This document provides information about a new website launching called www.letslinkmentalwellbeing.com. The website will provide news, information, and resources related to mental health and wellbeing. It will include links to local and national organizations as well as details of upcoming events and consultations. While focused on services in Surrey, the website aims to be a resource for those experiencing mental illness and their caregivers across the southeast region of England. Upcoming features on the website include a user survey on accessing mental health crisis helpline services in Surrey.
In Conversation with Compassion and Care
These essays are a poignant reminder that true compassion is visceral and deep in its emotion. There is depth in the experiences shared in these essays; some intimate, some heart-breaking. Collectively, these works highlight an essential need for self-compassion and compassion to one another with the aim of sharing knowledge and changing lives;
careif is planning to provoke more conversations on compassion and care, so please share with others and send your views/essays to enquiries@careif.org
https://publicmentalhealthbybhui.wordpress.com/2015/01/11/in-conversation-with-compassion-and-care/
Is best practice really elusive when working with Indigenous populations?MHF Suicide Prevention
The philosophy around the development of an Indigenous Australian specific psychological service and discuss the obvious value with an approach which is based on extensive community engagement, ongoing validation of models and services, and importantly ensuring that a rigorous research methodology is applied to all aspects of service provision. Indigenous Australians have amongst the highest rates of mental ill health worldwide, but continue to have the lowest levels of access to mental health services.
Presentation by Dr Tracy Westerman, Managing Director, Indigenous Psychological Services, Western Australia at the 2009 SPINZ National Symposium: Culture and Suicide Prevention in Aotearoa: http://www.spinz.org.nz/page/108-events-archive+spinz-national-symposium-2009+symposium-coverage
In Conversation with Compassion and Care
These essays are a poignant reminder that true compassion is visceral and deep in its emotion. There is depth in the experiences shared in these essays; some intimate, some heart-breaking. Collectively, these works highlight an essential need for self-compassion and compassion to one another with the aim of sharing knowledge and changing lives;
careif is planning to provoke more conversations on compassion and care, so please share with others and send your views/essays to enquiries@careif.org
https://publicmentalhealthbybhui.wordpress.com/2015/01/11/in-conversation-with-compassion-and-care/
Is best practice really elusive when working with Indigenous populations?MHF Suicide Prevention
The philosophy around the development of an Indigenous Australian specific psychological service and discuss the obvious value with an approach which is based on extensive community engagement, ongoing validation of models and services, and importantly ensuring that a rigorous research methodology is applied to all aspects of service provision. Indigenous Australians have amongst the highest rates of mental ill health worldwide, but continue to have the lowest levels of access to mental health services.
Presentation by Dr Tracy Westerman, Managing Director, Indigenous Psychological Services, Western Australia at the 2009 SPINZ National Symposium: Culture and Suicide Prevention in Aotearoa: http://www.spinz.org.nz/page/108-events-archive+spinz-national-symposium-2009+symposium-coverage
Post-Traumatic Stress Disorder, or PTSD, is a serious and common condition that affects up to 20 percen of American adults. While we may feel like we should be able to carry on with life, sometimes traumatic memories become so disabling that we can no longer cope or function.
It is a normal process, not a psychiatric disorder. Everyone moves through grief at their won pace and in their own way, It's a lifelong process.
Seek help from a qualified therapist if you feel stuck in your grief, you don't want to burden your close friends with your grief, or you want to provide active support to someone who is grieving.
Most managers hiring or supervising staff have little or no understanding of mental health and psychosocial disorders in the workplace. everyone is wired differently to learn, work, understand and comprehend, and engage in social settings. Some business activities require high levels of customer service while others are more research oriented and require less human interaction. There are many other issues related to mental health diseases and their controls prior to hiring and there are workplace stressors that can create anxiety and depression over time because of the nature of the work. How do managers and business owners deal with these situations and more importantly, how it is impacting the quality and quantity of work done. How do these issues impact the brand, reputation and image of the company? Learn more about this very important issue that most people don't want to talk about.
Depression is a mood disorder with symptoms that can range from mild to life-threatening. It's a complicated disorder because it can negatively impact so many aspects of a person's life, from physical health and job performance to parenting and personal relationships. People who are depressed feel helpless and hopeless that life will never improve.
