Dr Louise Newson [00:00:02] Hello. I'm Dr Louise Newson, and welcome to my podcast. I'm a GP menopause specialist and founder of the free balance app. My mission: to break the taboos around women's health and hormones, shining a light on the issues we've been too afraid to talk about, from contraception, sex and testosterone to menopause related addictions and beyond. We're covering it all. I'll also be joined by experts and inspiring guests, sharing insights and real stories, as well as answering your questions and tackling the topics that matter to you the most.      

Dr Louise Newson [00:00:42] Today on my podcast, I've had Ben West, who's a mental health campaigner and author. He's got an amazing story, very sad. He lost his brother by suicide when he was only a teenager. And we talk a lot about mental health, of course, mental health and hormones, but in general, how we can help improve how people are feeling and open up the conversation more to hopefully reduce more deaths by suicide. So, it's a great listen.

Dr Louise Newson [00:01:13] So, Ben, thanks ever so much for coming to my lovely studio that you've already complimented me on, which is great.  

Ben West [00:01:19] It’s lovely in here, so calming.  

Dr Louise Newson [00:01:22] I know, well, you know, life's really hectic, and I just wanted somewhere calm and comfortable. But I'm really excited that you're here. You've got a story which is sad for lots of reasons, we'll obviously talk about it, and most people, thankfully, haven't had your experience, but most of us have had bereavements that have affected us in different ways. You probably know bits about my work, and hormones have a massive role in our brains and mental health and hormones, mental health is something that I am so passionate about. Obviously, the brain is the most important organ of our body. I don't need to tell you that, but mental health means different things to different people. Lots of people have a bad day and say they're really depressed. Most people who are really depressed actually don't talk about it, and those that do don't know where to get help. So, tell me a bit about just your story first, if that's okay.

Ben West [00:02:16] Yeah, absolutely. So firstly, the fact that I am sitting in a podcast studio talking about mental health is not something I ever imagined my life turning into, when I was growing up my plan was to join the armed forces and go into the Army Air Corps, and I was 100% set on that path. I grew up in Kent. We were quite a rural community in Kent. I grew up with two brothers, a dog, both parents that were together. In a lovely, lovely part of the world and had just the most amazing childhood. And I had my vision. I had that path. It was sort of forming in front of me. And then in September 2017 my younger brother Sam was diagnosed with clinical depression, and I'd never heard of what that was  

Dr Louise Newson [00:03:06] And how old were you then?

Ben West [00:03:07] I was 17. And I remember this so clearly. We were having dinner in September, and we finished dinner, my mum was just like, oh, Ben, can I chat to you for a second? And she said, Sam's been diagnosed with clinical depression. And I just sort of sat there and went... alright. Can I go. Can I go now? I didn’t know what that was, and I'm I just thought, what does that… How can you be diagnosed with, feeling sad? That doesn’t make sense... So, I just sort of left and never, never thought about it again, really. And then in January 2018, it was a Sunday evening. I was packing my bag ready for school the next day, and my mum found Sam had taken his own life, and all I heard was just the most horrific screaming. And then went to see what was going on and came across the most catastrophic event you could possibly imagine, and my whole world very quickly unravelled in front of me, at just 17 years old, and here I am now.  

Ben West [00:04:16] It's been seven years. I'm not in the Armed Forces. I have changed what I am doing in life. I feel a very, very strong sense of purpose, and I have done every day for the last seven years that I don't want any other person to ever feel the same way that Sam did, and not have somewhere to go and someone to show them that there are other options. Because Sam had other options. And unfortunately, his disease stopped him from seeing that. And I'm very, very passionate now at trying to create that change in society and in individuals, so that more people get those options that Sam didn't see. So this is my full time job now, and I absolutely love it, and it brings me such an enormous sense of purpose, and it is really, really an honour to do things like this and have the conversations with people like you that are also doing fantastic work and being part of something really positive out of something that was just so catastrophically negative. It feels good, really good.

Dr Louise Newson [00:05:16] It's so important. You know, when something negative happens, I think you really have two choices. You can crumble, you can be identified by that, and it can ruin your life. Of course, it's going to affect your life and change your journey like it has for you, but you can then turn it into something in your belly that really wants to make a difference, but it's hard for many reasons, and we'll talk about a few of them, but one of them is being young. I think being young and having a mental health illness, absolutely, really hard, but being young and having a bereavement is a whole new level. I don't know how much support you had. But, you know, I'm sure a lot of focus was on your mum and your parents, but for you and your brother, like, that's so important.  

