Friday, 29 August 2014

centre of excellence?

What makes a university mental health nursing course a centre of excellence? Because they say so then is it so?  I don't think so.

I say this because I was involved with this university from the "lived experience" perspective, employed on occasion to deliver Wellness Recovery Action Planning (WRAP) to students and other plans were in the pipeline.  Then suddenly I was dropped unceremoniously.  Dumped.

Only to find out later on that they had formed relationships with other Scottish mental health organisations who had in the past excluded me from WRAP and Peer Support events.  

One of these organisations had taken my idea, a draft descriptor for an HNC Peer Support unit developed in partnership with a Cupar college head of care, in late 2007, showed it to government then left me out of any discussions from then on in, with SQA, although I asked on a number of occasions to be included.  Nothing to be proud of there.

You can't build a centre of excellence by stepping on people with lived experience or by using them then excluding them.  It leaves a bad taste in the mouth and isn't the way to win friends and influence people.  

The university is in my local area and I have another family member starting a degree there next month who I'll be mentoring and scribing for.  Therefore this blog post is to let the university mental health nursing programme leaders and their associates know that I won't be forgetting how I was treated.  

I've got over it now and am busy with other stuff however if they treated me like that then they are likely to be doing the same with others.  People need to know what is going on.

Using a person (a carer and psychiatric survivor) then discarding them is not a demonstration of excellence.  In my opinion.  

Wednesday, 27 August 2014

Powys Mental Health Blog: 'Mental Health Act 1983 – Code of Practice: the review (in England)'

Powys Mental Health Blog: Mental Health Act 1983 – Code of Practice: the review (in England) :  

"Jan Rogers, who recently wrote for us about Volunteering whilst getting benefits, has been playing a key role over the last few months in the review of the Mental Health Act 1983 Code of Practice in England. This work is being led by the Department of Health and backed by the Minister for Health, Norman Lamb, you can read more about PAVO’s role in this work here

Jan was recently asked to speak about her experiences, as someone in contact with mental health services, at the Expert Reference Group reviewing the Code. With her permission we are publishing Jan’s talk as a guest blog post."


Jan Rogers
"I was diagnosed and labelled with "Post Traumatic Stress Syndrome” and depression. The reality of it all and the issues I have had to deal with, and still do, day to day – are guilt, lack of self worth, failure to family and friends and society in general (although after I was labelled I didn’t seem to have as many friends), flashbacks, voices, hallucinations (even to the extent I can’t always tell if the people I am talking to are real or not).

When I an unwell I tend to pace backwards and forwards with my fist clenched usually talking to the people that others may not see. I feel that this is the only way to keep control and to stop them taking over. In the past people, police, doctors and other professionals, have perceived me as on drugs or alcohol and mistaken my pacing and keeping control as lack of control and a possibility of turning violent. Those that know me know I am not, and never have been, violent towards anybody.

Read complete blog post  

Tuesday, 26 August 2014

the bankruptcy of a system where the prevailing culture is coercive

There are no winners in a game where casualties are the outcome.  There is nothing to be proud of.

Stratheden signposts
The problem with psychiatric system thinking and the biomedical model of mental illness is that any resistance is met with patriarchal decision-making and the infantilisation of the conscripts.  On both sides of the fence.  The staff also lose their agency but not their liability.  

"If you fly with the crows, you get shot with the crows": If you wish to be associated with a particular high risk and/or high profile situation and benefit from the rewards of that association, you have to accept the consequences if things go wrong - you cannot dissociate yourself. (Cambridge International Dictionary)

Forcing psychiatric drugs into a person is very risky, regardless of the label they are given beforehand (or after) so as to justify the coercion.  Mental health acts are laws that reinforce the coercion although they are meant to also safeguard the person being detained.  But in my experience the safeguards aren't safe and the Act gives more power to the enforcers.

Stratheden - view from Lomond car park
The risks of working in mental health leadership or as a psychiatrist is that anosognosia (lack of insight) takes root and capacity wanes.  A godlike persona appears, surrounded by their sycophants, and they believe their own press.  Regardless of relationship or scientific proof.  Because they say it then it is so.  Delusions of grandeur.  Madder than a box of ferrets.  (I can name a number of folk like this in Scotland's mental health world)

But it's not funny when people are being disabled by a coercive system and mothers are having to pick up the pieces.  I am really fed up with numpties at the helm.  Mostly men but some women too who have left their marbles back in the playground.  

There are more issues when there are less resources, as with Stratheden Hospital and the other Fife psychiatric settings.  You just need to compare the cost of a patient bed per week.  In Fife it is around £2000-£2500/patient/week whereas in Carseview it is £3000 and in the new Rohallion low/medium secure unit at Murray Royal, Perth, I hear it is £4000/week.  A general acute inpatient hospital bed is around £4500/week.

