Friday, 27 February 2015

Letter to Chair of NHS Fife Board with tweets from 24 Feb15 meeting: "Families to me are what life is all about"

bio from NHS Fife website
On 25 February 2015 I sent a letter by Email to the Chair of NHS Fife health board, Allan Burns, with a link to the storify of tweets I put together from the board meeting on 24 February 2015.  No response as yet.

Mr Burns has spoken to me on a few occasions since the first board meeting I attended, on 29 April 2014, in Bute Hall at the Medical School, St Andrews.

Strapline: storify of tweets from yesterday's health board meeting with photos of the Lang Toun beach and high street

"Dear Allan

For your interest, here is a storify of my tweets from spectating at yesterday's NHS Fife board meeting:
https://storify.com/ChrysMuirhead/tweeting-briefly-nhsfife-board-meeting-then-lunch

By the time I got parked and into the meeting at the Town House, Kirkcaldy, it had already started so I could see no papers around.  Plus the parking place I got, at St Bryce Kirk, was 2 hours and not 4 hours as it used to be, when last I parked there.  So it meant I had to leave the meeting after about 90mins.  The fact I had no papers meant I really didn't know what was being discussed, in any detail, except to note that "shadow board" was often mentioned.

Observing the discussions it seemed to me that you were trying your best to bring everyone to order, to focus on the task at hand.  Employing "SMART" tactics, in management speak.  (I got an administration management degree in 1996, best student, did it in 2yrs instead of 3, at Fife College, Kirkcaldy)  However it appeared that others at the meeting like to talk for the sake of it and not to reach a decision.  I find that very frustrating and would not be able to thole being an NHS Fife board member.  It's bad enough being a spectator.

I sat on many committees back in the 1980's when a grassroots community worker in Rigside, South Lanarkshire, and other ex-mining communities.  Mostly voluntary work as a young mother bringing up my sons.  It was a great learning experience at the coal face, you might say.  I held a range of committee posts, on local groups and larger steering groups, Church and community.  Locally and further afield, in Lanark, Hamilton and Motherwell, then in Glasgow in a PT post with Strathclyde Youth Clubs Association by the end of the 80's.  I preferred chairing groups.  Now I wouldn't like it.  I prefer to be running on ahead with stuff, sometimes in tandem with others.

I'm not sure if I'll spectate at any more Fife health board meetings as there are so many other things I'm busy with, that are more productive.  Writing is mainly what I now do.  My father William (Willie) Patterson was a science fiction writer, with the Daily Express in London, 1956-69, Jeff Hawke daily comic strip:
https://en.wikipedia.org/wiki/Jeff_Hawke
http://www.amazon.co.uk/Jeff-Hawke-Ambassadors-Willie-Patterson/dp/1845765982/ref=pd_sim_b_1

We lived in Perth, my home town, and my dad travelled down and back to London.  He was a larger than life character, principled and autocratic, dying before his time, aged 57 in 1986.

Families to me are what life is all about.  It is why I am now a writer, activist and campaigner in mental health matters.

Yours sincerely,

Chrys Muirhead (Mrs)"




Monday, 23 February 2015

why I was shocked but not surprised at the scandal about NHS Scotland, IHI and HIS in yesterday's Scottish Sunday Express

Although I have been campaigning and speaking out critically about Healthcare Improvement Scotland for some time, including my exclusion from patient safety events and the bullying I have been subjected to by Scottish Government uncivil servants because of it, I was shocked but not surprised to read the Scottish Sunday Express news article yesterday about the millions of pounds changing hands, involving IHI, HIS and NHS Scotland, with links to government ministers:



'NHS Scotland in takeover by US health giant' Ben Borland, Sunday Express, 22 February 2015

It took my breath away, the scale of the scandal, and the fact that I had sat through a Derek Feeley "masterclass" in the Chrystal Macmillan building of Edinburgh University, on 5 November 2014, organised by the Health & Social Care (former Long Term Conditions) Alliance, for their new H&SC Academy, opened by Alex Neil MSP on 19 May 2014, at which I was a spectator.  


Mr Feeley, who was born and brought up in Fife, had lived here when he was the Chief Executive of NHS Scotland, at the 5 November Alliance event brushed off my question about the "unreasonable treatment" of my son in Stratheden Hospital, Fife, saying that things were worse in other parts of the world.  

As if human rights abuses going on in Fife psychiatric wards are OK.  Well I don't think so, not when it's my son who's being abused.  That is unacceptable in my opinion, and insulting.

It is very galling to read that the organisation Mr Feeley now works for, the Institute for Healthcare Improvement in Cambridge, Massachusetts, was involved in setting up Scotland's patient safety programme, linking with Healthcare Improvement Scotland, which has been excluding me from national and international events because I have a critical voice and a negative story to tell, of psychiatric abuse in Fife.  

