Intersectionality, Privilege and Twitter Etiquette

As the family therapy essay I’m currently procrastinating on would attest, I’m interested in group dynamics and the way people communicate with each other. I tend to think about these issues both in the real world and in social media, particularly Twitter. There’s lots of good and interesting ways that Twitter can be used for communications, but also some pitfalls. Chief of the latter is the Twitterstorm.

I used to presume, probably rather naively, that if someone is getting bombarded with angry messages from multiple tweeters, then they’ve probably done something pretty unpleasant to deserve it. All too often, that isn’t the case, particularly if somebody is spoiling for a fight.

Here’s the funny thing about Twitter. Where else would a single full stop be the source of enormous trouble? Quick technical primer for non-tweeters: if you start a tweet with somebody’s @ username, like this….

@thus_spake_z your mother was a hamster and your father smelt of elderberries!

….then it goes to them, and also appears in the feed of anyone who is following you both. However, if a tweet begins with text, then it appears in the feed of everyone who follows you. Hence people sometimes stick a full stop before the @ identity, like this:

.@thus_spake_z your mother was a hamster and your father smelt of elderberries!

….and so your caustic retort is re-broadcast to a much wider audience. If you have a large number of followers, then at least some of them will take that as an invitation to a pile-on.

There’s a certain segment of tweeters who seem to get embroiled in Twitterstorms on a fairly regular basis. Melissa Thompson has an excellent and detailed post about the discussions involved. To summarise briefly, those involved tend to identify with intersectional feminism, and also take an interest in questions of privilege.

Intersectionality discusses the way in which different systems of oppression – race, class, gender, sexuality etc – can interact, and calls for greater cooperation between various liberation movements. I think that’s a very worthy aim, and fully agree with it. It’s therefore a shame that the tweeters involved are so often involved in Twitterstorming other members of the left. Most recently it was the New Statesman editor Helen Lewis. Before that it was the Independent columnist Owen Jones, and on Lord knows how many occasions it’s been the author and Times columnist Caitlin Moran. All too frequently, these are over fairly minor issues of semantics. In Owen Jones’ case, it was because he condemned George Galloway’s rape apologism, but didn’t sufficiently emphasise the condemnation.

I guess this is why the right always wins.

Regarding the politics of privilege, I’d broadly agree that it’s good to think about how your relative advantages and disadvantages affect your thinking – but only up to a point. Privilege and oppression can affect people in various ways, and not always in a predictable way. For example, one might argue that George Orwell’s keen awareness of social inequality was at least partly because of rather than despite his Eton-educated privilege.

It also shouldn’t be used as an ad hominem retort.

“Thank you for aggressively tweeting at me to ‘check your privilege’. I appreciated that suggestion, which prompted me to engage in a bout of self-analysis and has enriched my awareness and insight.”

-No one. Ever.

It’s also important to remember that everyone has their own individual privileges and oppressions, not all of which may be immediately apparent. An online friend of mine was recently Twitterstormed over her perceived (though probably not actual) transphobia. Unfortunately one of her hidden oppressions was an anxiety disorder, and the Twitterstorm triggered a relapse.

I’m not going to get into the original reasons behind these various Twitterstorms – actually I think most of those reasons are monumentally banal. But what I am going to do is suggest a few etiquette points that might encourage people to debate in a more constructive way. If I were to get back to the family therapy essay that I really, really need to stop procrastinating on then this would be what’s referred to as “moving from content to process”. Which is a fancy way of saying that often it’s not what’s said that’s important, but the way it’s said.

1. Exercise caution before retweeting or deploying the Thermonuclear Full Stop. Just because you disagree with someone doesn’t mean you need to throw it open into a free-for-all. A discussion is not a gang fight.

2. Don’t presume to tell other people what their privileges are or aren’t. Particularly if you don’t know them offline.

3. Don’t use privilege as an ad hominem. “You are male/white/straight/cisgender/able-bodied, therefore argument invalid” is never an appropriate retort.

4. Remember that the ability to haul in large numbers of other people into the fray is itself a platform and a privilege.

5. If somebody blocks you, or makes their account private, or temporarily suspends their account, then respect the fact that they have the right to do so. Nobody is obliged to have a conversation with you.