It won't just be about the money but also about the management of resources.  I met with the Fife heads of Clinical Psychology and OT back in 2011.  The former said she had no authority in Stratheden, the latter said she wasn't about "micro management".  They may have now changed their tunes.  But I do know that there was no psychology available or OT groupwork going on in either Lomond or IPCU wards in 2012.

I also met with clinical management back in 2011 after first raising concerns about Lomond Ward in 2010, and the meeting was a right waste of time.  They were defensive and patronising.  I was bullied.  At that time the leaders at Stratheden were not accountable to their "customers".  I expect things to have improved but have no evidence to prove it.

Stratheden- older wards

In 2012 we tried to access CBT for my son at Stratheden and we could only get Mindfulness, regardless of our trying to negotiate it with the clinical psychologist.  He would not listen.  It was his way or no way and I had to work through CBT techniques with my son.  Like keeping a dog and barking yourself.

I think the patriarchal nature of psychiatry has impacted negatively on Stratheden Hospital in particular, because of its lack of resource and coercive culture.  If they take the facilities out of the wards then the nursing staff will be left to their own devices.  That's what was happening back in 2010.  I raised the alarm to no avail.  Shooting the messenger was our experience come 2012.

We need psychology and occupational therapies in the wards, also voluntary organisations with a presence.  The more people going in and out of the psychiatric wards will lessen the likelihood of abusive practices (keeping it in the family) and patients becoming casualties.  I recommended this back in 2010.  But no-one listened to me.  

I hope someone is listening now.

Monday, 25 August 2014

"keeping it in the family": the issues that can arise when family members work in the same psychiatric settings

I believe there can be problems with family members working in the same psychiatric setting as nurses or managers (or doctors although that is likely very rare) eg father and son, mother and daughter, husband and wife etc.  

Because if a patient or carer raises concerns or a complaint about the unprofessional behaviour of a nurse or manager then this can impact on future care and treatment of the person.  Especially if a culture of intimidation and abuse already exists in a psychiatric hospital.  

For example.  If a nurse in an acute ward was involved with an incident of restraint on a patient which resulted in the patient being injured and transferred to the locked ward where his wife worked as a nurse, then the treatment of that patient and their carer might be compromised.  

I suppose it is understandable that a person will want to protect their family member.  I know what that is like.  However, in my opinion, there is no justification for dehumanising treatment and using force, for bullying mothers and carers, for denying basic human rights to psychiatric patients, for using locked seclusion rooms with no toilets or drinking water. 

Clinical managers in psychiatric settings where there is a history of family members working as nurses or other professionals have to be extra vigilant to ensure that complaints about practice are investigated independently and thoroughly.  It also should apply where clinical managers themselves have family members working in the same medical discipline and geographic area.  

I believe that comprehensive feedback processes and procedures will help with transparency so that all patients and carers can speak openly and truthfully about what their inpatient treatment was like without fear of repercussions.  Like customer feedback in other settings.  

The Patient Opinion website can help with this, in my experience.  Although it's only a start.  All health boards should have their own feedback systems and complaints processes that make it easy for people to give positive and negative feedback on their experiences of NHS services.

This is particularly important in psychiatric and mental health services where people can be compelled and coerced to take treatment, against their will, under law.  Where phrases like "non-compliant" and "without capacity" can be used to justify the use of coercion and the denial of a person's wishes, even if written previously in an Advance Statement which is not a legal document.

Independent Advocacy is another important safeguard under the Mental Health Act which unfortunately, I think, has lost its power and is a postcode lottery, in terms of whether a person can access good quality advocacy when necessary or can only get a tokenistic service, 9-5, Mon-Fri, with workers on low wages, managed by a service provider, paid for by statutory monies.

Another safeguard is the Mental Health Tribunal but in my experience this has been weighted in favour of professionals and is rarely won by patients and their advocates.  To win a case requires a good solicitor, supportive carer and an MHO who is on the side of the patient.  The latter is also rare, in my experience.

However despite the MH Act appearing to be more of a tool for the professionals rather than a protection for the people labelled with "mental disorder", and respect for their carers, I will continue to speak out and have a voice, to bring about balance, for the sake of justice.

"There will be justice ... when those who are not injured are as outraged as those who areThucydides

remembering Saturday 4 February 2012 and being bullied by 5 psychiatric nurses

I woke up this morning and remembered what it felt like on Saturday 4 February 2012, to be bullied by 5 psychiatric nurses for wanting to see my son at visiting time in the Stratheden IPCU, to photograph his broken hand and bruising.  You might describe this as a flashback.

I'd only heard the day before, 3 days after it happened, that he had a swollen hand, likely broken, for no-one had said on the Wednesday when the injury occurred, cornered in a back room of Lomond Ward by 3 male nurses.  

