Wednesday, 29 April 2015

Letter to First Minister about SNP Manifesto and mental health: disappointing lack of attention: human rights; parity of esteem

I sent a letter by Email to the First Minister, Scottish Parliament, on 28 April 2015:

Strapline: mental health in the SNP Manifesto - mentioned 4 times in 38 pages - nothing about parity of esteem or human rights in mental health

Dear Nicola

I am writing to you regarding the SNP Manifesto and to express disappointment that "mental health" is only mentioned 4 times (three times in the one paragraph) in the 38 page document:
http://votesnp.com/docs/manifesto.pdf

"We will demand an urgent review of the conditionality and sanctions regime, in order to deliver an overhaul of the current, deeply ineffective arrangements, which impact on some of the most vulnerable in our society. The review will take particular account of the needs of people with mental health issues." page 16

"We’ve already committed £15 million to a mental health innovation fund and, as part of our proposals for higher health spending, will seek to increase this investment to £100 million over the next 5 years. Resources will be directed towards projects that will improve mental health treatments in the primary care sector. The fund will also enable further investment in child and adolescent mental health services. Scotland was the first country in the UK to introduce waiting time targets for these services, and we have increased the workforce by 45 per cent." page 30

There is no mention of Parity of Esteem between mental health and general health services, and neither is there any mention of mental health and human rights.  I notice that the main parties - Conservative, Labour and Liberal Democrat - have gone into detail about improving mental health services.  It was reading this report earlier that spurred me on to write to you:
https://www.mentalhealthtoday.co.uk/mental-health-goes-mainstream-an-analysis-of-the-party-manifestos.aspx

The main reason for my disappointment and dismay at mental health not being given its place in the SNP Manifesto is because of what happened to my son in Stratheden Hospital, Fife, in February 2012, when he was locked in a seclusion room with no toilet or water to drink, in the dark, for hours at a time, unobserved.  Broken hand untreated.  The psychiatric nurses were using the locked seclusion room to "manage" the patients.  Lack of resource.  Bad practice.  Patients at risk.  Mental Health Act not implemented properly or monitored effectively.  Human rights abuse.

The cost of an inpatient bed/week in Stratheden Hospital is approximately £2000-2500/week whereas in Carseview Centre, Dundee, it is £3000/week.  (I did FOI requests)  The cost of a general acute hospital inpatient bed/week is around £4500 (I heard Alex Neil mention this amount at the SNP national conference in Perth, October 2013, which I attended, all four days of it, when I was a member of SNP. 

The sums don't add up.  Mental health treatment is below par, resource wise, and I contend that psychiatric inpatients in Scotland are suffering for it.  Some are at risk of psychiatric abuse.  It happened to my son and it will be happening to others.  That is a given even if few are speaking out about it for fear of retaliation.  Following the abuse of my son Scottish Government gave £4.4million to NHS Fife health board to build a new IPCU (starting soon so I hear).  

Despite the lack of support for mental health in the SNP Manifesto I appreciate other points in the document.  The attention to Carers and to those on welfare benefits.  The points about equality.  However it is my belief and contention that until mental health treatment is on a par with physical health treatment, in terms of resource and human rights, then those of us entering a psychiatric ward in Scotland will be a risk of psychiatric abuse.  I speak from personal experience, as a psychiatric survivor.

I am copying in SNP Chief Executive, Peter Murrell, and my MSP Roderick Campbell, for their information.  Also the Cabinet Secretary for Health, Wellbeing and Sport, and the Minister for Sport, Health Improvement and Mental Health.

Yours sincerely,

Chrys Muirhead (Mrs)"


NHS Fife Board Meeting St Andrews 28 April 2015: my take on the talk

Tuesday, 28 April 2015

Dear Simon SRN: who is on the panel at ‘Rights for Life: Supporting Recovery and Challenging/Ending Discrimination’?

An Email sent to Simon Bradstreet, Director of Scottish Recovery Network, including the Director of See Me Scotland and others:

Strapline: who is on the panel at ‘Rights for Life: Supporting Recovery and Challenging (Ending) Discrimination’?

SRN (cheery) image
"Dear Simon

I would like to know who you have chosen to be panel members at the Rights for Life June event and hope that you can enlighten me.  This question is also directed at Judith Robertson, Director of See Me Scotland.

You say in your Email below to ...... of Autism Rights: "These invitations were  designed to allow for a range of perspectives to be voiced.".  Therefore I assume that you have included critical voices.

I look forward to hearing your, or Judith's, response.

Regards, Chrys"


Monday, 27 April 2015

Dr Peter J Gordon: “The progressive test” on Hole Ousia [reblog]

Dr Peter J Gordon: “The progressive test” on Hole Ousia:




"This commentary has recently been published:

008 Progressive Test

The commentary starts out stating that:

006 Progressive Test

But makes equally clear:

007 Progressive Test

A helpful definition of human rights is given:

002 Progressive Test

The Scottish Human Rights Commission outline five key questions that comprise “the progressive test”

004 Progressive Test

One of those five questions relates to:

005 Progressive Test

NHS Healthcare Improvement Scotland has, over the last few years, introduced mandatory “cognitive screening” for our elderly (generally considered those aged 65 and over). Such “cognitive screening” which I consider as a well-intentioned mandate, is nevertheless an example of a “blanket policy”.

I have found raising the subject of consent for cognitive screening a “difficult conversation” to have in NHS Scotland.

020 Progressive Test

As an NHS Consultant I use rating scales every day. As such I have come to appreciate what they can and cannot reveal about a patient.

Using brief scales for “screening”, rather than as part of an overall assessment, I consider a different matter. For screening, ten WHO criteria are required to be met. The UK National Screening Committee and all extant UK guidelines have concluded that these criteria have not been met for cognitive screening.

