Monday, 22 January 2018

FOI Response : DClinPsy funding Glasgow/Edinburgh Universities: what stood out for me

Here is the response, received today, to the FOI Request to NES about DClinPsy programme funding Glasgow & Edinburgh Universities I sent to Judy Thomson, Director of Psychology, NHS Education for Scotland, on 22 December 2017:



Here are the points which stood out for me:
  • Nearly £2million per year 2017-8 awarded to Glas/Edin Universities for DClinPsy training; 179 trainees in total; it's not a lot of money when compared to the cost of psychiatric inpatient treatment, at least £3000/person/week in Stratheden Hospital, Fife, more if low or medium secure ward.
  • mention of NES developing a "confidential trainee survey" which is interesting, has it been difficult for trainees to give honest feedback?
  • "number of trainees we can afford" regarding decisions about funding; I wonder what impacts on this?  is it just a matter of budgets or do they fund other psychological or psychotherapeutic training?
  • "There is no requirement for trainees to continue to work in Scotland post qualification."  I'm surprised by this, considering the cost of training, the fact that trainees are paid to do the doctorate; it doesn't make good business sense, in my opinion.
  • I have found that the teaching materials at both universities are not openly available for perusal and I suspect if I made an FOI request that I wouldn't get to see them.  The secrecy is a concern.  What have they got to hide?  I've been told it's to do with "intellectual property" but it seems a lame excuse.
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23 December 2017: FOI Request NES: DClinPsy programme funding Glasgow & Edinburgh Universities


Saturday, 20 January 2018

there are two sides to the story of mental illness & psychiatric diagnoses #PTMFramework

Some tweets this morning about mental illness and the patriarchy:

Janus







Tuesday, 16 January 2018

What are your burning issues for 2018? Safe Houses for Psychosis in Scotland #BMJ

'Re: What are your burning issues for 2018? Safe Houses for Psychosis in Scotland': my Response published in BMJ online, 16 January 2018



"My vision for 2018 and beyond is to influence the development of Safe Houses in Scotland for people who experience psychosis, alternatives to psychiatric inpatient treatment, offering a range of therapies and activities for mental wellbeing and recovery, including minimum prescribing of neuroleptics and help with tapering meds. Therefore I am researching safe haven crisis houses in other countries to evidence good practice, leadership and management, and to hear the stories from the people involved. 

Now aged 65, I’ve experienced puerperal psychosis twice, in 1978 and 1984, a menopausal psychosis in 2002, voluntarily entering psychiatric wards on all 3 occasions to be coercively drugged, eventually tapering meds myself, making a full recovery. More of my story can be found in a Psychosis Journal Opinion Piece, October 2017: 'Risk of relapse in psychosis: facing the fear, resisting mental illness' (1) and other stories in my main blog (2).

I’ve supported my 3 sons, 41, 39 and 33, when they experienced psychosis/psychiatry, helped them taper meds as I did. Then in 2015 I transitioned a 4th psychosis after years of campaigning for justice after my son's negative treatment as a psychiatric patient in February 2012, this time avoiding psychiatric treatment (3). This was a much more positive and life affirming experience from which I emerged a stronger, more confident, person. 

I believe that psychosis is transitional, can be a journey, an escape, a positive and uplifting experience if reasoned out, worked through and helped by companions, friends who are equals, without agendas. People who are willing to share in an Other's pain and imaginings, and in so doing may become part of the psychosis journey themselves. 

(1) Risk of relapse in psychosis: facing the fear, resisting mental illness: https://doi.org/10.1080/17522439.2017.1381757
(2) Chrys Muirhead Writes blog: http://chrysmuirheadwrites.blogspot.co.uk/
(3) Hospital Horrors: Patient locked in cell with no toilet, food or water; Scottish Sunday Express, 5 October 2014: https://www.express.co.uk/news/uk/518869/Patient-locked-in-cell-with-no-...



my drawing MH Strategy meeting Edinburgh 14Sep16


Risk of relapse in psychosis: facing the fear, resisting mental illness


DClinPsy Lesson #1 Hands Off 16Jan18

going into DClinPsy CUSP meeting 4Jul17
15 January 2018: This is the first in a series of short talks to Clinical Psychology Trainees at Glasgow and Edinburgh Universities, in the first instance.  I've been banned from teaching DClinPsy trainees at the University of Glasgow by programme director Hamish McLeod, backed up by Andy Gumley, which has spurred me on to do this, to have an influence and to resist their dogma and discrimination.

I will likely add to these talks in future, putting in links to information and other blog posts.

Gartnavel Hospital
Hands Off

When working with patients, clients, people, please do your best not to manipulate, direct or be prescriptive.  I've seen some of the DClinPsy teaching materials and watched role play videos on CBT which, from my psychiatric survivor Mother perspective, are counter-productive to independent thinking, too interventionist.  

When I was a mental health service user what I needed most was someone who treated me like an equal, believed in my ability to recover and shared information that would help me take back control of my life again.  I didn't need parental guidance or patriarchal decision-making, or for a Clinical Psychologist (ClinPsy) to compare me to their Bipolar Mother and offload their own thoughts and meanderings (2003, Fife).  That was unhelpful.  Fortunately the CPN was helpful when she came to my home for a visit, shared her life with me, believed in me.  

Maybe coming into my home made a difference.  Seeing something of my personality and potential, who I was underneath the psychiatric drug cocktail which had reduced my agency and made me dependent on the system.  That there was a human being under the skin & drug treatment.  This is important, I think, seeing the person for who they are, and listening, with no other agenda but to be of help.

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Protesting about being marginalised by ClinPsy academics, in front of the MH and Wellbeing Unit, Gartnavel, Glasgow where the DClinPsy Programme is based: "I didn't find it pleasant being in a psychiatric hospital, was always coerced, so I'm looking to research Safe haven crisis Houses ..."