IPCU back view
I went in through the back door of the IPCU, although other visitors got in the front door, and said about my wanting to take photos of my son's hand.  The nurses on duty said I couldn't use a camera in the ward.  I said it was the dining room, not the ward, as I wasn't allowed in the ward.

The nurses got agitated and went to confer with the charge nurse and others.  I sat at a table in the dining room, the only person there.  Eventually a group of 5 nurses returned, 4 of them standing round me at the table, the other main charge nurse of the hospital sitting down, an older woman about my age.

They said that my son didn't want to see me (wrong for my son phoned me later asking me to visit).  They said he was sleeping (wrong again).  They stood close and intimidated me by their standing over me where I sat.  I was looking through the IPCU patient booklet which was about 4yrs out of date.  

I stayed where I was, sitting at the table, until they moved away.  I was not going to let them bully me out of the dining room until I was ready to leave.  I eventually got up to leave and let the ward nurse know that I would be coming back at the evening visiting at 6pm.

I came back at 6pm, was let in through the back door, in the dark, no light outside or bell on door.  I had to keep knocking until someone heard.  I visited with my son, saw his broken hand, asked for the junior doctor to examine it, for it hadn't been treated.  I then instructed him to arrange an X-ray and on the Monday I went in my own car to the general hospital to keep an eye on my son during the X-ray where his hand breaks were confirmed.

For two weeks after the Saturday bullying incident I felt physically unwell, exhausted, like I'd been in a fight.  I had to take bed rest, was dehydrated, sore muscles, headache.  My oldest son came to visit, did some housework, got me messages.  My good friend shared the visiting of my son in the IPCU over the next few weeks.  

I won't forget the implied force that was used on me in Stratheden's IPCU which mirrored the forced treatment and human rights abuse perpetrated on patients within the ward at the time.  Learned behaviour by staff which was cultural and had been going on for quite some time, probably decades as I'd heard from a former patient of his experience over 30 years previously.  

I expect that staff in the Fife IPCU will have stopped using bullying methods in their practice and denying basic human rights to patients in their "care".  That staff will have stopped rolling their own cigarettes while they work, in front of patients.  That staff will not be locking patients in the seclusion room which has no toilet or water to drink and a light switch outside, and leaving them unobserved for hours at a time.

I expect that the conditions for patients in the IPCU at Stratheden Hospital will have vastly improved but I have no proof or evidence of it.  One thing is for sure I will not agree to any more of my family members becoming patients at Stratheden Hospital, and that includes me.  We have written Advance Statements to this effect.

It is far too risky for me and mine to be inpatients at Stratheden Hospital.  I raised a number of concerns about Lomond Ward and the nursing practice in 2010, didn't take them to a complaint but told management and Scottish Government mental health division about issues.  Then in 2012 my son and I both had to suffer for it.  Now I take everything to a complaint and speak out at any and every opportunity.

I am not prepared to put up with bullying and intimidation by psychiatric nursing staff and others in mental health organisations.  It's bad enough that they pin stigmatising mental disorder labels on to us which discriminate and mark us out as defective.  Diagnoses which allow staff to force psychiatric drugs into us.  The drugs disable and cause further mental health issues.  A double and even triple whammy. 

I want to see alternative ways of working with people in emotional crises, mental distress or altered mind states, that doesn't mean forced drugs and disabling disorder labels.  People are individuals and should be treated as such.  

The Scottish Mental Health Strategy: "fully supports and adopts the 3 Quality Ambitions for Scotland that health and care must be:

Person centred - which is;

Mutually beneficial partnerships between patients, their families and those delivering healthcare services which respect individual needs and values and which demonstrate compassion, continuity, clear communication and shared decision-making.

Safe - which is;

There will be no avoidable injury or harm to people from healthcare they receive, and an appropriate clean and safe environment will be provided for the delivery of healthcare services at all times.

Effective - which is;

The most appropriate treatments, interventions, support and services will be provided at the right time to everyone who will benefit and wasteful or harmful variation will be eradicated."

I expect Scottish Government mental health division and ministers to ensure that health boards comply with the strategy.  But we're not there yet, in terms of "mutually beneficial partnerships" and "shared decision-making".

Sunday, 24 August 2014

'Why I resigned from NHS Forth Valley' @PeterDLROW

Hole Ousia Blog post 'Why I resigned from NHS Forth Valley' by Dr Peter Gordon (@PeterDLROW), Consultant Psychiatrist

"I resigned from work on the 6th June 2014. Some folk have been wondering why. Below I offer briefly the background to my decision to resign and why it was a matter of more than just principle.

