Tag Archives: myths

Should we be worried about the rise of antidepressants? #PillShaming

6 Jan

Another post where I’ve set out my thoughts in tweets and hope to write it up into a blog post but, in the meantime, here are the tweets:

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How’s your day been? A Day in the Life

15 Nov

How are you cartoon

How’s your day been? That’s a question you’ve probably asked many times, and been asked a fair few too. It’s part of the normal everyday engagement between people that oils the social wheels. Often it’s not a genuine enquiry in the sense that a detailed response is not expected: instead, it’s a baton being passed, with you expected to pass it back and say, “Fine thanks. How about you?” That “fine” can mask a lot of days that aren’t fine, whether better or worse, but we’re all expected to join in the general cheerleading, pretending to be “fine” too.

For people struggling with mental health problems or managing a long-term mental health condition, how our day has been is probably a bit of a mystery to the general public. This can be a source of assumptions, stereotypes and prejudice, whether that’s the “lazy faker” of depression who just needs to take themselves in hand and go for a brisk walk; or the “dangerous maniac” of schizophrenia who should be monitored and contained for public safety. These prejudices and stereotypes can feed into self-stigma that brings about a sense of isolation.

Our daily lives are also likely to be a bit of a mystery to the professionals who provide our care, whether that’s a therapist an hour a week, 20 minutes with a psychiatrist every 3 months or 10 minutes with a GP every few weeks. What it’s actually like to live with a mental health problem can be pretty uncharted territory unless you’re doing it yourself or living with someone who is. There’s so much more to good mental health, and to good mental health services and support, than the NHS, drugs and talking treatments. People just like me are out there, living our lives, quietly getting on with things day to day, and there’s a new project that aims to capture that reality. It’s called A Day in the Life.Beatles A Day in the Life yellow

A Day in the Life (the mental health project, not the Beatles song) asks people with mental health problems to share what their day has been like – and what has helped or made the day worse – on four set days over a year.

The project aims to shine a light on the everyday lives of people with mental health problems to raise awareness and to help the general public better gain a better understanding: to challenge myths and bust some stigma. It also aims to get people who may never have blogged before writing about how their day went – and perhaps then finding an online voice they never knew they had. There’s guidance on how beginner bloggers can start writing.

But another objective – and the reason the project is funded by Public Health England – is to help policy-makers understand what makes a difference – good or bad – to the lives of people with mental health problems. Although not a scientific study, the project will provide an insight to help influence policy decisions on services provided in future. The online snapshot diaries will also help to highlight emerging themes and suggest future areas for investigation.

I’ve signed up to take part in the project and have already posted my entry for the first day, Friday 7th November. The remaining three days will be in winter, spring and summer 2015.

Follow the project on twitter using hashtag #DayInTheLifeMH and scroll down to find out more about the project and how you can take part.

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Below is my entry for 7th November, which will appear on the Day in the Life website when everyone’s contributions so far – totalling around 370 – go live on Monday 17th.

Please note: I chose to speak very candidly about what I experienced that day, so please read with care if you’ve been affected by suicide, suicidal thoughts or depression – or simply scroll down to the bottom where you’ll find useful links.

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I’m on Twitter – a lot! So, as usual, after turning off my alarm, the first thing I did this morning was to check what tweeps I follow had posted, to catch up on news in the mental health world. Then, returning to bed with breakfast and my pet, as it was the last day to sign up to #ADayintheLifeMH, I sent out a series of tweets to encourage as many people as possible to sign up. The more sign-ups, the more varied a picture of living with mental health problems it will provide.

Next, I checked what had been happening on the #SamaritansRadar hashtag. Samaritans Radar was launched by the Samaritans in October and, ironically, had had a disastrous impact on the Twitter mental health community. Numerous tweeps had contacted the Samaritans by Twitter, email, phone and letter to beg them to take the secret automated surveillance and alert app offline. Experts in various different professions had written about legal and ethical concerns. Mental health experts by experience had blogged about their pain and distress. There was an online petition, an investigation by the Information Commission and even a group proposing legal action against the Samaritans. I was involved in the campaign to have the app taken offline till it could be made safe.

On checking Twitter, it was clear that the outcry was continuing. And the Samaritans had tweeted their followers about A Day in The Life Mental Health!

Next, I tried to work on a blog post about the app. The powerful psychiatric medications I take have an impact on motivation, focus and concentration and, since I’d started taking them, I couldn’t quite connect the dots. It was cripplingly frustrating and is one reason I spend so much time on Twitter: 140 characters just about matches my attention span! Being sedated so your higher functions no longer work properly makes it hard to manage a home and get everyday tasks done, let alone get anywhere near organising your own healthcare in a system that relies on people being pushy. Being a sedated blob doesn’t get you very far and is one reason I haven’t been able to get proper treatment for myself over 3 years since I was discharged from hospital. Here I am, still parked on welfare benefits.

I struggled for a while to try to gather together my thoughts on Radar down on paper, but was unable to do so. I tried to make an overdue phone call, but couldn’t. So I had lunch, then caught the bus to a medical appointment.

Later, as I walked back through a tree-lined park on a beautiful autumn afternoon listening to the radio, I heard a trailer for this evening’s BBC Radio 4 Any Questions saying that one of the topics the panel would discuss was the Assisted Dying Bill. This caused my own “suicide radar” to go off.

