Key4Life Mentors Manual

Physical Health

GP Surgeries
The following link will give you all the information you need to check what help your mentee can get towards health costs. Learn more about 'Your choices in the NHS' - NHS (www.nhs.uk).

Registering with a doctor helps you take control of your own health. You can find a GP near you on the link: Find a GP - NHS (www.nhs.uk)

Contact the GP surgery and ask to register with them. They will usually ask you to complete a GMS1 form and give the following details:

your name and address
your date of birth
your NHS number (if you know it)
other information, such as the name and address of your previous GP Some GP surgeries will also ask to see proof of your identity, for example:
photo identity, such as your passport or driving licence
proof of your address, such as a recent utility bill (gas, electricity, water or phone bill, but not a mobile phone bill) or council tax bill

The GP surgery will send the GMS1 to the local clinical commissioning group (CCG), who will write to you confirming that you’re registered with the surgery. Your medical records will be transferred to the selected surgery.

If you want to see a GP and are visiting an area for more than 24 hours but less than three months, you can apply to register with a GP surgery as a temporary resident. The application can be made using a GMS3 form.

When you register with a new GP surgery, you’ll be invited to make an appointment for a health check within six months. It is usually done by the practice nurse, who will ask you about your personal and family medical history. They will also ensure that any tests or checks you need are up to date, such as measuring your blood pressure or arranging cervical screening.

NHS 111 is a new service that's being introduced to make it easier for you to access local NHS healthcare services in England.

You can call 111 when you need medical help fast, but it’s not a 999 emergency. When to use it? Only if you urgently need medical help or advice, but it's not a life-threatening situation.

NHS 111 is a fast and easy way to get the right help, whatever the time. It is available 24 hours a day, 365 days a year. Calls are free from landlines and mobile phones.

Dentists

To find dental surgeries in your area that are taking on new NHS patients: Find a dentist - NHS (www.nhs.uk)

Assume you should have an annual check-up. Your dentist will suggest when you should have your next check-up based on how good your oral health is.

Opticians

It is recommended that you visit an ophthalmic practitioner for a sight test every two years.

Opticians and sight tests - NHS (www.nhs.uk)

Contact the optician and ask if they will accept you, if you are exempt or can receive vouchers towards glasses check they accept NHS vouchers. You will then need to fill in the forms appropriate to that optician when you get there.

Sexual health

The following website is the best place to search for information related to sexual health issues. Sexual health - NHS (www.nhs.uk)

Quit smoking

If your mentee wants to quit smoking it is best they see their GP. If not, the following website is a good starting place: Quit smoking - Better Health - NHS (www.nhs.uk)

Self-esteem and confidence

Self-esteem is how you think about yourself, the opinion you have of yourself.

Having a low opinion of yourself can make you more prone to mental health problems such as eating disorders, depression or anxiety and phobias.

Self-esteem can just be down to your own temperament. However, people who have been abused or neglected in their childhoods often have low self-esteem or young people who feel they have not matched up to their parents’ expectations.

Other things that can affect someone’s self-esteem include bullying, trauma, poor physical health and social exclusion to mention a few.

Having low self-esteem can affect work, personal relationships and your social life, so it is important to tackle low self-esteem to boost positive thinking and positive mental wellbeing.

We all have self-doubt that challenges our self-esteem from time to time. If it is a consistent issue for your mentee work on one aspect; don’t try to solve everything in one go. The Wheel of Life might give a hint as to areas of greater importance.

As a goal is progressed towards, praise and encouragement are crucial.

Top TIPS to boost self-esteem www.youngminds.org.uk (used with permission)

