Today is World Mental Health Day, and amidst the stamping out of stigma and awareness raising there is also a loud and pervasive perpetuation of misinformation. I've already been asked to give money to people 'at risk of mental health', for instance, when mental health is surely the goal - mental ill-health is where it becomes problematic. I've certainly never been asked to donate funds to fight physical health."These shocking figures reveal an escalating crisis in women's use of antidepressants"I appreciate that their study goes on to explain that they are criticising the practice of prescribing antidepressants in the absence of any other psychological support, the frequently highlighted statistics like, "A quarter, 24%, of women on
"Worryingly, our research suggests that there is still a huge stigma attached to mental health problems. With 1 in 5 not telling their families and 1 in 10 keeping it a secret from their partner, it is clear that women fear they will be judged on the state of their mental health",seemingly without the awareness that scare statistics about antidepressants contribute to that stigma. Their chosen headline is not that rates of women in mental distress is at crisis point, rather our use of antidepressants to cope with it.
a new charity-in-the-making, set up in January 2011 to support mentally ill people who may be adversely affected by changes to the UK benefits system.and it made me so, so sad.
to encourage people to give, ideally to commit to regular giving of £5 per month, to enable us to offer a life-saving safety net beneath the benefits system.
Feminism and Mental Health – Call for Submissions – Deadline: June 1, 2010
Call for Submissions:
The lived experience(s) of mental health in feminist communities
Call for submissions from people of any gender who identify with feminism and have lived experiences of a psychiatric diagnosis.
Our upcoming anthology, Feminist’s Navigate Mental Health (working title), will explore the complexities of navigating mental health and how a feminist identity may (or may not) shape those experiences, thoughts and feelings.
Submissions are welcomed in the form of personal short stories.
The submissions received will shape the outcome of the book. The final
manuscript will be submitted to relevant independent publishers.
Possible themes may include (but are not limited to):
o Coping – what works and what doesn’t
o Any positive aspects of your mental health that are commonly considered deficits
o Treatment preferences and past experiences
o Medication
o Personal/lived understandings of your diagnosis (acceptance or rejection)
o Stigma/tension around mental health issues in the feminist community
o Feminism and well-being/strength/empowerment
o Feminism and distress
Guidelines:
o Remember to take care of yourself while writing about topics that may be distressing;
o Good writing skills are great, but not mandatory! We will work with you to edit your piece;
o Submissions should be saved in .doc or .rtf, size 12 font, Arial or Times New Roman, and double spaced;
o 500 to 4000 words
o Include contact information and a brief biography;
o Only email submissions will be accepted;
o Submission deadline is June 1st, 2010.
Who we are
The women behind this project are Jenna MacKay and Alicia Merchant. Jenna is a psychiatric survivor and community activist who is particularly interested in violence and mental health. Alicia is a freelance writer and contributing editor for various magazines and has been published in CR Magazine, thirdspace and the Globe & Mail. Both self-identify as feminist, are interested in critical perspectives of health and live in Toronto. This project is not affiliated with any institution or organization.
Comments, concerns, questions and submissions should be directed to:
fnmhsubmissions@gmail.com
DO NOT EXPECT YOUR DOCTOR TO SHARE YOUR DISCOMFORT
Involvement with the patient's suffering might cause him to lose valuable scientific objectivity.
BE CHEERFUL AT ALL TIMES
Your doctor leads a busy and trying life and requires all the gentleness and reassurance he can get.
TRY TO SUFFER FROM THE DISEASE FOR WHICH YOU ARE BEING TREATED
Remember that your doctor has a professional reputation to uphold.
DO NOT COMPLAIN IF THE TREATMENT FAILS TO BRING RELIEF
You must believe that your doctor has achieved a deep insight into the true nature of your illness, which transcends any mere permanent disability you may have experienced.
NEVER ASK YOUR DOCTOR TO EXPLAIN WHAT HE IS DOING OR WHY HE IS DOING IT
It is presumptuous to assume that such profound matters could be explained in terms that you would understand.
SUBMIT TO NOVEL EXPERIMENTAL TREATMENT READILY
Though the surgery may not benefit you directly, the resulting research paper will surely be of widespread interest.
PAY YOUR MEDICAL BILLS PROMPTLY AND WILLINGLY
You should consider it a privilege to contribute, however modestly, to the well-being of physicians and other humanitarians.
DO NOT SUFFER FROM AILMENTS THAT YOU CANNOT AFFORD
It is sheer arrogance to contract illnesses that are beyond your means.
