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mental health

Conference highlights mental health issues in animal welfare sector

Working collaboratively across sectors is the key to creating safer, more compassionate communities for everyone, with benefits including improved mental and physical health in both humans and animals, according to experts in animal welfare, psychology, veterinary science and law.

Representatives from organisations including Battersea Dogs & Cats Home, Dogs Trust and animal welfare charity Naturewatch Foundation, joined vets, researchers and a leading psychologist at Stormont on October 2 for Northern Ireland’s second annual animal welfare conference. Organised by Causeway Coast Dog Rescue (CCDR), the conference took collaboration as its theme and was entitled ‘What does collaboration look like to improve companion animal welfare?’ The event audience, meanwhile, included attendees from the PSNI, along with MLAs, various animal welfare organisations, Action Mental Health and the media.

Claire Sugden MLA addressing the conference.

Welcoming everyone to the event, host Claire Sugden MLA, highlighted the links between animal abuse and human violence and said, “The system can’t function if there’s no collaboration.” She added that it was important that anyone who reported an animal welfare issue was then updated about that, as a lack of communication with the public after reporting a welfare concern was a key issue in Northern Ireland.

“This erodes trust in the system and creates a hesitancy to report in the future,” she said, adding that there was also a need “to support both animals and their owners during tough times – for example, with mental health providers and social workers.”

“The emotional toll of working in this sector is huge,” she said. “People working on the frontline of animal welfare are at risk of burnout, trauma and fatigue from witnessing animal abuse. We must also care for the mental health of those dedicating their lives to animal care.”

Recognising trauma in animal welfare workers

Dr Tara Quinn-Cirillo from the Human Animal Welfare Alliance.

Protecting the mental health of those working within the animal welfare sector was something echoed by psychologist and author, Dr Tara Quinn-Cirillo, who has set up the Human Animal Welfare Alliance (HAWA) to help address this issue. Currently working on developing the UK’s first Emotional Health Toolkit for animal welfare workers, this digital tool will include resources “to help staff manage their emotional health.” The initiative also includes monthly emotional health check-in sessions where staff can speak in a safe space, along with targeted mental health training on vicarious trauma, stress, anxiety, overwhelm and burnout. Meanwhile, staff who need to discuss a particularly traumatic event can also arrange a one-to-one debrief session on the phone.

Discussing her ongoing research into the mental health issues experienced by animal welfare workers, Dr Quinn-Cirillo said that, while trauma was often present, employees didn’t always identify it as such.

“Quite often, there are different factors, where people don’t recognise that they’re going through trauma,” she said. “Trauma shows up so differently and can mimic things like anxiety and depression. Stress, overwhelm and burnout are trending words… but people aren’t being supported to recognise trauma, or they don’t realise you can get trauma from this sort of situation. It’s important to identify trauma because the way I work with that, as a psychologist, is very different from how I work with stress.”

She added that complex trauma was also an issue within the animal welfare sector, where events in people’s personal lives overlapped with those of their working lives to create a more multifaceted type of trauma. Meanwhile, vicarious trauma was another type of trauma experienced by some employees.

“Vicarious trauma is where you’re absorbing other people’s trauma,” said Dr Quinn-Cirillo. “That’s a really massive issue in animal welfare too – as is grief. People often don’t realise that grief isn’t just about loss through death. It’s about the grief that accompanies dealing with animals being handed in to shelters in distressing circumstances and the animals who are then later rehomed – there can be grief around that loss as well, which quite often isn’t acknowledged.”

Psychologist, Dr Tara Quinn-Cirillo, pictured with Claire Savage from Action Mental Health and Christine Alexandra from Mid Antrim Animal Sanctuary.

Dr Quinn-Cirillo is now beginning to work with animal charities across the UK, providing free online Monthly Emotional Health Sessions as part of the HAWA. Speaking to Action Mental Health after the conference, she said that anyone in Northern Ireland working in animal shelters could access this support and that she was in the process of recruiting more psychologist volunteers onto the project to help deliver it. Her long-term goal, she added, was to create bespoke toolkits for individual rescue organisations, to help address the specific issues they faced, alongside the more general mental issues experienced within the sector as a whole.

“What I really want to do in the long-term is to come up with a model of mental health support they can implement themselves, as each rescue might have slightly different needs,” she said. “The Human Animal Welfare Alliance isn’t a tick box project. We have a survey on the website that animal shelter workers can fill in and let me know what they’re feeling. The Monthly Emotional Support Sessions then give them a space to be heard – as do the telephone debriefs for key incidents. It’s not therapy or counselling, just straightforward debriefing, which is so important.”

Links between animal and human abuse

Also speaking at the conference was Animal and Human Nurse, Helen Ballantyne, who discussed One Health and what that means in terms of collaborative working. “The human-animal bond needs reframing,” she said. “There’s a lack of understanding about how animal welfare links to human welfare.”

Referencing the Independent Investigation of the National Health Service in England (September 2024), she said the evidence showed the nation’s health was deteriorating and that “our companion animals are a barometer for our own public health.” Dr Paula Boyland, BVetMed MRCVS Chair of The Links Group and Veterinary Director of Dogs Trust, also discussed the crisis link between animals and people and gave an example of a domestic abuse incident involving first a pet dog and later, a baby. On both occasions the reason given for injuries sustained was that they fell down the stairs – first the dog and, on the next occasion, the child. Dr Boyland said this was a case where the animal abuse had clearly preceded the human abuse, adding that, “this link between abuse of animals and abuse of humans is being more recognised.”

