Friday 30 September 2011

Another study showing antipsychotics reduce brain volume.

The Influence of Chronic Exposure to Antipsychotic Medications on Brain
Size before and after Tissue Fixation: A Comparison of Haloperidol and
Olanzapine in Macaque Monkeys
http://www.nature.com/npp/journal/v30/n9/abs/1300710a.html

This would disturb anyone with schizophrenia who happily accepts their
drug treatment and also anyone who likes monkeys..

"Three groups of six macaque monkeys each were exposed to oral
haloperidol, olanzapine or sham for a 17–27 month period. The resulting
plasma drug levels were comparable to those seen in subjects with
schizophrenia treated with these medications. After the exposure, we
observed an 8–11% reduction in mean fresh brain weights as well as left
cerebrum fresh weights and volumes in both drug-treated groups compared
to sham animals. The differences were observed across all major brain
regions (frontal, parietal, temporal, occipital, and cerebellum), but
appeared most robust in the frontal and parietal regions. "

Anyone who knows the history of antipsychotics knows when they were
first introduced they were described as a chemical lobotomy. This was
because they created the same effect without carving out a person's
brain. Clearly they are actually damaging people's brains after all.

Thursday 29 September 2011

Thoughts on how to rectify the disability of schizophrenia

I must admit my knowledge of equality other than in every day life is
very limited. All I know is the 5% in employment and education figure
for people with schizophrenia (Epsilon study though I've not read the
paper; it's one of the lowest rates in Europe). Oh and the info about
one of the root causes of the overdiagnosis of black people. Frankly I
don't feel my input is worth something unless I know my stuff. I've
spent over 2 years learning a lot about schizophrenia. (Never had the
diagnosis. Was diagnosed with schizoaffective ages ago but my last
diagnosis is mixed affective disorder and the last psychiatrist I saw
didn't give me a diagnosis).

In terms of equality the only thing I'd suggest would be based around
employment. This sort of forces the severely mentally ill back into
public sight. It's applied social contact theory which I feel is going
to be the only real way to make a change. An employment scheme linked to
something like Affirmative Action would be my suggestion for what will
benefit the equality of the mentally ill in the long term. It's very
simplistic though.

People with sz may still face the stigma without people's attitudes
truly changing in the short term. They'll continue to suffer from the
things which can't be controlled, i.e. how people talk about them behind
their back or how they're treated less well because they seem mad or
react in unusual ways. The individuals would suffer and this is not what
I want but without their sacrifice the root stigma of mental illness
will never change.

During the creation of the asylum system (The Great Confinement as
Foucault calls it) the expression of madness became hidden for
generations. People forgot that madness is normal in developed world
nations and the systems and cultures evolved without it. Medication
arrived and it continued the confinement. Remember: the meds don't help
the core pathology, i.e. the delusions and hallucinations. They just
suppress the expression of behaviour. Madness is still hidden and
society continues to expect that people aren't a bit crazy. The Great
Confinement is probably a major part of the WHO IPSS result, the one
which shows on 2, 5 and 10 year follow up (and has been replicated)
people in the developing world with schizophrenia do better on social
and clinical outcomes than those in the US and UK. Developing world
nations never experienced the Great Confinement though as they become
influenced by the methods of Western psychiatry they may find they too
start to see a worsening in clinical and social outcomes (social
includes occupational I think).

I think many people with schizophrenia are resistant to going back to
work and I think NICE are unlikely to commission an Affirmative
Action-bnased employment scheme. Sadly I just don't see how any change
is going to be made unless it is mandatory for organisations to fulfil
their equality duty. I suspect if anyone surveyed the national mental
health charities to see how many people with schizophrenia work there
(paid work) and how many of their senior management tier have ever been
diagnosed with schizophrenia or, perhaps more simply, have ever been
sectioned under the Mental Health Act 1983 I think we'd find a lot of
them aren't living up to their mission statements. I'm sure this would
be true of NICE, the Department of Health and many other healthcare
organisations. Wouldn't that be an interesting survey eh? The idea of
sectioning as a proxy for severe mental illness separates the wheat from
the chaff, i.e. it imposes a hierarchy of disability.

Wednesday 28 September 2011

There is still such a long way to go.

Those drugs which killed so many elderly people can be used on children
and for the rest of their lives. One of those drugs, clozapine, directly
killed 2 people in less than 5 years and has contributed to the
significant reduced life expectancy of the 6,000-7,000 people prescribed
it. These drugs are called "antipsychotics" but they may not be
antipsychotic, i.e. they may not actively stop delusions and
hallucinations which is what the public and patients expect these drugs
to do.

Electro-convulsive therapy is another extreme treatment the patient is
shocked to cause a seizure but has been found to be as effective as sham
ECT (where no current is passed) in the long term. Some people have died
because of this treatment and others have had detrimental side effects.
It has been used on pregnant women and many others but a recent review
of trials shows this treatment to be ineffective.

The Mental Health Act 1983 amendments allow for a person to be
incarcerated without having committed a serious crime but for being at
risk of committing a serious crime, a risk solely determined by a
psychiatrist; they may be hospitalised without treatment nor need for
any treatment to exist so this is little different from imprisonment in
the aspect of loss of liberty, society's greatest punishment which is
only allowed to be applied with the rigour and process of the criminal
justice system.

Of the 6,000 or so completed suicides every year around 20% are by
people diagnosed with schizophrenia; those who don't take their life
still die 20 years younger than the average person.

Saturday 24 September 2011

Two useful research software

These are two interesting packages, the first is a free version and the
second is one which is pay for but has a free option.

I've used Mendeley during the beta stage and it's an excellent program.
I could drag and drop papers or URLs to be indexed. It would
automatically fill in the details and it was reasonably reliable at
getting these right. At some point the drag and drop feature for PDFs
stopped working properly so I stopped using it but it's an excellent
package apart from that bug.
http://www.mendeley.com/

Zotero is the open source equivalent. It's totally free I think. I've
not tried it so can't comment further.
https://www.zotero.org/

Wednesday 14 September 2011

Science and psychic powers

I've had strange experiences which seem beyond the realms of reality.
Powers of prediction, if only I knew how to use them and interpret what
they meant. Powers beyond what modern science can explain as possible.

There are published examples too if people would be willing to look for
them and read them. There are powers which people yet understand.

But these powers and events which seem psychic are not predictable, at
least not in my experience. I am careful to stay away from the biases
which would be unscientific.

What I mean is testing these psychic powers and remembering that they
don't work. Let's say I tossed a coin three times and predicted the
right side it would land. It's within the realms of chance for this to
be possible. Let's say I tried it another day and got all three wrong.
This is the sort of testing which many people would avoid. They might
forget the three incorrect predictions and tell the story or remember
the time they got it right.

It's not to say this potential doesn't exist. It's just to understand
that it isn't predictable and for many people it may not be real. It may
be a product of remembering the times the guesses were right and
forgetting the times the guesses were wrong.

As a technique for schizophrenia and other mental disorders which
involve quasi- or pseudo-psychic experiences it is useful to teach
people to be scientific about their experiences.

Tuesday 13 September 2011

To die would be the best hing

To live....isn't.

sex, schizophrenia and creativity

Mention of a study relating more sexual partners, being artists and
schizophrenia


Of Note: Speaking of schizophrenia (and sex and art)
http://rebeccaskloot.blogspot.com/2005/12/of-note-speaking-of-schizophrenia-and.html

another paper relating dopamine transmission with creativity

Thinking Outside a Less Intact Box: Thalamic Dopamine D2 Receptor
Densities Are Negatively Related to Psychometric Creativity in Healthy
Individuals
http://www.plosone.org/article/info:doi/10.1371/journal.pone.0010670

Monday 12 September 2011

just some shit about hearing voices research

It is clear the interview question is important. Would "Do you have an
internal dualogue or dialogue, or a conversation in your head?" be
synonmous with "do you hear voices?" In my opinion the answer is yes in
the context of the wide definition used in this paper. Part of the
problem - as I thnk I've discussed - is the language of consciousness is
not rigorous nor well known. The high lifetime prevalance/incidence
figures for psychology students and mental health nurses could be seen
to be a measure of many things. I'd take it to be a sign that their
mental health education makes them more able to recognise the internal
dualogue as what some people call hearing voices. Other people may go
through the experience without the awareness that their stream of
consciousness has two or more sentient consciousnesses or they may
simply not call their thoughts voices.