Ever since getting notice of eviction from my home so my landlord could sell it (2 months’ notice, out of the blue, after over a decade), I’d been tipped into a deep, debilitating depression. At times, I was utterly tortured by suicidal thoughts. My home had been my security and stability and now I was losing that. And the awful Radar app had thrown a spotlight on suicide, meaning my Twitter feed was full of intellectual suicide talk.

Suicide was being discussed as a fascinating concept, rather than what it was to me and many other mental health folks using twitter: a very real mental pain we were struggling with at that very moment. At times, it seems as if there’s a part of my mind monitoring everything just in case it might be useful in some way in despatching myself – my own “suicide radar”. That’s why the Assisted Suicide Bill caught my attention. Being able to die with dignity alongside friends and family – rather than experience years of unalleviated suffering or go for a secret and uncertain DIY method –  was an option I’d like to have available too.

I’ve had thoughts about suicide in all sorts of places, with all sorts of people and whilst doing all sorts of things. Sometimes I’ll be plagued by all-consuming thoughts of suicide; other times they’d be a background hum, like a reflex response to every turn of events, a mental tic; and sometimes, as today, there’d be calm planning. These thoughts were going through my mind as I walked through the warm autumn afternoon, kicking up piles of fallen leaves. No-one looking at me would have known.

Back home, I checked Twitter again. At 6pm, the Samaritans tweeted to say that, after 10 days of uproar, the Radar app had been suspended! It was a begrudging statement which did not acknowledge the distress the app had caused, and the so-called apology was an example of how not to apologise. But, nevertheless, the announcement meant that mental health folks could sleep easier in their beds over the weekend. I continue to feel uneasy as to what “suspension” means in practice. Whilst no-one doubts the app was developed with good intensions, the way it was imposed on everyone had damaged trust in the Samaritans.

I spent the evening debating with people on Twitter about Samaritans Radar, listening to Any Questions, then retiring to bed to read Everyday Medical Ethics and Law. It didn’t use to be my sort of book at all, but that was before I was unlawfully arrested, sectioned, held in seclusion and treated by force. Nowadays, chapters on patient autonomy and choice and how they are glibly brushed aside for mental health patients concern me deeply.Close quotes

Sadly, lack of concentration scuppered my attempts to read the book – so it was back to Twitter.

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It’s okay to ask for help. Yes, but what if there isn’t any?

12 Aug

It is okay to ask for help Mind Charity

It’s okay to ask for help, as today’s Mind charity tweet says. However, it is NOT okay to have to ask again and again and still not get appropriate and timely help – or any help at all.

Thoughts exploring the theme of lack of actual help available for mental health problems, whether or not you’re able to ask.

(To be expanded into a written blog post when I have time.)

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“A murderous psychosis”: mental health and dangerousness

28 Jul
Photo credit: Sean Jones QC

Photo credit Sean Jones QC @seanjones11kbw

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You know the stereotype: the “mad axe-murderer” or “deranged maniac” who appear in the media in the extremely rare and therefore newsworthy instances where someone with serious mental illness commits a violent crime. I wrote recently about how the “unpredictable and potentially dangerous” stereotype is so accepted that it goes unnoticed, assumed to be a natural fact; how it is therefore repeated, and reinforces negative assumptions about those of us managing mental health problems in our daily lives. Almost goes unnoticed, that is, because I for one do challenge outrageously stigmatising and inaccurate stereotypes about mental ill-health when I see them. I say this sort of thing:

  1. People with mental health problems are far more likely to be victims of crime than perpetrators; and are far more likely to be victims of crime than the general population.
  2. People with serious mental illness are far more likely to take their own life than that of someone else; and the vast majority of people with serious mental illness are never violent towards others.
  3. The risk factors for violence – such as being male, having a past history of violence, or of alcohol or drug abuse – are the same as for the general population as they are for people with serious mental health problems; therefore, measures to reduce violence will be more effective if targeted at the general population, not specifically at mental health patients.
  4. Violent acts during psychosis are so extremely rare that it is not possible or practical to predict let alone prevent them – other than by measures aimed at the general population.
  5. Psychosis is causal in violent crime in a tiny minority of cases; where someone with a mental health diagnosis commits a violent crime, the mental illness causes the crime to be committed in only a tiny minority of cases. In other words, almost always, mental illness is simply another of a person’s characteristics, in the same way as diabetes or red hair.
  6. People with mental health problems are, well, people.

Yesterday, I was asked by Sean Jones QC to put my money where my mouth was and come up with research links to dispel his “murderous psychosis” stereotype that I’d just challenged. How did I know that these statements, which all contradict the stereotypical media portrayal of people with mental health problems, are true? How could I prove these points to someone who wants to know – or at least give them sufficient information so that they can go away, do their own checking and make an informed judgment for themselves?

When someone asks me what my proof is that the “murderous psychosis” stereotype is untrue, I usually refer them to organisations like Time to Change, Mind and Rethink Mental Illness. In other words, experts; organisations that make it their full-time business to know what’s what in the field of mental health.