Notwithstanding, Scotland has chosen to follow “improvement methodology” to guide its approach. Here Scotland is a pioneer.

Here is the policy that was introduced by NHS Forth Valley following the approach of Healthcare Improvement Scotland:

NHS Forth Valley 8on mandatory screening

The current NHS Scotland hospital guide on consent makes clear:

018 Progressive Test

Where consent is defined as:

019 Progressive Test

In this week’s Lancet  there is a an editorial that advises that there is “wisdom in the bigger picture”:

 014 Progressive Test 015 Progressive Test

The above ethos is very much in accordance with Hole Ousia. The philosopher Mary Midgley was one of the first to raise the potential consequences of increasing specialisation (here, might we consider the division of the medical humanities from day-to-day medical care):

013 Progressive Test

This week’s Lancet editorial gives a timely reminder of a broader, rather than narrower, appreciation of cognition.

016 Progressive Test

I have tirelessly offered reminders why a “brief” “screening tool” may likely struggle to be “patient-centred”:

017 Progressive Test

It has been argued that cognitive screening in Scotland, using “cognitive screening tools”, is not screening at all but rather it is “identification” or “detection”.

I argue that a better approach for “identification” (for this to be more accurate and patient-centred) is for NHS staff to use their professional training and to be given time to attend to proper assessment. This means following time honoured clinical assessments rather than taking shorthands. I Should reaffirm, that it is the case that a rating scale may be part of this overall assessment.

Robert Louis Stevenson remarked in one of his philosophical essays:The philosopher Mary Midgley, now aged 95 years herself, has said:

011 Progressive Test

In Summary: I am of the view that mandatory cognitive screening introduced by NHS Scotland as part of “improvement science” does not meet the requirements of “the progressive test” as set out by the Scottish Human Rights Commission."


my tweets to @PsychiatrySHO aka Alex Langford re his #BMJ Response 'Healy does a disservice to psychiatrists'

25 April 2015 
Alexander E Langford
Core Trainee in Psychiatry
South London and the Maudsley NHS Foundation Trust

in response to Dr David Healy's Editorial 'Serotonin and depression' 21 April 2015
BMJ 2015;350:h1771

My tweets this morning to Alex Langford @PsychiatrySHO:





Saturday, 25 April 2015

music therapy from The Proclaimers: 'You Built Me Up' (from new album out 27 April)




---------------------------



"I think there will be a lot of changes in these islands over the next 10 or 20 years..." hmv.com talks to The Proclaimers:
His Master's Voice


"Over the last two and a half decades, brothers Charlie and Craig Reid, otherwise known as The Proclaimers, have released nine studio albums, toured the world and even had a musical written based on their songs.

Next week the Scottish duo release their tenth album, Let's Hear It For The Dogs, and we caught up with Charlie Reid to talk about working with Manic Street Preachers producer Dave Eringa, having their songs adapted for stage and screen, as well as their take on the Scottish independence debate...

You toured pretty extensively with your last album, when did you start working on the new record?

We finished off the last round of touring around October 2013, we had a few weeks off before we started writing for the new record, then we just got on with it really. So we started some time in the autumn and just tried to get as many songs done as we could, we'd finished around August last year but it ended up being almost December before we actually went into the studio. We were down at Rockfield studios in Monmouth, I think it was all finished by about December 21st.
 .....

Read whole article





Thursday, 23 April 2015

my #BMJ Response: 'Sunshine Act for Scotland: transparency, independence and accountability'

Dr Margaret McCartney's Article: 'Forever indebted to pharma—doctors must take control of our own education'; BMJ 2015;350:h196; 13 April 2015

And my Response: 'Sunshine Act for Scotland: transparency, independence and accountability'; 22 April 2015 [Chrys E Muirhead; Writer; Carer, Cupar, Fife, Scotland]:

"'Paying our own way would enable doctors to regain control.” I agree with Dr McCartney's article. That doctors' independence in the area of pharmaceutical drugs is paramount so that patients can continue to trust the advice given and drugs prescribed. As an unpaid Carer I would also appreciate the reassurance that the doctors who support the family members I care for are free from conflicts of interest and that their attentions are firstly and firmly focused on the patient.

I would like to draw attention to the transparency work of consultant psychiatrist Dr Peter J Gordon in this respect, his ongoing Petition to Scottish Parliament urging the Scottish Government to introduce a Sunshine Act for Scotland. Creating a searchable record of all payments (including payments in kind) to NHS Scotland healthcare workers from Industry and Commerce. (1)

Dr Gordon is a writer and film maker who, through the medium of his Hole Ousia website and Omphalos videos, highlights a range of topics and issues in his profession, including sponsored medical education, conflicts of interest between pharmaceutical companies and doctors, and the underpinning ethics of the therapeutic relationship.

Scottish Parliament website
Up to this point Dr Gordon’s Sunshine Act petition has been heard and debated in Scottish Parliament on 4 occasions, the first of which was the initial giving of evidence by the petitioner and subsequent considerations by the Public Petitions Committee.

Most recently on 31 March 2015 (2) when there were discussions by MSPs about statutory legislation and it was agreed to keep the petition open while also writing to Scottish Government regarding further action. Requesting a review of their directive, NHS Circular HDL (2003) 62, instructing health boards to set up Registers of Interest so that staff can declare payments from pharmaceutical companies (3). The health boards in Scotland have not been complying with this government directive, in relation to transparency.

As an unpaid carer and now in receipt of a state pension I am encouraged by the transparency work of Dr McCartney, Dr Gordon and others, who are leading by example and advocating for people like us, customers of the health service.

1 PE01493: A Sunshine Act for Scotland, Petitioner Peter John Gordon, Scottish Parliament website:
https://www.scottish.parliament.uk/GettingInvolved/Petitions/sunshineact

2 A Sunshine Act for Scotland (parliamentary update), Hole Ousia website:
https://holeousia.wordpress.com/2015/04/15/a-sunshine-act-for-scotland-p...