6. Finally – and this is probably the most important point – be willing to accommodate difference and disagreement. This is particularly the case when discussing with people who are part of the same broad left. Outside of certain extremes, they’re mostly decent people who mostly share the same views and aims as you. That small part which they might think differently on is not as important as the larger common goals. You don’t have to agree with them on everything and they don’t have to agree with you. If you can do this, then that would be…..oh, what’s the word? Ah yes. Intersectional.

The Geoffrey Pick Case: The UK Council for Psychotherapy Responds

Last week I broke the news that a psychotherapist who had sexually abused his patient had been allowed to re-register with the UK Council for Psychotherapy. Yesterday that the UKCP issued a statement on their website.

 

A UKCP complaints case has attracted interest in the blogosphere. We would like to issue the following statement.

*waves*

The next part is more-or-less identical to the media release they e-mailed me last week:

In January 2011 Mr Geoffrey Pick was dismissed by his employer for gross professional misconduct. Following on from this his UKCP organisation, the Arbours Association of Psychotherapists (AAP) considered the matter in relation to his fitness to practise. It found Mr Pick to be in breach of Article 6 of the AAP Code of Practice, and Mr Pick was suspended from the membership of AAP and, therefore, UKCP for a period of one year from 16 May 2011.

AAP notified us of the decision and this was published on the UKCP website.

At the end of the suspension period AAP confirmed that Mr Pick had complied with the conditions imposed during his suspension and that it was now permissible for Mr Pick to resume membership of AAP and, therefore, UKCP.

In April 2013 Mr Pick informed us that he was resigning from AAP and UKCP with immediate effect. In compliance with this notification his name was removed from the UKCP Register again.

Plus there’s this bit about what’s happening in UKCP.

How UKCP is improving its complaints system

We are now working with our members to implement an improved central complaints and conduct process. This new system has been designed to be clear, fair and independent. Cases involving serious allegations, including gross professional misconduct will receive the highest priority in terms of both speed and depth of enquiry.

The complaints and conduct process was launched at the end of 2012 and we aim to cover all members by the end of this year.

The Geoffrey Pick case highlights the contrast between old and new ways of doing things. Under the old system, complaints about a therapist were directed to the therapist’s UKCP member organisation. Pick’s organisation, the Arbours Association, is still using the old way. It seems they thought that an appropriate sanction for the worst possible betrayal of a duty of care was to exile him from the club for a year, and then all would be forgiven.

The UKCP knows that this way of doing things is untenable. They also know it won’t pass muster to get accreditation from the Professional Standards Authority, which they need in order to compete with rival bodies such as the British Association for Counselling and Psychotherapy. Hence the new central complaints and conduct process which they mention.

The first time the new process was used was for a Jungian analyst called John Smalley. It was a total shambles. The process took over three years to complete. At the end of it seven allegations were found proven, but the panel declined to issue a sanction: not even a caution.

Last week a second decision was published under the complaints and conduct process. This one seems to be a much more rigorous hearing. The process was resolved in less than a year. Aggravating and mitigating factors appear to have been taken into account. What looks like a proportionate sanction (a conditions of practice order) was issued. Let’s hope this means the UKCP has learned some lessons from the Smalley case.

The Arbours Association has not yet signed up to the complaints and conduct process, but it seems clear that they are simply incapable of dealing with misconduct. They’ve shown this not only in their handling of Geoffrey Pick. As I previously mentioned, they also showed it in their co-authorship of the Maresfield Report, a 66-page work of steaming bullshit in which they’re kind enough to detail the various ways in which they simply don’t understand safeguarding and fitness-to-practice issues.

The Arbours co-authored the Maresfield Report with 9 other psychotherapy organisations. Those other bodies, so you know to avoid their therapists like the plague, were:

Association for Group and Individual Psychotherapy
Association of Independent Psychotherapists
Association of Psychoanalysis Users
Cambridge Society for Psychotherapy
Centre for Freudian Analysis and Research
The College of Psychoanalysts-UK
The Guild of Psychotherapists
The Philadelphia Association
The Site for Contemporary Psychoanalysis

Geoffrey Pick, UKCP and the Arbours Association: A Failure of Safeguarding

[Trigger warning: sexual abuse]

A few days ago I broke the news that a psychotherapist, Geoffrey Pick, had been allowed to return to practice after sexually exploiting a patient. His professional organisation, the Arbours Association, had given him a one-year suspension instead of a striking-off. When the suspension ended he was re-registered with both the Arbours Association and the UK Council for Psychotherapy. It was only after being contacted by a journalist that he resigned his registration.