Ben West [00:06:03] Yeah, it was, I mean, I guess I was very lucky in a way, in a sense that I was still at school when Sam died, so immediately, you know, it wasn't a sense that I could isolate myself. I had to go to school, the school had a safeguarding responsibility on me, so I was sort of forced into a quite in-depth network of support. And it wasn't, it wasn't an option for me so be isolated in that, my family were obviously great and really came together and sort of found a way of supporting each other. The school tried their best in a difficult situation and did put on quite a lot of support for me, but you're right. I mean, bad things happening to young people, it's, it's, really sad. I mean, at 17 years old, I didn't expect to have to deal with death.  

Dr Louise Newson [00:06:49] No

Ben West [00:06:50] Certainly not. You know, with Sam, who was 15, I lost a dog before. That was my sort of, and that's incredibly sad, but, you know,

Dr Louise Newson [00:06:48] a whole new level, isn't it?  

Ben West [00:06:59] Whole new level, because it's so unexpected. You know, these people are people you expect to spend to have the rest of your life with.

Dr Louise Newson [00:07:06] yeah, for sure

Ben West [00:07:07] You know Sam, like best man, weddings, drinks, like starting a new job, him going to university, all these things. So, you're not just losing a person. You're losing all of those memories that you’d played out in your head about the things that you’ll do in life. And suddenly that's never going to happen that is absolutely devastating. And at 17, your brain is rewiring, you’ve got a lot of stuff going on, just biologically anyway, and then to throw in trauma and grief, it really is a difficult experience, and probably not one that I gave myself enough time in the moment to realise. I think I was very, I'm a very practical person, and so I sort of went bad thing. What's the solution? I'm going to do this, practical solve it. And what I've learned through therapy and talking to professionals is actually, you know, when it comes to grief and trauma, it's stepping back from trying to find a solution, sort of allowing yourself to just go that was really bad, and that's how you sort of heal from those moments. And took me a long time to be able to do that, and also be able to be comfortable, sort of letting go of some of the guilt, from suicide, which is obviously you know guilt people that grief brings up feelings of guilt for almost everyone that goes through it, but particularly around suicide, there can be a huge burden of what did I do wrong, what could I have done differently. And in my case, that night, we had had an argument, so there was a huge amount of guilt that I felt. That that was what triggered that event that night, obviously that’s not how it works, and I know that now

Dr Louise Newson [00:08:43] But it's still… My husband, his best friend from school was a junior doctor, actually, and he was a very high or low person. And one night, Paul, my husband, said, I need to go and see Paul dot. This other Paul. I said, why? Why now? Like, we're in Manchester, he's in Devon. Why? No something's wrong, something's wrong. And he was really agitated, and this was a long time ago. We had no phones; we had no internet. You couldn't just like snap and see where his location was. Anyway, the next morning, we got a phone call to say that he'd been found in a hotel room and had taken his life, and Paul for even now, he feels really guilty, like, what if I'd gone down? Could I? And he could have probably stopped it that day. I'm sure he could have done, but I don't think he would have stopped the event, and it took him many years to stop feeling quite as guilty. It has such an effect on people.

Ben West [00:09:36] A massive effect on everyone. I mean, it's devastating. I will never fully recover from it. I mean, it's a trauma that will just, stay with me for the rest of my life. And also, you know, naturally, I know, I've come into contact with a lot of people that were bereaved by suicide and recently bereaved with suicide, and one of the first things I say to people when I do talk to them is, you know, your brain will try and rationalise this, but the suicidal brain is working in a completely irrational way. You know, you get cognitive constriction where you are essentially just creating this tunnel in your brain that only sees one final result, and there is no way that a rational brain can understand what that's like. And that's very, very difficult for me. I guess, from my point of view, when I've looked back at those feelings of guilt, you start to realise that me blaming myself was an easy option, because that makes sense. Oh, I did this? That resulted in this, and that's why he's died. It's so much more easy to understand than he had an illness I don't understand. There was something going on in his brain that I don't understand, and he decided to do this all of us I don't understand. So, you start to realise actually you're rationalising that situation by saying, ‘Oh, it must have just been something I did,’ which is much easier to then direct anger and sadness at than, this was an illness, and it's really, very, very difficult to understand.

