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Jaime A. Heidel - The Articulate Autistic

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Are You a Victim of Diagnostic Overshadowing?

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A set of five blank A3 sheets, each one relating to one of the Five Ways to Wellbeing.

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When you take a flight, the air hostess tells you one important rule 'PUT ON YOUR MASK FIRST'. It can be hard to look after others, when we don't look after ourselves. Here you can find tips for you, to help you be the best you....

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Sometimes, it is important to stop. Stop and think. Are you thinking this is something minor, because you are too busy? Are they being difficult?

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It is important that you take time for you, the mental health foundation has given advice here...

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2019 has been and gone, and now the New Year and possibilities of 2020 are upon us.

It is time to take a self-compassionate look at how we approach self development and our mental health this year.

With the New Year comes the temptation to hop on board the change train of 'self-criticism and self-reflection', head to carriage 'unrealistic expectations,' and 'comparing to others' and trundle on to destination 'new and improved you'. Purchase a ticket for the change train and find ... a more vibrant, healthy, driven, goal smashing, habit breaking, 100 billion new skills acquiring you by December 2020. With all this expectation you can arrive feeling overwhelmed and a little disappointed.

New Year self-improvement and intention setting doesn't have to be unrealistic and disheartening - it can be a positive thing with multiple benefits for people's mental and physical health.

Individuals may aim to eat healthier, take up new social hobbies, spend more time with friends and family, do 30 minutes of gentle exercise a day or get outside into green space more.

This year when thinking of self-improvement, find things that work for you, irrespective of what others are doing, and ask for support if you need it. New Year's resolutions have become a time of unhelpful self-criticism, a festival of finding ways in which we are not enough. Why not try setting a theme instead ...
Set your theme now
This year we hope you can

1. Accept yourself

2. Nourish yourself

3. Bring intention in to yourself

4. Take time for yourself

5. Find a theme for yourself in 2020

Accept yourself

It's "... cultivating the courage, compassion and connection to wake up in the morning and think, 'No matter what gets done and how much is left undone, I am enough.' It's going to bed at night thinking, 'Yes, I am imperfect and vulnerable and sometimes afraid, but that doesn't change the truth that I am also brave and worthy of love and belonging." Brene Brown - The Gifts of Imperfection: Let Go of Who You Think You're Supposed to Be and Embrace Who You Are

Resist the urge to strive for an entirely new you in 2020, instead accept the you last year, today and tomorrow and approach personal growth, habit change and goals with a kinder self-talk that cares for your mental wellbeing.

It's important to evaluate the relationship you have with yourself. Ask yourself, would you speak to someone else in the way you speak about yourself?

Self-care is about looking after yourself and your mental health. The relationship you have with yourself is crucial to your own wellbeing and also to creating healthy and happy relationships with others. Being kind to yourself regularly is one of the best things you can do.

Here are a few habits you could integrate in to 2020 to bring positive change to the relationship you have with yourself

Invest in yourself. Spend 15-30 minutes each day doing something that uplifts you

When your inner critic or an outer critic finds faults, try and find truth and exception to what is being said

If you stumble or feel you have failed, don't beat yourself up. Act as if you were your own best friend: be kind and supportive

Do something to wind down at the end of each day

Take a few minutes each day to appreciate yourself

Here's to taking time to accept yourself in 2020.

For more information on relationships with yourself and others please download our 'guide to investing in your relationships' for free.

Nourish yourself

There are many reasons why physical activity is good for your body - having a healthy heart and improving your joints and bones are just two, but did you know that physical activity is also beneficial for your mental health and wellbeing?

Sometimes it can be hard to resist the urge to reactively join the New Year trend that sees a surge of people joining fitness classes, getting new gym memberships or taking up the latest fitness fad. Instead, it can be beneficial to take a deep breath, pause and take time to work out in what ways do you want to nourish your body and mind in 2020.

People tend to have a renewed drive for positive change in the New Year and when channelled calmly and kindly this can have wonderful result for your physical and mental wellbeing.

Benefits of nourishing your body and mind with fitness

It can have a positive impact on your mood

It can relieve stress

It can increase self esteem

It can reduce anxiety and depression

The Department of Health recommends that adults should aim to be active daily and complete 2.5 hours of moderate intensity activity over a week - the equivalent of 30 minutes five times a week.

Social support can be a great motivator, and sharing your experiences, goals and achievements can help you to keep focus and enthusiasm with nourishing your body and mind. Physical activity is available to all, has few costs attached, and is an empowering approach that can support self-management.

Pause and work out what fitness is best for you and ask yourself

What do you want to get out of being active?

