Tuesday, 30 September 2014

'Almost 800k Scots are on antidepressants' Herald article today

'Almost 800k Scots are on antidepressants' Herald article, 30 September 2014

"New figures show a rise in the number of patients being prescribed antidepressants. 

Statistics show that 778,180 patients were dispensed at least one antidepressant during 2013/14.
The figure represents an increase of 4.2% from 2012/13 when the number stood at 747,158 patients, and an increase of 22.8% since 2009/10.

More than 518,000 patients were female while almost 260,000 were male."

"The figures also show that 8,924 patients received treatment for ADHD in 2013/14, up 12.7% compared to 2012/13 and an increase of 33% since 2009/10.

Prescribing for dementia was also up by 16.7%, with 23,063 patients dispensed at least one drug for the condition during 2013/14 compared with 19,763 patients 2012/13.

A Scottish Government spokeswoman said: "The Scottish Government has long worked hard to reduce the stigma faced by people with mental health problems.  As this stigma declines we would expect more patients to seek help from their GPs for problems such as depression.

"Any prescribing is a clinical decision and there is good evidence that GPs in Scotland assess and treat depression appropriately, and that GPs in Scotland are more likely to be working to clinical practice and guidelines than elsewhere.

"People with mental illness should expect the same standard of care as people with physical illness and should receive medication if they need it.  While we ensure those who need medication continue to receive it, we are also committed to improving access to alternatives, such as psychological therapies, that increase choice and best accommodate patient preference."

My comment:

It's concerning to read that at least one in seven Scottish people are taking antidepressants and of these twice as many are women.  There can be major issues getting off these drugs (see film Powerful Embrace by Dr Peter Gordon
about Seroxat/Paxil) and for some people they cause suicidal ideation, have black box warnings.

There is also the quote from Scottish Government about reducing stigma but with the "Psycho Ward" fancy dress costumes in supermarkets a year ago it seems that stigma unfortunately is alive and kicking.  I know this personally as I've had to make a complaint on behalf of a family member who was singled out and discriminated against in a council workplace by a social worker because of their "mental illness" label.  This stigmatising incident set them back in their mental health recovery.

Psychological therapies are still hard to get otherwise there would not be increasing numbers of drugs prescribed.  People might prefer to talk things through rather than popping a pill but if there is a long waiting list then what else can the doctor do with only 7mins or so for a chat?   In addition the increased drug prescribing for ADHD and dementia diagnoses are worrying.  Scotland seems to be becoming a serial pill popping nation because there is no time to talk.


Daniel Muirhead: Cupar town centre, road layout in Blender, GIMP, Unreal Engine 4

ContinuanceTechne: This video shows the player driving around some streets within Cupar.

Road layout data, including data pertaining to the roads' elevation profiles (the ascents and descents), was taken from the 1894 Ordnance Survey Town Plan of Cupar, viewed online at the website for the National Library of Scotland. The rough draft of the road layout which is presented in this video serves as a 'proof of concept' regarding the pertinence of the data which is embedded in the old OS Town Plans.

3D models were authored in Blender (version 2.71).
2D images were edited and authored in GIMP (version 2.8.10).
The game engine is the Unreal Engine 4 (version 4.4.3). 

Monday, 29 September 2014

"We are Scotland's Ombudsman" the last resort?

"The Scottish Public Services Ombudsman (SPSO) is the final stage for complaints about councils, the National Health Service, housing associations, colleges and universities, prisons, most water and sewerage providers, the Scottish Government and its agencies and departments and most Scottish authorities.

 "Our vision is of enhanced public confidence in high quality, continually improving public services in Scotland which consistently meet the highest standards of public administration. We aim to bring this about by providing a trusted, effective and efficient complaint handling service which remedies injustice for individuals resulting from maladministration or service failure."

(Quotes above from the SPSO website, bolding is mine.  Photos of Senior Management at SPSO, screenshot from website)

On 17 September 2013 I submitted an online complaint about NHS Fife to the SPSO website about my son's dehumanising treatment in Stratheden Hospital in February 2012.  I did this because I wasn't happy with the way that my complaints against NHS Fife were handled.  

On 9 December 2013, after conversations with an SPSO Complaints Reviewer that I didn't find particularly helpful or supportive, I finally was informed that my complaint would be passed on to the SPSO "investigation team".

On 16 December 2013 I received a letter from the SPSO Complaints Reviewer who had been "allocated" my complaint.

On 20 February 2014 I received an Email from the SPSO Complaints Reviewer who informed me that he had referred my complaint " to the Ombudsman’s mental health adviser for his comments".

I received occasional updates from the SPSO Investigator by Email on the progression of my complaint and then on Friday past, 26 September 2014, I received a voicemail at around 5pm to say that the decision letter on my complaint about NHS Fife had been issued with mention of an option to phone to discuss afterwards.

