Health and Wellbeing Promotion

Objectives:

To ensure medical students in placements within mental health are empowered on how to promote good health and advise patients who present to mental health services.

For medical students to identify problems first and be aware of what actions are needed to focus on improving our health.

How to measure the determinants of good health:

• Employment and quality of work
• Education skills
• Housing
• Income and debt
• Access to good services
• Built and natural environment (including air pollution).

What are the problems?

Health behaviours:

• Diet
• Smoking
• Alcohol misuse
• Physical inactivity.

Psychosocial:

• Isolation
• Social network
• Self esteem and self worth.

Physiological impact:

• High blood sugar or Diabetes
• High blood pressure 2
• High cholesterol
• Heart problems or heart attack.

A better understanding of the interrelationship between the body and the mind including the management of sleep, mental and physical disorders would help to improve our health and wellbeing.

Smoking

Smoking is the leading preventable cause of illness and premature death. Smoking is uniquely harmful, causing damage not only to smokers but also to the people around them. Smoking harms nearly every organ in the body. Smoking is also harmful to mental health and wellbeing.

Despite a continued decline in smoking prevalence, 13.9 percent of adults in England are still smoking. One in four patients in a hospital bed is a smoker. Smokers see their GP 35 percent more than non smokers.

Stopping smoking at any time has considerable health benefits:

• Shorter hospital stays
• Higher survival rates
• Better wound healing
• Decreased infections and shorter hospital stays.

Quitting smoking is not easy, there is support available:

• Speak to health professionals, speak to your GP
• Local stop smoking services
• Treat tobacco dependence with the help of services
• Stop smoking aids.

Poor diet and excess weight

Most adults in the UK are eating more calories than they need and should eat fewer calories. If you eat and drink more than your body needs, you’ll put on weight because the energy you do not use is stored as fat. If you eat and drink too little, you will lose weight.

You should eat a wide range of foods to make sure you’re getting a balanced diet and your body is receiving all the nutrients it needs.

• Try to include at least one starchy food with main meal
• Eats lots of fruit and vegetables, getting your five a day is easier than it sounds
• Aim to eat at least two portions of fish a week, including one portion of oily fish. Fish is a good source of protein and contains many vitamins and minerals. Oily fish are high in omega 3 fats which may help to prevent heart disease
• Cut down on saturated fats and sugar.

It is important to pay attention to the type and amount of ‘fat’ you are eating. There are two types of fats:

• Saturated: Too much saturated fat can increase cholesterol in the blood which increases your risk of developing heart disease
• Unsaturated: foods that contain unsaturated fats such as vegetable oils and spreads, oily fish and avocados.

Regularly consuming food and drinks high in sugar increases your risks of obesity and tooth decay. Food labels can help. Use them to check how much sugar foods contain.

Eat less salt: less than six grams per day for adults and children aged 11 or over. Younger children should eat less. Too much salt can raise your blood pressure. People with high blood pressure are more likely to develop heart disease or have a stroke. About three quarters of salt you eat is already in food when you buy it, such as breakfast cereals, soups, breads, and sauces.

Get active and be a healthy weight. As well as eating healthy, regular exercise may help reduce your risk of getting serious health conditions. It may also improve your overall health and wellbeing. Being overweight or obese can lead to health conditions such as Type 2 diabetes, certain cancers, heart disease and stroke. Being underweight could also affect your health. If you are trying to lose weight, aim to eat less and be more active. Eating a healthy balanced diet can help you maintain a healthy weight.

Lose weight with the NHS weight loss plan, a 12 week weight loss guide that combines advice on healthier eating and physical activity.

If you are underweight and you are worried about your weight, ask your GP or a dietitian for advice.

You need to drink plenty of fluid to stop you getting dehydrated. Avoid fizzy or sugary drinks especially between meals.

The risks of drinking too much alcohol

Regularly drinking more than 14 units of alcohol a week risks damaging your health. The type of illnesses you can develop include liver disease, some type of cancers, brain damage, stroke.

Regular drinking at high rates can make your mental health worse. There is also evidence that alcohol misuse risks self harm and suicide. The effects of alcohol on your health will depend on how much you drink. The less you drink, the lower the health risks.

Men and women are advised not to drink more than 14 units a week on a regular basis. Spread your drinking over three or more days if you regularly drink as much as 14 units a week.

Read about alcohol units to work out how much alcohol thereis in your drinks. If you are pregnant or think you could become pregnant, the safest approach is not to drink alcohol to keep risks to your baby to a minimum.

Benefits of cutting down include:

• Feeling better in the morning
• Being less tired during the day
• Feeling more energetic
• Long term benefits include mood being generally improved as well as sleep pattern
• Drinking can affect your judgement and behaviour. Memory loss can be a problem. All these may improve as you reduce your drinking
• Regular or heavy drinking can affect your heart and your immune system
• Speak to your GP if you think alcohol is problematic for you.

Steps to mental health wellbeing

Connect with others

Strong positive relationships help to stay connected with others and can improve your sense of belonging and self worth.

Be physically active

Regular physical activity and fitness, there are chemical changes in your brain which in turn helps to improve your mood.

Learn new skills

Even if you feel like you do not have enough time, there are new skills you can learn that challenges such as, new cooking skills, DIY, gardening or indeed anything you enjoy. It helps to:

• Boost your self confidence and raise your self esteem
• Build a sense of purpose
• Connect with others.

Pay attention to the present (mindfulness)

Paying attention to the present can improve your mental wellbeing. This includes your thoughts and feelings, your body and the world around you. Mindfulness can help you enjoy life more and understand yourself better. It can positively change the way you feel about life and how you approach challenges. Read more about mindfulness, including steps you can take.

Speak to friends and family or seek help from your GP if you have any concerns.

Sleep and tiredness

Feeling exhausted is so common that it has its own acronym, TATT, which stands for ‘tired all the time’. The strains of daily life can worry most of us at some point. It is also worth remembering that even positive events such as moving house or getting married can cause stress. Emotional shock such as bereavement, relationship difficulties or redundancy can make you feel tired or exhausted. If you think your lack of sleep and tiredness is due to depression with low mood and lack of energy or increasingly anxious, speak to your GP.

Advice on how to improve the sleeping pattern:

• Be consistent
• Make sure your bedroom is quiet, dark, relaxing, and at a comfortable temperature
• Remove electronic devices, such as TVs, computers, and smart phones, from the bedroom
• Avoid large meals, caffeine, and alcohol before bedtime
• Get some exercise.

In summary, get support and ask your doctor about the right support including:

• A weight loss programme or group
• A registered dietitian
• An exercise specialist or group
• A Type 2 diabetes prevention programme
• Book an appointment with your GP if you are concerned about any of the above.