Barricades, Weapons and Hostages

my comment on blog post;
“Where I live in Fife, Scotland, the psychiatric staff have been in the habit of calling police officers into the acute wards to deal with matters that are far removed from “barricades, weapons and hostages”. In fact it seemed like the police were part of the NHS team, special agents in uniform, called in to restore order in the “asylum” or to bring back the escapees. I am hoping that this has changed since I raised complaints in February 2012, regarding different situations where police officers were getting too involved in mental health matters they had no training or expertise in.

I agree that often situations are “better led by health professionals appropriately trained and equipped”. And I’d like to see people with lived experience both participating in the training of psychiatric staff and in the creation of the training materials. Nothing about us without us. We’ve been at the sharp end of psychiatric treatment and some of us have always been resistant to the force used, not liking to swallow the psychiatric drugs/medication or diagnoses/labels. For many of us the anosognosia is in the minds of psychiatry and we are experts of our own experience.”

Mental Health Cop

barricade This last week has brought a number of queries about the role of the police in restoring or maintaining order on psychiatric wards where disturbances have occured.  This is a difficult and controversial subject because we have seen incidents on wards involving the police which have then become subject to protracted inquiries after deaths in police custody or following contact.  Olaseni LEWIS and Kingsley BURRELL-BROWN are just two examples of ongoing enquiries where criminal investigations are ongoing after tragic events.

So it is not unsurprising that learn that the police are becoming alive to the to the risks and sensitivities of intervening in medical settings where disturbances occur.  And yet, there is an inverted point to be made here about parity of esteem: the police are frequently called to intervene in Accident & Emergency departments, despite the presence of security staff there.  The police are often asked to intervene if disturbances…

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it’s a murky world of pharma funded “educational” events in Scotland’s mental health world

I’ve recently had high heid yins in mental health telling me that pharma funded events promoting new psychiatric drugs are purely “educational” as if they expect me to believe it.  Are they serious?  I’ve never believed in mental illness and never liked being forcibly treated in psychiatric settings.  Why would I swallow that nonsense?

If an event funded by a pharmaceutical company like Janssen (subsidiary of Johnson & Johnson, revenue of over $71 billion in 2013) is promoting a new drug like Xeplion (depot injection) then it is all about sales and profit, nothing to do with education.  Let’s be quite clear about it.

Who’s educating who?  The drug company promoting their latest psychiatric drug (eg Xeplion) is “educating” psychiatry and their cohorts into swallowing their silver tongued rhetoric, that this new magic bullet will do the trick.  The performers at the event are part of the pharma team despite their protestations of independence.

I’ve heard this “independence” mantra before, in relation to mental health advocacy.  Service providers getting away with winning tendering contracts for “independent” advocacy and managing statutory funded projects.  Taking away the work from historical, grassroots, local groups.  Colluding with the funders.  Silencing the critical voices.

Psychiatric drug prescribers, mental health voluntary sector organisations, clinical psychologists and any other mental health professionals should remain separate from big pharma.  It’s obvious.  Their patients, clients and service users are in the habit of being coerced, pressured and persuaded to take psychiatric drugs.  

Depot injections are the means by which the “non-compliant” are controlled and made to conform, despite their objections.  The side effects of these drugs and the long term chronicity are unpleasant and even deadly.  Ruling lives.  Shortening lives. 

I say to anyone in Scotland’s mental health world who wants to partner big pharma in promoting their latest drug that they should taste it and see.  Take the pill or the jag in the bum, and see what it feels like.  Then you will have earned the right to be at big pharma promotional events, masquerading as “educational”.