Both are a good starting point. However, they may not satisfy someone who wants to drill down into the details themselves. Of course they could contact those organisations direct themselves, but what can I do to help? What else is there, if you want to dig a little further? Here are some more links I send to people:

Here’s more about psychosis and on still being human whilst having serious mental health problems:

  • Sometimes (I Have Schizophrenia)/All Of The Time (I’m Just Human) (3 mins). There are many more videos in Jonny Just Human, Jonny Benjamin’s YouTube channel on his experiences of schizoaffective disorder and other stuff on being human. In the words of Jonny Benjamin, “We’re not all dangerous or violent, as some papers would have you believe.”
  • Finding Mike – Short film (45 mins) including Jonny Benjamin talking about his experiences of psychosis (here’s the 50 second promo trailer).
  • Facts about psychosis from mental health charity Mind – “Psychosis (also called a psychotic experience or episode) is when you perceive or interpret events differently from people around you. This could include experiencing hallucinations, delusions or flight of ideas.”
  • A personal experience of psychosis from mental health blogger Charlotte Walker (April 2014)
  • Simon says: Psychosis! – Short film in which (amongst others) people with lived experience of psychosis talk about their experiences of psychosis in the context of receiving treatment from a particular Early Intervention in Psychosis service (June 2014)

These are all good places to start. But where else might I point people to? I’m good in 140 characters – but that’s about it. I’ve retweeted interesting studies when I’ve randomly stumbled across them, and that’s how I’ve formed my views. I’m not a mental health researcher. I’m not even organised. I don’t have access to scientific reviews behind pay walls. I haven’t been collating a database of relevant research – unless you count my list of favourites on twitter (currently running to over 2,000).

New research is published all the time but the general public (including me) will mostly only have access to press reports on the research, which typically highlight some juicy aspect to ‘sell’ the story to potential readers. I’ve also noticed that not all research is particularly good quality: sometimes research seems to ask the wrong questions; some studies look at just criminals or just people with psychosis, rather than looking at the whole population. Mostly it seems research conflates cause and correlation, simply counting violent crimes by people with mental health problems when the fact of having a mental health diagnosis (either at the time a violent act was committed or at a later assessment) does not prove that the mental health problem was the cause of the violence.  There was a US study I came across that said, in convicted violent criminals with serious mental illness, the mental illness was the cause of the offence in under 7% of cases. It was interesting because it highlighted the difference between having a mental health problem at the time of a crime and that mental health problem having been the cause of the crime. But then I lost the link to the study and haven’t been able to find it since. Like I say, I’m good in 140 characters.

Like plane crashes, “murderous psychosis” makes the headlines because it’s rare. It’s alarmist, inaccurate and causes suffering to people managing mental health problems in our daily lives. There’s ignorance about psychosis & violence, with the media stereotype we’re fed. But, when challenged, some people do want to know more.

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“He’s a psycho” – Professor Adrian Furnham on the importance of cleansing the workplace of undesirables

19 Jun
Harry Enfield as Kevin the Teenager (PA)

Harry Enfield as Kevin the Teenager (PA)

 

Have you seen this? Rachel Hobbs of mental health charity Rethink Mental Illness asked me this afternoon. She was referring to the charity’s response to a piece in the Sunday Times headed “I’m sorry, he’s not a differently gifted worker – he’s a psycho”. I’d just arrived home so hadn’t but, sadly, I had already seen the piece that prompted the rebuttal – and been shocked to the core.

The Sunday Times piece to which Rethink had issued a response advises employers of the necessity of screening job applicants and employees to weed out undesirable ones. The author writes:

“There are three important questions. The first is how you spot these people at selection so you can reject them … The second is, given that they have already been appointed, how to manage them … Sometimes it is a matter of damage limitation …  The third is how to rid your workplace of these maladaptive personalities, and that is the toughest question of all.”

Putting aside for one moment the reference to “maladaptive personalities” and the telltale use of “these people” (a clue that we’re about to experience a group of people being made “other”), this all seems fair enough. After all, what employer wants to end up lumbered with rogues or duffers, or people who are simply not suited to the post being filled?

In any recruitment process, whether to fill a new role or replace a departing employee, some sort of selection process is inevitable. Indeed it is welcome, since it will give both prospective employer and employee the opportunity to see whether post and candidate are a good fit. I’ve read plenty of books and done courses including interview techniques, networking, career development and workplace psychology. I’ve undertaken interviews and assessments. It’s an interesting field and one that can bear fruit for employers and employees.

So what’s the problem? The problem is that the premise of the piece is – regardless of the role to be filled – people fall into two categories: they are either desirable or undesirable in the workplace, and the “unemployables” are to be hunted down and excluded. “These people” are to be avoided at all costs. “These people” have “maladaptive personalities”.

“These people”, according to the piece, fall into 5 categories, namely people who exhibit what is classified as antagonism,  disinhibition (Harry Enfield’s Kevin the Teenager – pictured above – is the illustration the author provides for this category), detachment, negative affect or psychoticism (bear with me – this isn’t made up). Each, as described in the piece, has a clear link to mental health problems.

Reading the piece, I had several strong immediate reactions – to the extent I sat down and wrote out my thoughts (then, unhelpfully, lost the piece of paper; perhaps there should be a sixth category of “unemployables”, the abstent-minded).

First, I took away the message that (based on the characteristics of the people described in the 5 categories, some of which I share) I was most definitely not wanted in the workplace. I was not wanted in the workplace and there were armies of workplace psychologists devising tests designed to make jolly sure I wouldn’t be able to sneak in undetected.