Mark Randell, Naturewatch; Dr Paula Boyden The Links Group and Dogs Trust; Helen Ballantyne, One Health.

Indeed, research conducted by the Links Group in 2021 found that nine out of ten domestic abusers also targeted pets. Dr Boyland further outlined how domestic abusers also sometimes gave pets to their partners as presents, letting them bond before exhibiting coercive control over the other person. She added that, not only did any emotional and physical abuse inflicted impact upon the person targeted, but it also adversely affected the pet. Indeed, a real-life video clip played at the conference clearly showed how distressed a dog became when witnessing its owner being physically hurt.

“Domestic abuse has a massive impact on the dogs as well,” she said. “Specific pet foster services can help. There’s a huge need for pet fostering services in Northern Ireland, so we’re hoping we can get a service here.”

She added that pets could also be a barrier to someone leaving a domestic abuse situation, as they wouldn’t leave their animals at the mercy of the abuser, something also highlighted in a Belfast Women’s Aid article in 2017. The article stated: Many women will simply not want to leave their pets in a volatile and dangerous home and at the hands of an abuser who will utilise every means possible to establish and maintain power and control over his victim. He is not afraid to harm. Unfortunately in Northern Ireland, Women’s refuges do not have the means or facilities to temporarily home these pets.”

Reiterating the overall theme of the conference, Dr Boyland said that collaboration with animal and human welfare groups was therefore key, along with vet training for the entire protection team involved in such incidents. Meanwhile, providing mental health support for those involved in such work was also a crucial element of this.

Former senior police detective and current campaign manager for Naturewatch Foundation, Mark Randall, addressed the conference in a similar vein. He said that taking crimes against animals seriously would ultimately protect people too – both physically and mentally. Indeed a key part of his work now revolves around training police and others on recognising the importance of animal welfare and abuse within relationships, family units and communities.

“When you see that red flag, you need to do something about it,” he said. “Protecting animals isn’t ‘extra work.’ It helps keep relationships and communities safer, reduces abuse and violence towards people… issues that are always public protection priorities.”

mental health
Tara Cunningham from Causeway Coast Dog Rescue.

Tara Cunningham, manager and lobbyist at Causeway Coast Dog Rescue (CCDR) said the charity’s objective with the conference had been to be “positive and productive.”

“CCDR is like many charities in Northern Ireland, we rescue and rehome unwanted dogs, to ensure they have a second chance with a caring and loving family, free from abuse and neglect,” she said

“We look at animal welfare from a different perspective than any other charity, which is through legislation and governance, identifying the gaps and implications on the services being delivered. We look to ensure that there is accountability and transparency included by the three government service providers responsible.”

She added that they were “calling for the ministers of DAERA to support the movement and oversight of legislation and enforcement” in Northern Ireland and for councils to “fulfil their legislative remit.” Only in this way could the ongoing animal welfare crisis – which impacted upon both animal and human physical and mental health – be addressed. Ultimately, collaboration between organisations was key.

mental health

Lurgan skills coach wins Action Mental Health’s ICE Award

A skills coach from Action Mental Health’s Southern Region Service in Tannaghmore, Lurgan, has been presented with our bi-annual Chairman’s ICE Award in recognition of his dedication and the work he does in creating extra opportunities for clients.

mental health
Action Mental Health CEO, David Babington, presenting skills coach, Marc McCann, with his ICE Award.

Marc McCann, who joined Action Mental Health 12 years ago, delivers personal development training for clients. He said he was very surprised, but delighted, to win the award.

“I accept it on behalf of all of my colleagues in Portadown and Tannaghmore, who work tirelessly every day to provide a vital service for our clients,” he said. “It is a real team effort. Colin has inspired me and the whole team to be creative and passionate about our work, with the focus always on the support and recovery of each individual.”

Launched back in 2016, the Chairman’s ICE Award is presented twice a year in recognition of individuals’ contributions to innovation, creativity and excellence within Action Mental Health. Along with a commemorative trophy, the winner also receives an extra day of annual leave.

CEO of Action Mental Health, David Babington, said: “Many congratulations to Marc! His nomination highlighted that he ‘has worked in a very focused and dedicated manner for the betterment of our clients, broadening the reach and quality of service provision.’ 

“As part of the nomination submission, the comments also described Marc as ‘a great champion of attending clients’ and said he is someone who ‘relishes the challenge of empowering people to ‘reach for the stars’ and unlock their potential that is conducive to individual recovery.’ We think Marc is a very deserving winner of the ICE Award and I hope he enjoys that extra day off work!” 

In addition to the Open College Network NI (OCC NI) accredited training that Marc delivers to clients, he also seeks out numerous other opportunities for them to engage in. These include everything from reflective writing and mindfulness sessions to physical exercise opportunities.

“One example of this would be the links established with Armagh City, Banbridge & Craigavon Council (ABC Council) in South Lake Leisure Centre, where I support up to eight clients in using the gym each Tuesday morning,” he said. “This has been running for 12 months now. Also, I recently mentored and nominated a learner for the OCC NI Learning Endeavour Awards. Christine went on to win both her own category and the overall Hilary Sloan Award. This was a fantastic achievement for her and I was delighted to play a small part in that.