Then I read that Mr Feeley has "a gold-plated Scottish Government pension worth £1.1million" from Scottish Government and is still earning a fair whack, no doubt, while I am picking up the pieces after traumatic psychiatric treatment on a Carers Allowance.  I have attended 3 Carers Parliaments, from their inauguration in 2012 to the last one on 8 October 2014. 

Carers Parliament 2013, Alex Salmond speaking (photo by me)

Alex Neil MSP and at that time Cabinet Secretary for Health attended the Carers Parliament on 8 October 2014, along with Michael Matheson MSP.  I notice in the Express article that Alex Neil MSP, gave Mr Feeley a "glowing reference" along with the million pound pension handshake on his resignation as head of NHS Scotland in 2013.  Off he sailed to Boston and the IHI gravy train.  


Scottish Sunday Express page 4

Meanwhile HIS managers are swanning off to Florida with their sunscreen to have a "Team Scotland huddle", including Dr Brian Robson and Jason Leitch.  Here is a tweet that I sent to Dr Robson when he was at the Orlando conference on 10 December 2014:



Richard Norris is Director of the Scottish Health Council and I spoke to him at the Stronger Voice event on 9 October 2014 in the Dundee Discovery Point, where I was filmed by a social reporter speaking about the importance of critical voices and listening to people's pain:



[Although I mention in the video that the Alliance were supportive I am now not so sure of this and think they are more about political involvement, keeping government happy, rather than standing with unpaid carers and people who use services, on the breadline. Sad to say.  And so I have withdrawn my membership of the Alliance.]

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Here is another strand to what I and others see as the undue influence and power of HIS linked to IHI and NHS Scotland:

Dr Brian Robson (@brobson3), HIS Executive Clinical Director, IHI Fellow and GP, was responsible for hounding my friend, Dr Peter Gordon, an experienced consultant psychiatrist for older adults, out of NHS Forth Valley in the summer of 2014, because Dr Gordon has a questioning voice.

Blog post by Dr Gordon on his Hole Ousia website from 23 July 2014:

'Correspondence with Healthcare Improvement Scotland (HIS)'

Which contains a letter from Dr Brian Robson, dated 22 May 2014, to Dr Gordon's employers NHS Forth Valley, accusing Dr Gordon of "unprofessional" behaviour:

extract from Dr Robson letter 22 May 2014

"this individual" "Dr Gordon has persisted" "unprofessional" "misinformation" "behaviours" and so on, language that was both undermining and bullying by intention, I contend.

This attack on Dr Gordon's character caused him to resign from the permanent post he had been in for 13 years with NHS Forth Valley and led to him looking for temporary work in another health board area.  

And then on 5 December 2014 I witnessed another personal attack, on social media, by HIS National Clinical Lead Karen Goudie who used #unprofessional in a tweet to describe Dr Peter Gordon.



I immediately warned Ms Goudie that I was watching and thought her tweets were bullying in nature, then raised a complaint with the HIS Chief Executive Angiolina Foster.  On 30 January 2015 I received a letter from Robbie Pearson, Deputy Chief Executive, Director of Scrutiny & Assurance, Healthcare Improvement Scotland (HIS), to say that my complaint  had been upheld and an apology given, to both Dr Peter Gordon and myself.

Dr Gordon's blog post on Hole Ousia, 31 January 2015:

'Apology from Healthcare Improvement Scotland'
 
Here is a link to the blog post about my complaints process with HIS: 

'My Complaint to Healthcare Improvement Scotland about the Targeting of a Doctor by their National Clinical Lead


Link to HIS Complaint in a News Bulletin 7 Feb15

Dr Peter Gordon's blog post 7 February 2015: 'Why I have decided to leave Social Media'

Extracts from blog post: 
"There are several reasons why I have decided to leave social media behind however the primary one is that as an NHS employee in Scotland I do not feel safe in using social media."

"The personal consequences for me in raising ethical considerations on twitter to try and help improve care for our most elderly have been most significant. The organisation that appears to have struggled most with my ethical questioning has been Healthcare Improvement Scotland. There are individuals who have not shared my views who have associations with Healthcare Improvement Scotland and may have contributed to this response."

Here is just one aspect of Dr Peter Gordon's ethical endeavours, his continuing campaign for transparency in drug prescribing through his Sunshine Act for Scotland petition:


Open and transparent from omphalos

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After reading the Scottish Sunday Express news article yesterday morning, at 11.35, I wrote to my MSP Roderick Campbell, shocked and upset by the content:


 
And then later in the day yesterday, at 15.27, I sent another Email to my MSP copied in to other government ministers, including a blog post I'd written with the tweets from the Derek Feeley "masterclass" on 5 Nov14 organised by the Alliance.  I was still in a state of shock about the whole affair:



I forwarded on this Email to Derek Feeley and a number of his colleagues at the Institute for Healthcare Improvement, Mass, USA.  Then today I received a response from Mr Feeley to which I replied.  I will put these Emails in a following blog post, together with any other responses I may receive from Scottish Government ministers.   