3 NHS Circular HDL (2003) 62, Scottish Government:
http://www.sehd.scot.nhs.uk/mels/HDL2003_62.pdf


'The Role of Video Games and Virtual Reality in Psychiatric Treatment' & 'The Benefits of Playing Video Games' articles

'The Role of Video Games and Virtual Reality in Psychiatric Treatment': David Baron, Marientina Gotsis, Psychiatry Advisor, 8 April 2015

Introduction:

"Individuals and families of all ages are consumers of interactive entertainment in many forms. Games have matured as an artistic medium and they now explore emotional experiences that represent a wide spectrum of human emotions.

The game Journey, which has been dubbed by critics as a cinematic experience, is being used in clinical studies for depression at the Behavioral Sciences Institute (BSI) in Radboud University Nijmegen in Holland. The BSI is also behind of Mindlight, a sweet-scary biofeedback-driven game for children with anxiety. Its aesthetic merit beyond clinical applications has landed it at the Games for Change festival in New York City this month...."

Excerpts:

"Unfortunately, as the public lives increasingly in a networked and digital world, psychiatry remains deeply skeptical and removed from technological advances for going beyond patient engagement to interactive diagnostics and treatment. Interactive entertainment elicits emotions, can help regulate affect, and can provide “virtuous” pleasure of an epicurean era in which happiness (ataraxia) is the absence of unnecessary mental and physical suffering. But why isn't all this technology being used widely by psychiatry? ..."

"One of the most promising opportunities is to replace neurocognitive instruments with cross-validated entertainment-based experiences. This would be especially useful in developmental disorders.

Understanding how the design of interactivity affects brain function, and how that maps to executive function development trajectories, is especially critical for use of these experiences by children. ..."

Read complete article

-------------------------

'The Benefits of Playing Video Games': Isabela Granic, Adam Lobel, and Rutger CME Engels; Radboud University Nijmegen; January 2014; American Psychologist

Abstract:

"Video games are a ubiquitous part of almost all children’s and adolescents’ lives, with 97% playing for at least one hour per day in the United States. The vast majority of research by psychologists on the effects of “gaming” has been on its negative impact: the potential harm related to violence, addiction, and depression. We recognize the value of that research; however, we argue that a more balanced perspective is needed, one that considers not only the possible negative effects but also the benefits of playing these games. Considering these potential benefits is important, in part, because the nature of these games has changed dramatically in the last decade, becoming increasingly complex, diverse, realistic, and social in nature.

A small but significant body of research has begun to emerge, mostly in the last five years, documenting these benefits. In this article, we  summarize the research on the positive effects of playing video games, focusing on four main domains: cognitive, motivational, emotional, and social. 

By integrating insights from developmental, positive, and social psychology, as well as media psychology, we propose some candidate mechanisms by which playing video games may foster real-world psychosocial benefits.  Our aim is to provide strong enough evidence and a theoretical rationale to inspire new programs of research on the largely unexplored mental health benefits of gaming.  Finally, we end with a call to intervention researchers and practitioners to test the positive uses of video games, and we suggest several promising directions for doing so." 

Read complete paper


Monday, 20 April 2015

acknowledgement @scotgov: Jamie Hepburn MSP receipt of my Dundee Advanced Interventions Service letter

I have just received a letter from Scottish Government, dated 20 April 2015, in response to my forwarding the letter sent to Prof Matthews at the Dundee Advanced Interventions Service, which had Strapline:

"DAIS annual report 2013 - 36 referrals from Scotland - a staff team of 10 - home visits - £568K/year = £15,777/person (one person getting NMD for THIRD time) - Parity of Esteem"

Jamie Hepburn MSP is the Minister for Sport, Health Improvement and Mental Health.




Scottish Parliament website


Dear Prof Matthews: why are female patients in Carseview Centre Dundee being put under pressure to have ECT?




Another letter sent this morning by Email to Professor Keith Matthews, psychiatrist on the Advanced Interventions Service (DAIS) based at Ninewells Hospital, Dundee and Head of Neuroscience at the University of Dundee.  Copied in to his psychiatrist colleagues at DAIS, the Cabinet Secretary for Health at Scottish Government and her fellow MSP in Dundee, the CEO of NHS Tayside, the Director of National Services Division at NHS and the Head of the Scottish Mental Health Research Network:

Strapline: why are female patients in Carseview Centre Dundee being put under pressure to have ECT?

"Dear Professor Matthews

I am wondering if you can answer this question? 

I remember your article and quote in the Courier piece from October 2011: "Professor defends electroconvulsive therapy against Hollywood's portrayal":


http://www.thecourier.co.uk/news/health/professor-defends-electroconvulsive-therapy-against-hollywood-s-portrayal-1.55573

where you say "ECT is one of the single most effective treatments in the whole of medicine."  A shock to the brain or a knock on the head is more important than for example penicillin or insulin?

I am hearing, again, that female patients in the Carseview Centre, Dundee, are being put under pressure to have ECT.  I heard it first back in early 2013 when my middle son was a patient in Ward 1 at Carseview and an older female patient in the dining room, about my age, said to another patient that her psychiatrist wanted her to have ECT but she didn't want it.  The other patient, a young man, former Game student at Abertay, told her to refuse it.  That's what he was doing.  However the woman said that her doctor wouldn't discharge her until she agreed to the ECT.  Soon after this the woman capitulated, got the shock treatment and got discharged.  She had entered the ward with a black eye and left it with a knock on the head.  Same difference I suppose.  

