As a part of my series about “Mental Health Champions” helping to normalize the focus on mental wellness, I had the pleasure to interview Ann-Noreen Bird. Ann-Noreen Bird, of GlobalDementiaCare.com, is a dementia care expert with over 25 years of experience working with people with dementia and their families, Ann-Noreen is a qualified Mental Health Nurse and has held various positions during her journey as a nurse. Ann-Noreen now teaches people to recognize, cope with and embrace dementia so they can help those living with the condition. With populations living longer across the globe, the number of people living with dementia is set to rise worldwide, so now is the time to act. In 2015 there were 47 million people worldwide living with the condition and that number is set to rise to over 131 million people worldwide by 2050. Through education, discussion and raising awareness Ann-Noreen hopes to diminish the stigmas surrounding dementia and enable those in need to be treated and cared for effectively and with the dignity they deserve.
Martin Luther King Jr once said, “life’s most persistent and urgent question is what are you doing for others?” This is my contribution to society.
Thank you so much for joining us! Can you tell us the “backstory” about what brought you to this specific career path?
For as long as I could remember, I have always wanted to be a nurse. However, after my GCEs, I was barred from entering my beloved nursing course due to a change in the entry criteria. I took a job as an Accounts Clerk but hated it with a passion. A few years later, the decision was made to reverse the entry criteria and I enrolled to do my nurse training.
Three years after qualifying, I was successfully recruited by a British Mental Health Trust based in London. Upon arrival, I was placed in a Continuing Care Facility and was not best pleased to be working there as my colleagues from Trinidad were placed in what I believed to be more prestigious units. I was determined to leave and had a few job interviews lined up. One interviewer asked me why I wanted to leave the Older Adult service? In his opinion, I was an asset to my unit and my speech and persona suited working with that group of people. This made me question my actions and I decided to give working with Older People a chance. At the same time, I was studying for my Diploma in Nursing, and with researching and writing assignments about the mental health of older people, I began to develop an interest in the subject.
I no longer wanted to leave but wanted to learn more and sought promotions only within the Older Age sector of the Trust. I worked my way up to Lecturer Practitioner, where I taught Mental Health, specialising in Dementia at Kings College University. I was later promoted to Borough Lead nurse in an inner London Borough.
According to Mental Health America’s report,over 44 million Americans have a mental health condition. Yet there’s still a stigma about mental illness. Can you share a few reasons you think this is so?
Stigma occurs when society labels someone as contaminated or less important than themselves. Stigma involves three elements;
- a lack of knowledge or ignorance,
- negative attitudes or prejudice
- discrimination which involves behaving in ways that disadvantage a person.
There are mainly two types of stigma which occur with mental health problems. Firstly, there is Social Stigma which is associated with discrimination and negative stereotyping of people with a mental health problem. These stereotypes define the person, mark them out as different and defines the mental illness as bigger and more important than the person. It prevents them being an individual. The consequences of this form of discrimination, can further stigmatise a person.
The second type of stigma is Self-Stigma which occurs when a person internalises negative stereotypes. This leads to experiences of low self-esteem, shame, hopelessness and fear of being shunned or rejected. Consequently, this can lead a person to avoid seeking help causing the underlying problem to go untreated leading to further unnecessary suffering. Any delay in receiving treatment can worsen the outlook of some mental health conditions, so can the stress and anxiety caused by stigma. Family members sometimes find themselves experiencing so called, courtesy stigma, because of a relative having a mental health problem.
There are many physical health conditions associated with stigma including some cancers, HIV, AIDS as well as some skin conditions such as psoriasis. However, the stigma related to mental health problems is particularly severe and widespread. There’s no denying that society is more aware of mental illness today than in years past as many high-profile celebrities such as Stephen Fry, Catherine Zita Jones, have spoken out and continue to speak about their illnesses. Mental health issues are therefore no longer hidden away in the dark.