It felt as if, when I finally feel able to re-enter the competitive employment market and, were I ever to make it through to a job selection process, there would be a head to head battle. On one side would be the selectors, trying to expose my “maladaptive personality”; and, on the other, me, desperately trying to keep my deficiencies and undesirable characteristics under wraps. Then, in the unlikely event I was able to pull the wool over their eyes and win on that occasion, I would always be at risk of exposure and therefore dismissal. And, even if I started a job mentally healthy but then (for whatever reason – even if it was because too much work was loaded onto me at work, causing unnecessary stress) I became unwell, my employer wouldn’t seek to support me, a valuable employee, through that illness – but instead try to get me out.

I was reminded of the recent disappointment of prospective cabin crew Megan Cox. Notoriously, her offer of a dream job with Emirates Air was withdrawn when she disclosed a past history of depressive illness. In Megan’s case, it was clear that the prospective employer had based their decision on generalisations about depressive illness rather than the individual under consideration. Perhaps they were administering a standardised workplace psychological assessment which sought to weed out the undesirables. Megan Cox was deemed undesirable by Emirates Air. Lucky escape for them that they were able to spot her during the recruitment process. The piece made clear that, similarly, I would be weeded out.

Second, the contents made me want to send the piece to all those people involved in making decisions about the social security support of people who, like me, are managing disabilities, to show them the high barriers we have in getting into employment. Only today, it was reported that Employment and Support Allowance and the Work Programme were costing more than the predecessor welfare benefit Income Support and were getting fewer disabled people back into work. Is it any wonder that a system based around the notion that disabled people are out of work because of a lack of motivation (and incentives – or, rather, penalties) to seek work will fail when the actual barrier is the attitudes of employers – fed by pieces such as these – towards people with disabilities?

Third, having assumed at first glance that the piece was written by a generalist journalist to meet a deadline, I was gobsmacked to find it was written by a professor of psychology. A renowned academic – Professor Adrian Furnham – of a renowned institution – University College London – was the author. It simply did not compute.

So then  I did a little reading around the subject on the internet. I discovered that Furnham hadn’t made up terms like “dark traits” or “psychoticism”. No: they were legitimate. These terms came from last year’s new version of the US psychiatric manual (DSM5) and from workplace psychology (for the past couple of years).  The meat of the piece seemed to be almost a cut and paste from ideas that would be familiar to people who’d studied the field: nothing new, surprising or out of the ordinary. This wasn’t some rogue piece by a lazy journalist in a hurry: it reflected current thinking in (US) workplace psychology. That was hard to swallow.

However, on reading the piece again, there were some flaws (whether of the author or in the editing) which meant it was skewed to paint a worse picture than US workplace psychology actually seems to do. Thank goodness. For instance, the professor conflates the DSM5’s “maladaptive personality traits” (undesirable characteristics) with “maladaptive personalities” (undesirable people). To confuse a trait with a person is a big leap – and a damaging one for the people on the receiving end of the “undesirables” label. Furnham also conflates mental illness (with references to “disorders” and “pathology”) with personality disorders (he lists the 3 DSM5 clusters) and personality traits. Thankfully, therefore, the piece isn’t an accurate representation of the current state of play. In fact, it’s a bit of a mess.

In addition – as is common with fear-mongering pieces – the particular damage “these people” could do in the workplace is left vague; but the fact that they will cause damage is made plain.

The trouble is, however, that anyone not familiar with the nuances in the field (and that might be your average Sunday Times reader) would easily be expected to come away with the very clear message that people with mental health problems – yes, people like me – should be excluded from the workplace at all costs. And that is a damaging message.

Which leads me to my fourth thought on the topic: I wonder (and I don’t know) whether the piece might breach disability discrimination laws.

Furnham argues for keeping “these people” – people with “maladaptive personalities”, people whose symptoms which, as described, fall within mental health diagnoses such as anxiety, depression and schizophrenia – out of the workplace. My understanding is that, where a condition impacts on someone’s health for 12 months or longer, that counts as a disability and is protected by law. In other words, discriminating against someone in these circumstances counts as disability discrimination.

I’m trying hard to see how advising employers on how to avoid employing or get rid of people with disabilities is any different to advising employers to not employ black people or gay people or women. Whether or not it amounts to disability discrimination, it’s clear it is not good to advocate discrimination in the workplace.

Rethink Mental Illness has been in contact with the author and are hoping to have a piece – written with other mental health charities – published in this weekend’s Sunday Times. Rethink reports that Furnham and colleagues were surprised at the reaction to the piece and believe it has been misinterpreted. It seems to me there is a clear opportunity for a dialogue, and for largely commercially-focused workplace psychologists to gain a greater understanding of the crossover between their work and mental illness and the role they can play in the negative stereotypes.

Until employers are willing to consider job candidates or existing employees as individuals rather than categories based on assumption, the prejudices and assumptions of employers will impact on people managing mental health problems like a form of modern straight jacket.

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Update smallThe Sunday Times published a letter from Rethink Mental Illness and others on Sunday 22nd; and the following day Furnham wrote to explain, apologise and request that the article be withdrawn. Constructive engagement and a willingness to engage produced a positive result.

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Employment and Support Allowance

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Emirates Air and depression

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Here’s the full text of the piece written by Adrian Furnham and published in the Sunday Times on 17th June under the heading “I’m sorry, he’s not a differently gifted worker – he’s a psycho”:

Open quotesTWO things account for the success of a popular personality test: extensive marketing and the reassuring message you get with your results. Whatever profile you have, or type you are, “it’s OK”. We have different gifts. We can’t all be the same. Everyone is fine. Celebrate your quirkiness.