Would you prefer to be indoors or outdoors?

Would you like to be in a group or do an individual activity?

Would you like it to be integrated into daily life, such as doing housework, going on a walk, doing gardening (these are physical activities too)

Here's to nourishing your body and mind in a way that works for you in 2020.

For more information on nourishing yourself with exercise please download our 'How to look after your mental health using exercise' guide for free.

Bring intention in to yourself

Mindfulness can be practiced in person, either through a group course or a one-to-one with a trained coach. There are online courses, books and audio, too, where you can learn through self-directed practice at home.

After the Christmas break, or any time out of your usual routine, checking back into reality can feel quite hectic or confusing and leave you with a racing mind and launching into autopilot. By bringing intention in to your actions through mindfulness and stepping into the present helps to take care of your mental wellbeing. It can counter the New Year urgency to sprint when January arrives.

Mental wellbeing encompasses a sense of feeling good about ourselves, functioning individually and in relationships, handling life's ups and downs, feelings of connection to community and surroundings, control and freedom over our lives, and having a sense of purpose and feeling valued.

Mindfulness is a way of paying attention to the present moment, using techniques like meditation, breathing and yoga. It helps us become more aware of our thoughts and feelings so that, instead of being overwhelmed by them, we're better able to manage them.

Mindfulness has been shown to have positive effects on several aspects of whole-person health, including the mind, the brain, the body, and behaviour, as well as a person's relationships with others.

One-minute mindfulness

Take a minute a day to bring intent to you - mindfulness can be used in everyday life and doesn't need to take a lot of effort or time... to be precise it can take just one whole minute, 60 seconds, 60000 milliseconds.

Breathing - become present with the physical activity of breathing

Body scan - check in and bring awareness to the sensations in your body, head to toe

Mindful walking - bring awareness to the sensation of walking, how your feet feel when they connect with the ground, how the muscles in your legs feel when they move

Mindful listening - bring awareness to tuning in to your environment, listen to the sounds around you

For full descriptions of the one-minute mindfulness techniques and for more information on mindfulness please download our 'How to look after your mental health using mindfulness' guide for free.

Here's to bringing intention in to yourself in 2020.

Take time for yourself

'Woke up this morning with my mind set on loving me' Jamila Woods, Holy

Stress is a feeling of being under abnormal pressure, whether from an increased workload, an argument with a family member, or financial worries. Stress can affect us in a number of ways, both physically and emotionally, and in varying intensities.

Sometimes life can become a little overwhelming, and especially when you've got an expectation as well as the exciting opportunities that come with having a whole new year ahead of you. We recommend this year when things go from exciting to a prolonged period of stress that you hit the pause button and do something for you.

When you feel the balance isn't quite right, pause, be your friend and ask yourself:

Is this level of stress causing me a problem? Can I identify the causes? What small changes can I make to my lifestyle? Could I ... eat healthier, exercise, take time out, be mindful, get some rest and sleep, and most of all be kind to myself.

Here are some helpful tips from the supporters in our community to help with ideas for taking time to care for yourself and alleviate stress

Watch funny movies

Take a good walk in the countryside

Set aside 10 minutes a day to relax and collect your thoughts

Painting or drawing

Unplug the phone and get some time to yourself

Express your feelings and emotions

Spend time with positive people

Get a hot cup of something wonderful, a journal and a pen

Cheer up someone who is feeling down

Here's to taking time for yourself in 2020.

For all 101 tips! Look at our full article.

For more information of managing and reducing stress please download our 'How to manage and reduce stress' guide for free.

Find a theme for yourself 2020

Now it is over to you - what is your theme for 2020?
Download the 2020 theme template
Download our template for free and share your theme on social media tag @mentalhealthfoundation on Instagram and @mentalhealth on Twitter.

We have created a template to help you think of ways to choose yourself this year, instead of joining the change train.

What ways do you want to gently approach self-development and New Year's resolutions? What would you like to guide you throughout 2020? In what ways will you accept, nourish, bring intent and take time for you this year?
Here's to finding the theme for yourself in 2020..
Need support?

If you yourself are feeling like ending your life, please call 999 or go to A&E and ask for the contact of the nearest crisis resolution team. These are teams of mental health care professionals who work with people in severe distress.

If you need someone to talk to then Samaritans are available on 116 123 (UK) for free, 24/7. They are there to talk to, listen and they won't judge or tell you what to do.

C.A.L.M.: National helpline for men to talk about any troubles they are feeling. Call 0800 58 58 58 (UK). They are available 5pm-midnight 365 days a year.