Please excuse my flippancy.  I am really very angry and upset that women should be pressurised to accept electroconvulsive therapy when they don't want to have it.  It happened to my mother many times, in Murray Royal Hospital, Perth, in the 1950's and 1960's.  Forced ECT.  Against her will.  My mother was not suicidal or depressed.  Rather she experienced altered mind states, nervous breakdowns as they were then called, now "psychoses".  My mother was a gentle woman who was sensitive and caring.  She didn't deserve to be abused in psychiatric settings because of feeling emotional pain at the circumstances of life.

I am hearing that it is women who have diagnoses of OCD and/or depression who are being put under pressure to have ECT in the Carseview Centre, Dundee, by both nurses and doctors.  I am thinking that there has to be a link with the work that you do at the University of Dundee and the Advanced Interventions Service.  It cannot just be coincidence when there are so many factors in common.

On 16 May 2015 there is to be an international Day of Protest against Electroshock:

http://ectjustice.com/protest.php

And here is a recent article, for interest, by Dr Bonnie Burstow on Mad in America: Protesting ECT: A Moral/Existential Calling:

http://www.madinamerica.com/2015/03/protesting-ect-moralexistential-calling/



Excerpts:

"That noted, ECT has been proven conclusively to cause extensive brain damage (see Zarubenko et al., 2005) and extensive and enduring cognitive impairment — memory loss in particular (see Breggin 1991 and Sackeim et al., 2007). Moreover, however the so-called therapeutic effect may be theorized, it has been demonstrated to be no more effective than placebo (see, for example, Ross, 2006). Now admittedly, there have been ample studies that report effectiveness. As clearly demonstrated by Read and Bentall (2010) though, such studies are inherently flawed, with, for example, no criterion of improvement provided or improvement being predicated solely on the subjective opinion of caregivers."

"Additionally — and not surprisingly, given what has been revealed to date, as Breggin (1991) and Burstow (2015) have demonstrated — there is a one-to-one ratio between the damage done and the so-called therapeutic effect. An added reality which helps one ferret out the truth of what is happening here is that ECT is overwhelmingly given to two particular constituencies — women and the elderly. (For a strong feminist and anti-ageist analysis, see Burstow, 2006) Albeit the largest and most extensive study in ECT history (Sackeim et al., 2007) conclusively establishes that these are the very groups that incur the greatest damage from the procedure."


I hope that you are able to respond to this Email and I look forward to hearing what you have to say.   I cannot stay silent when I hear of women being subject to abuse in psychiatric settings.  I could not stay silent when it was happening to my son in Stratheden Hospital.  

Yours sincerely,

Chrys Muirhead (Mrs)"

cc Prof Douglas Steele, Dr David Christmas, Lesley McClay, Shona Robison, Joe Fitzpatrick, Deirdre Evans, Prof Steve Lawrie


Sunday, 19 April 2015

Letter sent to Professor Matthews: Head of Neuroscience at Dundee University and Lead at Advanced Interventions Service

Letter below sent by Email today, 19 April 2015, to Professor Keith Matthews, psychiatrist on the Advanced Interventions Service based at Ninewells Hospital, Dundee and Head of Neuroscience at the University of Dundee.

link to Dundee University website
Background information about DAIS and Prof Matthews from the Dundee University website:

"With the context of delivering a national specialist service for NHS Scotland, the Advanced Interventions Service is committed to the rigorous evaluation of a range of treatment approaches for patients with chronic, refractory mood disorders and OCD. These approaches include psychological therapies (e.g. CBASP, ERP and CBT), neurostimulation (vagus nerve stimulation – VNS and deep brain stimulation – DBS)  and lesion surgery (anterior capsulotomy and anterior cingulotomy)."

and

"Professor Matthews is executive adviser to the World Society for Stereotactic & Functional Neurosurgery Psychiatric Neurosurgery Committee.

Professor Matthews is Clinical Lead for Tayside and a member of the Management Board of the Scottish Mental Health Research Network (http://www.smhrn.org.uk/).

Professor Matthews is a Member of the Clinical Advisory Group for the charity OCD action."

------------------------

Letter Strapline: DAIS annual report 2013 - 36 referrals from Scotland - a staff team of 10 - home visits - £568K/year = £15,777/person (one person getting NMD for THIRD time) - Parity of Esteem

"Dear Professor Matthews

I am writing to you about the Dundee Advanced Interventions Service latest 2013 Annual Report which I have just been reading through:
http://advancedinterventions.org.uk/images/pdf/AIS_Annual_Report_2013_WEB.pdf 

I want to commend you on its thoroughness, the detail, the graphs and the various sections which explain even to a non-professional like myself what is going on. 

What first strikes me about the work of DAIS is the resources which are put in.  The amount of staff, the website, the variety of medical and psychological expertise involved.  For example I read that a team from DAIS will visit a person in their own home to discuss the range of therapies and treatments available.

In the everyday world of mental health services when people are in severe mental distress they can't get teams coming to their house.  I know this personally from when my youngest son was mentally distressed at Christmas time 2011 in NE Fife where we live, and remained so for a month, despite having a CPN.  My son could not access the simplest of crisis support.  And so he eventually was subject to "unreasonable treatment" in Stratheden IPCU.  Where there is a dreadful lack of resource to treat mentally distressed patients.

The point I am making is that DAIS has the resource to send teams out to patients but in Fife the NHS doesn't.  And neither does it happen in Dundee for people in mental distress.  I know this because my middle son couldn't access any support despite turning up at Ninewells A&E on Christmas Day 2012, in mental distress.  He ended up in the Carseview IPCU being medicated with up to 5 psychiatric drugs at the one time.  Very risky procedure.  Polypharmacy that resulted in catatonia at one point and having to take more drugs, in the form of Lorazepam.  Overmedicating.  Managing patients by drugging them up to the eyeballs.

Getting back to your annual report, it says for the year there were 40 assessments, 36 referrals from Scotland, one ACING undertaken.  A staff team of 10 members.  At what cost?  I am checking back the FOI request information I received in July 2014.  Where it said from 2012-2014 the cost was £568,000/annum, paid in monthly instalments.  1x Consultant Psychiatrist at £111,792.  See attached document.  Staff costs in total £428,499.  The largest part of the cost.

