Tag Archives: mental health

The stigma of an unpaid Mental Health Carer

matthew-mckenzieWelcome back to another blog from unpaid carer in the south of London. As world Mental Health Day draws near, a lot of emphasis is placed on those suffering angel problems. I find it quite important that you must not forget the hidden Heroes who’s tape in when their loved ones are in most need. This is not to take away the difficult battles mental health survivors face, however all too often sigma hits out at more than one person.

Mental health stigma hits the family, the friend, the husband, the wife and even the neighbour. This blog will concentrate on another type of stigma, which can be all Too Well forgotten. I am going to talk about carer stigma. Now it is very important that not all unpaid carers suffer from carer stigma.

First you must differentiate what or who is an unpaid carer. I am talking about the person who suddenly finds themselves caring for someone close to them who has been unfortunate to pick up either physical or mental health problem. I am not talking about paid care workers, although I do admit care workers to find they can have a difficult job, they are paid for their role and can be protected by Union.

Arguments.

With carers they are not trained and often care out of closeness and love for the person they are trying to look out for. It gets really difficult if that person has a mental health illness.

The types of carer stigma.

So Let’s Begin, I cannot really produce an exhaustive list of different types of carer stigma, but the ones that i am showing i’ll probably the most recognisable types of carers take life out there.

Depends on the illness.

When a loved one become very unwell, he often try as hard as he can to support them. The problem is the more chronic the illness the more is stigma lash out. A good example is when a carer is caring for someone suffering psychosis, those suffering from this difficult illness can often present challenging behaviours. If such behaviour is out in public, then the challenge is not only faced by the mental health Survivor but also the carer.

Embed from Getty Images

It only takes one person to ridicule the suffering from a mental health problem. This can then extend to the person family, the risk is once a community starts to gossip about the situation, it can cause the carer to become more isolated. This in turn leads to stigma of both mental health and carer. As a note not or carers go through this and it probably can depend upon the illness anyway.

The Label

Although not as devastating as the first form of carer stigma, it still can be rather destructive. Some people carry on caring and supporting those close to them out of desperation. They carry on caring regardless of the support mechanisms that amen applied to the family network.

At first it seemed really brave, it is great to hear a carer battle it out no matter what the situation. However there is one big problem, no matter what are the carers might say to this situation, the person still feels that they do not deserve the term of being labelled a carer. The problem is that this person will then like the support network available for carers.

Clashing forms of relations

This type of stigma is actually quite similar to the one mentioned previously. A good example is when a person marries someone they marry for better or worse. When the worst does arrived, the person cares especially out of love. They care because they are either the husband or wife. If you try to tell them that they are now a carer, that person may become very irritated. They refuse to be labelled as a carer, and yes this is the right, but the risk is lack of support network available to them.

This care stigma can also extend to other relations within the family, another good example is a young person caring for a parent, or even especially a young carer. Can you imagine as a child having to suddenly provide care for an older adult suffering a mental health condition?

The terrible characteristics of an unpaid mental health carer

There are several characteristics, which are aimed at carers. I am going to go through a few that come off the top of my head.

Embed from Getty Images

Being labelled as lazy

All too often we have to work for a living, we have to pay our dues. The harder the work we do, the more we expect to be paid. The more complex the role, the more we expect be rewarded. There is this review going around that the Caring role is fairly easy, because some people think that it is easy, they think that the carer does not have to do much at all. This can lead to carers being labelled as lazy. Once a person is targeted as lazy, they do not really want to be labelled as a carer.

Being blamed

This is quite common in the field of psychology/psychiatry, especially in America. When someone is unfortunate enough to develop a mental health problem, all too often psychiatrists tend to probe the family structure. All too often, it says if the carer is not doing their job properly. It might even go so far as to state that the carer is causing the mental health relapse or has caused the mental health problem to manifest itself in the first place.

One of the main criticisms of psychiatry, is at one end it might exclude the carer in their supporting role/care plans or confidentiality and at the other end label the carer as the problem within care plans and assessments. This can lead to a person not really wanting to find the energy battling a mental health system that can misunderstand the caring role.

Confrontational

Another good example of how the mental health system might fail families and carers, is if the carer has experienced failures in support of their loved ones and even the care of them self. It then becomes only a matter of time before the carer becomes more confrontational. No one really wants to be labelled as aggressive, uncooperative and confrontational. This is just another label a person can do without, so why would they want to be labelled as a carer?

