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KINGSTON WELL​BEING

What's on your mind?

Discussion on Stigma and Mental Illness

Follow the link to hear a 1-hour discussion on my views on stigma and mental illness, recorded in October 2021.


http://youtube.com/c/MeetMenaca

A difficult case

I am grateful to a colleague, Dr Ikechukwu Azuonye, Consultant Psychiatrist, for sharing this thought-provoking video about a challenging patient. It describes how, in 1984, Mrs A heard voices in her head telling her, “Don’t be afraid”. They tried to re-assure her she wasn’t mad but told her that she had a life-threatening brain tumour. Dr Azuonye "gambled his professional credibility on listening to the voices." Click on the image to view what happened.


“Science without religion is lame. Religion without science is blind.” – Albert Einstein

“Madness is like energy: it is not lost, it is merely transformed.” (N Yoganathan, 2019, after Isaac Newton)

February 10 2019

Trying to understand mental illnesses, psychological processes, changes in treatments and in the provision of care for the mentally ill over a period of 30+ years, has led me to this understanding. My conclusion is reinforced by the rapid increase in interventions with putatively wonderful outcomes, measurable but usually offering short-term benefits. Sadly, people with complex and longer-term mental illnesses are being marginalised and inevitably end up in penal institutions such as prisons and forensic units. The staff working in those institutions are increasingly becoming social policemen focussing on safeguarding issues and controlling symptoms, rather than helping people to understand and take responsibility for their personal wellbeing. Furthermore, the soaring number of prescriptions for psychiatric medications and the number of detentions under the Mental Health Act are a reflection of the madness of society.

A Tsunami of CBT

February 10 2019

I attended the book launch for this work by Farhad Dalal, a renowned group analyst and academic, at the Institute of Group Analysis last week. The book offers a very honestly critical assessment of the changes in the provision of psychological therapies, particularly in the NHS. Most of us who have worked in this field for the last 3 decades are of the view that such short-term measures only appear to meet the needs of the organisations, rather than the long-term understanding and recovery of the recipients.

The tsunami is an inevitable bi-product of the commodification of health and the market economy model that pervades so many aspects of our lives.

Don't try to be happy!

January 15, 2019

Surprise, surprise! A  Nobel prize-winning economist at Princeton has made the discovery I reported long ago in my own humble research on wellbeing: humans are not striving to be happy!!

Take a look at my findings from 2017 (click on image to the left) before you look at Professor Khaneman's e.g. Want to live well? Don't try to be happy, The Times 29 December 2018.

PSYCHIATRY IN TH 3RD DECADE OF THE 21ST CENTURY

30 December 2018

As the millennials are now coming of age, what is the state of mental health in the UK and what does it augur for the forthcoming decades of the 21st century?


FIRTLY, SOME FACTS:

• Despite significant increases in staffing (consultants, nurses, therapists etc), mental health services are drawing negative publicity

• There have been huge advancements in the range of medications available to treat mental illnesses, and we have a plethora of available therapies

• Over the last 10 years, the government has spent some £300m on improving psychological therapies, mainly CBT


NEVERTHELESS

• Patients with serious mental illnesses and their carers generally feel under-supported

• Increasing numbers of people are being treated under the MHA, with a bias towards the BME populations

• There has been an exponential increase over the last 25 years of people with MH difficulties being confined in forensic psychiatry, low/medium secure units and prisons

• Prescriptions for mental illness have soared – anti-depressant prescriptions have more than doubled over the last 10 years

• There are high levels of stress amongst MH professionals, being manifested in the rates of sick leave and staff turnover, and causing problems with recruitment and retention


WHY?

Are we, as a nation, becoming ‘madder’? Or does the problem lie in a conflict between our rights and responsibilities?

Or is this the manifestation of stigma operating at personal (self), familial (small groups) and societal and global (large group) levels, resulting in MH training no longer being fit for purpose?

My question is, how do we ensure that our MH professionals are prepared to negotiate the complexities of reality, where, when it comes to MH matters, emotions and unconscious factors (personal and collective) are in conflict with social regulation and control? Isn’t it time the trainers themselves review their training in order to develop the resilience and robustness needed by staff? 

Mental Health Act Review

December 2018

Independent report

Modernising the Mental Health Act – final report from the independent review

The Independent Review of the Mental Health Act 1983 has set out recommendations for government on how the Act and associated practice needs to change.

Published 6 December 2018

From: Department of Health and Social Care 

https://www.gov.uk/government/organisations/department-of-health-and-social-care

The Tree of Life

December 2018

One of the therapies we meet in Lifewide Education Magazine 21 is a project devised originally in Adelaide, Australia, but now being used world-wide in diverse contexts. It entails getting individuals to draw their 'life tree'. The start from the roots, which lie in their large and small groups, and work through each element of their experience to identify events and people that have both supported and hurt them. The individual trees are then brought together as a group 'forest'. In this safe environment, individuals are helped through dialogue with their peers to address and come to terms with the trauma of their past lives and look to the future. Do take a look at the articles or go directly to  https://dulwichcentre.com.au/the-tree-of-life/ .

