5 Ways to Wellbeing

Jodi: Good afternoon, everybody. Welcome to today's webinar. My name's Jodie Hudson. For those who don't know me, I am the Executive Manager of Client Engagement and Wellbeing here at MS Plus prior to that, I was an MS nurse for the last 25 years before I came into this job.

What we are talking today about is the five ways to wellbeing. It's one of my very, very favourite things to talk about. I think particularly during COVID, but I always thought wellbeing seemed to be really hard until about three or four years ago, probably three years ago now, just at the early days of COVID, I found this simple thing to think about which was five ways to wellbeing and during the last three years I've been in contact with the person that I'm going to interview shortly, Nicola McKay.

And in the spirit of reconciliation MS Plus acknowledges the traditional custodians of the country throughout Australia and their connections to land, sea and the community. We pay our respect to their elders past and present and extend that respect to all Aboriginal and Torres Strait Islanders peoples today.

Just this discussion that we are having does talk about wellbeing, but it touches very lightly on some issues of a sensitive nature. So, if you need any support, please contact Lifeline or Beyond Blue.

Nicola is responsible for the implementation and embedding of the Five Ways to Wellbeing program across Melbourne Health previously and now within Northern Health. And Nicola also works in community development at Northern Health. That's sort of the hub of where Five Ways of Wellbeing comes out of. Five Ways of Wellbeing was traditionally a mental health approach and so she works a lot with people navigating mental health issues, but also barriers to consumers overall from wholeheartedly engaging with their clinicians.

Nicola wrote this about herself, and I thought, oh, how true is it that when I think back of my role as a nurse, I certainly did try and remove barriers that it meant that people could wholeheartedly engage with their clinicians and their therapeutic journeys. What she does is so relevant across the board.

So, I'll start by asking you about Five Ways to Wellbeing is a concept that's popping up in many different places. Can you tell me a little bit about what it is and what's the background to Five Ways to Wellbeing?

Nicola: So, in the 90s, there was a lot of research being done by the New Economics Foundation in the UK, and the UK government had charged the foundation with finding something that would be workable and effective for the greatest number of people in the UK. The NEF, the New Economics Foundation, then drew on a lot of research that had been coming out of the World Health Organization since about the 70s around the social determinants of health, and how our environments and our social networks and, you know, our day to day living impacts our health physically and mentally. So, the research from the 70s then was feeding into the research in the 90s and the New Economics Foundation ended up distilling down research from about 400 scientists around the world. So that then was drawn into the beginnings of Five Ways to Wellbeing. Which was essentially identifying those five ideas that people are able then to follow through and to carry out and to adopt as a way of doing things or as a way of viewing life.

And then in about 2005, about 2008 the community development side of the community mental health team in Broadmeadows or in the northern suburbs of Melbourne. Our manager, a social worker, was really attuned to this idea of the social determinants of health. So, they went out her and her population health girl, and looking for something that we could bring into ourselves and use for our communities. So, they found five ways to wellbeing and then they were able then to, we changed a couple of the words instead of give, we decided to make it help others. Because give a lot of people saw as like a financial thing or you know here's a dollar in your hat whereas help others is a little bit more broad and in the way it can be applied. So, we came up with our own twists or our own interpretation of those five ways, but those five ways have been around since certainly in the 90s.

Jodi: Okay, so what are the five ways? And tell me a little bit about each one of them.

Nicola: Okay, so the five ways are connected, keep active, keep learning, be aware, and help others.

So, connect is the first one because it's the biggest one. And it's also the one that people will probably find easiest to miss or to leave out of their daily life. But in old money, The fatter your exercise book not exercise book, the fatter your address book. So, the more people you are connected with in some form the longer you live, the faster you recover from surgery the happier you'll be. And I think the idea is that even if you don't know anything more than your neighbor's first name, the fact that you know that person gives you a sense that if everything fell apart, there would be someone that you could walk up to and say, hey, I need a hand. And so, connection is, you know, the inner circle of your family and your friends. And then it's your work colleagues and school buddies. And the circles emanate all the way out to the people that give you your coffee every day. And you don't know them, and they don't know you. But you can have a yarn with them, and they can ask you how you are. So that sense of connection is enormously important.

And then we found that too, that in the pandemic, you know the silver lining for the pandemic was the fact that there are a lot of people who live alone and are quite isolated and marginalised in our communities. Because everybody's just totally consumed with their own, stuff. And then in the pandemic, all of a sudden people were knocking on their doors and saying hey, did you need me to buy some toilet paper? You know, are you able to get down to the shops? How can I help? So that sense of community and connection suddenly became visible and tangible and important. And that was why there was so much shift of ideas and perspectives during the pandemic because all of a sudden connection became super important and super valuable.