[It was my birthday yesterday]

This morning, 29 September 2014, I received the SPSO letter with the "decision" on my complaint.  I wasn't happy with what was written and phoned to discuss the letter with the Complaints Reviewer.  I then Emailed him, copying in the SPSO senior management team.  

Here is the last paragraph of my Email:

"I will be writing a full response to your Investigation, the points you make, the Adviser comments and your decisions on these (I may do this in a blog or book in full view).  It seems to me on first reading of your letter that the words of NHS Fife staff hold more weight than the words of a mother and her son.  Justifying human rights abuse and bad practice in "notes" (or "records") that read like works of fiction.  I am not surprised but I am disappointed.  I had hoped for justice.  It just means that I will keep on speaking out until justice is done."

Sunday, 28 September 2014

'Towards a hermeneutic shift in psychiatry' perspective by Dr Pat Bracken, World Psychiatry, Oct14

'Towards a hermeneutic shift in psychiatry' perspective by Dr Pat Bracken, World Psychiatry 13:3, Oct14


"Psychiatry is currently going through a crisis of confidence (1). Some medical commentators have even questioned the very credibility of the profession (2). There are many indicators of this crisis. For example, leading up to the launch of DSM-5 by the American Psychiatric Association last year, the chairperson of the DSM-IV task force raised serious questions about the validity of the whole DSM process (3), echoing earlier criticisms by the chairperson of the DSM-III (4). It is clear that psychiatry has been a particular target of the marketing strategies of the pharmaceutical industry (5), strategies that have led to the corruption of evidence-based medicine in general (6)."

"One of the major insights of 20th century philosophers such as Wittgenstein, Heidegger andMerleau-Ponty was the realization that meaning is not something that happens inside an individual mind or brain, but instead comes into our lives from the social practices that shape the world around us."

"I do not believe that we will ever be able to explain the meaningful world of human thought, emotion and behaviour reductively, using the “tools of clinical neuroscience”.  This world is simply not located inside the brain. Neuroscience offers us powerful insights, but it will never be able to ground a psychiatry that is focused on interpretation and meaning. Indeed, it is clear that there is a major hermeneutic dimension to neuroscience itself (17). A mature psychiatry will embrace neuroscience but it will also accept that “the neurobiological project in psychiatry finds its limit in the simple and often repeated fact: mental disorders are problems of persons, not of brains. Mental disorders are not problems of brains in labs, but of human beings in time, space, culture, and history.”

Read complete article


Pat Bracken video: "Beyond Reductionism: Towards a Hermeneutic Shift in Psychiatry"

Saturday, 27 September 2014

Pat Bracken video: "Beyond Reductionism: Towards a Hermeneutic Shift in Psychiatry"

"New frameworks for mental health care"

As part of a co-hosted event with the Royal Australian and New Zealand College of Psychiatrists (WA Branch), Dr Pat Bracken spoke on "Beyond Reductionism: Towards a Hermeneutic Shift in Psychiatry".  [TheMHS Conference, Perth, Australia]

Thursday, 25 September 2014

"with you through the highs & lows" Bipolar Scotland (but avoid Email contact as you may come up against a brick wall)

Here are the screenshots of Emails sent to the Bipolar Scotland ("with you through the highs and lows") Chief Executive and Service Development Manager (2 different people), on 4 and 28 August, then 22 September 2014.  I'm a carer member of this organisation.  

I decided to offer a piece for their magazine 'On the Level' from a different perspective, one I hadn't seen in their literature before: Bipolar Disorder from where I’m standing: a Mother speaks out.  Unfortunately I got no response after sending a reminder, over 6 weeks of waiting. 

Therefore I decided to blog the piece myself and sent it out to my mailing list on 21 September 2014.  This provoked a response from the Bipolar Scotland CEO the next day, a Monday, who professed not to have seen my original Emails or article.

I then resent the original Emails and again got no response.  I am wondering if there are communication issues at Bipolar Scotland? 

First Email 9 August 2014:

Second Email 28 August 2014:

Third Email with blogged article sent to mailing list 21 September 2014:

Finally a response from the Bipolar Scotland chief exec on 22 September 2014 to which I responded right away:

I then immediately forwarded the original August Emails I'd sent:

and got no response ...

However I happened to be at the Cross Party Group for Mental Health in Scottish Parliament yesterday evening and spotted the Bipolar Scotland Chief Executive (don't know her personally but her photo is on their website) so I went up and asked about the communication at their office.  Was there a difficulty with Emails and were some Emails of a higher priority than others eg funders.  

I wasn't happy with the delivery and response so complained about it in an Email.  This got an apologetic reply today in an Email from the CEO who also wrote:

"I have now received your email with a suggested article for On the Level. This will be considered when we are putting the next On the Level together. Sometimes, depending on the content we have, we plan one or two issues ahead". 

