… And they’re off! But it’s a disappointing start for the Mental Capacity Act

In the line-up for the 2007 legislation Grand National we see the return of some old favourites.  Waiting for the starters’ orders are the Mental Health Act alongside the NHS & Community Care Act. We also see the return of the Chronically Sick & Disabled Persons Act and … surely not … Yes it is, the National Assistance Act is back for another plod around the course, surely he should have retired by now.  We also welcome along one of the favourites this year, in his first year of entry, the Mental Capacity Act is confidently waiting for what must surely be a resounding victory for all those he represents.   They’re under starters’ orders, and they’re off …

… but it’s a rather lack-lustre performance from the Mental Capacity Act 2005 (MCA).  I’m probably not the only one slightly disappointed by the sluggish start; 5 years into the MCA I have to admit that things probably haven’t gone as some of us may have imagined.  I was prompted to write this blog having recalled a recent occasion concerning a gentleman with a learning disability. He asked his carers for support to obtain an application form for a driver’s license and then to complete the form. Instantly, the carers decided that it would be far too dangerous for the gentleman to be driving around and, quoting the MCA, in his ‘best interest’ decided that it would be better if they didn’t support the gentleman to obtain and complete a driver’s license application form. I think the only correct consideration of the MCA were the two words, ‘best interest’ and even they were out of context! On every level, they failed to apply the MCA correctly or even remotely well. If  they had, they would have approached the decision from the assumption that the gentleman had capacity (which, interestingly he did) and provided the support he was requesting in the first place.

This of course isn’t an isolated incident and only recently was also reported about on the Community Care website.  Poor application of the MCA is widespread, it crosses all levels of care professions and it has to be addressed for the sake of those it should be protecting. If I were the MCA, I would be suffering from a complex right about now. Being misrepresented, misquoted, ignored, it’s enough to make even the strongest legislation question themselves!

Some organisations see the importance of MCA training, but where I often see a glaring hole is in people’s ability to apply the principles and use the MCA as the framework it was intended to be. People can usually quote phrases, provide general themes or even list the 5 principles of the MCA but that is often where knowledge and application stop. Carers and professionals alike should be discussing it daily, in team meetings, formally in supervision and informally. They should be applying it to all decisions being made and actions being undertaken on behalf of someone who may lack capacity. They should be questioning everything and inquisitively discussing whether any action or decision being made is the least restrictive or whether a seemingly unimportant decision made by carers or professionals has just had a significant impact upon individual.

The MCA doesn’t have to be a complex piece of legislation unattainable to anyone who doesn’t have a law degree.  It even comes with a very user-friendly Code of Practice to which of course, anyone working with an individual who may lack capacity must have regard for.  But it does have to be a piece of legislation that is used well and frequently by all concerned to ensure that we really do act in peoples’ best interest.

Advertisements

Should men embrace feminism?

Just recently I’ve been marshalling my thoughts about the male view of feminism. Should men engage with feminism, take an active part in it, even call themselves feminists? I’ve come to this topic at least partly as a result of a bizarre, distressing sequence of events that happened to me over the past year.

First off, I’ll present a dissenting view. Stuart Sorensen is a blogger with whom I rarely disagree. His training resources and opinion pieces on mental health are of consistently high quality, and he is clearly a very decent guy who cares passionately about improving the care received by people who use mental health services. But if I agree with him on mental health, I have to disagree with his views on feminism.

I support the rights of all people but because of reactions such as this I and a great many men cannot support feminism. This is not because I disagree with womens’ rights but because I cannot & will not ally myself with this sort of bigoted, superficial reasoning.

At its heart feminism has some very laudable aims which I do support. But I’ll never call myself feminist because I don’t want my support for reasonable political principles to be hijacked by those who seem determined to maintain a divide between the sexes.

In all fairness to Sorensen, his view on feminism has been coloured by an unpleasant experience where he’d been falsely accused of domestic abuse by a former partner. Also to be fair, the feminist movement does have its nasty extremes. Only last week, there was an uproar on Twitter about the RadFem2012 conference, which plans not only to ban men from the premises, but also transgender women who were born as men. A classic case of the oppressed becoming the oppressor.

I certainly wouldn’t subscribe to any demonisation of men (or transgender people, for that matter). I don’t think men have to apologise for being men, and I certainly don’t think men accused of abuse should be considered guilty until proven innocent. But feminism is a broad church, not a narrow ideology. If I would reject the bigots of RadFem2012, I would also accept that certain branches of feminism contain little, if anything, that I would disagree with. Sex-positive feminism, for example, echoes a lot of my views on gender, sexuality and censorship.

I suspect, ultimately, my disagreement with Stuart Sorensen may amount to little more than a semantic debate about what does or doesn’t constitute feminism, rather than any dispute about how people should be treated.