I have worked for NHS Forth Valley as a Consultant in older adults in Clackmannanshire for nearly 13 years. This has been hugely rewarding for me and indeed a privilege to share in the lives of the wonderful elders of Clackmannanshire often in a time of need."


"I was concerned that our most elderly were more at risk of mis-diagnosis of dementia."

"My concern was that in the late stages of life individuals who would never develop dementia were being told they had it."

"My approach was first to discuss this with colleagues, which only confirmed that my view was that of the minority. I then raised the matter through the appropriate channels of line-management. Initially I was supported in raising my concerns. However this did not last: the most likely reason for support being withdrawn was that I was diverging from the majority."

"From that time on my professional life got tough."

"Through stress I was signed off by my GP and was off for 6 months. Interestingly having been off once before in 2004 (my only severe depression caused by discontinuation of Seroxat) I found that I was re-defined by some as a case of “recurrent illness".  I have found it very difficult to escape this stigma and my experience has been that my profession is just as likely as any other to see “illness” before the person."

"I have petitioned the Scottish Government for ‘A Sunshine Act’ and have argued that we should at least have transparency of financial interests equivalent to that which we expect of our parlimentarians.

My experience has been that it is not easy to pursue transparency in the health service. If anybody is interested much of this can be followed here."

Read complete Hole Ousia Blog post 

Thursday, 21 August 2014

Excellence in Practice Seminars @MentalWelfare and the Meaningful Involvement of people with Lived Experience

I'd received an E-bulletin yesterday from the Mental Welfare Commission for Scotland, advertising 'Excellence in practice seminars' in topics of:
  • Seminar 1; Medical Treatment for People who Lack Capacity: 22 Oct. 2014 at COSLA Conference Centre, Edinburgh 
  • Seminar 2; Restrictive Management of Individuals - Rights, Risks and Legislative Frameworks: 20 Nov. 2014 at COSLA Conference Centre, Edinburgh 
  • Seminar 3; Professional Challenges - Welfare Guardianship and Powers of Attorney: 26 Nov. 2014 at Discovery Point, Dundee 
I checked out the "target groups" as intimated by the MWC and these were all "professionals" working in statutory agencies eg Mental Health Officers, CPNs, GPs, Care Home Managers, but no mention of service users or carers.  So I Emailed to find out if people like me would be welcome at the seminars.

I received a response from Colin McKay, Chief Executive, MWC, confirming that  
"service users and carers are not the target group for these seminars"

"These seminars have been specifically designed for the practitioners identified in the target groups.  They address the difficult practice and legal issues that these practitioners face, and have been designed to provide detailed input from the Commission and to encourage reflective discussion by practitioners in response to this.  This format has been running for several years, and was established to support and enhance the guidance we issue, for practitioners who use it in their work.

We of course also provide guidance and advice for service users and carers, and we are conscious of the need to do more to support service users and carers in understanding their rights and how to claim them.  Following some research involving service users, we are looking at how best we can achieve this. Of course, the number of people with lived experience is considerably greater and more diverse than the specialist mental health professionals who might attend seminars such as these, so we need to think about how best to ensure what we offer is what people with lived experience and carers want and need, delivered in a way which is of most value to them. This work is at an early stage, but it will be a priority for us." 

Here is my Email reply:

"thanks for personally responding.  I appreciate that you have taken the time to do so. 
I can understand that psychiatric and mental health practitioners should be the main target for the MWC.  It's been my family's experience over the last few years that psychiatric and mental health staff are not well versed in the mental health act or in how the principles should be practised.  We have found out, to our cost, that what is written in the Act, to do with rights and safeguards, are not always happening behind the locked doors of psychiatric institutions.

It is good to hear that you are considering how best to inform and support people like me, carers and service users, in understanding what our rights are and how to claim them.  However it was our experience, as a family, that even when we knew our rights and tried to claim them, that we were not listened to.  This led in February 2012 to bullying and intimidation by psychiatric staff, to the use of a seclusion room with no toilet or water to drink, and human rights abuse, perpetrated on my son.  
I was also bullied and intimidated then badmouthed in psychiatric notes, as in "difficult and demanding mother" for trying to photograph my son's injuries.  Then, after highlighting the issues to statutory agencies, the fact that my son was at risk, I was then accused in an adult protection investigation of causing "psychological harm" to my son.

I found out, when eventually getting a copy of the adult protection investigation report months later, that a psychiatrist and CPN were questioned regarding my character while their colleagues were subjecting my son to human rights abuse.  The irony of trying to blame a mother for system failure.  I blew the whistle and for my pains became a target myself.

Therefore I would say that the Mental Welfare Commission for Scotland does need to target mental health professionals in areas/topics like restraint, coercion, capacity, risk, safeguards, respect for carers, safe practices and even how to write notes accurately.  Additionally I would like to see the Commission think of ways to meaningfully involve people like me in your seminars as facilitators.  People with lived experience leading the way.