Dr Louise Newson [00:10:58] Absolutely, and you know, I did a lot of psychiatry. I trained in Manchester, the psychiatry training I had actually was really good, but it was at around the time just before Prozac, so which is interesting, because we did a lot of training about just looking at this individual, the circumstances, looking at psychotherapy, looking at psychology, looking at exercise, looking at nutrition. And then Prozac came out, and it was around the time I was because I did hospital medicine first, then went into being a GP, and it really was this wonder drug. And people would come in ten minute consultations like, oh, I can give you this tablet, tablet, tablet, warning people they might get worse before they get better, like if they're bad, you don't want them to be worse, and not really, because they didn't give them any support, because in the NHS, there was less support, even now there's even less. So, we're medicalising something very quickly, and now with the work that I do, I do a lot, I see so many women who have been sectioned. They've been under psychiatrists. Obviously, no one's thought about their hormones, but the role of everything else other than just a medication is crucially important, isn't it?  

Ben West [00:12:10] Oh, you're so, so, so, right. And this is one of the frustrations I have with how we talk and treat mental health now, is it seems like we've completely forgotten about the biopsychosocial model of health and illness, and so essentially, what that means is we have those three categories to health, so we have biological health, psychological health and social health, and actually all of those things determine your mental health. And at the moment, if you're struggling with your mental health, you might go to a primary care professional, you might get diagnosed with depression, and then you might receive an SSRI or antidepressant, and then receive talking therapy. But that's just targeting psychological health, but you've got these two other things, your biology, your biological health, your social health, your relationships, your socio-economic environment, all these other things that feed into your mental health. And it does feel like, for a lot of people, we make them feel broken and unwell, but actually, in reality, they've got all this other stuff that's going on that’s not really looked at. And you're right, I think we need, we can't just treat an individual as this is one area of your health that we're going to target and make better, when actually it's very commonly a combination of all three of those things that just aren’t looked at.

Dr Louise Newson [00:13:28] It absolutely is. And, you know, the medicine is really siloed, which doesn't help. And then, you know, I was reading recently about the history of asylums and psychiatric hospitals. And psychiatric hospitals used to have really big grounds, as you know, they used to do, you know, they have swimming pools. They do all this exercise, and then suddenly they realised they could put loads of consulting rooms in. So, they'd cover the swimming pools, they'd put in loads of consulting rooms. Bang, bang, bang, bang, here you go. They could get through loads of people and medicalise. And I'm not saying medicine hasn't got a role. I've managed and treated lots of people with antidepressants, but it's not the only thing. And then, now there's so many people that are addicted to antidepressants that they are they do have side effects, they can have risks, but it's got to be looking more than that, and it's hard, it's really hard for any of us to take responsibility for our health, and it's really difficult when people are feeling low and down, because the last thing you want to do is exercise, the last thing you want to do is cook a really healthy meal. The last thing you want to do is socialise. But this is where awareness is so important. The work you're doing is incredibly important, it's the silent people, the people that are withdrawn, the people that hide it, I think are the ones that worry me the most. I don't know if that's what you're sort of experiencing with the work that you're doing.

Ben West [00:14:47] Oh, yeah, absolutely. I mean, obviously depression can be experienced in different ways. You've got mild, moderate and severe. I know that when Sam was at his most severe, it was a case of, there was nothing that could have got him out of his room. And you know, in my work as well, I'm a crisis volunteer, so I do a lot of work with people that are very at the very severe end of problems and issues. And, you know, sometimes it's a case of, you know, a very, very big step for them is opening the curtains. I mean, that's a big step for some people. So, the depths that you can go into that illness is just unimaginable for someone that hasn't experienced that. And I think that just goes to show why it's so important that we do treat this differently. You know, it's there's a lot of sort of catchphrases around mental health at the moment. You know, everyone needs to talk more, and there's no health without mental health. And it's all true, but it's like, actually, in real terms, what do we need to do differently? And that's what really interests me. I'm, you know, I went to Uni and did engineering, so I'm sort of, I like, said before and this podcast, I’m a practical person, I like practical solutions. I'm not into catchphrases. I want to get stuff done. And so, what on a policy level, in the NHS, or in the healthcare level, what can we be doing differently? Assesses that need better in an education environment, what can we do? Doing differently in schools is going to improve access to care pathways. And so, I'm really interested in actually, what are we doing, what can we be doing differently, rather than just, what can we be saying differently?  