Mr Pick caused enormous harm to the patient involved, who is still in therapy for the trauma. Having posted the news, I’m now going to consider how this could have happened.

I noticed something about the press release the UKCP sent me:

In January 2011 Mr Pick was dismissed by his employer for gross professional misconduct. Following on from this his UKCP organisation, the Arbours Association of Psychotherapists (AAP) considered the matter in relation to his fitness to practise, and found Mr Pick to be in breach of Article 6 of the AAP Code of Practice, and Mr Pick was suspended from the membership of AAP and UKCP for a period of one year from 16 May 2011.

AAP notified us of the decision and this was published on the UKCP website.

At the end of the suspension period AAP confirmed that Mr Pick had complied with the conditions imposed during his suspension and that it was now permissible for Mr Pick to resume membership of AAP and UKCP.

In April 2013 Mr Pick informed us that he was resigning from AAP and UKCP with immediate effect. In compliance with this notification his name was removed from the UKCP Register.

Maybe I’m reading between the lines a little, but there seems to be quite a bit of, “the Arbours Association of Psychotherapists considered the matter…”, “AAP notified us…”, “AAP confirmed that…” Almost as if the UKCP are keen to hand ownership of this almighty screw-up to the Arbours.

The matter of psychotherapy regulation is currently living in interesting times. At present the discipline is mostly self-regulated by its own professional bodies. Under the previous Labour government, there were plans for psychotherapists to be state-regulated by the Health and Care Professions Council. This was shelved when the Coalition took office in favour of “assured voluntary registration”. Self-regulators like the UKCP would be able to apply for official accreditation from the Professional Standards Authority, if they were deemed to be doing a good enough job at maintaining standards and dealing with complaints.

The UKCP have a problem here. Their main rival organisation, the British Association for Counselling and Psychotherapy, has been granted PSA accreditation. Another rival, the British Psychoanalytic Council, hasn’t been accredited yet but is expected to get it in the not-too-distant future. The UKCP, however, haven’t been accredited and probably won’t be for some time. There’s a blunt reasons for this: its complaints procedures simply aren’t up to scratch.

Back when HCPC regulation was being mooted, there were some vociferous opponents who insisted that state regulation would bring free-market values into psychotherapy (they didn’t do a very good job of explaining why, but that was their argument). Those opponents within the UKCP may well get a nasty lesson on what happens in a free market when your product is visibly inferior to the competition.

The UKCP is essentially an umbrella body for 75 smaller “member organisations”. Previously if you wanted to make a complaint against a UKCP therapist you first had to complain to their member organisation, many of which have shockingly bad complaints procedures. If your complaint was rejected you could then appeal to the UKCP.

The UKCP is aware that this “two-tier” complaints system is riddled with “cronyism and amateurism” (not my words, but the words of the UKCP former chair) and is unacceptable to the Professional Standards Authority. In order to get PSA-accredited, they need to bring in a “single-tier” central complaints service. The new system has only been tried once, with a Jungian analyst called John Smalley. It was a shambles from beginning to end. They need it to be more effective and credible in future.

There’s an article about this in the current edition of the UKCP magazine The Psychotherapist, by their new Complaints and Conduct Manager, Sultana Khanum. (Click here and go to pages 28-29) I wish Ms Khanum well in her new role, and don’t doubt her sincerity, but oh Lord has she picked up a poisoned chalice. This is alluded to in the article.

We believe that the system we have developed is robust and meets PSA requirements. However, to secure PSA accreditation, we need maximum sign-up from you…A number of individual and organisational members have signed up to our new scheme and we look forward to working with them. But several of you haven’t.

This problem is also alluded to in the December 2012 UKCP bulletin. According to the chief executive David Pink:

I am disappointed that many of our member organisations seem to be reluctant to engage with the central complaints scheme…By this time next year we need everyone to be signed up to the central complaints or in the process to becoming signed up. By then, other leading reputable therapy organisations (including BPC and BACP) are likely to be fully PSA accredited. Employers, referrers, commissioners and clients will begin to expect practitioners to be on a PSA-accredited register as a minimum requirement. We must not fall behind.