I am not sure if this is a Yes or a No to my piece going in On the Level. 

Time will tell. 

Reblog: Discursive of Tunbridge Wells: Electroconvulsive Therapy: Whose decision is it?

Discursive of Tunbridge Wells: Electroconvulsive Therapy: Whose decision is it? 24 September 2014 by
@steweatherhead & @THEAGENTAPSLEY 

What does consent to treatment mean?
"Lisa is a 42 year-old woman. She has had a difficult life. She has experienced multiple traumas and has at times struggled with her emotions. 
Lisa has a few close family members and a small social circle, though she does at times feel a bit oppressed by them. In 2010 Lisa contracted HIV. She has been treated medically and was stable for some time, however in 2013 she started to deteriorate.  She was seen by a psychologist as well as by medics. 
After a further twelve months she had had enough of interventions and decided she wanted to live the remainder of her life in her own way. Her family and friends objected as they could see she would rapidly deteriorate. However with support from professionals, Lisa utilised the Mental Capacity Act (MCA) to set some advanced directives. She was found to be capable of making these decisions under the MCA, and was legally allowed to refuse further intervention. 
Lisa did indeed deteriorate, and died a few months later in her own home with her family and friends around her.
Alternative ending:
Lisa did indeed deteriorate, and the professionals over-ruled Lisa’s decision and treated her with Electro-Convulsive Therapy (ECT)."
"These are fictional stories but according to our current systems, this is how they could (and probably would) play out. The only difference between them is that with one there is a medical diagnosis and with the other there is a mental health diagnosis. However, this detail leads to a wholly different intervention. In the first, Lisa is permitted to die in her own way, in the other her decisions are over-ruled. So why the difference?

An ECT machine. Should consent
always be required?
In medical settings a person can give an advanced instruction that they do not want further treatment even if their life is at risk. If they lose the ability to make decisions, the MCA protects their right not to be treated. In mental health settings a person’s similarly expressed preference can be over-ruled if two doctors agree that the person’s life is at risk and appropriate emergency treatments  (ECT  is deemed  as one) can be implemented. 
The Mental Capacity Act gives people the right to refuse treatment, even if that treatment may save a person’s life. That’s unless that person has been given a psychiatric diagnosis. In the case of a mental health problem a range of treatments (including ECT) can potentially be given without their consent.

This issue has come to the fore because of a recent report which showed that of the 832 people who received ECT whilst detained, in 2012-13, 695 were found to lack the capacity to consent to that treatment."
Read complete blog post
[My comment on this post, published:
"I am also concerned about NMD (anterior cingulotomies or brain surgery for mental disorder) that is the final stage for people who have had drug treatment and courses of ECT that "didn't work". They are deemed "treatment resistant" and in desperation ask for the brain surgery as a last resort.

In Scotland the anterior cingulotomy is performed at Ninewells Hospital, Dundee, under the auspices of the Advanced Interventions Service.

funded by NHS Scotland. People are referred to this service and a percentage each year get NMD. Small numbers so far. Eg in year ending May 2013 there were 40 actual assessments, 5 planned anterior cingulotomies and I carried out. 20% of referrals from England.

Sunday, 21 September 2014

Bipolar Disorder from where I’m standing: a Mother speaks out (a piece written for Bipolar Scotland mag)

[Here is a piece I wrote for the Bipolar Scotland (BPS) magazine 'On the Level'.  I wasn't asked to submit it, rather I felt compelled to write something, from my own personal experience, as I'm a member of BPS, get their newsletter sent to me, and I never see anything in it that represents my point of view.

I Emailed it to the two main workers at Bipolar Scotland on 9 August, got no response, so sent it again on 28 August, still no answer.  I have to therefore assume it's a No.]

Bipolar Disorder from where I’m standing: a Mother speaks out 

In 2002 the psychiatrist wanted to give me a bipolar diagnosis at an appointment and I remember debating with him, although not my usual assertive voice since I was on risperidone and venlafaxine at the time.  Saying that I didn’t have a bipolar illness as my moods were flat because of the medication or psychiatric drugs as I call them. 

The meetings with the psychiatrist back then seemed to consist of him asking “Are you tearful?” and my response “No I am flat as a pancake” or something in that vein.  For the drugs demotivated me, took away my sense of humour and singing voice.  I used to say to my husband that for him it must have been like the film “I walked with a zombie”. 

For I’ve never liked swallowing psych drugs after experiencing two earlier puerperal (postpartum) psychoses in 1978 and 1984, after sons 2 and 3, and being made to take chlorpromazine.  Fortunately I got off the drug within the year and got back on with my life.  I eventually did the same in 2003/4, getting off all the medication, including lithium which I’d been given to “augment” the antidepressant, although it didn’t work.

