Sunday, 27 August 2017

Eva Cox's wisdom: dare to be difficult

Eva Cox's wisdom: dare to be difficult; 9 February 2017, in The Guardian



"In a lifetime of pushing the boundaries, from her birth in 1930s Austria and through her postwar life in Australia, the feminist, academic and activist Eva Cox has never shied away from being difficult. In fact, she sees it as her duty. ‘Don’t worry about being called difficult. It shows you’re making a difference … We need the stirrers, we need the outsiders, we need the people who change things''


Thursday, 24 August 2017

my Story on See Me: surviving Psychosis & Psychiatry

Isle of Coll 24July17
See Me: Chrys's Story


"In 2008, aged 55, I got involved in mental health matters because I’d shared my personal story on the Scottish Recovery Network website in 2005 and attended their Glasgow Peer Support conference in the December, and so in January 2008 I started a voluntary organisation Peer Support Fife alongside my own website promoting recovery.  It was an exciting time, anticipating changes in the way that mental health services were run, giving more power to people with lived experience of overcoming mental health challenges.  Or that’s what I thought it was all about.  Empowerment and a civil rights movement.  Similar to the work I’d been doing since 1980 in communities, developing grassroots projects and providing opportunities for learning, to adults, young people and children.

Eight of my family through 3 generations have experienced psychosis and psychiatric treatment: my Mother and Father, two younger sisters, my three sons and I.  For us psychosis was a way of externalising mental distress which resulted in coercive drug or shock treatment which further re-traumatised.  In my case I experienced psychosis after the births of my second and third sons, 1978 and 1984, due to very painful, induced with oxytocin, labour, the drug increased so that I would deliver on the day shift, both sons born just after 3pm.  The effect of this was to cause altered mind states, acute sensitivity to the environment, difficulty with sleeping, and so I voluntarily entered a psychiatric ward, both times, separated from my babies and forcibly injected with antipsychotics.  I managed to make a full recovery after both these treatments, tapering the drugs myself, getting back on with my life.  Then in 2002 I experience another psychosis at the menopause, existential and hormonal, again voluntarily going into a psychiatric ward and being coercively drugged.  My stories can be found here: http://chrysmuirheadwrites.blogspot.co.uk/

In this See Me story I’d like to highlight the stigmatising and discriminatory impact and nature of psychiatric diagnosis and “family history of” written in medical notes, particularly in 2012 when my youngest son, who lives with me, experienced a mental health crisis or psychosis.  He wanted help and asked for help, then eventually was locked in a seclusion room of the IPCU (intensive psychiatric care unit) with no toilet, light or water plus other failures in duty of care.  I raised complaints and won an Ombudsman complaint in September 2014, and an apology from the health board (Scottish Sunday Express article).  However during the first year 2012 following my son’s negative treatment I became aware of investigations by social work into my character, having done an FOI request for the Adult Protection Investigation report which found nothing amiss with the hospital practices.  I asked for copies of my son’s hospital notes and saw written there “family history of schizoaffective disorder (my diagnosis)” and comments about me, including “difficult and demanding Mother” which appeared to justify my son’s coercive treatment.  I’d been advocating for my son in clinical ward meetings after he asked me to. 

Therefore the fight for justice following my son’s abusive treatment was further complicated by attempts made to lay the blame at my door because I’d been a psychiatric patient in the same hospital and was known to the nurses, having raised concerns already in 2010 about things I’d witnessed in the acute ward when visiting my son.  That year I had highlighted issues with a range of senior staff in different organisations, including our health board, the Mental Welfare Commission and Scottish Government’s Mental Health Division.  In retrospect I believe that my raising of concerns negatively impacted on my son’s treatment in 2012.  I’ve been called a “troublemaker” by a Professor in Mental Health Nursing and excluded from meetings for speaking out about my son’s treatment.  It’s not been easy.