The Arbours Association is one of those organisations that haven’t yet signed up for central complaints. This is entirely speculation on my part, but I’m wondering if that was why the UKCP were so keen to tell me that it was Arbours who handled the complaint, not them.

So, what sort of an organisation is Arbours?

I can’t claim to have an insider perspective on the Arbours Association, but it was founded in the 1970s by Joseph Berke and Morton Schatzman, former colleagues of that old psychiatric rogue and 60s counter-culture icon RD Laing. Berke and Schatzman were both involved in the famous (or infamous depending on your point of view) Kingsley Hall community. This was sort of a cross between a therapeutic community and a hippy commune where psychiatrists and patients shared a roof and an “anything goes” ethos. The Arbours Association still runs therapeutic communities and also trains psychoanalytic psychotherapists.

As so often seems to be the case with these organisations, I couldn’t find details anywhere on their website of how to make a complaint against a therapist. However, if you want an idea of how rigorous their standards are likely to be, some hints can be found in a little-known report.

Back in 2009 the Maresfield Report was published, supposedly a rigorous analysis showing how HCPC regulation would be completely wrong for psychotherapy. The Arbours Association was one of the organisations behind it, along with various psychoanalytic bodies such as the Centre for Freudian Analysis and Research, and other Laingian groups such as the Philadelphia Association. I wouldn’t necessarily recommend you read the whole thing. For one thing, it’s long and quite spectacularly boring and badly-written. It contains all sorts of straw-man arguments, leaps of logic and reductio ad absurdum claims. I’m rather fond of Jo D Baker’s description of the report as, “the most self-incriminatory piece of evidence since the discovery of human remains under Dr Crippen’s basement floor.”

Just to give you a brief flavour of the report, here’s an example from page 49. The report discusses a set of draft standards that the HCPC (then known as the Health Professions Council) had proposed for the regulation of psychotherapists.

Psychotherapists and counsellors are required here to ‘understand their duty of care with regard to the legislation on safeguarding children, young people and vulnerable adults’. There is a question here of differentiating the duty of care of the healthcare professional and the responsibility of a therapist. Many therapists would believe that they certainly have a duty in relation to their clinical work, but this duty must be differentiated from the standard of notion of duty of care, especially when it concerns questions such as confidentiality.

Do I even need to deconstruct this? Within a relatively short paragraph there’s several glaringly obvious statements of concern. For one thing, they seem to have assumed that the legal concept of duty of care only applies to healthcare professionals (it doesn’t). The bit about “with regard to the legislation” seems to have completely slipped by them, apparently blissfully unaware that the law doesn’t end at the consulting-room door. As for the suggestion that confidentiality overrides safeguarding obligations – no, no, no!

In this paragraph alone (never mind the rest of the report) there’s a message that might as well be flashing in great big neon letters about the authors. That message is, “We don’t understand our obligations with regard to safeguarding, and we don’t understand the concept of duty of care either.”

I’d suggest that this is how an organisation can believe that a therapist who sexually exploited his patient doesn’t need to be struck off.

Therapist who sexually exploited patient allowed to re-register with UK Council for Psychotherapy

[Trigger warning: sexual exploitation]

Last year I noticed that the UK Council for Psychotherapy had this listing on its online complaints archive.

Geoffrey Pick of The Association of Arbours Psychotherapists (AAP) has been found to be in breach of Article 6 of the AAP Code of Practice. Article 6 of AAP’s Code of Practice provides that ‘a member should maintain appropriate boundaries with their patients and take care not exploit their patients in any way, financially or sexually’.

In view of the above decision Mr Pick is:

1) suspended from the membership of AAP (and UKCP) for a period of one year from 16 May 2011;

2) required to enter therapy at least once a week with a therapist approved by AAP’s Ethics Committee and reports from the therapist are to be submitted to the AAP’s Ethics Committee once a quarter;

3) required to engage in further professional development as agreed between him and the AAP’s Ethics Committee liaison; and

4) required to meet a member of AAP’s Ethics Committee once a quarter.