In order to change your beliefs, you have to understand your negative beliefs. Think about what your weaknesses are, when you started to feel like this; can you identify something that has happened that might have caused you to feel like this?
Once you have identified the negative beliefs, gather evidence to challenge this and write them down so you have a list as evidence when you are feeling down. For example, if you feel you are unattractive, note it down when you receive a compliment from someone that says you look pretty, or they like your new haircut.
Positive thinking exercises – write down the things you like about yourself. Think about your best feature and write it down – I like my eyes, for example. Think about things you have achieved and add them to the list. Think about nice things you have done for other people, skills you have, talents that you or others have noticed and write all these positive things down. This is good to look back on when you are having a bad day or when you are nervous about something such as an exam.
Friends and family – look at the people you have around you on a regular basis and think about how they make you feel. If you are spending a lot of time with someone who makes you feel rubbish about yourself then spend a bit less time with them and spend more time with people who make you feel good about yourself.
Take up a positive hobby.
Set yourself an aim – maybe a sponsored walk for charity which will make you feel good about yourself. This could be an activity you do together.
If your problems are particularly deeply rooted, you can seek professional help and get access to talking therapies. See your doctor for more information.

Information from www.youngminds.org.uk Used with permission. 2013 Young Minds. Registered charity numbers 1016968 & SC039700

Emotional management

Managing emotions and mentoring is all about relationships. As a mentor you may well feel frustrated at times or elated, frightened, or even hopeless while watching your mentee navigate the ups and downs of their life journey.

Intrapersonal (your ability to reflect and monitor your own progress) as well as interpersonal (ability to communicate with other people) skills are needed to keep the mentoring connection helpful.

The emotions of your mentee will possibly soar or plummet, they may not even be able to express or name the emotion they are feeling. It is really helpful to get your mentee to express the emotion they are feeling as best they can.

There will be times when it is appropriate to refer your mentee on to a more specialised team/person. See the list of support numbers in the appendix.

For yourself, remember to use the time with your mentor supervisor well so that you don’t get overwhelmed. If you feel a situation is beyond your capacity, please contact your supervisor.

Understanding adolescent brain development

Young people do not always read situations and facial expressions correctly. There seems to be a rewiring going on in the brain. This means their perception of how others see them may be misconstrued; they may act in an inappropriate or reckless way. Your job is to help them to work this through without preaching!

Questions about the nature of normative and atypical development in adolescence have taken on special significance in the last few years, as scientists have begun to recast old portraits of adolescent behaviour in the light of new knowledge about brain development.

Adolescence is often a period of especially heightened vulnerability as a consequence of potential disjunctions between developing brain, behavioural and cognitive systems that mature along different timetables and under the control of both common and independent biological processes.

Taken together, these developments reinforce the emerging understanding of adolescence as a critical or sensitive period for a reorganization of regulatory systems, a reorganization that is fraught with both risks and opportunities.

(Ref: Steinberg,L. Cognitive and affective development in adolescence, Trends in cognitive sciences Volume 9, Issue 2 ,February 2005, Pages 69–74)

Stress

Stress is caused by a variety of things in life and excessive stress leads to anxiety and depression.

Learn how to spot the early symptoms:

Under or over-eating
Not able to sleep
Feeling constantly irritable
Not able to sit still and relax
Bursting into tears easily
Feeling bored most of the time
Not able to enjoy a good laugh
Feeling that you can’t talk to anyone about your problems
Frequent heartburn or stomach pains
Frequent diarrhoea or constipation
Feeling that everything has got on top of you
Feeling tired most of the time
Not able to concentrate
Unable to enjoy yourself
Putting on weight
Frequent headaches
Muscle spasms twitches

Simple steps to coping with stress

Recognise the causes of your stress
Eat regular meals and sensibly, lots of fruit and vegetables, not too many cakes and sweets!
Organise your time – do not take on more that you can cope with
See the humorous side of situations and try to think positively – it helps!
Talk problems over with a friend or mentor
Deal with tensions before they become too severe
Avoid too many changes at one time
Take regular exercise. Gentle rhythmic exercise – like swimming, walking, jogging – is a superb way of releasing tension caused by stress.
Avoid inappropriate ways of coping with stress e.g. overuse of alcohol, smoking or compulsive eating. They may seem to relieve stress but simply add to it in the long run.
Write it out – it is easier to see things in perspective when it is written down. List practical options, weigh, then decide and act.

Stress busting – the food way

Scoffing chocolate and cake is a common reaction to stress and bad moods. Yet sugary comfort foods can actually leave you feeling worse. Research has found that healthy foods such as fruit, oily fish (e.g. salmon, mackerel, trout, sardines, fresh tuna, etc) and vegetables help your body cope with stress and therefore have a better effect on your mood.