Dr Louise Newson [00:16:23] Yeah, and you're absolutely right. And I think that's forgotten, because often, especially in psychiatry, the way of the DSM [Diagnostic and Statistical Manual of Mental Disorders] criteria is you have this diagnosis, it's this treatment pathway, and it's about treatment, about medication. And like my father died when I was nine, and I was a long time ago, so I didn't have any support at school, and when the other children were being told I was sent out, and I was like, my job was to give the headmaster a note. And I thought, well, that's really important. I've obviously like, Aren't I good? I was only nine, and when I go to the headmaster, ‘I'm very sorry about your father’, And then my friends tell me afterwards, that was when it was announced to school. But no one would talk, you know, in the class about it, and I was really cross. And there were still times that I am still really cross, the way it was handled, but when you really miss someone, or when something awful has happened at work or something, there are times where you just think, do you know what? I just can't be doing this anymore. Now, I'm not clinically depressed. I don't need medication, but what I do need is somebody I can really trust, but then do I really want to tell my husband or my children? Because, no, because they they're really close, and they'd worry about me. So how do I? You know what I mean

Dr Louise Newson [00:17:29] And it's really important that people are not labelled and they're really treated in a very individual way, because that's the worry that I have, because people are literally, of gosh, if I say that, it's going to be on my medical record, so I've got a psychiatric illness, and I'll never get life insurance, and I'll never be able to get a job. Actually, all I just want is someone to talk to you on one day, because I'm really, really sad about something, and that's where I think so much there's a lot of shame and stigma. You know, if I had a rash down my arm, I'd show you Ben, and you'd go, oh, that looks really sore, are you okay? But if I tell you last night, I was feeling really low, like, how do I tell you, you're a stranger, you're not gonna, you know, it's and I think this is, I mean, it's getting harder, because we've all we read is that one in 10 people are on antidepressants. One in 100 have schizophrenia like, so what like, what are these stats we're showing? We know that mental health is worse. That's because we're labelling it more. But what are we actually doing? How are we changing it and we are we just normalising it? Are we just medicalising people? But it's the way we talk about is so important. And all these young people that are given hormonal blocking treatments, you know, the lot of the synthetic hormones just block our natural hormones. You know, your brother will have had some hormones flying around in his body, who sat down then and really spoke to him. You are not going to feel like this forever. You might feel like this for a bit. You know, it's, it's those, because it's enormous when you've got those feelings, isn't it?

Ben West [00:18:58] It is, oh, that was so perfect. And I wish more than anything, that Sam could have sat there and listened to that, because it's so so true and it's so heartbreakingly sad that so many people think of their, when they're in that low moment, that that is fixed and that's never going to change. And it is so, so, so normal for all of us to experience symptoms of depression at some point. You know, I completely reject this idea that one in four people will experience symptoms of a mental illness. And I think it's four and four everyone feels sad, everyone experiences poor mental health, and we've had, all of us have had days where we sit there and we have no motivation to do anything, and we feel awful and we feel dreadful, and we know that that passes. And even, even on the extreme end, suicidal thoughts, and suicidal actions, these are so, so common. One in five people will have suicidal thoughts. One in five  

Dr Louise Newson [00:19:55] It’s huge, isn't it?  

Ben West [00:19:56] Which is huge. So what that tells me is that it's not something to be scared of…

Dr Louise Newson [00:20:00] No or ashamed of.

Ben West [00:20:02] Or ashamed of, I think there's this real stigma that goes along with thinking about suicide and feeling sad that goes, something must be really wrong. And to a certain extent, we all have those thoughts, whether it be on the right path or what life has in store, and whether it's worth it, and it's very, very normal. And to your point as well, what I really like about your work and what you highlight here as well is that a lot of people sit there and receive a diagnosis and go through therapy and feel sad and think that they've done something wrong or they are inherently weak or broken, when actually it can be caused by something that is completely out of your control. It can be a medication you've been put on, that's affecting the chemical chemicals in your brain and hormones. It can be your diet, it can be your environment, it can be stress, it can be work, all these things that have nothing to do with your personality and yourself. And I think that's what I'd love to go back to Sam and say, is like you are not the problem, you are not the problem. And if we think back to that biopsychosocial model in mental health, you know, just because you're feeling bad does not mean that you have done something wrong or done something to deserve the way you're feeling. And in fact, actually, it's usually the opposite. And there are factors that are influencing how you feel, and if you can identify those and change those. There's no reason why you can't live a very, very happy, healthy life, which is achievable, I think, for almost everyone that goes through things.