Embed from Getty Images

Risk of declining health

Again this might depend upon the type of illness the person is trying to care for, the more chronic the illness, the most stressful situation is for the carer. Since the NHS is under severe strain, a person would have to think hard and long before they would want to commit themselves in becoming an unpaid carer. It is like that there has been a secret contract, stating that the carer now must take the role of the lack of staff within the health system. This could be administering medication, advocating, understanding side effects, understanding social welfare, mental health legal matters, engaging with doctors and also mental health advocate and peer supporters.

Is there any wonder why carers can end up with depression, anxiety, stress and worry? One could say that mental health illness can be catching.

Hiding it all away

I’m afraid I have bad news, for what I have mentioned is only the tip of the iceberg when it comes to Carer stigma. I did not want to make this blog post overly long. With the above issues mentioned, is it any wonder why someone wants to hide themselves from being labelled as a carer?

Advertisements

Recommended Carer books

10 Helpful Hints for Carers: Practical Solutions for Carers Living with People with Dementia – June Andrews, Allan House

A Carer's Chaos - Julie Nancy Wiltshire

10 Helpful Hints for Carers is an easy-to-read guide for carers living with people with dementia. It provides simple, practical solutions to the everyday problems family carers can face when looking after a person with dementia.

A Carer’s Chaos – Julie Nancy Wiltshire

10 Helpful Hints for Carers Practical Solutions for Carers Living with People with Dementia

When Julie Wiltshire’s husband, David, was diagnosed with cancer twice, he faced a series of treatments made all the more difficult by multiple complications. In A Carer’s Chaos, Julie records the details of David’s long journey of cancer treatment, but also offers a unique perspective into life as a carer to a loved one, exploring the love, hate, anger, loneliness and fear experienced on a daily basis by a carer.

A Carer’s Odyssey – Anna Chan

A Carer's Odyssey - Anna Chan

In the first part of A Carer’s Odyssey, Anna Chan describes how she and her husband Jeff were devastated 16 years ago by the diagnosis of their daughter Emma’s severe neurological disorder, called Rett Syndrome.

A Gift for Carers – William Long

A Gift for Carers - William Long

This book was written following the author’s personal struggle with the psychological and physical pressures of caring for his mum. His experiences and research led him to develop a solution which counters the devastating effects of what the medical world refers to as “Caregiver Syndrome.” He identifies seven areas that make for a joyful life.

A Gradual Disappearance – Elizabeth Lonseth

A Gradual Disappearance - Elizabeth Lonseth

“Dementia is like a maze. Its victims get lost in the labyrinth of their own minds, bringing confusion and despair to themselves and to others around them. Families watch helplessly as their loved ones drift further and further away from reality, and when decisions are made, emotions often get in the way of what is really necessary.” – Dr. Sameh Elsanadi, MD Geriatric Psychiatrist

An Introduction to Coping with Depression for Carers – Tony Frais

An Introduction to Coping with Depression for Carers

Looking after a person with depression can often leave carers emotionally and physically exhausted. This short, straightforward and easily understandable guide offers valuable advice on how carers can

BMA Carer’s Manual – British Medical Association

BMA Carer's Manual

Endorsed by the British Medical Association, this is the definitive guide to caring for the elderly or sick, offering practical advice and solutions for everyday concerns such as adapting living space and safe movement and handling. Step-by-step sequences explain essential activities such as helping someone in and out of a chair and special features focus on topics relating to common conditions.

Carer’s Bible – Amanda Waring

Carer's Bible

This accessible and detailed guide includes practical tips, checklists for best practice, descriptions of their experience from a wide range of carers that addresses solutions to common problems, and expert advice on how to deliver compassionate and dignified care to older people.

Caring for a Loved One with an Eating Disorder – Jenny Langley, Janet Treasure, Gill Todd

Caring for a Loved One with an Eating Disorder

Caring for a Loved One with an Eating Disorder: The New Maudsley Skills-Based Training Manual provides a framework for carer skills workshops which can be used by anyone working with these conditions.

