We need more than investment in services to solve the mental health crisis.
By Lea Milligan
It’s now widely recognised that there is a crisis in mental health. In September, a staggering 1.6m people in the UK are waiting for mental health treatment on the NHS, and 1 in 4 people globally are impacted by a mental illness at some point in their life.
This crisis is only being exacerbated by the increasing cost of living, global conflicts causing generational trauma and the ongoing fallout from COVID-19.
Lack of equitable access to services, treatment and resources means the most vulnerable in society continue to suffer disproportionately.
Everyone assumes that addressing this crisis requires more doctors, more appointments and more mental health treatment centres. Whilst one answer is, yes, we absolutely need more of these, it’s not the only answer.
More services are not the sole solution: We also need more research.
Mental health research is the secret weapon that often is overlooked by policy makers.
- Research shows us where to focus resources, so that we don’t just blindly throw money and time at the parts of the system that are not working.
- Research helps move people through the system faster, giving them more effective treatments and faster diagnoses.
- Research reduces the number of people requiring acute care by providing effective prevention strategies and intervention methods.
Research speeds up access to services:
The EnCAMHS project, sponsored by Greater Manchester Mental Health NHS Foundation Trust, is working to improve and refine the referral process to CAMHS (Child and Adolescent Mental Health Services). By mapping and raising awareness among professionals of the different types of support available for children and young people, the EnCAMHS team are hoping to reduce waiting lists and speed up access to care for the most urgent cases.
Research improves treatments:
I have seen firsthand the incredible breakthroughs in treatments that have come from targeted investment in research.
MQ researcher Dr Colette Hirsch from King’s College London developed a new treatment for anxiety and depression called cognitive bias modification for interpretation (CBT-I). New treatments such as this help provide a greater range of treatment choices, more important now than ever because, according to the World Health organisation, the pandemic triggered a 25% increase in anxiety and depression worldwide.
Dr Jennifer Wild from Oxford University has developed a new treatment for PTSD in health care workers, with a 90% recovery rate. This is an unprecedented success rate for a group highly vulnerable to traumatic stress.
And Dr Ethel Mpungu has developed a community-based therapy for people living with both depression and AIDS in rural Uganda. The 578 participants of her study remained symptom free from depression 12 months later. Her work has been internationally recognised and, due to its success and cost-effectiveness, it is being rolled out across other African nations, improving the lives of millions of people.
Research can help us prevent mental ill-health in the first place:
For example, the IDEA (Identifying Depression in Early Adolescence) project has created a prediction model to identify the young people who are most at risk of developing depression in later life. This tool can be used to identify the most vulnerable before depression can take hold, getting them timely interventions that can prevent a lifetime of mental ill-health.
This Mental Health Awareness Week (9-15 May), plenty of people will be talking about smashing stigmas, reducing loneliness and the need for more mental health support. And, of course, these are absolutely important. Vital even. But don’t forget about research.
Because it is only through research that we can truly make progress.
Lea Milligan is CEO of MQ Mental Health Research, a charity that funds world-class research and innovation to create better mental health care.
Improve your marathon time with proper pre-hydration
Andy Blow, sweat expert and founder of leading sports fuelling and hydration company Precision Fuel and Hydration, discusses how pre hydration can help improve your marathon time.
Dehydration can seriously impact an athlete’s performance, and enjoyment of a marathon.
Yet according to the International Journal of Sport Nutrition and Exercise Metabolism, 31% of amateur athletes arrive at training sessions or events dehydrated.
For those looking to shave minutes off their race time – simply starting properly hydrated could be the answer.
We caught up with Andy Blow, CEO of Precision Fuel and Hydration, to find out how pre hydration can have such a dramatic effect on your marathon, and how runners can start a race in the best possible condition.
The benefits of pre-hydrating
Optimising your hydration status before a marathon, or ‘preloading’, can increase your blood volume and significantly improve your performance.
According to Sport Nutrition by Jeukendrup and Gleeson, dehydration of just 8% of each individual’s total-body water could half their exercise endurance, based on a 121 minute session.