After all, the internal conversation is a conversation. It takes two
consciousnesses to talk.

Future research has to get this definition and language right. Asking
people in the community may not help if they don't know the language.
It's like asking people "are you tall?" when only you know what being
tall means. People would answer no more than height scientists.

Perhaps it may be important to add "...which caused you distress or
confusion" because I think that's important when considering the
psychopathology aspect. My experiences of consciousness during psychosis
were extremely distressing - I wanted them to end and I would die to
stop the control because I had no other means to stop it - whereas my
current experience of consciousness can include voices/thoughts not of
my "I" but it is not distressing.

It's also notable that the authors focus on the Intervoice/HVN dogma. I
wonder if they've found meaning to those people who feel the control is
coming for government forces or secret organisations? These explanations
are used instead of spiritual explanations by individuals. Are these
equally recognised as meaningful?

I'm not sure about the continuum of voice hearing. Is it a continuum of
intensity or distress or psychosocial dysfunction caused by the voices?
Or are we really talking about discrete states. Or am I getting this all
wrong?
1) [standard experience of consciousness without awareness of other
consciousnesses]
2) [ raised state of awareness to experience other consciousnesses
without distress] = normal or schizotypy
3) [ raised state of awareness to experience other consciousnesses with
distress] = schizotypy or psychosis
4) [ raised state of awareness to experience other consciousnesses with
distress and psychosocial dysfunction] = schizophrenia
5) [ raised state of awareness to experience other consciousnesses
without distress and psychosocial dysfunction] = schizophrenia

Psychiatrists only see people n states 3, 4 and 5 which is probably why
some still see hearing voices as psychopathological. Again, these
definition are important. Is the psychiatric definition of auditory
hallucination synonymous with the author's terms hearing voices and my
idea that the internal dualogue could also be described as hearing voices?

Something I need to totally rewrite for my schizophrenia treatment document

This bit is an important direction for mental haelthcare but I've gone off on one. It needs to be rewritten to be focused on what's rpactical.

"

Changing society

There is no profession tasked with this. It is vital to the true goals of mental healthcare but psychiatry’s mode of operation since its inception has been the change and normalisation of indiviuduals.

The removal of the mad from view created one of the biggest problems in the evolution of civilisation. Enmasse they were confined to asylums and hidden from view for generations. This is one of the great evils of the Industrial Age. In an act of compassion the Great Confinement (Foucault’s term for the creation of the asylum system) removed the extremes of the human condition and valuable human types from society’s view. In so doing it created an illness in society where natural behaviours and inalienable human types became evermore labelled as mad and mentally ill.#

Decades and centuries passed. Those with schizophrenia were imprisoned and maltreated for their entire lives. Many died in these asylums. Without seeing their madness society through psychiatry labelled more and more human experiences and types as abnormal, pathological and mentally ill. The psychiatric textbooks got ever larger.

Society grew more and more to value a human which was like a robot or slave but paid. Anyone who was part of the extremes of the beautiful diversity of the human being became labelled as mentally ill and experienced disability and exclusion, discrimination and stigma.

The invention of community care did little to solve the root illness in society. Madness was confined using the major tranquiliser. The diagnosis of schizophrenia was broadened to pathologise a broader swathe of humanity deemed unfit for life as they were in the malformed post-Industrial Age developed world nations. The major tranquiliser became used on more and more people. Though it allowed the severely mentally ill to live outside the confines of the asylum system they were still not free and the behaviours labelled as madness were still hidden from view by these drugs.

The WHO IPSS results# are but one indicator of this illness in post-Industrial Age societies. Developing world nations offer better results for those with severe mental disabilities because their cultures have not yet gone through the pathogenisis of the illness in developed world nations, yet. The new millennium sees this illness in society spreading across the world,

There are beacons of hope. The Disability Discrimination Act and the Equalities Act. The Human Rights Act. The Convention for the Rights of People with Disabilities. New Horizons. The mission statement of Mind and other charities driven by effecting social change which rectifies the illness in society. And, of course, the landmark Time to Change anti-stigma campaign.

These pitifully few examples are the hope for the future. They are the harringers of the progress required to heal the illness in society which creates the negative outcomes of schizophrenia and other mental disabilities. These disabilities mean people and their value is lost to modern society. It means they suffer when they don’t need to suffer.

It is possible to change this but it takes a leap in government thinking. The beginnings of change happened before the recession struck. The well being movement, Gross Domestic Happiness as a priority of governments and the New Horizons strategy were all beacons of hope lighting the way to a better society for all people.

These were the start of the changing in healing the illness in society which causes the disability, an illness which may go back further than the creation of the asylum system which hid the behaviours called madness for generations. Today the result of this is many people with severe mental disability are excluded from mainstream society. With the UK having one of the lowest rates of employment and education for people with schizophrenia there is a significant amount of change required to overcome the barriers which have been centuries in the making.

I know not if there is the will or the desire in the UK government to make the changes needed. I know what I feel and what I feel is that any true advancement in society is not measured by Gross Domestic Product nor other Industrial Age measures. The measure is how bad life is for those worst off and how wide the gap is between those who have little and those who have lots. Progress is making the lives of the worst off less worse and reducing the inequality gap.

There has already been significant work put into this objective by the UK government over the last half century, from working to providing more homes for the homeless to the plentiful supply of mental health and social care. It is the preservation of the ideals of the NHS even in times of national hardships and the expansion of the Improved Access to Psychological Therapies scheme.

There is so much more to do. The lives of the severely mentally disabled is one of the key areas which are a priority for progress. The solutions I’ve offered here are pitifully weak to help those that have been so let down in life. It will take more than small measures to undo the centuries of injustice faced by those who suffer severe mental disabilities.

The Time to Change programme is the first real step towards this better future and rectifying the problems caused through psychiatry’s methods of treatment. As far as I am aware the UK leads the world in the relative size of its national mental health antistigma and discrimination programme though the programme was initially funded through The National Lottery and Comic relief. It was initiated by Mind and Rethink, two charities which are leading the way towards a better society for all.
"

Sunday 11 September 2011

Major statistical cockup

http://www.guardian.co.uk/commentisfree/2011/sep/09/bad-science-research-error

"How often? Nieuwenhuis looked at 513 papers published in five
prestigious neuroscience journals over two years. In half the 157
studies where this error could have been made, it was. They broadened
their search to 120 cellular and molecular articles in Nature
Neuroscience, during 2009 and 2010: they found 25 studies committing
this fallacy, and not one single paper analysed differences in effect
sizes correctly."

I wonder in how many other fields of research this has happened?

This is extraordinary. I wonder if the simple solution is good software.
Aftter all, they're all just using numbers to work this sort of stuff
out. If the software they used ensured it outputted the right figures
and got the science spot on then perhaps this sort of error wouldn't happen.

Of course if the software writers got it wrong or the current
statistical science was incorrect then the error in research would be
far greater. an opensource-model project on the statistical science
required to say something works and something doesn't - with
contributions from inside and outside academia - might be the way to get
the science right and build software which outputs stuff which makes
sense to anyone as well as gets the science spot on.

Clearly the editors at these peer reviewed journals didn't spot the
errors. Even worse - neither did the readers. This is the whole point of
peer review. When something goes wrong the people who read the journal
are meant to spot it and correct it.

This paper and article is a bad one for the robustness of the peer
review process. This is a big science balls up and it seems no one
spotted it through the conventional peer review process. As I've already
asked, how many other peer reviewed journals are letting these same
errors slsip by?

