DDN Magazine July/August 2021 - Page 18




am a dual-qualified mental health nurse and psychotherapist , and I ’ ve worked across NHS Scotland , NHS England and the private sector . My focus has been on primary care mental health providing broad access care for all , and my practice comes from a modern cognitive-behavioural approach recognising relational , attachment and systemic factors as well as intrapsychic processes .
In his 2004 article The origins of addiction , Vincent Felitti focused on adverse childhood experiences ( ACEs ) and the link with substance use . The results were as predictable as they are tragically painful – Felitti concluded that ‘… the basic cause of addiction is predominantly experience-dependent during childhood , and not substancedependent ’. In other words , what has happened to people in their life has a greater predictive power on the development of addiction than the psychoactive properties of the drugs themselves .
Further research highlights the
Mental health and substance use treatments can complement each other in vital ways , says Peter Lindsayhall
links between addiction , mental health and ACEs . Traumatic effects disrupt our ability to regulate our emotions , feel safe , connect with others and understand ourselves . Whilst we are learning and developing through our lives , disruption has significant ripple effects . When all of this is coupled with Giano et al ’ s 2020 study showing that 57.8 per cent of people have at least one ACE , and 21.5 per cent have at least three , we can see that ACEs are not uncommon – but have powerful effects across social , emotional and physical health .
Interestingly , the research of neuroscientist Jaak Panksepp showed that infant bonding and intimacy triggered the opioid receptors in the brain – leading to further connections being identified between opiate addiction and deficits in experiencing close , nurturing and fulfilling relationships throughout our lives , particularly in early childhood . So , the need is clear – people who experience addictions are very
MY ROLE AS CLINICAL MENTAL HEALTH LEAD IS A NEW AND DEVELOPING ONE . Just as the physical environment is designed to ensure mobility is no barrier to treatment , my position seeks to ensure that psychological and emotional problems are also not a barrier to the curative effects of the therapeutic community . The role has three main areas of focus :
• Developing a core mental health treatment programme for all residents
• Higher intensity intervention for those with specific and acute mental health needs
• Support , training and guidance for the staff likely to have experienced trauma , anxiety and depression , had difficulty with emotional regulation and struggled with interpersonal and intrapersonal relationships .
This means services that guide and support people in resolving their substance dependency are ideally suited to , and enhanced by , evidence-based mental health treatments and interventions to establish understanding , skills and alleviation of psychological and emotional suffering . The mental health strategy being implemented at Phoenix Futures is progressive , compassionate and exciting , and the organisation exudes a sense of care and responsibility to provide holistic support to everyone who is part of delivering or receiving help .
The work to further enhance the mental health support available begins by focussing on residentials , and the plan is to then roll out initiatives across all services provided by Phoenix . The Scottish Residential service provides treatment that is already adept at supporting the multifactorial nature of the people they work with , and the staff , peers , programme and environment combine to provide a safe space to understand the experiences of the residents and utilise their own sense of self-efficacy . The house has also been designed to be accessible for those with additional mobility support needs .
We plan to ensure that the core therapeutic community treatment processes remain strong , and are aided by the mental health treatments . Where additional
‘ Adverse childhood experiences have powerful effects across social , emotional and physical health .’
support may be needed for a particular individual , we can respond proactively . For example , a resident may present with issues around emotion regulation – the ability to respond adaptively to our feelings , urges and beliefs about what is going on in a way that is productive . Difficulties in emotion regulation cut across trauma , mental health and substance use . People may feel powerless , overwhelmed or confused by the emotions they experience . Offering one-to-one interventions will help them to understand their emotions , develop the ability to be aware , curious and separate from their urges , choose their responses before , during and after powerful emotions , and cultivate acceptance and learning from each experience .
This should improve outcomes across all areas of the person ’ s life , and provide a feedback improvement loop within the therapeutic community . It ’ s an exciting time for mental health within Phoenix Futures , and I am grateful to have the opportunity to be a part of it .
Peter Lindsayhall is clinical mental health lead at Phoenix Futures