I want to challenge you, as the new MWC leader, to consider how my experiences and others who have had similar negative outcomes, may be an asset to the work of the commission rather than excluding us from the mix as has happened with Healthcare Improvement Scotland and the Scottish Patient Safety Programme in Mental Health.  It makes no sense, in my opinion, to ignore or try to silence the people who have been subject to abuse or negative treatment in Scottish mental health settings.

I would like to see Scotland leading the way in the meaningful involvement of people with lived experience of "mental illness" and recovery (or survival).  Up to this point since 2008, in my experience it's been a tokenistic, tick box exercise.  We are often kept at arm's length or patronised.  It wasn't like this in the community education world where I spent most of my working life, empowering people and promoting lifelong learning.

I do believe that when we sort out the issue of forced treatment (first do no harm) and offer a range of alternatives to psychiatric drugs then everyone will be a lot happier, patient, carer and professional.  For how can it ever be OK to forcibly inject another person with harmful drugs then tell them to stop falling over (happened to my son after getting 25mgs Haloperidol when locked in the seclusion room. I had to instruct the nurses to give procyclidine)?  Or deny them basic human rights so as to "manage" the patients (no pens to write with unless supervised by 2 nurses, water dispenser locked away in dining room, locked seclusion room light switch outside no toilet etc etc)?

There's the challenge.  Include us, involve us and learn from us.  Level playing fields and straight paths.
Regards, Chrys"

I forwarded the Email on to Geoff Huggins, Scottish Government, now Acting Director of Health and Social Care Integration, copying in Healthcare Improvement Scotland management, also Scottish Patient Safety Programme in Mental Health leads and Scottish Government mental health delivery team members and ministers.  For their information.  Saying:

"(For interest) A dialogue with Colin McKay regarding the meaningful involvement of people with lived experience in Mental Welfare Commission for Scotland matters.  Having us at the table, as equals, leading and facilitating, teaching and promoting learning.

It makes no sense to be excluding the critical voices of experience from dialogue and it would demonstrate a more skilful style of management to be incorporating psychiatric survivor and mental health service user voices at every level.  I do hope that sense prevails.  That we could have action and not just rhetoric."

Tuesday, 19 August 2014

Peter Kinderman's blog: Times of Change and Opportunity: Towards a psychological model of mental health and well-being

Times of Change and Opportunity: Towards a psychological model of mental health and well-being
by Peter Kinderman , Professor of Clinical Psychology at the University of Liverpool

Notes for a paper presented at 122nd Annual Convention of the American Psychological Association at Washington, DC, August 7-10, 2014.


It is a time of significant change in the field of mental health. The publication of DSM-5, the fifth edition of the American psychiatric diagnostic manual, has proved controversial, and has led many to question the creeping medicalisation of normal life, and to criticise the poor reliability, validity, utility and humanity of conventional psychiatric diagnosis. Reviews of the ineffectiveness and adverse effects of many psychiatric drugs as well as of the effectiveness of evidence-based psychological therapies have led many to call for alternatives to traditional models of care.

Psychological science also offers robust scientific models of mental health and well-being. These integrate biological findings with the substantial evidence of the social determinants of health and well-being, mediated by psychological processes.

We must move away from the ‘disease model’, which assumes that emotional distress is merely a symptom of biological illness, and instead embrace a psychological and social approach to mental health and well-being that recognises our essential and shared humanity."

Read complete post

Monday, 18 August 2014

Scotland's mental health strategy - a damp squib and a disappointment but I shall persist

Since getting involved in Scotland's mental health world in 2008 I have taken part in many consultations, run by government and government funded organisations.  In particular the "new" mental health strategy consultations in 2011 where I attended national events and completed an individual response, all of this in a voluntary capacity.

I remember asking the question in a blog post at the time of the strategy
launch in September 2012 - "is the new mental health strategy more than just a fine piece of rhetoric?". 

And the concluding paragraph: 

"I'm looking forward to the challenge of finding out if the new mental health strategy is more than just a fine piece of rhetoric.  More than an aspirational document.  And more like a template for action with a real commitment to change.  To bring about a transformation to the psychiatric system and the resulting mental health services.  While recognising and respecting the ongoing stories of the survivors."

Considering that in February 2012 my youngest son was subjected to human rights abuse, forced drugging and humiliations in Stratheden Hospital IPCU, I think it says something about my positive attitude that by the September of that year I was still hopeful that Scottish Government's mental health division was serious about meaningfully involving people with "lived experience".