The message makes it easy for consultants and trainers. Researchers, however, know that one of the best predictors of success at work is (raw) intelligence, along with emotional stability and adjustment. But too many in the selection business are afraid of using well-proven tests to assess these factors for fear of having to deliver feedback such as: “Sorry you were unsuccessful in your application: the reason is that you are too dim and too neurotic.”

However, the message of “we are all OK” is not true. There are people with a distinctly unhealthy personality. There are many words for this. Some talk of “dark-side” traits, others of “abnormal” traits. And for more than 20 years, clinicians have talked about the maladaptive personality.

Researchers have recently tried to spell out traits that are most clearly manifest in the maladaptive personality. There are five of them.

Antagonism
This is defined as manifesting behaviours that put people at odds with others. It has components such as manipulativeness, deceitfulness, self-centredness, entitlement, superiority, attention-seeking and callousness.

Antagonistic people put everyone’s back up. They are selfish, self-centred and bad team players. The clever and attractive ones are the worst, because they use their skills and advantages to get what they want, come hell or high water.

Disinhibition
Defined as manifesting behaviours that lead to immediate gratification with no thought of the past or future. It has components such as irresponsibility (no honouring of obligations or commitments), impulsivity, sloppiness, distractability and risk-taking.

Think Kevin the Teenager. It can mean enjoying shocking others with unacceptable language, outlandish clothing or poor manners. This may be amusing in the playground but hardly acceptable in any form in the workplace.

Detachment
This is defined as showing behaviours associated with social avoidance and lack of emotion. It has various components, such as a preference for being alone, an inability to experience pleasure, depressivity and mild paranoia.

These are the cold fish of the commercial world. They seem uninterested in nearly everything and certainly the people around them. Some seem frightened by others, most just not interested in being part of a team.

Negative affect
This is defined as experiencing anxiety, depression, guilt, shame, anger and worry. It has components such as intense and unstable emotions, anxiety, constricted emotional expression, persistent anger and irritability, and submissiveness.

These are the neurotics of the world. They can be very tiring to engage with and highly unpredictable because of their mood swings. The glass is always empty, and they seem always on edge.

Psychoticism
This is about displaying odd, unusual and bizarre behaviours. It includes having many peculiar beliefs and experiences (telekinesis, hallucination-like events), eccentricity and odd thought processes. Some may see such people as creative, others as in need of therapy.

Psychiatrists have grouped those with personality disorders into three similar clusters: dramatic, emotional and erratic types; odd and eccentric types; and anxious and fearful types.

There are three important questions. The first is how you spot these people at selection so you can reject them. This is easier with some disorders than others. It is virtually impossible to spot the psychopath or the obsessive-compulsive person at an interview. Clearly, you need to question those who have worked with them in the past to get some sense of their pathology, which many are skilled at hiding.

The second is, given that they have already been appointed, how to manage them. There is, alas, no simple method that converts the antagonist into a warm, open, honest individual or the disinhibited worker into a careful, serious and dutiful employee. Sometimes it is a matter of damage limitation.

The third is how to rid your workplace of these maladaptive personalities, and that is the toughest question of all.

Adrian Furnham is professor of psychology at University College London and co-author of High Potential: How to Spot, Manage and Develop Talented People at Work (Bloomsbury) Close quotes

 

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Autism and mass murder

21 May

Minority report Philip K Dick

Some thoughts on the new study that finds a link between autism and mass murder (here). I’ll turn it into a proper blog when I have time but in the meantime it’s the tweets I sent earlier today together with the responses of the lovely twitter people. Below are links to mainstream media coverage.

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This morning, there was an interesting piece on BBC Radio 4’s Today programme reporting on a study which reported a link between autism, head injury & mass murder. One of the researchers was interviewed, together with a professor of criminology who provided an interesting critique.

It was  a shame that the presenter seemed unsure how to pronounce “autistic”. And a very great shame when he repeated the harmful misconception: “surely murderers are psychotic”. And funny to learn that the study into mass murder and serial killing was done at the Glasgow Institute of … Health and Wellbeing.