Saturday 10 September 2011

The legalisation of assisted suicide

It was in the 20th century that the UK decriminalised suicide. Before
this it was an offence to try to kill oneself. Thankfully society has
progressed but there is further progress needed. Assisted suicide must
be legal in any advanced society. It must be legalised for the so-called
mentally ill.

Currently it isn't. The UK penalises those who assist people to kill
themselves though in practice prosecutions are rare.

This isn't good enough. This is the sort of immorality which must end
and will end eventually. We live in a society where a life can be
aborted by a doctor. Abortion is legal but assisted suicide isn't. This
is a strange situation. Suicide is an individual's choice about thier
own life. Abortion is choice over a potential life, a life which may
chose to live if allowed to exist.

Assisted suicide for mental illness sounds immoral but it is based on
compassion and understanding, an understanding which comes from living
with suicidal ideation for much of my adult life. It comes from an
understanding of having read a lot of material on suicide as well as
having made a few attempts in my adult life. Sadly I've survived every
single fucking one of them.

Those without lived experience would never understand what it's like
living with the silent torture which people call severe mental illness.
They could never understand why so many people take their life not in
states of intense distress or confusion but with clear minds and calm moods.

The fact is many people already take their life or attempt to. 6,000
succeed every year. Sadly some of those might be regretable suicides,
i.e. they are driven by short term circumstances, moods or psychosis.

Many others aren't. Many other suicides are simply the best thing for
the individual. They offer them the peace they could never find in life
or through mental health treatment. Rather than live another day of a
tortured existence they find their salvation by taking their life.

But it is a horrible process. Many of these people who make a rational
and informed choice to take their life die alone. They don't have their
loved ones around them. Their last moments are just like the hell of the
rest of their life. They risk failure and all that failure can entail.

The compassionate thing would be to counsel them through their decision,
just like a mother-0to-be might be counselled through her choice to have
her baby aborted or a person with gender dysphoria may be counselled
before their decision to have a sex change is accepted.

There is then the period between decision and termination. This may be a
long period and I feel immoral for proposing it. The suicidal person has
to wait for their death. This is a safety mechanism to prevent
regrettable deaths. During this time they are helped and they help
themselves to find a way to live. For myself I'd arbitrarily picked a
period of 4 years but it is potentially four years of hell. Since I
could not get an assisted suicide I've thrown away this plan.

But I would campaign to help those who suffer like me get them peace
they want. Fuck those who wouldn't understand and would judge me. I know
that helping a person out of their pain in this way is a hard choice but
it is the right thing.

Thursday 8 September 2011

3 papers about dopamine and sexual behaviour

Eisenberg, D. at al. 2007, Polymorphisms in the Dopamine D4 and D2 Receptor Genes and Reproductive and Sexual Behaviors, Evolutionary Psychology (abstract read only)
http://www.epjournal.net/filestore/EP05696715_corrected.pdf

Giulianoa, F. et al. 2001, Dopamine and Male Sexual Function, European Urology (abstract read only)
http://www.angelfire.com/d20/medicina_ucsm/revistas/revision/003.pdf

Garcia1, J. et al. 2010, Associations between Dopamine D4 Receptor Gene Variation with Both Infidelity and Sexual Promiscuity, PlosOne (abstract read only)
http://www.plosone.org/article/info:doi/10.1371/journal.pone.0014162

The dopamine receptor is what antipsychotics work on. The diagnosis of schizophrenia has been used to suppress promiscious women and I guess men too though I think wanting sex was probably more of a problem for women back in the day than men. The sexual revolution changed this thankfully but sluttiness is probably still in some psychiatrists unwritten diagnostic rules.




Winter-born males were more sensation seeking than non-winter born males.

Season of Birth and Dopamine Receptor Gene Associations with
Impulsivity, Sensation Seeking and Reproductive Behaviors
http://www.plosone.org/article/info:doi/10.1371/journal.pone.0001216

Schizophrenia is also associated with sensation seeking and venturesomeness.

Dopamine receptors and altruism

Dopaminergic polymorphisms associated with self-report measures of human
altruism: a fresh phenotype for the dopamine D4 receptor
http://www.nature.com/mp/journal/v10/n4/full/4001635a.html

The link between biological brain mechanisms and human qualities is
extraordinary. Way beyond my level of understanding.

Mens rea and mental health

Mens rea is a legal concept about culpability and stuff. I'm not a lawyer but I can read a Wiki page.
http://en.wikipedia.org/wiki/Mens_rea#England

Here's another page
http://e-lawresources.co.uk/Mens-rea-intention.php

It seems doctors can avoid this legal concept.

They killed 1,800 old people unnecessarily every year when they used major tranquillisers on old people. There is significant vidence about the risks of these drugs before this mass slaughter happened. Even after the mass slaughter happened they continued to use these drugs on the elderly. And yet there has been no punishment.

These drugs are used on schizophrenics for life and it is cheaper than bothering with non-drug treatments which are safer. Many have died as a result of these drugs. Many have had their life expectancy reduced. There are other options but these are not investigated. The drugs are treating behaviour, not any real physical component of a biological disease, and they cause real disease. There is significant evidence to support this idea and there is significant evidence to challenge the biomedical model of mental illness. And yet the psychiatrists get away with it. There is no punishment.

There is the case of the suicide of David Reimer, a child experimented on by an immoral doctor, Dr Money.
http://en.wikipedia.org/wiki/David_Reimer

Dr Money was not punished through criminal law and mens rea, i.e. the understanding that such tortures wrought upon a person by a doctor are illegal and f they lead to death they should be treated as murder because the doctor knows the risks.

There's what happened to H M.
http://en.wikipedia.org/wiki/HM_(patient)

This may be harder to apply mens rea to. The result was not a physical death of the patient but it was a mental death. Rather than hang their heads in shame and help this individual have the best quality of life, mental health researchers used this poor human being for the rest of his life.

Doctors who performed lobotomies without knowing or considering the damage were reckless. They sought answers to behaviour using neurological means. They killed a few people. There was no punishment.

Rosemary Kennedy's story is a prime example. She was a risk to the good name of the Kennedy presidential family because of her behaviour so they used a lobotomy on her. She was probably promiscuous and flighty and fun loving in a time when this was considered a behaviour different to the norm. The operation damaged her for life but there was no punishment for the person who committed this malfeasance.
http://www.cerebromente.org.br/n02/historia/important.htm

Doctors who performed ECT - a clearly dangerous treatment which causes seizures to change behaviour and emotion - and killed patients also got away with it.

I wonder if any patients have died because of a failed paradoxical intervention where a suicidal patient is goaded by a practitioner into suicide? Mens rea and culpability under British law - to my lay perspective - would mean the mental health practioner responsible for goading a person into suicide is guilty of murder. But they'd get away with it.

It is perhaps because doctors are assumed to be treating real illnesses. Though there is no truly scientific proof and though every decade seems to see the lie of the biomedical model disproven evermore there seems no punishment for the crimes to individuals and humanity.

So many deaths and years of lost life expectancy because it is doctors doing it. They're murdering and slaughtering people when they know the risks and they know they're not treating real illnesses. The risks of treatment of real illnesses is how they get away with it in phuyscal healthcare.

The example of the dementia patients on major tranquillisers is the example which makes the difference. The drugs did not heal the illness. The drugs did not arrest the degeneration of the brain. The drugs did not heal the brain. The drugs were used for social convenience and not treatment of a real illness.

1,800 old people a year died unnecessarily. There was no punishment for this crime. Doctors continued to use the drug on old people even after this mass manslaughter happened. Not one was punished but, according to my lay understanding of mens rea, they should have been because they were not treating the illness.

I'm not a lawyer so I probably don't understand. I don't understand why they were not punished. After all, isn't that the point of law and the theory of crime and punishment? Punishment is there to prevent further crimes. Without punishment psychiatrists and other mental health professionals will keep on killing patients because of their behaviour and emotions.

