As a specialist provider of mental health support, caring for some of the most clinically complex patients in the UK’s mental health system, the team of experts at St Andrew’s provide bespoke clinical and therapeutic approaches that enable vulnerable patients to recover. Here, NR Times meets senior social worker, Emma Wakeman
Can you tell us about your experience in mental health
I’ve been at St Andrew’s for three and a half years and I’ve always worked in neuropsychiatry. I actually did a student placement here when I was training to be a social worker and just absolutely loved it. I loved the patients and the work so I applied for a job and got it.
Before St Andrew’s, I worked with the charity Mind and had done a lot of work in mental health.
Can you give us some insight into the service that you work in
I work as a social worker within St Andrew’s neuropsychiatry service and am based on our brain injury wards. We have different wards based on the needs of patients; an admissions ward for people who are acutely unwell, often with complex needs and behaviours that challenge and rehabilitation wards where we focus on a patient’s recovery with a view to discharge.
Within our rehabilitation service we support people to re-learn skills of daily living and help them to psychologically manage the changes to their cognition, speech and language and mobility. It’s really about them being able to move on and out of hospital. This is always the goal, no-one wants to stay in hospital for long.
Our neuro service also includes specialist Huntington’s disease wards and a new dementia hub. Dementia can be an extremely debilitating disease so it’s essential that we are able to support people with their activities for daily living (ADL) and provide the compassion and care that they need at the end of life.
Describe a typical patient presentation
Of course no patient is the same as another, but you do see some common themes when you’re working with people with brain injuries or neurological conditions.
A lot of the time patients can lack motivation and this can be perceived as laziness, but it’s actually not, it is the changes in their brain that affect how they see the world and the tasks ahead of them.
People who have suffered a brain injury can be very impulsive as they have lost that filter that ordinarily says ‘Stop, don’t do that as it could be dangerous to me or someone else’, so that can be really difficult for them and others.
Then we have people who, following a brain injury, have retained abilities in some areas, so for example, their speech could be fine but they aren’t able to use their hands, and that can be really distressing for them.
What is the difference between the service you work in and a general neuro rehabilitation ward?
Our neuropsychiatry service is very different, often people, unfortunately, come to us from a failed placement because ours is a very specialised service that is able to support people with behaviours that challenge in a compassionate and least restrictive way.
Our years of expertise and knowledge at St Andrew’s mean that we know what works well and we are always pursuing new approaches and resources, such as virtual reality (VR). Our specialisms helps people who don’t flourish elsewhere to rebuild their lives following brain injury.
In addition to their medical care, in what other ways do you support patients?
As a social worker in a hospital I am are here to make sure the patient’s social needs are met and we do that in a variety of ways. It could be ensuring that people have good contact with their family members, however that looks, or it could involve making sure that their finances are in order, so if they are entitled to benefits they get those and determining whether they are safe to spend their money. Sometimes people can be at risk of financial exploitation or they are unable to budget and they can end up in debt.
We also oversee patient safeguarding incidents and check that protocols and support are in place to make sure that people are safe in hospital and once they leave us.
As well as working on behalf of the patient we also support their family and carers and liaise with commissioners and external networks to ensure that people’s recovery journey here goes as smoothly as possible and that at the end of their stay with us we discharge them to the right place.
What sets St Andrew’s apart?
Well, the first thing is that St Andrews have ward-based social workers. While I’m ‘bigging up’ my own profession, it is very much needed. If you think about hospital it is very medically focused, so that social emphasis on, and support for, patients is very important.
Within a hospital environment we are a point of contact for carers who can be very confused and distressed. St Andrew’s often helps people from outside of area, so it is really important to have that person on the ward that can support family and carers through the process. We also have a carers’ lead on site who can offer additional guidance and help.
The role of hospital social worker is not something you get everywhere.
What challenges do you face in your role?
Personally, I think one of the big challenges is making sure that you are working in the patient’s best interests, not putting your own values and judgement on their situation. Making sure that they have a voice and you’re doing the best you can for them.
People with a neurological condition or brain injury can find it difficult to express what they think and feel. Often their emotions can betray them because they will feel one thing and do another or they don’t have insight into their condition, which makes it really hard for them to accept treatment and they will almost resist what is really good for them and that can be hard to deal with sometimes.
What do you most enjoy about your role?
In social work, we deal a lot with discharge and I think anyone who works here will say the best thing is to see a patient moving on, going to the next placement, going back home, returning closer to family. It’s an amazing achievement when you see that.
Another key and enjoyable part of my role is working with family members and I think they are often forgotten in the world of mental health. I love helping family because you meet people from all walks of life so it’s really interesting and providing this support is something that gives me a great deal of satisfaction.
Tell us an interesting fact about yourself…
I actually have two scars on my face. One from when I was hit by a boomerang, and the other one on my chin from a skateboarding accident. Unfortunately none of them was as an adult, both as a child, I’m not that interesting now!
PFA leaders pledge to donate brain to Concussion Legacy Project
Two senior figures at the PFA have pledged to donate their brain to research as part of the pioneering Concussion Legacy Project to protect future generations of players.
PFA Chief Executive Maheta Molango and PFA Chair John Mousinho have both made the pledge through a partnership with the Concussion Legacy Foundation UK, following the lead of England Rugby World Cup winner Steve Thompson.
The Concussion Legacy Project, unveiled yesterday, will research Chronic Traumatic Encephalopathy (CTE) and other consequences of brain trauma in athletes and military veterans in the UK.
