All posts by Simon

Time to talk?

This month the mental health team is giving its support to the new campaign hoping to end discrimination against mental health.

It’s time to talk, it’s time to change.

The statistics show that 1 in 4 of us will need help from Mental Health services during our adult lives. However, we also notice that if we break a leg we celebrate it with our friends, signing the cast and showing us care, but if we have a mental health problem we keep it to ourselves and our friends may even avoid us. This campaign wishes us all to address this imbalance.

As someone who has suffered depression I welcome this initiative. I have always believed that I have the right to talk about my experience and be accepted for who I am. The response I get when telling people about my mental health issues is varied. I have met incredulity, one student’s reply on hearing I was a service user was “no you’re not”.

I was not believed because I did not fit their idea of how the mentally ill present. I have also met with a lot of kindness and a wish to know more. Talking about mental health also empowers those students who have issues themselves. I have found that those who have felt alone with their problems, and there are more than you think, welcome this approach

So now it’s up to you. Get involved in this campaign, end the silence and misconceptions about mental health issues and be a friend. Hopefully a little bit of kindness and care will help someone return to a healthy happy life.

The following addresses will take you to the websites where there is a lot of information for you to read

Time to change campaign website Facebook page & Twitter

Shrek theatre asks autistic boy to leave – what do you think?


The mother of an autistic boy said she was “ashamed of society” after her eight-year-old son was asked to leave a performance of Shrek the Musical.

James Geater, from Worthing, West Sussex, was taken to the Theatre Royal Drury Lane in London with another autistic boy by four carers.

They were asked to leave the auditorium because they were too noisy. James’s mother Karen said it was unacceptable.

The theatre said the party was asked to sit outside until James calmed down.

©BBC News 31st August 2011 (Link to full article here)

James’s mother is ashamed of society, but I would like to pose the question “Should poor behaviours be acceptable if they are the result of an illness”. In a recent blog Tony mentioned road rage. Is it the fault of this condition that people assault one another or do they still have choices? For many years I have told young men who have schizophrenia that assaults on others are not acceptable. Is it really unreasonable to ask that having paid to see a show I should be allowed to do so without distraction?

I remember travelling from New York to Baltimore on a bus with a very noisy child, who threw high pitched tantrums at any opportunity. His mother was asked to either control the child or leave the bus. What sort of society would strand a mother and small child because of its behaviour?

The phrase “For the greater good” has been used to allow some terrible acts in mankind’s history and maybe James should never be allowed to go to the theatre again so the rest of us can watch in peace or maybe the theatre should put on special shows for people with problems?

Photo of Shrek on Wikimedia Commons click here for information re author

Cruel world

The events in Bristol must be a source of shame and disgust to us all. I make no attempt to condone the actions of these appalling people but it got me wondering. If you take the conditions in that “hospital” must we fear similar events in the NHS?

A national company set up for profit, where workers seldom if ever meet the bosses, work long hours and are poorly paid, is it just Castlebeck or is this the future of the NHS?

Lack of support, control and training can affect the morale of workers leaving them embittered and shattering their self esteem.

I once heard a nurse jokingly (I hope) remark that “this job would be okay if it weren’t for the patients”

When demoralised staff begin to view those in their care as “The Problem” then resentment and bitterness can take over.

I stress again I am not trying to defend these people and I hope their prison sentences are long, although Ken Clarke would probably prefer community sentences. That’s a thought now, what service could these evil people do to the community? I just think that where money is the basis for all care I hope never to get sick.

PS This is the link to the Care Quality Commission inspection reports on Winterbourne View

Rather than love, than money, than fame, give me truth : Thoreau


Consider these examples:

  • One of my personal students told me that when on placement some staff told their patients that they would do things for them and then never bothered. The student was upset by the fact that staff would systematically and routinely lie to their patients.
  • I did an exam with a group of students, I told them about the assessment criteria and then used something else to work out who passed or failed, ok, I lied but who cares?

The above examples are completely untrue but what would you think about health care staff or University lecturers who routinely lied to people?

Lies: Everyone’s at it?

“It is that truth that guides our action in Libya……………………………………… …………………………………….That is why we stopped a massacre in Libya. And we will not relent until the people of Libya are protected, and the shadow of tyranny is lifted.
(Barack Obama speaking in London’s Westminster Hall)

Is it just me or did the West court Gaddafi for his oil money? Are we now supporting the insurgents so we can now court them for the same?

Then I came back to the NHS. I watched a daughter talking about the death of her mother on the news. Her story reflected the lack of care given to the elderly in the NHS according to the Care Quality Commission report. Yet when we visit websites belonging to these same hospitals we are bombarded with mission statements and philosophies about “putting the patient first”
Is it possible that the public does not need to know the truth? Or is it that we don’t want to? If people in power told us the truth could we handle it? If people in power told the truth could they remain in power?
We live in a world that claims to put transparency above all else but uses smoke and lies to blind us.

What could I say to this student or the daughter? I suppose I’ll just have to say that’s the way things are?

(BBC News 26th May 2011)

Universities, the new motorists?

woman in car

Everyone knows that successive governments have plundered the pockets of motorists to swell the National coffers. They know that we will not give up our cars to use overpriced, dirty and unreliable public transport.

It now seems that if something becomes a priority to people and high on their wish list then that too can become a valuable source of income. Higher education has become something which all people are beginning to realise will improve not only the lives of the individual but of society as a whole.

