Thursday, 25 April 2013

comfort agreement? no, ground rules

A reflection on the use of comfort agreements at groups and trainings, to control and have power.  It happened recently to me and was only a repeat of the behaviour at previous group meetings.  But this time I managed to stay put and not leave when under pressure and ganged up against.  

The facilitator used the agreement/ground rules to have personal power, to keep silent any critical voices and to enlist the power of professionals to have her way.  It was a perfect example of manipulation and political maneuvering, likely learned behaviour in psychiatric circumstances.  You have to applaud it even when it's directed at you.

I've since been excluded from the group and that's OK for I won't be silenced or bullied into submission or compliance.  Straitjackets aren't an effective threat in what should be a free and democratic society.  The fact that I appeared to be a lone voice doesn't mean the majority was right (although it could have been they were too feart to speak out, as in losing their 'position')  Calling it a comfort agreement doesn't make it any different from ground rules, which is what they were.

Rules and regulations dressed up to be something else.  Keeping critical voices silent and women in their place.  Women doing it to other women.  For the benefit of the patriarchal status quo, not for the sake of the individual.  Hierarchical shenanigans that don't help the cause, of psychiatric system transformation and real person centred care.  Human rights for all.

WRAP as a power tool

I want to see WRAP - wellness recovery action planning - used as a power tool in terms of a person taking charge of their own mental health, taking back the power from the psychiatric system and getting back on with their life.  It can be done, that's what I did, and many others too.  WRAP can help with this.  

WRAP isn't just about keeping well.  It's got recovery and action in the title.  Now action is what I like and have always preferred to do something and not just talk about it.  Whereas in Scotland's mental health world there seems to be a lot of talking and not much doing.  Consultations and having users, survivors and carers 'involved' but often it's a tick box, tokenistic task.  

We go along, say our piece, they decide what fits in with their strategy and plans, and then we get left behind.  It felt like that with the SRN narrative research project.  I shared my story in 2005 then updated in 2008, others told their stories to interviewers, they went in a book and then?  Who knows what has been the result.  It's a mystery.  For things seem to be going on just the same as before.

Human rights abuses in locked psychiatric wards, psychiatric drugs the only option for the 'severe and enduring' with 'mental illness', recovery for some and not for others.  ECT and brain surgery continues as a 'therapeutic' option.  Mostly to women because obviously we are the depressed ones.  If that's the case then why are See Me doing primetime TV adverts just now in Scotland aimed at men?  On golf courses.  And what is it costing?  Will the men be up for ECT and brain surgery if the drugs don't work and they are deemed 'treatment resistant'?

Let's get WRAP into crisis plans and advance statements.  Give it the power it deserves.  Not just a wishy washy arty crafty tool that makes everyone compliant and a nice person.  What's nice got to do with it when they are coming towards you with anti-psychotic in syringes and mood stabilisers in pill form?  Drugging the distressed, shutting up the sensitive among us who feel the world's pain and our own powerlessness. 

Let's get into developing strengths and resilience, discovering and recovering abilities to withstand the pain and the psychiatric onslaught.  Support for getting off psychiatric drugs, involving tapering techniques and peer support, sharing mutual experiences.  Because for me to get off the psych drugs I had to do it on my own in 2003, and nothing has changed since then in Scotland.

See Laura Delano's latest post on Mad in America 'Finding the Meaning in Suffering: My Experience with Coming off Psychiatric Drugs (in a Nutshell)', a powerful testimony of her escape from psychiatry and plans to build "a directory of “mental health” providers across North America (and eventually, we hope, the world) who will work with people wanting to come off psychotropic drugs".  Scotland should be part of this movement and not be left behind in this important piece of work.

Wednesday, 24 April 2013

WRAP in Scotland, top heavy with health professionals

A brief post about WRAP - wellness recovery action planning - in response to an Email I got on Friday from SRN, excommunicating me from the facilitator network.  With mention of needs rather than free speech, personal responsibility, equality, fairness, justice.  For the network is top heavy with mental health professionals who run to the rescue of those with "needs".

This is what's wrong with the recovery movement, it's really a recovery for some movement and wrap in cotton wool others movement.  Hierarchical just like other mental health institutions rather than taking back the power and being responsible for our own lives and welcoming the risks.  

