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Care in crisis: why I'm supporting Mind's campaign
Posted Monday 18 October 2010
This summer would not have been a great one for anyone keeping track of mental health issues in the media. Amidst all the discussions around spending reviews, benefits cuts and rising unemployment, there were nightmarish stories about mental health care, even as the Government talked about world class services.
In June news broke that the South London and Maudsley Trust has been piloting a programme for medium and high security patients to be fitted with electronic tagging devices. In August, on BBC Radio 4 a Brunel University professor advocated sterilisation for the ‘mentally disabled’. Later that month, two black men, 23 year old Olaseni Lewis and 52 year old Colin Holt, were killed while being restrained by police. Seni was killed in a mental health hospital and Colin in his home. If these are examples of mental health ‘care’ in crisis, then we are in big trouble.
I also spent part of the summer leading a research project talking to black women about what helped them recover from mental health problems. Their experiences of what helped and what did not resonated with my own experience of accessing mental health services over the last two decades. When we are in crisis, many of us are frightened, vulnerable and helpless. Many of us have no choice but to put our faith in a system that we assume is resourced and tasked with providing sensitive and appropriate care.
Research shows that there is still a long way to go to make acute and crisis care a safe and enabling experience for many people. A recent Care Quality Commission research showed that 39% of all suicides were of people who were under observation. Service users, especially women, have long talked about the importance of single sex wards in their recovery; yet the Count me in census 2009 found that 67% of the people surveyed were not in single sex wards. Many people from black and minority ethnic communities face extreme coercive treatment at the acute end of services, including use of seclusion, hands-on restraint and higher rates of admission (Count me in 2005 - 2009).
I believe that the care we receive while is crisis is absolutely crucial to our subsequent recovery and has to work for all of us, especially the most marginalised and vulnerable in society. That is why I have joined the inquiry panel of Mind’s campaign to improve care in crisis. Over the next few months, the panel will be hearing evidence about people’s experiences of acute care wards, crisis resolution teams, access to crisis houses, and alternative approaches to crisis care. And based on this evidence, we will campaign for long-term improvements in crisis care.
Jayasree Kalathil
Survivor Research
2 Comments
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The UK is a backwater in progress in mental healthcare. If you're interested Jayasree there's a review by John Bola published in Psychosis. It looks at 5 sites around the world that offer no or low dose medication strategies for first episode psychosis. It's noteworthy that the UK is absent.
http://psychrights.org/Research/Digest/Effective/PsychoSocialMoreEffective2009Psychosis.pdfThe only efforts I've heard about are through service user activists in Bradford for are campaigning for a Soteria-based facility.
The psychiatric ward is the first point in the journey which can often be terrible for people with severe mental illnesses (rather than common mental disorders treated in primary care which is part of the ever-growing mispathologisation of normal behaviour). The Soteria principle tries to understand this.
At the moment the NHS sticks people in wards under section to get them on medication. It leaves them to rot in the ward till the medication kicks in. That's pretty much it. No information about their condition, no help from therapist and coercive practices used to get people to take medication by any means necessary. Marion Janner did a huge project to make change so that conditions were better however I suspect without the inertia created by her passion there's little chance any of the changes have been sustained.
About a month or two ago I was chatting to a doctor who'd just sectioned a black man. She spoke to me in psychiatric language - he had thought disorder. He'd been brought in by the police but was no risk to himself or anyone else. She told me she sectioned him to get him on medication and her only treatment desire was to keep him on medication even though he didn't want it.
It's a great campaign but it's like p*ssing in the ocean. There's a mountain to shift in psychiatric crisis care.
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MENTAL HOSPITALS
There is an enormous stigma in most minds when we mention mental patients or mental hospitals. The people who are unlucky enough to have been taken to one of these places will be treated like second class individuals. Liberty is lost in every sense as these people are usually mal-treated, mal-nourished, and miss-understood and generally treated and thought of as similar to animals.