PFA Chief Executive Molango, a former striker at Brighton & Hove Albion, Lincoln City and Oldham Athletic, said: “While being very mindful of taking immediate steps to protect current players, in the long-term ongoing research is vital to enable us to be able to answer more questions and best support members.
“We have been listening and engaging with leading academic experts, and they tell us that brain donation is a key piece to the puzzle in understanding CTE. We are excited to join a global network of the most prominent researchers in this area.”
Yesterday, Steve Thompson became the first athlete to pledge to the Concussion Legacy Project’s Brain Bank, with the former Lion previously stating that he cannot remember playing in England’s 2003 World Cup final win over Australia.
Today, Oxford United’s captain Mousinho, who has amassed over 500 league appearances over a fifteen-year professional career, committed his support for the project.
PFA Chair Mousinho explained: “Brain donation is an intensely personal decision for former players and their families. However, I have been inspired by the team at the Concussion Legacy Foundation and The Jeff Astle Foundation, and I have decided to commit my brain to future research in the hope that it can help play a part in protecting future generations.
“The Concussion Legacy Foundation has a strong ethos of supporting families and everyone affected by brain injury, and they are values we share at the PFA.”
Dawn Astle, who has been campaigning for two decades for football’s authorities to publicly recognise a link between the repeated heading of a football and dementia in later life, has given her full support to the new concussion initiative.
Speaking on behalf of The Jeff Astle Foundation, she said: “Brain donation is the most valuable gift of all for future generations of footballers. It may be many years before this jigsaw is complete but adding each piece, one at a time is the only way we will understand the true picture and make a better future for others.
“The Jeff Astle Foundation encourages families of athletes and veterans to donate the brain of their loved one to the Concussion Legacy Project at PledgeMyBrain.org.”
‘We want to be part of the solution – for Bill and future generations’
Dr Judith Gates speaks to NR Times about this weekend’s football match organised by Head for Change, which will be the first ever to involve no heading of the ball
The first football match which involves no heading of the ball will help raise awareness and stimulate conversation about the impact of head injury in sport, its organisers have said.
The 11-a-side match, involving 25 former professional footballers, has been hailed as an experiment as researchers try to discover whether the game can function without heading, in light of ever-growing research which links football to neurodegenerative disease.
It is organised by Head for Change, the organisation helping to drive forward calls for changes to player safety, and will only allow headers in the penalty box for the first half and then restrict all heading during the second half.
It will be held at Spennymoor Town Football Club, in County Durham, on Sunday at 3pm.
The event forms part of the “legacy” for former Spennymoor Town and Middlesbrough defender Bill Gates, who has sports-related dementia, and whose wife Dr Judith Gates is co-founder and chair of Head for Change.
“When Bill received his diagnosis in 2017, we made two promises to him,” Dr Gates tells NR Times.
“One was to optimise his life and do all we could to make his life as good as we could as a dad, grandad and great grandad, and the second was for his legacy, to do everything we could to be part of the solution for future generations of footballers and their families not to have to face this.
“The purpose of this match is to raise awareness of the dangers of heading the ball and to provide alternative discussion with purpose. It’s an experiment to see what the game will look like.
“To be clear, Head for Change is not suggesting heading should be banned, that is a decision for football’s governing authorities, not for us.
“But we want people to realise the impact. Bill was a Titan to me in his 20s, fit and indestructible, so if this disease can do this to him, it can happen to anyone.”
The match has attracted widespread media attention and comes after an array of stark academic findings, including the research from Professor Willie Stewart that footballers are up to five times more likely to suffer from dementia than the general population.
“Part of why I co-founded Head for Change was to be part of the solution,” says Dr Gates.
“We’re extremely aware that there is a lot of bashing going on and everyone is saying it’s someone else’s fault, but lessons must be learnt from the past.
“For too long we have been assured that our brain was safe in our skull, but we are increasingly understanding how the brain works and how it can be damaged through contact sports. Education will continue to play a very important role in what happens going forward.”
The match itself – which will also be raising money for The Solan Connor Fawcett Cancer Trust – will be held at Spennymoor Town’s stadium, The Brewery Field.
The town is where Dr Gates grew up and met her husband, and in a quirk of fate, Spennymoor Town’s chief executive Brad Groves used to work for Bill as a warehouseman when Bill owned a chain of sports stores.
The club, alongside those playing in the match, have been hugely supportive of their ambitions, says Dr Gates.
“We’ve been amazed at the extent to which they have stepped up, Spennymoor have been phenomenal. Brad has been so kind in offering whatever he can do to help. We are hugely appreciative,” she says.
“The players taking part are excited to be part of it, they may not be able to use one of their many footballing skills but they can use the rest of them.
“Spennymoor is a small town with a big heart and we are so pleased to be able to hold this match, and particularly here, at Bill’s first club.”
Marching to a different beat
NR Times reports on how Chroma is helping amputees prepare for prosthetics through neurologic music therapy (NMT).
Tech3 weeks ago
Cognitive assessment pioneer expands into US
Interviews2 days ago
Emilia Clarke’s SameYou – a catalyst for change
Brain injury4 weeks ago
History of concussion ‘may worsen later injuries’
Brain injury4 weeks ago
Rugby players ‘show cognitive decline in just one season’
Dementia3 weeks ago
‘The world is failing people with dementia, and that hurts all of us’
Tech3 weeks ago
Google and Mayo develop AI algorithm to improve brain stimulation
Insight3 weeks ago
Nexgear Tango: increasing options on orthotics
News1 week ago
Is the Rehabilitation Prescription improving patients’ lives?