I am still very unhappy at the way I've been treated by Scottish Government civil servants and health board staff, for speaking out about psychiatric abuse and unreasonable treatment in Stratheden Hospital, Fife.  I have been targeted by uncivil servants and excluded from key patient safety events for no good reason, had my reputation and character slandered by people who are paid by government.  

For over 3 years I have been fighting for justice and to be heard while also supporting my son singlehandedly after his traumatic experience as an NHS Fife psychiatric inpatient in February 2012, through the flashbacks and coming off the psychiatric drugs.  In addition I support another son who has a disability.  On £61/week as an unpaid carer and at 62 years of age, a grandmother. 

It's a scandal right enough.


Sunday, 22 February 2015

spitting peas like Garfield

yup that's me, spitting peas like Garfield:



'NHS Scotland in takeover by US health giant' Sunday Express & my tweets #DerekFeeley masterclass 5Nov14 @alliancescot

'NHS Scotland in takeover by US health giant' Ben Borland, Sunday Express, 22 February 2015:


"THE astonishing and largely hidden influence of an American private healthcare giant at the heart of Scotland's NHS can be exposed today.

Boston-based multinational Institute for Healthcare Improvement (IHI) has been paid millions of pounds in public money to introduce sweeping reforms across Scottish hospitals.

The extraordinary relationship was cemented two years ago when the former chief executive of Scotland's NHS stepped down in the wake of a scandal to become Executive Vice President of IHI.

Derek Feeley and his colleagues in Massachussetts now work closely with Scottish Government and play a key role in steering policy in the NHS, as well as social services, early years care and education.

This is despite the SNP insisting that the private sector is only involved in the "margins" of the health service in Scotland.

Last week, Health Secretary Shona Robison praised a fall in hospital death rates and announced a funding boost for the "world-leading" Scottish Patient Safety Programme.

However, the programme was in fact developed by IHI and the firm has been instrumental in rolling it out across the country ever since the SNP first came to power.

IHI website
Carol Hararden, another IHI Vice President, "currently leads IHI's work with Health Improvement Scotland aimed at transforming the safety of every Scottish hospital over five years".

The Scottish Government has paid IHI at least £5.6million in Scottish public money for its various contracts. 

IHI - founded by Professor Don Berwick, who led the controversial 'Obamacare' health reforms in the USA - is a not-for-profit company.

However, accounts show it generated some £26million in operating revenues last year and had £62million in cash and investments. It also receives funding from a number of US health insurers, such as Kaiser Permanente and Blue Cross Blue Shield.

Mr Feeley resigned to join IHI in April 2013, with a glowing reference from then Health Secretary Alex Neil, just weeks after it emerged he had put pressure on Audit Scotland to water down a report on problems with hospital waiting times. 

A career civil servant, who also served as Principal Private Secretary to First Minister Jack McConnell, he retains a gold-plated Scottish Government pension worth £1.1million. His new salary has not been disclosed, although IHI paid out £17million in wages and other benefits to its 140 staff last year.

Mr Feeley had to be granted special permission from then First Minister Alex Salmond and Permanent Secretary Sir Peter Housden, head of the civil service in Scotland, in order to take up his new role in August 2013.

Derek Feeley (Express photo)
A letter from Sir Peter, released by the UK's Advisory Committee on Business Appointments, shows that Mr Feeley was forbidden from "lobbying" the Scottish Government for two years from that date.

However, he was back in Scotland earlier this month to attend a "strategic meeting" between IHI and the Scottish Government.  

He also spoke at the firm's National Forum in Orlando, Florida, last December, which saw a number of senior NHS and Scottish Government officials jet across the Atlantic at taxpayers' expense.

They included Jason Leitch, the National Clinical Director Healthcare Quality and Dr Brian Robson, the Executive Clinical Director of Healthcare Improvement Scotland.

Indeed, so many Scots were present at the sun-soaked conference that photos have emerged showing Dr Robson leading a "Team Scotland huddle".

It was held at the Orlando World Center Marriott Resort & Convention Center, a luxury resort with its own swimming pool "oasis", giant waterslides, 18 hole golf course, award-winning restaurants and spa.

In December 2011, Mr Feeley - then still in charge of the Scottish NHS - was a keynote speaker at the Florida conference, alongside the Hollywood actor Michael J Fox.

Two years later, in 2013, he posted on Twitter: "Just arrived in Orlando for my 1st Forum as an IHI staff member. Can't wait to get underway. Weather lovely - bring sun screen."

Back in Scotland, the most recent contract has appointed IHI to act as NHS Scotland's "Quality Improvement Partner". Awarded in June 2013, it has so far been worth more than £860,000.

A "core team" of seven employees runs the "Scotland Programme", making crucial decisions about the day-to-day operation of the NHS and advising on everything "from healthcare to road safety".

