Simply the Best

It’s been a good long while since I last blogged. This has been partially due to being extremely short on time recently, but also because I had slightly lost direction and was unsure what stories I still had to tell. However, it seems that despite my recent silence, interest in my blog has remained with almost 600 “hits” since my last post. This has reminded me why I started this blog…

…there are still very few Speech & Language Therapists working in the field of adult mental health [so] The purpose of mentalhealthslt is to share my experiences not only with other Speech & Language Therapists but with anyone who works in or has an interest in mental health.

So it’s about time I got back to doing just that!

One of the things I regularly do with people is help them to focus on positive situations and work to their strengths rather than dwelling on negatives and difficulties. A friend of mine also writes a blog which is titled “Rachel’s Three Beautiful Things” which does exactly what is says on the tin. Rachel writes about three beautiful things that happened to her that day – an idea I love. So I am going to borrow the concept (which she also borrowed so I don’t think she will mind) for the next wee while to help get this blog back on track.

By highlighting the three best things each week about being a Speech and Language Therapist working in mental health services, and hopefully encouraging other colleagues to do the same, I believe that I can continue with my mission to spread awareness and develop understanding of the unique and valuable role we play.

So here goes. Here are here the 3 best things about this week…

1. The Sweet Sound of Success – About 18 months ago I met a lady called Sarah* who had become mute following a significant psychological trauma. She had not uttered a word for over 10 years and had become completely socially isolated and reliant on her family for even basic tasks. This week marked my final session with a now very talkative Sarah* who is living her life to the full having rediscovered herself and her role as wife, mother and grandmother.

2. Group Fever – There are a significant number of people with Asperger Syndrome who access mental health services. Many have very little understanding of their diagnosis and can find it difficult to participate in mainstream groups run by the community mental health teams. From next week I am running a group along with an Occupational Therapist and a Support Worker specifically to meet the needs of these clients. We had our final planning meeting this week and everyone is so positive, excited and enthusiastic – it’s infectious!!

3. All for One – This week I have been working in partnership with a broad range of people including a University Disability Advisor, staff in the local library, family members, nurses and psychologists to name but a few. These partnerships help me to ensure that my clients get the best possible service from me and from others, and being able to do that is one of the best things about my job.

*Sarah is a pseudonym to protect client confidentiality


Communication at Risk?

I am delighted to be able to share this blog by another mentalhealthslt about her role working with people with dementia. Joy has been an inspiration and an invaluable source of information for me (and I know to others) on my professional journey as a Speech and Language Therapist in Mental Health. Joy has also agreed to contribute to future blogs on mentalhealthslt so look out for more in the future…

Communication at Risk?

Speech and Language Therapy in Dementia #SLTDementia

Joy Harris           


P1I have always felt privileged that I have a job which is never dull and has challenge and reward in equal measure. There is no such thing as a typical week. I work with people newly diagnosed with dementia who have significant communication difficulties. These are most often people diagnosed with a Fronto- temporal type dementia or with language deficits associated with an atypical Alzheimer’s .I have an additional role of Clinical lead for Dementia in Lothian. This means that I constantly juggle day to day clinical work with more strategic work on developing the awareness of the speech and language therapy role in dementia and increasing the knowledge and skills of speech and language therapy . I am most passionate about increasing our role in facilitating communication in people with…

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What Counts?

Apologies for my recent silence – October has been a busy but very productive month for raising the profile of Speech and Language Therapy in mental health settings.

The month started off with 2 conferences in Edinburgh for Allied Health Professionals from across Scotland, the UK and the world. I was pleased to have a poster accepted for the Scottish conference and honoured to be asked to present a workshop at the International conference. My topic for both was person-centred care and I shared the outcomes and learning from the staff training and support programme I have been piloting with a team of local social care staff.


I am proud to say that my poster won joint first prize as voted for by delegates attending the conference, and even prouder that my workshop was attended by the CEO and Chair of Royal College of Speech and Language Therapists!

Our outcomes are so important but sometimes it can be difficult to measure what is truly important. As Albert Einstein is reported to have said, “Not everything that can be counted counts, and not everything that counts can be counted”. In an age where we are driven to seek the evidence to underpin our practice where can we find the evidence about what really counts for the people in our care?

With this in mind, the RCSLT Mental Health Clinical Excellence Network met in London, Glasgow and Limerick (embracing video-conferencing technology) to discuss “What works for SLTs in Mental Health?”. We had a packed day of presentations from therapists working in the field; sharing information, approaches and tools that have really made a difference for the people they support. While far from the scientific “gold standard” of research evidence, this sharing of anecdotal experience does start the process of unpicking what really counts in the work that we do.

In my work supporting good communication between people with mental health problems and social care staff I have not improved any one person’s speech, language or conversational skills as could be measured on a standardised assessment. However, what we have achieved are significant improvements in people’s quality of life in terms of their participation, independence, involvement, relationships and mental wellbeing – and that, in my opinion, is what really counts.

Are You Listening?

During a session a client once said to me, “Our conversations are different”. “What do you mean?”, I asked. “Well you let me talk until I am done. And then you say what you have understood from my ramblings. And when you say it back to me I realise yes that is how I feel; that’s exactly it”, he replied.

I started this blog a while ago and have been encouraged to complete it by an interesting Twitter conversation that emerged this weekend with the hashtag #DearMentalHealthProfessionals. So much of what I read was about communication, and the impact on people’s mental health and wellbeing when they do and do not feel listened to.

