For the uninitiated, being “sectioned” in England and Wales means being detained in a hospital under the Mental Health Act (MHA). This can happen if someone is experiencing a mental disorder of a “nature and degree” that could jeopardise their health or safety or the safety of others, and they are unwilling or unable to agree to hospital admission.
To put it bluntly, detaining somebody under the MHA is a big deal. Normally you can’t deprive someone of their liberty unless they’ve committed a crime. That isn’t the case, however, if three senior mental health professionals agree that detention is the right course of action. There are checks and balances
I am an NHS consultant liaison psychiatrist, meaning my area of expertise is the interface between physical health and mental health. Often I work in the accident and emergency department, providing the kind of support the chancellor promised to bolster as part of last month’s budget, which contained plans for a much-needed increase in funding for mental health crisis services. Whatever the financial context though, assessing patients for detention under the MHA is always part of my role. It might be a young man with schizophrenia who has been brought to A&E by his desperately worried family as he has become consumed by voices telling him to kill himself; a woman with a depression so severe that she has lost the ability to eat or drink and requires feeding with a tube; or an elderly man originally admitted due to a fracture, but whose recovery has been railroaded by the fact that his dementia has caused him to become incredibly agitated on the ward.
I think of the MHA as a life-saving intervention. Just as an A&E doctor will use a defibrillator to shock a patient’s heart back into life, I will advise detaining a patient under the MHA with the intention of saving life too. Most commonly, the life at risk is the patient’s own. But the MHA asks us to consider the “protection of other people” too, which puts psychiatrists in the difficult position of balancing the needs of the individual patient against the needs of the community. (At this point let me emphasise that people with a serious mental illness are much more likely to be the victim, rather than the perpetrator of a crime, although you would be forgiven for thinking otherwise based on how this issue is portrayed in some media.)
Psychiatrists are sometimes characterised as power-hungry creatures who get their kicks from being able to exert control over others via the MHA. Although it would be wrong to pretend a power differential doesn’t exist, I can wholeheartedly say that if I never had to section a person ever again I’d be thrilled. That’s because this would mean that every patient I saw would be willing and able to receive the necessary care for their mental health problems in a truly collaborative manner – that would be therapeutic gold. Sadly, just as I can’t envisage my A&E colleagues packing away the defibrillator any time soon, I think that the MHA will need to remain a vital tool in helping people with serious mental health problems for the foreseeable future.
Full story: Guardian
New research from Stonewall, Britain’s leading charity for lesbian, gay, bi and trans equality, exposes alarming levels of poor mental health among LGBT people compared to the general population. Stonewall’s study also reveals a shockingly high level of hostility and unfair treatment faced by many LGBT people when accessing healthcare services.
The research, based on YouGov polling of over 5,000 LGBT people, shows more than half of LGBT people (52%) have experienced depression in the last year, and three in five (61%) had anxiety. This compares to one in six adults in England who faced a common mental health problem, such as anxiety and depression, according to Mind.
Experiences of anti-LGBT abuse and discrimination on the street, at home, and at work were also revealed to significantly increase the risk of poor mental health. Two-thirds of LGBT people who’ve been the victim of a hate crime (69%) experienced depression, while three in four (76%) reported having episodes of anxiety.
The situation is particularly concerning for trans people. In the last 12 months alone, more than one in 10 trans people (12%) attempted to take their own life, compared to 2% of LGB people who aren’t trans. Almost half of trans people (46%) have also had thoughts about taking their own life.
Full story: Mental Health Today
One child in every twelve in the UK risks having “behavioural problems from a young age into their teenage years”, putting them at risk of a lifetime of disadvantage and poor health, according to a major new study published today by Centre for Mental Health and University College London Institute of Education.
Children of the Millennium is the report of an analysis of the Millennium Cohort Study, which follows the lives of a large sample of children born in 2000 and 2001, funded by the Economic and Social Research Council.
The report finds that 8 percent of children have severe behavioural problems throughout childhood and early adolescence. The same proportion also have multiple mental health difficulties such as emotional difficulties and hyperactivity which also persist over time. Children with persistent problems are much more likely to have a multitude of risks early in life, including poverty and housing insecurity, parental mental illness and developmental delay. These risks are linked to behavioural problems early in life but are also faced by children with behavioural problems that start later.
Full story: Mental Health Today
Despite the seemingly earlier positive announcement in the Autumn Budget for investment in mental health services, the regulations published on 5 November confirm many people with mental health problems on existing benefits will be forced to make a new claim for Universal Credit. People risk losing their income – and even their homes – in the process of re-applying for financial support they’re already entitled to.
Many people have told us they struggle to read or understand letters from the Department for Work and Pensions (DWP), while others are unable to negotiate the complex, labyrinthine process of applying. People in this situation could face having their existing benefits stopped if they have not claimed Universal Credit in time.