Occassionally a doctor gets struck off for doing something unethical. For example my old psychiatrist Theodore Southzos. All he did was connect too much with his female patients. No one died. But they struck him off.

1,800 old people were killed. Many others have been killed by drugs or ECT. Yet there's no punishment for them. They broken the "first, do no harm" bit of their fundamental oath yet they continue to 'treat' behaviour and emotion and kill their patients.

No one gives a shit about another dead schizophrenic. That's why.

Wednesday 7 September 2011

How can you help someone who's made the decision to kill themselves?

Honestly I don't think you can unless you know what drove them to it.

I think it's just something that they have to go through. I think the
compassionate thing would be to legalise assisted suciide but there's
none of that compassion in mental health politics.

Obviously the framework of assisted suicide is key to avoid regrettable
deaths but for those that want to die they'll do it anyway. 6,000 people
a year are successful and many more fail.

The reason there's nothing a person can do unless they know what drove
them to it is because people who've made a decision to do something
don't usually ask for advice after they've made a decision. That's
pretty fucking obvious. They might go through a personal journey and
change their mind but this is where it is left in god's hands.

Knowing god is a fucking cunt means leaving it to god is a bad idea.
Prevention of people getting to this stage is the only solution.
Preventing people making that cold, rati9onal decision to kill
themselves is what I'm talking about as well as preventing the
circumstances which lead a human being to prepare to die.

MAD, science, religion and let the human race die

the early 20th century the theoretical steps were discovered for
splitting the atom. The Manhattan project rapidly weaponised this in a
short space of time during the late stages of WWII. Oppenheimer, the
lead researcher, quoted Shiva when they tested the first bomb. "Behold I
am made death, destroyer of worlds."

After WWII the Russians quickly caught up. This once third world country
quickly became a superpower thjrough socialism/capitalism applied.
America and the USSR built immense nuclear arsenals. The fission bomb
was superseeded by the fusion bomb, a weapon of war which could release
the energy of the processes of the Sun uncontrollably on Earth. The
figures were something like at the peak there was enough nuclear weapons
to nuke each bit of the land area or habited areas 7 times over. One
nuclear submarine could wipe out an entire nation and there was nothing
anyone could do to stop it.

This was the state of play in the mid-20th century. The public assume
the superpowers stopped making more effective weapons of mass
destruction. Particle and quantum physics research kept on going so
there's no reason to assume the weaponisation of this tech also didn't
continue.

I imagine that at least two countries - maybe more - have doomsday
weapons. I assume these are weapons so powerful they could crack the
Earth's crust and bring forth a nuclear winter the likes of which has
not been seen since the ice age. The principle of nuclear power in the
Cold War was MAD. Mutually Assured Destruction.

The sickness in humanity is the only way to ensure peace was MAD,
because without MAD the Cold War would have been a hot one.

But who cares? Perhaps if the human race were wiped out a better race
would evolve, one that cared and gave a shit about each other. One that
would develop without the ills of the modern day.

It's been 2,000 years since a schizophrenic - Jesus - gave his life. He
gave humanity commandments. Thou Shalt Not Kill. The first one. You know
what? They don't even teach this shit in schools anymore? Science
lessons don't offer this sort of basic wisdom, but we learned the
processes which go on in a nuclear bomb.

Science is the new religion - the new dogma of absolute truth where the
truth of god is replaced by the truth of the scientific method - but it
doesn't teach the good stuff which religions offered.

Alcohol really does work

and so does cannabis. I've been so much more consistently unhappy since
I stopped smoking cannabis. I've also been a lot more mental. I'm sure
many people in my local area could attest to that. They only see the tip
of the iceberg of the madness inside.

Alcohol works too. Last night I found my mind wandering to my lost love.
This soul pain seems unendless. I drank and it salved the pain.

Such s the value of personal medications found by personal experience
which work for unique individuals (we're all unique). If I went to a
doctor and said, "please mend my broken heart" then they'd know not what
to do. They have no science to answer this important question. They have
no life experience and no wisdom.

The French had a system for this way back when. Rather than death
romantic French men would join the Foreign Legion. Their culture knew
there were men who were like this. They may want to die for other
reasons. Their culture, without our modern methods, developed a way to
help these men.

Now we ask doctors to solve our problems. LOL. So many of them are
alcoholic anyway so they already know the answer but they can't
recommend their own medication to their patients.

4 continua of mental health

The two standard ones are psychopathology and distress. The latter is a
complicated one given the third one I've been thinking about.

The third one is subjective report of mental unwellness. I separate it
from psychological distress because I assume psychological distress is a
feminised continuum based upon affect and particularly low mood.

Mental unwellness can be concurrent with low mood or it can be separate.
This third continua is about individual measures. It is about pure
subjective report of mental unwellness. It is determined not by
psychiatrists or psychologists. It is defined and determined by an
individual.

The fourth continua is flourishing...or perhaps thriving. Essentially it
is achievement of potential - either for the individual or for society.
What that separation is about is a person with a high capability for
physics who wants to be basketball player. Their flourishing in
society's valuation is for them to be a physicist. Their flourishing for
themselves is to be a basketball player.

the film Happy Gilmore might explain this better. The main character
wants to be an hockey player but he's rubbish. He ends up learning golf
and he's amazing. His bipolar tendencies - that's how I see Happy(the
main character's name) - abate as the film progresses. This is one of
the key changes in the film. His psychopathology reduces. He flourishes
at something he doesn't want to flourish in. The film doesn't really
explore his distress levels apart from the harm to his grandmother by
Shooter Magavern (the bad guy). I don't remember the p[arts of the film
which explain his report of subjective unwellness.

In the end he gets everything he wants but this is a film and doesn't
explore the true complexities of the mind. I don't think there was a
Happy Gilmore 2 which explores the problem of the hedonic treadmill. The
latter is perhaps one of the reasons that few things work on long term
followup once treatment has ended.

Tuesday 6 September 2011

Of course I'm wrong

On the comment nelow.

The first and most important label is human being.

What is the right world for the mentally ill?

There are terms like service avoiders (those who stay away from
services) and survivors (of psychiatric abuse) of which GENUS is but one
organisation which represents the voices of those who others don't..

Perhaps the catch all term is those who incur a mental disability or,
perhaps more correctly, those who have worse outcomes in life because of
their emotions, behaviours, beliefs, choices or experience of
consciousness.

This avoids the problems of precision in language and concepts of terms
like "service user" and "consumer." It avoids the inaccuracies of the
term "mental illness" (after all, homosexuality was not ever an illness).

The focus on the idea of social disability also lays the 'blame' and
what is the true cause of the disability: societies not made right for
human beings and the human condition..

The human race is beautiful in its diversity and complexity but the
post-Industrial age developed world societies are designed to value
this. They value those who feel a little but not a lot. They value those
who work continuously and stably. They value those who contribute to
Gross Domestic Product rather than Gross Domestic Happiness. Those that
are like robots prosper and the rest are disabled by a society which
isn't adapted to our beautiful diversity.

The mental healthcare system's current mode of solving this problem is
to change individuals to make us homogeneous. The method is to make us
all fit in to these false expectations of humans. It doesn't work and
this is one of the reasons behind the evidence that people with a
diagnosis of schizophrenia - one of the severest mental disabilities -
have better clinical and social outcomes in poor developing world
nations compared to the UK or US. (World Health Organisation IPSS on 2,
5 and 10 year follow up).

Changing the focus of the language to enforce the idea of chaning
society rather than changing individuals is the sort of manipulation of
language which leaves a distaste in my mouth. However the idea of the
problem being routed in society rather than the individual and shifting
treatment towards this cause is a laudable motive.

The change in healthcare towards this goal of changing society is best
seen by the Time to Change anti-stigma programme. It is just the
beginning and I hope it is the harbinger of the real change we need to
reduce the suffering and disability.