Research has proven that taking onboard a high concentration of electrolytes, the salts and minerals that help your body function, promotes fluid retention which in turn increases the blood volume in your body.
This increased blood volume supports cardiovascular function helping transport oxygen and fuel to your muscles, and your body’s ability to dissipate heat produced by your working muscles.
This can reduce fatigue and improve endurance performance – helping you run your best marathon possible.
On the other hand, exercising in a dehydrated state can reduce blood volume, limit cardiovascular performance and limit the body’s ability to cool itself through sweat – all limiting the body’s ability to perform.
Pre-hydration is more than drinking water
Hydration is much more than just the amount of water we drink.
Your body is constantly aiming to maintain a balance between water and electrolytes.
It’s therefore important to take on correct levels of both to properly hydrate.
Drinking just water can upset that balance, diluting the body’s concentration of salt. Always wanting to maintain equilibrium, the body’s solution to this is to expel the excess water through urine. It’s basically going make you pee!
Unfortunately, this will also take with it some of the electrolytes in your system, further diluting your blood sodium levels and impacting your performance (and wellbeing in extreme cases).
However, consuming a strong electrolyte solution in the build up to a marathon will boost your salt levels, encouraging your body to retain the water you drink, helping you to start the race fully hydrated.
How to hydrate before a marathon
The timings of a race day, particularly an event as large as the London Marathon, can be vastly different to an athlete’s usual routine.
That’s why planning your hydration strategy is key.
Athletes preparing for a marathon should drink a strong electrolyte drink the night before the race to encourage your body to retain fluid, which will boost blood volume.
Aim for drinks containing >1,000mg of sodium per litre.
The morning of the race, 90 minutes before the start is recommended, athletes should drink another bottle of strong electrolyte drink to top-up blood plasma volume.
It is important to finish this drink 45 minutes before you set off to give the body time to process it.
While this plan will enable the average marathon participant to arrive at the start line hydrated, every person’s sweat concentration and sweat rate will be different, so athletes looking to maximise their potential should know their numbers, do a sweat test and form a more personalised hydration plan.
Dangers of over drinking
As much as beginning a marathon dehydrated can negatively impact your performance, there is also a danger that athletes can drink too much water in anticipation of a race – leading to a new set of problems.
Nervous drinking before a race is common for newcomers to marathon running, and those who haven’t planned their hydration.
Drinking too much water without taking on electrolytes can lead to hyponatremia.
Hyponatremia can be summarised as low blood sodium levels. This can be caused by inadequately replacing the sodium lost when sweating, compounded by drinking plain water or weak sports drinks mixed that further dilute sodium on the body.
Sodium is vital for several bodily functions like blood pressure and working nerves and muscles.
Hyponatremia can cause nausea or vomiting, fatigue, loss of energy, muscle weakness and cramps; all things you want to avoid when running a marathon.
According to National Kidney Foundation, when sodium levels are particularly low, more serious health implications can occur, even resulting in death.
Don’t waste your training
It’s probable that if you’re signed up to a spring marathon, you’ve done months of hard training.
By making sure you start the race properly hydrated, you not only reduce unnecessary discomfort, fatigue and muscle weakness, but will allow your body to realise its full potential come race day.
Training is also an ideal opportunity to test out your hydration strategy. Try running through your pre-race hydration and timings with the confidence that you are in the best possible shape.
Finding time for training in the busiest of schedules
Whether you’re a serious runner or casual athlete, fitting your training sessions into a busy schedule can be tough. Once you factor in rigid work hours, family duties, or other commitments, it can feel like there are few available opportunities to get your trainers on and hit the roads. Andy Blow, former elite triathlete, leading sports scientist, and CEO and founder of sport nutrition multinational Precision Fuel & Hydration (PF&H), shares his tips for training with a busy schedule.
Make a plan that works for you
Planning ahead is the key to making the most of every hour in the day.
Consolidate all your commitments onto one central calendar. Whether it’s work meetings, school runs, or domestic chores, you’ll be able to get a clearer idea of your schedule, and what is going to be a realistic amount of training for you to achieve.
Instead of picking a high intensity programme, then trying to cram it into your week, start with non-negotiable commitments and build up your plan around these.