In Carseview Centre the cost of a one inpatient bed per week is £3000 (Ward I has two rooms set aside for NMD) whereas in Stratheden it is more like £2000-2500/person/week.  Dormitory accommodation and on occasion sub-human treatment.  Compare this to adult general acute inpatient wards where the cost is more like £4500/patient/week. 

Therefore I contend that if every person was given the resources in their own health board area with which the DAIS team have been given then the outcomes would be much, much better.  Without having to perform irreversible brain surgery or ACING.  Because, let's be honest, it all comes down to the resource put in and the person-centred focus of the service. 

I find it annoying that Scottish Government would fund a project like the Advanced Interventions Service to the tune of more than half a million a year yet they won't do anything to bring parity of esteem to mental health services compared to physical health services.  That is very unfair.  To favour invasive neurosurgery for "mental disorder" (or fiddling in the brains of people for whom the drugs don't work) over everyday crisis support I think demonstrates the failures in our government's mental health division. 

The patients who access your service will be glad of the attention they get even if it has to end in brain surgery.  The fact that medical people care about them, send teams to their home, meet with them on many occasions and want to know about them individually, will be a great boost to their self esteem.  I notice that one person has even come back 3 times for an ACING/anterior cingulotomy.  See attached screengrab from 2013 report, the only person getting an ACING in the year to 2013.

I am copying in your colleague Dr Christmas, the NHS Tayside CEO, the Director of the National Services Division and Shona Robison, Dundee MSP and Cabinet Secretary for Health.  For their information.

Yours sincerely,

Chrys Muirhead (Mrs)"


from page 17 of 2013 Annual Report DAIS

from page 13 of 2012-14 Service Agreement for DAIS


Friday, 17 April 2015

meeting arranged with Chair @ScotHumanRights to discuss election briefing "Human rights for all - forwards or back?"

I am pleased to report that Professor Alan Miller has agreed to meet with me in May at the SHRC offices in Edinburgh, to discuss their election briefing "Human rights for all - forwards or back?".


Response from Prof Alan Miller, today 17 April 2015, saying:

"Thank you for your email setting out your concerns.  I am sorry that you have had such a difficult time with the treatment your son received and with the lack of support you experienced thereafter.  I am always happy to meet and to hear the concerns of people, such as you, who have experienced very real difficulties in their lives. ..."

Also "the Action Group on Health and Social Care has been formed under Scotland’s National Action Plan ...".  

And "We are ... looking to achieve long-term change within the system, which requires change across strategy, policy and practice. ..."

------------------------------

Letter sent 13 April 2015 by Email to Prof Alan Miller, Chair of Scottish Human Rights Commission:

"Dear Professor Miller

I am writing to ask for a meeting with you to discuss the recent election briefing from SHRC "Human rights for all  - forwards or back?":
http://www.scottishhumanrights.com/application/resources/documents/Human%20rights%20for%20all%20-%20forwards%20or%20back.pdf 

I contend there are few if any human rights for locked-in mental patients.  In certain situations.  Your/our/my rights will be denied if you resist their forced drugging.  You may be locked in a seclusion room with no toilet, water to drink, in the dark (light switch outside), for hours at a time, unobserved.  This is what happened to my son in February 2012, Stratheden Hospital IPCU, Fife.  NHS Fife have been using the locked seclusion for decades as a way of "managing" psychiatric patients.


I have just been engaging in some twitter dialogue with your Communications Manager,
........., about the briefing:
https://storify.com/ChrysMuirhead/brief-one-sided-twitter-engagement-with-shrc-re-th

....... suggested I contact the SHRC about the human rights abuse of my son in Stratheden Hospital IPCU, February 2012, via Email or phone.  But I've been there and done that, with ........ at the time, around June 2012.  Because the SHRC does not deal with individual cases.  ....... is now Stateside as far as I am aware.  I have also on occasion engaged with you from the audience at events in parliament and at conferences.

Therefore I had to singlehandedly complain about the dehumanising treatment to NHS Fife, to Scottish Government, to my MSP and others in parliament, to the Mental Welfare Commission who did nothing (wise after the event).  Eventually taking my complaint about NHS Fife to SPSO and it was upheld as "unreasonable treatment".  Mainly on two counts:  the fact that my son was transferred between wards (I was a witness) in only his underpants and in bare feet by two hospital porters, no dignity; secondly that my son was locked in the seclusion room with no toilet, unobserved, needed the toilet, no-one came, had to defecate on the floor, still no-one came so he did a dirty protest.  Human rights abuse.

However human rights abuses have to go to a criminal court for any justice.  The issue is that mental patients who have been abused in psychiatric settings are not in the best of mental health, or in financial wealth, to be taking a powerful health board to court.  As an unpaid carer I was left to pick up the pieces after the psychiatric abuse.  No support from either health or social work.  Apart from occasional psychiatrist appointments for my son.  On £61/week as an unpaid carer.

The statutory agencies closed ranks.  The Fife Council Adult Protection Investigation report tried to blame me, in 2012, finding no fault with the "care".  I only got a copy of the report later on in the year after making an FOI request.  I had been the one to raise the issues with Fife Council social work from 1 February 2012 onwards.  They refused to believe a mother and her son.  They preferred to side with abusive healthcare staff who did not tell the truth.  Their notes read like a work of fiction.  We have copies of these.  Folders of them from Feb/Mar12.  I do not have the time to analyse such a huge work of fiction.  They badmouth me through the notes, justifying their dehumanising treatment of my son and their bullying of me.

I hope that you can find the time to meet up with me.  I am prepared to travel to Edinburgh from NE Fife to do so.  I am an unpaid carer, now a pensioner so I get no Carers Allowance although still a carer for two sons with "mental disorder" diagnoses.

