Sunday, January 28, 2007

CARER INVOLVEMENT

Though the Government emphasizes Carer Involvement in every new Guideline, Framework, etc. and the Trust and other Services invite Carers to endless Meetings, seldom or never are Carers effectively involved, which is particularly noticeable in crisis situations. There are too many known cases which illustrate this fact and inevitably result in drastic measures having to be taken when the crisis has escalated into the practically unmanageable. To consider are: Drain on Resources, Stress on staff, More beds required / alternatively Police intervention and appearances in Court, and of course added trauma to the Service User and to his Carer. Why is the Carer not allowed to alert Services in time to avert these outcomes. What is the OBSTACLE or rather WHO OPPOSES THE CARERS INVOLVEMENT? This attitude goes against the most basic logic and common sense.

Friday, January 26, 2007

FOOD FOR THE BRAIN

At a recent Conference in London, Chrissie Sugden, MSc, spoke on METHYLATION in connection with depression, schizophrenia and autism. Methylation is the cell's ability to switch on and off gene activity. It is crucial for balancing neurotransmitters and for mental health. The vital nutritional co-factors for methylation are vitamins B2, B6, B12, folic acid, zinc, magnesium and the amino acid trimethylglycine. High homocysteine levels generally indicate poor methylation.
NIACIN and SCHIZOPHRENIA Dr. Abram Hoffer was unable to attend the conference but he sent a video presentation detailing his 50 years' experience of successfully treating schizophrenia with niacin (vit.B3). His comparison with hallucinogenic drugs of schizophrenic patients suggested that supplementation with niacin might prevent the conversion of adrenaline into the hallucinogen adrenachrome. In his first trials with 8 schizophrenic patients who had failed to respond to any other treatment he used 1 gm of niacin (combined with Vit. C to prevent oxidation) three times a day. This has remained the basis of his treatment since, although he has subsequently added vitamin B6, zinc and essential fatty acids. Dr. Hoffer also emphasised the vital importance of including hope in the treatment he offers his patients - with whom he always discusses what they will do when they get better - not if.

Thursday, December 28, 2006

Evening Standard

On 19th December 2006 appeared an article in the Evening Standard written by the Journalist Sue Arnold about her experiences with the Mental Health Services regarding her son who has been diagnosed with Schizophrenia. I reproduce here
some excerpts which strongly resonate with what many Carers in our borough have been and are concerned about and the issues that many of us have been bringing up at endless meetings with the Mental Health Trust, the Social Services, the D. of
Health, our MPs, in endless Meetings over many years. The changes we have experienced are an increased amount of paperwork in the form of Guidelines, National Frameworks, Reviews issued by different bodies, like the Mental Health
Trust, the Healthcare Commission, the Royal College of Psychiatrists. Alas, all these noble exercises have not resulted in
any noticeable implementation. On paper everything sounds perfect, the reality however, is very much like the excerpts
that follow: The mental health charity SANEs Marjorie Wallace advice: "Tell them that if anything happens to your son, you will hold them accountable". "Providing support before the accident happens was not the NHS mental health department's forte"
"The psychiatrist, who had never seen my son before, said that, in his opinion, there were not sufficient grounds to section him. I told him that the duty social worker, who has known my son for three years, had absolutely no doubt that he was extremely unwell and needed to be in hospital. SANE has analysed 69 independent inquiries into mental health related
serious incidents and found that one in three could have been prevented if doctors used a little more common sense and were less concerned with being politically correct. I talk to the duty nurse in my son's ward at the Chelsea and Westminster
Hospital every day. He often says the Consultant, who has not seen my son yet, is coming. I tried to speak to her just now but she is not taking messages. Don't worry, Ill tell her you called and you need to talk to her, said a switchboard operator, but it is after 6pm and nobody has contacted me". Above everything else, it is the TOTAL LACK OF COMMUNICATION that infuriates. - ward nurses who say they've never heard of the doctor who has been treating my son for two years, bed managers who direct you to the wrong hospital, social workers who haven't got round to seeing my son for three weeks because they are so busy, duty psychiatrists who go off duty without passing on vital information to their replacements.
Parents do not feature on the communications list. "Is he changing medication? When is his next tribunal? Is he going to another hospital? I ask and I am told they are not at liberty to divulge confidential information without my son's consent. He is the judge. But, right now, his tormented mind is incapable of judging anything. Families, especially mothers, who, when everyone else has washed their hands of the whole thing, are still there, begging and battling, hoping, waiting, praying, need to be kept informed, not shrugged off like an irritant. I shall still be here providing the only continuity, the only certainty my son knows."

Sunday, October 29, 2006

Responsibility / Punishment?