“My accredited sessions are very conversational in nature and I pride myself on creating a ‘safe space’ for people to share their feelings and emotions in a friendly and supportive environment.”

menopause

Menopause, mental health and the workplace

With October marking Menopause Awareness Month, there’s no better time to get talking about the perimenopause and menopause.

For the third of our menopause-related blogs this month, we’ve subsequently spoken to Siobhan Kearney, founder and CEO of Menopause NI, an organisation which raises awareness of the menopause and delivers training to workplaces, communities and the statutory sector. Established in 2020, Menopause NI draws on evidence-based research for all of its workshops – currently delivered by Siobhan – with clinical insight and support provided by Dr Gwyneth Hinds.

Siobhan Kearney of Menopause NI.

Having spent more than 25 years working in senior leadership roles across the community and voluntary sector in Northern Ireland, Siobhan was a CEO within the mental health sector when her own experience with the menopause began. As is the case with many, however, when she began feeling low, anxious and overwhelmed in a job she had hitherto been managing just fine, the menopause didn’t even cross her mind.

While there are a variety of both physical and mental health symptoms associated with the perimenopause (which occurs in the lead-up to menopause itself), Siobhan said that the mental health symptoms could be particularly hard to identify and understand. Indeed, along with other menopause symptoms, they can often cause people to reduce their working hours and even leave their jobs altogether. 

“When I’m doing presentations to workplaces it seems that the common physical health symptoms of menopause are easier to talk about,” she said. “When it comes to the mental health impact, however, I don’t think people fully understand this. The menopause is also still really stigmatised. It can still be very difficult for people to talk about it, let alone talk about the mental health side of things alongside that.”

Although Menopause NI is now helping to increase awareness and understanding of the perimenopause and menopause, when Siobhan started her own menopause journey, she didn’t understand what was happening to her. “That’s why I do what I do now, at Menopause NI,” she said. “I thought to myself, ‘Here I am, a chief executive and I’m feeling anxious with hot flushes and palpitations’. I didn’t know it was the perimenopause. When I began to understand, however, I then thought – why did I not know this? It actually contributed to me leaving that job.”

Impact of menopausal mental health on careers  

Research from the Chartered Institute of Personnel and Development (CIPD, 2023) found that, in a survey of 2,000 employed women aged 40-60, more than half said they had been “unable to go into work at some point due to menopause symptoms.”

They further found that two-thirds of the women (67%) reported their most common menopause symptoms as being “psychological, such as mood disturbances, anxiety, depression, memory loss, panic attacks, loss of confidence and reduced concentration.” Meanwhile, approximately one in six people (17%) had considered leaving their job “due to a lack of support in relation to their menopause symptoms,” with a further 6% having actually left work.

“It’s important to get the recognition that perimenopause can have a real impact on your mental health and wellbeing,” said Siobhan. “Things like anxiety, loss of confidence, low mood, depression, feeling overwhelmed, having difficulty making decisions… For myself, I remember thinking – where did the real Siobhan go?”

She added that depression associated with menopause was hormone-related but that many were still being prescribed anti-depressants by their GPs, instead of being offered HRT. Indeed, the NICE Guidelines state that there is no clear evidence that anti-depressants such as SSRIs or SNRIs ease low mood in menopausal people who have not been diagnosed with depression.

Meanwhile, for those who may have pre-existing mental health issues, Siobhan added that it was important to discuss this with GPs, so extra steps could be taken. Having GPs who were attentive to the perimenopause was key, she said, in supporting those navigating this transitional period of their lives.

“Menopause happens at a very very busy stage in our lives,” she said. “So, maybe you’re not thinking about the menopause at all. Perimenopause can last anywhere for up to ten years, however. So, when you think about experiencing these mental health symptoms for up to ten years, perimenopause can be the most challenging time for women.”

Reflecting on her own menopause experience, Siobhan said that, once she began to understand what was happening to her, she was able to take back control and better manage her symptoms. She did this through a combination of lifestyle changes and HRT, working on herself in terms of reassessing her diet and exercise. She added that, while HRT was “very helpful” for her own symptoms, the menopause was a “very individual journey for every woman” and that each person should find what worked for them.

“The good news is that symptoms tend to diminish over time,” she said. “A lot of people who are post-menopausal say things have got back to a new normal. For me, I’m a different version of myself now. I’m a stronger person – and more confident. I no longer care what people think about me.”

Realising that there was an obvious deficit when it came to awareness about the menopause and how to handle it, Siobhan decided that someone needed to do something about that.

“That’s why I started to develop menopause awareness programmes and workshops and looking at clinical governance,” she said. “My main programme was 12 hours, so then it was all about tweaking that for workplaces. I knew it needed an identity of its own.”

Tackling menopause in the workplace

Keen to create a culture in workplaces shaped around understanding menopause and supporting staff who are menopausal, Siobhan said that being able to have conversations at work about these issues was key – and “so empowering.”

To have an understanding manager on the other side of those conversations is so important,” she said. “It’s all about having that balance. The statistics support the fact that the mental health symptoms of menopause are some of the most common symptoms reported by women and yet, they’re the most difficult to talk about. 

“When I speak to companies, a lot of them want me to speak to their management team first and also, to consider what legislation is in place to protect staff experiencing menopausal symptoms. When speaking with the staff, however, that requires a more proactive approach, looking at how to build up the confidence to have that conversation and to look after yourself.”

