and dopamine, all of which can have a positive effect on your mood and energy.

Even small increases in activity can be beneficial. Just 10 minutes of moderate exercise (such as brisk walking) is enough to improve your mood, increase motivation and decrease fatigue.

A survey by Mind found that 83% of people with mental health problems looked to exercise to help lift their mood or reduce stress. Two-thirds said exercise helped to relieve the symptoms of depression and more than half said it helped reduce anxiety.

Taking part in physical activities offers many other opportunities. It’s a great way to meet people and connect with friends, or it can be a chance to give yourself some quiet time and take your mind off things. Exercise can give you a goal to aim for and a sense of purpose.

Dr. Alan Cohen, a GP with a special interest in mental health, says that when people get depressed or anxious, they often feel they're not in control of their lives. “Exercise gives them back control of their bodies and this is often the first step to feeling in control of other events.”

The great thing about physical activity is that it’s incredibly varied, so it doesn’t have to be difficult, time consuming or boring. You can find activities that work for you and go at your own pace.  It’s also something easily incorporated into your daily life – a walk, doing housework and gardening all count! 

When we train our volunteer mentors, we encourage them to do some sort of physical activity when they meet up with the ex-servicemen and women they are mentoring. It could be something light to start with like joining a gardening club or walking around a museum, or something more active like joining a gym, swimming, yoga, hiking in the countryside or playing sports such as football and rugby (all things suggested  by the veterans on Shoulder to Shoulder). It doesn’t have to be anything big - for some people something as simple as leaving the coffee shop and going for a walk in the park once in a while can make a huge difference.

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Young people in Tower Hamlets are delivering some great community projects

Engage is our new project that matches volunteer mentors with young people living in East London who are not in education, employment or training.

The idea is to support them to develop and deliver a community project of their choice in the borough, which will help them learn new skills and grow confidence.

Engage is now in its ninth week and the 10 young people from Tower Hamlets have come up with some really exciting community projects, from arts workshops to clothes swaps, face painting and a football tournament. They are working hard to finalise them before delivering the projects in the borough over the next couple of weeks. 

As part of the programme, we have delivered training sessions on planning a project, how to budget, marketing and communications and monitoring and evaluation.  We have also recruited mentors to support the young people and they have all completed their mentor induction and are eager to start sharing their skills and expertise. As part of the mentor induction we invited Mahdi Alam, the mayor of Tower Hamlets, who shared some useful tips on how to engage with young people.

 I am really looking forward to seeing the delivery of each of the projects – and given all the effort that the young people have put in to plan each one, I’m sure they'll be a great success.  Watch this space to find out from the young people themselves how they got on!

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Banners, balloons and biscuits

Last week was Carers Week. It seems like every cause has an allotted day or week dedicated to them – this week is Small Charity Week.  Often support organisations are accused of working in silos, not talking to each other and not promoting themselves sufficiently to the people who need their help. Casting the spotlight on a particular cause is a great way of getting a message across and reaching out to people.

Our Carers Together project in Birmingham recruits volunteer mentors to support carers, both online and face to face. As a volunteer project wanting to extend our base of both volunteers and beneficiaries, Carers Week was an excellent opportunity to get out there. Carers are a particular challenge as they often don’t access services provided directly for them, but come into contact with services through the person they care for. Part of the purpose of Carers Week is to make people ‘Carer Aware’, that is to help people recognise that they form part of a large group of people in a similar situation, who have shared needs, that can be addressed if they access services.

With this in mind, getting us out there took us to three very different events:

Birmingham and Solihull Mental Health Trust Carers Event

Things are changing around how mental health is perceived. There is still a lingering attitude that people who provide support for those with a mental health problem are not ‘real’ carers. Experience of our carers tells us something very different. The stresses of caring for someone with a mental health problem can put a lot of strain on a carer. This event was to encourage carers to look after their own mental health, and asking from support from Carers Together is an excellent way of doing this!