There wasn’t any more detail than that, which left me wondering what he did.

At the end of his suspension period the above entry disappeared from the UKCP website, and Mr Pick’s name was put back on the UKCP’s online register of therapists. He was free to practice again.

I can now reveal that Pick was having a sexual relationship with one of his patients, a vulnerable adult under the care of mental health services.

I have a media statement from Surrey and Borders NHS Foundation Trust, which reads.

“Surrey and Borders Partnership NHS Foundation Trust dismissed Geoffrey Pick from his role as a psychotherapist with the organisation on 27 January 2011 following an inappropriate relationship he had conducted with a client.

“We take our duty to protect the people that we serve very seriously and reported Geoffrey Pick to the local authorities, the Independent Safeguarding Authority and to the United Kingdom Council for Psychotherapists. We also undertook an investigation into the practice of Geoffrey Pick which included talking to his manager and other team members to identify any lessons to be learnt.

“We have spoken directly with the client and continue to offer her our sincere apologies.”

The patient in question reports having been severely traumatised by the episode. She suffered a catastrophic deterioration in her mental health, spent several months under the care of a Home Treatment Team and took two overdoses. She subsequently sued Surrey and Borders for the damage inflicted upon her. The NHS trust admitted liability and paid a significant sum in an out-of-court settlement. She continues to receive mental health treatment, but does so from a neighbouring NHS trust, and is still in psychotherapy to come to terms with what happened.

The UKCP sent me this press statement.

In January 2011 Mr Pick was dismissed by his employer for gross professional misconduct. Following on from this his UKCP organisation, the Arbours Association of Psychotherapists (AAP) considered the matter in relation to his fitness to practise, and found Mr Pick to be in breach of Article 6 of the AAP Code of Practice, and Mr Pick was suspended from the membership of AAP and UKCP for a period of one year from 16 May 2011.

AAP notified us of the decision and this was published on the UKCP website.

At the end of the suspension period AAP confirmed that Mr Pick had complied with the conditions imposed during his suspension and that it was now permissible for Mr Pick to resume membership of AAP and UKCP.

In April 2013 Mr Pick informed us that he was resigning from AAP and UKCP with immediate effect. In compliance with this notification his name was removed from the UKCP Register.

I’m absolutely shocked that the Arbours Association, and by extension the UKCP, didn’t strike him off. I was curious to see what my own regulator, the Nursing and Midwifery Council, has to say about such acts of misconduct. I looked up their Indicative Sanctions Guidance.

In all cases of serious sexual misconduct, it will be highly likely that the only proportionate sanction will be a striking-off order. If panels decide to impose a sanction other than a striking-off order, then they will need to be particularly careful in explaining clearly and fully the reasons why they made such a determination, so that it can be understood by those who have not heard all of the evidence in the case.

Well, this was certainly within the category of serious sexual misconduct. Even worse, it was sexual misconduct with a vulnerable adult. Worse still, the patient endured significant harm as a result of his misconduct, and her life was endangered due to the overdoses. I don’t have any doubt that if this was heard by the NMC instead of the UKCP this guy would have been struck off.

I decided to find out whether Pick was still accepting patients, so I created a bogus e-mail account under the name “Clare Stiller”. On 21st March 2013 I sent him an e-mail posing as a vulnerable adult looking for a therapist.

Dear Mr Pick

I found your details from the UKCP website.
I have a diagnosis of borderline personality disorder, though I feel that my main issue is a period of sexual abuse that happened when I was a child. I don’t think think I’ve ever properly come to terms with it, and this is what I’d like to work on in therapy.
Do you work with these sorts of issues? If so, in what way do you do so?
I’m still “shopping around” and trying to work out what sort of therapist I want, so it would be helpful if you could send me some information on your qualifications and experience, and in what ways you tend to work.
regards
Clare Stiller
On 23rd March I received a reply:

Dear Ms Stiller

I do have experience of working with the issues you describe but, unfortunately I do not have a vacancy now until the end of May. If you are still looking for a therapist then contact me again . In the meantime if you let me have your address I will post details of my practice to you.
yours sincerely
Geoff Pick

In late March 2013 Pick was contacted by a journalist from a national newspaper. He responded by announcing his resignation from both Arbours and the UKCP, and stated that he would now retire from psychotherapy.