Other programmes include Safety in Maternal Care, based on a project with disadvantaged mothers in Louisiana, and the Primary Care Safety Collaborative, which learns from IHI's work with Native Americans.

IHI has contracts with with private healthcare providers across the USA, and also operates in England, Saudi Arabia, Qatar, Singapore, India, Denmark, Sweden, New Zealand, South Africa, Brazil, Chile and Colombia.

It was founded by Professor Berwick, who went on to become Barack Obama's head of the Medicare programme and later carried out a review of patient safety in English hospitals.

Although his appointment was opposed by Republicans, his work with IHI - including his mantra that much health spending is "waste" - had previously won praise from ultra-right wing American politicans such as Newt Gingrich.

Last night, the Scottish Conservative health spokesman Jackson Carlaw said: "This exposes the SNP's referendum rhetoric on the independent healthcare sector as a fraud.

"It's incredible that the Scottish Government should be so damning of private health on one hand, yet so dependent on it on the other.

"These revelations have left the First Minister with some very tricky questions to answer indeed."

A Scottish Government spokeswoman said: "The Institute for Healthcare Improvement is a not-for-profit organisation, and has been instrumental in helping to deliver the world-leading patient safety programme that has had such a positive impact on the safety of patients across Scotland.

"The programme has become internationally recognised for the improvements in care and safety that it has delivered, since 2008, as we have seen a reduction of 25.5 per cent in surgical mortality, an 80 per cent fall in C.Diff rates in the over 65s and an 89 per cent decrease in the number of MRSA cases in Scotland. 

"Derek Feeley has had no involvement in contractual decisions, has not lobbied Ministers or officials, and has operated within the Business Appointment rules.

"A small number of officials travelled to the Institute for Healthcare Improvement International Forum in order to ensure Scotland continues to learn from and share the very best practice on patient safety and quality improvement.""

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Here are a series of my tweets from a masterclass with Derek Feeley on 5 November 2014, organised by the Health & Social Care Alliance through their #handsascademy (health and social care academy) initiative, which I attended and walked out of during Mr Feeley's talk.  (Alex Neil, MSP and CabSec Health at the time, launched the H&SC Academy 19 May 2014 at the Edinburgh City Chambers, another event I was present at)

I was annoyed at Mr Feeley's response to my question about the "unreasonable treatment" and human rights abuse going on at Stratheden Hospital, Fife, where he used to work.  I find it insulting that IHI, where he now holds a high position after receiving a large pension from Scottish Government, should be main players in the Scottish Patient Safety Programme.

I am also concerned about the links between IHI and HIS who have banned me from attending Scottish patient safety events and have blocked me from their twitter accounts.  For speaking out about psychiatric abuse and the bullying of healthcare staff. 
















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Link to Healthcare Improvement Scotland page on my blog


the great divide - them and us - the clinical gaze or gauze

This morning I'm working on the Foreword of my first book of blog posts from 2012 which I'm planning to self-publish on Amazon Kindle.  I'm telling my family's story, setting the scene, from childhood to the present day, in as few words as possible (not easy).  To make sense of my journey and engagement with psychiatry. 

As often happens when writing I find another truth coming out in the doing of it.  And so it was in the consideration of how I felt in 1970 when visiting my mother in the locked ward of Murray Royal psychiatric hospital then meeting with psychiatrists.  I was dispassionate and remember thinking at the time that I'd never be a mental patient.  It wouldn't happen to me.  Them and us.  The great divide.

Until it did happen to me after a painful induced childbirth, my second son, and experiencing an altered mind state, becoming a mental patient, forcibly injected with chlorpromazine in 1978,.  Then I knew what it felt like and understood my mother because I had become just like her.  One of them.  And like my mother I was resistant.

'You've abandoned me, love don't live here anymore' released 11 November 1978 was playing on the radio in Hartwoodhill psychiatric hospital, Lanarkshire, when I was an inpatient.  It was my song.  Separated from my baby son, 4 months old, and my oldest son who was 2, I was heartbroken:




 
I managed to escape and avoid ECT (shock treatment) in 1978 because I knew what it was and how my mother had resisted it.  Also because my husband had supported me in my decision, taking me out of the hospital in my pyjamas when the staff tried to force me to sign the ECT form.  He was always anti-psychiatry, it's probably the main reason I married him.  Twice.

I was fortunate not to have been a mental patient in the same hospital as my mother.  In a different health board area where they didn't know I was my mother's daughter.  The labels didn't stick.  I had another puerperal psychosis, after another painful induced childbirth in November 1984, while still in the maternity hospital.  

And again was a psychiatric inpatient at Hartwoodhill, forcibly injected, my third son only a week old.  Separated from my 3 sons, I was made to take the pills and go into a zombie state, my agency taken away.  Unable to breastfeed due to the chemicals.  I didn't want my boys to see me as a mental patient.  I got discharged after about 3 weeks.  (No ECT pressure due to the influence of the film "One flew over the cuckoo's nest")

After both psychiatric inpatient stays I tapered the drugs and got off them within the year, getting back on with my life.  It was far more difficult after the menopausal psychosis in 2002 because the "family history of" was in the notes, and because of polypharmacy, drug cocktails, tying me in as a "service user". 