Confidence to Care: A Resource for Family Caregivers Providing Alzheimer’s Disease Or Other Dementias Care at Home – Molly Carpenter

Confidence to Care A Resource for Family Caregivers Providing Alzheimer's Disease Or Other Dementias Care at Home

Confidence to Care is the essential handbook for the family caregiver offering practical insights to understanding, managing and preventing the behavioral symptoms associated with dementia and Alzheimer’s disease. Touching, personal stories come together with practical and easy-to-access tips and techniques drawn from decades of caregiving experience by internationally-recognized experts.

Guide to Mental Health for Families and Carers of People with Intellectual Disabilities – Geraldine Holt, Anastasia Gratsa, Nick Bouras

Guide to Mental Health for Families and Carers of People with Intellectual Disabilities

A practical and comprehensive introduction for carers to mental health problems, this accessible guide outlines a range of signs and symptoms of mental health problems that can affect people with intellectual disabilities. The guide explains why mental health problems develop, and advises on what can be done to help people with intellectual disabilities and carers themselves.

Living with Dying: A Complete Guide for Caregivers – Jahnna Beecham, Katie Ortlip

Living with Dying A Complete Guide for Caregivers

  • This easy-to-use guide for caregiving instructs you how to:
  • Have the conversation
  • Navigate the emotional and spiritual journey
  • Control pain
  • Address symptoms
  • Work with hospice
  • Care for yourself
  • Get your loved one’s affairs in order

Mindfulness for Carers: How to Manage the Demands of Caregiving While Finding a Place for Yourself – Cheryl Rezek

Mindfulness for Carers How to Manage the Demands of Caregiving While Finding a Place for Yourself

Carers are particularly vulnerable to feeling stressed, worried and worn down by the vast demands that often come with caregiving, be they physical, psychological or emotional. Mindfulness can be enormously beneficial to carers, whether professional or voluntary, as a means of developing greater inner stability, resilience and gaining more control over their thoughts, feelings and emotions.

No Saints Around Here: A Caregiver’s Days – Susan Allen Toth

No Saints Around Here A Caregiver's Days

When we promise “in sickness and in health,” it may be a mercy that we don’t know exactly what lies ahead. Forcing food on an increasingly recalcitrant spouse. Brushing his teeth. Watching someone you love more than ever slip away day by day. As her husband James’s Parkinson’s disease with eventual dementia began to progress, writer Susan Allen Toth decides she intensely wants to keep her husband at home—the home he designed and loved and lived in for a quarter century—until the end.

Self-Care for Caregivers: A Twelve Step Approach – Pat Samples, Diane Larsen, Marvin Larsen

Self-Care for Caregivers A Twelve Step Approach

For those serving as a caregiver for a loved one, the authors of this down-to-earth, encouraging book can help you make the most of the experience without losing yourself in the process.

Supporting Families and Carers: A Nursing Perspective – Mary E. Braine, Julie Wray

Supporting Families and Carers A Nursing Perspective

Understanding the perspective of carers is an essential aspect of nursing. Supporting Families and Carers: A Nursing Perspective offers insights into the fundamental principles of caring for families and carers irrespective of age, gender, ethnicity, sexuality or religion.

Take Care, Son: The Story of My Dad and his Dementia – Tony Husband

Take Care, Son The Story of My Dad and his Dementia

Hi Dad . . . can we have a chat about your dementia . . . Can you remember how it started?
When Ron Husband started to forget things – dates, names, appointments . . . daft things, important things – it took a while to realise that this was ‘a different form of forgetting’. But it was just the first sign of the illness that gradually took him away from the family he loved.

The Carer’s Handbook: Essential Information and Support for All Those in a Caring Role – Jane Matthews

The Carer's Handbook Essential Information and Support for All Those in a Caring Role

This indispensable guide aims to be a one-stop-shop for the huge percentage of the population who, now or later, find themselves in a caring role, whether that involves shopping for a housebound neighbour, or giving up work to care full-time for a disabled child or confused parent.

The Complete Carer’s Guide – Bridget McCall

The Complete Carer's Guide

There are around six million carers in the UK, a figure estimated to reach nine million by 3037. Being a carer can be rewarding, but it is often stressful and exhausting: it involves a range of tasks, such as providing personal care, managing medication and ensuring that the needs of the person being cared for are met. This practical, much needed guide discusses how to ensure that you have a life of your own while caring, how to make informed decisions and, most importantly, how to access the support and help you need.