It’s a more sustainable way to train, which means you’re more likely to stick to the plan and hit your long-term goals.
Use your time wisely
Waking up an hour or two earlier means you can get some training in before your day has even begun.
Not only does this add extra hours into your schedule, but they’re hours which are unlikely to be filled with other commitments. How often do you plan an evening run, only for something more pressing to be added to your diary halfway through the day?
Hit the trails early and clock up those morning miles before the world wakes up.
If you’re responsible for taking children or other family members to clubs and appointments, use this time to your advantage. Keep a pair of running shoes in the car and plan a route to complete while you wait.
If your office building has a shower available, turn your commute into a training opportunity by running part or the whole of your journey.
Training smarter also means you’ll get the most out of your time. Instead of running for the sake of running, incorporate sessions that are specific to your end goal, whether this means regular hill sessions, speed intervals or longer, slow runs.
Fuel, hydrate, and recover
What you do between sessions can be as important as the training itself; you’ll never get the best out of a run if you’re lacking energy or have improperly recovered and hydrated. When you’re short on time, every run must count.
When people talk about hydration, it’s often about what and how much you should drink during exercise. But your performance is also hugely influenced by how hydrated you are when you start exercising in the first place.
There’s strong evidence to show that taking in additional sodium with fluids before you start sweating is effective in promoting increased acute fluid retention and improving endurance performance, especially in the warmer weather.
There’s more to fuelling than just calorie intake, and there’s a few common pitfalls which can catch you out.
Not taking enough carbohydrate to adequately support your rate of energy expenditure is the number one fuelling mistake, but it’s possible to take on too much carb as well – primarily because of the gastrointestinal (GI) distress a sugar overdose can cause.
Fuelling using pre-packaged sports nutrition is a no-brainer for short to moderate training sessions or endurance events, where taking in palatable, simple carbohydrates is the key to success. They’re convenient and can simplify getting your carb intake just right.
Despite already recommending getting up that bit earlier sleep is also worthy of mention and is an extremely powerful tool for recovery – something many of us are guilty of neglecting. If you’re an athlete, getting enough sleep should be as big a part of your training program as your exercise sessions.
Set a clear goal
Even if you’re a casual runner, take on the challenge of a race or event you can train for. Having a goal will keep you motivated, especially if it has a fixed date to work towards.
True performance comes from long term consistency, not weeks of hard training, so a long-term goal is a great way to stay accountable over a sustained period.
With busy schedules and multiple commitments, life can very easily get in the way of our goals. But I truly believe that there’s time for training in even the busiest schedule if you train smart, set priorities, and plan your time carefully.
The role of social media and celebrity culture in making cosmetic surgery accessible
By Michael Saul, Partner at Cosmetic Surgery Solicitors
The popularity of cosmetic surgery has grown in tandem with social media and celebrity culture. Once thought to be only accessible to celebrities or the rich, cosmetic procedures today are more affordable than ever. The demographic of those facing the knife has changed dramatically over the last few years, and the reason for wanting to may be more linked to celebrity culture than economic access.
Here, Michael Saul at Cosmetic Surgery Solicitors explores how social media and celebrity culture have facilitated widespread access to cosmetic surgery, and the potential implications associated with this trend. For the trend to be understood, we must consider the measures taken by the government and medical professionals to ensure that the priority is to safeguard the health of individuals who pursue procedures.
The popularity of cosmetic surgery
The increase in popularity can be partially attributed to the influence of social media and celebrity culture, which have made it easier for people to access information about different cosmetic treatments. While the accessibility of these treatments is beneficial in certain circumstances, it has also led to serious concerns. Most notably, it has highlighted the emotional and physical consequences of chasing an ever-changing beauty standard. Wider accessibility also translates to difficulty in regulating procedures on a wide scale.
A report from the International Society of Aesthetic Plastic Surgery (ISAPS) states that there were over 24 million surgical and non-surgical cosmetic procedures conducted worldwide in 2018 – a 4% annual increase.