Because I’d refused the bipolar label I thought it meant I was disorder free and had nothing written in my notes.  However I found out this wasn’t the case in around 2006 when going for an eye clinic appointment at my local hospital and the nurse said to me “I see you’re schizophrenic” or something similar.  I’d been recovered and off all drugs for a couple of years, was back working and back to myself.  What was going on?

It felt like a swear word, to be honest, when the nurse said this, and I was taken aback.  I hotfooted it to my GP to ask about the label in my notes.  She said there wasn’t a box in their database for schizoaffective disorder.  I said I didn’t have that either and could she remove it?  She recommended I see the psychiatrist about it.  Which I did, dropping by later that day and catching him in his office.  He said he’d write a letter to the GP.  But the label still sits in my notes to this day, “in perpetuity”.

Psychoses are normal in my family and 8 of my family, from my mother and father, my 2 sisters to me and my 3 sons, have all experienced altered mind states and psychiatric inpatient treatment.  Which means we have all been diagnosed and labelled with a disorder.  Presently two of my sons have bipolar disorder diagnoses although one of them has had a few other labels on route.  My oldest son made a complete recovery after a year on psych drugs in 1996 and hasn’t looked back.

My two younger sons have both been in and out of the psychiatric system on a few occasions, receiving different psychiatric medications and I think the bipolar disorder label is an accurate description of their condition.  For my take on it is that the psychiatric drug treatment has affected their moods and made them more sensitive to life situations and other stimuli.  They have been disabled by the treatment.  One of them still takes medication, the other doesn’t. 

I do get annoyed with psychiatry for only having drugs in their toolbox for working with people in psychoses or altered mind states.  I have always resisted the antipsychotics (they call it non-compliant, I call it non-conformist) because I knew they would depress me and they did.  I don’t like to be depressed and my natural state is upbeat and positive, since childhood.  However my resistance was futile and I was made to take the drugs, by injection then orally.  But I was able to taper them under my own steam, against the advice of psychiatrists, and make a full recovery after each episode. 

Therefore I have come to terms with the bipolar disorder label although I don’t believe the condition is due to a person’s “mental illness”, another psychiatric construct to my mind.  As I see it if the drugs don’t work then the drugs don’t work.  It’s not the person who is “treatment resistant” but the treatment that is useless. 

Let’s take our critical gaze away from the person and focus it on the system.  That’s what I do as a writer, activist and campaigner, from the psychiatric survivor perspective.  The system includes psychiatry, government and the agencies funded by the state.  And if the system has disabled its members because the treatment doesn’t work then the system is liable for looking after these members.  It stands to reason and makes sense. 

It’s why I am very annoyed about the targeting of people on welfare benefits.  The mental health recovery agenda, some say hijacked by government, was the reason I got involved in Scotland’s mental health world in 2008, when I set up Peer Support Fife.  I believed the PS agenda was a civil rights movement that would shift the paradigm and redistribute power.  I’d been a community development worker since 1980 so knew that it was possible.   The reality has been somewhat different and led to my shift in focus.

I now find myself in the dual role of being an unpaid carer and an activist.  My lived experience of mental health difficulties and psychiatric treatment means that my sons call me in to advocate for them at clinical meetings or other situations where my support is a strength to them.  They call me the “big guns”.  I take it as a compliment. 

I have advocated for many family members over the years since 1970, aged 17, and visiting my mother in a locked psychiatric ward.  I have also worked in jobs where I advocated for people with disabilities, including in 2001 a man in a forensic psychiatric ward who avoided being transferred to the State Hospital.  So speaking out on behalf of others and standing with them as they speak out has been a big part of my life.  I won’t be stopping now and wouldn’t want to. 

Thursday, 18 September 2014

tweets & photos from today's Scottish Independence Referendum


Where I live we are approaching an important day in our nation's history on Thursday 18 September 2014, when a referendum will be held and the question asked: "Should Scotland be an independent country?". Whatever the outcome it is an exciting time to be Scottish and to consider what being independent means. I think it has great relevance to the work I do as a mental health writer, activist and campaigner, a psychiatric survivor and unpaid carer of family members who have mental disorder diagnoses/labels, through 3 generations or more. Tied in as my family are or have been to the psychiatric system do we have independence or the right to be independent?

I want to consider the paradox of psychiatric system thinking which tells us that the mad people are those with mental disorder labels and the rest of the people in society, including the psychiatric/mental health staff, are the sane ones with their heads screwed on right.  I have probably always seen the asylum, now psychiatric hospital, as an institution like any other eg school, army, university, political party, government, with conscripts, rules and rule breakers. I didn't believe the mental illness mantra because it didn't make sense.