The Essential Carer’s Guide – Mary Jordan

The Essential Carer_s Guide

Illustrated with individual case stories, this book covers physical, social, and financial needs, across the stages of immediate, intermediate and advanced care. It is useful as a practical companion for those caring for, or responsible for the care of, an elderly friend or relative.
The Selfish Pigs guide to caring – Hugh Marriot

The Selfish Pigs guide to caring

Over six million people in the UK…provide unpaid care for disabled or elderly relatives, friends or neighbours. Their job is long, lonely and hard, yet there is limited support and no formal training. As a result, carers suffer frequent damage to physical and mental health. Oddly, though carers by definition are anything but selfish pigs, they are liable to feelings of guilt, probably brought on by fatigue and isolation.

Where There is No Psychiatrist: A Mental Health Care Manual – Vikram Patel

Where There is No Psychiatrist A Mental Health Care Manual

Even though mental illnesses are common and cause great suffering in every part of the world, many health workers have a limited understanding about mental health and are less comfortable dealing with mental illness. This book is a practical manual for mental health care for the community health worker, the primary care nurse, the social worker and the primary care doctor, particularly in developing countries.

Young Carers and their Families: Working Together for Children, Young People and Their Families – Saul Becker, Jo Aldridge, Chris Dearden

Young Carers and their Families Working Together for Children, Young People and Their Families

Young carers are children and young people under the age of 18 who provide care for an ill or disabled parent or relative in the community, usually within their own home. They perform many of the same domestic, caring and other duties as adult carers but often without the recognition and support received by many adult carers.

Influential poem from Patrick Lee

cover

Welcome one and all to a new blog for the month of August. I have to apologise for not putting anything up for some weeks now since I have been really busy doing a lot of carer campaigning. To be honest I have not had much time to provide feedback from the 4 carer forums in South London.

I have also just recently come back from a lovely forum held over in West London, from the West London Collaborative, they do excellent work over there helping to build communities.

Going back to this particular post, I want to dedicate this blog post for its creative content. A while ago I met Patrick who provides peer support for those using the mental health services. He spoke to me how he used the power of poetry to help others express themselves. Poetry can be very creative and powerful in a non-combative way. Sometimes just saying things is hard enough, but if we use the power of poetry then anything is possible.

I have recently created a video about one of his poem’s which is from his book “The Nearly Man”. The Poem from the video is called “Cardboard City Dweller”. You can watch the full video below

 

Patrick has released several books of poetry, let me know if you want to try catch him in order to hear more about his work. I hope to do some more blogging real soon.

Thanks for dropping by.

Lambeth MH Carers Forum update May 2018

IMG_20180531_195653Welcome to the May’s update of the Lambeth Mental Health Carer forum. It has been a while since I did an update for the forum, since I could not attend the previous Lambeth MH carer forum and forgot to blog about the other previous forums.

This forum caters for unpaid carers who are caring for someone with a mental health need, e.g. someone suffering from psychosis, eating disorder, depression, bipolar and other MH illnesses.

The forum is strategic and gives carers the involvement and empowerment to query, question and even compliment the mental health services in Lambeth and sometimes beyond e.g. we are hoping to have a representative from NHS england attend in future.

This Lambeth MH forum was on the 31st of May and was well attended with some very good questions and statements from the forum members. The Lambeth MH Carers forum is run from the 336 building off Brixton road.

20140710_143445

Guest speakers at the forum was Stacey Hemphill from the ‘Living Well Network Hub’ and also Lambeth Police Mental Health lead inspector Mark McLeavery.

Updates from Stacey was on how and why the Lambeth Living Well Network was started up and provides support people’s Mental Health and wellbeing. They liason with Lambeth GPs and those using the services.

Stacey talked about how the network engages with carers and what support they can provide service users. The Living Well network runs at the following places being the Mosaic Clubhouse on Effra Road, Clapham Methodist Church and also at 336 Brixton Road, you can call them on 0203-691-5080 or email them on slm-tr.lwnhub@nhs.net

LWN

Next up was Inspector Mark McLeavery from the Lambeth Met Police. He spoke about how the Lambeth police engages with someone who is in a crisis out in public. The forum were very interested to hear how someone in crisis ends up at the Maudsley’ hospital ‘Central Place of Safety’.

Mark mentioned Lambeth has a challenging and high rate of mental health needs, plus the stigma of mental health can make things even more challenging.