[I will put this Email in a blog post for the sake of transparency, taking out other names except for yours as SHRC lead.]

Yours sincerely,

Chrys Muirhead (Mrs)"


Tuesday, 14 April 2015

disruptive innovation versus grassroots activism

"Disruptive innovation, a term of art coined by Clayton Christensen, describes a process by which a product or service takes root initially in simple applications at the bottom of a market and then relentlessly moves up market, eventually displacing established competitors."

Today I came upon a tweet that contained a link to a post by the  Scottish Recovery Network Director on Patient Opinion where he said: "Patient Opinion is also, I would argue, a great example of disruptive innovation".  Comparing it to Wikipedia.

I didn't agree with this statement and entered into a twitter dialogue with the protagonists, including the CEO of Patient Opinion.  Here is a flavour of our interaction:



I didn't like the inference that I was disruptive but had no innovation.  It seemed disrespectful, patronising and untrue.  I don't particularly like the term "disruptive innovation" and prefer "grassroots activism".  Because I have been a grassroots community development worker since 1980.  Working with others to set up projects in communities, underpinned by a philosophy of empowerment and lifelong learning.

It wasn't about agitating, rather it was about local people leading and setting up projects in response to demand or need.  More recently, in the last few years, I have had to become an activist and campaigner in mental health matters because of human rights abuse in psychiatric settings, perpetrated on my son.  Although Patient Opinion was a useful space to have a voice, it did not help with my cause.  I had to do the work myself.

Which consisted of raising complaints and keeping on doing so, then taking the complaint to the Scottish Public Services Ombudsman, in all 30 months of complaining, before there was any justice.  My complaint upheld.  Unreasonable treatment.  Human rights abuse.  A locked seclusion room in a psychiatric ward with no toilet or drinking water, light switch outside.  Locked in for hours in the dark, unobserved.

To compare Patient Opinion with Wikipedia is a large stretch of the imagination.  The former has a few paid workers.  The latter has many volunteers, globally, in a community who spend many, many hours keeping the massive information resource updated.  I have a Wiki log-in and have posted on pages myself.  It is a complex network that in my opinion does not in any way resemble the work of Patient Opinion.

Here is my comment in response to the SRN Director's piece, still being moderated:


There are many people working at the grassroots to bring about a paradigm shift in psychiatry and in general health services, so that people are treated like human beings and there is an end to systemic bullying and abusive cultures.  Patient Opinion is a useful resource but it is the people at the sharp end, feeling the pain, meeting the cost and having to cut their coats accordingly that are the real innovators and change agents.

In my opinion.

son Ed Muirhead's 'Day Job' album short film of roots and blues selection - due out 1 May 2015




Day Job is the new album from Ed (son Edwin) Muirhead

12 tracks of roots and blues with an East-of-Scotland twist

http://bit.ly/getdayjob

Released May 1st 2015 on Tattie Records

EdMuirhead.co.uk

High Girders track
























Monday, 13 April 2015

engaging with @ScotHumanRights regarding their election briefing 'Human Rights for All - forward or back?'

levelling the ground; listening to the real experts; meaningful involvement

SRN link Dec05 event
Thinking back over the years of trying to be meaningfully involved in Scotland's mental health world and in having a voice locally in Fife, what sticks out most is the hierarchical shenanigans alongside the infantilisation of mental patients and the patronising of people with "lived experience", the real experts by experience (EBE).

I caught a glimpse of it at the Scottish Recovery Network Peer Support conference in December 2005, Glasgow, when noticing the organisational leaders who were going about as if on a different level from the rest of us.  No time to speak to anyone who wasn't a crony.

I had also by that time been a volunteer in a few mental health organisations in Cupar when recovering from psychiatric treatment in 2002, and noticed the patronising behaviour by paid workers towards EBE.  Mirroring the infantilisation techniques used in psychiatric settings.

It put me off getting involved and by 2006 I'd got a full-time post in Fife (Adam Smith) College setting up a student mentoring project, also finding work placements for students who were disabled or had other barriers to employment.

Latterly I got into lecturing at the FE college, doing a self funded postgrad qualification at Stirling University, in my own time.  I enjoyed the college post and got involved in various activities, including the Scottish Mentoring Network and writing pieces for local press about the projects I had set up.  At the same time I had evening posts, lecturing in care subjects and doing paid work for Fife Council in a community use school at Glenrothes.

Peer Support Fife bulletin front page
I decided to get meaningfully involved in mental health, January 2008 starting up Peer Support Fife, because of the peer movement, linked to recovery and the government arm SRN, which appeared to be about civil rights.  But it was more about employability, reducing the welfare budget and numbers of people with mental health problems on benefits.  The hierarchy and cronyism in SRN, VOX (national MH service user led organisation) and their buddies I found difficult to thole.

The more I spoke out with a questioning or critical voice, the more I was excluded, nationally.  There was no room for opposite opinions or for people who were independent thinkers, who would not fall into line and become a crony.  As if we should challenge psychiatry and patriarchal thinking by adopting the same mannerisms.  Very irritating.  A surfeit of badmouthing, backstabbing and bullying behaviour kept arising. 

The local Fife situation wasn't any better.  Tokenistic involvement of EBE and any critical voices not listened to.  Independent advocacy in Fife was not recognised or respected.  And in 2009 the advocacy tendering by statutory agencies resulted in the local groups losing out and an English learning disability service provider Circles Network winning the contract.  An end to independent advocacy in Fife.  A continuation of psychiatric abuse and tick-box involvement.

SPSO decision report link
The exposing of the "unreasonable treatment" of my son and human rights abuse going on in the Stratheden IPCU (intensive psychiatric care unit), in my Email complaints all through 2012 and in the successful Ombudsman complaint against NHS Fife, instigated by me and supported by my son, should have resulted in the health board attempting to meaningfully involve us.  Rather it is still a case of drawbridges up and a refusal to engage with us, and to work through the issues.