Of course, as with other such studies looking at the characteristics of people who’d committed heinous crimes, The implication is we’re to walk down the street keeping our eyes peeled in case someone with & chops us up with an axe. What is the purpose of such studies? What’s the desired outcome from going through old murder case? And to what use can the results be put? The aim of such studies seems to be to find similarities between those who commit heinous crimes – to come up with groups & percentages. But what then? What’s the purpose in knowing these groups & percentages when such heinous crimes are incredibly rare? What’s the use? It must be a buzz for researchers when they come up with a theory ( + = mass murder) then find it works in other cases. The researchers claim the purpose of the research is predictive & preventative: to predict future murders, & prevent them. But can we? What prediction can we make by knowing a certain % of mass murderers have , when mass murderers are a miniscule % of people with ? What prevention can we do by knowing a certain % of mass murderers have , when mass murderers are a miniscule % of people with ? What prevention can we do by knowing a certain % of mass murderers have , when mass murderers are a miniscule % of people with ? How would we predict or prevent mass murder & serial killing – using some sort of screening programme? Who would we screen? And how? Screen all people convicted of one murder to see if they have & then predict they’re at risk for serial murder? Then what? Screen all people with to see if they have &, if they do, predict they’re at risk of being serial killers? And then what? What do you do with such predictions? How do you turn that into prevention? And how will you know it’s worked? If you screen people then predict their likelihood to be serial killers, what do you do with them – lock them up based on a prediction? Screen people & then, on the basis of statistics, predict they’re at risk for being a mass murderer, then lock them up? How long for? Where? Who does the screening? Who does the prediction? Who decides who gets locked up? Psychologists? Psychiatrists? Who? Considering such questions makes it plain & clear that prediction & prevention of mass murder in this way are non-starters. Predicting & preventing heinous crimes using screening programmes based on statistics from old cases will not & cannot work. Statistics & screening to predict & prevent heinous crimes makes for a good science fiction plot – but would not work in practice. It’s a simplistic solution with a superficial appeal which breaks down under any sort of scrutiny. Yet locking up people preemptively purely to prevent heinous crimes was looked at in the UK very seriously a decade ago. It was almost law. Remember the proposal to detain people with dangerous and severe personality disorder even where they had committed no crime? At the time it was said that 6 people would have to be detained to prevent 1 from acting violently. What about the other 5? So why – when screening, prediction & prevention could not work – do researchers quote them as justifications for their work? Hard to say. What is the reason for carrying out such studies? What do we hope to learn? And to what use can such knowledge be put? Hard to say. What is easy to say, however, is that studies linking with mass murder & serial killings raise fear & concern by & of people with ASD. Even though researchers – rightly – say the vast majority of people with are LESS likely than the general public to be violent. What are the benefits of such studies (other than to the intellectual curiosity of the researchers)? Press reports I’ve seen don’t say. The purpose & benefits of such studies are unclear. But, on the other hand, the harm caused to people with is clear. With mass murder & serial killings so rare yet so common, that’s a huge number of people needlessly labelled “potentially violent”. If you want to prevent (or reduce) violent crime, there are better ways to do it than screening people with . If you want to prevent (or reduce) violent crime, you will not do that by creating fear & suspicion of a vulnerable group. As Prof Wilson of Birmingham Uni said, theorising about mass murder doesn’t help us or get us any further in understanding mass murder.In other words, such studies shed more heat than light: they are inflammatory & stigmatising, without providing any helpful information. And yet they get reported. Because heinous crimes are rare & therefore newsworthy. And that gets researchers excited. Have people with or those who care for them learned anything helpful from the study? No. They’ve just got another reason to be fearful.

 

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Section 136: Mental health, places of safety and criminal records

10 Apr
My Enhanced Certificate from the Disclosure & Barring Service, April 2014

My Enhanced Certificate from the Disclosure & Barring Service, April 2014

This is a photo of the Enhanced Certificate I received yesterday from the Disclosure & Barring Service (DBS) which last year took over from the Criminal Records Bureau in providing criminal records checks.

Here’s a twitter conversation yesterday about places of safety, mental health and criminal records, including the law relating to section 136 (and yes, it is an arrest; and yes, it’s up to police to decide whether to include it in an enhanced DBS check) from the perspective of award winning police inspector Mental Health Cop.

I’ll write this up into a blog when it’s not bedtime! I’m having to be strict with my bedtime routine at the moment to try to get back on an even keel.

Night night.

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Patients or prisoners? Late back or escaped?

25 Feb

The Great Escape film poster

Have you ever been an “escaped prisoner”? Or, to be more specific, have you ever been in a mental health hospital and been more than half an hour late back from leave? I’ve done the latter. And, according to last night’s BBC London News lead story, these two are the same thing.

Yesterday, as I was working on the computer, I had the BBC on in the background. My ears pricked up when I heard that a story on a mental health unit would lead the news that night. But not for a good reason. Of course, it was a story about mental health and violent crime. I tuned into the news bulletin on iPlayer later on. And it was worse than I thought.

The story was about patients at the John Howard Centre, a mental health hospital in London. A request under the Freedom of Information Act had revealed that patients had been recorded as being over 30 minutes late back from leave over 200 times in the past 13 years. Patients coming back late to their ward? Not that interesting a story, you’d think.

That is until you replace the words “late back” with “escaped” and “patients” with “prisoners”. BBC journalist Jean MacKenzie had translated that into a report that over two hundred prisoners had escaped.

For extra frisson, MacKenzie delivered her piece to camera outside the high chain link fence surrounding the centre (a medium secure unit), and the story was illustrated with the unsmiling photograph of one such “escaped prisoner”, who had been convicted of murder. The message to the public? Behind these high security fences is a seething mass of unpredictable and potentially dangerous prisoners; and two hundred violent, deranged prisoners have escaped and are loose on the streets of London.

Somewhat different to the picture revealed by the Freedom of Information Act request. But far more lively for the evening news audiences, playing, as it did, to stereotypes and prejudices linking mental health and violent crime.

The way this story was reported, I would once have been recorded as an “escaped prisoner”. Who’d have thought it? When I was sectioned, I was once late back from leave. Why? Because I’d been at the funfair with my neighbour and her children (one in a pushchair) having been told by one nurse before we’d left for my two hours leave that I had half an hour’s leeway so long as I rang to let them know. We spent a wonderful time on the dodgems and other fairground rides and still had tokens left to spend when I noticed the time and realised I’d be back late unless we left immediately. I rang the ward right away, as I’d been told to do. This time, unfortunately, I got through to another nurse – the ward’s enforcer – who said no, I had to be back on time or I’d be reported to the consultant. I looked at my neighbour, she looked at me, we grabbed the children and ran all the way to the hospital. The elder child was dragged, howling with disappointment and hunger; the younger one pushed at high speed in the pushchair. I was delivered back to the ward just after the 30 minutes leeway had expired. Some “escaped prisoner”.

