Blogging about mental health issues
Each week we publish blog posts on a whole range of topics, relating in some way to mental health — written by Mind staff, service users and health and policy professionals. Some blog posts may not reflect official Mind policy.
We welcome comments and questions on our posts, but have a few ground rules to keep the site welcoming and interesting to every body. The first rule is the most important: be respectful of other commenters and bloggers.
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12 November 2009
Alastair Campbell: May Robert Enke's death increase understanding of depression
I'm in Austria to make a speech and speak to government communications specialists. The news is wall to wall coverage of the dreadful suicide of top footballer Robert Enke, who had fought depression for years. I have no idea what channel I am watching but there is a calm and dignity to the coverage which adds profoundly to the sense of loss clearly felt right across Germany.
Most moving of all a remarkable interview with his widow Teresa, speaking of how she always tried to be there for him, and aways lived in hope that he would one day be free of his illness.
Politicians from Angela Merkel down are expressing their and their nation's grief. Footballers and coaches are doing the same, many saying they had no idea that the Hannover goalkeeper was ill, let alone liable to take his life.
When news coverage gives way to pictures, set to music, of candles being lit and memorabilia being laid outside the Hannover stadium, and slow motion shots of Enke in action, you almost sense the makings of a Diana moment for Germany.
It is certainly incredibly sad and nobody will ever know what was really going on inside his mind as finally he decided to end his life.
But the only hope to be found in this horrible event is the hope of greater understanding of a disease which is still surrounded by too much stigma and taboo.Alastair Campbell is Mind Champion of the Year. This post was originally published on his personal blog.
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12 November 2009
German goalkeeper's suicide highlights mental health stigmaAs a long suffering Reading FC fan, and a keen supporter of England, the ups and downs of football are a big part of my life.
So this week's news of the suicide of Germany's goalkeeper Robert Enke is desperately sad for his family and friends, and for football supporters everywhere. Here was a player at the top of his sport who took his own life. Why?
Perhaps the words of his courageous widow give us a clue - "he was fearful he would lose Leila." Enke was depressed and desperately anxious about the consequences of his depression. He feared for his livelihood but most of all he feared that he would lose his adopted daughter. He said that he had deliberately not talked about his mental state.
Sadly, he's not alone. Time to Change, the national campaign to end the discrimination faced by people with mental health problems, found that many people fear disclosing their mental distress to employers, to authorities, even to friends and family. The fear of stigma can in turn lead to a greater sense of isolation and despair. In some tragic circumstances that in turn can lead to people choosing to take their own lives. Over 5,400 people in the UK take their lives every year.
But maybe from this tragedy of Robert Enke's suicide, some good will come. The media coverage of this has been sensitive and fair. Messageboards like the BBC's 606, where fans are not afraid to say what they think, has been sympathetic and concerned - it feels like the football community has united in its compassion for one of our own.
Perhaps the most important message has come from those who have said that it should be unacceptable that people feel they have to hide their poor mental health from others, that we as a society should be more supportive of people and bury the stigma once and for all.
For anyone out there who may be suffering in silence, Mind can help, so please get in touch with the Mind info line on 0300 123 3393.
Paul Farmer, Chief Executive
5 Comments -
6 November 2009
Mental health services for refugees and asylum seekers - a messy pictureFor many years, Mind has stood up for (and with) people who are marginalised in our society.
We stood up for people in institutional care in the asylums, we stood up for people who faced a loss of liberty because of their mental health, and we continue to tackle the stigma faced by 90 per cent of people who experience a mental health problem.
But it is the plight of people who are seeking refuge in our country which has been highlighted by two new Mind reports (A civilised society: mental health provision for refugees and asylum seekers in England and Wales and Improving mental health support for refugee communities) which were launched yesterday. The product of two years of research seeking to understand the experiences of refugees and asylum seekers who experience mental health problems, the results make for interesting reading.
And it's a pretty messy picture. There's a lack of joined up policy between the Home Office and the Department of Health. Refugees and asylum seekers are entitled to access very limited services, and evidence shows that even these are being provided in a patchy way. There are cultural and linguistic barriers, and in many cases there is a lack of expertise and understanding.
Perhaps this quote from an Afghan refugee best summarises what we found:The relationship with mental health services is one of extremes - from nothing being available on one hand, to overreaction and sectioning on the other. It is often difficult to find the appropriate middle ground.
Many people arrive in this country fleeing war and persecution because of their beliefs - they may well arrive without having had a chance to seek help for their mental health, because at home they feared for their lives. And so they may well arrive with an existing mental health need.