Changing society is the future of mental healthcare and if words have
power then I think the terms used should describe this future of mental
healthcare.

Monday 5 September 2011

Addicted to altruism

I wonder if this pathology has ever been codified.

Of course not. Though the pattern could be the same for any other
addiction related mental illness the social judgements which are really
what the mental health system is all about haven't bothered to
pathologise this. Probably because they depend on the altruists like the
Eygptians depended on slaves to build the temples.

The pattern could exist though. The first hit of the joy of doing
something unselfish or for the greater good. The continued altruism
always hoping to feel that first hit again. The repeated abuse of the
high which leads to it no longer being a high. The poverty and other
poor outcomes which come from altruistic instead of selfish ways of
getting high.

But it's not considered bad. LOL. Drink and drugs are, and those who are
addicted to them are so heavily stigmatised and discriminated against.
Even by the Human Rights Act. LOL.

Sunday 4 September 2011

It is hard to extend compassion to this person

http://news.sky.com/home/article/16061457

This kid murdered.

What happened to him to make him become?

Bridgend is already the site of the only 'organic' (unplanned) cluster
suicide in modern UK history.

I assume there's lots of research going into the causal factors of the
Bridgend suicides. What are the factors which created this solitary
homicide? The research is about understanding that homicide and suicide
is also another canary in the mine (see post below if you don't know
this phrase).

This article or another notes that the kid liked watching horror movies.
An idiot might want to ban horror movies but the evidence in reviews
shows that these movies are watched less by killers than the average,
perhaps because it is a safe way to externalise these violent desires.

It would be the sort of thing the Conservative government might do
because it suits their idea of a moral society. The journalists have
picked out this little bit of information and added it to the story. I'm
sure it will fuel a debate about something or other.

But the search for the answer of how people become needs to be better
aligned with a search for absolute truth.

We've all done stupid things as kids. At least I hope we all have. It's
part of growing up.

But what about the basic commandment about taking another person's life,
be it on a whim, as punishment or in war? Thou shalt not kill. It took a
schizophrenic to work out that this was the first commandment over 2000
years ago.

And yet today this doesn't seem to be embedded in the same way as the
first commandment of Jesus.

The result is the child will be spending a long time without liberty. He
clearly didn't want to get caught for the crime because he lied to get
out of it but it shows the crime and punishment system doesn't stop
homicides. The death penalty wouldn't have stopped the victim's death.

But what could have? Well perhaps having the compassion to understand
the biopsychosocial model of cause of events and stuff. Particularly to
stuff like this.

But this sort of question method and the desire to use this method
starts with compassion. It starts with wanting to understand why and how
another human being would come to kill another. It does not come from
the judgements that people will make about this boy's actions in the
present.

An idea for all population mental health and changing society as an objective of mental healthcare

Rather than see mental disorders as a cost to society and a disability
see them as the canary in the mine. Canaries were taken into coal pits
because they'd die before the miners would die from gas poisoning.

--skip past this section of you're interested in getting to the crux of
the idea--

I'm thinking about this because I'm thinking about sleep[. I haven't
drunk anything tonight so I'm not asleep yet. It's the first time in a
week I haven't had a good few drinks in the evening. It's not surprising
I'm finding it hard to sleep. I'm currently sleeping a lot. 10-12 hrs a
day. It isn't enough but that's to do with suffering rather than
anything else. My mood is ok at the moment.

It lead me to think about a Harvard study on sleep. It found that 8hrs
is associated with living longer and 6hrs is associated with better
performance at work. It is a study I use to ask people a question: would
they prefer to sleep 6 or 8hrs?

It also lead me to ponder what 12hrs might do. I suspect there's a bell
curve for the living longer thing. I remembered another study noting
that people used to sleep 9.5hrs before the invention of the lightbuilb.

--you can read on from here--

Seasonal Affective Disorder is now a recognised syndrome. It took a
while for psychiatry to accept this as a mental illness.

Everyone goes through a degree of change in mood and whatever else
during winter. Obviously SAD is an extreme.

A person with SAD might be able to get reduced hours during winter to
assist with their SAD.

But why do it just for them. Why not do it for everyone? Why not ,make
standard practice to reduce working hours during the winter months.

We are, after all, still mammals. For all our technology and stuff we
forget our basic animal needs. In winter we want to hibernate and rest.
I think it's why so many people feel the winter blues.

So why not change society to accept that humans have these animal needs
too? Bring the 35hr working week down to 26hrs or whatever. Allow people
to hibernate.

It takes this principle of seeing mental disorder as a canary in a mine
to begin to think about the changes in society. Rather than see their
disability as a problem see them as the warning light that there's
something wrong.

Allowing everyone to benefit from the privilege extended through
disability discrimination law is the true path to an equal society for all.

Saturday 3 September 2011

I wish I'd never fallen in love with her

I tried not to. I really did.

I've never so fallen out with the emotion of love till this beautiful
person became the thing I love so dearly.

She may not be the most beautiful girl in the world but to me she is.
She may not be the funniest girl in the world but I think she is. She
may not be...well she's pretty smart. She's not perfect but she is to me.

Her eyes are gems. Her cheeks pearls. Her lips the finest petals. Her
voice the most beautiful melody.

She was great company. It's why she's the only person I'd want to share
my journey of life with. I would love to sit in silence with her.

Her smile made me smile. When her eyes lit up my heart lit up. When she
thought I was being an arrogant, cocky idiot it would only make me love
her even more.

If she was unhappy I would do anything to help..in my blundering stupid
way. If she were ever scared I would scare the thing that scares her. If
she were hungry I would give her my plate. If she were ever in need I
would give my all and my anything. If I have to be alone so she can be
happy then it is a small price.

I can't even look at her at the moment. It hurts so much inside. I saw
her last night and it took the wind out of my sails. It beat my bravado
from me and opened the chasm inside that will never heal. Not in the
months and year since I last saw her. This miserable paradox is another
of the unending miseries.

But I can't unwish my feelings for her. That's what feelings are all
about. Not rational nor logical nor swayed by reason. They are the curse
I have to live with. Otherwise I wouldn't be human.

But what I would do to undo this mistake of falling so deeply in love
with my best friend...

Some might say I should think positive. I should be glad I can feel this
intensity of emotion. I should believe that she misses me too...perhaps
in a small way... I just don't know, nor care.

My love. I miss you so much tonight. I just don't know what to do anymore.

I feel so cold and empty and alone

It seems nothing works for this inner torment. No solution but a
struggle I can little be bothered with any more.

Something the Dalai Lama said

Someone asked the Dalai Lama: "What's the thing about humanity that
surprises you the most?"

The Dalai Lamai replied:

"Man. Because he sacrifices his health in order to make money.
Then he sacrifices his money to recuperate his health.
And then he is so anxious about the future that he doesn't enjoy the
present.
And as a result, he doesn't live in the present or the future.
And he lives as if he is never going to die
and then he dies, having never really lived."

Trauma, schizophrenia and the internal reality

This is something I'm writing to a friend in response to qeustion about
psychosis as a manifestation of trauma.

"
I think trauma forces a person to withdraw into their inner reality
more. This was my experience during the emotional abuse. My dad would
lecture me for an hour or two about what a worthless shit I was. (no
exaggeration. This could happen 2 or more times a week and with the rest
of the family watching.) To survive I withdrew inside my mind.

This may be why there's a relationship between cannabis and
schizophrenia. It too helps a person to withdraw into their mind. It is
a usually a wonderfully pleasant state for me. Smoked alone it can be a
useful tool for thought and reflection and all sorts of other stuff. But
it too leads a person to this more internalised state.

I think this is sort of in line with what Jung said in his paper from
which he wrote psychological types. If I remember right he described a
scale. At one end were hysterics and at the other schizophrenics.
Hysterics focused on the outside reality. Schizophrenics focused on the
internal reality.