The next one is to be active and obviously we all know that, you know, going for a walk is better than leading a sedentary life, standing up is better than sitting down. But being active is a little bit more broad than that because it's about doing things, so doing things around the house, doing things, walking to the photocopier, things like that. All buy into or all part of this, you know, cumulative effect of building a brick wall. Every little brick in and of itself is nothing, but all of those bricks together build your resilience and your positive mental wellbeing.

Keep learning, that's the old thing, use it or lose it. So that's about using your brain. And keep learning doesn't mean going back and doing a PhD. It means learning how to say hello in all the community languages that are in your street. Learning peoples. Learning ways to remember names. Learning how to knit. Learning a musical instrument. All of these things are enabling us to to be curious and to be connected into our environment and to be always wanting a little bit more so that we're not drawing things into ourselves. We're pushing our comfort zone out further around us. So, we're living in a bigger space, mentally and emotionally and spiritually and physically. If you know how to garden, if you know how to bake scones, if you know how to say hello in Turkish, all of these things allow you to live in a bigger sphere in your life.

The fourth one is be aware and that is about being mindful, about being grateful, about being happy in your own skin, about being able to stop and relax and let go of the stresses of life. It's about some of the things that we don't evaluate anymore in our modern society is fire watching. You know, men do it when they're channel surfing. Being, just being. And so that whole idea of staring into a fire for a period of time allows your brain to switch off and then also explore other facets of itself. And so, pondering is no longer a valuable activity because pondering means you're not doing anything which is like, you know, terribly lazy and not very productive. But pondering is really important for our sense of being present. Where am I? I've got to here from somewhere else. I've got a lot of opportunities of where I'm going to go forward. But the most important thing about that whole journey is right here. So being aware, being mindful. Being grateful is enormous. Gratitude exercises have fantastic evidence, evidential research that says, you know, people who are grateful, are happier, are more relaxed, are less stressed and have a better sense of purpose.

And then finally help others is, as it says that, we know there's lots of research around the joy and the benefits that you receive when you are helping others. So, volunteers, you know, the stalwart of our communities are amazing people, but there's something in that for them as well as the people that they're helping. So, helping other people, random acts of kindness, and also help others reminds you that you're a part of a community. And in a community, we have rights and responsibilities, and our right is to expect our community to help us when we need it, which is that sense of connection. And our responsibility in a community is to give back into that community what we are able to give. So, it's not a cup of sugar to the neighbour next door every day for a year. It's about answering questions and bringing in wheelie bins and being there for people because that's our responsibility as being part of a community.

And certainly, the pandemic highlighted that people with community were far better placed to tough out the storm than people who had been a rock in an island for a long time, because that's just the way that modern life appears to be successfully lived. And we've certainly now much more in touch with the idea that community is really important.

And community then sits through those five ways. So, you can do them all by your own self, but each of those ways in some manner encourages you to go out into your community. So that's a little plug for community development right there.

Jodi: Right there. What I love about the Five Ways to Wellbeing is that you don't need, it's simple and you don't need to learn anything new, you don't need to, you don't have to do a course for it. It's just so simple in its applicability to you know, you don't have to be, you don't have to subscribe to a gym, you know, there's nothing about it.

Do you find that that's a real success point of it?

Nicola: Yes, that people don't have to pay gobs of money, that they don't have to be outside of their comfort zones, that they don't have to go to another suburb, that they don't have to do things that are not entirely in tune with how they are choosing to live their lives.

The fact that an eight year old can do five ways and an 80 year old can do five ways and they can do it together but they're actually doing different things in each of the ways means that it is entirely personal. And when you decide how you're going to live each of those ways all of a sudden you have skin in the game. You know your idea, you've decided to connect by doing X, Y, Z. Your idea means that you are now better motivated than your doctor or your employer or your priest telling you, you know what? now this is what you have to do, because you know, what's in that for you? And who's going to make me? Whereas when you come up, when you design your own five ways, yeah, that's your motivation right there.

Jodi: Yeah. We get a lot of questions when we do things about wellbeing and I think a lot of people have that sense of overwhelm when they first think about wellbeing, they're like, where do I start? What do I do? How do you help people get on the path? What do you recommend in terms of getting to. Often the first step is the hardest step, but how do you help people with that?

