Mental Health for Better Days

People living with long-term conditions, such as diabetes and cancer, are more at risk of experiencing mental health problems, such as anxiety and depression. This became even more apparent during the pandemic. Our COVID-19 research study found that people living with long term physical health conditions were among those whose mental health was most adversely affected. With the reduced availability of health and social care services and social support networks throughout lockdowns, many were left to deal with emotional distress alone.

That’s why as part of our Covid Response Programme, we worked with the Healthy Living Centre Alliance (HLCA) in Northern Ireland on the Mental Health for Better Days project.  We set out to develop a mental health wellbeing module within the HLCA’s award-winning Better Days Chronic Pain Management programme.  

Working together with Healthy Living Centre staff and programme participants we co-designed the mental health wellbeing module. We helped to build capacity of staff and volunteers at Centres by increasing knowledge and awareness of mental health.  We also trained facilitators to deliver the sessions.  To ensure we could reach as many staff as possible, we used a ‘train-the-trainer’ model so that attendees could share the learning with colleagues.

Staff who took part in the training reported high satisfaction with the course and increased understanding of:

• trauma informed practice
• stigma and discrimination
• impact of stigma and discrimination
• mental health inequalities.

Since the modules started being delivered in April 2023, 345 people across Northern Ireland have taken part.  They have reported feeling more confident in talking about their mental health, feeling more in control of their lives and increased understanding that if they take the right steps they can reduce their risk of developing mental health problems.

What’s next?  

We are delighted that there is an agreement to continue the partnership and delivery of the mental health and wellbeing module within the HLCA’s Better Days Pain Management programme for five years.   

Bill*, 62, from Co. Armagh is a husband and father of three who has worked all his adult life in physically demanding jobs, as well as tending to his own small farm in the evenings and at weekends.  Following a diagnosis of osteo-arthritis in his 50s, Bill was determined to carry on working as it was a big part of his identity, giving him a sense of purpose.   

Unfortunately, the progressive nature of his arthritis coupled with a debilitating virus that left him in capacitated for 18 months took its toll.  Despite trying to get back to work, the strain on his physical and mental health was too much and Bill had to retire.  

This was a challenging time for Bill, learning to live with long term chronic pain was already affecting his wellbeing. The end of his working life was causing him to lose his sense of self-worth. He began to avoid going out and socialising and found it difficult to talk to family and friends about his condition or how he was feeling.  

Although he had regular contact with his GP and had received physiotherapy, Bill felt that his condition was getting worse. The pain was limiting his opportunities, he didn’t have anyone to talk to about how he was feeling, and he was feeling isolated and alone.  Bill’s GP offered to refer him to the Better Days programme at his local Healthy Living Centre which offers support with pain management as well as a mental health module co-designed with people living with long term conditions and the Mental Health Foundation.  

Bill was unsure as to what help this group could actually give him and wasn’t keen on the idea of opening up and talking about his experiences and feelings in front of strangers but decided that in the absence of alternatives, he would give it a try.  

The first few sessions, Bill was more of a listener but gradually with the help of the facilitator he began to open up. He was surprised to find that many of the struggles he had, particularly with the unpredictable nature of his condition, were common across the group. Just hearing that others were faced with the same challenges made him feel that he was not alone. 

The session on mental health encouraged Bill, a man who wasn’t one for discussing feelings or emotions, to talk about how his mental health was impacted by his condition. Thinking about stigma and discrimination can be difficult but having talked about it in the group, Bill is more aware of how his life can be affected by these. In the past he would have found asking for or accepting help very difficult but now he can see that there may be times when the help of others would be useful to him. 

Bill feels now that he can recognise when his mood is slipping and can take steps to support his mental health. His favourite mental health tip was to plan things to look forward to. He uses this by both making plans to look forward to and when he is feeling unwell, he will reflect back on recent happy events to help him. Bill also, when his pain is not as severe, tries to include movement into his day by taking his dog for a walk. As the dog likes to stop and explore the world, Bill gets to enjoy the walk at a pace he can manage.  Instead of feeling pressure to exercise, he knows that just moving a little more can help both his physical and mental health.  

Bill explains that although the mental health was a session on its own it was also threaded through the whole programme. A chance to learn from a pharmacist helped him to understand his medications and reduce some of them which lessened the toll on his stomach. Learning techniques such as deep breathing gave him a sense of being able to manage his own pain a little more. Both of these things have helped Bill to feel more in control which has enhanced his mental health and wellbeing.  

The support from his peers on the group meant a lot to Bill. He says:

Bill recognises that the Better Days course and the mental health support from it has helped to positively change his life; I was very sceptical, but I had to eat my words!  He feels his earlier resistance to asking for help was because of the shame and stigma he experienced while now he can talk more about his needs. Bill feels that by being more open about himself, he can both help himself and others who may be feeling how he was.   

Bill’s advice to others is to give a programme like this a go:

*Name has been changed.