Those who seem to do best in these institutions may be the ones who can say one thing and do another. Sleight of hand stuff. Like magicians and card players. You might describe it as being slippery or a chancer or a game player, ducking and diving to avoid the opposition. The end goal to be in power, to influence others and to make some money out of it on the way to the top. Nothing wrong with that as everyone else is doing it, aren't they? No, not everyone.

The problem with the hierarchical shenanigans in psychiatric settings is that the availability of "compulsory treatment" means that there are some conscripts who don't play the game and bend the rules, who are independent thinkers and expect the system to support and protect them in their mental distress. They expect the mental health act safeguards to be safe and that the principles and practice within the law will be implemented properly and monitored effectively. Unfortunately it can be more like going through the looking glass, like Alice, or falling down a rabbit hole. Nothing is as it seems or should be.

I am aware that many people are happy to be in the psychiatric system when unwell or feeling the stress of life, and see it as a refuge. I couldn't be one of them because of the disruption the system has had on my family's life. It's a matter of principle. The use of force, of ECT, of brain surgery for mental illness (my family fortunately avoided this), drugs that don't work and some staff/people who shouldn't be working with anything that lives or breathes, made me determined to be independent of psychiatric influence and beliefs. Even though they labelled and coercibly drugged me I was resistant in my being, to the religion that marked out some of us with defects that inevitably lead to stigma and discrimination. I can't be a conscript even though they make me dependent, for a while.

For madness or psychosis or altered mind states aren't "mental illness", rather they were for me to do with life transitions, sensitivity to changes in my body and in the world around me. I came out of it stronger and more self aware, self confident and resilient. But the forced drugging was traumatic, beating me into submission, or so it felt like, taking away my sense of humour and singing voice.

"I know why the caged bird sings, ah me,
When his wing is bruised and his bosom sore,  
When he beats his bars and would be free; 
It is not a carol of joy or glee,  
But a prayer that he sends from his heart's deep core,  
But a plea, that upward to Heaven he flings –  
I know why the caged bird sings."

Dunbar, Paul Laurence (1993). Joanne M. Braxton, ed. The Collected Poetry of Paul Laurence Dunbar, Charlottesville: University of Virginia Press. p. 102

Why does the system do this? Fear of the unknown perhaps. Yet life is unpredictable, that's for sure. We're kidding ourselves on if we think that it's under our control. Being independent is knowing that nothing controls us even if it seems like we are constrained. 

I attended a conference the other day in Edinburgh and a workshop on mentalisation ("the ability to understand the mental state of oneself and others which underlies overt behaviour" Wikipedia) facilitated by a psychiatric nurse and concerned work with patients who were diagnosed Borderline Personality Disorder, BPD. I was alarmed at the military terminology in the presentation: "secret weapon", "ammunition", "coercive bondage", to describe the usefulness of the approach, for nurses. It conjured up images of patients as the enemy. 

There was a quote from nurses in training who said about the BPD patients "they suck the life out of you". I tweeted that I felt the same about psychiatric treatment. It confirmed my concerns about the government mental health strategies that read like battle plans, fighting this, that and the other, and how they reinforce the negativity for everyone involved in face-to-face work with people.

I want to remain independent of these tactics that are reductionist and dehumanising in their execution (I use this killing term on purpose). But I also want to have a positive influence in changing the government's battle plans which I think are having a detrimental effect on psychiatric system workers and their practice. Their continuing meaningless involvement of the real "experts by experience", those of us who have come back out of the looking glass with our psyches intact, independent of spirit and mind, even though drugged and labelled or labelled and drugged.

I am working with others in Scotland's mental health world for level playing fields and straight paths, and in particular these include a psychiatrist and mental health nurse, the three of us equal protagonists in the quest for justice and fairness, scientific enquiry and a willingness to learn. Here is a link to examples of work from my colleagues:

An Omphalos film from psychiatrist Dr Peter J Gordon: Ageing is Truth  "Time Passes. Listen. Time Passes." and Peter's website Hole Ousia: The whole being: bridges cultures of science & arts.

And a paper from Dr Rosie Stenhouse, Edinburgh University Nursing Lecturer, Doctor of Philosophy: ‘Safe Enough in Here?’: Patients’ Expectations and Experiences of Feeling Safe in an Acute Psychiatric Inpatient Ward', Journal of Clinical Nursing, July 2013.

Rosie (facilitator), Peter and I, along with other people with "lived experience", take part in a national mental health User Led Research Group (@ScotMHResearch) with initial funding by the Scottish Mental Health Research Network.  

Our first task will be to undertake research into mental health crisis and acute care services from the service user, patient and carer perspective. With the aim of inviting research questions from people with lived experience in every Scottish health board area, gathering a range of views and perspectives.  We plan to engage and form collaborative relationships with other similar groups and a visit to Northumbria University in the North of England is planned.