Lambeth_London_UK_labelled_ward_map_2002

Mark Spoke about the Crisis Assessment Team ‘CAT’ and the use of ‘street triage’ Mark stressed that there are no use for police custody cells for those in mental distress, although I did mention the problem with beds and he mentioned at worse A&E might be the last option for someone in serve distress.

Embed from Getty Images

The forum moved on to discuss GDPR and updates from Carers Hub Lambeth, it now seems that the charity ‘Help for Carers’ is being disbanded and Carers Hub Lambeth has split from it.

Going on to the minutes of the last forum that took place in April, the updates were from how Lambeth Healthwatch are engaging with its support networks. Updates on the King’s Health Partners ‘Mind & Body’ programme. Updates on C4C visits, plus the good news on the Money and MH Link update with government passing a law that supports those suffering debt from MH illness, which involved one of our very own carer member of the forum helping to lead on the project.

Other updates have been no news on the rota from SLaM regarding guest speakers, but I mentioned the trust were under reorganisation, so we will see what happens after that. There is also a push to have a Lambeth MP engage with the forum to see the wonderful work unpaid carers are trying to do to help their community.

This concludes the update from the Lambeth MH carers forum.

Lewisham MH Carers forum April 2018 update

IMG_20180529_135451Welcome to the Lewisham MH carers forum update for May. Out of all the four Mental Health carer forums in South London, this is the oldest one I chair. The MH carers forum ran on the 29th of May.

Carers Lewisham have been very good in supporting the forum and helping to advertise it, but we still need to reach other mental health carers in the borough of Lewisham. It is very important unpaid mental health carers know what is going on with the mental health services, let alone being engaged and trying to influence them.

For the month of May, we had guest speaker Stephanie Edwards who is the Clinical Team Leader for the Psychosis service in Lewisham. This forum was highly strategic as the forum members got a brief breakdown of the mental health services in Lewisham. The mental health service structure for the borough of Lewisham was complicated due to the current restructuring of SLaM staff, but hopefully we will have Donna Hayward-Sussex at the April forum, she is the Deputy Director of the Crisis Services within the Psychological Medicine Team.

The forum members need to know and query how mental health staff restructuring will affect service user and carers in the borough of Lewisham. As far as the forum knows, there will be be senior management consultations regarding interim posts.

Lewisham Ward Map

The mental health trust that covers 4 boroughs and a few more regarding mental health services is preparing for the CQC visit in July, they have spent a long time preparing services and involving carers and service users in ward/service inspections, which was good to hear. The MH carers forum appreciates staff have worked very hard.

IMG_20180529_145134

Regarding future forum engagement, the members look to be updated on the NHS trusts estate developments, governance structure and involvement oppertunities. I queried how many carers does Lewisham MH services have on the books, but it can be difficult to pin down the answer, still heard that around about over 800 Mental health cases are in the books, so it gives us some idea of the number of families and carers we need to reach.

Stephanie Edwards is preparing for Lewisham’s People’s Day, so the forum looks to provide cards, posters and leaflets.

After discussions, I brought out a large map of SLaM’s services and Stephanie took time to explain what the services in Lewisham are about, who was responsible and answered queries from the forum members.

There is concern that not enough carers in the borough know what is going on and are not getting involved. There are plans to have the forum held alternatively in the evenings at the Depford community centre. We also hope the carers support group can be set up in Lewisham Hospital so new carers can gain therapeutic support since there is limited time for carers stories at a Carer MH Forum.

IMG_20180529_140109

The forum has requested an MP visit soon from the borough of Lewisham to boost carer empowerment and understand carer issues with the borough

This concludes the update for the Lewisham MH carer forum.

Embed from Getty Images

Southwark MH Carers Forum May 2018

Untitled-2

Here is the update from the forum I run after the BME MH Carer/SU forum in the afternoons.  This forum is aimed at unpaid carers in the borough of Southwark, although mental health professionals are free to attend.

The May carer forum was very well attended with representatives from Southwark CCG, Southwark Healthwatch, Kings Health Partners and nurses from the Southwark inpatient acute wards.

At the start of the forum I presented what a mental health carer is, that being basically an unpaid carer supporting someone with mental health needs.

