Tuesday, 7 December 2010

Psycho-social wellbeing.

A recent report entitled “The role of local government in promoting wellbeing” written by nef (the new economics foundation) is interesting reading. This report examines how local government can support a better life for its citizens to help build resilient communities, both now and in the long term.

The following extracts emphasises the importance of psycho-social wellbeing:

“Psycho-social wellbeing is people’s sense of how their lives are going, and the strength of relationships that sustain community life, are strongly influenced by psychological and social wellbeing: Having a positive outlook in life and feeling good about oneself – the elements that make up emotional wellbeing – directly promote a more positive experience of life."

“The factors driving both material and psycho-social wellbeing are not equally distributed among local populations. Some individuals or population groups live in better-quality housing than others. Some have fewer money concerns. Some have stronger support networks. Some feel valued, respected and included in a way that others do not. Some have the time and facilities they need to engage in activities to promote their wellbeing. Wellbeing is highly dependent, therefore, on the distribution of social, economic and environmental resources in any population. The prevalence of social or cultural discrimination (on grounds of social class, gender or ethnicity, for example) impedes equality in the distribution of social determinants of wellbeing."

One of their "online contributions (www.idea. gov.uk/wellbeing) Lynne Friedli distinguishes between “efforts to address the symptoms of inequality - for example, the steep social gradient in health and education – and the wider strategic challenge of reducing the gap between rich and poor”. Research suggests that high levels of inequality are damaging to communities and society as a whole. There is growing evidence that relative deprivation and social injustice erode mental wellbeing and increase stress, and some have argued that the differences between us put a strain on social relations, by reducing trust and interaction. The conclusion from all this is clear: local government cannot improve the wellbeing of its local population without directly addressing inequalities."

Source: Above extracts from page 11 and 12 of report referred to.


Prometheuswrites said...

Picking up on the theme of psycho-social well being I offer the following.
For anyone who knows someone suffering from the neurological condition of ME/CFS (Chronic Fatigue Syndrome) this has real relevance.
I’m going to post it in two parts due to the length.

In August this year, following a survey of NHS Trusts and Patient Groups the WAG health minister decided to follow the clinical care pathway recommended by NICE. This approach considers ME/CFS to be a ‘psycho-social’ condition and advocates treatment using CBT (Cognitive Behavioural Therapy) and GET (Graded Exercise Therapy), both of which are opposed by the National ME/CFS Patient Groups as for many ME/CFS sufferers the consequences of these approaches are detrimental in the mid to long term.
Recent research into ME/CFS has demonstrated that about 70-80% of ME/CFS sufferers test positive for XMRV and MPL retroviral markers, suggesting that ME/CFS may have a viral component.

Testing of control groups and the public blood supply in the USA, Holland and Japan shows a 2-8% incidence of the XMRV retrovirus.
For this reason many countries including Canada, New Zealand, Australia, USA, and a growing number of EU countries have banned blood donations from people with ME/CFS to the public blood banks. On the 1st of November this year the UK also banned anyone who has or who has had ME/CFS from giving blood. (Personally I think this is a wise move; following the precautionary principle).

So now we have a strange situation in Wales where what is most likely a viral infection is being treated as though it were a mental health problem. A bit like telling someone who has HIV or Hepatitis C (both retroviral conditions) that they should think positive thoughts and do a bit more exercise to get better.

Letters have been sent to the WAG minister for health asking for clarification. Sadly came there none, just a letter explaining WAG health review policies.
To top all this a statement was made by one of the blood transfusion services that the reason for bringing in the ban was, ‘to protect people with ME/CFS as they didn’t want to cause any further fatigue as a result of their having just given blood’.

Prometheuswrites said...

Two things here: Firstly, what about all those people who had ME/CFS and have since recovered – they won’t be getting tired, no more than ordinary Joe Public anyway.

Secondly, in all the surveys that the NHS and the patient groups have completed into how the condition affects sufferers not a single one has even mentioned giving blood as a cause of fatigue, so where is the evidence based justification for the ban?

What I find disturbing in this is the trend for institutional explanations of policy that avoid giving reasonable, evidence based justifications for the decisions made.

More to the point these explanations suggest a pre-occupation with NHS and Government finances over and above the needs of the patients. The problem the health service have is that acknowledging that ME/CFS has a viral cause would mean that they would have to change their clinical care pathways from a psycho-social model to a viral model and that would cost money; for research, for testing and for treatment. (Ironically, getting people better would save money on welfare benefits and long term medical costs).

I fear however that financial considerations will become the order of the day and there will be an increase in ‘sleight of mouth’ justifications being given for policy decisions that will affect all wider aspects of ‘the public good’ – car parking, library closures and council mergers included.

Of course, if you feel that ‘balancing the books’ is the overriding consideration of good governance then maybe it is ‘experienced business accountants’ that we should be voting for in the coming elections next year.

Prometheuswrites said...

"Consultation on new health, social care and well-being strategy underway"


The website I found this on is a great little web-site, a good source for local happenings here:


Rhys Williams said...

From BBC Radio 4 Today program

There is more evidence that chronic fatigue syndrome could be caused by a virus, according to scientists in Scotland. Professor of vascular medicine Jill Belch outlines the recent research



Promo said...

NOBA: Thank you for that link.

Prometheuswrites said...

"One in 10 adults in Wales 'has no natural teeth'"


I wonder what the figures are for Anglesey - Didn't we have a programme of 'fluorination' to improve the health of our children's teeth.

As for 1 in 10 adults in Wales having 'no natural' teeth that is I suspect something to do with the appalling level of NHS dental service provision across Wales.