Trauma Informed Care & people of colour

Race Reflections

“If you are silent about your pain, they’ll kill you and say you enjoyed it” Zora Neale Hurston

There are different kinds of injuries. Not all pain is deemed legitimate. Oppression causes trauma. Amidst the (fairly) obvious, debates around what really constitutes trauma as laid out in criterion A of the Diagnostic Statistical Manual (DSM) ‘s diagnosis for PTSD; are alive and well. Criterion A now requires that an individual has been “confronted with”: ‘death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence’ in order to qualify as trauma. In comparison to DSM-IV, the DSM-V notably includes sexual violence but not racial violence…troublingly evoking the fight for racial justice.

As a reminder, white woman were afforded the right to vote in both state and federal elections in 1920 but, it was only in 1954 that people of Asian heritage could vote and well into…

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Still Too Many Questions

Mental Health Cop

I wrote last week about three separate process which had concluded after adverse events involving the police and their response to mental health calls. I mentioned the conclusion of the inquest in to the sad death of Joseph Phuong and couldn’t say much about it as details weren’t covered in the media. I heard about this case shortly after it happened, when discussing policing and mental health matters with the Metropolitan Police and had awaited the inquest, interested in the view that would be taken of how events had unfolded – but I was aware I didn’t know anything like the full picture and I still don’t. I don’t know whether the Coroner will issue a ‘Regulation 28’ Preventing Future Deaths report, but I would imagine, if it’s coming, it will be worth reading. The IPCC have also suggested they’d review whether or not they can publish their report in…

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Hole Ousia



The two quotes about industrialisation and healthcare 
come from Intelligent Kindness by Ballat and Campling.

The considerations on conferences are included in a
this BMJ perspective

This post is creative, made in my own time and intended 
to ask questions in the spirit of the Freedom to Speak Up 
recommendations by Sir Robert Francis.

My forebear, Alexander MacCallum Scott grew up in Polmont, 
Scotland. He became an MP and was Private Secretary to 
Winston Churchill. I mention this as he turned down an OBE 
for his work connected with the war (WWI)


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Credible or incredible: experience is evidence

Hole Ousia

A senior Scottish figure once gave me advice that it is very important to be perceived as “credible”.

I was thinking about this advice recently when the convener of the Parliamentary Committee considering polypropylene Mesh implants concluded:

It is not surprising, therefore, that those who have experienced harm from healthcare may feel that they are not being listened to.

In the same week another example featured in a week long series of articles in the Herald: “A Bitter Pill”. On a background of ever increasing prescribing of antidepressants it appears that my profession is still struggling to accept the value of people’s experience (which may not always be positive) and can respond defensively:

One responder has already articulated my feeling about this:

My understanding is that this series in the Herald arose, at least partly, because of a petition to the Scottish Parliament which seeks consideration of prescribed drug dependence and withdrawal.


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Isle of May National Nature Reserve

Thursday 28th September comments: Today there is something different on the blog as we celebrate national poetry day. As a way of celebrating, the small team on here wrote and produced an Isle of May poem called freedom (brilliantly read by our volunteer Simon). (Unfortunately technology would not allow us to switch the image around as you can see!)

For those who would like the wording, here is the poem in full…


Freedom is a Fulmar, soaring through the waves

Freedom is the Seals, that call their homes the caves

Isle of May is blissful, magical and free,

A home from home, in the middle of the sea.

Windy, rainy spring to fall,

Nothing compares to the Puffins call.

Seabirds galore on the cliffs so high,

Terns displaying, dancing in the sky.

People arrive from boats south and north,

To see the jewel in the Firth of…

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What is “realistic” in terms of public expectation?

Hole Ousia

On the 12th August 2017 I sent the following letter to Shona Robison, the Dear Cabinet Secretary for Health and Sport for the Scottish Government:

Dear Cabinet Secretary for Health and Sport,
PE01493 on a Sunshine Act for Scotland. Are the Scottish public being listened to?

PE1493, A Sunshine Act for Scotland was closed by the Scottish Parliament in March 2016.

The Scottish Health Council published its public engagement exercise the same month.

The Scottish Government’s last public statement about this matter was in your letter dated 22 March 2016. In this letter you confirmed that “a majority of participants felt that publication of financial payments to healthcare professionals should be mandatory. In terms of next steps, the Scottish Government will discuss the contents of this report with the appropriate regulators and scope out options of how mandatory publication of payments to healthcare professionals from industry could be delivered.”


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Improvement science: engineering 42 – ethics 0

Hole Ousia

In my last post I considered a “thought paper” entitled “The habits of an improver” and welcomed that critical thinking was considered a necessary habit.

The word “engineer” or “engineering” is to be found on 42 separate occasions in this Health Foundation thought paper.

The word “ethics” does not appear at all. Despite the fact that the introduction begins with this quote:

That ethics do not seem to be considered amongst the “habits” necessary for “improvement science” is concerning.

The last time I looked, I found this result using the Healthcare Improvement Scotland search facility:

The former Chief Executive for the Mental Welfare Commission for Scotland used to introduce me as “Bayesian Peter”. Bayesian is the name given to interpretations of probability and returns to Reverend Thomas Bayes original considerations of complexity.

Healthcare, like life, is complex. We are human and live in an ever changing world.

This is not…

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