With the feedback from women who have attended Siobhan’s workshops overwhelmingly positive, there is now an increasing demand for these. She added that many men attended them as well, talking about their wives or partners and how they had changed due to a loss of confidence or anxiousness resulting from menopause.

Siobhan also shares her own menopause experience at the events, using humour to help ease people into the conversation.

“I’m doing all this for the generation coming behind me,” she said. “We need to talk about the menopause with confidence and competence and understanding. That’s a legacy I would like to leave – that women are confident about the menopause. It’s not embarrassing. There’s no shame attached. We need to educate about it and provide access to good information.”

Resources:

I am someone

“I AM SOMEONE” campaign shares the stories behind the statistics

I am someone
James Nesbitt introduced the “I AM SOMEONE” campaign via video message. [Photo by Philip Magowan, Press Eye].

With today (October 10) World Mental Health Day, we’re excited to share details of our major new campaign, which aims to raise awareness of mental health issues in Northern Ireland and raise vital funds for our services. Supported by local actor, James (Jimmy) Nesbitt, along with our ambassador, Olympic Champion Rhys McClenaghan, the “I AM SOMEONE” campaign officially launched at Stormont’s Long Gallery yesterday (October 9).

At the heart of the campaign – which shares stories from Action Mental Health clients who have accessed support from our various services – is a message that, with the right intervention, recovery is possible. With one in five adults experiencing mental health issues and one in eight children encountering emotional difficulties, it subsequently shows the human side of these statistics.

Action Mental Health Ambassador, Rhys McClenaghan.
[Photo by Philip Magowan, Press Eye].

James Nesbitt, who introduced the campaign trailer via video message, said: “I’m delighted to be supporting Action Mental Health’s “I AM SOMEONE” campaign. Mental health matters and it’s something which affects us all. We often hear about how bad healthcare waiting lists are in Northern Ireland and how mental health services are close to breaking point. We therefore need to ensure that timely access to support is there when and where people need it.

“Action Mental Health’s “I AM SOMEONE” campaign reminds us that that one in five person could be someone you know. It could be your friend, neighbour, co-worker … It could even be you. As the saying goes, it’s always darkest before the dawn, but remember – no matter how dark it gets, help is out there and recovery is possible.”

Our ambassador and Olympic Gold Medallist, Rhys McClenaghan, who attended the launch in person, told the audience he hoped the campaign would “keep the conversation going about mental health and serve as a reminder to us all that there are real people behind the statistics we read about but that help is available, no matter what you’re going through.”

Meanwhile, our CEO, David Babington, added that, when discussing the statistics behind service delivery it was easy to forget that “we are talking about people – their lives, their careers, their futures.”

“This campaign provides some ownership to those who experience a wide range of mental ill-health and, as a result, are directly affected by ongoing funding cuts, closures of support services and programmes,” he said. “‘I AM SOMEONE’ forms part of our wider efforts to highlight the need to protect and enhance mental health service provision across Northern Ireland. If we are to truly implement the transformation agenda, we need to acknowledge the critical role played by the community and voluntary sector in delivering support to the most vulnerable in our society.”

mental health
(L-R) Ross, Vicky and Deirdre shared their stories at the launch.
[Photo by Philip Magowan, Press Eye].

With three of the five Action Mental Health clients also attending the launch on the day – Vicky, Ross and Deirdre – they shared some of their stories to those assembled as part of a panel discussion, facilitated by NI presenter and reporter, Barra Best. Meanwhile, Northern Ireland’s Mental Health Champion, Professor Siobhan O’Neill, was also in attendance and discussed the wider impact of poor mental health on society, the local economy and local communities.

NI’s Mental Health Champion, Professor Siobhan O’Neill.
[Photo by Philip Magowan, Press Eye].

She said: “As Mental Health Champion, I’ve seen the amazing work undertaken by community and voluntary sector services across NI, to support those struggling with their mental health. It’s wonderful to read the stories of the people who have benefited from the support offered by Action Mental Health and it’s important that we celebrate these services, and acknowledge their essential role in providing support to people across NI.

“However, every day more and more services are struggling to keep their doors open as funding grows thin. We urgently need investment in the third sector and full funding for the Mental Health Strategy to achieve the transformation of mental health so all those people who are struggling can receive the help that they need.”

(L-R) Robbie Butler MLA with Deirdre Kennedy and Vicky Hawkins. Back row Action Mental Health CEO David Babington and Ross Anderson. [Photo by Philip Magowan, Press Eye].

mental health

Action Mental Health’s relocated Foyle service officially opened by Mayor

Action Mental Health’s Foyle service enjoyed its official opening on World Mental Health Day (October 10), when iconic buildings across the city of Derry~Londonderry also lit up in purple in support of mental health awareness.  

Having provided mental health services in the Foyle region for more than 30 years, Action Mental Health recently relocated from Springtown Industrial Estate to its new Pump Street location in the city centre. The Mayor of Derry City & Strabane District Council, Cllr Lilian Seenoi Barr SDLP, subsequently cut the ribbon to mark the official opening of the new premises.

The launch event was attended by a range of guests from across the voluntary and statutory sectors, along with Action Mental Health clients, the charity’s CEO, David Babington and Action Mental Health chair, Damian McAuley. Western Trust Assistant Director, Colleen Harkin, was also in attendance.

Action Mental Health’s Foyle Service Manager, Pauline Flanagan, said the day was a great success and incredibly well supported by the local community.