In Indian this internal focus would not be a problem. Those people
called schizophrenics might end up as Sadus. In the UK they might have
ended up as monks who spend lots of time in contemplation. In 2011
Britain this type ends up being traumatised and misunderstood. The
environment may also contribute. Schizophrenics attempt to function and
survive the suffering. They have to act normal to get along in modern
culture which forget that this state existed. This is what I reckon the
negative symptoms are all about. (These were defined before teh advent
of medication and they were what I experienced when I went through acute
psychosis.)

This internalised state may have value. It may be hard to understand in
modern society but that's a problem with modern society, not the
schizophrenic type. Trauma may cause a person to become more focused on
their internal reality but there are other routes. I don't know why
stress can be a trigger to psychosis.

The inward state manifests based on different psychosocial environmental
factors, e.g. 200 years ago there would be no paranoid schizophrenics
thinking their mind was being monitored using technology. I have the
image of the schizophrenic with aluminium foil on their head to block
the transmissions/monitoring. This experience has nothing related to
trauma expressing itself.

My experience was not related to my childhood traumas except in the
aspect of fighting for control. The fight for control - the fight that
my arm of scars is a timely reminder of and nearly cost me my life - as
well as the ultimate knowledge of the existence of a non-corporaeal
entity were primary facets of my last proper bout of psychosis. During
my childhood there was a few months where there was a battle for
control. This ended me up in a children's home and foster home briefly.
(it's noteworthy that even during this traumatic experience I still went
to school, revised and took my exams. My friends didn't believe me that
I was in a children's home because they couldn't tell any difference in
my behaviour.)

The main trauma though - the emotional abuse which partially results in
my low self-esteem (the other part being it is now a control mechanism
against hypermania) - was not part of the distress of psychosis. When my
non-corporeal entity tells me I'm worthless I agree then I just get on
with whatever I have to do. If the inner thoughts tell me I'm a genius
or whatever then I reject them and get on with whatever I have to do.

Alien hand syndrome, consciousness and interesting research

I had a notion about the internal dialogue. A treatment for epilepsy
involved the severing of the corpus callosum - the bit which connects
the two hemispheres of the brain. In a documentary one person who had
this done found one side of their body had a mind of its own. It was
quite frightening to watch as one arm involuntarily slapped the
patient's face. There is an even more severe operation done at John
Hopkins in the US where half a child's brain is removed to stop their
seizures. It leads me to consider whether these people have the same
experience of consciousness as anyone else, i.e. do they experience the
internal dialogue as we might? I know it's quite biomedical thinking to
consider this but...well...whatever. It would be an interesting piece of
research into the human consciousness.

This is the video of the patient who had the operation and lost
voluntary control of one side of her body.
http://www.bbc.co.uk/news/uk-12225163

It is also know as Alien hand syndrome.
http://en.wikipedia.org/wiki/Alien_hand_syndrome

The problem, of course, is the communication of the internal experience
of consciousness. Our language and science is so limited in this area.
For this to be truly scientific great leaps would be needed. Perhaps
this is more important: creating the true language of consciousness.
Then so much more could be done to explore this area.

There would also be the problem of very small sample sizes.

But let's say this research happened. If, perhaps, those who have had a
corpus callosotomy.or hemispherectomy.have a different experience of
consciousness then it would lend credence to the biological model of
consciousness. It may also add food for thought to the Cartian Theatre
idea or other models of consciousness and biology.

This relates to schizophrenia in that the experience of control of the
body or thoughts could be a battle between resident consciousness. The
basic assumption about consciousness is we have one inhabiting our brain
and making up our mind. One sentience. My personal experience of
psychosis shatters this idea. The internal struggles I faced during
acute psychosis and the observation of my consciousness makes me think
there are more than one consciousnesses operating upon our biological
brain matter.

It is my belief that that at least one of these consciousnesses is not
of my body. This soul or spirit or god or non-corporeal alien connects
with my biological brain. There is also my own consciousness. My "I".
There may be other facets too. It is hard for me to remember my
experience of consciousness to better describe this experience of
multiple awarenesses existing within my stream of consciousness - the
stream of consciousness which most people (those without the changed
state of awareness) consider as their unitary consciousness and sense of I.

Schizophrenia, voice hearing, paranoia, unshared perceptions, psychosis – the alternative view

This is something I wrote ages ago for Radio 4, back when I used to get
paid for my work in mental health information and activism.

"
The medical model
Firstly, the Western medical model sees psychotic experiences and states
of mind as something that
needs to be treated and is 'unusual', abhorrent and outside normality.
This goes back to Emil Kraeplin
and dementia praecox (the old name for schizophrenia) but this
misunderstanding stretches further back
in history. An analogy to the psychiatric view of psychosis would be to
describe an elephant by looking
through a telescope: they mistake the trunk for a leg and conclude a
five-legged animal is abhorrent.

The medical view is rooted in symptoms not causes. The medical view is
defined by either ICD-10
(used in the UK and most of the rest of the world) or DSM-IV (used in
the US and for research). In fact
the diagnosis of schizophrenia may only be people who are severely
affected by the distress this state
of mind causes. In fact the only meaning a diagnosis has is it indicates
the treatment program that a
psychiatrist would use however in practice the label carries with it
stigma from the public which further
adds to the person's suffering. There is also stigma in the profession
because some of the books on
schizophrenia paint a negative picture of those who are diagnosed with it.1

It is noteworthy that the traditional view of psychiatry is that these
experiences are not real however in
the last couple of decades this view is changing. This is through the
work of people like Prof. Romme
and Sandra Escher, the Hearing Voices movement, Rufus May, the survivor
movement and others who
challenge the status quo. However the alternative view of the experience
of schizophrenia/psychosis can
be seen in the Iliad where (apparently) actions are initiated by the
'hallucinated' voices of the gods2.

The medical model has looked at brain chemistry using MRI scanners but
has found limited evidence for
causality between the way we know the brain to work and the experience
of psychosis. Tiny differences
have been found in the amygdale, hippocampus and other parts of the
brain between people with and
without the diagnosis of schizophrenia. There is research being done
into genetic pre-disposition as
well, though this may be a resurgence of the hereditary argument –
something that can have dangerous
consequences (Hitler used this as a justification for chemically
castrating people with schizophrenia).

An alternate view
Many people who are diagnosed with schizophrenia look for ways to
interpret where these voices come
from. A common one is telepathy, i.e. that these thoughts are projected
into the mind from someone else
– you can imagine how these ideas could be extremely distressing. Other
people, including the famous
mathematician John Nash believed them to be a government conspiracy.
There are many different ways
people attempt to understand the experience of psychosis and where the
voices come from.

Other cultures view the experience of psychosis differently.
Rastafarians see the voices as those of their
ancestors. In Nigeria people who hear voices are thought to be possessed
by spirits. Hearing voices is
something that features in profound religious experiences. The voices of
god that saints and prophets
have heard are akin to the modern concept of voice-hearing. There is a
phenomenon (observed by the
medical profession) called Jerusalem syndrome where people who visit the
city experience psychosis,
yet many people would see this an ecclesiastical epiphany ,

The artistic and creative fields have had a longstanding relationship
with an alternate and positive view
of schizophrenia. It's not something that I know a lot about but there
people who are better informed
could cite several examples. One study found that subjects who were more
likely to experience
psychosis also scored higher on a scale of self-interest and skill in
music, art, poetry and mathematics.

There have been many famous people who have experienced voice hearing4:
Abraham, Moses, Jesus, Mohammed, Socrates, Joan of arc, Bruno (the
philosopher), Jung, Churchill,
Gandhi, Anthony Hopkins and Micheal Barrymore
(there are undoubtedly others).
It is worth noting that these people would undoubtedly be treated and
possibly sectioned had they been
exposed to the modern psychiatric system.
The fringes of the fringe

There is a view that psychosis/schizophrenic disorders are caused by a
state of awareness and perhaps
a higher state.5 It says that everyone 'hears' voices and those who
report the auditory hallucinations,
paranoia and other facets of psychosis are noticing what other people do
not notice. People commonly
talk about the voice in their head and see this as their 'self' however
people who hear voices may see
the self as one part of a conversation that is happening in their head,
as though there is a committee in
their head and they are the chair.