If it was a nasty set of events that propelled Sorensen away from feminism, it was an equally unpleasant experience that has recently drawn me towards it. A couple of years ago I was editing a group blog called Mental Nurse, which had developed a reputation (which I like to think was deserved) for campaigning for the rights of people with mental health problems, and for challenging stigma. At the time that the site closed in March 2011, it was one of the UK’s most popular mental health blogs.

In August 2010, somebody e-mailed me a link to an article about borderline personality disorder, written by an American psychologist. The tone of the article shocked me.

Cluster B’s aren’t “mentally ill” like Schizophrenics and Bipolars are mentally ill. Schizophrenics and Bipolars can’t control their bizarre thoughts, behaviors, impulses and/or hallucinations without medication and deserve our compassion and sympathy. Many self-identified BPD’s and other Cluster B’s plaintively bleat the following statements with great regularity:

“But I can’t help the way I am!”

“I didn’t ask to be BPD!” (Reminds me of a disaffected teen shouting, “I didn’t ask to be born!” Yeah, well, you’re here now, so what’re you gonna do about it?)….

Instead, let’s call them what they are; sociopaths. All the Cluster B disorders are just similar flavors of sociopathy. Giving Cluster B individuals and their ilk the protective cloak of “mental illness” provides them with a “get out of jail free card” and allays our existential dilemma on the concept of evil. Instead, we tell ourselves, “She has problems. She’s sick. We have to be patient and understanding.”…

There’s a lobby of BPD activists who want the psychiatric community to change the term “Borderline Personality Disorder” to Emotional Dysregulation Disorder. Aside from having to edit all of my previous posts, I say a rose by any other name would still have nasty, hooky little thorns. Pardon my language, but I think the terms crazy asshole, mean jerk, toxic person or bad person are better than diagnostic labels. Why? Because everyone knows that you should avoid crazy assholes at all costs and whenever possible.

This is stigma. Pure and simple. And against a very vulnerable group of people. I don’t believe people with borderline personality disorder are simply bad people. As a CAMHS practioner, I’m a strong believer in early interventions, getting them into therapy at a young age to help them to develop the coping skills in order to function with life.

I didn’t know it at the time, but the psychologist in question was part of what’s come to be known as the “Manosphere”. They go by various names – the Mens Rights Movement, Mens Rights Activists, Men Going Their Own Way. They advance a view that men are emasculated in contemporary society, by feminism, by false allegations of rape and so on. The psychologist’s rant against borderline personality disorder was intended as a warning about the dangers of manipulative or deceitful female partners.

Whatever one thinks about such a viewpoint, these Mens Rights Activists (MRAs for short) have an unfortunate tendency to come out with statements can be, quite frankly, vile, to an extent that they have come to the attention of anti-hate organisations such as the Southern Poverty Law Center.

There are literally hundreds of websites, blogs and forums devoted to attacking virtually all women (or, at least, Westernized ones)…While some of them voice legitimate and sometimes disturbing complaints about the treatment of men, what is most remarkable is the misogynistic tone that pervades so many. Women are routinely maligned as sluts, gold-diggers, temptresses and worse; overly sympathetic men are dubbed “manginas”; and police and other officials are called their armed enablers.

For an eye-opening (and frequently hilarious) primer on the antics of the Manosphere, I highly recommend David Futrelle’s Manboobz (Warning: possible abuse triggers) blog, which documents and mocks online misogyny.

I didn’t know about the wider Manosphere back then. I just knew that I was reading a spectacularly hateful article by a self-proclaimed mental health professional. Some British women attempted to debate with the psychologist on her (yes, her – the Manosphere has a Women’s Auxiliary) blog, and got some very obnoxious replies for their trouble.

As tends to happen when a bunch of British people come across a bunch of Americans being not only very nasty but also with a total lack of self-awareness, the result was a minor explosion of mickey-taking, on the Mental Nurse site, on other blogs, on Facebook and on Twitter. After Mental Nurse started being described by the MRAs as “the primary enabler site”, several people amended their Facebook profiles to read “Mental Nurse is my primary enabler”. Admittedly some of the ridiculing did become rather juvenile and silly, but no worse than many of the regular Twitterstorms that erupt whenever somebody says or does something offensive.

A couple of months later, when we’d by and large forgotten all about it, the Mental Nurse site got an e-mail from a UK solicitor, who had been hired by the psychologist, demanding damages and information about various people who she held responsible, including me. We then did what most people do when they get a legal nastygram – we bricked ourselves and backed down on the spot. All references to the psychologist were removed from the site, we e-mailed other people to warn them to take stuff down, and then my co-editor e-mailed the solicitor asking him for an update on the situation. We got no reply.

No response? Fair enough, we’ve had a nasty letter intended to scare us and scour her Google rankings of anything negative about her. That seems to be the end of it.