We then had Eliza Hinchliffe presenting on Kings Health Partners project ” Mind and Body Programme”

She presented on the new Mind and Body programme, which is a Kings Health Partners initiative between Guys&St Thomas, Kings College Hospital and SLaM. The Mind & Body programme looks to close the gap between mental health needs and physical health needs.

IMG_20180525_164456

The forum discussed ways engagement can be made with carers in mind. There is an offer to promote the forum via the hospitals in Southwark, which means families and Carers can link up on what is going on.

The forum hoped to have Mick Wright Turner – Head of PMIC Southwark Pathway, but he was unavailable.  However we were very impressed that nurses from the Mental Health unit attended the forum to speak about the carers pathway progress.

Next up to present was Karen Clarke who is the mental health lead at Southwark CCG. The forum is particularly interested in collaborating with her regarding updates on mental health services in the borough of Southwark, especially services that needs to give more thought/involvement and engagement about families and carers.

Karen spoke about her role and an introduction about Southwark’s mental health strategy. There will also be a IAPTs review,  the Southwark wellbeing hub review and more updates.  The forum spent some time comparing it to Lambeth’s Mosaic clubhouse. The forum would like southwark CCG to help promote what we do and let carers know there is a place to be heard.  Karen aims to continually engage with the forum, so carers and carer champions can be involved and spread the word.

Next was Southwark Healthwatch updating on projects regarding carers?

healthwatch

Southwark Healthwatch spoke about their new initiative to engage with carers about mental health services.

The engagement officers took the time to ask carers on what they think would be a mental health crisis and where would the carers take their loved one during a crisis and would like to interview carers about mental health services in the borough of Southwark.

IMG_20180525_175811

The forum again would like Southwark Healthwatch to help promote the forum, which Healthwatch agreed via their community board.

The next part of the forum looked into engagement requests Updates

There was a very short discussion on meeting the MP Neil Coyle, the MP has helped promote the forum and there will be a Southwark MH event in Parliament with members of the forum talking about why such a forum is needed.  All members noted that this will bring much needed awareness of what carers are trying to do while being empowered to do so.

Members are also excited that MP Helen Hayes is due to visit the forum in June.

Lastly we had an update from Carers involved in SLaM Foundation Trust

I have been helping train staff on the wards, one ward was actually done over at the Maudsley, this is in regards to carers & confidentiality. The training is being done with help from the trusts Modern Matrons.

Another member of the forum attended NHS England’s conference and raised if their 5 year plan includes try Triangle of Care.

This concludes the update for the Southwark MH Carers forum, stay tuned for the Lewisham carers forum update and also the Lambeth Carers forum update.

 

Mental Health Awareness week 2018

Welcome to a new blog from a mental health carer in South London. This video helps to raise awareness of mental health. Specifically mental health awareness week 2018.

stress-mhaw18

What on earth is mental health awareness week you say? I actually have done a few videos on the awareness event some years back, but let me refresh your mind.

As a note, I have also done a video version, press play to watch it.

Mental Health awareness week aims to raise awareness of mental health and mental illness or health needs. Mental illness can affect us all ranging from minor mental health problems to chronic mental health needs. Mental Health Awareness Week runs from 14th to the 20th May. For 2018 the theme is on stress. Research has shown that two thirds of us experience a mental health problem in our lifetimes

Without campaigns or events to raise awareness about stress and mental health, many people would fall victim to stress, which can actually get out of control. We all experience stress and minor levels can actually help us achieve what we are trying to do, but prolonged and high levels of stress can cause damage to our mental and physical health.

Sad man sitting head in hands on his bed in a bedroom at home

Stress can affect your mood, behaviour and body. Stress can cause any or a combination of the following.

  • Headaches
  • Sleep problems
  • Lack of focus
  • Social withdrawal
  • Feeling overwhelmed

Stress can also lead on to other mental health issues being

  • Anxiety
  • Sadness
  • Depression
  • Addiction problems in order to cope with stress
  • Eating issues

Sometimes what we need is to recognize when we are stressed and either stop or behaviour or seek help. Taking time out from stressful situations can do us a world of good, especially speaking to friends in the community.

So what have I done for MH Awareness week 2018? Not only did I promote awareness via this video, but I took part in a Curry & Chaat event over at Southwark carers. It is important not to forget those who try to protect and care for someone with mental health needs.

I hope this blog has been educational to you and hope you have a happy mental health awareness week 2018.