Friday, 10 April 2015

There is a Crack in Everything, That’s How the Light Gets In

[on Mad in America 10 April 2015]

In January 2012 I was invited by Bob Whitaker to write on his new blogging website Mad in America as the Scottish "foreign correspondent" and my first post was published on the 29th January: Navigating the System.  At that point my aim was to write about developments in peer work in Scotland as I was leading Peer Support Fife, a voluntary organisation I had started up in January 2008.  In November 2011 I had invited Bob to speak in Cupar, Fife, a lecture on Anatomy of an Epidemic, after travelling to Athlone, Ireland, to hear Bob speak in the February of that year, with my youngest son Daniel.

However a couple of days later, on 1 February 2012, things changed dramatically when my youngest son experienced mental distress and went into the acute ward of Stratheden psychiatric Hospital.  When I was out of the ward, collecting a holdall of clothes for my son, he was assaulted by a psychiatric nurse, restrained face-down in the psychiatric ward by 3 other nurses which I witnessed on coming back into the ward, and then later he sustained a broken hand.  Which led to his being escorted in his bare feet and underpants by porters, again witnessed by me from outside in the car park, to a minibus up to the locked ward in another part of the Stratheden Hospital grounds.  I didn't know at that point about his broken hand for no-one told me.  From that day on my writing changed focus and I became a campaigner for human rights in mental health.  For justice in psychiatric settings.

I began to raise complaints in Emails on a daily basis, from 1 Feb12, sent to NHS Fife managers, to Scottish Government mental health division civil servants, to the Mental Welfare Commission for Scotland and to my local Member for Scottish Parliament (MSP).  I didn't know the full story of what happened in the locked ward, the Intensive Psychiatric Care Unit (IPCU), until my son was discharged from Stratheden Hospital in April 2012.  I did not know in early February that he had been locked in seclusion room with no toilet for hours at a time, broken hand untreated, no water to drink, overnight, in the dark, light switch outside.

Following my son's discharge we were left to pick up the pieces after the dehumanising treatment, to cope with the flashbacks, with no support apart from occasional outpatient appointments with my son's psychiatrist.  Who eventually revoked the 6 month Compulsory Treatment Order and supported my son, and I as his advocate, to taper the Haloperidol and come off the drug completely by the August of 2012.  My son has been on no psychiatric drugs since then but has a Bipolar Disorder diagnosis and continues to meet occasionally with a psychiatrist.  He graduated in June 2014 with an honours degree in Sociology which took him 11 years to complete.  He is now 30 years old.

After nearly 18 months of complaining to NHS Fife we raised our complaint to the Scottish Public Services Ombudsman in September 2013 and a year later we had our complaint upheld as "unreasonable treatment”.  The two actions which guaranteed a successful outcome were the transportation of my son in only his underpants and bare feet which I witnessed, and the fact that my son was left locked in the seclusion room unobserved, no toilet and had to defecate on the floor.  This sub-human treatment caused my son to stage a dirty protest and eventually the nursing staff appeared on the scene, unhappy at what they found.  They subjected him to further abuse and humiliation.  My son spoke out about his traumatic psychiatric experiences for the first time in a Scottish Sunday Express article on 5 October 2014, front page and inside:

Psychiatric abuse is a reality in psychiatric settings when mental health law and the safeguards within it are not implemented properly or monitored effectively.  We have found this out to our cost and others also.  Forced drug treatment can be used on mental patients who resist by declaring them to be "without capacity".  This was our experience in February 2012.  Drugs are the frontline treatment in psychiatry, used to "manage" patients and any talking therapies are secondary, usually months later after a person is discharged from inpatient treatment, and in addition to the drugs.  Some psychiatric wards in Scotland do have psychological therapies available, given by clinical psychologists or nurse practitioners.  However these seem to be more of a sticking plaster variety than a means by which people/patients might explore the causes of their mental distress and work through their difficulties.

I would like to see alternative ways of working with people in altered mind states, mental distress and emotional crises that don't just mean psychiatric drugs, given forcibly if resistant or "non-compliant".  It's for this reason that in 2011 I became involved in clinical psychology training groups at Glasgow and Edinburgh universities, for people who are "experts by experience", or service users and carers.  For over 3 years I tried to be meaningfully involved and to have a voice at the table.  However it became increasingly difficult to be heard and to be valued as a psychiatric survivor, an unbeliever in mental illness.  I was up against it from both academics and the people with lived experience, and their carers, who believe in biological psychiatry and that forced treatment is necessary.

The biopsychosocial model of mental health treatment in my opinion isn't a good enough option because the "bio" bit comes first and dominates the discourse.  I attended a workshop in Edinburgh on CBT for Psychosis, in January this year, organised by clinical psychologists, the workshop led by a nurse and professor.  I didn't like the presentations which focused on identifying young people at risk of psychosis.  The term "treatment resistant" was used, also "family history of", "mental disorder", "increased surveillance".  It felt like a Big Brother is watching you scenario.  Here is a storify of my tweets from the event.  I wasn't the only person attending who was critical of the model and the presentation.

I have come to realise that the biomedical model of mental illness is a very dominant discourse in Scotland and psychiatric survivors are a rare breed.  The recovery movement, which drew me in with its promise of peers leading and meaningful involvement of experts by experience, was more about reducing the numbers of people on welfare benefits and getting people back to work.  My recovery story was an account of surviving psychiatry, tapering psychiatric drugs and getting back on with my life, on 3 separate occasions, from 1978 to 2002.  Doing it under my own steam, going against the advice of psychiatry and making a full recovery.  But psychiatrists called it remission and the schizoaffective disorder label remained in my "notes".   A two-tier system of recovery.