Go on.  I dare you.



conflict of interest and unethical? questioning the motives for supporting a pharma funded event

Here is my latest response sent to the SAMH Chief Executive in our dialogue regarding his participation in a Janssen sponsored event promoting Xeplion (followed by a screenshot of the actual Email):

Billy here is the blog post link of our Email exchanges thus far:
http://chrysmuirheadwrites.blogspot.co.uk/2014/03/email-exchanges-with-billy-watson-samh.html

I accept your statement that you did not benefit financially however I’m not convinced that you have responded to my statement regarding your participation in a pharma sponsored event promoting a new drug being a conflict of interest and unethical.  SAMH has a history of working with service users and survivors, of mental illness and psychiatric treatment.  Your projects support vulnerable people with mental health issues, including people bereaved by suicide.  I am trying to understand your motives for supporting a pharma funded event.  Side effects of pharma drugs are known to include suicidal ideation. 

Here is a Mad in America blog post by Maria Bradshaw who lost her only child to SSRI induced suicide in 2008, entitled ‘No More Tears? The Shame of Johnson & Johnson’:
http://www.madinamerica.com/2014/01/tears-shame-johnson-johnson/

Opening paragraph of Maria’s post:
“In 1972, prisoners at Holmesburg Prison in Philadelphia were paid $3 to have their eyes held open with clamps and hooks while Johnson & Johnson’s baby shampoo was dropped into them. In 2011, mothers of newborns were arrested when their babies tested positive for exposure to cannabis, a false result caused by the use of Johnson & Johnson’s Head-to-Toe Foaming Baby Wash. Young men have undergone mastectomies to remove breasts grown as a result of Johnson & Johnson antipsychotics, which were used as a result of Johnson & Johnson’s criminal promotion of its drugs for off-label purposes.”

I look forward to hearing your explanation,

Chrys

[Johnson & Johnson is the parent company of Janssen with a revenue in excess of $71 billion in 2013]

 

 SAMH_Stress_Balls

SAMH stress balls

Delirium Screening

Peter Gordon @PeterDLROW:
“A recent correspondent asked that I submit my considerations for peer review in formal academic journal. It is my view that those behind improvement work on delirium in Scotland need to do this first and I am of the view that this might be an important element of improvement work before policy recommendations are embarked upon. The Clinical Standards, on which screening recommendations for delirium have been based, are 12 years old. The involvement of Healthcare Improvement Scotland in pilot work, as guided by the Scottish Delirium Association is most welcome. The limitations of other avenues of communication about this improvement work have been pointed out to me. Yet we must acknowledge that OPAC, HIS and SDA are using other avenues extensively (tweets, blogs and videos), thereby inviting responses.”

Hole Ousia

Some people have asked me to try and summarise my considerations on delirium assessment. In what follows I will also try and outline an alternative approach to the one currently being recommended across Scotland following Older People in Acute Care (OPAC) Inspection visits.

1. DETECTION: If I understand I have been asked the entirely understandable question as to what approach I would advocate for detection of delirium if we were to depart from the Healthcare Improvement Scotland (HIS) mandate to screen all those 65 or over for “cognitive impairment”. Here, I shall try to make clear that my principle concern is with screening rather than with the brief rating scales themselves. These scales have a place, even if not yet fully validated. However, in my view, and that of NICE, they should be used for further clarification, and on-going assessment of those who are determined by professional nursing and…

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It’s time we talked about ‘dementia friendly communities’

shibley @legalaware :
“I’ve thought long and hard about the need to try not to dismiss worthy initiatives in dementia policy. For example, whilst I am concerned about the error rates of ‘false diagnosis’ of people with dementia, I would be equally concerned if NHS England did nothing to try to identify who the undiagnosed with dementia currently are.

Likewise, my natural instinct is to think about whether the charity sector is distorted with initiatives such as ‘Dementia Friends’. According to the Government’s website, by 2015, 1 million people will become Dementia Friends. The £2.4 million programme is funded by the Social Fund and the Department of Health. The scheme has been launched in England, and the Alzheimer’s Society is hoping to extend it to the rest of the UK soon. And that linking the global policy of dementia friendliness to one charity, when other similar initiatives exist (such as the Purple Angels, Joseph Rowntree Foundation, University of Stirling, WHO, and RSA) and may get unfairly ‘squeezed’.”