“It went very very well,” she said. “We’re now in the heart of the city, beside the Garden of Reflection. We’re surrounded by local businesses and lots of voluntary sector organisations as well, which is wonderful as it creates lots of opportunities for our clients and also allows us to build better networks.

“The new Pump Street premises are so accessible as well. We’re very close to the bus depot and the train, so are within walking distance now for a lot of our clients.”

Mayor of Derry City & Strabane District Council, Cllr Lilian Seenoi Barr SDLP said: “I was honoured to attend the official opening of Action Mental Health’s state-of-the art new premises at Pump Street.

“Action Mental Health plays a key role in community life by actively promoting mental health and wellbeing in our city and district. This new facility will help them to deliver their wide range of key services from the heart of the city and ensure they can make a positive impact on the lives of anyone in our council area who needs their support.”

(L-R) Western Trust Assistant Director Colleen Harkin, Action Mental Health Foyle Service Manager Pauline Flanagan, Mayor of Derry & Strabane District Council, Cllr Lilian Seenoi Barr and Action Mental Health CEO, David Babington.

Action Mental Health CEO, David Babington, added: “The opening of the Foyle service in its new premises in the city is the start of a new chapter for client support in the area, which Action Mental Health has been doing for over 30 years. We’re very aware that communities really need help with their mental health and wellbeing and this move will ensure that support continues and is even more accessible.”

Foyle art trail raising awareness of mental health support

Already making the most of their new and improved city centre location, the Foyle service team also organised an interactive Art Trail in collaboration with almost 30 local businesses.

The trail ran from Monday, October 7 until Sunday, October 13 and was located in the city’s Cathedral Quarter area, displaying various artwork from clients which depicted their lived experiences of mental ill-health.

The trail linked in with this year’s World Mental Health Day theme of prioritising mental health in the workplace, with Action Mental Health also using the initiative to raise awareness of the range of mental health support available in the local area. The artwork was subsequently displayed in the windows of the participating businesses and organisations and featured QR codes which, when scanned, signposted people to local mental health service providers.

“As we’re now based in the Cathedral Quarter we decided to use this area for the Art Trail, to highlight what it’s like to have a diagnosis of mental ill-health,” said Pauline.

“Some of the designs also had information on the additional mental health supports available to people. It’s not just about Action Mental Health, but showing other support services as well, for example, the Western Trust and private voluntary sector organisations. We wanted to raise awareness of all the local support services and would like to extend our thanks to everyone who took part in the trail.”

Businesses and organisations which participated in Action Mental Health’s Art Trail included:

Newgate Arts Centre, Hidden City Café, Northwest Volunteer Centre, Ferry Clever, Foyle Women’s Centre, the office of Sinn Fein MLA Padraig Delargy, Barnardos, The Sandwich Co., Oxfam, Salmueria Café, Forsight, Joe Jacksons, Yum Cakes, Cancer Research, Java, Claude’s, Vine Living, Number 19 Craft & Design, The Sacred Tree, Walled City Crafters, Foyle Books, Derry City Tourist Office, The Void Gallery.

Iconic buildings go purple for World Mental Health Day

Ulster University’s Magee Campus lit up in purple for World Mental Health Day on October 10.

As well as the official opening of the Foyle service and the interactive Art Trail, Action Mental Health also celebrated the launch of our new “I AM SOMEONE” campaign on World Mental Health Day. Backed by Action Mental Health ambassador and Olympic Gold Medallist Rhys McClenaghan, as well as actor James Nesbitt, “I AM SOMEONE” aims to raise awareness of mental health and to fundraise for the services we provide.

Iconic buildings in both Belfast and Foyle were subsequently lit up in purple to highlight the campaign, with Stormont, Derry Playhouse, Ulster University’s Magee Campus and the City of Derry Airport all going purple for mental health.

Derry Playhouse lit up in purple for World Mental Health Day.
City of Derry Airport marking World Mental Health Day by lighting up in purple.

To find out more about our “I AM SOMEONE” campaign and/or donate, visit www.amh.org.uk/iamsomeone

menopause together

Tackling the Menopause Together …

October is Menopause Awareness Month, with October 18 specifically being World Menopause Day – all of which is focused on tackling the stigma surrounding menopause and creating conversation about this important transitional stage in women’s lives. With mental health symptoms often a significant part of the perimenopause/menopause journey, we’ve been speaking to women who are raising awareness about this, as well as providing support and signposting to services across Northern Ireland.

Having already featured an interview with one of Northern Ireland’s first accredited menopause specialists, Dr Siobhan Kirk, our second blog focuses on Northern Ireland’s first menopause charity, Menopause Together. Established by Roisin Hillman from west Belfast and Fiona Brown from Magherafelt, the charity was created to provide a space where women experiencing the menopause could find the information and support they needed. Initially beginning as a private Facebook group – which is still a thriving social space of more than 10K members – Menopause Together officially launched as a charity at Stormont on October 17, 2023.

“For us as a charity, it’s about making sure women are getting the support and the knowledge that they need – and that we’re able to sit around the table with the different government departments,” said Roisin. “Women need this support and at every meeting so far, the door has been open, so it’s been very positive.