The old Stratheden IPCU/Ward 4 building was declared "unfit for purpose" by the Mental Welfare Commission.  Locking mental patients in a seclusion room with no toilet or drinking water for hours at a time is human rights abuse.  Prisoners got compensation for slopping out: "seeking to challenge slopping out as being in breach of Article 3 of ECHR in that it amounted to inhuman or degrading treatment or punishment"

For the culture to change in Stratheden Hospital will require the meaningful involvement of EBE and for NHS Fife health board managers to work with complainers, listening to our experiences and asking for our participation.  Otherwise it's like closing the barn doors after the horse has bolted.




Friday, 10 April 2015

There is a Crack in Everything, That’s How the Light Gets In

[on Mad in America 10 April 2015]

In January 2012 I was invited by Bob Whitaker to write on his new blogging website Mad in America as the Scottish "foreign correspondent" and my first post was published on the 29th January: Navigating the System.  At that point my aim was to write about developments in peer work in Scotland as I was leading Peer Support Fife, a voluntary organisation I had started up in January 2008.  In November 2011 I had invited Bob to speak in Cupar, Fife, a lecture on Anatomy of an Epidemic, after travelling to Athlone, Ireland, to hear Bob speak in the February of that year, with my youngest son Daniel.

However a couple of days later, on 1 February 2012, things changed dramatically when my youngest son experienced mental distress and went into the acute ward of Stratheden psychiatric Hospital.  When I was out of the ward, collecting a holdall of clothes for my son, he was assaulted by a psychiatric nurse, restrained face-down in the psychiatric ward by 3 other nurses which I witnessed on coming back into the ward, and then later he sustained a broken hand.  Which led to his being escorted in his bare feet and underpants by porters, again witnessed by me from outside in the car park, to a minibus up to the locked ward in another part of the Stratheden Hospital grounds.  I didn't know at that point about his broken hand for no-one told me.  From that day on my writing changed focus and I became a campaigner for human rights in mental health.  For justice in psychiatric settings.

I began to raise complaints in Emails on a daily basis, from 1 Feb12, sent to NHS Fife managers, to Scottish Government mental health division civil servants, to the Mental Welfare Commission for Scotland and to my local Member for Scottish Parliament (MSP).  I didn't know the full story of what happened in the locked ward, the Intensive Psychiatric Care Unit (IPCU), until my son was discharged from Stratheden Hospital in April 2012.  I did not know in early February that he had been locked in seclusion room with no toilet for hours at a time, broken hand untreated, no water to drink, overnight, in the dark, light switch outside.

Following my son's discharge we were left to pick up the pieces after the dehumanising treatment, to cope with the flashbacks, with no support apart from occasional outpatient appointments with my son's psychiatrist.  Who eventually revoked the 6 month Compulsory Treatment Order and supported my son, and I as his advocate, to taper the Haloperidol and come off the drug completely by the August of 2012.  My son has been on no psychiatric drugs since then but has a Bipolar Disorder diagnosis and continues to meet occasionally with a psychiatrist.  He graduated in June 2014 with an honours degree in Sociology which took him 11 years to complete.  He is now 30 years old.

After nearly 18 months of complaining to NHS Fife we raised our complaint to the Scottish Public Services Ombudsman in September 2013 and a year later we had our complaint upheld as "unreasonable treatment”.  The two actions which guaranteed a successful outcome were the transportation of my son in only his underpants and bare feet which I witnessed, and the fact that my son was left locked in the seclusion room unobserved, no toilet and had to defecate on the floor.  This sub-human treatment caused my son to stage a dirty protest and eventually the nursing staff appeared on the scene, unhappy at what they found.  They subjected him to further abuse and humiliation.  My son spoke out about his traumatic psychiatric experiences for the first time in a Scottish Sunday Express article on 5 October 2014, front page and inside:



Psychiatric abuse is a reality in psychiatric settings when mental health law and the safeguards within it are not implemented properly or monitored effectively.  We have found this out to our cost and others also.  Forced drug treatment can be used on mental patients who resist by declaring them to be "without capacity".  This was our experience in February 2012.  Drugs are the frontline treatment in psychiatry, used to "manage" patients and any talking therapies are secondary, usually months later after a person is discharged from inpatient treatment, and in addition to the drugs.  Some psychiatric wards in Scotland do have psychological therapies available, given by clinical psychologists or nurse practitioners.  However these seem to be more of a sticking plaster variety than a means by which people/patients might explore the causes of their mental distress and work through their difficulties.

I would like to see alternative ways of working with people in altered mind states, mental distress and emotional crises that don't just mean psychiatric drugs, given forcibly if resistant or "non-compliant".  It's for this reason that in 2011 I became involved in clinical psychology training groups at Glasgow and Edinburgh universities, for people who are "experts by experience", or service users and carers.  For over 3 years I tried to be meaningfully involved and to have a voice at the table.  However it became increasingly difficult to be heard and to be valued as a psychiatric survivor, an unbeliever in mental illness.  I was up against it from both academics and the people with lived experience, and their carers, who believe in biological psychiatry and that forced treatment is necessary.

The biopsychosocial model of mental health treatment in my opinion isn't a good enough option because the "bio" bit comes first and dominates the discourse.  I attended a workshop in Edinburgh on CBT for Psychosis, in January this year, organised by clinical psychologists, the workshop led by a nurse and professor.  I didn't like the presentations which focused on identifying young people at risk of psychosis.  The term "treatment resistant" was used, also "family history of", "mental disorder", "increased surveillance".  It felt like a Big Brother is watching you scenario.  Here is a storify of my tweets from the event.  I wasn't the only person attending who was critical of the model and the presentation.