Recently I have withdrawn from the DClinPsy training "user carer" or EBE (experts by experience) groups.  The main reason was because of the tokenistic involvement.  I just couldn't hack it any more.  We were kept at arms length and there was a great divide, them and us.  I could not cross over.  They wouldn't let me.

It was cultural and systemic.  The division was also apparent in the behaviour of the EBE/users/carers taking part.  We were often at sixes and sevens, with our own agendas.  I contend because the facilitators had their own agendas.  Over 3 years of agendas and hierarchical shenanigans.  What a right waste of time when we could have been collectively working together as human beings and equals.

I found that the higher up the ladder the less human the engagement.   The clinical gaze or gauze. 




Thursday, 19 February 2015

Letter to the DClinPsy staff at Edinburgh and Glasgow Universities - "on being perceived as a guinea pig" (updated formal response)

Formal response letter received today, 19 February 2015, from the two DClinPsy Programmes and NHS Education for Scotland:



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Here is a letter I sent in an Email on 14 February 2015 to the academics with whom I have engaged, at the Edinburgh and Glasgow DClinPsy user/carer groups, since September 2009, trying to be "meaningfully involved" as an "expert by experience":

Strapline: on being perceived as a guinea pig - the long road of
humiliation and jumping through the hoops with the DClinPsy 

"Dear DClinPsy Professors and Academics

I woke up this morning looking back over the years of trying to be involved as an equal, a person, on the "user carer" groups at both Glasgow and Edinburgh.  And how difficult it was.  Apart from my relationships with the admin staff who treated me like an equal and not as a guinea pig, for research purposes.

At the very first meeting in September 2009 in Glasgow at the Mental Health and Wellbeing Unit, or the red brick building as the taxi drivers call it, they were looking for research subjects.  I can remember going in to the meeting, late because I couldn't find where to park, and feeling like the odd one out. I'd recovered from psychosis, three times, and was in good mental health, not on drugs.  A psychiatric survivor.  There was a woman there, lead worker with (voluntary sector mental health organisation), who wasn't feeling well, and it seemed that the clinpsy staff were going into CP mode, doing an "intervention". 

It wasn't long after that the (voluntary sector mental health organisation) woman resigned and another worker got the job, the guy who accused me of "demonising psychiatry" at the final Glasgow CUSP meeting I attended in 2014.  He pointed the finger because I had been criticising the use of ECT on children and he said only a few would be getting it, as if that was OK.  This man and his service user colleague, who holds positions at the (voluntary sector mental health organisation), bullied me off the SEAN user reference group at the end of 2012, ganging up on me.  And then there is the other guy, (position), who objectifies women at the meeting.  And gets away with it.  Nothing was ever done to shut him up.  Yet I got bullied for speaking out against ECT for children.


Fast forward five years to the CBTp workshop in the Playfair Library Hall, 16 January this year, and (lecturer) saying to me that "service users" were invited to the event as it was hoped to recruit them (us) for research purposes.  Guinea pigs.  Interestingly, before going in to the event I spoke to a voluntary sector colleague, who said that she had been the one who had asked that people with lived experience might get a place at the workshop.  In other words, we weren't originally getting invited.  But then we were because we might be useful.  As guinea pigs.  

I always had the feeling at both DClinPsy groups that those of us with "lived experience" weren't there to be engaged with as equals but as useful subjects, specimens if you like, to fit in with your agenda, your research, your academic syllabus.  I didn't fit in at either university DClinPsy course because I am an unbeliever in the biomedical model of mental illness and continually recover from psychoses and psychiatric treatment.  Despite being told I have a lifelong condition.

Yet I persevered over these years in trying to be "meaningfully involved".  At one point we had three male academic staff at the Edinburgh group who it seemed were trying to get us to fit in with their agenda.  By this time there were only a few of us left attending.  Others had dropped by the wayside.  I remember (lecturer) going on about physical illness being a priority.  Another (lecturer) going on about the meeting not being about influencing CP in health board areas.  They were trying to make us fit their agenda.  I kept reminding them that we were there voluntarily, unpaid.  If they wanted to recruit people for their agenda then they'd have to pay them/us.

I remember many battles like this at the Edinburgh group as they tried to make us, who were left, conform to their way of thinking.  It went on for 3 years.  Meanwhile at the Glasgow group there were a few chosen ones who were favoured.  I got to do the Plain Language Summaries, eventually, and then the CBT/IPT workshops.  After about 4 years.  A long apprenticeship, considering I am well qualified and experienced in real life, as a community development worker, trainer and facilitator of learning.  The whole experience has been an exercise in humiliation and jumping through the hoops.  And having to fight for travel expenses.  Disgraceful really.  