I didn't recover, and survive mental illness and the psychiatric system, just to be straitjacketed by so called networks of people with 'lived experience'.  A euphemism for let's keep it just the same as it always was with a few at the top and most of us at the bottom.

Here's to being at the bottom, at the grassroots and having a voice!  


Tuesday, 23 April 2013

the Scottish Human Rights Commission and psychiatric human rights abuse

I've just sent an Email to Professor Alan Miller at the Scottish Human Rights Commission in response to their news item just tweeted, regarding their 'Submission to the United Nations Committee Against Torture' .  Although there is mention of "abuse of the elderly within care settings", I can see nothing about human rights abuses in psychiatric locked wards.  And I wonder if it really doesn't matter to the commission or to anyone outside of the psychiatric system, as to what happens behind the locked doors of mental institutions?

Does having a mental disorder label mean that anything goes, in terms of seclusion, restraint and forced treatment?  Can psychiatric nurses lock patients in seclusion rooms without a toilet or water to drink, and leave them there for hours unattended?  Is it OK for carers to be bullied and intimidated for trying to protect their family member in the locked ward from being inhumanely treated?  Will the police force be sent for to further intimidate and frighten a mother in her home so that the psychiatric system can do what it likes with her son?

I don't understand why psychiatric patients are treated worse than prisoners and why psychiatric hospitals get away with it.  Where is the justice in this?  Who is standing up for people with mental ill health who find themselves in distress, locked up and forcibly treated?  And who is there for the mothers and carers of the locked up psychiatric patients as they do all in their power to protect their families from human rights abuses in places that are meant to be about care and treatment?

From Mad in America web magazine: "In a statement to a session of the United Nations Human Rights Council in Geneva on March 4, the U.N. Special Rapporteur on Torture and Other Cruel, Inhuman or Degrading Treatment of Punishment (Juan Mendez) called for a ban on forced psychiatric interventions including forced drugging, shock, psychosurgery, restraint and seclusion, and for repeal of laws that allow compulsory mental health treatment and deprivation of liberty based on disability, including when it is motivated by “protection of the person or others.”".   Statement from Juan Mendez.

Prof Miller says “Whilst people living Scotland and the UK are fortunate in enjoying a relatively high level of human rights protection there are many important issues that the Committee can raise with the UK Government next month.”.  I contend that the "high level of human rights protection in Scotland" does not extend to locked-in psychiatric patients who are at risk of seclusion, restraint and forced drugging. 

Friday, 19 April 2013

WRAP and Peer Support in Scotland from my point of view (part one)

I first heard about WRAP - wellness recovery action planning - in 2006 at a presentation in Edinburgh by Stephen Pocklington of the Copeland Center.  Prior to this I'd attended the SRN conference on Peer Support in Glasgow, December 2005, where my interest in the American mental health movement began.  For I saw the potential of psychiatric system and mental health service change.  Or so I thought.

Something different to what was going on in Scotland at the time, in terms of user/survivor power and a human rights movement which didn't seem to be happening here.  But I knew what I'd experienced at the hands of psychiatry, the grabbing and jagging, the sense of being treated like a criminal because of so-called mental illness.  We were just as much in need of a movement for change.

And so I got involved by starting up Chrys Muirhead Associates (to deliver workshops) and Peer Support Fife (voluntary organisation) in January 2008, organising the Celebrating Recovery conference in April 2008, and training as a WRAP Facilitator in June 2008.   What seemed to be a natural progression in the Scottish scene, after sharing my recovery story on SRN in both 2005, updated in 2008.  And then the fireworks began as the powers that be tried to make me conform.

I had completely recovered and survived mental illness and the psychiatric system but they were trying to reign me in and disempower me.  But I just went out and about with WRAP, delivering workshops in tandem with another facilitator, in response to demand, our first one in Fife.  We talked about being in control when things were out of control.  We shared our stories of recovery and what it was like in the psychiatric systems.  No holds barred and telling it like it is.

Others were still trying to put a leaflet together explaining WRAP and debating how it should be facilitated.  Meanwhile we went out and about in Scotland delivering WRAP and learning as we went along.  Which is the way of community development, from my experience of 30 years.  Taste it and see.  Think of the outcome and then work towards it.  Risk taking rather than being risk averse.  Putting recovery into practice.