In conclusion, I hope that this blog post has demonstrated that independence of thought and action is possible even when the system constrains us for a while with labels and drug treatment. It's been a matter of persistence as I see it. Keeping on keeping on and a determination to speak out and have a voice, in solidarity with others. I have found allies in every setting even among adversaries, people whom I have disagreed with and yet formed relationships with. 

A couple of months ago one of these adversarial allies, a psychiatrist, left this earth before his time and I mourned him [in remembrance]. We didn't agree on many topics but I was free to say so and he took it on the chin. We were equals and that is what counts.

Whatever the outcome of the Scottish Independence Referendum on 18 September 2014 I know that in my heart and mind I am a free spirit even if at times I may feel restrained or restricted. These times are temporary and fleeting in the scheme of things, and I am, and will be, encouraged at the possibilities and opportunities that independence brings, in the here and now.

Wednesday, 17 September 2014

Little Red Riding Hood and the Wolf by Roald Dahl

As soon as Wolf began to feel
That he would like a decent meal,
He went and knocked on Grandma's door.
When Grandma opened it, she saw
The sharp white teeth, the horrid grin,
And Wolfie said, ``May I come in?''
Poor Grandmamma was terrified,
``He's going to eat me up!'' she cried.
And she was absolutely right.
He ate her up in one big bite.
But Grandmamma was small and tough,
And Wolfie wailed, ``That's not enough!
I haven't yet begun to feel
That I have had a decent meal!''
He ran around the kitchen yelping,
``I've got to have a second helping!''
Then added with a frightful leer,
``I'm therefore going to wait right here
Till Little Miss Red Riding Hood
Comes home from walking in the wood.''
He quickly put on Grandma's clothes,
(Of course he hadn't eaten those).
He dressed himself in coat and hat.
He put on shoes, and after that
He even brushed and curled his hair,
Then sat himself in Grandma's chair.
In came the little girl in red.
She stopped. She stared. And then she said,

``What great big ears you have, Grandma.''
``All the better to hear you with,'' the Wolf replied.
``What great big eyes you have, Grandma.''
said Little Red Riding Hood.
``All the better to see you with,'' the Wolf replied.

He sat there watching her and smiled.
He thought, I'm going to eat this child.
Compared with her old Grandmamma
She's going to taste like caviar.

Then Little Red Riding Hood said, ``But Grandma,
what a lovely great big furry coat you have on.''

``That's wrong!'' cried Wolf. ``Have you forgot
To tell me what BIG TEETH I've got?
Ah well, no matter what you say,
I'm going to eat you anyway.''
The small girl smiles. One eyelid flickers.
She whips a pistol from her knickers.
She aims it at the creature's head
And bang bang bang, she shoots him dead.
A few weeks later, in the wood,
I came across Miss Riding Hood.
But what a change! No cloak of red,
No silly hood upon her head.
She said, ``Hello, and do please note
My lovely furry wolfskin coat.'' 

Little Red Riding Hood and the Wolf
Roald Dahl, Revolting Rhymes 

Write to Recovery? you can't be serious

I sent an article to Scottish Recovery Network (SRN) on spec which had recovery as one of the themes.  It was a serious piece, narrative with references, of some length.  I didn't expect that it would be published but I did expect that my writing would be considered.

I received a response on Monday from an SRN worker which rejected my article for publishing on their website but recommended I consider posting it on their new sister website 'Write to Recovery'.  

So I did a search on google and it said ""Write to Recovery is designed to help people improve their mental wellbeing by sharing their stories and experiences.".  I was in Glasgow at the time, participating at a meeting from the lived experience perspective.  So I sent back an Email to the SRN worker saying I thought that pointing me to this website for publishing my writing might be patronising.

For in 2005 and then in 2008 I had shared my "recovery story" on the SRN website.  It's still there and here it is 5 March 2008 'Recovery Update' with introduction: 

"Chrys Muirhead originally submitted her recovery thoughts via the 'Submit your story' on this website in 2005. Three years on and Chrys brings her recovery story up-to-date and also revisits the past to make sense of the present."

When I got home I had a proper look at their 'Write to Recovery' sister website and was quite frankly flabbergasted at what I saw and read.  I checked out some stories and read posts with swear words, defamatory religious and political comments.  I didn't have to search long to find them.

I immediately Emailed the SRN leads and the hosting organisation Penumbra with screenshots of these posts which could be deemed offensive.  It seemed the moderation was lax or non-existent.  I was concerned that some of the writing could hinder people's recovery.  

There was also an issue of privacy as one of the blog posts I read identified where a person came from and named her colleagues in the writing (I didn't screenshot this one, having no desire to further expose someone's identity).  SRN has this statement on the blogging website:

"At Scottish Recovery Network (“SRN”), we pride ourselves on our commitment to protecting your privacy."