While I was striving to be accepted in both these DClinPsy groups my son was also being humiliated, and abused, in Stratheden psychiatric hospital.  Locked in a seclusion room, no toilet or water to drink, light switch outside, broken hand untreated, an asthmatic who had in the past experienced 3 collapsed lungs.  So as I tried to be accepted and respected at the DClinPsy user carer groups I was also having to fight a battle for justice, in respect of my son, while picking up the pieces after traumatic psychiatric treatment.  The flashbacks from the abuse.  No support from clinpsy in Fife, or anywhere.

That's the reality.  

My questions to you therefore are: what is clinical psychology in Scotland there for?  What is your purpose?  Are you only there as a political force, to have a position and a paid job?  Are the Experts by Experience (EBE) only guinea pigs in your quest for recognition and power?  Do you think that your treatment of the EBE is acceptable?  And if it's not acceptable then what are you going to do about it?

I will have more to say about this, now that I'm not a guinea pig.

Yours sincerely,



Monday, 16 February 2015

'Empowerment and enlightenment: a Scottish doctor/carer partnership in action' my Response #BMJ to @ePatientDave

'Empowerment and enlightenment: a Scottish doctor/carer partnership in action' my Response published on BMJ website, 15 February 2015.

Response to ‘From patient centred to people powered: autonomy on the rise‘ 10 February 2015
by Dave deBronkart, speaker, policy adviser, and co-chair, Society for Participatory Medicine, 17 Grasmere Lane, Nashua, NH 03063, US; dave@epatientdave.com

Analysis Spotlight: Patient Centred Care, BMJ 2015;350:h148

"Patient peers: “eyes, ears, and a voice that they’ve never had before. These are the precursors of autonomy, emancipation, and self determination.” 

Yes I agree wholeheartedly with these words and the exhortation from Dave deBronkart in his refreshing Spotlight piece. It’s what I’ve had to do since becoming an unpaid carer for sons experiencing mental health difficulties who had no choice but to engage with an under-resourced psychiatric system and on occasion face “unreasonable treatment” (as described by the Scottish Public Services Ombudsman upholding my complaint against NHS Fife in September 2014). My own experience of recovery from mental illness and psychiatric treatment equipped me for the advocacy role.

I’ve also had to become a writer and blogger (1), an activist and campaigner, to have a voice and influence in the places where decisions are made. Some might describe my involvement as being like a hair shirt or the unwelcome guest at a party. Critical or questioning voices are not often welcome.

However the upside of my campaigning has been the forging of alliances with medical professionals, on level playing fields, with shared aims and life experiences. One of these partnerships is with Dr Peter J Gordon, Consultant Psychiatrist, who is petitioning Scottish Parliament for a Sunshine Act: “creating a searchable record of all payments (including payments in kind) to NHS Scotland healthcare workers from Industry and Commerce”. (2)

Dr Gordon and I are in regular contact, working together, exchanging information, helping to foster transparency and ethical practice in the relationships between drug compan ies and health boards. Having been a community development worker for over 30 years I am now finding empowerment in our knowledge transfer and in the act of writing to be heard. A reciprocal agreement based on mutual respect."

References

(1) Chrys Muirhead Writes:
http://chrysmuirheadwrites.blogspot.co.uk/

(2) A Sunshine Act for Scotland, Petitioner Peter John Gordon:
http://www.scottish.parliament.uk/GettingInvolved/Petitions/sunshineact


Sunday, 15 February 2015

'Hollywood prosthetics helping trainee mental health nurses' - Robert Gordon University statement update - masks curtailed - a volte-face

Update Sunday 15 February 2015 Statement on masks from Robert Gordon University:



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'Hollywood prosthetics helping trainee mental health nurses' BBC News, 12 February 2015.  [In Aberdeen where stigma is obviously very much alive and kicking]

I heard about this news piece from Irish mental health activist colleagues on Facebook.  

Their comment:

"All they are missing is Frankenstein! This kind of bull makes a person want to run away and create a new identity. So much stupidity in the world"  

I agree.  It's inherently stigmatising and discriminatory against people with mental health difficulties. 




"Prosthetic masks made in Hollywood are being used to help trainee nurses in Aberdeen learn about mental health issues.

The life-like masks are worn by tutors at Robert Gordon University to create scenarios for the students to deal with.

It is thought to be the first institution in Scotland to use the masks." (let's hope it's the last)



'Prozac Nationalism' by Siobhan Tolland, May/June 2012, Scottish Left Review

This morning I was sent this piece by a colleague, from the Scottish Left Review, Issue 70, May/June 2012: 'Prozac Nationalism' by Siobhan Tolland, and thought it very pertinent for now:

"Prozac Nationalism,
Written by Siobhan Tolland 

 In 2010, the Scottish Government quietly abandoned its commitment to reduce antidepressant use within Scotland. The original commitment came amidst a wave of concern and worry that ten per cent of Scots were taking antidepressants, and the SNP promised to promote alternative treatments. Recommending this abandonment, the Scottish Governent Audit Committee suggested that the reduction commitment did not reflect the complexity of treatment options within Scotland. Importantly, it argued, recent research concluded most GPs were prescribing appropriately anyway. Thus concerns over the high use of antidepressants within Scotland were unfounded. 