Vicki Nash, Head of Policy and Campaigns at Mind, said:
“These regulations have confirmed what we have long feared and argued against – that in the move over to Universal Credit (UC) three million people, including hundreds of thousands of people with mental health problems, will be forced to make a new claim. This risks many being left without income and pushed into poverty.
“Overwhelming cross-party concerns about moving people over to Universal Credit (UC) is a testimony to how unfit for purpose the final regulations are. We have repeatedly raised our concerns and are appalled to see them being ignored. The regulations are insignificant in fixing this broken process – as it stands there is still no safety net for people before or during the move to Universal Credit.
“We need a welfare system which works for everyone and allows people to live full and independent lives, not one that leaves people destitute. The Government must do the right thing and withdraw these regulations, before they fall squarely on some of the most vulnerable in society.
“If the regulations are not withdrawn, we are urging them to be voted down.”
Source: National Mind
Islington Mind will be celebrating Black History Month and World Mental Health Day with an event at the Mind Hub on Friday 2 November.
Click here for details.
Outcome, our LGBTQ+ service, will be holding its annual open day on Tuesday 30 October.
Click here for details.
The Business Design Centre will be hosting an evening of music and entertainment in aid of three local charities, including Islington Mind, on Sunday 28th October 2018 from 2:00pm.
There will be light refreshments and raffle prizes.
There is a voluntary ticket donation of £5 and all proceeds go towards the charities.
Click here for a leaflet.
As part of World Mental Health Day, Theresa May announced the introduction of Jackie Doyle-Price who will be responsible for suicide prevention. Mind responds to this, highlighting what must be done to better support those of us with mental health problems.
Paul Farmer, Chief Executive of Mind, said: “We welcome the introduction of a minister responsible for suicide prevention. We lose almost 4,500 people in England a year to suicide and, although not all are mental health related, many are, and every one is a tragedy.
“By introducing this role, the Government appears to be upholding its commitment to transform our over-stretched mental health services, as a key part of the picture is making sure services can prevent people with mental health problems reaching crisis point. The new minister and her taskforce will need to do all they can to make sure people at risk of suicide are able to access the services they need, when they need them, which includes marked improvements to patient safety, both during and after a hospital stay. We’re soon expecting a new long term plan for the NHS, which will set out how services will improve over the coming years.
“But it’s not just about mental health services, because the reasons for suicide are many and complicated. Life can be challenging and living with a mental health problem can make the ups and downs of day-to-day life that much harder to manage. Mind found that half of people with mental health problems have thought about or attempted suicide as a result of social issues such as housing issues, finances, benefit support, and employment.
“We need a benefits system that doesn’t drive people into poverty, support for employers to make sure they are looking after their workforces, access to housing that is fit for people to live in comfortably, and health and social care services that prevent people becoming unwell in the first place. It’s paramount that the government takes these issues into account and makes sure people get the right support to deal with difficult circumstances in life, reducing the chance of people of taking their own lives.
“Having a minister who can work across government departments is crucial in tackling the complicated issue of suicide. For the minister to really bring about positive change, any work by the minister and her taskforce must be done hand-in-hand with people who have direct experience of suicide.”
Source: National Mind
It started with a feeling of isolation, of not wanting to engage with the world. He didn’t want to answer emails, and hundreds of answerphone messages went unreturned.
Feeling as though the world was against him he didn’t want to leave home. Gripped by anxiety and a fear of impending doom there was a sense everything was about to fall apart and that he was powerless to do anything about it.
Nonetheless, if his world was going to collapse, it was going to collapse on his own terms.
That was in late 2014, when former footballer Clarke Carlisle came very close to ending his life.
“How can I sit here in front of you and say that four years ago, I put myself in front of a 10-ton lorry, at 60 miles an hour and I didn’t break a single bone in my body,” Carlisle told CNN Sport at his home in Preston.
Carlisle had intentionally stepped out in front of a lorry on a road near York, just before Christmas. After several weeks in hospital, he managed to recover from the collision — remarkably unscathed. He describes his survival as a “miracle.”
Full story: CNN
Three of the UK’s biggest banks and eight of the UK’s top law firms have joined together in an unprecedented alliance to change avoidable working practices that can cause mental health and wellbeing issues for employees.
The Mindful Business Charter, developed by Barclays alongside law firms Pinsent Masons and Addleshaw Goddard, is the first time banks and their legal services providers have come together to reach a shared agenda for supporting mental health and wellbeing.
A signing event this week marks an important first step in adopting the charter by Lloyds Banking Group, NatWest and law firms Ashurst, Baker McKenzie, Clifford Chance, Eversheds Sutherland, Hogan Lovells and Simmons & Simmons.
All of the signatories have committed to a set of principles centred on improved communication, respect for rest periods and considerate delegation of tasks. Performance against these principles will be monitored as part of relationship review meetings.
In signing, these organisations pledge to promote a culture of openness about mental wellbeing, ensure responsible business is included as an area of assessment during significant procurement processes and drive forward the actions and necessary change in support of the principles of the Charter.
Full story: National Mind