Window Tax by Peter J Gordon, 2012, Mental Health and Social Inclusion

thanks to @PeterDLROW for spot-on blog post.  Unfortunately stigma is alive and kicking for my family.

“The term stigma refers to a mark that denotes a shameful quality in the individual so marked. Mental illness is widely considered to be such a quality. Goffman (1963), in his classic formulation, defines stigma as ‘an attribute that is deeply discrediting’ and proposes that the stigmatized person is reduced ‘from a whole and usual person to a tainted, discounted one’. In Goffman’s view, stigma occurs as a discrepancy between ‘virtual social identity’ (how a person is characterized by society) and ‘actual social identity’ (the attributes really possessed by a person).”

Hole Ousia

Peter J. Gordon, (2012),”Window tax“, Mental Health and Social Inclusion, Vol. 16 Iss: 4 pp. 181 – 187

http://dx.doi.org/10.1108/20428301211281032

Purpose of paper: The purpose of this paper is to discuss concerns that, despite recent campaigns, stigma has not been fully addressed by the psychiatric profession and that evidence suggests it may have unwittingly contributed to iatrogenic stigma.

Approach: The writer of this paper is a psychiatrist and considers the subject of stigma by employing the metaphor of bricked up windows. Arguments are supported through the evaluation of scientific research in addition to ideas from philosophy and literature.

Findings: This paper highlights areas of ongoing stigma and also identifies possible explanations for this in the current approach of the psychiatric profession.

Practical implications: It is hoped that this paper stimulates further discussion particularly within the psychiatric profession about our approach to tackling stigma.

Originality of paper: 

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A Little Knowledge Is Dangerous by @MentalHealthCop

another great blog post from @MentalHealthCop

“Whenever I do talks to groups of police officers about this interface with mental health, I often ask, “What is it that really annoys or frustrates you in how our mental health system or our NHS works?” and you always get a flood of answers. It will usually include something about section 136 facilities; having to wait around for hours; being asked to do things which are, properly considered, health responsibilities and lots more besides. I don’t ask the question because I particularly care about the answers – I ask it in order to set up another question: “What is that you think really annoys of frustrates our colleagues in mental health about police officers and the police service?”

This question is ALWAYS greeted with total silence.”

Mental Health Cop

e=mc2Mental health has been creeping up the agenda in policing for some while now.  I will confess to mixed feelings about this progress and I imagine that might surprise you.  On the one hand, I’ve spent years banging on about mental health in the hope of its importance being recognised and slowly but surely, it is.  I really think we’re on the verge of getting somewhere with this.  However, I’m also concerned about a trend over the last year or so, in particular – this trend arises partly from the fact that the police are having to manage remaining resources ever more closely as they become scarce; it also arises from that old adage that ‘a little knowledge is a dangerous thing’.  The next part of that phrase is “A little want of knowledge is also a dangerous thing.” As more officers are told to undertake work on mental health, I…

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Life After Darkness: NMD Ninewells “recovery” story then suicidal depression recurring taking “much longer to get better from”

On 7 June 2014 I was researching the book by Cathy Wield in 2005 on her recovery from depression following NMD/brain surgery for mental illness at Ninewells Hospital, Dundee, with the Advanced Interventions Service when I came upon a recent article in the Baptist Times, from January 2013, by the same person, telling of the suicidal depression returning and it taking “much longer to get better from this bout”.

I immediately sent an Email to Prof Keith Matthews head of the Advanced Interventions Service, copied to his colleague Dr David Christmas, with the subject heading ‘Cathy Wield – neurosurgery for mental disorder then another severe suicidal depression taking “much longer to get better from”‘ concluding with:

“I am interested to hear your comments on the fact that Cathy Wield underwent serious brain surgery, irreversible and risky, only to again experience suicidal depression, hospitalisation and repeat ECT.”

  As yet I have had no response.

 Life After Darkness: A Doctor’s Journey Through Severe Depression’ by Cathy Wield, foreword by Keith Matthews, Professor of Psychiatry and Head of Advanced Interventions Service/Neurosurgery for Mental Disorder Service, University of Dundee.

Publication date 31 December 2005:  lifeafterdarkness

‘My life journey took me through a single, but continuous seven year episode. It was a terrible nightmare of torture and imprisonment. I am one of the fortunate ones to have survived and recovered. I hope through my story, I will be able to bring to you some insights into this kind of suffering and I hope that the stigma which is attached to mental illness will lessen as a result.’ The remarkable and moving story of a doctor and mother of four who endured seven years of severe depression. 