I have had no response from SRN or Penumbra to my Email raising concerns.  Here are the screenshots of blog posts which I sent to them:

Tuesday, 16 September 2014

Hello? Is anyone listening to the mothers? re Stratheden Hospital IPCU Fife

I received an Email yesterday from a mother who had read this blog, saying that her son was in Ward 4 (IPCU) at Stratheden and was being forcibly injected then shut in the "padded cell" or seclusion room.

This mother talked about being at her "wits end".  

IPCU back door March 2012
This mother speaks about having to go in the back door of the ward and asks "is it to hide anything?".

(just as I had to in February 2012, when other visitors got in the front door although now it has a window and bell)

This mother mentions having written an advance statement a few years ago saying she didn't want her son to be put in Stratheden Hospital again.

This mother says that her son's phone has been taken off him because it has a camera.  His phone is a lifeline and means of communication with his family and the outside world. 

Hello.  Is anyone listening to the mothers?

Monday, 15 September 2014

Community-based psychodynamic group psychotherapy for treatment-resistant schizophrenia

'Community-based psychodynamic group psychotherapy for treatment-resistant schizophrenia'
by Giuliano Aiello & Sheraz Ahmad
Advances in Psychiatric Treatment Journal, 2014, 20:323-329.


We describe the work of a psychodynamic psychotherapy group for individuals affected by chronic schizophrenia in our community-basedrehabilitation and recovery service. Despite presenting with negative symptoms, over time patients made good use of the psychodynamic setting: they attended, expressed emotions, made connections and reflected within the group on their personal experience of mental ill health.  

We discuss the rationale and indications for psychodynamic psychotherapy for individuals with severe and enduring mental illnesses. We also reflect on the challenges we faced working psychodynamically with psychosis and on the necessary adaptation of the approach to work with chronic psychosis. We present vignettes from group sessions to illustrate themes that we identified in the therapy, making links with the literature. 

We conclude that the unstructured setting of the psychodynamic group approach can help individuals affected by most severe forms of psychosis to make sense of their experiences and use the space.

Learning Objectives
  • Understand the rationale for psychodynamic group interventions for psychosis.
  • Understand what adaptations of psychodynamic approaches are necessary to work with patients with psychosis.
  • Change attitudes toward offering psychodynamic interventions for psychosis."

Read complete article

Friday, 12 September 2014

Support in Mind Scotland (NSF) in Fife: a critical perspective

I admit to being a long term critic of NSF (SIMS) in Fife.  It didn't get any better over the years despite engaging with the staff, most of whom I got on with quite well at times, at other times we were poles apart.  I think the dividing line was the "severe and enduring mental illness" mantra.  For I am an unbeliever and their services are geared towards the "mentally ill".

Recently I got a letter from the NSF/SIMS chief exec, sent to my home, which announced that it was withdrawing my membership of SIMS and excluding me from attending or using any SIMS service anywhere.  I was banned.  It mentioned my "publicly-expressed discontent" "undermining" their organisation.  

I've made a formal complaint about the letter coming to my home address, an invasion of privacy, for I gave no permission for my personal details to be used in this way.  Secondly I have complained about the language used against me in the letter which I contend is patronising, belittling and derogatory.  

They may have the power to ban me but they don't have the right to badmouth and undermine my character in an official letter so as to justify their actions.  This is bullying behaviour from an organisation that purports to "support and empower all those affected by mental illness".  

Of course they prefer positive feedback and any negative stuff to be sugar coated.  Who doesn't?  But I contend it's the critical voices that should be listened to.  Especially in mental health matters where compulsion is rife by virtue of law ('Legal coercion: the elephant in the recovery room' Mary O'Hagan, SRN).  And I won't be silenced on their say so.  It's a free country, democratically speaking.

The main issue I have with SIMS in Fife is that their (organisation's) belief in "mental illness" has negatively affected the way they work with people who use their services, reinforcing stigma and discrimination.  However I do believe that they have always wanted the best for the people they serve.  The people who themselves believe they have a severe and enduring mental illness (SEMI).  For I was the odd one out.  Recovering from SEMI.

Cupar Cottage conservatory
I am critical of the way that the SIMS head office handled the closure of the Cottage drop-in facility in Cupar.  There was no consultation with the membership, of whom I was one, and instead the decision was made on high and a head office manager came out to announce the closure without any forewarning.  

I had received an invitation to attend with mention of Cottage "developments".  If I'd known the aim was to announce a closure without consultation then I wouldn't have attended.  Not a good use of my time.  

Therefore when I challenged the head office worker about there not being any consultation or negotiation with members she patronised me, gave me a telling off.  A woman about half my age and obviously inexperienced in how to work with difficult people.  At least she didn't resort to bullying.  