Chinese Community Centre Carers Event

This was perhaps the liveliest and most joyful carers event we have ever attended - starting with games, followed by presentations, prizes and a communal lunch. The large of group of carers who attended approached every part of the day with such enthusiasm we were compelled to join them. After a few disastrous practice rounds we did manage to secure first place in the balloon retention coxless pairs. The picture was taken on the starting line and I think we can all see the determination to win found in all semi-professional athletes. Well done to Amy Cui for organising such an excellent event!

Carer Aware Training Day, Moseley Hall Hospital

Birmingham community healthcare trust employs 5000 people and their ‘Carer Aware’ event is aimed at raising the profile and needs of carers amongst the staff of the hospital. One of the things we have noticed is that caring often falls on the family member who has worked in a caring profession. Although carers who have been nurses and other health professionals may have a particular aptitude for caring it doesn’t make it any less taxing, especially if you have to juggle your home caring responsibilities with a demanding caring role at work.

All the events were an excellent opportunity for learning about the different services available to carers, to meet carers and explain Carers Together to them. It’s clear to us that carers form a large community and we are beginning to feel like an important member.

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We don't leave care - care leaves us

Starting Together is our exciting new project in Southwark, matching female care leavers with volunteer mentors. I’ve just started working as its Project Coordinator and have been getting up to speed over the last few weeks, making sure we have everything in place to get things off the ground.

There’s a real need for this kind of mentoring as women are particularly vulnerable when they leave care.  They are much more susceptible to anxiety or depression than other young people and can struggle to access education or work. They are also more likely to become mothers earlier on - a quarter of these young women will be parents by the time they leave care.

A focus group carried out by King’s College highlighted the demand for this service. It was undertaken with a group of female care leavers who spoke openly about their experiences and how hard it can be when you are suddenly ‘launched’ into adulthood. They often feel overwhelmed and unready to make such a huge transition; as one young woman put it: “We don’t leave care, care leaves us”. The group said how great it would be to have a mentor at this point in their lives; someone who could support them and help with all the challenges they need to tackle.

We are running the project with the London Borough of Southwark and the Health Service and Population Research Department at King’s College, London. The initial plan is to match 15 young women to mentors. If things go well, we’d really like to extend the project so many more young women can benefit from this fantastic service.

We hope to start matching the first mentors and mentees in July. At the moment, we can only take referrals from the Southwark Care team,so if you’d like to refer a young woman who will be leaving the care system within the next six months, please contact me to start the referral process on 020 3111 0730 or at    

Alternatively, if you would like to be a volunteer on Starting Together, I would love to hear from you. You can find out more and register online here or contact me on the details above.

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Volunteering can change lives - including your own

The Switch is our mentoring project for young people leaving Child and Adolescent Mental Health Services (CAMHS). It’s a crucial time in their lives and the transition to adult services or life without mental health support can leave them feeling uncertain and overwhelmed.

That’s why the project recruits volunteer mentors to support them. The mentors are matched to a young person (mentee) and they meet for five hours a month – they might go for a coffee, enjoy a hobby together or explore London. It doesn’t sound like much, but simply being there for them, listening and supporting them, can help build these young people’s confidence and emotional resilience.

For one of our volunteers, Marie, mentoring on The Switch was her very first volunteering experience. She told us how much she enjoyed it – and how much she learnt about herself as well.

Marie says: “I’m really glad my mentee has achieved so much and I'm happy to have been a part of it. She is going to make a lovely young adult and she finally understands that small achievements can add up to one big amazing one!”

“I just wanted to say thank you so much for giving me the opportunity to work on this project.  In all honesty, it has been much harder than I expected, and very tiring and stressful at times, but I really wouldn't change it for the world.”

“Being a mentor has taught me so much about myself as well, which I wasn't expecting at all. I thought I was patient before, but I think this has taken it to a whole other level, and I realised that sometimes I wasn't participating in life either, so I am trying to take my own positive advice and work on areas of my life which I haven't been happy with too.  Also, I am much more aware of what kind of image I want to project to people in my life who look to me as a responsible or professional person e.g. my young cousins, at work etc, and I am much more thoughtful about what kind of role model I want to be to young people around me.”