I have now retreated from the clinical psychology training involvement on the DClinPsy courses at both Scottish universities.  I liked the men at the top leading but lost patience with the slow pace of change, the lack of real action and the seeming inability to challenge the dominance of psychiatry.  They were just too comfortable and didn't seem to care enough about human rights abuses in psychiatric settings. 

I prefer to be aligned with others who are challenging the status quo, the biological psychiatry paradigm, the conflicts of interest and lack of transparency in drug prescribing and doctors’ relationships with big pharma, the human rights abuses in mental health matters and psychiatric settings.  I am attempting to become more politically aware and to this end am getting acquainted with Scottish Parliament affairs, attending debates and meetings, or watching them online.  I may put my hat in the ring and stand as an independent candidate at the Scottish government elections in May 2016.  It will be a steep learning curve but I believe we need more psychiatric survivors speaking out in our parliament.  People who have survived mental illness and psychiatric treatment. 

Here are examples of action and speaking out in Scotland which I believe are bringing light into the area of mental health matters and are a demonstration of collective action.  You might describe them as like the patterns in a Scottish country dance or the steps in a Highland Fling:

The Sunshine Act for Scotland Petition PE1493 raised by Dr Peter J Gordon, Consultant Psychiatrist, was considered again in parliament at the Public Petitions Committee meeting on 31 March 2015:

"Calling on the Scottish Parliament to urge the Scottish Government to introduce a Sunshine Act for Scotland, creating a searchable record of all payments (including payments in kind) to NHS Scotland healthcare workers from Industry and Commerce."

Dr Gordon attended the meeting as a spectator and in the Windows post on his Hole Ousia website, says "This post is to thank the Committee for considering the opening of a window.".   And here is a link to his writings, films, the history and submissions of his petition: A Sunshine Act for Scotland.  

Open and transparent from omphalos

At the same parliament meeting on 31 March there was a new petition submission PE1550 from Andrew Muir, on behalf of Psychiatric Rights Scotland, a Mental Health Act inquiry:

"Calling on the Scottish Parliament to urge the Scottish Government to set up a public inquiry into historical cases of abuse of people detained under the Mental Health  (Scotland) Act 1984 and the Mental Health (Care and Treatment) (Scotland) Act 2003"

Here is the Summary from the meeting, regarding Mr Muir's petition: "The Committee took evidence from Andrew Muir. The Committee agreed to refer the petition, under Rule 15.6.2, to the Health and Sport Committee, to consider in the context of its scrutiny of the Mental Health (Scotland) Bill. In doing so, the Committee also agreed to write to the Scottish Government."

Meanwhile Hunter Watson, Scottish human rights campaigner from Aberdeen, continues his quest for a wider review of Scotland's mental health legislation so that it may be compatible with the European Convention on Human Rights.  In his recent paper Legal Matters he recommends that:

"The Minister should seek legal advice as to whether the Convention on the Rights of Persons with Disabilities and the General Comment on Article 12 issued by the UN Committee on the Rights of Persons with Disabilities require that significant amendments be made to the 2003 Mental Health Act." 

Mr Watson has also campaigned against the use of forced ECT on mental patients: 'Mental health patients could go to court over electric-shock treatment', 16 August 2014, Press and Journal.
I am continuing to keep an eye on the Dundee Advanced Interventions Service (DAIS) which offers NMD (neurosurgery for mental disorder) in the shape of Anterior Cingulotomies to people experiencing "severe and chronic treatment-refractory depression (TRD) and obsessive-compulsive disorder (OCD)".  

Consultant psychiatrist Dr David Christmas is part of the staff team at DAIS and I have devoted a page on my main blog to a critical consideration of his MD thesis from 2006: 'Functional neurosurgery for intractable mental disorder: long term effects on mental health, neuropsychological performance, social function, and quality of life'.


"I think it's somewhat of an understatement to say that Moniz (credited with inventing lobotomies) and Freeman (ice pick lobotomies) were not "truly objective".  The fact is that these men powered ahead with invasive brain surgery which severed the neural pathways to and from the prefrontal cortex, the anterior parts of the frontal lobes of the brain."

Another extract:

""A Surgically Induced Childhood" from The Lobotomy Letters, The Making of American Psychosurgery By Mical Raz:

 "In 1947 Freeman answered a letter from a frustrated father of a lobotomy patient. The father complained that his daughter was often uncooperative and childish, and that he and his wife experienced considerable difficulties in caring for her at home. “The best means of controlling such behavior,” Freeman advised, was “a rapid change from one type [of activity] to another around the house and frequent outdoor activity, lots of affection and once in a while a good old span[k]ing if she does not behave herself.” On this point, Freeman cautioned, “It may take two of you to get her down,” but the spanking ‘should be a good one and followed by a dish of icecream [sic], then a kiss and make up.’" 

In conclusion, my son's exposé of psychiatric abuse together with my blogging campaign from 2012 until now has cemented our standing as psychiatric survivors, writing to resist.  We are not alone in speaking out and the solidarity with others is an encouragement even if we do not always all agree.  For there is room to fall out and to fall in again.  None of us is perfect.  There is a crack in everything.  That's how the light gets in.

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