Then in August 2015 I experienced another reactive psychosis following the years of campaigning for justice and fortunately this time around managed to avoid psychiatric treatment.  I got Lorazepam from an out-of-hours locum Doctor at a community hospital and taking one pill on two separate nights helped me regulate sleep.  My son supported me through and I also engaged with clinical friends by Email.  I found this to be a positive experience despite at times being unsettled by altered mind states and extreme sensitivity to the environment.  I reasoned these through as being helpful scenarios eg if people were watching me then it was for my own good.  If insects and birds were somehow more noticeable then that was positive and natural.  That love of nature has continued to be a positive experience and I’m much more appreciative of the environment, following this last psychosis.

I don’t fear another psychosis as I believe it will be a life-enhancing experience, just like the last one.  It was far more risky for me entering a psychiatric ward as a voluntary patient.  The drugs don’t suit me, I find them iatrogenic.  And so I am now working to promote, and hopefully research, Safe Houses for Psychosis, alternatives to psychiatric inpatient treatment."

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Tuesday, 22 August 2017

'The Junkies Take over the Asylum' Dr David Healy

'The Junkies Take over the Asylum' Dr David Healy 



"Some markers first. I am a committed believer in what may now be a last millennium concept – the medical model. I think antidepressants – the older tricyclics and ECT, not the more recent SSRI and other antidepressants – can save lives. I figure conflict of interest, crucially important in other areas of life, is of minor importance if not irrelevant in science. Although by science I mean something that can only happen in the presence of publicly available data. 

This post links to Honey I Shrunk the Shrinks, What’s Going on Here, and to Grassy Knoll.

I used to sit on training scheme interview panels some years ago. We ended up being told we had to ask exactly the same question of every candidate. By accident I hit on a question and amazed by what I was hearing stuck to it:


Tell me about some mistakes you’ve made and what you’ve learnt from them?  


When women were asked this, they immediately looked comfortable and answers tumbled out of them. When men were asked, they looked puzzled and if they could be said to have hopped from foot to foot while sitting on a chair this is what they did.

Junk News 


But of course if SMC are writing a brief for you, whether you are a female or male President of a College, they are unlikely to let you admit to mistakes.

The SMC mantra in the background of the recent Panorama fuss, aside from the weird plug about stigma, and the junk in the background to other artificially created concerns about related issues, is that Antidepressants Work and Save Lives.  Millions are benefiting, more and more each year, and its just not right to worry people with Bogeymen. These are the dog-whistles they expect the junkie opinion leaders they have helped create to parrot.

Allen Frances and others now tell us we can’t put DJT’s labeling of inconvenient facts as Fake News down to mental illness. For thirty years the presidents of the American Psychiatric Association and Royal College of Psychiatists (except one), along with Allen Frances, have endorsed a ghostwritten news in all the best journals with zero chance to fact check.  Endorsed a News so obviously Fake it beggars belief. They dismiss the inconvenient facts of suicides, homicides and other harms by an appeal to this Fake News. This is not a mental illness.

Antidepressants

One of the difficulties here is the word antidepressants.  From 1957 to 1987, this meant treatments that could produce a benefit in melancholia.  The tricyclic antidepressants and ECT did this and psychiatrists using these treatments judiciously may have saved some lives.

The word has now changed meaning completely. SSRIs and related “antidepressants” are ineffective in melancholia.  There are no trials showing they work for what until recently was regarded as depression.

The clinical trial evidence for SSRIs comes from people with much milder conditions, who are at little or no risk of dying if left untreated – as the placebo arm of these studies shows.


There is a myth that SSRIs and related drugs treat severe depression.  This comes from the trial data that shows that in people whose rating scale scores are little worse than many of us might have on a Monday morning, it is not possible to show any budge in the rating scale score.  You have to head to the severe end of normal to show a budge.  This is not severe depression.  Its probably not depression.  Its certainly not blood test positive depression as in Dexamethasone Suppression Test Positive depression. SSRIs don’t work in people who are DST +ve.

The SSRIs are essentially anxiolytics.  People toyed around with words like Serenics in the 1980s, when the drugs were first developed. They adopted the term antidepressant in part because the word didn’t suggest dependence. They adopted this word, knowing SSRIs cause dependence.