Or that’s what we thought.

What followed was a long saga in which the psychologist – initially entirely unkown to any of us – went to extraordinary and expensive lengths to track down the people who had ridiculed her views – sending solicitors letters to domain providers, hiring bailiffs to go to peoples’ homes, obtaining court orders for internet providers to reveal peoples’ addresses.

In February 2011 she found someone, and submitted a court claim against him. Bizarrely, the defendant was in Scotland, but the claim was submitted in England. It was struck out on the spot on jurisdiction grounds, and never went to court.

The defendant was concerned that she might try again to sue him in Scotland, and decided to write to her solicitor and offer a settlement. He had taken legal advice and been assured that she had no case. Even so, the eye-watering amounts of money needed to fight civil litigation mean that it’s not at all unusual for people with good defences to cave in rather than risk being bankrupted by the cost of fighting.

Fast forward to June – I and two other people got e-mails from the defendant. The claimant wanted our personal details as a condition of settlement. Did we consent to our details being handed over? We all wrote back refusing consent.

In July, one of the other two people got a letter from her solicitor to his. It transpired the identities had been passed to her as demanded. I don’t blame the guy for doing so. He was just trying to protect himself and his family. To his credit, there was one identity that he didn’t reveal. I don’t think it’s a coincidence that it’s the person who he regarded as the most vulnerable if publicly outed.

This second defendant was entitled to Legal Aid, and so was able to fight. There was a court hearing, and the judge ruled that the psychologist’s claim was so riddled with errors (both factual and procedural) that she would have to re-draft it, pay for wasted court time and also pay a deposit sufficient to cover the defence costs if she were to lose. Predictably, she never showed up to the next hearing, and that was that.

She now owes an absolutely ridiculous sum of money in legal costs. Naturally I would never indulge in Schadenfreude.

By encountering this woman and her MRA goons, I feel like I’ve stared hate in the eyes. I’ve had nearly a year of living in fear, experiencing anxiety, nightmares, thinking every estate agent that parked up on my street was a bailiff hired to look for me.

Hate needs to be challenged. This mens rights “movement” is an affront not just to women but to common human decency. That is why I now think it’s right that men should align themselves with feminism.

Do I think there should be a Mens Auxiliary of the kind imagined by Valerie Solanas, in which men are expected to repeat, “I am a turd, a lowly, abject turd”? No. Men are entitled to proudly and unapologetically be men. Just not at the expense of women.

For feminism to truly succeed, there needs to be a cognitive and behavioural shift in men. We need to be willing to challenge assumptions, both in ourselves and others. I commend Manboobz author David Futrelle for doing exactly that, in a very educational and entertaining way.

I’ll say it now. I am Zarathustra, I am a man, and I am a feminist. To the psychologist who’s occupied my mind so much over this past year, I say this. I owe this conversion to you.

An Invite to Rod Liddle

Some typical disabled people

Rod Liddle’s Sun column today is repulsive even by his standards.

Also, I am nothing if not a creature of fashion, a cool and with-it hipster, daddio, who is always up to date with the latest trends.

And being disabled is incredibly fashionable. The number of people who claim to be disabled has doubled in the past ten years.

And who can blame them? Not only do you get money from the Government and don’t have to go to work – but if you play your cards right you might get one of those badges that lets you park wherever you want. Right in front of the cashpoint, for example. And you can use those enormous toilets with levers and handgrips and emergency buzzers they have in all public places, without feeling too guilty about it.

You know what, Rod? I think you need to put your money where your mouth is. You want to be disabled? I cordially invite you to disable yourself. Saw your own legs off. Blind yourself with a spork. Binge-drink until your liver and kidneys are comprehensively wrecked…Oh wait, you were probably doing precisely that when you wrote this drivel. Live the dream, enter the fashion set and actually become disabled.

And then you’ll be cool.

 

Britain on the Make – A Review

It was with some trepidation that I watched last night’s Panorama programme ‘Britain on the Make’. I caught it late after the initial ‘rush’ and I went into it with a slight pang of distaste in my mouth having read some of the comments from Twitter but I felt that I should watch it, if only to be able to review it because I think we must hold these programmes to account as they are made with licence-payers money.

It was as distasteful as I suspected it might be and the level of depth of information and reporting felt very uncomfortable from the start. There was much titillation and ‘benefit fraud porn’ – let’s look at this man on incapacity benefit with a yacht and house in France – type thing and next to no genuine investigation or interpretation of figures given to us.
Continue reading

Caption Competition: Daily Mail and Mental Illness

Following my post yesterday on THAT awful Daily Mail article about mental illness, it looks like the Fail have at least partially responded to all the people condemning it on Twitter. They’ve removed the incredibly triggering self-harm image from the webpage.

