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.

Friday, 30 May 2014

Against Mindfulness


Eat, pray, love and proselytise?
Mindfulness, it gets everywhere. From mental health services, to schools and into the House of Commons  pupils, prisoners and politicians are taking a breath, holding that thought and just...noticing. It begins to feel like Woody Allen’s vision of 1970s New York, where everyone is in psychoanalysis. Mindfulness is not just a new form of treatment, it is a way of life for growing numbers of people.

Thursday, 22 May 2014

20 years on: Finally our myopic brain obsession is on the wane

Professor John Read, back in the UK after a long period away, is struck by some important changes in the way we view mental health problems

Has how we talk about mental health changed?
Illustration: Mend the Mind
It’s good to be back in the UK after twenty years in New Zealand – well, apart from the weather, the political, economic and spiritual state of England, and the endless phone calls to India to get someone from up the road to install a phone. Amid it all I’m writing my first ever blog! What an antiquated old prof.

As regards mental health research, the difference I notice most is how far people’s thinking has moved on from the old, simplistic, ‘blame-the-brain-for- everything-and-medicate’ idea. 

Thursday, 10 April 2014

A national scandal: psychological therapies for psychosis are helpful, but unavailable




Can talking therapies be a realistic response
to psychosis and schizophrenia?
Photo: minds2mend.com
For years, drugs were it. If you felt paranoid, heard voices or were diagnosed with schizophrenia, the only thing likely to be on offer was ‘antipsychotic’ medication.  Like all drugs, these have a number of different effects on our nervous system. Some of the effects can be helpful, for example calming us down or making our experiences less intense or distressing.   Others may be less desirable. The unwanted effects – euphemistically called ‘side’ effects – of these particular drugs can be seriously distressing.  For some people, they can be more disabling than the original problem.  Despite the drug industry hype, it’s been a fine balance for many people, and worrying evidence is now emerging that some drugs can cause serious and permanent problems such as brain shrinkage if taken long-term.

Friday, 7 March 2014

Pro-Ana communities: why they draw those starving for sustenance and support

Rosie Gilderthorp

Pro-ana: Less is more
Photo: Gideon Malais
A colleague recently brought to my attention a ‘pro-ana’ thread he had noticed on Twitter. He was horrified by what he read and I can see why. Twitter exchanges and message boards like this, consist of young women swapping tips on how to maintain a dangerously low weight and provide each other with ‘thinspiration’ pictures of sinewy celebrities. Pro-ana networks are a world of women with glossy hair, gleaming skin and sculpted cheekbones. There are no pictures of bad skin, thinning hair or infertility (difficult to photograph I accept), and there are certainly no stories about the death toll of eating disorders.  I, like my colleague, initially recoiled from these groups. It’s hard to avoid concluding that they maintain distorted thinking, fetishise a dangerous aesthetic and uphold judgments of women based on their weight. I started to think about writing a blog about shutting them down. However, when my initial horror abated, I began to wonder why people access them and what needs pro-ana groups seek to fulfil.

Thursday, 20 February 2014

Seduced by biology: The BBC, black dog and biological bias

Sue Holttum suggests that biological explanations for distress may easily be over-emphasised

Do brains turn our heads?
Photo: Helmut Januschka
A couple of mornings ago (Tuesday 18th Feb) there was an item on Radio 4’s Today programme about depression. Specifically, it related to the discovery that teenage boys with mild (non-clinical) depression, and higher-than-usual levels of the stress hormone cortisol, were 14 times more likely to develop clinical depression than other boys of similar age. Presenter, Evan Davis, interviewed respected neuroscientist, Prof Barbara Sahakian, from Cambridge University. Instead of asking the obvious question about why these youngsters are suffering enough stress to raise cortisol levels and be mildly depressed, Mr Davis asked about possibly correcting cortisol levels and whether cortisol was the cause of the depression.

Friday, 14 February 2014

Guest post: What will help prevent tragedies like Mid Staffs happening again? Time for a shift in attention.

Steve Onyett

Care and appreciation. Simple but more
powerful than we realise
Pictue: Deviant Art
It seems to have become fashionable to criticise the NHS – or in newspaper-speak to ‘attack’ it. Of course scrutiny of public services is important, but the relentless focus on blame for failures worries me. In the words of Dr Cliff Mann, president of the College of Emergency Medicine, ‘we want to make sure that we don't end up demoralising the very people that we need to keep our health service going’. This sentiment was echoed in a recent open letter in the Guardian from leaders of ten NHS organisations. I’m encouraged by campaigns like ‘Big Up the NHS’ on Twitter which recognise that, as all parents know, praise and encouragement generally get you much further than relentless criticism.

It’s worth being absolutely clear, though, about the scale of the culture shift needed to restore a sense of meaning and vocation among NHS staff. Can this be achieved? How should we go about it? I’d suggest the solutions are radical but also surprisingly simple.

Monday, 27 January 2014

Guest post. The manufacture of madness? Why social construction in psychiatry is not as simple as it seems

Huw Green

Mental health problems: Constructed or discovered?
Anyone who has spent time reading or listening to psychologists recently is likely to have encountered the idea that mental health problems are ‘social constructs’. What is meant by this is that entities such as depression or schizophrenia and personality disorder, which we might ordinarily think of as diseases; are actually descriptions that flow out of our culture and moment in history. There may be good reasons for thinking about mental health in this way. Anybody who claims that there is no social construction involved in the disorders outlined by the American Psychiatric Association (APA) is unaware of the way the manual is written. Prior to 1952 there was no DSM, and every 15 years or so since, a revision has appeared. These updatings are usually chock full of new diagnoses, many of which have been regretted by the very people who helped bring them into existence. Indisputable though this may be, it is a form of description which can stand in the way of understanding the true complexity of such problems. If they are just constructs then why do so many of the people who experience them find the experience so like a disorder; so real? In order to be clearer about this we need to ask exactly what we mean by social construction.

For some commentators, the implication seems to be that if we stopped talking about ‘schizophrenia’ or ‘personality disorder’, then they would more or less disappear. This is the argument which Mary Boyle appears to make in the final chapter of Schizophrenia: A Scientific Delusion? In this line of reasoning, there is much to be gained from demonstrating that life events, social inequality, abuse, and even the mental health system create ordinary, understandable distress, which then gets inaccurately and arbitrarily labelled. It is likely that this depiction is true in a good many cases.