Years of self-harm, attempted suicides and admissions to psychiatric units culminated in her resorting to brain surgery as a final attempt to escape her illness. The story of Cathy Wield covers the horrors of time spent in archaic institutions, the loss of any hope of recovery and certain death, to a full recovery following surgery. Today, she has returned to her career and rediscovered the joys of life and her family. This story is one of hope from an often hidden and stigmatised disease.” Amazon UK

Then 5 January 2013: ‘Cathy Wield Shares Her Experiences of Living with Depression with the Baptist Times’

Excerpts:

“I have suffered two bouts of major depression; the first lasted for seven years continuously with no break, during which time I received just about every medical treatment available – psychotherapy, drugs, ECT and then when the prognosis was that I would die, brain surgery …… On the eighth day post op, I suddenly experienced a light switching on in my head and I was instantaneously better; the depression had gone!”cathy-wield21

“I thought since I had been healed in such a way that I would never suffer with depression again so we were surprised and disappointed when I began to have symptoms just at the time that we moved to Aberdeen in Scotland ….. This time it was more gradual, but eventually the illness became so severe that I was once again suicidal and therefore hospitalised. 

The church was extremely supportive – they had had teaching on depression and so recognised that this is not something you can snap out of, or that it was the fault of the sufferer or that I was not as spiritual as I should be. They sent cards and presents, visited and prayed. I had to have ECT again and thankfully this time it was successful and my recovery began.  It has taken much longer to get better from this bout”

“We now live in Watford.  My husband, who is a counsellor, and I run a workshop on depression, for churches and other organisations.  More details are on the website http://www.cathywield.com/  We would love to hear from you if we can be of help.” 

Read complete article

 

Correspondence with Healthcare Improvement Scotland (HIS)

Hole Ousia

I want to thank Dr Brian Robson, Executive Clinical Director for Healthcare Improvement Scotland, for agreeing that I can include his letter to my employers, NHS Forth Valley, dated 22 May 2014. I explained to Dr Brian Robson that I would like to include here his entire letter and my letter of reply.

But first a few quotes from a psychiatrist and professor for older adults (these are not quotes by me):

“I want to make a case and I want to argue why ethics is as important, if not more important than quality” 2011

“Quality is a by-product of ethics and not vice-versa”  2011

“It is extremely important for healthcare organisations to invest in ethics. Who should be trained in ethics? Each and every person in our healthcare organisation: Chief Executive, Directors, Managers, medical and nursing staff, as well as support staff. Each and every person.” 2011

Below is Dr Brian…

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Powerful Embrace

Powerful Embrace from omphalos 

“Anxious I consulted my doctor.

This was 1997.

I was started on Seroxat (Paroxetine). In America this is Paxil.

Today (2014) I am still on Seroxat/Paxil (Paroxetine) 

17 years: this has indeed been a “powerful embrace”. 

After I made this film (in 2011) several of my consultant psychiatrist colleagues expressed concern.  I had apparently brokered acceptable boundaries; my thoughts were loose and I was misguided, perhaps even “disordered”.  Label upon label was how it felt to me.”

What the City Wanted to Show Me

another great post from Faith

PROOF OF GOD! ...and other tragedies.

note: in progress
  IMG_20140713_124731
The curved wall drops into a parking lot, with a higher, much bigger wall behind it, old-paint block letter warnings TOW AWAY ZONE, NO PARKING ALONG THIS WALL. There is a network of fields and fences stretching out under the slow setting Northwestern sun, a tangle of empty play equipment on a Sunday night. The woman sits there on the little ‎wall, beside the entrance to the back-of-the-school’s parking area and looks like she’s waiting for someone. She’s typing into a phone and maybe it seems like she’s texting, like she’s talking with someone.
She’s writing an email to herself, and wondering if she should call her children, who are a long-drive a day further south, on a different trip. 
 
‎She stood up and dialed their number, saw that a man was standing in the window in the house across the street, which was smaller…

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Psychiatric Interference

In this post I want to make the case as to why I am “critical” and not “anti” psychiatry although at times I can feel very “anti”, because of being a survivor of psychiatric treatment and mental illness labels three times over and because all of my family through 3 generations have been targeted by psychiatry. The biomedical model of mental illness has dogged our footsteps with “family history of” in psychiatric notes and disorder labels from hebephrenic schizophrenia to schizoaffective to bipolar. A progression depending on our “performance” or as I like to see it the “whim” of a psychiatrist. For I’ve never believed any of it and left the labels behind when tapering the drugs and getting off them and getting back on with my life in the real world.

In the 1960’s when we first had a television it could at times get “interference” on the screen which meant we couldn’t see the picture properly and the causes could be either just a blip requiring a thump to the box or a more permanent problem needing fixed by a TV engineer. Psychiatry to my mind has similar problems with “interference”, most particularly in its use of psychiatric drugs for any and every situation it is having to deal with. It’s much more than a blip and requires a system overhaul or paradigm shift. A thump to the box won’t do it. We need to get into the workings and root out the defective parts, replacing them with new ones.