Antidepressants Save Lives

If by working we mean save lives, the clinical trial evidence base does not show SSRIs or recent antidepressants saving lives.  Quite the contrary.  In 2006, FDA called for all trials. They made a curious call that eliminated all data from taper periods, run in periods and had other odd features.  Even so they only got some trials.  Some other trials in which there were suicides and deaths just didn’t make it to FDA’s offices.

Despite all this, there was an excess of dead bodies in trials that combined involved 100,000 people on antidepressants compared to placebo.  These deaths were not just from suicide.

When the regulators finally put a Black Box on antidepressants it was because there was an excess of suicidal acts on these drugs – not because there was some evidence there could be a suicidal act on treatment.

Antidepressants Work

If by working we mean correcting an abnormality in serotonin or other systems, there is no evidence for this and never was.  Ideas about abnormalities in serotonin systems were fringe hypotheses before marketing copy transformed them into a biobabble that has degraded clinical encounters.

Antidepressants make people’s serotonin systems abnormal.  The longer you stay on them, the more abnormal your serotonin system becomes.

A lot of people seem to sense this, because pharmaceutical company research shows that more than half of those put on antidepressant stop by the end of the first month.

Millions are Benefitting

There is up to a 10% increase in people on antidepressants each year.  There are 65 million prescriptions in England per year. What does this mean?

Roughly the same amount of people get put on antidepressants for the first time each year. The increasing number on these pills comes from people continuing on them at the end of each year. Roughly 90% of the people now on antidepressants have been on them for a year or more.

Of this 90%, the bulk continue taking them because they can’t get off.

They may think the pills are saving their lives when they stop and feel awful and go back on them and feel better. And their lives may be saved but they are being saved by a treatment for withdrawal rather than for depression.

This is dependence – addiction in lay language. It’s difficult to know where this story is going to end – probably in a lot people being dismissed as neurotic or psychosomatic. The caravan will move on leaving a lot of dogs barking.

What Antidepressants Do

SSRIs change the genitals of 100% of the people who take them. They do so within an hour of the first tablet.  In most cases, this means numbing, but in some cases it may involve the opposite.  In almost all cases, except some men (and women) with premature ejaculation (or its equivalent), this leads to sexual dysfunction.

A significant number of people with sexual dysfunction will never recover normal function. A decade after stopping they will not be functioning normally and may not be functioning at all. We don’t in fact know how many people return to full sexual function after an SSRI. It may be less than half of those who have been on treatment for more than a few months.

Numbing

SSRIs and related antidepressants also produce an emotional numbness in most takers. This is at the core of their therapeutic action. We prefer to talk about these drugs “working” rather “numbing” because numbing doesn’t sound ethically quite right.

But SSRIs were developed to produce precisely this effect – not to correct a serotonin problem.

It would be helpful for people offered them to know this is what is being aimed at, and indeed more honest, even though some people might then say they’d prefer not to go down this route.

Women of Child-Bearing Years

Women of child-bearing years have been the target population for these drugs – even though from before their marketing there were strong warning signs these drugs might cause birth defects.

SSRIs double the rate of birth defects in children born to women who take them during the first trimester. These range from almost all cardiac defects through to spina bifida and other problems.

SSRIs also double the rate of autistic spectrum disorders and developmental delay in children born to women who have been on them in pregnancy.

SSRIs double rates of miscarriage – one of the biggest causes of nervous problems later.
SSRIs trigger alcoholism in a significant number of people, especially women. They can lead to compulsive drinking pregnancy and later Fetal Alcohol Syndrome.

Psychotropic Drugs in Children and Adolescents 


Prozac is licensed for depression in adolescents. It doesn’t work. The Prozac trials are indistinguishable from paroxetine and other trials in showing no evidence of benefit and evidence of a great deal of harm.

It remains licensed because regulators are never willing to admit mistakes and the academics involved appear unwilling to come clean. It may be legitimate to talk about a conspiracy to hide its problems.

Children’s mental health is the place with the greatest divide in all of medicine between what the published evidence shows and academics say and what the data in fact shows.
Children’s mental health used to be the clearest place where the magic lay in the doctor rather than the pill. If this were still the case, there would be place for a judicious use of medication even though except for OCD there is not a lot of conventional evidence to support doing this in the case of SSRIs.