NEVER REVEAL ANY OF THE SHORTCOMINGS THAT HAVE COME TO LIGHT IN THE COURSE OF TREATMENT BY YOUR DOCTOR
The patient-doctor relationship is a privileged one, and you have a sacred duty to protect him from exposure.
NEVER DIE WHILE IN YOUR DOCTOR'S PRESENCE OR UNDER HIS DIRECT CARE
This will only cause him needless inconvenience and embarrassment.
One year after its damning report into the delivery of health care to disabled people, the Disability Rights Commission, the statutory watchdog organisation for people with disabilities in England, Wales, and Scotland, says in a new report that little has changed to bridge the gap in health care.
An investigation into healthcare given to people with mental health problems and learning disabilities shows they often get worse treatment than others.
The Disability Rights Commission (DRC) - which examined eight million health records - says the government could face legal action unless things change.
The study concentrated on primary care in England and Wales, which will soon fall under new equality laws.
The government says it has already started acting on the report.
The 18-month investigation shows that people with learning disabilities and mental health problems are more likely to have a major illness, to develop a serious health condition younger and to die sooner than the rest of the population.
Such people were less likely to have routine tests and screening to pick up signs of a problem in its early stages.
'Lazy fatalism'
The DRC also found that people with learning disabilities and mental health problems face "real barriers" when accessing services.
"The acid test of a national health service is not whether it works for those who are generally healthy, but whether it benefits those with the greatest risk," said DRC chairman, Bert Massie.
He said that the response from the government and the NHS was "deeply inadequate", a situation which was made worse by "a dangerously complacent attitude and a lazy fatalism" on the part of the medical profession.
"This is completely unacceptable - we need to see a radical change in the commissioning, targeting and delivery of health services in order to close this gap quickly."
The British Medical Association (BMA) has described the findings as "extremely worrying".
"As doctors, we believe it is unacceptable for the healthcare needs of this group of people to be ignored," said Dr Sam Everington, who co-chairs the BMA's equal opportunities committee.
He said the report would be discussed by GPs at the BMA in the near future.
The Department of Health said it would be working with the DRC to develop a full response to the investigation.
Mental health charity Sane said it was "disturbing" that people with mental illnesses were at greatest risk of becoming physically ill through neglect.
The charity's Marjorie Wallace called for a "new drive amongst all health professionals to ensure that each time a person with mental illness receives medical help, they are given a physical health check".
Eight million records
The investigation spoke to senior health professionals, policy makers and disabled people themselves.
Researchers analysed eight million health records in three primary care trusts (PCTs) in England and one local health board in Wales.
The DRC says that in spite of increased needs of these two groups, important checks are provided less often.
For example, people with learning disabilities who have diabetes have fewer measurements of their body mass index, while those who have had a stroke have fewer blood pressure checks.
The investigation identified a problem known as "diagnostic overshadowing" - where symptoms of physical ill health are often seen as part of a patient's mental health problem or learning disability and are not properly investigated or treated.
More than 50% of people who spoke to researchers said they experienced difficulties when trying to see their GP.
They identified the attitude of reception staff, inflexible appointments and inaccessible information as being some of the causes.
A few said they were not registered with a family doctor or had been struck off the list for being too demanding.
The report did identify areas of good practice but the DRC says services are frequently working in isolation and initiatives developed by specialists have not become part of the mainstream.
The government is being urged to put in place a number of improvements to "close the gap".
"We agree with the broad thrust of the DRC's recommendations and have already started to act," said health minister Rosie Winterton.
She said £7m had been made available to almost 90 PCTs to employ "wellbeing nurses" to help mental health patients.
The department has also allocated £42m to PCTs to help them to implement further measures to improve the care of people with learning disabilities.
There's a plague stalking the land and I'm terrified. But here's how to avoid Norovirus meltdown ...
Fear stalks the land; stalks my land at any rate. I've landed a starring role in my own personal horror movie: Day of the Norovirus. Gastric flu, the winter vomiting bug, spewmonia: whatever you want to call it, it's out there, somewhere, festering on every surface, waiting to infect me. Britain is diseased: a septic isle bobbing on an ocean of warm sick.
The media have had a field day, and to an emetophobe like me (someone with an uncontrollable, inbuilt fear of puking), this merely amplifies the terror. A headline such as "Vomiting bug spreads across nation" sets my pulse racing twice as effectively as "Mad axeman on loose".