I have come to realise that the biomedical model of mental illness is a very dominant discourse in Scotland and psychiatric survivors are a rare breed.  The recovery movement, which drew me in with its promise of peers leading and meaningful involvement of experts by experience, was more about reducing the numbers of people on welfare benefits and getting people back to work.  My recovery story was an account of surviving psychiatry, tapering psychiatric drugs and getting back on with my life, on 3 separate occasions, from 1978 to 2002.  Doing it under my own steam, going against the advice of psychiatry and making a full recovery.  But psychiatrists called it remission and the schizoaffective disorder label remained in my "notes".   A two-tier system of recovery.

I have now retreated from the clinical psychology training involvement on the DClinPsy courses at both Scottish universities.  I liked the men at the top leading but lost patience with the slow pace of change, the lack of real action and the seeming inability to challenge the dominance of psychiatry.  They were just too comfortable and didn't seem to care enough about human rights abuses in psychiatric settings. 

I prefer to be aligned with others who are challenging the status quo, the biological psychiatry paradigm, the conflicts of interest and lack of transparency in drug prescribing and doctors’ relationships with big pharma, the human rights abuses in mental health matters and psychiatric settings.  I am attempting to become more politically aware and to this end am getting acquainted with Scottish Parliament affairs, attending debates and meetings, or watching them online.  I may put my hat in the ring and stand as an independent candidate at the Scottish government elections in May 2016.  It will be a steep learning curve but I believe we need more psychiatric survivors speaking out in our parliament.  People who have survived mental illness and psychiatric treatment. 

Here are examples of action and speaking out in Scotland which I believe are bringing light into the area of mental health matters and are a demonstration of collective action.  You might describe them as like the patterns in a Scottish country dance or the steps in a Highland Fling:

The Sunshine Act for Scotland Petition PE1493 raised by Dr Peter J Gordon, Consultant Psychiatrist, was considered again in parliament at the Public Petitions Committee meeting on 31 March 2015:

"Calling on the Scottish Parliament to urge the Scottish Government to introduce a Sunshine Act for Scotland, creating a searchable record of all payments (including payments in kind) to NHS Scotland healthcare workers from Industry and Commerce."

Dr Gordon attended the meeting as a spectator and in the Windows post on his Hole Ousia website, says "This post is to thank the Committee for considering the opening of a window.".   And here is a link to his writings, films, the history and submissions of his petition: A Sunshine Act for Scotland.  


Open and transparent from omphalos

At the same parliament meeting on 31 March there was a new petition submission PE1550 from Andrew Muir, on behalf of Psychiatric Rights Scotland, a Mental Health Act inquiry:

"Calling on the Scottish Parliament to urge the Scottish Government to set up a public inquiry into historical cases of abuse of people detained under the Mental Health  (Scotland) Act 1984 and the Mental Health (Care and Treatment) (Scotland) Act 2003"

Here is the Summary from the meeting, regarding Mr Muir's petition: "The Committee took evidence from Andrew Muir. The Committee agreed to refer the petition, under Rule 15.6.2, to the Health and Sport Committee, to consider in the context of its scrutiny of the Mental Health (Scotland) Bill. In doing so, the Committee also agreed to write to the Scottish Government."

Meanwhile Hunter Watson, Scottish human rights campaigner from Aberdeen, continues his quest for a wider review of Scotland's mental health legislation so that it may be compatible with the European Convention on Human Rights.  In his recent paper Legal Matters he recommends that:

"The Minister should seek legal advice as to whether the Convention on the Rights of Persons with Disabilities and the General Comment on Article 12 issued by the UN Committee on the Rights of Persons with Disabilities require that significant amendments be made to the 2003 Mental Health Act." 

Mr Watson has also campaigned against the use of forced ECT on mental patients: 'Mental health patients could go to court over electric-shock treatment', 16 August 2014, Press and Journal.
 
I am continuing to keep an eye on the Dundee Advanced Interventions Service (DAIS) which offers NMD (neurosurgery for mental disorder) in the shape of Anterior Cingulotomies to people experiencing "severe and chronic treatment-refractory depression (TRD) and obsessive-compulsive disorder (OCD)".  

Consultant psychiatrist Dr David Christmas is part of the staff team at DAIS and I have devoted a page on my main blog to a critical consideration of his MD thesis from 2006: 'Functional neurosurgery for intractable mental disorder: long term effects on mental health, neuropsychological performance, social function, and quality of life'.


Extract:


"I think it's somewhat of an understatement to say that Moniz (credited with inventing lobotomies) and Freeman (ice pick lobotomies) were not "truly objective".  The fact is that these men powered ahead with invasive brain surgery which severed the neural pathways to and from the prefrontal cortex, the anterior parts of the frontal lobes of the brain."

Another extract:

""A Surgically Induced Childhood" from The Lobotomy Letters, The Making of American Psychosurgery By Mical Raz:

 "In 1947 Freeman answered a letter from a frustrated father of a lobotomy patient. The father complained that his daughter was often uncooperative and childish, and that he and his wife experienced considerable difficulties in caring for her at home. “The best means of controlling such behavior,” Freeman advised, was “a rapid change from one type [of activity] to another around the house and frequent outdoor activity, lots of affection and once in a while a good old span[k]ing if she does not behave herself.” On this point, Freeman cautioned, “It may take two of you to get her down,” but the spanking ‘should be a good one and followed by a dish of icecream [sic], then a kiss and make up.’" 

In conclusion, my son's exposé of psychiatric abuse together with my blogging campaign from 2012 until now has cemented our standing as psychiatric survivors, writing to resist.  We are not alone in speaking out and the solidarity with others is an encouragement even if we do not always all agree.  For there is room to fall out and to fall in again.  None of us is perfect.  There is a crack in everything.  That's how the light gets in.