Next time you're stressed, bypass the cake and reach for a healthier snack. Boost your mood by eating foods that release the happy, calming hormone, serotonin, into the body. Carbohydrates, like mashed potato and bananas are good picks, but be warned, too large a portion of carbohydrate can leave you feeling groggy.

If you have been under stress for an extended period of time, top up your body's stores of vitamin C by eating foods such as pineapple, fresh berries, sweet potatoes, oranges, peppers, dark green vegetables, wholegrains, nuts and seeds, pulses and dairy produce.

Give your liver a helping hand by cutting out junk foods and eating raw, fresh and unprocessed foods instead. Top up your daily intake of vegetables with a green salad.

Dealing with stress (www.youngminds.org.uk – used with permission)

The following actions are simply some practical ways in which people can be assisted to perceive situations from a more resourceful and positive perspective.

They will help equip the young men to manage challenging situations. These techniques and perspectives form elements of the field known as Neuro-Linguistic Programming (NLP).

Encourage well-formed outcomes

Establishing a very clear idea of what it is you want to achieve in any particular situation is extremely powerful, not only in terms of motivating someone to take action but also in terms of raising their belief that change is possible. In so doing a person can feel more in control, and as a consequence be less stressed.

Guide the young man through the following questions, helping them to explore them as fully as they are able. There is a sheet to help you work through this with your mentee at the end of this chapter (How do I get there?).

* What is it that you want and when do you want it?
* Imagine that you are at that point in time now and you have what you want – what do you see, hear, and feel that lets you know you have it?
* Is there anything you have to lose in order to get what you want?
* Are there any resources you need; will you need any help from anyone?
* What is the impact of getting what you want on others, for example your friends and family
* What is the first thing you are going to do to move towards where you want to be, and when will you do it?
Use State Management
When someone feels under stress, they will often feel that situations are increasingly beyond their control, that somehow they are helpless to respond in any kind of a resourceful manner. In such circumstances people can experience negative self-talk and feelings of being overwhelmed, sensing themselves falling into a state of fight, flight, or freeze.

Use the following simple exercises to allow the young man to experience a renewed sense of calm and control:

* Encourage the young man to take several slow, deep breaths, modelling the behaviour for them and then asking what they notice is now different about both how they feel physically, and about how they perceive the situation and their ability to cope
* Ask about any internal dialogue they may have in particular stressful situations. Find out about the tone, volume, and speed as well as about the specific language used. Then support the young man in playing with these details, slowing down the words, making the voice comical, even ridiculous, and again ask what they notice has changed
* Demonstrate to them how they can look in peripheral vision as opposed to having a narrow focus, supporting them to do so, and assisting them in experiencing the quietening of internal dialogue that follows
* Demonstrate how any emotional state has its own accompanying physiology and show how by simply changing your physiology you can begin to move yourself out of a negative state and into a more resourceful one.

Escalation:

If your problems are particularly deeply rooted, or if you feel you are not in a comfortable or safe place with dealing with the emotional state of your mentee, you can seek help.

Contact your KEY4LIFE supervisor and seek advice
Contact the young man’s YOT worker (see your contact sheet – sheet 1.2)
If appropriate contact their mental health worker

Here are a few emergency numbers:

Samaritans: 08457 90 90 90

Victim support: 0845 30 30 900

Leisure time & activities

Your role as a mentor is to focus on the aspirations of the young person finding out what they enjoy and would like to get involved in.

Acting as a facilitator and showing/encouraging the young person how to access these services. The Wheel of Life is a good place to start. You can also talk about activities they have enjoyed in the past.

It is important to look at how leisure time is used; not only is it important for physical health but also mental health.

Community-based mentoring and leisure-time activities for youth at risk of offending can have promising effects for a variety of outcomes such as deviant behaviour, violence and delinquency – even when the young people’s negative behaviour is group-related.

(The Effectiveness of Mentoring and Leisure-Time Activities for Youth at Risk - A Systematic Review. The Danish Crime Prevention Council; May 2012)

TIP: Meeting your mentee and joining in an activity if appropriate can be a good way of building relationship. It could be gardening, going for a coffee, cycle ride; be cautious of joining in very physical activities e.g. swimming, salsa dancing that can be close and intimate.