Mental Health and Mental Illness1Discussion Qu.docxARIV4
Mental Health and Mental Illness
1
Discussion Questions
How do you hear mental health and mental illness talked about (or not talked about) in:
your family
your congregation
wider culture
Identify at what ‘level’ of a systems perspective you most often hear mental health discussed (and give examples):
Individual/Interpersonal Systems
Family Systems
Congregational Systems
Macro-Systems
-- Divide into groups of 3-4 where they are seated
-- Not offering a definition of mental health or mental illness yet – want to get at popular perceptions first, and do some analysis of that, before offering any definition
-- Reminder of multi-systems approach on next slide
2
Contextual (Multi-Systems) Approach
3
Individual and Interpersonal
Often, mental illness is discussed and diagnosed (in both professional and popular language) as individual pathology
Professionally, the Diagnostic and Statistical Manual of Mental Disorders is used to make diagnoses based on clusters of symptoms experienced by individuals
Examples of popular language?
“They must be crazy.”
“He’s just a schizophrenic.”
“The shooter must have had a mental illness”
Whether professional or not, the discussion tends to be about individual pathology, not family or societal context
4
Mental Health in Systems Perspective
John Swinton. Resurrecting the Person: Friendship and the Care of People with Mental Health Problems . Nashville: Abingdon, 2000.
-- from 2000, so a bit out of date, but holds up well in large part because it takes a community and systems perspective seriously rather than focusing on the ever-shifting understanding of individual pathology
-- title, “Resurrecting the Person,” refers to the way that stigma about mental health problems creates “non-persons”; the task of the church is to engage in the liberative practice of friendship by standing in critical soldiarity with those with mental health problems, thus participating in the resurrection or re-creation of the person
5
The Medical Model for Mental Illness
Strengths:
attempts to destigmatize mental health by putting it in the same conversation as physical health issues
gives a name to an experience that was previously confusing and difficult to explain
potentially opens doors for treatment and care
recognizes limits of pastoral response
Weaknesses:
the “nothing but” of neurobiology
care is entirely in the realm of the paid professional
diagnosis can equal prognosis and/or become a label
medical terminology of treatment and cure doesn’t always match lived experience of mental health problems
Focuses on individual pathology while ignoring context and “person-in-relationship”
Swinton, pg 77ff
Strengths – note that many of the organizations advancing a medical model are advocacy groups that seek to support folks with mental illness, like NAMI. Whatever critiques can be made of the medical model, it’s intentions are good
-- names have power; calling something “bipolar” gives me a power over some ...
Post-Traumatic Stress Disorder, or PTSD, is a serious and common condition that affects up to 20 percen of American adults. While we may feel like we should be able to carry on with life, sometimes traumatic memories become so disabling that we can no longer cope or function.
It is a normal process, not a psychiatric disorder. Everyone moves through grief at their won pace and in their own way, It's a lifelong process.
Seek help from a qualified therapist if you feel stuck in your grief, you don't want to burden your close friends with your grief, or you want to provide active support to someone who is grieving.
Most managers hiring or supervising staff have little or no understanding of mental health and psychosocial disorders in the workplace. everyone is wired differently to learn, work, understand and comprehend, and engage in social settings. Some business activities require high levels of customer service while others are more research oriented and require less human interaction. There are many other issues related to mental health diseases and their controls prior to hiring and there are workplace stressors that can create anxiety and depression over time because of the nature of the work. How do managers and business owners deal with these situations and more importantly, how it is impacting the quality and quantity of work done. How do these issues impact the brand, reputation and image of the company? Learn more about this very important issue that most people don't want to talk about.
Depression is a mood disorder with symptoms that can range from mild to life-threatening. It's a complicated disorder because it can negatively impact so many aspects of a person's life, from physical health and job performance to parenting and personal relationships. People who are depressed feel helpless and hopeless that life will never improve.
Mental Health and Mental Illness1Discussion Qu.docxARIV4
Mental Health and Mental Illness
1
Discussion Questions
How do you hear mental health and mental illness talked about (or not talked about) in:
your family
your congregation
wider culture
Identify at what ‘level’ of a systems perspective you most often hear mental health discussed (and give examples):
Individual/Interpersonal Systems
Family Systems
Congregational Systems
Macro-Systems
-- Divide into groups of 3-4 where they are seated
-- Not offering a definition of mental health or mental illness yet – want to get at popular perceptions first, and do some analysis of that, before offering any definition
-- Reminder of multi-systems approach on next slide
2
Contextual (Multi-Systems) Approach
3
Individual and Interpersonal
Often, mental illness is discussed and diagnosed (in both professional and popular language) as individual pathology
Professionally, the Diagnostic and Statistical Manual of Mental Disorders is used to make diagnoses based on clusters of symptoms experienced by individuals
Examples of popular language?
“They must be crazy.”
“He’s just a schizophrenic.”