Nicola: So, what happens when people want to lose weight, what they do is they look at 20 kilos. And 20 kilos is a bag of chicken seed, I can tell you that, and it's very heavy. And when you're looking at it as one big thing, then it's overwhelming, and it's a mountain with no steps. It's impossible. And so, what we try to do is we try to break it down to small, daily attitudes then motivations and then activities that allow people to understand that every little thing that they do for themselves is building a cumulative effect. So, it's not about losing 20 kilos. It's about all I need to do today is say hi, help my neighbor, go for a walk, you know, learn how to do purl on knitting needles. Really simple and what we say to people is that by doing those little things every day, most days, when you can, what you are doing is you are actively contributing to your own mental wellbeing. And mental wellbeing is, again if it's one big thing, people are like, yeah, whatever. I'm just, it's easier to stay the way I am but if people understand that every time they put 20 cents in a jar, you know, it's the journey. It's building something really big and solid and resilient, simply by doing a little thing today. And what we try to do is break it down to those little, tiny, almost inconsequential actions that people are doing, and they are paying themselves. They're putting twenty cents into their own jar.

Jodi: Yeah, and that's another thing I love. It's very scalable, Five Ways to Wellbeing. It's just can be a little thing and it's really then achievable, which is so important, isn't it? I've done something. I've done something. I've actually achieved a goal that I set myself. That's just a small goal and often I find when thinking about five ways, some people are really good at one of the ways to five ways to wellbeing, but the others aren't quite as effective or there's a bit of a gap in. You can sort of do a self-check and say hey there's a little bit of a gap in what I'm doing, or I haven't really been active this week. I've been really helpful, but I haven't done that so how am I going to kind of address that little area rather than feeling like I have to do all of everything all in one day. It's so easy to get caught up in. You know, make these seven changes in your life and tomorrow you'll bang, you'll be amazing tomorrow.

Nicola: And like you've also said, Jodie, people need to understand that they're already contributing positively to their own resilience because I'm already doing the connect, and I'm already doing the be active, which means that I'm two fifths of the way to being there. So, it's about giving yourself credit and understanding that you already get runs on the board for the things that you're already doing.

Because like I say, some people are every day moving about and doing the vacuuming and gardening like a mad woman. And knowing that that activity is positively contributing to your own mental wellbeing is just like, I haven't had to start a new thing. I'm already doing it. So, I do that and then all I might do is just pop one more way into my day to day.

So, it's a very undaunting, I don't know if that's a word, but it's a very undaunting process because once you understand how it works, you're already giving yourself credits. You're already like, oh my goodness me I'm, you know, I'm a third of the way there, go me, and when you understand that tangible assistance to your own self, it's just like, fantastic, I'm already doing it.

Jodi: Yeah, I'm already on board or I could just a little thing can add it.

I know that the Five Ways to Wellbeing has often been linked with mental health, but I also am aware just even looking in your organisation the enormous variation in the different partners that you have.

So, where’s the research sort of leading into other ways and in your experience how is the five ways of wellbeing being utilised in different ways and organisations?

Nicola: That's a fantastic question and it speaks to the scalability and the tailoring, the opportunity to personalise the five ways. So, we have organizations like Holt, which is helping assistance for local tradies. And it was an organization that just said Hey, there's a whole lot of tradespeople out there that are suiciding unnecessarily because they don't have any support. How can we help them? So, they set up this organization and then came to five ways and thought, well this is great because this is something this opens the conversation between us and tradies. So, they used five ways as a, hi we're here to help, suicide's an issue. What do you need? And if you do these little things, then all of a sudden people can go, actually, you know, I am so unconnected. I feel very socially isolated. I don't actually have any friends. I just come to work and, you know. It's an opportunity to start a conversation and also to open up conversations and people who may not see that having, it's not about having loads of friends, but having a lot of connection, feeling connected is, is important. So, it allows organizations to have those conversations.

So, we have schools who are using it. We have councils who are using it for their staff. We have organizations that are using it for their community, the people that they touch. And this is essentially a mental health program. You know, there's lots of other benefits in it, but it is a mental health program because if you have positive mental wellbeing, then you're able to flourish. And it doesn't matter who you are or where you are or at what point in your journey you are, to feel that you are increasing your ability to flourish is really valuable and the organizations that you're interacting with for whatever reason if they're able to open those ideas and start those conversations then that's really awesome. And so, I think lots of different organizations, but using five ways to start a conversation.

Jodi: Mm hmm. I think that I often think of mental health as we know that there's lots of different aspects of wellbeing. And people living with chronic health conditions, you know, need to tap into lots of different elements of wellbeing. I often think without mental health, that's the foundation. You know that's, if you, if that part of your wellbeing isn't working, all the others are going to be, are not going to be able to be. That's the concrete base of, the mental health is the concrete base and so I often think if that part of it is not working for you, and I've seen it, you know, after 20 years of being a nurse, it's that concrete base. It's that foundation. If that's not there, if your mental health isn't strong, all the other parts of wellbeing are just going to be extraordinarily hard to add, your physical wellbeing, your financial wellbeing, your safety wellbeing, all those are the elements that we talk about. Just and I think that's why it's so important and why we at MS Plus think it's so important as well, too, for people to have confidence. Positive mental health because we know that that's where it starts, you know, that's the foundation of it.