Guidelines for physical activity for young people aged 5-18 years Physical activity guidelines for children and young people - NHS (www.nhs.uk)

To maintain a basic level of health, children and young people aged 5-18 need to do:

At least 60 minutes (1 hour) of physical activity every day, which should be a mix of moderate -intensity aerobic activity ; such as fast walking, and vigorous intensity aerobic activity , such as running.
On three days a week, these activities should involve muscle -strengthening activities , such as push-ups, and bone -strengthening activities , such as running.
Many vigorous-intensity aerobic activities can help you meet your weekly muscle- and bone-strengthening requirements, such as running, skipping, gymnastics, martial arts and football.

Exercise is a great way to improve your health, reduce stress and in combination with healthy eating be used to control weight. Many benefits to be gained:

Relaxation – control of stress and anxiety
Fun – make new friends
Reduces some of the effects of ageing in particular bone loss (osteoporosis)
More efficient heart and circulation
Reduces blood pressure
Toned muscles and therefore body shape
Stronger muscles, joints and bones
More stamina
Increased mobility and suppleness
Self-confidence
Sense of well-being – lifts mood
Improved sleep
Alertness and vitality

Some barriers and solutions to exercise

Your mentee will sometimes put up barriers to exercise, either real or perceived. Using your motivational behaviour skills, here are a few barriers and possible solutions.

NB you need to induce “change talk” or you will be wasting your time! They need to do it for themselves not for you.

The social aspect of their leisure time is an important part of potentially improving mental health and self-esteem.

Suggestions for Overcoming Physical Activity Barriers

Lack of time

Identify available time slots. Monitor their daily activities for one week. Identify at least three 30-minute time slots they could use for physical activity.

Add physical activity to their daily routine. For example, walk or ride their bike to work or organize school activities around physical activity, walk the dog, exercise while you watch TV, etc. Select activities requiring minimal time, such as walking, jogging or free online gym routine.

Social influence

Explain their interest in physical activity to friends and family. Ask them to support their efforts.

Exercise with friends, they’re more likely to go. Plan social activities involving exercise. Develop new friendships with physically active people. Join a group, such as the leisure centre or a dance club etc.

Lack of energy

Schedule physical activity for times in the day or week when they feel energetic.

Convince themselves that if they give it a chance, physical activity will increase their energy level; then, try it.

Lack of motivation

Plan ahead. Make physical activity a regular part of their daily or weekly schedule and write it on their calendar.

Invite a friend to exercise with them on a regular basis and write it on both calendars.

Join an exercise group or class.

Fear of injury

Learn how to warm up and cool down to prevent injury.

Learn how to exercise appropriately considering age, fitness level, skill level, and health status.

Choose activities involving minimum risk.

Lack of skill

Select activities requiring no new skills, such as walking, climbing stairs, or jogging.

Take a class to develop new skills.

Lack of resources

Select activities that require minimal facilities or equipment, such as walking, jogging, rope skipping. Free online gym routine with no equipment which can be performed at home.

Identify inexpensive, convenient resources available in your community (community education programs, park and recreation programs, worksite programs, etc.).

Weather conditions

Develop a set of regular activities that are always available regardless of the weather (indoor cycling, aerobic dance, indoor swimming, stair climbing, rope skipping, dancing.

Here are a few ideas to getting started with exercise and leisure activities:

Volunteer at a library, hospital, or other community health facility
Play cards and other games with your friends
Go to the theatre, a film, or a sporting event
Meet a friend for a coffee
Garden either as a volunteer or in own home (if appropriate)
Organise a park clean-up
Take a cooking class
Sing in a group, a choir
Join a club e.g. swimming, climbing, canoeing, taikwon-do, athletics etc
Join a local theatre/amateur dramatic group
Go dancing – look at local groups
Take a group exercise class
Play a musical instrument, learning a new instrument
Join a group interested in a hobby

General - Health and wellbeing

Physical Health

Self-esteem and confidence

Emotional management

Stress

Leisure time & activities

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