What was once considered the province of the upper and middle classes has become widely available to all. This importance placed on education by the people has opened it up to charges. Not only has public funding for Universities been plundered but now Vince Cable, the Business secretary, has come up with an even better cash cow. Let’s tax Graduates forever. Well, maybe not but it could seem like it. We can also means test them to ensure we get the most out of the process. Not only will this force higher education facilities to increase their bureaucracy to manage tax collection but will also increase the number of civil servants required.

Isn’t it about time that the value of higher education to the country was realised and the country properly funded it?

LONDON - OCTOBER 29:  A student takes part in a demonstration to protest over higher tuition fees on October 29, 2006 in London, England. Students are calling on the British government to reform the new student finance policy. Students who started degree courses in September 2006 will have to pay up to GBP3,000 a year towards their tuition costs.  (Photo by Scott Barbour/Getty Images)

Another great reform

Britain's Prime Minister David Cameron (front C) calls an end to a group picture with his new cabinet in the garden of 10 Downing Street in London May 13, 2010. (L-R) Eric Pickles, William Hague, Tom Strathclyde, Andrew Lansley, George Young, Michael Gove, Nick Clegg, Andrew Mitchell, Sayeeda Warsi, Philip Hammond. REUTERS/Andrew Winning (BRITAIN - Tags: POLITICS PROFILE)

Another Great Reform.

Ha, Ha, Ha finally the management are getting their come-uppance. These people who have oppressed the working nurses for years are all going to be put out of work. After all it’s their fault that the NHS is in the trouble it is. Isn’t it?

Before we celebrate let’s take time for some sober reflection. Having been in the health service for over forty years I have seen many great reforms. From Salmon in the seventies, through the establishment of trusts, the move to the community and agenda for change we have all seen how Government policies have improved the service for workers and patients.

Do we know enough about the work of PCTs and SHAs to be able to judge their worth? Everyone is aware that in some areas there are non-jobs that could be swept away, but could we be chucking out the baby with the bath water? For example, who will commission the number of nurses to be trained from Universities?  If G.P.s are to be given control of huge budgets there must be some questions to be answered before this happens. Are they capable of administering these monies? Do they have the time to balance clinical work with the need to run a business? Given that G.P.s have a personal relationship with their patients will they be able to look them in the eye and say “we can’t fund your treatment”? Will mental health and learning disabilities be given the same priority as neo natal or cancer?

A Government spokesman says that G.P.s can be trained and that they will employ managers to help them. So we are not removing a management tier just replacing it. Plus ça change, plus c’est la même chose.

Finally, we have struggled in nursing for years to get our voices heard; we had great hopes for nurse consultants and modern matrons. With all the power being placed back in the hands of medics where will this leave us? So before we sit back and enjoy the cull of the faceless ones let’s take a long hard look at the alternative. We should demand consultation on this as it is our area of expertise and we should be involved in the process.

Thoughts on assisted suicide?

The Royal College of Nursing (RCN) recently carried out a survey on assisted suicide. It was only open to their members, quite rightly as it will inform the policy of the RCN, but this restriction will result in a flaw in their research.

It is right that we have this debate – but it will only be worthwhile if we involve much broader opinion. There have been legal arguments in court about what will happen to people who assist suicide abroad. Is it right that terminally ill people have to travel abroad to get relief from a life that is painful and miserable?

Gordon Brown has come out against assisted suicide, but is it right that MP’s legislate for their own private convictions or should they only be allowed to represent the wishes of their constituents?

I have long held the belief that I should have the right to die with dignity and free from pain. No one has ever objected to people making the choice to end the lives of much loved pets but to help a person that we love to end their lives is illegal.

The most used argument against relies heavily on the premise that the right to die could be abused. Relatives may pressure people to die in order to inherit, or people may feel guilty for being a burden. I believe that effective regulation would prevent this.

If I were to get a diagnosis of dementia I would worry more about the pain inflicted on my wife (who would have to witness my suffering) than I would worry about dying myself. Furthermore the cost of nursing care, with no hope of recovery, would seriously impact on her quality of life.

These are my personal views and do not reflect any Institutional views and I very much look forward to hearing from you your opinions.



Photos fromFlickr creative commons (Click images) 

‘One day later’ : by Bolshakov

‘Solo la muerte puede salvarte de este mundo : Rodrigo Basaure

A case for appropriate treatment?

Since the “Treatability Clause was removed from the Mental Health Act in 2007 and the phrase ” Appropriate treatment must be available” replaced it we have to consider what is “appropriate treatment”? 

For example can detention alone be appropriate treatment?

In the case of   R(Home Secretary) v MHRT (2004) this matter was ruled on.

It concerned a person alleged to have a psychopathic disorder. Both the medical team and the court felt that in the community he was extremely dangerous. The question was, was he treatable? He was deriving no benefit from treatment programmes. However, it was felt that he could cope in the structured hospital environment.

The Court held that this was enough. The Tribunal accepted that hospital could prevent deterioration by his continuing in custody. Having accepted that factual proposition it was bound to conclude that the condition was susceptible to treatment as it would prevent deterioration of the symptoms of mental disorder were he suffering from a mental disorder

What can we foresee as the implications of such a legal precedent? How will this type of detention impact on our wards? At what point can the detained person hope for discharge?If it is detention alone that prevents the worsening of a disorder will the person ever be fit for discharge?

I would love to hear your views on this case. If there is enough interest I will post another legal and ethical poser soon.