One and the same

“let me dispel a myth. It has been argued that for case-finding one has already “symptoms” but with screening generally one does not. This is a false divide. Symptoms are not all or nothing and may or may not be experienced. Dr Wilson and Jungner made no distinction here and the World Health Organisation agreed.

Screening and case-finding are one and the same thing.”

Hole Ousia

In this short film I will explain to you why I have come to understand that case-finding and screening are actually one and the same.

One and the same from omphalos on Vimeo.

All around us national clinical leads and disease champions argue that early detection policies are exercises in ethical case-finding. They insist that such policies are not screening. This is important because criteria have been set for the introduction of any national “screening” programme. It appears that by calling any programme “case-finding”, these criteria can be ignored.

In this film I will briefly look at the historical development of case-finding and screening. This provides clear evidence that these terms have been consistently used one and the same. This film will argue, along with Dr James Maxwell Glover Wilson, that the ten principles that are considered necessary by the World Health Organisation for screening, should also apply…

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‘Overcoming challenges in schizophrenia – a Scottish perspective’, Janssen sponsored event September 2013

I was concerned to see this poster advertising a “meeting” ‘Overcoming challenges in schizophrenia – a Scottish perspective’ on 6 September 2013, in Stirling, with “speakers and catering sponsorship provided by Janssen” and advertising the psychotropic drug Xeplion (paliperidone):

 

 Dr David Hall, NHS Dumfries & Galloway Consultant Psychiatrist and Clinical Director, lead for the Scottish Patient Safety Programme in Mental Health, chaired the programme and speakers included Billy Watson, SAMH Chief Executive, and Dr Mark Taylor, Consultant Psychiatrist, NHS Lothian.

 Here’s what Wikipedia says about paliperidone (Xeplion):

Paliperidone palmitate (trade name Invega Sustenna, named Xeplion in Europe) is a long-acting injectable formulation of paliperidone palmitoyl ester indicated for once-monthly injection after an initial titration period. Paliperidone is used to treat mania and at lower doses as maintenance for bipolar disorder. It is also used for schizophrenia and schizoaffective disorder.

Netdoctor.co.uk says that the Xeplion injection “helps to control schizophrenia“.  

 And if the person who has the label doesn’t believe they have schizophrenia?  Then they can be declared to be “without capacity” and be compelled to take the drugs, said to have anosognosia, a lack of insight.  Fortunately I wasn’t on a CTO and had the power to taper my drugs and make a complete recovery in 2004.  

 Others in my family haven’t been so fortunate when labelled with schizophrenia and submitted to being injected [remembering my mother’s 3 weekly depixol injection – 25 years of having to pull her pants down]

 In September 2013 I was heavily involved, voluntarily, in organising the Scottish Crisis & Acute Care Network conference ‘Improving Pathways‘, of which Dr Hall is the co-chair.  Getting the venue sorted, the programme, the workshops, involving people with lived experience, preparing my presentation and workshop materials.  [see blog post of my talk]

 I am very unhappy to think that at this time I was, and still am, an unpaid carer on £59/week, picking up the pieces after traumatic dehumanising psychiatric treatment.  [I helped support my son to taper the drug haliperidol which was forced upon him in Feb12 and he got drug free within 6 months]  While Dr Hall, Billy Watson and others were busy working inpartnership with the big pharma company Janssen-Cilag, a subsidiary of Johnson & Johnson which has annual revenue of over $71 billion.

Drugs are not the answer to human distress, trauma and emotional pain.  They might give temporary relief but in the longer term they are fraught with difficulties, causing chronicity, physical health issues and shortened life spans.  Risperidone, developed by Janssen, caused me to be clinically depressed then the venlafaxine prescribed gave me suicidal impulses, bone loss.  

If I hadn’t taken control of my own mental health, in 2003, then I could have ended up coercively treated in the community with Xeplion for schizoaffective disorder.  A label that was unhelpful and inaccurate.  The drugs didn’t work for me and I’m not the only one.  See the new website The Council for Evidence-Based Psychiatry and the video Imagetestimonies from survivors, of the effects of, and the recovery from, psychiatric drugs and disorder labels.