For support in a crisis, Text Shout to 85258. If you're experiencing a personal crisis, are unable to cope and need support. Shout can help with urgent issues such as: Suicidal thoughts, abuse or assault, self-harm, bullying, relationship challenges.

Find our more about getting help
Your mental health matters

To anyone that is experiencing mental health problems right now. We want you to know that we care, and that you are not alone.

To anybody that passionately wants to create change - join our movement and let's do this together.
Get involved

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2019 has been and gone, and now the New Year and possibilities of 2020 are upon us. It is time to take a self-compassionate look at how we approach self development and our mental health this year.

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Encouraging a better diet is also a great way to promote wellbeing

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Information and guidance about eating a healthy, balanced diet.

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Research shows that exercise influences the uptake of chemicals in the brain that make you feel good. This booklet is a pocket guide to using physical activity to boost your wellbeing.

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The inter-relationships of mental and physical wellbeing 

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The inter-relationships of mental and physical wellbeing 

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We often separate 'mind' and 'body'. But when considering mental health and physical health, the two should not be thought of as separate.
Poor physical health can increase the risks of developing mental health problems. Similarly, poor mental health can negatively impact on physical health.
The promotion of good overall health and wellbeing should be discussed, and encouraged by all health care professionals.

Below you will find ways to improve wellbeing..

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Closing the Gap between physical healthcare?

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Closing the Gap between physical healthcare?

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Stigma, negative attitudes and lack of training for staff should always be addressed

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Diagnostic overshadowing can delay appropriate treatment and increase risks of complications

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There is a wide range of evidence highlighting the poor physical health of mental health service users

* Poor Lifestyle choices
* Un-coordinated physical health care
*Inappropriate practitioner response to history of physical symptoms
* Lack of practitioner training
*Stigma and Diagnostic overshadowing
*Poverty and Health Inequality

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"I am still conscious of being treated first and foremost as a mental health patient, rather than just a patient. It worries me, as I feel they give less attention to my physical needs than they would otherwise"
Sheila, Service user

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Preventing diagnostic overshadowing is challenging because it requires staff to reflect continually on their attitudes, skills, education needs, and practice. Mental Health service users have relatively poor physical health and poor health outcomes from physical disorders

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To Carers..

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Look into it, take the physical observations. Ask the questions.

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If you feel that it might be something else, INVESTIGATE

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Listen to the Service user..

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What can you do to help reduce the institutional discrimination of those with mental illness and learning disabilities.....

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The misattribution of physical symptoms to pre-existing mental illness.

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The Pressing need to understand the factors contributing to inequalities

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The Pressing need to understand the factors contributing to inequalities

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People with mental illness die prematurely and have significantly higher rates of medical co-morbidity compared with the general population. One suggested factor for this is the discrimination by health care professionals against people with mental illness

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Worse Physical Healthcare for People with Mental Illness?

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Worse Physical Healthcare for People with Mental Illness?

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What about Psychiatrist' attitude to mentally ill people?

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What about Psychiatrist' attitude to mentally ill people?

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Physical health issues may be undiagnosed in people with Mental Health Disorders and Learning Disabilities due to 'diagnostic overshadowing'. This is when a person's symptoms may be wrongly attributed to being a symptom of mental health factors.

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This guideline covers the period before, during and after a person is admitted to, and discharged from, a mental health hospital. It aims to help people who use mental health services, and their families and carers, to have a better experience of transition by improving the way it's planned and carried out.

The Care Quality Commission uses NICE guidelines as evidence to inform the inspection process.

Recommendations

This guideline includes recommendations on:

Who is it for?

Providers of care and support in inpatient and community mental health and social care services

Front-line practitioners and managers in inpatient and community mental health and social care services

Commissioners of mental health services

People who use inpatient and community mental health services, their families and carers

Is this guideline up to date?

We checked this guideline in July 2017. We found no new evidence that affects the recommendations in this guideline.

Guideline development process
How we develop NICE guidelines
Your responsibility

The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.

All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.

Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.

Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.

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Transition between inpatient mental health settings and community or care home settings

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This guideline covers the period before, during and after a person is admitted to, and discharged from, a mental health hospital. It aims to help people who use mental health services, and their families and carers, to have a better experience of transition by improving the way it's planned and carried out.

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The Mencap report on diagnostic overshadowing and the abundance of healthcare discrimination

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Mencap's report on institutional discrimination

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Check the medication contra-indicators, side effects and information

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British National Formulary | BNF Publications

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Practical, evidence-based information for health professionals who prescribe, dispense, and administer medicines.

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Why not check this out.

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Answer questions about your main symptom on 111.nhs.uk and get NHS medical help near you.