With psychiatry I think it’s better the devil we know rather than doing away with it and getting something else in its place which could be much worse. Remembering the olden days when witches were hunted by the church, sink or swim it made no difference, and mad people had demons cast out or were singled out for “special” treatment. I don’t want to go back to that and anyway I have at times found psychiatric treatment to be a refuge of sorts and psychiatrists to be people, usually in my experience men, who will work with me on my terms. Eventually. It takes some negotiation and determination not to be under their direction. But I have been able personally to get out from under their authority even although on every occasion I was forced to comply and to swallow the drugs.

I didn’t like being forced and would resist any compulsion in the future because I’m non-conformist in the real world and therefore non-compliant in the psychiatric setting. It stands to reason. I’m no different a person just because I’m in an altered mind state or psychosis. That’s normal for me and my family to experience altered mind states. It’s not normal for us to be forcibly injected with psychiatric drugs. So I’m against coercive psychiatric treatment and drugs as the only tools of choice for mental health difficulties or emotional distress or altered mind states. Many of my family members didn’t mind being in a psychosis. Some of us repeated the experience because we liked it so much. Others of us didn’t like it that much but we liked the treatment far less.

Another psychiatric interference problem is what can be happening behind the closed doors of institutions, the dehumanising treatment by psychiatric nursing staff who are left to their own devices and are the sort of people who shouldn’t be left in charge of anything that lives or breathes. I use the expression: “I wouldn’t put a cat or dog in this psychiatric hospital” to describe bad practice and mental health acts not being implemented or monitored. It’s a cultural problem that needs spoken about and the issues continually raised until improvements happen. And how will we know that the culture has changed? When all the patients and family members give positive feedback, not just the chosen few.

In the UK we now have the Patient Opinion website where anyone can give feedback on their hospital experience: “An independent site about your experiences of UK health services, good or bad.  We pass your stories to the right people to make a difference.”. I’ve used this resource on a few occasions and found it helpful. Recently the Scottish Government Cabinet Secretary for Health and Wellbeing Alex Neil MSP said “We need the voices of patients and their families to be heard in a clearer way”, ahead of a speech at a conference in June for NHS workers.

I have every reason to believe that things can only get better in Scotland’s mental health world. And this includes psychiatric treatment.

I want to see talking therapies available for everyone and not just those with “common mental health problems”. To have a choice of psychological or psychodynamic therapies when in an altered mind state is what I’m working towards. The drugs didn’t work for me and for other family members. We want choice and not just drugs or nothing, forcibly given if resistant. Interference. I believe that a more gentle transition when in a psychosis, bringing us back down to earth, will be less traumatic and more effective in the short and longer term. The antipsychotic depressed me, the chlorpromazine in 1978/1984, and the risperidone in 2002. The latter treatment leading to a psychiatric drug cocktail of venlafaxine and lithium. The antidepressant gave me suicidal impulses and bone loss (fractured fibula in 3 places resulting in 6 inch metal plate inserted), and didn’t lift my mood, so in fact ineffective and useless. The “mood stabiliser” didn’t stabilise my moods and I remained as flat as a pancake.

I was able to take charge of my own mental health, taper the drugs against the advice of the psychiatrist, and get back on with my life. I told the psych doctor what I was doing and he tried to persuade me otherwise, saying I had a lifelong mental illness, spoke about the DSM at the time, it was 2003/4, but I told him I didn’t believe it or in the chart of diagnoses. I saw the same doctor about a year ago in the passing and caught his attention, telling him about my complete recovery against his direction. He passed the buck, saying something to the effect that it wasn’t his responsibility. I wasn’t impressed by his response despite the fact he was wearing full leathers and carried a motor bike helmet, in a psychiatric day hospital which I was visiting at the time. It seemed that the female nurses were impressed by his stature and appearance as they fluttered around him as he departed. I’ve had motor bikes in my time. They were another means of transport. I prefer a car these days.

I like to think we activists and campaigners are similar to that TV engineer sorting out theea93f-normalservice1 interference. Getting in to the workings and rooting out the faulty parts. Those of us who have been affected by the faulty parts and subject to the interference know what the remedy is, and what doesn’t work, for us. Our opinions matter because we have been at the sharp end, is how I see it. You can describe it as “lived experience” or “experts by experience”, describe us as “psychiatric survivors” or “recovered”. Whatever gives us the power to sort out the interference and to ensure that normal service will be resumed as soon as possible.