Nicola: Absolutely, and I think that you know, the information that we've been given from the health industry is that it's all about something that's negative. So, when you say mental health people go, oh, depression, psychosis. When you think about physical health you go dodgy knees, bad back. But the thing is that good health is not just the absence of issues, and the problem is that we don't, when we run up a flight of stairs and then run to catch the bus and then, you know leap about on the dance floor on a Friday night. We don't realize that it's a good health, physical health that allows us to do that. And so, you're right. If you have positive mental wellbeing, you may not really see it as a thing that you have, but it's your positive mental wellbeing that allows you to go, oh, I might try that. I've always wanted to do that. I feel really happy where I am right now in my life. Oh, I've got motivation. I've got plans. I've got purpose. And those things come from good mental health. So, it's not just like, oh, aren't I lucky? I don't have psychosis, I don't have schizophrenia, you know I don't have bad mental health. I think it's trying to change that perspective so that people see and value and desire good health and wellbeing because they see the value in that as an idea.

Jodi: Yeah, yeah, so true, so true. And how do you think that the helping others thing I think is one of the ones of five Ways to Wellbeing that people kind of get a bit, how does this connect to my health?

How does that, how does this kind of connect to my health? How do you think that that is, what's your experience of that?

Nicola: Well, research says supporting others is shown to be associated with reduced mortality rates. So, helping you makes me live longer. Committing an act of kindness once a week for six weeks is associated with an increase in wellbeing compared to control groups. So, someone's done a study on that and that's an act of kindness. So, it might be helping an old lady across the street, but it might be just a random act of kindness. Here, take the park, I'll go find another one. Volunteering is associated with positive wellbeing and more meaning in life and in older people it acts as a preventative agent against cognitive decline.

So, by having a focus on somebody other than yourself gives you benefits. And so, helping others again, it might you can interpret it literally, but it is simply a random act of kindness. You don't have to help someone you know. And it doesn't have to be big. It doesn't have to be a $100 donation. It can be something as little as, as small as, you know, can I help you lift this into your car. And again, it’s all interconnected because it all relies on connection to your community and to your environment and to your space to be able to say, you know, just bring my neighbor's wheelie bin in, you know. And it's not something that you get it's not the thank you It's not the box of roses chocolates that you get. It's not the payment. It's not the, you know, recognition certificate. It's the act of doing that gives you that better cognitive support, reduced mortality and a sense of wellbeing.

Jodi: Yeah, and it's a bit of a serotonin surge really, isn't it? Because you just feel so good about doing something good for others. And I think it's such an important part of it, a part of that whole sense of wellbeing. So, I'm going to thank you for your time today and for sharing, sharing the five ways to well so joyously sharing the five ways to wellbeing with us. And so positively as well, too, and helping us, I think, recognise that wellbeing is not just like the absence of something wrong. It's sort of, you know, that sense of mental health. You can always work on it. And it's simple to do. You can always keep working on your mental health and keep flexing it, as they say, keep flexing those muscles.

Nicola: That's right. And as long as you make it your own, I mean, I think people, someone who's caring for someone is able to take different things out of the program than someone who is experiencing MS and yet they can do it together. So basically, anyone with a neighbor, anyone with caring responsibilities, anyone with kids, you know, we all have opportunities to do all of these things. And you know, once it becomes a habit three weeks apparently to form a habit, and once it becomes a habit, it gives you a perspective on life. That will just pay you back in spades, and I think if people understand that, then they're unleashing fabulousness on their own selves.

Jodi: Thanks. I love that. Unleash the fabulousness of yourself.

Nicola: I think I need a sequence and a feather to go with that statement.

Jodi: we're moving on to questions now. So that was lovely to speak to Nicola yesterday about the five ways to wellbeing and unleashing your fabulousness. I really love that. I'll definitely take that one home. So, Jess is going to give us, give me some questions.

Jess: Yes, so we had a few questions around fatigue management and how people manage that.