Most media and government statistics are based around fear here also, in the sense that these people are a bargaining method. ‘We will protect you from these ‘dangerous peoples, if you comply with our other wants‘.
“ Potentially dangerous mental health patient is located after wandering from Pine Rest ”
“ Dangerous mental patients fitted with satellite tracking devices in hospital ”
“ Are Psychiatric Patients Really Dangerous? “
The last headline quoted above stipulates that ‘mental “patients” are a conglomerate and that we can catalogue them in this manner. Surely every human is different? Is it not biologically, psychologically and sociologically impossible to be identical to another human being?
The last headline is quoted from a psychiatric journal. It is obviously using deliberately foolish language in order to appeal to the possibly slightly less media aware public masses. Using baby language, if you will, for the sake of raising some false awareness of a phony topic. If you read this article, from a logical point of view, you will find no evidence stated whatsoever, hence it is one of thousands of bogus articles aimed at the public to produce fear. (see note on production of fear and subsequent soothing of by media and government).
The fact is that I have met approximately three hundred mental patients and not one was dangerous, in the least. I suggest that most of the nurses and some doctors are more capable of ignorance. Ignorance is far more dangerous than any other form of mal-adjustment in society. Society as a whole has to be a little more adult when considering this side of things as we cannot ignore oppression of any sort. This form of ignorance still holds certain remise culpability.
These institutions, in most countries in the world, are unlawful, in that they are designed to strip away liberty from the individual. Some of the processes which were in place one hundred years ago are still in place now in 2010. Recently, in the Czech republic, we could read in the newspaper about one ‘patient’ being found chained to a wall.
In Britain, there are still camera systems in rooms to monitor the ‘patients’ in order that the over-seeing eye can decide on matters. This kind of mechanism is obviously abused by any over-seeing eyes. Just as the use of chains is simple abuse also.Suffice to say all problems stemming from & by mental hospitals can be said to be caused by individuals such as bad nurses, ignorant or bad or unthinking doctors, other official people & bad people in general with ill intent for others.
These people with bad intentions or selfish intentions have ruined the world & ruin lives & so weigh down the burden on society’s shoulders. The good people who would save the worlds interests are obliterated in these types of circumstances.
If these people are not helped by some unselfish people they will live their lives in one of these hospitals and the disintegration process will be harsh. They will become some misshapen form of human beings which society can and will despise. We will refer to these people as pathetic but is us who are pathetic and wretched in the face of this oppression.Electro convulsive shock treatment (ECT) is used in many countries in order to pacify patients. It is claimed by doctors and nurses that this treatment calms the patient to an extent where they can be controlled with greater continuity by nurses.
I agree that ECT will indeed appear to pacify in the sense that the patient becomes catatonic for a number of days, months, years etc. The main drawback is that the patient will mostly never recover. From patients I have known, I could see that the brain patterns and systems which they had created as adults had been damaged. Most patients were, afterwards, afraid to leave the hospital, as they were not sure how to go about or start going about things as they had done without problem before the ECT treatment. If we are to believe it is important to make nurses jobs easier, maybe we could train these nurses in better caring rather than penalize patients for simply being ill.
Needless to say, ECT in many countries is miss-used and sometimes used to penalize patients who do not comply with nurses orders in Britain and in various countries across the world. This use of torture has been used by various dictatorships across the world, including the Nazis, Polpot, various governments in the form of torture treatments, etc.
ECT sends out a very sinister message to society. The main message is one of ignorance of the damage ECT can do to a brain & body. The other frightening message is that despite the fact that this barbaric mechanism is banned in many right-thinking countries, many other countries choose to ignore the seriously harmful health implications.
MENTAL HEALTH LAW
Mental health law is laughable in most countries.
The fate of the patient lies completely with the nurses and doctors. The nurses write up reports on each patient for the doctor’s perusal. In every sense, the nurse can write up anything they want to on a patient. If they do not like a patient e.g. if the patient is from an opposing religion or supports an opposing football team or has a higher IQ.
