Suicide and Social Welfare

I came across this paper from the International Journal of Social Welfare titled ‘Role of social welfare in European suicide prevention’ – happily with open access so freely available. I thought it was useful to share as it echoes some of my concerns about the move towards stigmatising those who receive welfare payments that is becoming the norm amongst politicians and journalists in this country (with few, notable, exceptions).

One of the aims of this paper was to

Evaluate attitudes towards the welfare system in 26 European countries and how they are related to suicide mortality, among both men and women.

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Compulsive Hoarding

Last night, I watched a programme on Channel 4 ‘Obsessive Compulsive Hoarder’. I wasn’t planning particularly to sit down and watch it  but I was too curious in the end. While this isn’t a review of the programme, I wanted to write about my experiences of people who become ‘hoarders’.

Trash house, October 2003

I was concerned the programme would evolve into some kind of ‘freak show’ to show the world, with little understanding, how ‘odd’ this phenomenon is. It was more sensitively treated than I expected with the reactions of the neighbours – from horror to help – presenting one of the more interesting aspects.

I’ve seen a fair bit of ‘hoarding’ through my work. I don’t work in a leafy Surrey ‘commuter-belt’ town. I work in an inner city location. Most of the people I work with are older and we come across, what we call ‘Diogenes Syndrome’ relatively frequently although at different levels. Continue reading

Vote in the 2011 This Week in Mentalists Awards

Back when I was running Mental Nurse, I set up the This Week in Mentalists Awards, an annual online event to celebrate the best of mental health blogging.

Mental Nurse may be no more, but the TWIM Awards are still happening, and you can all nominate your favourite mental health blogs, whether by patients, professionals, carers or academics.

Go here to cast your nominations.

Crisis in Mental Health Care

Crisis Care in Mental Health – both community and inpatient –  is inconsistent and increasingly unable to deliver quality services.  Mind published a report today following an independent inquiry which they have carried out called ‘Listening to Experience’. This inquiry looked at evidence from 400 patients, professionals and providers and was intended to provide a qualitative shapshot of care in England.

While the press release points out that some outstandingly good levels of care were reported, it is useful to note some of the main points of criticism that were raised.

When looking at some of the examples cited in the statement from Mind, it’s hard to separate these issues from the agenda of cuts that is currently underway in public services and despite the government’s vehement denial that this is not going to lead to reductions in clinical staff, all I can say is that on the ground, I see it happening with my own eyes.

We have, and this is personal experience, wards closing, staff with redundancy hanging over them, downgrading of professionals and replacing qualified staff with unqualified staff. These are not management posts. These are all clinical posts. Staff remaining are pushed further and yes, eligibility is rising and service delivery is reaching a smaller group of people.
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The More Acceptable Kind of Stigma

Today is World Mental Health Day. Among the various excellent articles I’ve read to mark the occasion, the one that stuck out the most for me was on the F-Word blog.

I’ve taken psychiatric medications for 17 years, and that’s unlikely to change any time soon. I’m not overjoyed at the sheer range of pharmaceuticals I swallow every morning and evening, but it is far from the most significant aspect of my mental distress. So why do so many people focus on the pills as the problem?

The author points to articles raising concerns over the rise in antidepressant use. She responds that, while it’s true that medications shouldn’t be a replacement for psychological therapies where required, we also shouldn’t criticise people who genuinely need those medications. She quite reasonably concludes.

Antidepressants are not the enemy. I agree that appropriate psychological support should be more widely offered, and that medications should be reviewed regularly. However the problem is not with the pills. The problem is the world we live in that makes so many of us despair enough to seek medical help to manage it. It’s with the levels of rape, domestic violence, female genital mutilation and sexual abuse that can make live unbearable for so many. World Mental Health Day should not be ‘celebrated’ by stigmatising us for coping in whatever ways we can.

I couldn’t agree more. When I tell people I work in mental health, I regularly get asked whether I “believe in therapy or medication”. I always think that’s a really weird question. It’s not as if car mechanics get asked if they “believe in” spanners or screwdrivers. If somebody did, then that mechanic would respond that some problems need a spanner, some need a screwdriver, and he needs a variety of different types of each.

Likewise, some people need a certain type of meds, some people need a certain type of therapy. Some people need both. I really don’t get why that’s so difficult to understand.

But some people do seem to have a problem understanding it. There’s pretty much an industry in chin-stroking broadsheet articles decrying the evils of psychiatric medications – the Guardian seems to average one every couple of weeks at the moment. They have a habit of coming out with slightly crass remarks like this.

But doctors could recommend group running for depression, proved to have far better effects than SSRIs. Reading groups, too, offer a definite lift.

Depressed? Join a reading group! Well, that’s fine until you remember that as people get more depressed their concentration and short-term memory gets worse and worse. I’m sure a reading group would get somebody out of a bit of a rut, but a deep depression? They’d probably smack you in the mouth for suggesting it, if only they had the energy.

I really am tired of this tedious meds-versus-therapy false dichotomy, as though offering one prevents us from offering the other. I’m not saying everybody should take a pill, but there are a lot of people who can cope with life when they use psychiatric medications and can’t when they don’t. Those people shouldn’t be criticised or patronised for it.