On 3rd April 2013 I took this screenshot from the UKCP online register.

PickScreenshot from 2013-04-03 18:59:30redacted

The day after I took the screenshot, Pick’s details were removed from the register. On 6th April I sent Pick another e-mail from “Clare Stiller” asking for further details of his practice. I received a reply back stating that he has now retired from psychotherapy.

I’ve previously covered the ways in which the UKCP’s fitness-to-practice procedures are utterly failing to deal with complaints effectively. The John Smalley case, which I’ve covered extensively, wasn’t so much shocking for what he did, but for the myriad ways in which the UKCP procedures failed.

This case is of a different order altogether. The misconduct involved is far more serious. Mr Pick was found to have abused his position of trust in the worst possible way. Terrifyingly, he was allowed to return to practice. It would seem that the only reason he has now retired is because the media started taking an interest.

Unbelievable. Utterly unbelievable.

Race To The Bottom Commissioning

Writers are obsessed not just with words but with wordcount. That innocuous, humble figure in the drop-down menu or nestling innocently in the bottom left hand corner of your screen should be a record of achievement. Instead, too often it’s a curse, an ever-tightening straitjacket on the creative flow. Blogging at least allows me to stretch out a bit as opposed to a commissioned piece for another site or magazine, but there’s lots of evidence to show people seldom read to the end of the article or  even past the opening paragraphs. If you’ve reached this point, you might well be in the minority.

Lately I’ve been a victim of the oppression of wordcount for a very different reason. Creativity has no place in the dark murky world of contract compliance and tenders.

These form an increasing proportion of the workload of any independent provider in fostering and residential work. I understand why they have appeared. After all, I’m old enough to recall the old days when social work had no systems for measuring its effectiveness, the days when we just knew and that got us nowhere. However, the last few months have taught me that while it appears we have swung to the other extreme with compliance coming out of every orifice, not only are we no nearer to truly demonstrating effectiveness, it is stifling innovation and good practice that children and young people need more desperately than ever before.

Two weeks ago I completed a tender for an authority in the southeast. I wrote 12,098 words. As each question was limited to 500 words, you can see how much ground they wanted to cover, except that this document, clearly designed by committee, was intensely repetitive. There are only so many ways you can say you are child centred, needs-based, work in partnership and strive to keep children safe.

Anyway, there were four lots to this tender for different groups of children but the responses were similar, so that’s 48,392 words in total, half a decent novel in another world. For this sought-after tender there would be at least 40 providers going for it, which means the authority will have to read and digest 1,935,680 words. The responses  must be processed to ensure the quality threshold is achieved, graded on a scale of 1 to 5 then compared to rank the providers in a tiered system.

My 48,392 words does not include any of the policies and procedures that were requested, nor any of the considerable business, insurance and financial information. Then this whole quality exercise counts for only 40% of the tender because 60% is price. This imbalance between quality and cost is common – one tender went 70-30 in favour of price.

This modern approach to commissioning is an exercise in futility. I simply do not believe that all my words will be read, let alone systematically compared with the other 1,887,288 that have been submitted. It cannot possibly be done.

I resent the fact that quality is less significant than price. More and more, authorities are looking to the bottom line of the balance rather than good practice when it comes to children’s futures. I accept that they don’t have as much money and that the cuts are not their fault. However, this is not the most effective way of using their scarce resources to provide a child centred service.

I’ve said before how prices can be kept down in the sector – you provide a placement without extra services like contact, therapy and other forms of support. Yet carers as well as children need those packages of care as the demands of fostering are ever more complex. A price-based approach does not encourage that.

With the contract comes compliance. Fine, I understand why this is important. However, what happens in practice is that each authority wants very similar information but in a slightly different form. The 5 outcomes are the same, the info they require ever so slightly different. In passing, you can work out the problems affecting every authority by the nature of their requirements. A heavy emphasis on, say, staff checks or allegations means they’ve had a real problem in the recent past.

The lack of consistency means providers have to collect different statistics for every authority. Providers are of course inspected by Ofsted but this seems to be irrelevant when it comes to the tenders and perish the thought that Ofsted might want stats that are in any way similar to those required by authorities. Ofsted for example uses ethnic monitoring categories that do not match with any other I have come across.