When was the last time you really felt listened to?

Being a good listener is a skill and it can be hard work. It is not just hearing and understanding the words; it is seeking to understand the meaning behind those words and demonstrating that understanding in your responses. The world of business has recognised this important difference for many years and it is considered one of the 7 Habits of Highly Effective People with the strapline Seek First to Understand, Then to be Understood.

One of the key roles for Mental Health professionals is listening to people, but what kind of listening do we do? Do we listen to understand or do we listen to respond? Is our objective to comprehend the person’s experience or to offer an appropriate solution? These things are not mutually exclusive, but in my experience the listener who takes an active role – seeking to understand and explore an issue – helps both parties to gain a deeper understanding and to find solutions together.

One Year On

365 days, 21 posts, 2133 views in 36 countries, 28 comments, 23 mentions, 28 followers, 202 shares, 25 ‘likes’, and a partridge in a pear tree!

It doesn’t seem like a year since I started my blog, but they do say that the years get shorter the older you get. As I had a significant birthday this year it appears that this particular adage is holding true. Yet, despite the fact that the year has disappeared at lightening speed, I feel that I have learned a lot.

I have learned that blogging is a powerful and effective way to promote and discuss the professional issues I feel passionate about, and make connections with like minded people.

I have learned that I place exceptionally high expectations upon myself and need to moderate these to an acceptable level – Out with the Old, In with the New.

I have learned that people are actually interested in what I do – A Tweet in the Life – and that I can write in a way others find entertaining and thought provoking – What’s in a Name?.

I have learned that I can inspire others to contribute to my blog and share their thoughts and experiences too – Therapy Through the Looking Glass – and that I can be quite persuasive as well (more guest blogs expected later this year).

I have learned that writing a good blog is a craft and takes time; and gauging the right length to make it interesting and informative without boring the reader to tears is not easy.

I have learned that it is challenging to write in a professional capacity and ensure that I am not breeching anyone’s confidentiality or trust – Adding Fuel to the Flames and Communication Matters.

I have learned that I am part of a growing community of Allied Health Professionals who are spreading our message about the vital role we play in supporting the mental and physical health of people in our communities – AHPScot Blog and Ayrshire Health to name but a few.

But most of all I have learned that blogging is something I really enjoy doing and want to continue, and I intend to bring as many other people along for the journey with me as I can. So buckle up people; here comes Year 2!

The Language of Mental Health

A young man in a ward of a psychiatric hospital is talking to one of the nurses. Suddenly, he starts shouting and then storms off. He says to you “I don’t know what these nurses are talking about. They’re from the same place as me but it’s like they talk a different language. I don’t trust them. They are up to something. It’s like they are talking in some kind of code. What’s going on?”. As you speak to this young man you realise that his sentences don’t always make sense. Some of the words he is using are not even real words. You struggle to understand what he is meaning yet he looks at you are though you are the one with the problem.

What are your first thoughts? Paranoid? Psychotic?

An elderly man in a nursing home is tearful and withdrawn. You try to talk to him but he says to you “I just don’t understand. I’m so confused. I’m sorry. Please leave me alone.” When he does speak to staff the old man is difficult to understand. His speech is mumbled and he doesn’t always make sense so staff struggle to grasp his meaning and the old man just looks away.

What are your first thoughts? Dementia? Depressed?

Why are you drawn to thinking about these labels? How much of your judgement was based on the way they are talking and the things they are saying?

These men have something in common – they are both experiencing dysphasia. Dysphasia is a language disorder that impacts on your ability to understand and use spoken language. It can result from a stroke, a head injury and some people are even born and grow up with forms of dysphasia. What is different about them is our assumptions and expectations based on their age, circumstances, and the way they are reacting to the difficulties caused by their dysphasia.

Our communication ability, the environment we find ourselves in, and our personality all interact to influence our behaviour and within the context of adult mental health services that behaviour is often labelled with reference to a psychiatric diagnosis without due consideration of all the causative factors. Without a good understanding of a person’s language skills we need to be very cautious about interpreting and labelling their behaviour as a mental illness.

Singing from the Same Songsheet

What happens when you ask a Speech and Language Therapist to talk to a group of professionals including Mental Health Nurses, Social Workers,  Occupational Therapists, Mental Health Officers, Police Officers, Advocacy Workers and Employment Advisers about how they work with and supporting adults with mental health problems?

Firstly, you get a slightly anxious Susan. I am accustomed to speaking to large groups of people so an audience of around 70 was not the issue. My trepidation came from speaking to such a diverse audience. Usually I have an idea of how receptive or otherwise my audience are likely to be; not so on this occasion. So maybe it was fitting that I was speaking at the home of Captain Robert Falcon Scott’s Discovery as I embarked on this journey into unknown, possibly frosty and potentially treacherous territory!

I need not have worried, as what transpired on the day was an incredible conversation where everyone agreed about the importance of recognising and addressing communication difficulties.  If I was to summarise the message from the audience it would be…

  • we cannot do our jobs without good communication,
  • it is an ongoing challenge to communicate well with the people who use or come into contact with our services,
  • we don’t always get our communication right,
  • so how are you going to help us?

So I need not have worried. It would appear that we are all singing from the same songsheet – my job now is to be good conductor and pull this performance off!