But the magic no longer lies in the clinicians.  Child Shrinks have become Model Shrinks – where a model means a shrunken replica of the real thing.

Children’s mental health services have become a horror story with children even more likely than adults to end up with a plethora of gateway diagnoses leading to shocking cocktails of treatment – this is in the UK not the US.

And its getting worse.  There are proposals to increase the numbers of child psychiatrists to meet an unmet need. This is a nightmare.

The Difference Between ...

In response to the interview question above, Women like Blacks vis-a-vis Whites, or Irish vis-a-vis English can spot the mistakes they make.  The powerful can’t.  Who me?  Make a mistake?

The confidence that comes with power leads to a blindness to mistakes. Strangely, it also leads to extreme nastiness when faced with any evidence of a mistake.  The powerful feel very threatened by those they subjugate. They worry about death threats.  The surprise to me always has been that women and blacks and people whose lives are ripped apart by what was known to be junk information on a drug don’t in fact get violent with the junkies who have robbed and injured them for the sake of a quick fix.

This doesn’t mean that all women and Irish and BMEs are better than WASPs.  The Irish have shown themselves at least as capable of bigotry and nastiness as any other group on earth.

But you’d expect shrinks of all people to be aware of psychodynamics and defense mechanisms like this.

Upton Sinclair famously said you can’t depend on a man to understand something if his job depends on not understanding it.

Sinclair was so twentieth century.  APA and RCP today don’t seem able to understand things their jobs tomorrow depend on them understanding.  If drugs like the antidepressants work wonderfully well and are free of side effects, if it doesn’t require the magic an expert can bring to bring good out of the use of a poison, shrinks are toast. They will be replaced by cheaper prescribers, and Sinclair News (see next post) outfits and SMC will welcome the benefits.

Trains

Simon, the train above is about to leave Prague train station and head West.  It’s just before other trains start heading East.  Pius XII is about to start hearing, seeing and speaking no evil in case the people who produced Beethoven, Mozart and Goethe decide to destroy the Sistine Chapel.

There are more important things than the roof of a Chapel. Children are more important. You know this better than anyone."




Thursday, 10 August 2017

on being an independent voice, leader, educator, survivor: Safe Houses for Psychosis

A wee reflective post about being an independent voice in mental health matters, speaking out and, in a sense, leading the way.

My psychosis in 2015, following a complete physical and mental breakdown after years of campaigning for justice, resisting bullying and exclusion by various head honchos in Scotland's mental health world, was transitional and strengthening.  It was a matter of survival, with no recourse to system support.  My whistleblowing had put paid to that.  I was persona non grata with community MH services, having exposed them as incompetent.  There was no trust, on either side.

The psychosis was a painful process, facing the fear, feeling isolated, not belonging, remembering the past, recounting stories, recalling memories, sharing experiences, adjusting, adapting, rearranging, accepting.  There were yearnings, deep longings for more children, lost opportunities, what might have been.  I grieved for babies unborn and considered how this might be overcome.  Time was relative, ageless.

It propelled me back into creative pursuits and getting fit, eventually cycling after not being able to afford a car.  We got poorer as NHS Fife got richer, to the tune of £4.4million, a new Intensive Care Unit at Stratheden psychiatric Hospital as a result of my campaigning and my son's abusive treatment.  It was very unfair, hard to withstand, seeing the new build unit from the 64 bus, Springfield to Cupar, most days.  Like rubbing salt in the wounds.  My son avoids this experience as much as possible.  I thole it and externalise my distress.

I'm glad to say that the pain of isolation experienced during the psychosis has lessened and I've come to terms, to some extent, with the role assigned to me.  Which is to speak out as I find it, without fear or favour.  I'm not perfect and that's OK.  I'm entitled to my opinion, based on a lifetime of psychiatric system engagement, surviving psychosis/coercive drug treatment and caring for my 3 sons coming through the same, supporting other family members too.  I've got the scars to show for it and fortunately the education, and experience, of being a well-seasoned reflective practitioner, trainer, mentor and facilitator of learning.  No mean feat.