A few questions immediately spring to mind, they are: Do people always and continuously SUFFERfrom mental health problems? Or do people live with mental health issues? Do they not deal with problems as and when they arise and continue living their lives? Do they not take their prescribed medication to manage their symptoms or do they just sit and wallow in their SUFFERING?
There is a big difference, isn’t there? So, I prefer to think of people as living with mental health problems as opposed to suffering from Mental health problems. This is just an example of how some of societies innocent statements can be stigmatizing.
As a society, we fear what we do not know or understand. Consequently, it is the unknown element of mental illness which drives the stigma. It must be acknowledged that the popular as well as the entertaining media play a role in perpetuating stigma stereotypes of people with Mental Health problems. For example, cinema illustrations of people with schizophrenia are often characterised by misinformation about the symptoms, causes and treatments of the condition. The fictitious characters are usually violent with homicidal or suicidal inclinations. These views only act to reinforce stigmas held towards people with mental health problems.
Many people around the world have the inaccurate perception that individuals who live with forms of mental health disorders are dangerous, deviants, neurotics or psychotics.
For centuries, people living from mental conditions, such as schizophrenia or bipolar disorder, were considered insane or “mad.” They were locked away in mental institutions or prisons. However, advances in science have shed light on the fact that these are diseases which can and should be treated instead of being stigmatized.
While more people than ever before are getting the help they need, there are still far too many who are afraid to seek help because of the ‘label’ that is placed on people receiving mental health treatment. Getting help for a condition does not mean a person is weak, or crazy. Society need to understand that without proper treatment, many people will self-medicate with drugs or alcohol to try and ease the pain or escape from their problems. This would only create a dual disorder of substance abuse and mental illness.
It’s not hard to understand why there is a stigma around issues of mental health. Communities have always feared what they didn’t understand. Now, though, the focus is largely going in the right direction, with mental disorders being widely regarded as treatable illnesses. More than anything, this means that those suffering can come forward and get the proper treatment. It’s time to end the stigma of mental illness.
Continuing research into causes of mental illness is urgently needed otherwise stigma would be perpetuated. Only knowledge can improve treatments, challenge stigma and recover lives.
The more we know and understand the less fear there would be. A culture of no fear would encourage people to talk openly about their experiences which would be of help and support to others.
Can you tell our readers about how you are helping to de-stigmatize the focus on mental wellness?
I work within a very specific niche of mental health and I help to reduce stigmatisation of people in the following ways. I know the facts about the condition, and I challenge negative words and attitudes. Over the years I have worked on my own attitude, and behaviour and I choose my words thoughtfully and carefully. Additionally, I educate others whenever I can, I focus on what people can do and not on the negatives and I support others and include everyone.
Was there a story behind why you decided to launch this initiative?
I had been a mental health nurse for 30 years and I have seen the devastation caused by mental illness and the effects it can have on families. Many families struggle to care for the person affected by mental illness with little or no support from government agencies.
My initiative is to support the carers of people living with specific mental health problems.
In your experience, what should a) individuals b) society, and c) the government do to better support people suffering from mental illness?