There are many reasons why a nurse might write up a damning report on a patient - it seems to be the modern prerogative, in that jealousies can flare up at the least thing especially if power or control is an issue. Pettiness is the new vogue.Any psychiatric doctor can detain any individual, despite what family members or siblings say, if they decide they should be put into mental hospital. After the individual goes into one of these places there is very little in the way of recuperation taking place. Despite whether the patient is ill or not it is extremely difficult to get out of one of these places. Even if the patient manages somehow to secure a legal aid lawyer, these lawyers have very little in the way of power against the likes of the doctors or nurses opinion.
Needless to say, there are many organizations who are trying to rectify the wrongs which are afoot with these mental hospitals. One of these organizations is MIND, based in England and mainly deals with English and Welsh mental health issues. There are also several human rights groups who disagree strongly with the current way patients are dealt with in these places, but so far these organizations opinions have fallen on deaf ears.
NEED
Oxford English dictionary definition:
1) Require something because it is essential or very important rather than just desirable.
2) Expressing necessity or obligation.
3) archaic; Be necessity.The archaic and all meanings express a necessity inherent in any need. Something which is not desired.
I suggest most of us ‘desire’ before consulting our needs or inherent necessity. Need could be thought to be subjective in this sense but if the dictionary definition is to be believed then needs become things which are not desirable - this should be easy to resolve.
Need is important if we are ever to understand what is good for us. If we cannot distinguish need from want we will never understand beauty or freedom.SUSPICION
English dictionary definition:
1. Act of suspecting.
2. The state of mind or feeling of one who suspects: Suspicion kept him awake all night long.
3. An instance of suspecting something or someone.
4. State of being suspected: under suspicion; above suspicion.
5. Imagination of anything to be the case or to be likely; a vague notion of something.
6. A slight trace, hint, or suggestion: a suspicion of a smile.A natural suspicion is something the vast majority of us possess. This suspicion informs our decisions and even our choice of friends if we are not entirely clued-up on the subject or person in question. When we exercise our suspicion we test our theories of what is bad or good for us. The police & government and many business people use their suspicion to decide on fact and fruitful future proposals.
PARANOIA
English dictionary definition:
1. A psychotic disorder characterized by delusions of persecution with or without grandeur, often strenuously defended with apparent logic and reason.
2. Extreme, irrational distrust of others.This is an odd definition. If a mental patient is termed paranoid by a doctor or nurse does someone test the theory of the “apparent” logic? Or the inferred “delusion”? The answer is no, unlike a criminal in a court of law, the patient is not asked many questions. No one does any research whatsoever into the source of the “apparent” logic or source of the paranoia. In mental health terms, across the world, the term ‘paranoia’ is entirely at the disposal of doctors who may or may not make mistakes on behalf of a patient.
This is of grave concern to many organizations that are currently campaigning for the legal rights of mental health patients.DELUSION
Dictionary Definition;
1) The act or process of deluding.
2) The state of being deluded.
3) A false belief or opinion: laboured under the delusion that success was at hand.
4) Psychiatry: A false belief strongly held in spite of invalidating evidence, especially as a symptom of mental illness: delusions of persecution.If the psychiatric definition is legally binding then most doctors and nurses in this profession are in breach of the law. There is no investigative work which is undertaken the medical profession. The ‘invalidating evidence’ which is referred to is the doctor’s ‘opinion’. The patient’s opinion or ‘delusion’ is either disregarded or pitied or pushed to the side. This is especially dangerous where the patient has no family. The patient literally becomes a number to keep a particular ward running and keep nurses and doctors in jobs.
No additional thoughts are formulated by doctors as to why someone might be experiencing dark or inferior thoughts. Generally I have never met a patient with superior thoughts - only medical staff.SCHIZOPHRENIA
Definitions:
1)
Schizophrenia is a severe mental disorder characterized by delusions, hallucinations, incoherence and physical agitation; it is classified as a "thought" disorder while Bipolar Disorder is a "mood" disorder.