People were condemning the article, not only for the self-harm pic, but also for having an utterly patronising and outdated view of people with mental health problems. So, naturally they’d want to replace the photo with something that avoids all those stereotypes that they’ve been accused of propagating.

Oh. That’s, erm….much better?
Continue reading

Daily Fail on Mental Illness

There’s an article from yesterday’s Daily Mail that’s been causing quite a bit of discussion on Twitter, particularly from Mark Brown (editor of One in Four magazine, which I can’t recommend highly enough), Dawn Willis and Ali Quant.

Before I link to the article, I should warn people that they’ve stuck a VERY triggery self-harm photo slap bang in the middle of it. If you’re okay to handle that, the article is here.

This may have been simply due to low expectations, due to it being not only in the Daily Mail but written by Harry Phibbs, but I was actually expecting this to be a lot worse. There’s a germ of a good article in here, trying to make a decent point about the need for a balance between inpatient and community provision of mental health services. There’s other worthwhile points about how voluntary sectory agencies can do a lot to help people with mental health problems to improve their quality of life. The trouble is, even when Phibbs is making a valid observation, his language and tone is so utterly hackneyed, antiquated and downright condescending that it ruins the points he’s making. I’m referring to language such as this:
Continue reading

‘The Future State of Welfare’ with John Humphrys – A Review

Despite my hopes, dreams and wishes, I don’t think I’ll ever be able to switch professions and hold down a career as a TV critic although I’d lay claim to much ‘television watching’ experience. I sat down to watch ‘The Future State of Welfare’ last night  but after a very busy day and week covering ‘duty’, I may have nodded off one or two times during the programme so while I want to give my thoughts and feelings about the programme, I must mention that as a rider.

OT on Wheels has a great analysis of some of the figures that Humphrys presented. Left Foot Forward also analysed the figures. My response is more emotional than cerebral.

I knew from the advance information that this was a programme which was going to be challenging for me to watch. I take great offence at the way this government (and the opposition) stigmatise people who are out of work and who need to rely on the provisions of the welfare state to exist.

Humphrys had a very firm view on playing on the ‘idleness’ of the workless and feckless and seemed staggered that there wasn’t the old style stigma related to unemployment, recalling with some mirth and incredulity the ‘one man on the street who never worked’ and who everyone else on the street stigmatised.

That made uncomfortable viewing for me. When I was growing up, you see, my father was unemployed for periods of time and I remember that projected shame and stigma. It hasn’t left me. I genuinely wouldn’t want another child or family to feel that.  The way to ‘solve’ the benefits ‘crisis’ is to shame people into work? Really? Is there no more human way to promote and encourage the right environments to work in?

So from that premise, Humphrys casts a glance at some of the worst ‘offenders’ in his view.

But the people who Humphrys spoke to, I’d argue were hardly typical although that’s what he would want us to believe. The panned shots of young men hanging around on street corners makes too many assumptions about types of work or the fact that work is something that is undertaken from 9am – 5pm on workdays therefore (he seems to imply) anyone out and about at 2pm on the Wednesday afternoon, must be workless.

Not having a job does not make someone ‘different’ except by luck and opportunity. We had a constant undertone of ‘paid work’ = good  ‘not paid work’ = bad/feckless/idle

He even raised the ‘deserving and undeserving’ poor which is more than patronising and pans across to a group of people who are looking for work and therefore ‘good’ in his very judgemental eyes.

The part filmed in the private training centre run by a private company that have been contracted on a ‘payment by results’ basis illustrated some of the patronising talk and ‘lessons’ that the people attending receive. Adults designing cupcakes? Really? I do wonder about what is actually taught and how.

There was a glance across the Atlantic to the workfare schemes initiated there and I felt the tone was almost admiring. Certainly there’s no doubt that Humphrys was scornful of those who needed to rely on state benefits to exist.

The family on housing benefit, he implied should not be helped with rent because they live in central London and bafflingly he raised their nationality both in the voiceover and directly to the family when there was no question that as a Spanish citizen, the man had the right to live and work in the UK. I am unclear why the nationality was even raised as an issue.

There was an overtone of disdain regarding the high rates of claimants for ‘Employment and Support Allowance’ which seemed to emphasise a high rate of ‘fraud’ and yet the programme consistently referred to ‘Disability Benefits’ without mentioning Disability Living Allowance at all – probably because it has such low rates of fraud.

Of course I think that work should be encouraged but decent paying dignified work as well as support for appropriate child care should also be encouraged.

Stigmatising groups of people will not build a cohesive society but more and more this government and moreover the governing classes seem to depend on a ‘divide and rule’ type way to build gaps between those who have and those are have-nots.

Humphrys’ skewed and rather unpleasant programme exacerbated this. I look forward to the BBC putting together a programme exploring the realities between the ‘benefits’ myths that it has enjoyed perpetrating through this programme.