Dr Louise Newson [00:21:36] I think so, I think it's being strong of mind as well. One of the things a while ago, when I was really feeling awful, someone said to me, Louise, you not being kind to yourself. You've got this inner thing that you're almost torturing yourself, and you're you've suppressed your emotions for so long and it is actually thinking, no, I've got to put myself first. I've got to, like, be kind, but, but kind in a way that you can respect those emotions and understand them and not ignore them. You know, like, yes, I don't want to open the curtains this morning, but you know what I'm going to because the sun might be out there and then. And its sort of, it's that way of thinking, because things can be very catastrophic very quickly. But it's also, you know, anyone that's listening to this thinking about, are there other reasons? And it's often more than one reason. So, you know, mental health and hormones are very closely associated, but often there's something else, maybe a poor relationship or diet or not exercising. You know, it's not usually one thing, and therefore there's not just one treatment as well, but it is. You know, as a doctor, I feel very responsible trying to make the right diagnosis and asking the right questions is really important. So as an example, I saw someone in my clinic about a year ago. Someone phoned me up and said, like my best friends, brothers, sisters, cousins, whatever, wife is really, really struggling, as I say, well, that's fine. Tell me a bit more. Well, we're really worried that she's going to harm herself. So, I said, okay, I'll see them. So, I spoke to her the next day, She's in her mid-40s, fit and well, no problems at all, so, I said, ‘Do you feel like this every day?’ She said, ‘No, not every day, but some days I do.’ I said, ‘Well, what stopped you from doing it?’ ‘Oh, because I can hear my children playing in the garden,’ and think that's really not. So, she's got insight, which is great. So, then I said, ‘But, but anything about you still getting your period?’ She said, ‘Yes.’ I said, ‘So do you get symptoms on any is it any correlation with your periods?’ ‘Oh, yeah.’ She said, ‘just before my periods come, that's when I feel so low, and then my period comes and I feel fine again, apart from my dreading my next period coming because I know it's going to happen.’ So, she's made her diagnosis. All she needed was some hormones to just balance natural hormones, not contraception, on those few days. And she's become perimenopausal, so now she's absolutely fine, very simple, but very scary. But it's also very scary to talk to people with mental illness, because you think, oh, if I mention that, then they might actually do it. They're less likely to do it, actually, if you can talk about it. So, I think you know ways that we can talk about it, ways that we can be open. And I know you're doing amazing work with Shout! as well, and your book here, this book could save your life. Well, not just yours, but anyone's really. So, talking about it, acknowledging it, but talking to others, recognising others is, is just crucially important. So it's just great that you're talking here on a hormone podcast. Who'd have thought, it's brilliant. So you've done your ultra marathon? I'm feeling very like, I've done some yoga this morning, but I'm not sure if that's anything compared to an ultra-marathon, but it's amazing, great achievement.  

Ben West [00:24:45] Thank you, well, I think it's, you know, it's something I feel so passionate about, is trying to really, you know, move this forward and get more people talking about it and really, and raise money and do these challenges. And I've just run of my first ultra marathon on Sunday. I'm feeling very sore. It's quite nice to sit down on a very comfy chair and it's, it's lovely to be able to do something like this. And I just think it's so important to have conversations like this, because it's really important that we're not just talking about mental health, we're talking about the specifics and treating and I think we can just talk about mental health and sort of turn the page and go, well, that was a good conversation, but actually talking about what we've been talking about, which is treating the individual, asking questions, not just not just treating a diagnosis, but treating a person as a holistic individual, treating their, you know, talking about relationships, talking about their biology, talking about their psychology. And it's really interesting as well, how, when you look at some of the research in terms of how men and women deal with certain issues, those individual factors start playing out. And I know there's, there's some research that suggests that women can be much more internal with their response to stress. So when something happens, you can, you can sort of internalise those feelings, much sort of negative opinions and thoughts about yourself and things like that. Whereas men can be more likely to externalize things, and we can see that in aggression and things like that. It's really interesting, when you think about things like that that go actually, there are not many issues, not many social issues that you can't tie back to mental health in some way. And so particularly with men and some of the problems we're seeing in society. You know, I'm really passionate about, I was in a school just a couple weeks ago with a group of group of boys in an all-boys school, and it's, it's so nice to be able to talk about these things and go, you know, what's really important, is feeling angry is one of the most important things, because the only time that emotions become a problem is when you stop them from coming out. And the reason that we suddenly feel these really intense moments of rage is because we've bottled up all this anger. And we've got a whole generation of men that have sort of grown up not being able to express emotions. And one of the key ones there is anger amongst a lot of others. And so, you know, being able to be angry in a healthy way is so, so important.