“The menopause isn’t just a health issue – it affects every single walk of life. We’ve now met with all the departments, including the health committee and have come up with four key asks:

  1. Mandatory menopause training for all GPs.
  2. The development of a fully funded Women’s Health Strategy which makes provision for services and support for menopausal women across Northern Ireland.
  3. Removing barriers to prescribing for menopausal symptoms – for example, if a woman goes private and the consultant gives her a prescription, that the GP fulfills that prescription.
  4. For research to be conducted into the broader benefits of prescribing testosterone for women.”

Roisin’s story

Having started Menopause Together in July 2021, the journey of what has become a thriving charity is tied in with Roisin’s own experience of the menopause. Following a hysterectomy in May 2021, she had to come off the HRT she’d been on to manage her perimenopausal symptoms. Told that she would have to wait some weeks post-surgery to get back onto HRT, Roisin felt she had no choice but to put up with the physical and mental symptoms that HRT had, for her, successfully managed – alongside now recovering from major surgery.

menopause together
Roisin Hillman from Menopause Together.

“By week two, the night sweats and the anxiety and mood swings were all back,” she said. “I had written a post on an app to ask if there was anything I could take while on blood-thinner and someone said ‘you could have been on transdermal HRT all along.’ To say I was angry was an understatement. I did some research and discovered that it’s a gel you rub onto the skin.”

While HRT may not work for everyone, because Roisin had previously benefitted from it, she rang her GP to request the transdermal version, which she duly received. She said that “within two days, the night sweats had stopped and everything was back to normal.”

The theme for this year’s Menopause Awareness Day is Menopause Hormone Therapy, known as HRT (Hormone Replacement Therapy) in the UK. For Roisin, HRT has been a great help in managing her symptoms, although it may, of course, not be the solution for everyone.

“When I was 46/47 and trying to get HRT I probably went to my GP about seven times,” she said. “I had real itchy skin and sore joints, especially my ankles. It felt like I was 90 years old – I wasn’t able to stand up. Menopause wasn’t even something on my radar. I told a friend about the itchiness and she said, ‘could you be menopausal?’”

Recovering from her operation in June 2021, Roisin spotted an online survey about the menopause which she went to fill in, only to find that it wasn’t applicable to Northern Ireland. Frustrated about this, she subsequently got chatting to another woman from Northern Ireland on social media and the idea for a menopause Facebook group arose.

“I thought about what everybody would think about me,” said Roisin. “I had all the self-doubt but I thought, ‘I’m doing it’. In July 2021, I started Menopause Together. To date, we have just over 10,000 people on the Facebook group. It just went from strength to strength.”

As the group grew, Roisin realised there was a need for a more joined-up approach regarding menopause services and related support, as “nobody really knew what everyone was doing.” This inspired her to create Northern Ireland’s very first menopause conference, bringing together menopause experts to speak to local women and share knowledge, as well as signposting to various services.

“I contacted Dr Siobhan Kirk, along with a yoga teacher I knew and a GP,” said Roisin. “Marie-Louise Connelly then asked if we needed a hand. We got a plan together and she became a number one supporter of the group. It was just absolutely fantastic. I also got in touch with Robin Swann as a keynote speaker. The room was full. That was Northern Ireland’s first menopause conference.”

Creating NI’s first menopause charity

Following the conference, Roisin was subsequently contacted by Fiona Brown, who asked if she could offer any help with what was fast becoming a dedicated menopause mission. The pair subsequently met in November and began having conversations around starting an official menopause charity. Many other women had also been in touch with Roisin after the conference, requesting something similar for their local communities, so it was clear there was huge demand for events providing information about the menopause.

Indeed, Roisin began delivering awareness sessions in January 2023 alongside her full and part-time job commitments – the first one being in the Foyle area. A key element for her was in keeping costs low, so that anyone could access the sessions without financial barriers.

“I know that £30 could be meals for a week for someone,” she said. “So, I’m very aware that it’s very important to keep costs as low as possible. That was one of the factors for starting a charity – so any awareness events could be free. I didn’t want women not being able to go. We needed women from every walk of life to feel they could come along and to get access to the information they needed.”

Having spoken with many women since launching the charity and delivering awarenss sessions, Roisin has heard lots of first-hand accounts about how menopause has affected women’s lives. This information, combined with both her own and Fiona’s experience with menopause, has ultimately led them to their current position of having four key ‘asks’ for government.

menopause together
Fiona Brown (L) and Roisin Hillman (R) of Menopause Together.

“When a woman is 45 it doesn’t matter who you are, you’re perimenopausal,” she said. “So, if you’re 45 and you’re saying to your GP, ‘my mood is low and I don’t feel I can go on anymore,’ the GP should have training to know that it’s more than likely that you’re perimenopausal.

“At work, women often reduce their hours because of menopause symptoms. I had a hysterectomy in May and in November I started a new job, so I was learning a whole new system. Even though I was on HRT, however, my cognitive thinking was shot. It was absolutely terrible and I thought I might have to leave my job.

“We have to talk to the ministers about that – about the drain on work and the economy. If a woman is having menopausal symptoms, then it affects everybody. Every male has a mother or a sister or a partner… They will have someone in their lives who is potentially perimenopausal or menopausal.

“We’re holding another conference on October 13 – with amazing speakers and goody bags – so we hope that as many people as possible come along to that. We have to bring everyone along on this journey. Talking about the menopause needs to become the norm.”