I was always a natural leader, even as a child, although didn't realise this until a youth leaders training weekend at Wrangholm Hall, New Stevenson, Lanarkshire, in around 1981, when we undertook a serious of "trust" games and other leadership activities, aged 29, with 2 sons, having survived one puerperal psychosis and coercive drug treatment in Hartwoodhill [avoiding ECT when hospitalised in 1978 after first postpartum psychosis; then Krypton Factor 1980].  During the tasks I took the lead, getting folk organised, usually when others had tried and couldn't manage.  I didn't trust much when it came to the games.  Learnt this lesson more during my first mental patient experience.  I'm a quick learner.
student mentor awards Fife [Adam Smith] College 2007

I've often been a lone worker, in paid and voluntary posts, sometimes the only paid person with a team of volunteers, or taking the lead in setting up community projects, all of us volunteers.  Community development, local activism, groupwork, children's and youth work, in various settings, including schools, latterly colleges and universities.  The student mentoring project I set up at Adam Smith/Fife College in 2006/7 involved partnership working with many other agencies.  Therefore the move into promoting MH peer support and delivering recovery training in 2008 made sense, based on my past achievements.  However I soon met resistance, exclusion, bullying and cronyism, the extent to which I'd not anticipated or experienced before in life.  I've had to get tougher to survive.

In conclusion, I've survived another psychosis without psychiatry this time around, and there is no comparison between the two.  Avoiding coercive, invasive drug treatment and risky psychiatric ward settings is the way forward, in my opinion, for people, especially women, wanting to journey through psychosis with the minimum of damage and the maximum of enjoyment.  To become more yourself, stronger, fitter, drug-free, retaining an independent mindset, avoiding predatory behaviours and increasing self confidence.

Safe (haven crisis) Houses for Psychosis are the way forward, to my mind, and I'll be considering how to make this happen in the time that I have left, researching and evidencing good practice in the UK and abroad.  I'm still focused on teaching, facilitating learning, mentoring within the DClinPsy (Clinical Psychology doctorate) programmes at both Edinburgh and Glasgow Universities, because I believe that my survivor voice and considerable life experience are of value to, will benefit trainees and academic staff, practitioners.  I also want to do the same within Mental Health Nurse training programmes in Scotland, finishing what I started. These are statements of intent.

"That which does not kill me makes me stronger" - Friedrich Nietzsche





Wednesday, 9 August 2017

'Hard to reach: Coercive system or defective gene?' DCP-Scotland Review Aug17

Wallace Monument 24Mar17 after event
Many thanks to Dr Simon Stuart [@soothron], Clinical Psychologist, Editor of DCP-Scotland Review, for inviting me to write a piece on the 'Psychosis & Complex Mental Health Faculty' event which I attended in Stirling 24 March 2017.  Link to Summer 2017 DCP-S Review Issue 16.



 
  
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Presentations #BPS #DCP #Psychosis & Complex MH Faculty event 24Mar17 Stirling

Storify of tweets: teaching #BPS #DCP #Psychosis & Complex MH Faculty event 24Mar17 Stirling; it's hard to reach out

 

Friday, 4 August 2017

'Mental Health Nurse training programmes: involving survivor voices' @FionaCMcQueen

Prof Fiona McQueen
Here is an Email letter just written, to Prof Fiona McQueen, Chief Nursing Officer Scottish Government, copied in to Prof Hugh Masters, Associate Chief Nursing Officer, Scottish Government, Dr Rosie Stenhouse, Mental Health Nurse Lecturer, University of Edinburgh, and Others:

Strapline: Mental Health Nurse training programmes: involving survivor voices

Dear Fiona

I am writing to you again with a topic that I think is important, the involvement of survivor voices in Scottish MH Nurse training programmes.