Public Health England (2018) states that: All healthcare professionals have a responsibility to promote the physical health and well-being of individuals who are at risk of, or living with, mental health problems. Healthcare professionals should:
- be aware of relevant policies and guidance on physical health for people with mental health problems and on improving mental health within everyday practice
- understand the mental and physical health needs of individuals, communities and population and the services available in their local area
- think about the resources available in health and wellbeing systems
- understand specific activities which can prevent, protect, and promote mental health and wellbeing and prevent, protect, and promote the physical health of people experiencing mental health problems
On an Individual level
Healthcare professionals can have an impact at an individual level by:
- promoting mental health and psychological aspects of care alongside physical health care and prevention
- be aware of the life course approach to promoting good mental health and the benefits of intervening early particularly in childhood and teenage years to prevent mental illness
- be aware of the mental health problems that may be faced during pregnancy and post-birth (‘perinatal’)
- establishing positive relationships with individuals who have mental health problems and be able to signpost individuals, their families and carers for further help, resources or guidance about mental health problems
- be aware of the importance of families, carers, friends, social networks and wider community for individuals experiencing mental health problems
- be able to use basic coaching techniques in supporting an individual who may be in mental distress and understand triggers and responses to stressed or distressed behaviours
- be able to identify co-morbid conditions and understand the links between alcohol, substance misuse and mental health
- know the steps that an individual may take in promoting positive mental health through self-care e.g. eating habits, increased physical activity, sleep, recreational activities, personal social and community relationships, spending time in nature, mindfulness and meditation
- Be able to identify risk factors and indicators for potential self-harm and suicide and support individuals who may present with suicidal thoughts and referral appropriately
Community level
Community level interventions may be based around a specific geographic locality or outside of hospitals environments. Healthcare professionals can promote mental health and wellbeing interventions by:
- working collaboratively with local authorities, primary, secondary and specialist services to achieve a truly whole person approach to care and prevention, including physical and mental health
- forging links with local services (including voluntary and community) and encouraging and supporting patients to link in with their local community health and wellbeing initiatives for example, that enhance social connections, reduce isolation, improve confidence and resilience
- working with community members and groups to support them to take action on improving mental health and wellbeing
- working collaboratively with services and communities to develop community-centred approaches including peer support and community engagement in decision-making
- working collaboratively with colleagues and other teams to raise awareness of mental health and reduce stigma associated with mental illness
- knowing who or where to get further advice from to support healthy lifestyles for people with mental health problems such as local authority services via public health initiatives namely exercise on referral and adult weight management programmes and stop smoking services; and specialist services (diabetes services)
- knowing who or where to get further advice from, such as local authority and voluntary services, to support welfare and social issues such as debt, domestic violence, housing
Population level
Healthcare professionals should be aware of the interventions for promoting mental health and wellbeing at a population level and improving the physical health of people with mental health problems, which include national and local strategies, targets and multi-agency action on prevention of mental health problems and suicide, promotion of mental health, reduction of health inequalities and stigma and reducing the premature mortality of people with mental health problems. Local authorities, NHS and other healthcare providers should:
- build prevention and health promotion into their day-to-day work
- take action to address wider factors of mental health such as reduce poverty, violence, improve housing and employment
- develop integrated systems to identify people with long term conditions who may experience mental health problems
- provide accessible information and resources to support mental health and wellbeing within the community, including services to signpost to
- support the development, promotion and access of e-learning and training
- provide and promote healthier lifestyle choices within mental health settings including healthier food options, access to physical activities, and support to reduce and stop smoking
- provide accessible information and resources on physical health and wellbeing for people who experience mental health problems
- be aware of services to signpost patients towards healthier lifestyles (local authorities often have a section of their website which provides information on what’s available locally, although mental health services may have to create service directories to enhance accessibility)
- work with relevant local services to improve housing and employment of people with mental health problems, and tackle stigma and discrimination and reduce overall health inequalities
What are your 6 strategies you use to promote your own wellbeing and mental wellness? Can you please give a story or example for each?
My 6 strategies for promoting my own well-being and mental health are as follows:
- I stay connected with people having at least one long conversation with someone outside of work daily.
- To stay active going for walks on a regular basis
- To keep my brain stimulated by learning something new every day and by reading which gives me confidence and a sense of achievement.
- To get enough sleep
- To give to others
- To be mindful and to practice forgiveness
What are your favourite books, podcasts, or resources that inspire you to be a mental health champion?
I must confess that I do not have one favourite book or podcast. What I do have is topic which deal with dementia and the mental health of older people. Whenever I feel challenged by an issue in any of these areas, I go searching books, journals, podcasts or YouTube videos for answers. I have a collection of books on the subject, but not favourite amongst the lot.
Thank you so much for these insights! This was so inspiring!