Jodi: Okay, great. I think, look, fatigue management is the number one issue in MS, isn't it? And fatigue, certainly, it's like a vicious circle, isn't it? You know, your fatigue gets worse if your mental health is not good, and your mental health gets worse because you fatigue is such a bother and that just makes everything worse, and it all blows up. So, I guess that it's about well I think in my years of experience it's about what you can do to give energy back into yourself for fatigue management. I think fatigue management in MS is really complicated and I in no way would minimise the difficulty and the challenges, and how hard it is to live with fatigue. But I think like if you've got a battery of energy, and unfortunately with MS the battery of energy is lessened. The little things that you do to be able to give you, to make that battery a little bit, to extend that battery, a little bit. And I think all the aspects of the five ways to wellbeing contribute too Even in small ways, to be able to give that battery a little bit longer and a little bit extended a little bit. And then there's lots of other ways of supporting better. Eating well, sleeping well, breathing well. You know, they're the simple things, but they're the things that are within someone's control as well too. So, I think that that I said even just having connections around you and making sure that, I think people should be strategic about getting the support that they need around them to be able to live their life the best way that they can. And so, there's lots of resources to do that for people. But it's about thinking like, I do need a village here and I do need that certain person to help me in terms of being active. I know personally that I'm pretty bad on my own. So, but if I've got a group, I'm pretty committed. So, for my health, my, group of exercise people are far more important than any doctor will ever be because they're keeping me active. So that's why I think the five ways to wellbeing can be really important.

And also, the joy, joy is hard to get sometimes, but it's also really important and things like helping others really do give you energy, give you that little bit of energy back. So, I wish with all my heart that I had something to help people manage fatigue. But all I know is that it's just, it's sort of one building block at the time, really.

to give that energy back.

Jess: Great. And there was another question. What would your number one top tip out of the five ways to wellbeing be?

Jodi: I think for me personally because I really like to use the five ways of wellbeing in my own life and for me, it's about a self-check. So, it's not one particular one at any given time, but I have a big magnet on my fridge that’s got the five ways to wellbeing, and I'll often think to myself, what am I not doing? What am I slipping on? You know, just thinking about my life over the last couple of weeks? You know, what sort of, have I done anything nice for anybody over the last couple of weeks? Probably not, so I think that sort of I often give myself a little bit of a self check and think, yeah, that's right. I haven't really learned any new skills, or I haven't really pushed myself to, you know, just have a look at something different that I hadn't thought about or learnt before. So probably my number one tip. And I guess I am with Nicola as a very strong believer in the value of connections in your life and the importance of when you think about your health, you think about the people around you who are supporting you within the small circle around you and then out you go in the bigger circles as well too.

So that they're probably mine Jess.

Jess: Great. And then we just had a question which was touching on you know, maybe how to sort of reduce anxiety and mood swings and maybe how that sort of relates to the five ways to wellbeing.

Jodi: That's, it really depends on the degree to which I think anxiety is a terrible thing to suffer. It's such a black cloud in your life and I know living with a chronic illness of any description, it's like you never really know. And we kind of, you know, the pre MS days is when you had that sense of security of, you know, you kind of would know what your day was or what your body was going to do and where you met. It kind of takes that away a bit. So, I think managing anxiety is really hard without help and unfortunately there are lots of resources available on the internet as well too, as of how, of strategies to managing anxiety and I think it needs to be very intentional in the way that you manage anxiety as well too.

There's so much in life that we can't control and if you're in the middle of an anxiety attack, someone telling you that is of no value. And so, I think anxiety is tricky to manage and if you don't have the means and resources to get mental health support there are lots of things on the internet that can give you tips and tricks about how to manage anxiety.

And then overall, what was the other part of that question, Jess? Oh, the mood swings and the mood ups and downs. I think that there's a lot of women have mood swings for other reasons, so I'm very big on not blaming MS for other things. Hormonal changes, menopause, all those things. It's really important to think, is there anything else impacting on my health that is causing these mood swings as well too? Because the women's health clinics certainly in Victoria, there's women's health clinics anywhere. They know a lot about that. So, in my days as an MS nurse, I certainly spoke to a lot of women and were, you know we talked a lot and had lots of hot flushes together. So, I think that's a really important part about managing mood swings as well too. And again, where you can get help to be able to do that if you've got the means to be able to support accessing psychologists and counsellors. I just, I'm a big fan, big fan of being able to do that. So that's sort of one thing about the mood swings.

So, thank you for your time this afternoon. There are other things that we do at MS Plus. So, if you want to MS Plus has allied health services, continent services, our nurse advisors, and dieticians on board with us now, peer support, and, you know, like that sort of Peer support is a great way to get connections.

We also have a resource hub that's available where you can find lots of different information about all sorts of aspects of wellbeing, so tap into that any time. And if you want to have a chat to someone and you want to know more about that you can call our, the wonderful team on Plus Connect which is 1800 042 138 or send an email.