Nearly two years have passed since the mental health strategy was launched.  What are my thoughts about the strategy?
  • it's an aspirational document that hasn't lived up to its expectations
  • it's not been a template for action or real commitment to change, rather a reinforcement of what has gone on before
  • it hasn't brought a transformation to the psychiatric system or mental health services 
  • the stories of survivors have not been truly recognised or respected
Why is this? 
  • it's a top-down affair
  • meaningless involvement has underpinned the strategy
  • they wanted puppets not flesh and blood people
  • they expected obedience and not free thinking individuals
  • they are used to "service users" kowtowing
  • they don't know how to translate words into action
 What is the solution?
  • meaningful involvement of mental health users, survivors and carers
  • level playing fields and straight paths - civil servants being honest, behaving with integrity, demonstrating equality, admitting their weaknesses
  • team playing, delegating, sharing information, risking relationships
  • recognising and rewarding the hard work of users, survivors and carers
  • breaking down barriers and admitting that we are all in the same lifeboat
How can this be achieved?

For my part I will continue in writing, activism and campaigning, to influence positive change in mental health matters.  I've started so I'll finish.  I will continue to be meaningfully involved with individuals who are of like minds and in groups where my voice is being heard.  

I will also agitate and attend events where I can speak out about the reality of mental health care in Scotland and human rights issues in psychiatric settings.  First do no harm.  I want to see an end to forced psychiatric treatment and alternative ways of working with people in altered mind states, mental distress or emotional crises, that don't just mean drugs.

I expect civil servants to be civil and to be accountable, to the public and to government ministers.  I expect the psychiatric system to improve where I live and for justice to prevail.  I expect that voices of reason in mental health matters will be heard and respected, eventually.  It makes sense.

Sunday, 17 August 2014

#Stagecoach launch & walkabout home town of Perth 14 August 2014 on Storify

"To McDiarmid Park by way of Dunsinane Drive (where my family lived back in the 50's) then down the town to the shops and lunch in a Tay Street posh pub next to St Matthews Church were I attended Sunday School as a wee girl, on my own, helped to get ready by my mum."

Lost [remastered]: film from #Omphalos

Lost [remastered] from omphalos

"This film is about identity."

Friday, 15 August 2014

my exasperated tweets in response to @online_his silly film bite - someone should be keeping an eye on this quango

Here are screenshots taken of a tweet by Healthcare Improvement Scotland yesterday about a Vine loopy video made by one of the HIS senior managers which in my opinion trivialises their work and makes them look silly:

I have Emailed various HIS high heid yins, Scottish Government senior managers and ministers with this subject strapline: 

"can someone please keep an eye on quango HIS? Their films and tweets are embarassing to those of us in Scotland trying to improve mental healthcare. Thanks."

In the hope that someone, somewhere, will see sense and stop them sharing this pap.

And here is a screenshot of the blog post tweeted just now:

Wednesday, 13 August 2014

Bonnygate and Crossgate of Cupar, in Unreal Engine 4

"Video shows player moving along the Bonnygate then down the Crossgate.

Images processed in GIMP (version 2.8.10).
3d models generated in Blender (version 2.71).
Game engine is Unreal Engine 4 (version 4.2.1).

Video captured with Open Broadcaster Software (version 0.584b)"

Monday, 11 August 2014

Triggered by Mark Brown @MarkOneinFour on ABC Tales

Mark Brown (twitter photo)
Triggered by Mark Brown on

"Glass partitions, laminate flooring: the Jobcentre plays at being a corporate space.  A man jokes with the security guard. ‘At least the bookies serve coffee,’ he says.  He winks at me, a tiny blond woman, but I know it’s sex not solidarity.

‘Why don’t they help themselves?’ I hear my dead mother say.  Never worked a day in thirty years of marriage.

I imagine exploding screens, carpet burning like toast, bomb a slicing wind punching off clothes and flesh. 
 ‘There is nothing more dangerous than a clever person deprived of purpose,’ I think; but I am lying.  

I will not bomb this place.  I will not bring it all crashing down any more than I told my dead mother where my Dad’s well-manicured hands went.

“Always best to defuse tensions,” my mother would say.

The man behind the desk is younger than me, forehead detailed by tiny pimples.

“We have to sanction your benefits.”

“But I was at an interview,” I say.  I cannot hear for whooshing in my ears.

“You can appeal, “ she says.

“But I need money now.”

I stand, too much to hold in.  He looks afraid.  

Once I begin bellowing I cannot stop."