Dr Louise Newson [00:27:04] I’ve gunna to tell my husband that!

Ben West [00:27:07] You know, yeah, so when I do this with running, it's a great way of doing that. So sometimes I'll just go for a run, and I will find a hill, and I will just sprint as hard as I can up the hill, and I'll just be so angry and divert all my anger into that or, you know, go and kick a football as hard as I can into a goal and probably miss, or, like, shout into a pillow and finding ways to express that anger, is so important. And that's not a difficult thing to do in your day to day, but it's the fact that we're not told that growing up, I was never told that I've had to learn myself and learn that from professionals and read research, which obviously I wouldn't have done unless I was interested in this sort of thing. So that's what makes me really passionate about actually, how do we change the curriculum in schools? How do we change the environment in schools so that we we sort of put a bit more onus on learning about ourselves and our brains? I mean, you mentioned it, right at the start of this podcast, the brain is probably the most, or certainly the most important organ in the body. Why on earth, do we not learn more about how it works?

Dr Louise Newson [00:28:08] It's so important.

Ben West [00:28:10] and how to keep it healthy and happy

Dr Louise Newson [00:28:12] Yeah, so important, so much we need to talk about. So much we need to change. Really need to change now, not in 10 years, 20 years’ time, but now. So, before I end, three take home tips. So three things, if people are listening, and there will be people listening, thinking, do you know what? That's me, and I don't know how to get help. I don't know what to do. I've gone to my doctor. I've got antidepressants. I'm still feeling low, or I think it might be my friend that's feeling like that. What are the three things that they should do, or they should do with their friends?

Ben West [00:28:42] It’s a Good question. If it's you that's struggling, the first thing I would say is, I know it's a really difficult thing to for me to say, because it feels a bit patronising. But just have a little bit of sympathy on yourself. I think there's a real pressure to sort things and feel like you have to have everything sorted and that you've done something wrong and or you're not strong enough to get through something. And I just think having a little bit of sympathy for what you're going through is really important, not blaming yourself and sort of creating an environment where you can be supportive and of yourself is really important, if things aren't working. You know, I think what's really important is to be demanding, if your inner care, if you're you have a care team. If you're in touch with professionals and doctors and you have a care team, whatever that looks like, or if you don't, you know, ask for what you need. I think people have this idea that you know you sort of accept what you're given and be quiet. But actually you know whether it's whether you're at school or university and you're getting treatment, or you're in the NHS or private and you're not getting what you need, then don't just accept what people give you, just challenge that, and you know that that you're well within your rights to say this isn't working. This is how I feel, and I think this is something I only need, or this is why I'd like to focus on and look at now, I know that's a really difficult thing to do, but don't feel like you're putting anyone out by doing that.  

Ben West [00:30:08] If you're worried about someone else, the first thing I say is, there's nothing you can say is going to make someone more likely to take their own life. Talking about suicide categorically, categorically, doesn't make people take their own life or cause more harm. There is reams of research that can show you that asking someone about suicide isn't going to put thoughts in their head. It is not going to make them suddenly go, oh that's a good idea. It just doesn't happen. So, asking straight up is really, really important. I've asked that question now, so many times in my job, and I promise you, there is no, there is no such thing as a bad answer to that question, because if the answer to that question is no, I'm not, that's great. If the answer to that question is yes, amazing. We know what we're dealing with, and we can sort out a plan together. So asking and sort of talking about these things head on is really, really important. And like you said, finding the environment. So going for a drive where you're not looking at the person going for, I love going for a walk. I try and avoid environments where you're talking to someone face to face, like we're doing now because it’s intimidating right, if you’re talking about difficult things, but asking is really important, and try and working out what you want to say before so you're not just making it up on the spot can be helpful to sort of find the words, because it's a difficult conversation to have, but always err on the side of caution and ask those questions. People don't get offended because you've asked, they know that you're doing it because you care, and you're certainly not going to make people more likely to come into harm by asking questions. So those are what I'd say to those people.

Dr Louise Newson [00:31:42] Brilliant, great advice. And really, thank you for your time and thanks for all the work you're doing. It's really good. Thank you.  

Ben West [00:31:48] Thank you so much. Great to be here.