It is estimated that one percent of the world's population has schizophrenia. While there is evidence that genetic factors have a role in developing schizophrenia, other unknown causes play a significant part as well.
While Bipolar I Disorder may include psychotic features, Schizophrenia cannot include mood swings. Schizoaffective Disorder bridges the gap between Bipolar Disorder and Schizophrenia. #
2)
Schizophrenia is a mental disorder characterized by a disintegration of the process of thinking and of emotional responsiveness. It most commonly manifests as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social or occupational dysfunction. Onset of symptoms typically occurs in young adulthood, with a global lifetime prevalence of around 1.5%. Diagnosis is based on the patient's self-reported experiences and observed behaviour. No laboratory test for schizophrenia exists.#
3)
The term schizophrenia is widely used in the mental health system. Doctors may describe it as a psychosis. They mean that, in their view, a person can't distinguish their own intense thoughts, ideas, perceptions and imaginings from reality (the shared perceptions, sets of ideas and values that other people in that culture hold to be real). Among other symptoms, a person might be hearing voices, or may believe that other people can read their mind and control their thoughts.
Many people prefer to look at schizophrenia 'holistically', and argue that these symptoms are logical or natural reactions to adverse life events. In other words, an extreme form of distress. They emphasise the need to think about individual experience, and the importance of understanding what the experiences mean to the individual. Hearing voices, for instance, holds a different significance within different cultures and spiritual belief systems.#Bearing in mind that all these varying definitions are used by doctors to categorize patients then we may be able to assume that psychiatry is like a guessing game.
DEPRESSION
English dictionary definitions & psychiatric definitions:1)
- The act of depressing.
- The condition of being depressed.
- An area that is sunk below its surroundings; a hollow.
- The condition of feeling sad or despondent.
- Psychology: A psychiatric disorder characterized by an inability to concentrate, insomnia, loss of appetite, anhedonia, feelings of extreme sadness, guilt, helplessness and hopelessness, and thoughts of death. Also called clinical depression.- A reduction in activity or force.
- A reduction in physiological vigour or activity: a depression in respiration.
- A lowering in amount, degree, or position.
- Economics
- A period of drastic decline in a national or international economy, characterized by decreasing business activity, falling prices, and unemployment.
- Depression The worldwide economic depression from the late 1920s through the 1930s. In the United States, it began with the stock market crash in October, 1929.
- Meteorology A region of low barometric pressure.
- The angular distance below the horizontal plane through the point of observation.
- Astronomy The angular distance of a celestial body below the horizon.2)
Depression is a common mental disorder that presents with depressed mood, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, low energy, and poor concentration. These problems can become chronic or recurrent and lead to substantial impairments in an individual's ability to take care of his or her everyday responsibilities. At its worst, depression can lead to suicide, a tragic fatality associated with the loss of about 850 000 lives every year.
Depression is the leading cause of disability as measured by YLDs and the 4th leading contributor to the global burden of disease (DALYs) in 2000. By the year 2020, depression is projected to reach 2nd place of the ranking of DALYs calculated for all ages, both sexes. Today, depression is already the 2nd cause of DALYs in the age category 15-44 years for both sexes combined.
Depression occurs in persons of all genders, ages, and backgrounds.#Oliver James, a British psychologist, suggests that schizophrenia and depression are products of modern society.# Other psychologists here in Britain suggest that these illnesses are wrongly construed in the psychiatric profession and should be re-classified. MIND, a mental health organization in England also believes this.
I suggest that modern society is an extremely busy place and if we do not slow down we will continue to make mistakes in our professions. Health care, the world over is extremely flawed and especially mental health because it is not an exact science or a proven science in any way. It is entirely presumed by a hierarchy of official people. The mentally ill are the new ‘slaves’ in the modern system as they are sorely misunderstood by the rest of us, including the doctors and nurses themselves.
If we do not revolutionize our modes of classifying people our entire moral and intellectual fabric will crumble.
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