My complaint in July about the way the Cottage closure was handled resulted in another telling off by the chief exec, a woman I have met on a few occasions.  I can't say we hit it off.  Obviously any discontent or complaints by SIMS service users and carers will be met with patronising treatment, keeping everyone in their place.  If that doesn't work then "go to your room" or exclusion is the result.

The Fife SIMS way of handling critical voices was to exclude us from the mailing list and only invite chums to workshops and the like.  I challenged them on many occasions over the years as to why I wasn't sent this and that information.  I would hear about events after they happened.  But at least they didn't patronise and bully me.  

Rather they fobbed me off.  It meant that we stayed in touch and I could still drop by the Cottage and chat to the workers and other service users.  We had a relationship of sorts, were allies on occasion even if we didn't agree.  I am very annoyed in the way that the Cottage closure was handled.  It was unprofessional and a poor way of dealing with Fife SIMS staff and service users.  Nothing for the SIMS head office to be proud of.  

The Cottage was a base of historical importance for the user voice in Cupar, people speaking out and taking back the power, in the 1990's.  People with lived experience were key movers in developments, so I hear, and there were many positive achievements.  Unfortunately the user voice has been silenced over the years, culminating in the local mental health advocacy projects losing their funding in 2009, the council awarding it to an English service provider.

I think the Fife SIMS workers have had a difficult time over these years and have not been supported properly or effectively by the SIMS head office.  Not sure why this is. It's likely a combination of the Fife cultural situation regarding statutory mental health services and lack of resource.  Another issue is that east, west and central Fife all do their own thing, lack of joined up working which impacts negatively on voluntary sector mental health services.

Which results in competition between services rather than collaborative working.  Divide and conquer mentality fostered by statutory agency managers so as to keep more of the money for themselves.  Poor management of resources in NHS Fife and Fife Council psychiatric and mental health services.  Not being accountable to the public, to the patients, carers and service users.  Meaningless involvement of people with lived experience.  I've seen all of that since 2008 and trying to become involved in Fife mental health service design and delivery.

Support in Mind Scotland should have tried harder to keep the door open with me and taken on board my critical comments, rather than trying to control me by various means, failing then having to shut me out.  I prefer level playing fields.  The problem is theirs not mine.  The power rests with them as an organisation but as an individual I can have influence.  I do not respond to the misuse of power or to abusive treatment.  I will always resist.

Thursday, 11 September 2014

reblog Scottish Mental Health User Led Research Group: Northumbria University visit photos

Scottish Mental Health User Led Research Group (@ScotMHResearch) blog post: some photos from visit with Mental Health Research Group at Northumbria University 10 September 2014  

Here are a few photos from yesterday's visit to Northumbria University, Newcastle, at the invitation of the Mental Health Research Group based there.  Five of us travelled down on the day and were warmly welcomed by the team who shared their research learning processes and outcomes.  

Thanks to Helen Atkin, Research Fellow at Faculty of Health and Life Science, for organising and to the carers and service users on the group, all of whom made us feel at home. 

Arrived! (I'm taking photo)

Tuesday, 9 September 2014

(updated) £100 bursary travel expenses for Scottish carers to attend Carers UK Summit in London

[update: response from Carers UK, received 8 September 2014, with apology for delay:

"We realise that the bursary may not cover the full costs of attending the summit, especially for those who are coming a long way. Unfortunately, we have limited resources and so the budget for bursaries is not as much as we would like it to be. The ballot for bursaries is always oversubscribed and we try to allocate the fund as fairly as possible. This naturally involves making some difficult decisions about how much to allocate to each group, and some will be disappointed however this is done. We will, however, look at the issues you have raised when we consider how to do this in future, particularly the level of bursary that we are able to offer to members travelling greater distances.

To answer the specific point about the Scottish Carers Parliament which was organised by Carers Scotland, this was funded by the Scottish Government and so there was money available to pay expenses in full for all attendees.

Thanks for taking the time to contact us about this and I am sorry that you will not be able to attend the summit on this occasion."]

Email received 14 August 2014 from Carers UK with this announcement:

So I started to work out the cost of my travel and one night's accommodation in a cheap hotel, the night before the event at Canary Wharf which would involve driving from NE Fife to Edinburgh airport, a flight to Stansted, Luton or Gatwick, a train into London then travel out to the venue.  A conservative estimate was around £250.

Which means I would be out of pocket by at least £150 for the privilege of attending the Carers UK AGM and Summit.  I can't afford this expense as an unpaid carer on an allowance of £61/week.  

I Emailed Carers UK on 21 August 2014, saying:

"I am writing to let you know that unfortunately I won't be able to attend the Carers UK AGM and Summit on 13 November 2014 as the bursary of £100 is not enough to cover my travel and accommodation expenses."

I've had no response as yet.