Sunday, 10 August 2014

'Wittgenstein,Tolstoy and the Folly of Logical Positivism' Stuart Greenstreet

'Wittgenstein,Tolstoy and the Folly of Logical Positivism' by Stuart Greenstreet in Philosophy Now July/Aug 2014 (thanks to Carl Elliott @FearLoathingBTX for sharing on twitter)

"Stuart Greenstreet explains how analytical philosophy got into a mess:

Austrian artillery unit, Eastern Front 1915
This year’s centenary of the First World War coincides with Ludwig Wittgenstein beginning writing his Tractatus Logico-Philosophicus (Latin for ‘Logical-Philosophical Treatise’), the only book the Austrian philosopher published in his lifetime. Not the least astonishing fact about it is that, as we shall see, most of it was written between 1914 and 1918 by a brave young soldier fighting at the front line.

In July 1914, when the whole of Europe suddenly found itself at war, Ludwig Wittgenstein, a son of one of the richest men in the Austro-Hungarian Empire, was twenty-five years old. He had spent the previous two years (1911-13) at the University of Cambridge, studying philosophy with Bertrand Russell, who was a lecturer there. But he happened to be at home in Vienna on 28th July 1914, when his country declared war on Serbia. A week later, the day after Austria had declared war against Russia as well, Wittgenstein volunteered to join the Austrian army as an ordinary soldier, even though he was exempted from compulsory service by poor health."

"Tolstoy had distilled the four biblical accounts of Christ’s life and teaching into a compelling story. Wittgenstein was so profoundly moved by it that he doubted whether the actual Gospels could possibly be better than Tolstoy’s synthesis. “If you are not acquainted with it,” he told his friend Ludwig von Ficker, “then you cannot imagine what effect it can have on a person.” It implanted a Christian faith in Wittgenstein. Before going on night-duty at the observation post, he wrote: “Perhaps the nearness of death will bring me the light of life. May God enlighten me. Through God I will become a man. God be with me. Amen.”"

"Wittgenstein’s leading idea in the Tractatus was that propositions – that is, statements asserting facts, such as ‘it is raining’ – are a picture of what they describe. This is Wittgenstein’s ‘Picture Theory of Language’, or as he himself called it, his ‘Theory of Logical Portrayal’:
“We can say straight away: Instead of: this proposition has such and such a sense: this proposition represents such and such a situation. It portrays it logically. Only in this way can the proposition be true or false: It can only agree or disagree with reality by being a picture of a situation” (Notebooks p.8).
He added later:
“The great problem round which everything I write turns is: Is there an order in the world a priori, and if so what does it consist in?” (Notebooks p.53) ..."
"To the question ‘What is your aim in philosophy?’, Wittgenstein replied, “To show the fly the way out of the fly-bottle.”"

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'Mindfulness is all about self-help. It does nothing to change an unjust world' Suzanne Moore, in the Guardian

'Mindfulness is all about self-help. It does nothing to change an unjust world' by Suzanne Moore, in the Guardian 6 August 2014.
Suzanne Moore

"Why are we trying to think less when we need to think more? The neutered, apolitical approach of mindfulness ignores the structural difficulties we live with"


"Most of what is wrong in the modern world can be cured by not thinking too much. From psoriasis to depression to giving yourself a "competitive advantage" in the workplace, the answer touted everywhere right now is mindfulness. Just let go for few minutes a day, breathe, observe your thoughts as ripples across a pond, feel every sensation around you. Stop your mind whirring and, lo, miraculously, everything will improve "at a cellular level".

Sorry, it's not working for me because I cannot rid myself of the thought: "Why this, why now?" There is nothing wrong with trying to relax: the problem lies in the "trying". And there is nothing new about meditation, so why has it suddenly gone mainstream?"

"Living in the moment, non-judgmentally, being more self-aware, it's all good. But, actually, more and more people are switching themselves off. They cannot even watch the news because they feel so powerless to do anything about it.

The mindfulness coalition of life coaches, business people and healers cannot – and does not –promise peace, but why are we to think less when we need to think more?

Something here is, well, mindless. Maybe a mantra is all you need and maybe we should all devote more time to changing our minds. But for the time being I am just letting that thought drift right through me."

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Saturday, 9 August 2014

Ageing is Truth from #Omphalos: Time passes. Listen. Time passes.

Ageing is truth from omphalos 

"Time passes. Listen. Time passes

Sculpture: "The Ageing stone" by Dr Peter J. Gordon

Track: "Truth" by Hue & Cry

The Latin inscription (copied and translated below) was carved on Mavisbank house in 1724:

Concedatque Deus, Nunquam Vel Sero Senescas
Seroque Terrenas Experiare Vices
Integra Reddantur. Que Plurima Saecula Rodant
Delui Et Ut Serio Pulchrior Eniteas.

And may God concede that you grow old either never or late,
and that you experience earthly changes late.
And may what the numerous ages erode be restored intact,
and may it be granted that the older you are,
the more beautiful you may shine."

Friday, 8 August 2014

Scotland's Mental Health Strategy Key Theme One: Working more effectively with families and carers?