Resources:

menopause

Menopause matters …

With October being Menopause Awareness Month, this is a great opportunity to focus conversation on something which affects half the population here in Northern Ireland – and indeed, the world over. Still sometimes considered a taboo topic, the menopause (and perimenopause) is a significant time in a woman’s life – and how this transitional period is experienced is very much individual to each person.

menopause matters

Menopause, as explained by the NHS, is “when your periods stop due to lower hormone levels. It usually affects women between the ages of 45 and 55, but it can happen earlier.” Menopause can also occur following surgery to remove the ovaries or uterus and can be triggered by cancer treatments such as chemotherapy.

Perimenopause, meanwhile, is when the symptoms of menopause occur alongside your periods, so it ends once periods have stopped for 12 months – and then menopause begins.

Common menopause and perimenopause symptoms can include (but are not limited to):

  • Mental health issues such as anxiety, problems with memory or concentration (‘brain fog’), depression, mood swings and low self-esteem.
  • Irregular periods.
  • Physical symptoms such as hot flushes, trouble sleeping, palpitations, headaches/migraines, muscle pain and various other symptoms.

The theme for World Menopause Day 2024 – which takes place on October 18 and is spearheaded by the International Menopause Society – is Menopause Hormone Therapy (also known as Hormone Replacement Therapy or HRT in the UK).

HRT is “the main medicine treatment for menopause and perimenopause symptoms … which replaces hormone that are at low levels. There are other treatments if you cannot, or choose not to, have HRT.” (NHS).

In the first of our series of menopause-related blogs this month, we’ve subsequently spoken with one of Northern Ireland’s first accredited menopause specialists, Dr Siobhan Kirk, to get her views on using HRT and to chat about the menopause in general, along with its potential associated effects on mental health.

Always access accurate advice

An accredited menopause specialist and trainer with the British Menopause Society, Dr Kirk is also a fellow of the Royal College of Obstetricians and Gynaecologists and the Faculty of Sexual and Reproductive Healthcare (FSRH). In addition to this, she is on the Specialist Register for Community Sexual and Reproductive Health and is chair of the NI FSRH Committee and FSRH rep on the Royal College of Obstetricians & Gynaecologists (RCOG) NI Committee.

menopause

As a full-time Consultant in Sexual and Reproductive Health in Belfast HSC Trust, Siobhan primarily works with women presenting with POI (Premature Ovarian Insufficiency), as well as with those who are in early menopause following cancer treatment or surgery. Patients also include women with complex medical problems and those experiencing bleeding issues with HRT.

Initially only one of two accredited menopause specialists in Northern Ireland, Dr Kirk said that there had been an increased uptake in menopause training over the past few years, which was great. However, she added that, alongside the certified advice available to women, there was also a lot of misinformation circulating about the menopause, so her advice was always to seek support from reputable sources.

“Women need more accurate information,” she said. “There are a lot of people jumping on the menopause bandwagon and trying to make money out of women. There’s a lot of misinformation out there.

“The majority of menopause care is delivered through primary care, so that’s where education needs to be focused. General practice is on its knees all over the UK, so it’s difficult, as it’s very hard to do a menopause consultation in 10 minutes. It’s also a bit of a postcode lottery for treatment and advice.”

Considering this year’s World Menopause Day theme of HRT, Dr Kirk said that because every woman experienced the menopause differently, how they managed it was therefore very unique to them. As a result, HRT could work well for some, but might not be the best option for others. Some women may also experience lots of menopause symptoms, while others may experience fewer symptoms or, indeed, none at all.

“HRT is a very individual thing,” she said. “Not everybody needs HRT and not everybody gets symptoms. The main reason for taking it is for the symptoms, but some women can feel left out if they have no symptoms. There are a lot of women coming forward for advice who are doing fine and don’t have symptoms. There are unrealistic expectations too – some people think HRT can fix everything.”

menopause

Menopause mental health

Dr Kirk added that it was important to consider the mental health implications of the menopause alongside any physical symptoms women may experience.

“Sometimes the psychological symptoms can be worse than the hot flushes and the sweats,” she said. “Unfortunately, some of these women are still being offered anti-depressants, rather than HRT. Sometimes, CBT (Cognitive Behavioural Therapy) might be a better option as well – it’s all very individual.

“We need to raise awareness of the psychological aspects of menopause. The anxiety is quite often crippling and it’s often out of your control – for example, lying awake at night worrying about things. If you have no previous history of mental health issues and it all ties in with perimenopause, then HRT is the first plan, rather than anti-depressants.Existing mental health conditions can also exacerbate those experienced during menopause, sopsychologists and psychiatrists need to educate themselves around this.”

When it comes to advising women on where to go for accurate advice on the menopause and perimenopause, Dr Kirk said she recommended visiting the Women’s Health Concern website for accredited information.

Women’s Health Concern (WHC) is part of the British Menopause Society and has been providing accredited, independent advice to women on menopause, gynaecological and reproductive health since 1972. According to their website, lifestyle choices play a key role in managing menopause symptoms:

“Hormone Replacement Therapy (HRT), Cognitive Behavioural Therapy (CBT) and other complementary and alternative treatments can all be very helpful, but the transition to menopause is a good time to review your lifestyle. Not only can this help manage menopausal symptoms in the short term, it can lay the foundations for good health through perimenopause, menopause, and the years to come.”

Other local menopause resources are Menopause NI – which aims to raise awareness and to educate about the menopause – and Menopause Together (Northern Ireland’s first menopause charity), both of which are running conferences in October.