“The shooter must have had a mental illness”
Whether professional or not, the discussion tends to be about individual pathology, not family or societal context
4
Mental Health in Systems Perspective
John Swinton. Resurrecting the Person: Friendship and the Care of People with Mental Health Problems . Nashville: Abingdon, 2000.
-- from 2000, so a bit out of date, but holds up well in large part because it takes a community and systems perspective seriously rather than focusing on the ever-shifting understanding of individual pathology
-- title, “Resurrecting the Person,” refers to the way that stigma about mental health problems creates “non-persons”; the task of the church is to engage in the liberative practice of friendship by standing in critical soldiarity with those with mental health problems, thus participating in the resurrection or re-creation of the person
5
The Medical Model for Mental Illness
Strengths:
attempts to destigmatize mental health by putting it in the same conversation as physical health issues
gives a name to an experience that was previously confusing and difficult to explain
potentially opens doors for treatment and care
recognizes limits of pastoral response
Weaknesses:
the “nothing but” of neurobiology
care is entirely in the realm of the paid professional
diagnosis can equal prognosis and/or become a label
medical terminology of treatment and cure doesn’t always match lived experience of mental health problems
Focuses on individual pathology while ignoring context and “person-in-relationship”
Swinton, pg 77ff
Strengths – note that many of the organizations advancing a medical model are advocacy groups that seek to support folks with mental illness, like NAMI. Whatever critiques can be made of the medical model, it’s intentions are good
-- names have power; calling something “bipolar” gives me a power over some ...
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
Students, digital devices and success - Andreas Schleicher - 27 May 2024..pptxEduSkills OECD
Andreas Schleicher presents at the OECD webinar ‘Digital devices in schools: detrimental distraction or secret to success?’ on 27 May 2024. The presentation was based on findings from PISA 2022 results and the webinar helped launch the PISA in Focus ‘Managing screen time: How to protect and equip students against distraction’ https://www.oecd-ilibrary.org/education/managing-screen-time_7c225af4-en and the OECD Education Policy Perspective ‘Students, digital devices and success’ can be found here - https://oe.cd/il/5yV
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
We all have good and bad thoughts from time to time and situation to situation. We are bombarded daily with spiraling thoughts(both negative and positive) creating all-consuming feel , making us difficult to manage with associated suffering. Good thoughts are like our Mob Signal (Positive thought) amidst noise(negative thought) in the atmosphere. Negative thoughts like noise outweigh positive thoughts. These thoughts often create unwanted confusion, trouble, stress and frustration in our mind as well as chaos in our physical world. Negative thoughts are also known as “distorted thinking”.
Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
In this webinar you will learn how your organization can access TechSoup's wide variety of product discount and donation programs. From hardware to software, we'll give you a tour of the tools available to help your nonprofit with productivity, collaboration, financial management, donor tracking, security, and more.
This is a presentation by Dada Robert in a Your Skill Boost masterclass organised by the Excellence Foundation for South Sudan (EFSS) on Saturday, the 25th and Sunday, the 26th of May 2024.
He discussed the concept of quality improvement, emphasizing its applicability to various aspects of life, including personal, project, and program improvements. He defined quality as doing the right thing at the right time in the right way to achieve the best possible results and discussed the concept of the "gap" between what we know and what we do, and how this gap represents the areas we need to improve. He explained the scientific approach to quality improvement, which involves systematic performance analysis, testing and learning, and implementing change ideas. He also highlighted the importance of client focus and a team approach to quality improvement.
Palestine last event orientationfvgnh .pptxRaedMohamed3
An EFL lesson about the current events in Palestine. It is intended to be for intermediate students who wish to increase their listening skills through a short lesson in power point.
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
Thesis Statement for students diagnonsed withADHD.ppt
Digging Yourself Out of a Hole: Gardening for Heart and Soul
1. issue 09 Inner space for women’s
Summer/autumn 2010 mental health & wellbeing
(across Surrey and the south east)
Digging yourself out of a hole
gardening for heart and soul
No clean knickers – let alone a toothbrush
the indignity of being sectioned
Painting yourself into the picture
art therapy creates self knowledge
3. No clean
knickers
–let alone a toothbrush
Being aDmitteD to an acute “I had to ask for soap and stuff, and probably one of the swiftest ‘done
psychiatric unit under section of the worse, sanitary wear – traipsing through deals’ I’ve ever known. In a matter of I went to a CPA (care plan) meeting – on my own, I didn’t
mental Health act – especially for a ward full of men, going to the office, half an hour, the trust manager and I know I could have someone with me, and they told me I had
the first time – can be a frightening requesting Tampax and going back had said we could joint fund a pilot! to go into hospital straight away. I felt alarmed and horrified.
