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.


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!

Are You Aware?

Did you know that this is Mental Health Awareness Week? This year’s focus is on the impact of physical activity and exercise on mental health and well-being. However, it has made me ask myself what I am doing as a Speech and Language Therapist to raise awareness about mental health. Not amongst the teams and services I work with week in week out, but amongst the general public and the community services we all use.

Raising awareness is important but it isn’t as easy as it sounds. How do we persuade people that they want their awareness raised? How do we make our message sufficiently interesting and relevant to ensure people listen to what we have to say? And how do busy clinicians undertake awareness raising activities without taking valuable time away from the individuals to whom they have a duty of care? Is it a justified use of my clinical time to undertake activities that raise public awareness of mental health and communication difficulties?

Individuals and communities that are more aware, more understanding and more willing to include everyone are an important step in combating the stigma and social exclusion associated with mental health problems. But on a practical level how do we achieve this? And who should be raising awareness?

This is a blog of questions rather than answers. So over to you, tell me, what do you think?

Agents of Change

More than 300 Scottish Allied Health Professionals converged on our capital city this week to consider the role of AHPs as Agents of Change in Health and Social Care.  The buzz during the day was infectious as we were treated to a range of inspiring speakers and copious examples of excellent practice, as well as the launch of new tools to support AHP practice across all care groups.

As a Speech and Language Therapist, I was delighted to see the launch of NHS Education for Scotland’s on-line training package: Making Communication Even Better.  Developed in partnership with Capability Scotland and Talking Mats, and involving members of Communication Forum Scotland, this resource highlights the power of the patient voice in shaping better services and emphasises the importance of effective communication in the provision of good health and social care – something I feel passionately about.

My other key messages from the event were…

As the conference was coming towards its end, the Agents of Change were given a mission by M, aka Derek Feeley (CEO of NHS Scotland), to implement, innovate and improve within the services we deliver and I personally have chosen to accept this Mission Possible.

We Are The Champions

This is the summer of Champions.  We have been enthused by our Olympians, and with the Paralympics just around the corner I am sure there will be many more inspirational stories to remind us what can be achieved even when the odds are apparently stacked against us.  However, being a champion is not only about sporting prowess.  The Oxford dictionary also defines a champion as a person who vigorously supports or defends a person or cause, and that is what my Communication Champions are all about.

The evidence suggests that up to 80% of people accessing mental health services experience some degree of speech and language difficulty (Walsh et al. 2007, Emerson & Enderby 1996).  It would be ridiculous to suggest that this number of people should be referred to a Speech and Language Therapist, particularly with the current level of SLT resource.  However, finding a way to ensure that people with mental health problems who experience communication difficulties get the appropriate support is imperative.

Realising Potential outlines three different approaches to AHP service delivery – direct service provision, partnership working and consultancy – and if you want to reach a large number of people with a small resource then consultancy is undoubtedly the way to go.  The Communication Champions initiative aims to use the Speech and Language Therapist’s knowledge to ensure that the general communication support needs of people with mental health problems can be met by the staff who work with them on a daily basis, and to educate staff to recognise more complex communication disorders that require specialist intervention.  This not only makes effective use of a limited NHS resource but also increases an organisation’s capacity to provide high quality person-centred care through improved communication between staff and service users.

Working in partnership with local operational and training managers from The Richmond Fellowship Scotland, we have launched a pilot project to start the development of a Communication Champions training programme that I hope can be rolled out across the region (and who knows possibly beyond).  Although it is still early days, we have seen some incredible work from our Communication Champions and I am extremely proud of their achievements.  They are making small changes to their practice that are making a big difference to the people they support.


Emerson, J. & Enderby, P. (1996) “Prevalence of Speech and Language Disorders in a Mental Illness Unit”, European Journal of Disorders of Communication, 31(3): 221-36

Walsh, I., Regan, J., Sowman, R., Parsons, B. & McKay, A.P. (2007) “A Needs Analysis for the Provision of a Speech and Language Therapy Service to Adults with Mental Health Disorders”, Irish Journal of Psychological Medicine, 24(3): 89-93

Do Something Different

I have been inspired to create this blog by Elaine Hunter, a fellow mental health Allied Health Professional, who urges us to be the change we expect and to do something different as a way of achieving this.  So that is exactly what I am doing!

I am, what they call around here, a “rare beastie” – a Speech & Language Therapist providing a dedicated, specialist, community based service for adults who experience mental health difficulties.  The change that I want to see is mental health services recognising the important role Speech and Language Therapists can play and including us in their teams.  As there are not many of us about, if I want to see this change then I need to do something about it.  So I have decided to do something different, to raise my profession’s profile in the field of adult mental health and to share the lessons I am learning from the incredible people I am privileged to work with.