Tuesday, 17 February 2015

Can robots help care for us as we age?


 Tony Prescott


Where'd my robot go?
In fifteen years there will 50% more over 65s than there are today, and the proportion of older people in our society will continue to grow for some time after that.  The 2013 House of Lords report Ready for Ageing?   looked at the likely consequences of this on-going demographic shift and stated the problem plainly: “The UK population is ageing rapidly, but the Government and our society are woefully underprepared”. 

On 5th March politicians from all parties will appear at an event in London, organised by the Guardian newspaper, to explain their policies for addressing the ageing challenge.  I hope they offer some ambitious proposals: the status quo is not an option.

Tuesday, 10 February 2015

Mad, bad or maybe merely human



Is a mental health diagnosis
necessary to avoid prison?
Photo: Liam Quinn
The British Psychological Society’s report ‘Understanding Psychosis and Schizophrenia’ has challenged many commonly held beliefs about serious mental health problems. While the report has been widely welcomed, it has also prompted questions, particularly focusing on the report’s key recommendation that we move beyond seeing distress as a symptom of disease:



‘services should not insist that people accept any one framework of understanding, for example the idea that their problems are symptoms of an underlying illness’. 

This issue has been addressed on this site on a number of occasions and it’s clearly one that arouses strong feelings. The disease-model of modern psychiatry views emotional distress as the result of illnesses or disorders. Treating such problems in this way, as healthcare issues, is often seen as essential for ensuring that people get the help they need, and vital in avoiding inappropriate treatment.  In particular, some colleagues have suggested that viewing people as ‘mentally ill’ prevents them being blamed for actions for which they are not responsible. Rather than being seen as bad you can be mad (or more accurately sick) and more likely to be treated rather than simply punished.  Removing this protection (the argument continues) may even result in people being sent to prison inappropriately. These are clearly serious concerns and deserve careful consideration.

Tuesday, 3 February 2015

The allure of the new



Charlie Tyack

Going deep. But are we getting
to the roots of distress?
Photo: DARPA
As human beings, we are attuned to notice the special or different. We also tend to like simple answers to complex questions. Perhaps they make us feel more in control of the complicated environments we find ourselves in. I wondered about this during a recent trawl for ‘depression cures’ on news websites. Suggestions included 9-stone weight loss, magic mushrooms (complete with obligatory 3D brain picture to enhance credibility), laughing gas and ketamine. It seems that we are on the lookout for simple-sounding and miraculous cures for our ailments. After all, the prospect that things can be fixed ever faster and with less effort sounds great. With a bias towards the novel and apparently miraculous, I wonder how we can appraise new, glamorous or cutting edge treatments? Can we judge such shiny new arrivals fairly?

Friday, 23 January 2015

We have the right to offend, but when should we?

Following the Charlie Hebdo attacks Angela Gilchrist looks at how we think about those we see as ‘different’.

We can protest for our freedom but can we
also accept difference?
Photo: Claude Truong Ngoc 
The right to freedom of speech reached a watershed with the Je Suis Charlie march in Paris. Not only did it reveal double standards but it highlighted how easily liberty is talked about, yet how impossibly difficult to realise.

The sentiments were admirable, even moving. But as world leaders who have journalists locked up in their own countries marched under the Je Suis Charlie banner along with well-known Western leaders, some began to worry about the trickier, more complex aspects to this debate.

Does the legal right to offend others, make it desirable, and if so, when? If you’re a person who belongs to a marginalised, often discriminated against group,  such as those with disabilities, LGBT people or those who happen to be religious, you’ll know how it feels to have your particular ‘issue’ lampooned. It’s painful, and we become defensive. What many fail to understand though, is how this all too human foible remains (as indeed it must) separate to the right of free speech.

Friday, 12 December 2014

We need brave people to speak out

Angela Gilchrist on the launch of ‘Understanding Psychosis and Schizophrenia’ , a new report from the British Psychological Society

This is a critical moment in mental health history: never have so many decision makers wanted things to change. That’s according to the National Clinical Director for Mental Health, Dr Geraldine Strathdee, speaking last week at the launch of ‘Understanding Psychosis and Schizophrenia', a report from the British Psychological Society’s Division of Clinical Psychology.
The event, described by many as 'ground-breaking and momentous', was remarkable in that it brought together numerous and disparate voices in the mental health community including psychiatrists, psychologists, policy makers, third sector workers and people with lived experience of psychosis. Among the guests were the Shadow Minister for Public Health and Mental Health, Luciana Berger; and the founder and principal theorist for the Hearing Voices Movement, Professor Marius Romme.