Even worse are the war stories: vivid blog postings from survivors, gleefully describing the full extent of their biological meltdown. They're trying to outdo each other.
"I had to lie naked in the bath for three days, blasting hot fluid from both ends."
"Yeah? Well I vomited so hard, all the hair on my head got sucked inside my skull and out my mouth."
"Pfff - think that's bad? At one point I spewed with such force, the jet fired me backwards through a stained-glass window, and I literally burst apart on the patio, sending a geyser of vomit and crap 600 feet into the sky."
And if they're not online, they're crawling into the office to tell you all about them. While still infectious. If I was running things, it would be dealt with like a zombie outbreak: shoot all victims in the head at the first sign of infection, then barricade the windows till the end credits roll.
Worse still, it apparently strikes without warning. Infection takes 12-28 hours to come to fruition, quietly making its way to your small intestine, and, at first, you're none the wiser. The physical symptoms come on so suddenly, you only truly know you've got it when you suddenly spot a jet of vomit flying away from your face. And then you're locked in. It's like knowing the sun could explode at any second and being powerless to prevent it.
Naturally I want to avoid it like the plague, because it is a plague. And I've become an expert. Here's how to avoid it yourself.
Forget those fancy anti-bacterial handgels. They're pointless. Don't worry about breathing it in; unless you're unlucky enough to inhale a fresh droplet of sick or faeces (which can happen if someone explodes right beside you), you can still get away unscathed even if someone in your immediate vicinity comes down with it. It's not carried in saliva either. The one thing you must do is wash your hands with hot water and soap for a minimum of 15 seconds before putting them in your mouth, nose or eyes.
Easier said than done. Once you're aware of it, it's incredible how often you touch a shared surface, then your mouth, without even thinking. Say you pop to the newsagents and buy a bag of crisps: that door handle could be caked in sick germs, and you've just slid them down your gullet along with the salt and vinegar. Or you're in an office: you use someone else's keyboard, then eat a sandwich. Why not lick a toilet bowl and have done with it?
But even washing your hands is tricky. Take the workplace toilet. The door handle, the taps and the button on the automated dryer may all be infected. You have to turn the tap with your elbow, wash for 15 seconds (time it: it's longer than you think), then turn the tap off with the other elbow. Then you'll need two paper towels: one to dry yourself, and the other to open the door with on your way out. Unless you do all of this, you're doomed.
I've become an obsessive compulsive disorder case study, repeatedly washing my hands like Lady Macbeth on fast-forward, acutely aware of where my hands are at all times, what I've just touched, and where they're heading next. It's exhausting, like consciously counting every blink.
Yesterday, in an attempt to prod some sanity back into my life, I went to a restaurant. Eating out is insane: even if your chef is hygienic in the first place, unless he's devoutly following the paper-towel hand-washing routine outlined above to the letter he may as well wipe his bum on your plate. Nonetheless, I decided to risk it. Giving in to emetophobia would be like giving in to the terrorists, yeah? End result: I lay awake for hours last night, convinced that I'd start hurling any second.
There's one chink of sunlight for us emetophobes: we hardly ever actually vomit. There are various theories as to why, and it's all a bit chicken-and-egg: either we're so naturally hardy that vomiting is a rarity (and therefore more traumatic when it does occur), or we're so psychologically averse to it, we can will ourselves to stop. In fact, if I was on Heroes, that would be my superpower. A few years ago I caught a noro-style gastric nasty that made all my friends spew like ruptured fire hydrants. I lay in bed with cramps and a fever, battling extreme nausea for four days, and somehow didn't snap. Although what was happening at the other end of my body was another story altogether. Magic powers only stretch so far. That's why Superman wears rubber knickers.
Anyway, it'll blow over soon. The media have already got new scare stories to torture us with. In the meantime, if you're reading this on a bus, in an office, or at a shared computer, and you're eating your lunch - God help you. Now wash your hands.
Self-Harm and Medical Treatment
The National Institute for Clinical Excellence (NICE), in 2004 issued some guidelines on
The short-term physical and psychological management and secondary prevention of self-harm in primary and secondary care
These include instructions such as,
People who have self-harmed should be treated with the
same care, respect and privacy as any patient. In addition,
healthcare professionals should take full account of the
likely distress associated with self-harm.
[...]
•
If a person who has self-harmed has to wait for treatment,
he or she should be offered an environment that is safe,
supportive and minimises any distress. For many patients,
this may be a separate, quiet room with supervision and
regular contact with a named member of staff to ensure
safety.