Lifewide Education Magazine 21

December 2018

The latest edition of Lifewide Magazine, which Jenny edits, has just been published. The theme of this issue is story-telling and narratives. It includes theoretical articles, personal stories and examples of how narrative therapy is being used worldwide to support individuals who have experienced personal trauma, be it through environmental disaster, social repression or family grief. The magazine is free to download at www.lifewideeducation.uk.

An alternative Christmas read

December 2018

If Out of the Darkness is too heavy for you, try Clare Allan's brilliant parody of 2006, Poppy Shakespeare. Set in the fictional Dorothy Fish Hospital in North London, the central character, N, has been a patient for 13 years when she is asked to show around a beautiful newcomer, Poppy Shakespeare. Poppy is wearing a mini-skirt and snakeskin heels. She is clearly not mentally ill and, unlike N, wants to get out of hospital. Their attempts to upset the system leave the reader seriously questioning our mental health organisation.

ISBN 978-0-7475-8584-8

Recommended reading for Christmas

December 2018

One of the best books I have read this year. Linda Caine recounts the tortuous journey she took with her psychiatrist, Dr Robin Royston, over a period of some 3 years, as an in-patient in the UK. She eventually discovers the source of her severe depression, which uncovers unconscious memories from her childhood and adolescence in Africa that threaten to destroy her.

ISBN 0-552-14869-5

Dance as therapy

1 December 2018

Don't miss this opportunity to see how expression through dance is helping individuals with vastly differing mental health problems achieve greater wellbeing. Darcy Bussell visits some inspirational projects. 

https://www.bbc.co.uk/programmes/b0btt5n1

Fake psychiatrist practices in the NHS for 22 years without a licence

30 November, 2018

The recent case of a bogus doctor who practised as a psychiatrist in the UK for 22 years has sparked outraged headlines such as this from the Independent.


How could this scandal have occurred? The GMC has apologised for ‘inadequate checks’ in the 1990s. I wonder if the checks would have been so ‘inadequate’ had the woman concerned been a man, and from the Indian sub-continent? I ask this not out of blind prejudice, but as a concerned observer who has monitored the ethnicity of doctors appearing before GMC hearings for many years.


Is it really reassuring that:

“The GMC said its checks are now more "rigorous" and stronger than they were. The council said that now any similar fraudulent attempts to join the medical register would be identified.

But the records of up to 3,000 doctors - who registered for a licence under the same rules as Alemi - are now being urgently reviewed.

The GMC said it was not expecting to find anything untoward.”


What are the consequences of their neglect? The following headline says it all!

Some 3,000 foreign doctors in the UK are being urgently checked after a woman practised psychiatry for 22 years without any qualifications.


Are we to be reassured that

“The GMC said patients place a great deal of trust in doctors, and "to exploit that trust and the respected name of the profession is abhorrent".

A Department of Health and Social Care spokeswoman said: "As the organisation responsible for regulating doctors, we expect the GMC to investigate how this criminal was able to register as a doctor and put measures in place to make sure it can't happen again." ?


And that the Trust which employed the bogus doctor for more than a year and reported her to the GMC has just been rated inadequate by the CQC for the third time? In a statement this week, the BBC reported,


‘A spokesman for the Norfolk and Suffolk NHS Foundation Trust said: "Our trust terminated her contract as a result of safeguarding concerns and reported her to the GMC."’


Methinks there is a case of buck passing going on. Let us hope that it is not to the detriment of professional moral and patient care!


NHS Digital Survey: 1 in 8 people under age 19 have a mental health disorder

23 November 2018

This is the finding of a recent digital survey. Are young people really under greater pressure today, or are we medicalising what were once accepted as natural maturational processes?

Data source: https://digital.nhs.uk/news-and-events/news

Autistic children groomed for transgender

The Sunday Times 18 November 20​18

A shocking report in the Mail alleges autistic children are being disproportionately encouraged to change gender. Worse still, a new hierarchy in stigma emerges: a whistleblower teacher believes "many of those who say they are the wrong sex are simply gay but would face bullying if they were to 'come out'. By contrast, transgender children are idolised by other pupils."

Centenary of the Armistice

11 November 2018

It is an auspicious coincidence that setting up our new website comes as we commemorate the dead of successive wars since WW1, a significant period for developments in psychiatry and our response to the mentally ill.

In this moving article for The Times (10 November 2018), Ben Macintyre reminds us of the journey we have come over the last century, when shell shock was deemed an indicator of 'lack of moral fibre' (unless you were an officer! In which case neurasthenia was a respectable condition!). Yet, even today, the armed forces still have much to learn if they are to care properly for those who have given their mental health in the service of their country. Macintyre rightly ends:

"we should remember this: war continues to kill, long after the fighting stops."

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