All of this costs money. Providers will have to pass on the costs of extra posts and databases in one way or another, and goodness what the local authority staff costs are in processing 1,935,680 words.

Three other southeast tenders are between 3 and 5 months late because authorities are unable to reach a conclusion. Two face legal challenges because they request information that breaches data protection legislation. Some simply do not realise that having a policy for everything does not guarantee better quality. One organisation was censured for not having a child protection policy on gangs, but what do they expect. “For children and young people we do all we can to keep them safe but if they join a gang, sod ’em.” It’s reached the stage where I would be tempted to submit that.

Forgive the ranting. It’s helped me let off a bit of steam. I’ve just spent the day on a Section 11 audit for a council in East Anglia. It’s about safeguarding and that’s important, really, I get it, but question whether this is the right way to go about it. Self-assessment. Frankly unlikely that I’m going to give a score of anything less than perfect. ‘Do you have a policy on such and such?’ Answer: “Yes I do have a policy on such and such.” It will keep them happy because this is the fourth one I have filled in and everyone has been happy with that answer so far. Doesn’t say how good this provider is or the difference good safeguarding and risk-management makes.

The Fostering Regulations require that organisations send their child protection policies to every authority they work with or could work with. I know another provider who sent out 42 responses and did not hear back from one of them, not even an acknowledgement. Utterly futile.

It has reached the point where I don’t know what piece of legislation it is Section 11 of and I’m past the point of caring. 1,974 words, if you’re interested. I’m hacked off – you can tell, can’t you – because it’s a waste, of precious resources and of my creativity and innovation as a practitioner. I have several ideas stillborn because there is simply no time. Putting them into action would improve the well-being of children in care far more than any of the compliance mechanisms do.

But if by some chance you’ve bucked the stats and reached this far, have a look at two recent pieces that are considered, definitely non-ranty but point out the consequences. “Commissioning services drives up costs” from Public Service Europe and “race to the bottom commissioning” from the Third Sector. Commissioning is important. It needs to focus on value and quality. There must be a better way. That’s 1213 words I wanted to write.

The Philpott Case – A Lesson from History

I’m idly flicking through a copy of The Burning of Bridget Cleary by Angela Bourke. It tells the tale of what’s sometimes referred to as “the last witch-burning in Ireland”.

In 1895 Bridget Cleary, a 25 year old woman from County Tipperary, Ireland, was burned alive by her husband. It was a bizarre and grotesque tragedy in which her assailant used an unusual defence. He claimed that his wife had been abducted by the fairies, and he had only killed her changeling rather than Cleary herself.

The case provoked huge media interest, and that interest turned into politicised comment. To give a flavour of how this was reported in some quarters, here’s a quote from the Clonmel Nationalist around the time of the trial.

We found yesterday that the dreadful occurrence has been utilized editorially by the Tory-Unionist Dublin Evening Mail for purposes of political capital and as a suitable occasion to pour forth slander, odium and abuse on Irish people generally; to stir up racial and religious passion and prejudice, and if possible to damage the cause of Home Rule.

As you might gather, right-wing newspaper barons used this unusual and shocking event to slander an entire people, dismiss them all as unreasoning savages, and to advance a political agenda against them.

Thank goodness we live in 2013, not 1895. This is a much more responsible media era.

philpott philpott1

Annabel Willetts, who tweets as @CAMHStoAdult, has written this account of poor practice in liaison psychiatry. It provides a salutory lesson in the importance of showing sensitivity when working with people in crisis.

CAMHS To Adult

On Saturday 30th March at noon, I took a paracetamol overdose. It wasn’t a big overdose and I’m not going to go into the circumstances surrounding the overdose because they are not important and that isn’t what this blog is about. 

I had already accessed Duty Psychiatry earlier on in the week when my GP did an urgent referral. I had been unimpressed by the lack of compassion displayed by the mental health nurse and the student mental health nurse even though I was obviously in a mess. I’m not going to go into that into too much detail either. 

At 6pm on Saturday, I decided that I should probably go and get checked out at the hospital. I didn’t want to tell my family what I had done so I text my best friend – who really was the bestest friend EVER on Saturday night – and she came…

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