“He delivered piercing insights”

Hole Ousia

The Royal College of Psychiatristsdescribes“7 highlights” from its “sold-out”, and no doubt lucrative, International Congress 2018 which this year was held in Birmingham.

The Royal College of Psychiatrists gives this “keynote” as one of the highlights:

Professor Hamish-McAllister’s declarations of interest can be accessed from the British Association for Psychopharmacology. His declaration of 27th March 2017 confirms that in the previous three years, he had “accepted paid speaking engagements in industry supported symposia”from:

  1. AstraZeneca,
  2. Bristol Myers-Squibb,
  3. Eli Lilly,
  4. GlaxoSmithKline,
  5. Janssen-Cilag,
  6. LivaNova,
  7. Lundbeck,
  8. Merck Sharp & Dohme,
  9. Otsuka,
  10. Pfizer,
  11. Pulse,
  12. Roche,
  13. Servier,
  14. SPIMACO,
  15. Sunovian,
  16. Wyeth

It would be interesting to know how many of the  2,700 delegates from 54 countries, “more countries were represented than in the World Cup”  had  “piercing insight” into Professor Hamish McAllister-Williams extensive financial competing interests?

In June 2017, Professor Hamish-McAllister came to the small District General hospital that I work…

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“Objectivity” does not come in a title

Hole Ousia

On the 17 July 2018 Professor Roy Perlis shared the publication of this paper in which he was lead author:

Professor Perlis who is Director, Center for Experimental Drugs and Diagnostics, Massachusetts General Hospital did so with this introductory statement:

“Papers suggesting that antidepressants are associated with adverse birth outcomes get published in JAMA and hyped on NPR and BBC. Think this one, suggesting the same for psychotherapy, will get noticed? Confounding by indication is the point, of course.”

Two senior Scottish Psychiatrists shared this. One was Professor Keith Mathews and the other was Dr David Christmas, both of whom work for NHS Tayside.

In a post that I wrote in April 2018 I considered another recent paper by Professor Perlis, “Anxiety about Antidepressants” , where he considered “the cognitive and affective biases that may prevent effective treatment“. In this paper Professor Perlis referred to the recent publication…

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Hole Ousia

This post is not about Donald Trump.

I first communicated with Professor Sir Simon Wessely not long after he had been elected as President of the Royal College of Psychiatrists. In his e-mail of introduction to me he asked me to call [him] “just Simon”. I appreciated this to be nothing but an act of extraordinary kindness. I was wowed that the President of my college was on level with me.

At this time my uncle, Dr Guy Scott, was President of Zambia.

My uncle’s Presidency of Zambia was short lived.

Professor Sir Simon Wessely has since moved on from President of the Royal College of Psychiatrists to be elected as President of the Royal Society of Medicine.

I have never met Professor Sir Simon Wessely, however he did walk by me when I protested outside the RCPsych International Congress in Edinburgh, 2017. I noted that he arrived with a carefree…

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Transparency: Revision of NICE guidance on Depression

Hole Ousia

In a recent post I shared a letter that I had sent to the BMJ that was not published. It was based on correspondence with Professor Sir Simon Wessely who is one of the members of a stakeholder group who requested a revision of the Draft NICE Guidelines on Depression in Adults: Recognition and Management

In correspondence with Professor Sir Simon Wessely he suggested that I make a Freedom of Information request to NICE. I followed this advice and have received the following four documents (shared here below as received).

I also share here, to provide open and transparent context, the correspondence that I had with Professor Sir Simon Wessely. I will let the reader decide on whether this is the correct thing for me to do. I have concerns that such a powerful and influential UK medical leader should confuse transparency about a matter of public interest with me as…

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‘Flight of Ideas’

Hole Ousia

One of the current clinical definitions of “flight of ideas” is: “a rapid flow of thought, manifested by accelerated speech with abrupt changes from topic to topic: a symptom of some mental illnesses, especially manic disorder.”

I have never experienced mania and reckon that I never will. I am naturally of a quiet temperament and may be inclined to think a little more negatively than positively.  However I have found that “flight of ideas”, as a psychiatric concept, can be misapplied and misused. I have two personal examples.

First example:

In the early days of my writing on mental health I wrote a reply to a paper on the renaming of “schizophrenia”. I shared my reply with a psychiatrist colleague who sent me his perspective on it:

“There are two types of comments I want to make, one relating to the theme, and one to the way you put your…

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Healthcare Improvement Scotland and Realistic Medicine

Hole Ousia

Last week I sent an open letter to the Chair of Healthcare Improvement Scotland on Realistic Medicine in NHS Scotland. I have received this prompt reply:

I am sure that we all welcome the initiatives that Dame Denise Coia has outlined. I certainly do. However, it is the case that the improvement work undertaken by Healthcare Improvement Scotland is based on IHI methodology – a reductionist approach that was developed in the engineering industry. It remains to be seen whether this approach can be used as a universal model for healthcare and whether it delivers the outcomes that really matter to people.

I note that Dame Denise Coia has not responded to my open question on allocation of resources to the Institute for Healthcare Improvement, Boston, USA.

If anybody has any thoughts on realistic medicine I would welcome them. Please add as comments below.


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Accountable to the Law, not the NHS

Mental Health Cop

On 12th November 2013, I wrote a blog entitled ‘Here We Go Again‘, following the death of a vulnerable man in Bedfordshire who we now know was called Leon Briggs. His death is subject of an ongoing criminal inquiry, more than four and half years later and that means, regardless of what happens criminally, there is still a potential disciplinary process to come, certainly followed by a Coronial hearing to establish all the issues around Mr Briggs’s unexplained and unexpected death on 4th November 2013. The full circumstances around that incident are yet to emerge and be tested and my best guess is, the legal process for that will run well in to 2019, if not the next decade.

But on 12th November 2013, I sat down in the evening to write that very general post, trying again to point out to police officers the various factors that…

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