The point being that if I'd waited for direction from leaders in mental health and psychiatry well I'd never have recovered, got off all the psych drugs and got back on with my life.  Straitjackets are not the answer, in my experience, and demonstrate limited negotiation skills and have nothing to do with recovery.

Saturday, 6 April 2013

making a start to comparing psychiatric services in Fife and Dundee

Most of my recent carer experience of psychiatric services has been in NE Fife, Stratheden Hospital, since 1995.  I also was a Lomond Ward inpatient myself in 2002 when I went in voluntarily only to be detained for 72hrs and made to take the psychiatric drugs, the anti-psychotic risperidone.  I didn't want to take it for I knew that anti-psychotics would depress me.  It had happened before in 1978 and 1984, when I was a psychiatric inpatient at Hartwoodhill Hospital, Lanarkshire, in the days when grabbing and jagging could be done without having to detain a patient.  And ECT was more commonplace although I managed to resist it.

I knew in 1995 that the care in Lomond Ward for my oldest son wasn't good enough and we complained at the time but to no avail and there were critical incidents that caused us major concerns.  The psychiatric discharge support was minimal, it was more about staying on the psychiatric drugs and remaining in the system.  But my son wanted to recover so I helped him on the journey and recommended getting off the drugs within the year and getting back on with his life.  That's what I had done in previous episodes of psychoses.  He followed my advice and recovered.

In 1999 when my second son experienced a psychosis I made sure to get him out of Fife and back to Dundee where he had been living, and so he went into the Liff Hospital as a psychiatric patient, also again in 2000, then made a recovery and got back on with his life, although still on psychiatric drugs as he was OK about taking them.  In 2005 my third son had a mild psychotic episode and went into Lomond Ward, Stratheden, and has had 3 other inpatient stays since, each one a more traumatic experience because of the dehumanising treatment, poor nursing practice and lack of therapeutic input.

There's something in Fife's psychiatric services that wants to make revolving door patients out of people who experience psychoses or hear voices, and keep them in the system for life.  They tried it on with me in 2002 and it took me 2 years or more to escape, from the prognosis of 'severe and enduring mental illness' and lifelong lithium.  Fife has the most Left Behind patients according to the Mental Welfare Commission report of 2011, on their visits to people with 'severe and enduring mental illness'.  I always think "it could have been me" if I'd lived in Fife back in the day and believed the mantra of mental illness.

My youngest son's 2012 Stratheden Hospital psychiatric inpatient stay was the worst one yet and a year of complaints were not answered to my satisfaction.  It caused me to write in frustration 'don't bother complaining, it's not worth the effort' because of the sense of cover-up and justification of dehumanising 'care' and social work colluding with psychiatric services in the use of restraint, seclusion and forced treatment.  Although I've lived in Cupar, Fife since 1990, my present house for 15 years about a half mile from Stratheden, this last encounter with Fife's psychiatric/mental health services has forced me to consider a move out of the area.  

I am scunnered by the tokenistic involvement of users and carers, the failure to resource mental health services properly and the justification of poor practice and shoddy management.  I organised many events through Peer Support Fife to raise awareness of recovery, peer working, meaningful involvement and the problems of long term psychiatric drug use.  But it will take a major cultural shift for real changes to happen so that recovery is recognised and people with lived experience have a voice, are listened to and can participate as equals at the table.  Until then it's just going to be more of the same in a different wrapping.

And then at the end of 2012 my middle son came back into the country and to Dundee, to live and work, couldn't access any crisis support so we had to get him into Carseview Centre for psychiatric treatment.  It's been three months of engagement with the Dundee psychiatric services, management and practice workers.  Some complaints by me which have been handled quickly and competently.  I've challenged issues as they've arisen and been treated with respect.  A different ball game altogether from my Fife experiences, like night and day.  And yet I'm told that Carseview isn't the best on offer in Scotland.  The postcode lottery of mental health care in Scotland.

I will write more about the specific differences in future blog posts.  About nursing practices, recovery focus, management of patients, therapies on offer, environmental considerations, volunteer involvement, information resources, social worker input.  And the overall experience from the carer point of view and something about the patient's perspective, third party.