Monday, 27 October 2014

Robin Williams, depression and the complex causes of suicide

While many people who kill themselves have been experiencing the extreme distress we might think of as depression, that’s not always the case and is rarely the whole explanation. 

This article originally appeared on the Guardian Science Website on the 18th of August 2014 and is reproduced here with permission.

Anne Cooke, Angela Gilchrist and John McGowan



Photo: Eva Rinaldi
As the tributes to the actor and comedian Robin Williams continue, so too do the arguments over the meaning of his death. Suicide is a profound act that touches many, and it would be surprising if it didn’t raise strong feelings. On the one hand we have Shep Smith of Fox News calling Williams a “coward” (he has since apologised). On the other we have a range of articles defending the star, usually along the lines of “don’t blame the guy – he had a mental illness.”

Most of the coverage has encouraged us to see his anguish as a symptom of a sickness as real and biologically based as measles or a broken leg. Just like those afflictions, we’re told, depression can strike anyone out of the blue. A piece by Guardian science blogger Dean Burnett offered a variation on this theme, asserting that depression is an illness and attacking any suggestion that suicidal acts might involve anything but desperation and a wish to escape. While we’re sure that the piece was written with the intention of defending someone in pain, we worry that it contains ways of thinking about mental health that oversimplify complex issues and can be unhelpful.

Wednesday, 24 September 2014

Electroconvulsive Therapy: Whose decision is it?

@steweatherhead & @THEAGENTAPSLEY

What does consent to treatment mean?
Lisa is a 42 year-old woman. She has had a difficult life. She has experienced multiple traumas and has at times struggled with her emotions. Lisa has a few close family members and a small social circle, though she does at times feel a bit oppressed by them. In 2010 Lisa contracted HIV. She has been treated medically and was stable for some time, however in 2013 she started to deteriorate. She was seen by a psychologist as well as by medics. After a further twelve months she had had enough of interventions and decided she wanted to live the remainder of her life in her own way. Her family and friends objected as they could see she would rapidly deteriorate. However with support from professionals, Lisa utilised the Mental Capacity Act (MCA) to set some advanced directives. She was found to be capable of making these decisions under the MCA, and was legally allowed to refuse further intervention. Lisa did indeed deteriorate, and died a few months later in her own home with her family and friends around her.

Thursday, 24 July 2014

Guest post: But they look like you and me!

Jo Mueller investigates how parents could hold the key to tackling mental health stigma

Alien? Or simply struggling? Views about
mental health are formed early.
Photo: nadja robot
When it comes to attitudes to mental health, things are getting worse. Despite the high-profile campaigns, stigma and discrimination against people with mental health problems seem to be on the rise. Part of the reason may be that our campaigns are promoting the wrong message. The way we often address stigma is to promote the idea that mental health problems are illnesses. The rationale is noble. Rather than give the impression that someone is weak or blameworthy, isn’t it surely better to say they are sick?

The danger of this is that the idea of something going wrong with people’s brains can be scary and alienating. Put this together with the ‘1 in 4’ idea - that one in four of us will suffer ‘mental illness’ at some point - and it can add up to a frightening message: there’s a dangerous disease out there that might strike at us any time.

Monday, 21 July 2014

The winner takes it all

John McGowan considers the horrors of school sports day and suggests a surprisingly simple remedy

The loser's standing small? Photo: Alethe
‘Well done darling! You did brilliantly.’  As summer term draws to a close, parents get to enact the timeless rituals of sports day. Cheer, take photos of a sprinting child and celebrate success. The chance to shine in front of the whole school, and mums and dads too. A good thing, no?  Rolling up to my own children’s sports day this year though, my eye was distracted by the other end of the proceedings: the kids labouring in while the winners were posing for pictures. I swear they were pretty much the same kids who brought up the rear last year. In fact, I know they were. What, I wondered, is the benefit of sports day for them?

Friday, 20 June 2014

Guest post: 'Schizophrenia then and now'

Continuing our recent reflections on how things in mental health have changed Richard Hallam and Michael Bender take the long view of schizophrenia


The cuckoo's nests have closed. What
else has changed in mental health?
The theme of this year’s World Mental Health Day on 10th October is Living with Schizophrenia. For those of us of a certain age, and with a historical bent, it’s also an opportunity to compare services now with those provided when we started out in the 1960s. Recently we’ve had the privilege of editing the diaries and letters of a young man, David, a patient in the mental health system five decades ago. The resulting book offers, we think, a window into the social attitudes of the time and the way mental health problems were treated.