[...]
•
Always treat people with care and respect.
[...]
•
Take full account of the likely distress associated with
self-harm.
•
Offer the choice of male or female staff for assessment and
treatment. If it is not possible to give people a choice, explain
why and write it in their notes.
•
Always ask the service user to explain in their own words why
they have self-harmed. Remember, when people
self-harm often, the reason for each act may be different on
each occasion; don’t assume it’s done for the same reasons.
•
Involve the service user in clinical decision-making and provide
information about treatment options.
[...]
•
Always offer necessary physical treatments even if the person
doesn’t want psychosocial or psychiatric assessment.
•
Always use proper anaesthesia and/or analgesia if treatment
for self-injury is painful.
•
Offer sedation if treatment may evoke distressing memories
of previous sexual abuse, such as when repairing harm to the
genital area.
[...]
• Don’t delay treatment because it is self-inflicted.
There is an awful lot of info in the report, but some of the pertinent points I have listed above.
I have heard endless stories of people in A&E being refused stitches to a self-injury cut, on the basis that 'You've got so many scars already, one more won't make a difference', or 'There's no point - you'll only do it again'. Similarly with people who have been refused anaesthetic before being stitched or having other painful treatments.
These situations appall me. People who have caused their own injuries deserve just as good (physical and psychological) care as those whose injuries were accidental or caused by others. People do not self-harm for no reason - it almost always occurs within a context of intense distress and desperation, and can frequently prevent the person from further harm (for example, suicide attempts) by releasing some of the pressure before it boils over.
People who need treatment for self-harm injuries are likely to be feeling dreadful, full of their own inner guilt for needing treatment, and very possibly feeling quite vulnerable. They do not need doctors or nurses or ambulance staff to reinforce their own feelings of self-hatred or to imply that they are wasting people's time.
I cannot talk for everyone who self-harms, and I also do not want to downplay the incredible sensitive and appropriate treatment offered by many medical staff. There are people who self-harm who won't relate at all to what I say, and there are doctors, nurses and ambulance staff who do brilliant work. There's no doubt about that.
However some people are treated appallingly, and this only leads to the person who has self-harmed to feel even worse about themselves, and further self-harm feels more appealing because they have had all their worst fears and feelings confirmed.
So, where am I going with this?
Well, there are cases of blatantly bad treatment (being refused stitches when they are needed, not using local anaesthetic where it normally would be used, derogatory comments by staff etc.), and these are easy to criticise. But there are also many, many occasions when someone who has self-harmed gets bad-mediocre treatment, but it is hard to know what the motivation behind the not-really-caring is.
I needed treatment the last couple of weeks for a burn. I went to a GP, who asked the Practice Nurse to dress it. The nurse's treatment was, well, lukewarm to say the least. She dressed the burn very badly - using inadequate dressings and suggested no follow-up at all. I needed to go back 2 days later because of the state of the dressing and the injury and although she dressed the injury better than the first time, it was still very careless, unnecessarily painful and there was no plan for follow-up again.
I came out of both of these encounters very upset, especially the second one. I was spinning between 'I deserve better treatment than this' and 'Why on earth should I expect decent treatment? It's my own stupid fault anyway'. On top of that, I really didn't know whether the nurse didn't treat me well because my injury was self-inflicted, or whether she was actually just quite incompetent and not very interested in general.
I still don't know the answer to that, but the following week I saw a different nurse at the practice, who dealt with my injury competently, and was actually nice to me. It made a huge difference to how I felt when I left the surgery. I didn't feel full of self-hatred, full of self-loathing, full of self-directed anger.
I have that age-old double standard. I believe, without a doubt, that people who have self-harmed deserve and require treatment which is as good as people who have injuries which were accidental or caused by someone else. However, when it's *me*, I of course don't deserve a single nice word or a dressing which actually deals adequately with the wound. I am stupid and a waste of time, though noone else is!
I really don't know if I got sub-standard treatment because the nurse wasn't up to speed on burn dressings, or on 'bedside' manner, or whether it was because she didn't want to deal with a self-inflicted injury, or didn't think it deserved time and treatment, or indeed deal with someone who could self-injure.
All I know is that I came out of the appointment with the second nurse feeling much more positive and capable and listened to. I'm no expert on dressings, but even I knew that the first two were inadequate. I came out of those appointments feeling disgusting and loathsome.
I do believe that in terms of avoiding future self-harm, feeling positive and capable and listened to is certainly a better place to start!
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