I was looking again at Scotland's Mental Health Strategy 2012-2015, and the Key Themes, first of which is:

1. Working more effectively with families and carers

"Families and carers can have an important role in providing support to those with mental illness, but can often feel excluded from making the contribution they would like to because of how services are structured or delivered:

The work from Healthcare Improvement Scotland on learning from suicides shows that better work with families can contribute both to safety and to better outcomes23;

Caring Together: The Carers Strategy for Scotland 2010-201524 sets out the action that is being taken with partners to provide better support to family members and carers to enable them to offer care and support without coming to harm themselves."

From The Carers Strategy for Scotland:

"7.6 The Healthcare Quality Strategy for NHSScotland, published in May 2010 21, will also help ensure the voice of carers is heard. It is the key driver for further change and improvements in healthcare. This strategy will seek to ensure that healthcare is of the highest quality, with improved safety and clinical effectiveness based on person-centred support and the full involvement of care partners. There will be an emphasis on developing relationship-based care and shared decision-making. A further aim is to ensure that patients and carers have clear instructions and information on care, treatment and symptoms and that they are fully involved in treatment choices. There will be a clear emphasis on treating carers as equal and expert partners with knowledge and experience, especially about the person they care for."

I was voluntarily involved in consultation events for the MH Strategy in late 2011 one of which was organised by Scottish Government (I remember Geoff Huggins, head of mental health division, coming up and sitting next to me at a table) and submitted an individual response from the carer and survivor perspective.

Looking back over the last two years of the strategy do I think that Scottish Government mental health division and Healthcare Improvement Scotland have worked more effectively with me?  Have they included me, made services safer for my family members, helped to involve me more in treatment choices and shared decision making?


Tuesday, 5 August 2014

Update on NHS registers of interest (Scotland) - Letter from Scottish Government 5 August 2014

Hole Ousia blog: Update on NHS registers of interest (Scotland) - Letter from Scottish Government to Dr Peter Gordon, 5 August 2014:


"we are aware of your interest in these important matters and also that you are the author of a petition for a Sunshine Act which is currently being considered by the Scottish Parliament. The Scottish Government remains happy to consider any recommendations from the Public Petitions Committee on this issue."
"We are aware that there are a range of issues that have led to the creation of registers of interest not being implemented in full and we consider that national collaboration is important to address these issues and challenges and to consider how the Scottish Government can support NHS Boards in implementation for what is needed in 2014 and beyond. To facilitate this, the Scottish Government is undertaking work with NHS Boards with a view to supporting consistent implementation across Scotland in a way fit for 2014 and beyond."

Link to Hole Ousia blog post 

another @rcpsych stigma piece 'Too similar, too different: the paradoxical dualism of psychiatric stigma'

'Too similar, too different: the paradoxical dualism of psychiatric stigma' by Tania Louise Gergel, King's College London, Psychiatric Bulletin, August 2014:

"Challenges to psychiatric stigma fall between a rock and a hard place. Decreasing one prejudice may inadvertently increase another. Emphasising similarities between mental illness and ‘ordinary’ experience to escape the fear-related prejudices associated with the imagined ‘otherness’ of persons with mental illness risks conclusions that mental illness indicates moral weakness and the loss of any benefits of a medical model. An emphasis on illness and difference from normal experience risks a response of fear of the alien. Thus, a ‘likeness-based’ and ‘unlikeness-based’ conception of psychiatric stigma can lead to prejudices stemming from paradoxically opposing assumptions about mental illness. This may create a troubling impasse for anti-stigma campaigns."

"Challenges to psychiatric stigma fall between a rock and a hard place. Decreasing one prejudice may inadvertently increase another.  Emphasising similarities between mental illness and ‘ordinary’ experience to escape the fear-related prejudices associated with the imagined ‘otherness’ of persons with mental illness risks conclusions that mental illness indicates moral weakness and the loss of any benefits of a medical model.  An emphasis on illness and difference from normal experience risks a response of fear of the alien.  Thus, a ‘likeness-based’ and ‘unlikeness-based’ conception of psychiatric stigma can lead to prejudices stemming from paradoxically opposing assumptions about mental illness. This may create a troubling impasse for anti-stigma campaigns."

"The root of attitudes such as blame may lie in stigma based on another equally disturbing view, which we might term likeness-based stigma and which stems from the idea of similarity and a view of mental illness as infirmity of character rather than legitimate illness. Whereas unlikeness-based prejudice suggests that mental illness is a defect in the very qualities which define a normal human being, likeness-based stigma implies a problem that is moral rather than substantive or biological - that those with mental illness share the same biological and environmental factors as others, but lack the strength of character to deal with them."

"it is hard to imagine a psychiatric intervention underpinned by a more neurological model than psychiatric neurosurgery"

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