“If you ever need volunteers again I would be more than happy to put myself forward!”

The Switch has had such a positive reaction from potential volunteers that we're no longer recruiting female volunteers. However, if you are a male, aged 21-40 and living in London, you could become a mentor on the project. You could change a young person's life  ... and possibly even your own. Find out more here.

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Does caring cause depression - or is it the lack of support?

Carers have hit the headlines over the last few months. Media, politicians and the general public are beginning to recognise the difficult situation many carers find themselves in.

Having met a lot of different carers over the last few months I know that many of them will welcome this recognition, especially when there is a lot of negative comment about those living off State benefits. ‘Scrounger’ is hard to hear when you are living on £59.75 pounds a week and providing 24 hour care. We all know that ‘scrounger’ doesn’t apply to carers, but the rhetoric associated with changes in the benefits system is creating a stigma for anyone that receives financial support from the state. Coverage that highlights the realities of caring is therefore much needed and welcomed.  

Much of the recent coverage around carers has focused on a Royal College of General Practitioners [RCGP] report that suggests carers are more likely to get depression.  At any given time 40% of carers are at risk of becoming depressed due to their caring role. Most of the report’s suggestions are quite sensible: improve GP access by allocating routine appointments and vaccinations at convenient times for carers; appoint a carers' "champion" in all GP surgeries; maintain a carers' register within the GP practice; and carry out audits to measure improvements in carer support. 

However, the report also recommends that all carers should be screened for depression. I am sure this is well intentioned, but it also may create the dystopian scenario where all carers are tested to see if they are mentally unwell, and then offered medical treatment to ‘cure’ them.  At our Carers Together project in Birmingham, we work really hard to strike a balance between understanding what a strain caring can create and recognising that carers are not a patient group. Support, information and services are welcome, but we have to be careful not to pathologise carers. 

The RCGP report suggests that carers feel a sense of shame in coming forward and asking for support. I’m sure this is true, but perhaps we are not sending out the right signals. Many of the carers I speak to suggest the support isn’t out there when you ask for it. If you have to fight hard for every inch of financial and practical help you get, and people who receive support from the state are tarred with  the tag  ‘scroungers’,  it’s not surprising that a reluctance is created around coming forward. 

The questions we have to ask ourselves are: is it the caring role that creates the depression, or is it the lack of support? And, are we even talking about depression or is it just an appropriate emotional response to a difficult situation? I hope this can be thought about because the answer to the problem of how to improve carers’ wellbeing may not be anti-depressants and cognitive therapy, but good quality care services, financial help and on-going emotional support when it’s needed and asked for.

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Anxiety management course improves outlook for Stafford prisoners

Our Shoulder to Shoulder project in Birmingham, which supports ex-service men and women who are recovering from mental health issues, was recently contacted by Jo Tomlinson, Staff Nurse at Stafford Prison, who has developed an innovative anxiety management course for prisoners.

Jo works closely with resettlement teams at the prison and recognised Shoulder to Shoulder as a key component of a resettlement plan for veterans leaving prison. A recent evaluation of the project showed that having a mentor increased veterans' sense of wellbeing, their trust and hope for the future, making it an effective way for veterans leaving prison to build on the work they've done with Jo, as well as being a valuable stepping stone towards adjusting to a new life in the community.

I went to visit Jo and a potential mentee, due for release next month.

Jo introduced me to the veteran and the three of us sat down to watch a short film made recently by The Royal College of Nursing, in which my potential mentee and two other prisoners talk movingly about how the anxiety management course has turned their lives around.

Jo, who was awarded Nurse of the Year in 2012, spoke at the Royal College of Nursing National Congress in April about the course and is campaigning for it to be adopted in prisons across the West Midlands and ultimately nationwide. She explained that it is based on the principles of care and compassion; it draws out understanding of emotions and equips prisoners with the tools to modify their behaviour, backed up by healthier self-esteem, belief in themselves and ultimately hope for the future.

The 10-week course is available to all prisoners at HMP Stafford and Jo also runs a separate group specifically for ex-service personnel, which is supported by Combat Stress.

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