Freud described three parts of the self or mind: the id, ego and super
ego. He understood these through
observation of his own thoughts and considered all three to make up his
'self or 'I'. In the schizophrenic
mind the 'I' is only one of Freud's id, ego or superego and the other
parts may be considered to be the
auditory hallucinations spoken about in schizophrenia. Psychiatry might
consider schizophrenia to be
a breakdown of the self but it could also be a higher state of
consciousness or awareness and this is
something very difficult to understand without having experienced it.

For a person who has first become aware of the voices in their head the
effect on their esteem is
catastrophic: what a person would have known as free will before becomes
a fallacy. Every decision
they have ever taken suddenly becomes not their own but a combination of
them (their new sense of
I) and their voices6 (that they used to think was 'I'). All their
actions from the point of reaching this state
of awareness become seen as being controlled by these voices as though
they are a puppet. This
reasoning can explain some or indeed all of the negative symptoms.

The main problem with this theory of schizophrenia is that it is
virtually impossible to prove using the
hypothesis-testing paradigm that is the fundamental philosophy of
science. (interestingly the godfather of
this philosophy of science, Socrates, also was an untreated schizophrenic).
"

Women attempt suicide twice as often as men, but men complete suicide 4 times more often than women.

http://www.merck.com/mmpe/sec15/ch205/ch205a.html

Friday 2 September 2011

Abortion, the double effect and mens rea

The Double Effect was explained to me in a talk by a senior lecturer in
bioedmical ethics, a talk where I called him an idiot. LOL.

Personally I don't understand it but here's the info.
http://www.saintmarys.edu/~incandel/doubleeffect.html
<http://www.saintmarys.edu/%7Eincandel/doubleeffect.html>

I think I don't understand it because I'm not a religious person. I'm
not a lawyer either but I get he jist of Mens rea.
http://en.wikipedia.org/wiki/Mens_rea#England

Its the "knowingly bit" which seems to be confusing me.

Regardless, I think the rhetoric of abortion could be applied to
assisted suicide.

It's my body and it's my life and it's my death to chose how and when it
happens.

stuff I just wrote on acute/crisis care

I hope who I sent to bothers to read my shit.

1 - monitoring of deaths in psychiatric wards
One bit is from the Rethink Fair Treatment Now report. P11 onwards has the info they've uncovered on acute care. One of the most chilling things I've heard is
"Rethink has advised families in cases where a Mental Health Act ‘section’ has been lifted when a person is dying, so that there is no need to report the death to the Coroner for investigation. The solution to this would be extending the requirement to report deaths to apply to those who have recently been detained under the Mental Health Act. It is not fair to leave these deaths uninvestigated."

Anon 2010, Fair Treatment Now Report, Rethink
www.rethink.org/document.rm?id=11234

It is obviously very scary if it is true that NHS staff are fudging the figures; it may simply be a case of the need to remove a section top get treatment outside the confines of a psychiatric ward. Regardless, it means their deaths are not investigating nor noted in the figures.

2 - the lives of long stay patients + BME experiences
It leads me to something else though. Imagine spending that long in a psychiatric ward that you died in there.

This is a quote from the last Count Me in Census.
"67% of [BME] patients had been in hospital for one year or more; 31% for more than five years"

The lives of long stay patients are akin to the lives of prisoners, however the only crime committed by a long stay psychiatric patient is not getting better. The amendments to the Mental Health Act 1983 removed the treatability test so no  existing treatment needs to exist. There is no mandate to provide treatment and therefore this is de facto imprisonment; in practice the only treatment is drugs and these may not be working for these long stay patients. Their quality of life may be appalling too. I've only spent a month at most under section and it was awful. I can't imagine what 5 years would be like.

More information may be gathered from the NHS Information Centre which is responsbile for collecting these statistics. The hospital episode Statistics are also useful - http://www.hesonline.nhs.uk/Ease/servlet/ContentServer?siteID=1937 - but needs someone with some good Excel skills. Of course the most up to date figures would be useful. There's stuff other than gender, for example average length of detention.

3 - provision of beds
Rethink has done a press release on the result from this paper already. Sadly the authors of he paper didn't take into account episode counts which may help to build a better picture. I've emailed one of them but they've not responded.

This is the relevant text however there's a caveat.
"Between 1988 and 2008 the provision of mental illness beds in the NHS decreased by 62%, from 166.1 to 63.2 per 100 000 adults (total numbers decreased from 63 012 to 26 430; fig 1). During the same period the rate of involuntary admissions increased by 64%, from 40.2 to 65.7 per 100 000 adults per annum and exceeded bed provision by the end of the study period"

At the end of the study period is around the time the Community Treatment Order was introduced into the medico-legal framework when the Mental Health Act was revised. This was aimed at reducing the number of 'revolving doors' patients (the term given to those who would leave hospital but be readmitted within a year.

Association between provision of mental illness beds and rate of involuntary admissions in the NHS in England 1988-2008: ecological study
British Medical Journal
http://press.psprings.co.uk/bmj/july/beds.pdf

4 - progress in acute care for first episode psychosis
Once again I'd like to reiterate the need for progress in acute care. by progress I mean an alternative treatment paradigm, one which focuses on low or no dose medication. The John Bola review takes data from international sites where this is being experimented with. The UK is absent because there is no experimental or progressive treatment paradigm. The Bola reivew and the systematic review of Soteria both show better outcomes from these alternative paradigms compared to treatment as usual.
Bola, J. et al. 2009, Psychosocial treatment, antipsychotic postponement, and low-dose medication strategies in first-episode psychosis: A review of the literature, Psychosis
http://psychrights.org/research/Digest/Effective/PsychoSocialMoreEffective2009Psychosis.pdf

Calton, T. 2008, A Systematic Review of the Soteria Paradigm for the Treatment of People Diagnosed With Schizophrenia, Schizophrenia Bulletin
http://schizophreniabulletin.oxfordjournals.org/content/34/1/181.full

for persuading policy makers and doctors the review of Soteria is more persuasive than the John Bola review (because it is a systematic review and is published in a reputed peer reviewed journal) how the results for Soteria in the Bola review seem to indicate it may offer the worst of the outcomes of all the sites reviewed (if I remember right it had the highest number of suicides). The Soteria review persuaded a friend of mine who used to be a GP in the UK and completed a Masters in Public Health policy and Harvard.

The NHS is meant to be delivering world-class mental healthcare. That's what all the policy stuff says. The NHs is far behind is this area. People to speak to are Rufus May and the Soteria Network. There's a strong argument for any new paradigm to first be done in London because of the large population and high rate of psychosisi (2x higher than other cities according to the well regarded AESOP trial).

My advocacy of alternative approaches for first episode is based on my personal experience. In the New Horizons consultation, in my letter to Openmind which wasn't published, in my work to better the NICE schizophrenia guidelines 2 years ago and my current work on NICE's guidelines and schizophrenia treatment in general I am always promoting the possibilities of alternative approaches.

The simple reason is the trauma I experienced. There is evidence that hospitalisation can cause PTSD symptoms (no reference - it was from a talk by Jacqui Dillion, chairperson of the Hearing voices Network). It is my desperate hope that these alternative paradigms avoid the trauma and, as the small body of evidence shows, may offer better outcomes in the long term.

5 - ECT
This doesn't really work and it harms patients. Sham ECT is almost as effective during treatment and as effective on follow up. On the other hand ECT induces seizures which is geenrally a bad thing and it also means electricity is run across the brain which is another generally bad thing. This Read and Bentall review is causing a stir in international practice regarding ECT. Katherine Darton would be able to explain the significance. Essentially this barbaric treatment doesn't work better than the same treatment but without the electricity used. It has killed many people.

http://www.mindfreedom.org/kb/mental-health-abuse/electroshock/irish-times-read-bentall-ect
(Link to paper at the bottom)


Hope that info is of use to the campaign. Acute care is a very important area which is so desperately in need of progress.