From what I witnessed when taking part in Abertay and Dundee University MH Nurse training, 2012/13, there were various issues or flaws in the recruitment and selection process, and the way in which people with lived experience were involved.  To reiterate, I'm an experienced, qualified, community educator and facilitator of training, since the 1980's in the field.  Here is my Biography page on the blog:
http://chrysmuirheadwrites.blogspot.co.uk/p/bio.html

The abusive treatment of my son by Stratheden IPCU MH Nurses in February 2012 impacted on my involvement in nurse training.  This is understandable.  We exposed, whistleblowed, about the locked seclusion room with no toilet, light, drinking water, the fact that my son was left for hours unobserved.  I made an FOI request for observation reports, there were none, according to then General (Nurse) Manager Bob McLean, now retired.  My son had to defecate on the floor of the cell, then when still no-one came he did a dirty protest which, together with the bare feet and underpants move from Lomond Ward by Porters, led to my "winning" the Ombudsman complaint against NHS Fife.

Dr Rosie Stenhouse's PhD thesis was on patient safety, however I maintain that this is flawed.  A nurse researching psychiatric inpatient treatment cannot be independent.  Her supervisor was Nurse Steve Tilley.  Her thesis was marked by Nurse Phil Barker.  I contend that psychiatric inpatients wouldn't be free to tell a nurse everything about their treatment if it was abusive.  Fear of retaliation, retribution, payback.  Which is what happened to us after I reported poor nursing practice in Lomond Ward, summer of 2010.  I witnessed many inappropriate behaviours by nurses and told various people in authority, including Geoff Huggins, then Head of Mental Health Division at Scottish Government, and Dr Donny Lyons, CEO of Mental Welfare Commission.

I'm not happy about Dr Stenhouse's treatment of me during the PhD preparation, the fact that she was instrumental in scuppering my Safe haven crisis House research.  She met with Prof Schwannauer without me present and took charge at our final supervision meeting, trying to put me in my place.  This was out of line and is nothing to do with 'Developing and Maintaining Therapeutic Relationships'.  I did not raise an official complaint about Stenhouse, showing compassion because of her head/eye injury caused by her hobby of horse-riding.  But I do believe that she scuppered my research plans.  This has happened on various occasions with Dr Stenhouse where she did not respect my survivor/carer voice, enough, wasn't considerate of my situation.  After my son was abused Dr Stenhouse reframed his treatment objectively, from the nurse perspective.  I remember this.

Therefore I am even more convinced of the need for psychiatric survivor voices teaching and mentoring within the Mental Health Nurse training programmes at Scottish Universities (this could be achieved by remunerating with honorariums and travel expenses).  I'm concerned that there will be a continuation of abusive psychiatric nursing practices because lecturers are not independent or do not have the appropriate reflective practitioner skills and abilities to properly equip new MH Nurses for the tasks they will have to deal with.

I believe that MH Nurses deserve the best of training and teaching in reflective practice, self awareness, human rights issues, social justice, how to stand with patients and carers, how to stand against abusive cultures, keeping themselves and others safe from being dehumanised.  Survivor voices like mine, qualified reflective practitioners, can add value to MH Nurse training programmes, bringing insight and learning.

I hope that you are listening to my voice Professor McQueen.  I'm not prepared to be quiet or to put up with bad practice.  I know my worth, I'm not worth less.

Yours sincerely,  

Chrys

cc Prof Hugh Masters; Dr Rosie Stenhouse; Prof Matthias Schwannauer; Prof Charlotte Clarke; Robin Ion; Mike Ramsay


Chrys Muirhead

Safe Houses for Psychosis

writer, researcher, activist; cyclist, photographer, gardener, swimmer

ChrysMuirheadWrites.blogspot.co.uk
 
@ChrysMuirhead



Thursday, 3 August 2017

Hunter Watson: Prospect of a Wide Review; August 2017; Mental Health Act Scotland

Hunter Watson
Email letter sent to MSPs and Others, 3 August 2017:

"Now that the final day has arrived on which signatures can be added to my petition PE01667 on mental health and incapacity legislation I have produced the attached paper which not only makes the case for a wide review being necessary but also provides reasons for my being hopeful that one will take place. You might find it of interest.
                         Best wishes,
                                           Hunter Watson"

Paper:


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24 June 2017: #HunterWatson Petition PE01667: Review of mental health and incapacity legislation @ScotParl

W Hunter Watson Papers