Here are some of the responses of the lovely twitter people:

Clairus (@Hellsbell) tweeted BBC London News to say:

“Why did Jean MacKenzie call mental health patients late back from leave “prisoners” who’d “escaped”?” apology needed!

Doris (@isthismental) did the same, but added more detail:

“Shocking repeated error BBC London News. Patients at John Howard Centre and any mental health hospital are patients not prisoners. If I’m 35 minutes late back from leave from hospital, it is right that this is recorded as AWOL [absent without leave]. It would be neglectful not to. Usually I’m late because my bus was late and [there is] only 1 irregular bus [that] actually goes to the hospital (that screams of stigma). All your report has done is whip up misguided fears and stigma about mental health and given Majorie Wallace a platform. I’ve been late back from hospital leave so I can get a take away. H&S [Health & Safety] rules say hot food can’t be kept so it’s take away or starve. Once I was technically AWOL from a ward, but on site. I ‘refused’ to return to the ward until homophobic abuse was sorted.”

Earlier today, I (and several others) received the following response from Antony Dore, Editor, BBC London TV News weekdays:

“You’re right – we shouldn’t have used ‘prisoners’. Have discussed this issue with those involved.”

To which I responded:

“Thank you. Will there be a correction broadcast in the same news bulletins tonight?”

Several others raised the same point, which is that, if a prominent report is incorrect – and the story lead the 6:30pm bulletin and was story 2 of 2 in the 10:30pm bulletin – a correction should be issued with equal prominence. The incorrect impression given must be corrected.

It’s stories like these – presenting mental health problems and mental health units purely in the context of violent crime and escaped prisoners – which help to perpetuate ignorance, prejudice and discrimination against people like me. Stories like these create shame and stigma. Stories like these belong to the past. It seems the John Howard Centre is portrayed in stories like this as almost equivalent to a Broadmoor in the heart of residential London.

I’ll be watching the news tonight to see BBC London News does broadcast a correction.

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There was no correction on the evening’s news bulletin.

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The BBC is not alone in the way it reported the story:

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Schizophrenic leaders

9 Feb

Hypocrite

“As long as they’re not two-faced, hypocritical, schizophrenic.”

What would you say if you heard that in a meeting? Would you pipe up there and then to challenge the misuse of a psychiatric diagnosis in that way? Would you seethe and stay quiet, lost for words or not wanting to expose yourself to scrutiny? Would you follow up quietly afterwards? Or let it drop, for the sake of self-care or personal privacy? What’s the best way to educate people about the negative impact of stigmatising stereotypes and the use of terms related to mental illness as insults? What would you do?

Here are some thoughts on the topic of the casual use of the word “schizophrenic” in a derogatory way and how (and whether) to challenge it. First my musings, then the responses and suggestions of the lovely twitter people.

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That question: So, what do you do?

19 Dec

Difficult question (2)

I was at a party last tweek when, out of the blue, I was asked That Question. You know the one. The one you avoid answering (or even avoid being asked) if you don’t currently have paid work or if you’re working in a job you’re not especially proud of.

So, what do you do?

A pleasant, friendly enquiry, not unexpected at a social gathering, meaning, “What’s your job? How do you earn a crust? What useful function do you serve in the economy?”  It seems such a harmless question when you have a job, income and place in society in the conventional sense. But not all of us do.

My response? In this case, I trotted out the old “portfolio career” cover story. I mentioned a bit of this and a bit of that, brushing the enquiry aside with as few details as possible and then quickly asking about the other person, so as to change the focus onto them. Luckily, he was a talker. I’d side-stepped the need to disclose anything about my current status (which I would describe to myself or family and close friends as convalescence or sick leave). I learned a lot more about the guy I was chatting to.

Then, on Monday evening when participating in a hobby, that same question popped out again. Except, this time, it came with added emphasis, including a reference to the fact that I used to wear a suit to work:

So, you used to be a high-powered executive* What do you do now?

*(His words, not mine!)

This caught me off guard. I realised just how much of a gulf there was between what this guy (mistakenly) perceived my old job to bes and what I’d actually done that day. In fact, I’d let the gas man in to take a reading and written out 4 Christmas cards. Oh, and I’d opened a card from my mother containing a pDifficult questionostal order (which had felt a bit weird at my age). But that’s how I’d spent my day. My plan for the following day was to buy stamps. Hardly a high-powered executive.

How did I respond? Surprised, I went for a transparent dodge. It left the questioner in no doubt that I was avoiding answering, and left me wishing I’d had a bit more practice at lying. He stepped away, I stepped away, and we both pretended we were just getting on with our hobby.

In both cases, I’d succeeded in concealing the truth of my situation. In both cases, I’d put distance between myself and the other person. In both cases, I felt I’d had a lucky escape.

During a recession, it’s probably more socially acceptable to be “between jobs”. But on the other hand it’s probably a less good time to ask the question. What do you say when asked “So, what do you do?” Here are some options, including suggestions by the lovely twitter people, for how to respond.