Thursday 1 September 2011

To ne or not to be?

There is a lot of rhetoric in English NHS policy about healthcare. Often
choice is extended to those with real illnesses whereas it is restricted
for those who have mental disabilities. Involvement and listening to the
service user voice can often be an exercise in tokenism. Too often the
mainstream doesn't have the capability to listen to the service user or
survivor voice.

There are some examples of good practice in involvement and service user
citizenship. For example Marion Janner's Star Wards project.
http://www.starwards.org.uk/

The UK mental health charities purport to be the user voice. Mind,
Rethink and NSUN are examples. Unfortuneatly they follow Anglophile
top-down organisational practices (which contrast to the French system).
There are some good practice examples however there are bad ones where
user voice is used to justify or confirm the top-down campaign
objectives rather than full inform them.

The voice of survivors is often the least listened too. Many like Bernie
Owen (Damaged Minds) or Mary Maddocks (Mind Freedom Ireland) are active
in their efforts. Some have success too, for example on the grapevine I
heard that ECT had been banned in one area in England (I think it was
Leicestershire). Many others don't and the evidence is the lack of
progress. The speed of change is so slow. Those that speak in agreement
with the mainstream are listened too and those who don't are often
sidelined.

Too often though health services and national mental health charities
don't know how to listen. The charities are often facing a battle
themselves. The ideas of the survivor movement are usually far in
advance of the mainstream and - rather ridiculously in my opinion -
considered too radical. This means the organisations which are meant to
be our voice often take a soft position. They're also influenced by the
work of peer organisations working on mental health policy but which
don't have a strong user focus.

I must admit my own failings in this area. A few years ago I made a
lengthy personal response to the UK New Horizons mental healthcare
strategy. I saw it as an important opportunity to influence national
mental healthcare and put in a sizeable amount of work to ensure that UK
mental healthcare was humane and ethical. It was a ten year strategy. I
am unaware if my efforts made any impact.

For the last two years I've been working on stuff related to our
national clinical guidance. I've spent hundreds of hours reading and
thinking about best practice recommendations for the treatment of
schizophrenia. During this time I have been excluded from receipt of
mental healthcare until my addictions were resolved. As I am finalising
my work into a coherent document I admit I am selling out on my beliefs.
I am attempting to steer away from radical or survivor-based ideologies
because I need to speak the language of the hegemony and get them to
agree. I am doing this through writing to my Minister of Parliament and
I doubt she is aware of the progressive theories. She may consider
mental illness a real illness. She will be worried about cost
effectiveness and I've had to cage some of my ideas in these terms. I've
had to bring psychiatric evidence to bear to further my point because I
hope my MP will once again forward my views to the National Clinical
Institute for Excellence, the Department of Health and the local hospitals.

This is the burden of activism. I am desperate for impact because I fear
many people are dying and being mistreated all in the name of
compassionate mental healthcare. The mainstream, in general, still
consider the paradigm of illness applied to behaviour and emotion to be
a real thing,. The mainstream don't understand Foucault's arguments nor
the sociological aspects of mental healthcare. It has been my burden to
leave these out of my current work in the hope that what I write has impact.

I've explained this little bit of my current life to help answer the
question of what is a survivor and what is a citizen, and can they be
exclusive. In a sense and in this example they can be. I can be a
survivor - someone who has suffered through ill treatment and become
burned into demanding progress beyond what the mainstream can understand
- or I can serve the goals of citizenship and activism but insodoing -
for the price of impact and effectiveness - I can not be true to being a
survivor, at least in this example of lobbying.

I suppose the exclusivity of pure surivor and effective activist may be
a facet of my fear of lack of impact. I see a somewhat black ad white
picture in this sense: the ineffective survivor/radical or the
(hopefully) effective sell out. My belief is citizenship is aligned with
servitude therefore I chose the latter over my own integrity as a survivor.

As Shakespeare said, "to be or not to be? That is the question."

I wonder if anyone has surveyed the average salary of people who have a severe mental illness?

I wonder if anyone has surveyed the average salary of people who've been
in a psychiatric ward?

The discrimination that women faced a century ago is akin to the
discrimination which the mentally ill face. It's not the same. It sounds
like women had a really fucking awful experience. The mentally ill
still suffer a lot of discrimination.

There is a significant difference in the disability, discrimination and
exclusion faced by the severely mentally ill compared to those with
common mental disorders when it comes to salary (and of course other
areas of life).

So many are poor. So many are excluded from employment by a variety of
factors related to their life course through mental illness and deficits
in other people and employment structures.

The severely mentally ill are as capable as automotons and some may even
excel if ever given the opportunity. Just like women and men.

I dare not denigrate the suffering of unmarried mothers in the early 20th century...

...by comparing what happened to them to what happens to psychiatric
patients today and how the immorality of the past may be the immorality
of the present which we can not see.

What happened to those women was terrible. What happened to women in
general - subjugation, oppression, discrimination - in the early 2-th
century was awful. It continued for too long but times are changing
thankfully.

Unmarried mothers and detention in 2-th century mental health instituions

http://uk.answers.yahoo.com/question/index?qid=20091110160657AAeN4ye

This is deeply saddening.
"Unmarried mothers without family support or independent financial means
could be held in Mental Institutions on the pretext that they were
morally deficient. Their babies were taken from them and placed for
adoption, but the mothers remained forcibly detained."

A snip from the book linked to at the bottom of the page.

"
Poor Law practice discriminated against them, judging them to be a
particularly wanton example of self-induced poverty. Unmarried mothers
were sometimes given less food in workhouses than married women, and
if they had a second illegitimate child they might be forced to wear
distinguishing
gowns as part of their disgrace.78 As with other paupers, many
were forcibly returned to their original home area under the settlement
laws. In desperation the babies were often abandoned, sold or even
murdered.
"

"

Early intervention for psychosis

is one of the new ways to pathologise those who aren't ill.

I wouldn't give so much of a shit if early intervention didn't mean
drugging a person for life. But it does at the moment. This means a
person who is never going experience psychosis or full blown
schizophrenia is given harmful medication, medication which reduces life
quality and life expectancy as well as causing real illnesses and death
for some.

apparently the King's Fund argue it is cheaper to do this. I would argue
it is cheaper for them to suck on my chocolate salty balls. I would
guess the people who work there have never been on antipsychotic
medication. Perhaps they should try it for the rest of their lives
before they recommend that anyone else is given this medication.

It would save more lives in the long run if the people who thinking drug
solutions and early intervention are a great way to save money. Kill
those fuckers off for killing people without need. Give them the
experience of what it's like to live on strong behavioural change
chemicals. Let them experience the harms of psychiatric
medication....and then....only then...could they dare to recommend early
intervention for psychosis involving drug treatment.

Cunts. Murdering fucking cunts. I bet they'd love to drug kids too.

Stick them on 700mg a day of quetapine, 3000mg of sodium valporate and
225mg of sodium venlaflaxine.

Then, perhaps, they'll stop writing shit about early intervention for
psychosis being cheaper. Those doses above are what I had to take. I
wasn't psychotic. I almost ended up on clozapine instead of taking all
those drugs.

The humane option is talking therapies and changing society. But those
fuckers don't think like that. Those fuckers would drug their elders to
death using the major tranquilliser. After all, it's far cheaper to kill
the elderly using major tranquilliser drugs than accept their behaviour
as natural to the human race.

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About Me

We It comes in part from an appreciation that no one can truly sign their own work. Everything is many influences coming together to the one moment where a work exists. The other is a begrudging acceptance that my work was never my own. There is another consciousness or non-corporeal entity that helps and harms me in everything I do. I am not I because of this force or entity. I am "we"