At present the mental health strategy, Towards a Mentally Flourishing Scotland, is under review, but the abandonment of that commitment is a cause for concern. And abandoning it on the basis of the Aberdeen University research is extremely concerning for it accepts a very controversial view of mental illness that reduces complex emotions to a single biomedical cause. Depression, for instance, is caused by chemical or biological abnormalities of the brain, and should be treated accordingly. Accepting the study’s conclusion that GPs were prescribing appropriately then means they also accept Depression is biomedical in origin. As a consequence, it promotes antidepressant medication above, say, counselling, CBT or even exercise.

The biomedical view additionally prevents any social analysis of unhappiness or desperately low mood, and medicalises these problems. It ignores the correlation between poverty, inequality and poor mental health, for instance. Research suggests that poor mental health is caused by poverty, for instance, with Bristol University suggesting that as many as 50 per cent of people in poverty have signs of depression. Reverting to a biomedical discourse of poor mental health prevents these social and economic connections from being established, siting responsibility on the individual’s biology, and not society.  And thus any sense of collective social responsibility for our health and welfare is abandoned. We don’t need to change society to make it more mentally healthy, we just need doctors and scientists manipulate the brain.

The SNP’s change in strategy is important then because the biomedical discourse moves away from a social analysis of health. It is also often seen as a discourse  that is of considerable benefit to the pharmaceutical industry. There was a 234 per cent rise of antidepressants between 1992 and 2002, for instance, and this has steadily increased since then. The pharmaceutical industry’s profit has risen accordingly, outstripping most other industries in terms of median profit. The industry is staggeringly massive, the Guardian newspaper comparing their size to ‘behemoths’, ‘outweighing entire continents’. ‘Big Pharma’ (as they are often called) has promoted and pushed antidepressant medication continuously, facilitated by the biomedical discourse. That the Scottish Government accepts current antidepressant use as ‘appropriate’ then shows a strategy more in alignment with industry’s needs than those who need mental health support.

This alignment with industry is actually disturbing when we consider that the actual usefulness of antidepressant medication is under question. The Scotland Action on Mental Health (SAMH) study, for instance, stated that around 50 per cent of people found medication did not actually improve their mood, and that 60 per cent of people reported side effects from the most common antidepressant type (SSRIs), when taking it and when trying to withdraw. More generally, Joanna Moncreiff, Psychiatrist and critic of the ‘chemical cure’ states that the biomedical origin of depression is a myth and that the only reason medication works is because they put people in a chemically-induced altered state that suppresses or masks emotional problems. Antidepressant medication does not really solve the issues of Depression then. At best they mask people’s feelings through drugs.

Worse, the side effects reported by SAMH are severe, including anxiety, anger and even violence. Some critics even accuse this medication of being dangerous, and point to thousands of deaths caused by such drugs. A very public example of this was Glaxo Smith Kline which was accused of withholding important clinical trial information regarding the high likelihood of under-18s having suicidal thoughts when taking Seroxat. Some independent trials suggested the suicide risk was up to six times higher than normal. It was suspected that such information was withheld for nearly a decade.  One ex Pharmaceutical industry chemist suggests that we have a billion dollar industry making a lot of people sick and profiting from it. Antidepressant medication as ‘appropriate’ treatment is a statement that should be treated with extreme caution then. Something the Scottish Government clearly has not done.

Behind the Aberdeen University study then lie a lot of question marks over their assumed truths of antidepressant medication. As a result the Scottish Government’s acceptance should be seriously questioned. The fact that the side effects of these drugs are so common and sometimes so terrible seemed to have no impact on the study’s conclusion or the Scottish Government in accepting it. It seems that antidepressant medication does not actually support or help people with poor mental health, but merely serves to put people into a drug-induced state. This ultimately functions as a form of social control because it prevents any serious questioning of the system that causes such poor mental health in the first place.

Given the controversy over antidepressants then, it seems strange that the Scottish Government saw no relevance in the fact that two authors of the Aberdeen University study were on the payroll of various drugs companies as speakers or consultants. Objectivity in such research is often questioned because of the considerable influence the industry exerts over it. In such medical research one-third of writers have substantial financial interest in their published work, through sponsorships consultancies and general payments by the industry. Indeed, a lot of the time the industry doesn’t need to offer financial incentives because they ghost-write over half of all publications about medication. Financial interest and profit skews a lot of medical research and there is often not even a pretence of objectivity.  It is this influence that the Scottish Government is rigorously trying to encourage, as it entices Big Pharma into Scotland and open NHS research up to that influence.