9Sep17 doing a peaceful protest
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In Cupar, food shopping, my rucksack with bags inside to carry messages home in the bus.  Can't afford to run a car now, since the end of 2015, after 40yrs of driving.  It's costly to speak out about bad practices in mental health and to be an unwaged Carer, singlehandedly supporting my son after we whistleblowed about the human rights abuses of the locked seclusion room, Stratheden IPCU, Fife.  NHS Fife benefited, receiving £4.4million from Scottish Government.  It definitely doesn't pay to be a MH campaigner in Scotland.

8Nov17 at Cupar Rail Station passing through
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Risk of relapse in psychosis: facing the fear, resisting mental illness

My Opinion Piece published in Psychosis Journal, October 2017: http://www.tandfonline.com/doi/full/10.1080/17522439.2017.1381757

Link to complete article

"In my experience psychosis was a journey from one place to another, necessary and transitional, in response to life trauma. I believe that we are all on the psychosis spectrum but only some of us will require respite and a break from everyday existence. Preferably a safe haven and secure base from which we can rise again, stronger than before, wiser and more able to face the next challenge that life brings to us."


Monday, 15 January 2018

Risk of relapse in psychosis: facing the fear, resisting mental illness

My Opinion Piece published in Psychosis Journal, October 2017:
http://www.tandfonline.com/doi/full/10.1080/17522439.2017.1381757

In my experience psychosis was a journey from one place to another, necessary and transitional, in response to life trauma. I believe that we are all on the psychosis spectrum but only some of us will require respite and a break from everyday existence. Preferably a safe haven and secure base from which we can rise again, stronger than before, wiser and more able to face the next challenge that life brings to us.

Introduction

I first experienced psychosis three months after the birth of my second son in 1978, due to a number of factors, the main one being an induced labour, with oxytocin, and insufficient pain relief, additional stressor was living with in-laws, in one room, another family member unwell, and all of this combined to cause me difficulties in sleeping. Psychiatrists eventually came to visit and witnessed the situation, my stress, named it “puerperal psychosis” and said it was caused by “hormone imbalance”. I had insight and agreed to voluntarily enter a psychiatric ward for respite, only to be forcibly injected with Chlorpromazine, my breasts bound to stop the milk, separated from my baby son and his two-year-old brother. I was heartbroken at being so inhumanely treated but kept these thoughts to myself, eventually took the pills, conformed and was discharged within three weeks, back into the same situation at the in-laws farm. Within a year I had come off the antipsychotic, the psychiatrist had reduced the 400 mgs/day to 100, 4 × 25 mgs, and then I just stopped it, telling the doctor at the next appointment. He wasn’t happy but the deed was done and I made a full recovery, taking another year to build up my resilience, more confident and outgoing than before. In 1984 after another traumatic childbirth, my third son was born and within a week I again voluntarily entered the local psychiatric hospital.

Critiquing risk of relapse

In “Staying Well After Psychosis” Chapter One first page the authors write:

In psychological terms, relapse is a potentially devastating and critical life event with profound consequences for the emotional and psychological well-being of the person and their family or loved ones. Gumley and Schwannauer (2006 Gumley, A., & Schwannauer, Matthias. (2006). Staying well after psychosis. Chichester: Wiley. [Google Scholar], p3)

I would like to deconstruct this terminology from my lived experience of psychosis and recovery, caring for family members similarly. And attempt to reconstruct it by asking questions, providing a response through storytelling of lived experience. Is risk of relapse in psychosis more about the fear of (more) coercive psychiatric (drug) treatment? Is the concept a form of scaremongering, keeping the fear alive? Should there be a better way of reframing additional episodes of psychoses on a natural continuum rather than an illness paradigm? Do mental disorder diagnoses linked to psychosis hinder the well-being of those experiencing altered mind states as a way of externalising mental distress? 

Every time I experienced a psychosis, after childbirth then at the menopause, I voluntarily entered a psychiatric ward as an inpatient then was forcibly medicated with antipsychotics. After the first episode in 1978, I got off the drugs within the year and regained more confidence. By taking charge of my own mental health and well-being, deciding to recover, I increased my resilience and self-determination. A major influence in regaining independence was my Mother’s personal experience of psychiatric inpatient treatment and Schizophrenia diagnosis, many courses of ECT against her will and my younger sisters being taken into foster care when I was a teenager. This made me even more determined to resist any interference by social work agencies and mental illness labels.

We decided to have another child in 1984 and considered the risks but it didn’t put me off and I was optimistic of a better outcome. It wasn’t to be. My puerperal psychosis in 1984, which began in the maternity ward, was more swiftly acted upon by our local GP who was a friend and I was dispatched quickly into the same psychiatric ward, subjected to forced internal examination and neuroleptics. It was too much for my husband and he got a vasectomy, didn’t want me going through the same coercive psychiatric treatment again. I would have risked it, to have another child. So I was effectively sterilised at 32 years of age.

I found it easier to make a full recovery in the 1970s/80s than in 2002, because of only being on one antipsychotic compared to a cocktail of antipsychotic, antidepressant and “mood stabiliser” in the later episode and a diagnosis of Schizoaffective Disorder justifying the treatment.

Psychosis runs in my family, cancer doesn’t. I don’t see altered mind states at times of life trauma to be the major issue, rather it’s the treatment which can be re-traumatising, overpowering and iatrogenic. Therefore, I’m working towards researching and developing Safe Houses for Psychosis in Scotland, therapeutic alternatives to psychiatric hospital inpatient care.

Declaration of interest

No potential conflict of interest was reported by the author.

    Reference

  • Gumley, A., & Schwannauer, Matthias. (2006). Staying well after psychosis. Chichester: Wiley