The SAGB (Schizophrenia Assoc. of GB) in its latest Newsletter has published an article entitled " INDIVIDUAL RESPONSIBILITY,
PSYCHIATRY and the paradox of PUNISHMENT". Dr. Sally Baker and Dr. Brian Brown discuss the peculiar case of a mental health system where no one is responsible except the client." The following are excerpts:
"The idea that people with mental health problems, even those deemed ill enough to have been detained or 'sectioned' under the Mental Health Act, should take responsibility, is becoming very deep rooted within the mental health services. These developments have left the older generation of mental health professionals aghast at the tragedy and brutality of vulnerable people finding their way into the prison system. Mental Health practitioners who qualified before the 90's have spoken of the change in climate, of how a new generation of mental health professionals has been educated to accept this idea uncritically, and of the inhumanity that they believe is arising from it. Some practitioners feel that there has been almost a complete abdication of mental health professionals' responsibility to care for their clients. Our attention was initially drawn to this issue when we became interested in the extraordinary reasons why some mentally ill people were being brought into contact with the criminal justice system and were even ending up in prison. Far from being serious offenders in the making, the events involved in these cases are often tragic and the so-called crimes extraordinarily trivial, i.e. the case of a sectioned patient being pursued through the courts for two years for calling an NHS manager a 'fat idiot'. The police expressed clearly that they were unhappy about charges being pressed, and possibly also unhappy that the man who had been called a fat idiot called them eight or nine times in the course of a single day to complain about this particular incident and insist that charges be brought. These charges are often pressed in the context of the 'zero tolerance' policy of threat to NHS staff."
"The notion of individual responsibility is extremely elastic, and it is this versatility that contributes to its usefulness as a means of undermining the status of the client. In the case of people who have been sectioned, the client by definition has had choice and responsibility removed from them. In many of these cases there seems to have been no discussion of the legal principles of McNaughton where the intentions and presumed responsibility of a person committing an offence can be called into question if they are mentally disordered."
"Many of the adult mentally ill are being cared for by parents entering old age and we have heard of carers themselves being told that they must also take responsibility when, at breaking point, they make demands on the services."
"In the course of our work so far we had many conversations about 'individual responsibility' with practitioners, discussing the possible ideological or political reasons why, after generations of seeing the mentally ill as predominantly not responsible for their actions, we should now be encountering such a forceful promotion of the opposite notion - that they should 'take responsibility' is clear that as our prisons swell with the mentally ill, as they continue to become destitute and as they (and
sometimes their carers) kill themselves, that some people cannot take responsibility, no matter how severe the sanctions. At a time when our mental health services are scandalously inadequate, one of our interviewees observed: 'if we deem the mentally ill responsible, it absolves us of our responsibility to help them'. EXACTLY WHO IS REFUSING TO TAKE RESPONSIBILITY?"

Sunday, October 22, 2006

RISK ASSESSMENTS - THE KEY TO A PATIENTS TREATMENT

From a survey of complaints received by the K&C MH Carers Association.
Risk Assessments (AOR1 and AOR2) often contain subjectively written assumptions and misunderstandings and exaggerate the "danger" of particularly African Caribbean & BME patients. A history of forensic assessments is often created even without orders from the criminal justice system, thus prejudicing the patient for life and impacting on referrals to more secure wards and hospitals, loss of liberty, long hospital confinement, denial of mainstream rehabilitation programmes including talking therapies, misdiagnosis, higher dosage of medication, fierceness of restraint, limited or compulsive choice of accommodation in the community and lack of prospects of employment. Psychiatrist tend to protect their sole responsibility by "erring on the side of caution", - which is an 'error' nevertheless and against the interest of the patient.
Because of the absence of "Strength Assessments" (cultural, creative, spiritual, religious,academic, occupational,capability, belief & value system etc.) the perception of the person is biased and out of proportion measures are taken.- A human rights issue.
Carers and family concerns are logged in the medical notes of the patient and equally assessed as a risk.
All carers feel very strongly that carers concerns for confidentiality reasons should be kept on a separate file and not be part of a patient's medical notes.
A patient can obtain his risk assessments and medical notes under the Freedom of Information Act and Data Protection Act from the hospital manager, but nevertheless often 'sensitive' information is witheld at the discretion of the psychiatrist.

Friday, October 13, 2006

SAGB

These are excerpts from the last SAGB Newsletter Oct. 06. "Please WRITE to the Home Secretary, John Reid, to express your disgust at the large-scale imprisonment of the mentally ill offender. The Rt.Hon John Reid House of Commons London SW1A 1AA DISREGARDED MCNAUGHTON RULES: Thus we punish, in increasing numbers, the mentally ill offender. The McNaughton Rules of 1843 seem to be totally ignored these days and yet these rules made it clear that if an accused person was of unsound mind they should not be punished for any criminal action they had committed. It is a most terrible indictment of our present-day society that we so often add cruel punishments to the suffering endured by the mentally ill.
URGENT NEED FOR MORE HOSPITALS AND NOT MORE PRISONS
The discovery of the NEUROLEPTIC DRUGS was undoubtedly a blessing, but they certainly are not a cure. If the drug is withdrawn then the symptoms return. And they have their own side effects. There are also reports that they can alter the structure of the brain. The real answer for cure will only come when the cause of the brain symptoms is discovered.
IT IS THE CAUSES WHICH MUST BE THE FOCUS OF ATTENTION AND NOT MORE NEUROLEPTICS.
Research on physical causes of mental illness has been going on through the 20th C. The hypothesis of a genetic link between mental illness and coeliac disease is still being investigated. For details write to the SAGB (The Schizophrenia Assoc.
of GB, Bryn Hyfryd, Bangor, Gwynedd, LL57 2AG) for a copy of their No.42 Newsletter.