Social media giants such as Instagram and Facebook can display information about different cosmetic treatments and procedures to billions of people worldwide. Social media platforms are pedestals for celebrities to constantly flaunt their appearance and endorse particular cosmetic surgery brands or services. The never-ending feed of celebrity content creates pressure on individuals to conform to unrealistic ideals of beauty or attractiveness. In a celebrity-praising society, it is no surprise that many people are led to pursue such treatments to “fit in” with what they are told is the standard.
A growing concern is an ability to control and regulate the emerging offers for cosmetic surgeries. Accessibility without proper regulation can lead to misled, ill-prepared, or unfit individuals undergoing surgery. More businesses in the industry drives price competition between practitioners, potentially resulting in substandard treatment and medical care in an effort to cut costs. In response, governments must put in place more stringent and considered regulations governing who can offer these services, and the expected standard of service from practitioners, to ensure safety for those who opt for such treatments wherever they receive treatment.
The complications with accessible cosmetic surgery
More accessibility to cosmetic procedures without regulation can easily result in a decrease in safety and efficacy standards. Increasing demand has seen some medical professionals cut corners to keep up with unprecedented demand. Cutting medical corners leads to dangerous consequences, such as botched surgeries, infections, and scarring.
It is important to consider that even elective procedures often result in serious psychological implications on the patient if they are not performed properly, or if the patient is not prepared for them. Individuals contemplating cosmetic procedures must consult a board-certified surgeon with longstanding experience in the latest techniques and standards before making any decisions.
Apart from possible health dangers, there is also worry that the ease of availability of cosmetic surgery may lead to a warped perspective of beauty and body image. While social media has been primarily praised for increasing people’s access to cosmetic treatments, it has also been criticised for encouraging unrealistic beauty expectations. As more people pursue these procedures without understanding the ramifications or investigating all of their alternatives, the danger of needless operations and an unhealthy preoccupation with physical beauty grows.
Is the blame on social media?
Social media has had a huge influence on the cosmetic surgery industry. This is primarily due to the prominence of “influencers” on various social media platforms who advertise themselves and their lifestyles. Several influencers have undergone cosmetic operations, and they frequently show off the results, giving their huge following an idea of what they may look like if they went through with it as well.
This type of promotion can be especially problematic for young people who are easily impressionable. The syndrome known as “Snapchat dysmorphia” has been observed, in which people feel motivated to change their look in order to resemble manipulated photographs that appear on social networking sites.
Additionally, not all cosmetic surgery centres offer safe or high-quality procedures. Untrustworthy therapists may utilise social media to entice vulnerable patients who are yearning for a physical change. Despite warnings from medical professionals, some patients may still be tempted to take this risk just to achieve the same results they see others getting on their timelines and news feeds.
Finally, persons seeking cosmetic surgery operations should be aware that, while it may appear beautiful and easy at first look, social media may be a powerful yet harmful influence when making judgements regarding aesthetic improvement treatments. It is also worth mentioning that certain countries are starting to take action against fraudulent advertising connected to cosmetic surgery, particularly those associated with influencer culture, in order to safeguard consumers from misleading information and potentially dangerous practices.
Is the blame on celebrities?
Celebrities have been known to impact many elements of life for their fans, including fashion trends and haircuts, as well as lifestyle choices. It has also been proposed that celebrities can have a significant impact on people’s decisions to undertake cosmetic operations.
While celebrities may inspire people to assume that cosmetic surgery is far less dangerous than it is, there are always dangers involved with these treatments. Consumers should also be aware that not all cosmetic surgeons provide the same degree of care or skill; it is critical to conduct adequate research and locate a trustworthy practitioner who follows all safety measures before undergoing any sort of operation.
It’s important to remember that everyone’s body is different, so what works for one person might not work for another. As a result, every choice to proceed with surgery should be made cautiously and with a full understanding of all potential risks and results. Taking ideas from celebrity culture may be entertaining, but when it comes to health care or cosmetic surgery in particular, we must always exercise prudence and make our own educated judgements rather than depending primarily on external influences.
It is undeniable that social media and celebrity culture have made cosmetic surgery more accessible. Governments and medical experts must be mindful of these dangers to protect the safety of people who undergo such procedures before irreversible physical and psychological damage is caused.