Since the opening of the Scottish Parliament, the lobbying organisation of the pharmaceutical industry (the ABPI) set up camp in Scotland and has continuously lobbied the government. ‘Big Pharma’ has the biggest political lobbying budget in Washington and spends more on marketing and advertising than they do on research and development. The ABPI is open about creating ‘foot soldiers’ within important areas such as support groups and sympathetic health professionals to weaken the political and ideological defences. And their presence in Scotland has initiated a political and cultural change that transforms science and health care to meet the needs of the industry. SNP’s change in policy regarding antidepressant medication highlights this influence.

SNP’s policy change reflects a wider financial strategy to bring more of the industry in to Scotland. In 2007, the Government announced a 55-acre Bio-quarter project beside the Edinburgh Royal Infirmary, as site of excellence in Life Sciences research. Attracting investment was one of the key objectives and the pharmaceutical industry now sits in the grounds of the hospital and research facilities. The next year, the Scottish Life Sciences Advisory Board (SLCAB ) was set up. This was a joint government, academic and industry initiative to develop innovation and growth within the life sciences (of which the drug industry makes up seventy per cent). This has led to government initiatives, grants and a close working relationship between the health minister and the ABPI, determining policy and future initiatives according to the needs of Big Pharma.

More worrying, by 2011 the SNP was openly promising to open NHS Research Scotland up to the pharmaceutical industry. This involved a mission to double the economic contribution of life sciences and accelerate growth with an emphasis on business and institutional collaboration. Promoting health seems pretty absent against this language of business interest. One example of such a promise was a joint partnership with companies carrying out clinical trials which involved streamlining the ‘regulatory approval processes’, meeting the open demands of the ABPI. Since Psychiatry and Neuroscience are proposed areas for NHS Research/industry development, the biomedical influence of mental health and illness seems pretty inevitable. Certainly the interests of industry will be higher up the agenda than ever before, as health becomes business and profit.

As the SNP prepares for the vote on independence then, it has been busily trying to develop the economic and financial future of Scotland. Life Sciences is one area where the SNP has seen an opportunity to develop wealth, making Scotland a viable independent economy. And it seems to be working. Scotland is bucking the European trend by attracting more drug industry investment in clinical trials, for instance. There is a real worry, however, that in the mission for independence, we have become lured by the promise of wealth and the might of Big Pharma.

The consequences of allowing the drugs industry this level of control over our mental health is terrifying, as SNP’s promotion of alternative treatment becomes less compatible with Big Pharma’s interests. Donald Trump’s permission to have a practically free reign over parts of northern Scotland has been met with incredulity and even horror. Allowing Big Pharma control within our health sector, however, has been met with very little opposition or even analysis within Scotland. The ABPI makes it clear: treating poor health is irrelevant if it cannot meet the needs of shareholders. And we are allowing this industry control over our mental health.

Dr Siobhan Tolland researches the politics of health in contemporary Scotland."

Link to Scottish Left Review, Issue 70, May/June 2012

Friday, 13 February 2015

once I was blocked, now I can see: @opachis (Healthcare Improvement Scotland)

On 8 February 2015 I had been checking out the OPAC (improving care for older people) twitter page "Official page for improving care for older people in acute care workstream" led by Healthcare Improvement Scotland, and noticed that I - @ChrysMuirhead - was blocked from seeing their tweets:



So I Emailed the National Clinical Lead Karen Goudie at Healthcare Improvement Scotland, copied in to various HIS senior managers plus my MSP Roderick Campbell, to find out why I was getting "special treatment".

[The reason I sent this Email to Ms Goudie is because I had seen the @opachis twitter handle on her work Email signature and thought she may be lead worker on this project]
 
"Dear Ms Goudie

I am writing to you about the @opachis twitter account as it seems I am blocked from seeing the tweets via my @ChrysMuirhead account.  See screenshot attached.

I can view it as a member of the public and note that it says:

"Official page for improving care for older people in acute care workstream, led by Healthcare Improvement Scotland."


I am wondering why I would be blocked from seeing tweets on an "official" NHS Scotland account.  Is there a reason for this?  

I look forward to hearing from you.

[I am copying in Christine Hill, Robbie Pearson, Denise Coia, Brian Robson and Angiolina Foster, for their information.  Also my MSP Roderick Campbell.]

Yours sincerely,

Chrys Muirhead (Mrs)"



I received a response on 9 February 2015 from Penny Bond, Implementation and Improvement Support Team Leader, via Jane Millar, Project Officer, HIS, to say that my twitter account had now been "unblocked":



I responded to this Email from Jane Millar/Penny Bond on 10 February, asking who had blocked my account and the reason why:



I received a response from Penny Bond on 11 February by iPhone, which said "At the moment we don't know how this happened, as there are a number of staff who have access to the account some of whom are on leave at the moment."



It's now 13 February 2015 and I still don't know why I (@ChrysMuirhead) was blocked from the OPAC "official" twitter account.