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  • .Respond with a vague job description

I end up saying I’m now freelance, which is a total lie. – James (@polarbear3127)

“I’m a consultant” suitably vague? -Lexx Clarke (@LexxClarke)

Some retired people say the R word proved offputting to others so they may dress something up into ‘consultancy’ to ward off any negative reactions, especially when dating. – Roslyn Byfield (@RosylynByfield)

Ah, the portfolio career. This was the option I took at the party last Friday. It’s a delicate balance. I mumble about this (which I used to do) and that (which I’ve also done) and the other (which I’ve done a bit of in the past). I’m always hoping the questioner doesn’t do this, that or the other and therefore see through my story. I try to make this, that and the other all sound pretty dull, so the questioner doesn’t enquire further. But then, at the same time, I try to make it sound a little interesting so they don’t think I’m a total waste of time to chat to.

I think that probably I should sit down and write out a fake portfolio for my portfolio career (which did once exist but now doesn’t), so I can reel it off as needed. And also so I remember what I’ve said to people!

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  • Lie

I lie to taxi drivers and the women on the check out because I am so mortified. I know I don’t look ill, either. – Velveteen Rabbit (@velveteen85)

A Sufi master once said to me, “Ask a man no questions, for you may force him to lie.” That is true. If you put someone on the spot in a social situation by asking them a direct question like this, you may create distance by forcing them to fend you off with a lie.

Personally, I’m a terrible liar. If I’m going to lie, I know I’ll need warning and time to practice. When surprised, my lies are unconvincing – as they were on Monday. And I do believe that, if you’re going to lie, you really should take the trouble to lie convincingly. It’s only polite to put the questioner at ease rather than embarrass them with a bad lie.

I rarely ask people a direct question like “What do you do?” It’s not that I’m not fascinated and curious about what other people do. I am! It’s just that I’d rather let people tell their own story, in their own time. That way they reveal what they’re comfortable with you knowing. I’m not sure if people think I’m dreadfully self-centred for not asking what they do. Or perhaps, when engaged in a hobby, it just doesn’t matter.

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  • Deflect with a reference to personal issues

“I’ve had some family issues” is a good short term cover, and also technically not a lie as you are in your family … – ZaFoosBoootla (@dav0lah)

An alternative could be, “Ooh, I’ve been off this past week. Women’s problems.” I’d imagine that would probably curtail someone’s curiosity.

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  • A defensive response that keeps people at a distance

Ask them to ask you an easier question. Meliora Rose (@meliorarose)

 I hate that question, and need to find a suitable sarcastic answer. Sure someone will come up with one … – Martin (@msmithbass)

I always answer, “what do you mean, what do I *do*??!” Sometimes it makes them realise the rudeness & stupidity of the question – PWX (@flossiepie)

On the one hand, this response means you keep private what you want to keep private. On the other, it creates distance rather than intimacy. It doesn’t help develop friendships or potential work contacts. It just says “no”.

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  • Humour

Just tell them “I kill people with my mind.” Government pay is great! – My System (@JazzyJ1112)

Replying “for business or for pleasure?” normally gets a laugh, so then you can change the subject! come to the woods (@cometothewoods)

I spend most of my time drugged up to the eyeballs in a psychiatric ward, just out for the day. Now, where’s the hors d’ouerves? – Martin (@msmithbass )

You put the swirls in cats eyes marbles … Design new chocolates … Taste tester for mouthwash … The voice on the lottery show “I read, I write, I cook, I dance …” Sally Price (@saspist)

You’re an activist! Now people will avoid you for new reasons! – Verity Allan (@verityallan)

“I could tell you, but then I’d have to kill you.” – FWT (@FWT4)

The most popular response was humour. Always a winner.

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  • Avoidance 

My personal favourite and, it appears, popular with others too as a means for not having to give a vague job description, lie or deflect the question with sarcasm or humour. Just keep away from social situations where you might meet new people. That’s one I employed to good effect for a long time after coming out of hospital: I stuck to socialising with people I knew well.

I was speaking to a guy last Friday who’d isolated himself from other people since the 1980s. That’s when he’d lost his job and got his diagnosis. Ever since then, he’d kept himself to himself. He went to the gym, worked out, left – without making eye contact with anyone (except at the day centre we both attend). All for fear of being asked, “So, what do you do?” He was too ashamed he wasn’t working.

I suggested we sit down together, work out some lies, then go out and practice them on people! Thirty years is too long for a lovely guy like him to steer clear of people. Perhaps, if we each have our own convincing cover story to throw people off the scent, we might be more comfortable with meeting new people. Until then, we’ll both continue in our small social circles.

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  • Honesty

During the twitter conversation that led to the writing of this blog post, no one said they’d come clean and say they weren’t working at the moment due to mental illness. It could be a bit like marching into a nursery school in the 1980s and announcing you had HIV/Aids. That would have guaranteed a frosty reception.

Times are changing, but people who feel comfortable saying they’re not working due to mental ill health still seem in the minority, and understandably so: there’s still a huge amount of prejudice and discrimination against people with mental ill health. I long for the day when I can talk about my convalescence from mental ill health in the same way as people do about their experiences of physical illness. But we’re not there yet.

So, in the meantime, I think it’s time to polish off my portfolio career patter and practice those lies so that next time I’m not caught off guard.

 

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