Dr Kirk added that, with more conversations happening around menopause online and elsewhere – which was positive – this did also increase the risk of inaccurate information circulating. Obtaining advice from reputable sources such as Women’s Health Concern and linking in with reliable support locally was therefore key.

For women seeking help with the menopause her top tips are:

  • Access accurate sources of information.
  • Make the GP your first port of call.

Resources:

How reading and writing can improve wellbeing

Many of us love a good story, but did you know that reading – as well as writing your own stories – can positively influence your mental health?

Whether you enjoy fiction or non-fiction, research indicates that reading can help to improve our wellbeing, while creative writing can also increase happiness and thereby support our mental health.

Literacy as a therapeutic tool

No matter what age you are, the research shows that literacy can boost your mental health and wellbeing, with children, teenagers, students and older people all benefitting. So, if you’re struggling with your mental health, then activities such as reading, journaling or writing stories and/or poetry can all have therapeutic benefits.

Even the simple act of writing down a list of what’s worrying you can alleviate anxiousness, so putting pen to paper (or writing on your iPad or computer) can really help. It allows you a space to express thoughts, feeling and emotions and has long been used as in therapy to help people cope with difficult experiences.

Research into the ‘Emotional and physical health benefits of expressive writing’ (Cambridge University Press, 2018) found that writing about traumatic, stressful or emotional events improves physical and mental health – both in clinical and non-clinical environments.

A study from the National Literacy Trust (2018), meanwhile, showed that “children who are the most engaged with literacy are three times more likely to have higher levels of mental wellbeing than children who are the least engaged (39.4% vs 11.8%).” [1].

Another 2023 study [2] which looked at the effects of literacy on student mental health and wellbeing found that “through reading, creative writing, and bullet journaling, the students found relaxation and immersion, were able to release and process emotions, and reflect on their mental health.” By engaging in these activities, the study also showed that the students built up more positive self-esteem and had increased opportunities for benefitting from supportive relationships.

According to research from the University of Plymouth and Nottingham Trent University (2023) reading and writing poetry can also help people cope with loneliness, isolation and depression [3]. Indeed, during the pandemic, they studied a website (now archived at poetryandcovid.com) where people shared their own poetry and read other people’s.

The researchers discovered that, of the 400 people surveyed from the website, more than half said that reading and writing poetry had helped them cope better with feeling lonely or isolated. Meanwhile, 50% said that poetry had helped them manage their feelings of anxiety and depression.

Creative writing at Action Mental Health

At Action Mental Health, we offer a wide range of programme and services to help people manage their mental health and wellbeing, some of which include creative writing workshops. Indeed, our Skills Coach Trainer, David Allen, has facilitated a variety of creative writing-related workshops for clients through our Antrim and Larne outreach programme, focusing on everything from narrative fiction and short story writing to poetry and children’s picture book writing.

“We’ve covered areas such as plot and structure, characters, setting, point-of-view, narration, dialogue, themes and symbolism,” he said.

“With the poetry, we looked at different forms of poetry, such as blank verse, free verse and sonnets, along with figurative language, rhyme, rhythm and meter. I think our clients also enjoyed the children’s picture book course, as we were able to incorporate many of the above elements, but adapt them for young children.”

He added that Michael Di Maggio, a client from the Larne outreach programme was so inspired that he actually went on to publish his own children’s book, Luna’s Mission to the Moon.

Clotworthy House exhibition

With the Five Ways to Wellbeing focused on connecting with people, getting active, taking notice, learning and giving, creativity feeds into each of these in various ways, with creative writing just one example of something you can do.

Joining a book club or reading group is another way to connect with people and get creative, while workshops like those offered at Action Mental Health and other organisations are also great ways to enhancing wellbeing.

Having participated in various creative workshops recently, our clients from Antrim will subsequently be exhibiting some of their work at Clotworthy House at Antrim Castle Gardens in October.

One piece of work that will feature is a poem entitled The Fear, by Jill O’Neill, which she was motivated to write after attending one of Dave Allen’s creative writing courses and describes living with poor mental health.

John Davis, service manager at Action Mental Health’s Antrim location, said: “Our client art exhibition will be open to the public until the end of October. The exhibition will consist of a selection of work completed by our Antrim clients, showcasing their work using different mediums, such as fine art, abstract art, pencil and photography.

“This is a great opportunity for clients to see their work displayed in public areas and to be purchased, which really does boost their confidence and self-esteem.”

The launch event will take place at Clotworthy House at Antrim Castle Gardens on Monday, October 7 at 10.30am. It will be officially opened by the Mayor and the exhibition will be available to view until the end of the month.

References

[1] Clarke, C., Teravainen-Goff, A. (2018) Mental wellbeing, reading and writing: How children and young people’s mental wellbeing is related to their reading and writing experiences. National Literacy Trust, London.

[2] Peach, E. (2023) Creative Mental Health Literacy Practices: A Qualitative Study Exploring How Students Use Literacy to Promote Wellbeing and Manage Mental Health Conditions While at University. Int J Environ Res Public Health; 20(15): 6475.DOI: 10.3390/ijerph20156475

[3] Caleshu, A., Waterman, R. & Kemp, S. (2023). Poetry and COVID-19: the benefit of poetry and the poetryandcovidarchive.com website to mental health and wellbeing. Journal of Poetry Therapy, 37 (3), 198–218. https://doi.org/10.1080/08893675.2023.2250921