and traumatic experience; on top of through the ward clutching them – So began a partnership between a But they knew best I thought. I asked to go home and pack
the traumatic experience of finding hardly dignified to say the least! patient, a charity and an NHS mental some things. They said no, I couldn’t do that. I said what
yourself mentally unwell! and when Julia was able to transfer to a private health trust: ‘The Wellbeing & Dignity about if someone comes with me. No was the answer. So
you arrive with nothing, just the clinic however, because of a health Partnership’ was born. they bundled me off to a secure psychiatric unit. I felt very
clothes you stand up in, maybe insurance scheme.One major difference frightened and so alone. I was in total shock about being
because you arrived in the back of stood out for Julia. When she went it gets better admitted, and to have nothing – no personal belongings –
a police car, the entire experience to her room at the private clinic, it Funding was limited. What could made me feel even worse. It was three days before a relative
can be an affront to your dignity and was like stepping into a hotel (with a be provided were ‘hotel style’ packs could bring anything in for me.”
self worth. sanctuary’s editor, megan few exceptions!) and in the en-suite of essential toiletries – shampoo/
met a young woman who’s been bathroom was a beautiful box of toiletries conditioner/shower gel/dental kit Young woman at a Sanctuary women’s group
4 there, done that, wouldn’t mind the from the White Company. Everything etc – with simple, caring messages of 5
t-shirt (on the ward as a change of she needed for a few days or so. Sadly, hope, for everyone admitted over a 6
clothes!) but also, passionately, wants the NHS ward just didn’t compare. Items month period onto the wards at the
something else… might have been available but not in Department of Psychiatry in Epsom.
individual packs for each patient. A few months down the way of
I first met Julia after she contacted But it was how that simple gesture of organising this though, came some good
me to say how much she had enjoyed fresh smelling toiletries made Julia feel news. Let’s Link has been awarded a
reading Sanctuary. So much so that she that was the real eye-opener. Comic Relief grant. This will enable us
was keen to get involved in some way. “To have something – slightly to produce leaving hospital information
We met. In a very short space of time pampering – and extremely ‘normal’ had a packs to complement the toiletries packs.
we had gabbled our way (constructive profound effect,” Julia told me “Suddenly Work is now underway to get the pilot
gabble!) through a myriad of subjects I felt I was being treated with respect – my up and running as soon as possible.
and issues linked to mental health sense of dignity was intact again. And I The beauty of this project is that it will
and wellbeing and other things totally thought, ‘I wish everyone admitted to a include people in the community who
unrelated. I soon discovered that Julia mental health ward could have this’.” have ‘been there / done that’ as well.
is full of ideas. But not just ideas: Julia Clients of the Joseph Palmer Centre will
has a real ambition. Two very different Cutting the long story… help assemble the packs. So people in
experiences of being hospitalized The work of my organisation Let’s hospital will have the added benefit of
in a private and an NHS acute unit Link, publishers of Sanctuary magazine, knowing the toiletries packs were put
highlighted a real need in Julia’s mind. echoed what Julia was saying; together by fellow sufferers / survivors: a
She thought everyone admitted to everything we do is about promoting message of hope in itself.
NHS units should have the quality of dignity, privacy and respect for people For Julia and everyone concerned it is
experience she had received in the who suffer mental distress. an exciting project based on a gesture
private unit. She explained: Together, we felt the time was right of kindness, respect, privacy and dignity:
“I had arrived at a psychiatric unit after to really see if we could get something the simple gift with the big heart. Julia’s
being compulsorily detained under going. Julia, along with Occupational next ‘Big Idea’ is to build a retreat in the
Section of the Mental Health Act. I had Therapist (OT) Bryonie from the Joseph Peak District – and possibly Italy: form
nothing but the clothes I stood up in. Palmer Centre in Molesey, Surrey set an orderly queue everyone!
I was feeling very low anyway, as you up a meeting with one of Surrey &
can imagine; being without personal Borders Partnership NHS Foundation
belongings or a change of clothes made Trust’s (SaBPFT) key managers and See the article starting on page 16 for another
me feel a lot, lot worse. myself from Let’s Link. I think it was woman’s experience of being sectioned.
4. Sometimes it’s difficult to ground yourself.
There is a way though, almost literally, by butterfly.
,’ said the
participating in a little gardening. ‘Just livin
g is n ot enough d a little flower.’
ine, freed
om, an ndersen
ave sunsh ans Christian A
The Old Moat Horticultural Services in ‘On e must h H
Epsom, Surrey helps people with mental
health problems dig deep for recovery...
Digging yourself
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now
The Old Moat is a garden centre with a and become expert in. n
difference. Many of the people who work For the visitor, the Old Moat provides a
there suffer mental ill health. It is a haven for wonderful array of all the plants and flowers
anyone needing some calm, thoughtful, safe you need: shrubs, ornamental trees, roses
and supported occupation. Achieving the from David Austin are all there. Up to 80%
sowing, growing and maintenance of plants of the plants are grown in The Old Moat’s
and flowers is satisfying in itself. What it own nursery, reducing plant miles, with
does for lifting the spirit, boosting self worth bedding plants grown in biodegradable
and taking away some of the pain of mental pots, showing further consideration for the
ill health is immeasurable. environment. You will find a wide variety
But the Old Moat isn’t just about recovery of vegetable and fruit plants and trees in
and restitution. It is a not for profit, but stock, and if you don’t fancy growing your
nonetheless commercial enterprise and own, you can buy seasonal, freshly picked
offers training in the real world of garden produce from The Old Moat shop.
centre work and management. Contract
gardening, park maintenance, conservation Find out more about the training The Old
work, stock growing, propagation, Moat offers. It’s a kind of down to earth
vegetable and fruit production, retailing and thing to do!
Contact The Old Moat to enquire about referrals or you can visit the garden centre anytime.
The Old Moat Garden Centre, Horton Lane, Epsom KT19 8PQ. T. 01372 731971 (office) or
01372 731970 (retail); email: oldmoatgardencentre@richmondfellowship.org.uk
Visit the Richmond Fellowship website to learn more about our work
http://www.richmondfellowship.org.uk
5. Getting
itthe BME
for
right
community
8
Helping people from black and “The key issues that prevent engagement of black people with services and vice versa.” 9
minority ethnic backgrounds people from African/Caribbean communities – and from
elsewhere such as Asian communities – accessing mental
Social risk factors impede engagement with the right health
and social care services as well. Poverty and homelessness
(BME), particularly refugees, health services,” says Lorraine “are stigma, racism and lack of (many refugees seeking asylum for instance are living destitute
to access mental health awareness and knowledge of mental ill health.”
Whilst some of the issues reflect those experienced by a
in the UK with no recourse to public funds); loneliness and
isolation or contact with the criminal justice system all put
services demands a special white community, such as stigma and even a lack of awareness people at risk. African Caribbean people for instance are more
understanding of how mental around what happens to you when you receive mental health
services, there is far less acceptance of the condition. Mental
likely to be held under a section of the Mental Health Act.
They are also over-represented in Special Hospitals, secure
health is perceived in countries health simply doesn’t translate properly in other languages
and attracts misconceptions of witchcraft and other negative
institutions, medium secure units and prisons.
For those who do get to see someone, there is hope and
like Africa. Lorraine is a attitudes linked with tradition. Put simply, a mental health enlightenment. However, services don’t always get it right:
community development worker problem translates as someone who has ‘lost it’. Mental illness
is associated with shame and stigma and a fear of being
there is evidence that BME patients are more likely to receive
medication rather than be offered talking therapies. As
who knows that building labelled, isolated or alienated by friends or family members. mentioned, compulsory admission to hospital is prevalent and
relationships is the first step to In addition, it is seen as a sign of failure or something to be
feared. And perhaps pertinently ‘madness’ is thought to be
families and carers have difficulties accessing help.
Lorraine and her colleagues believe the way forward is for
supporting this community. She incurable, unlike our view that people can recover from mental
ill health. It is not surprising then that language is the key
better working relationships with faith leaders to promote
inter-cultural understanding of race equality in mental health
explained some of the issues to contributing factor to misdiagnosis. and better involvement of communities in the planning and
Sanctuary... Lorraine also sees a circle of fear surrounding mental health.
“If you combine the different layers of fear – fear of mental
implementation of services from the outset.
In this way people will begin to benefit in a very real way
illness and fear of mental health services, you witness a vicious from being supported and cared for, and respected for their
circle,” she explains “A circle that impacts negatively on the culture and race rather than misunderstood and abandoned.
Contact the team:
Lorraine yates – CDw, african/Caribbean,
refugee & asylum seekers; 01483 459292, ext. 214
Charmaine Valler – CDw, gypsies & travellers;
01483 459292, ext. 235
kate Johnson – CDw, asian, Chinese & nepalese;
01483 459292, ext. 203
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