However it is also possible that the asylum process can add to this distress, and exacerbate poor mental health, as this Iraqi mental health advocate explains:
Family and other support systems may have been left behind...people can become very isolated.
Yet, our reports suggest it doesn't have to be like this. A Somali Advocacy Project, run by Mind in Harrow, works with the local community to ensure that people get the help they need, that interpreters (both linguistic and cultural) are on hand. Funded and evaluated by the King's Fund it offers hope of a long-term sustainable model.
Abdi, who runs this project, describes passionately the help he offers:This sort of self sustaining model is what we have been looking for and it's giving people their life back.
So where next? Our own funding for this work, from the Lloyds TSB Foundation and Department of Health has enabled us to map available help, develop a training course for refugee community organisations, and recommend ways forward. It's a great start, and a unique piece of work but there's much more that needs to be done.
The issues around immigration are often politically sensitive, and it's not always a popular cause, but Mind is committed to helping refugees and asylum seekers find the help and support they need. We need to stimulate debate and discussion, through this blog and beyond.
Paul Farmer, Chief Executive, Mind
Mind's reports
A civilised society: mental health provision for refugees and asylum seekers in England and Wales
Improving mental health support for refugee communities
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4 November 2009
Dogs don't discriminateThere's an amusing and touching column in today's Guardian by Clare Allan, who was nominated for Mind Journalist of the Year 2009, about her dog's blindness to mental health stigma.
Though whether pets can improve mental health is still an object of discussion.
4 Comments -
3 November 2009
Challenging the tax manMoney worries can be a major trigger for mental distress. For some people, mental health problems can make it harder to manage money. When Mind undertook to tackle the cycle between financial difficulties and mental health, banks and other creditors were our obvious target. But as our recent research shows, the problem is not just with the financial sector - the tax man needs to take note too.
In January of this year, Mind was commissioned by Her Majesty's Revenue and Customs (HMRC) to look into how well its service allows for flexibility when supporting people with experience of mental distress to deal with tax issues. We heard from around 125 people about their tax affairs, and contact with HMRC.
The results highlighted that there is much to do to make the tax system accessible to people with mental health problems. Many people said they find calling HMRC difficult during periods of distress, and often there is no alternative to telephone contact. Deadlines are not flexible, so people experiencing distress who are unable to file their tax return can be penalised for their illness. Some correspondence fails the plain English test and can create unnecessary anxiety.Perhaps more worrying was anecdotal evidence from respondents to our survey that when someone reports a mental health problem to HMRC they feel they are not believed.
HMRC staff involved in the research also commented that that staff sometimes think people who are in trouble for not fulfilling their tax obligations are using their mental health problem as a “get out of jail free card”.
One man we spoke to had been accused of lying about his financial circumstances over and over until he doubted himself – creating significant distress and eventually family breakdown as he struggled to make his case heard.
Mind submitted a report of our findings to HMRC in September 2009 and made a number of recommendations. We are now working with the Department to ensure that changes are made.
It is crucial that all government departments meet their requirements under equality law, to provide reasonable adjustments and a service flexible enough to meet the needs of disabled people, including people with mental health problems.
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23 October 2009
Tackling hate crimes is a responsibility for us allThe tragic case of Fiona Pilkington highlights what a mountain we still have to climb to tackle crime, harassment and victimisation against disabled people. Following seven years of abuse at the hands of a local gang, Ms Pilkington set fire to her car while she and her disabled daughter were inside.
At the inquest, the jury found that she killed herself and her daughter due to stress and anxiety about her daughter's future, and the ongoing abuse they were experiencing. The jury foreman said the police's response had an impact on Ms Pilkington's actions, and records show that she had contacted the police on more than 30 occasions, but no one had ever been prosecuted.
In a similar case, one woman recently told Mind of the daily harassment she and her son face, which started when their neighbours found out about her family history of mental distress. Like Fiona Pilkington, she has reported the crimes against her to the police on a number of occasions, but no action has been taken. She and her son continue to live in the shadow of constant abuse, with no expectation of it going away.
To me, the Pilkington case is a clear example of disability hate crime, and many others agree. Courts have a duty to treat these crimes more seriously and increase the sentence for any offence where there is evidence of hostility based on disability.
The Home Secretary, Alan Johnson, is quite right to criticise the "ludicrous" attitude expressed by one police officer at the Pilkington case inquest, that anti-social behaviour is "no longer a police matter". Anti-social behaviour can be a serious threat to all of us and it should not be left to local councils to deal with. The police must take lessons from this about the importance of responding promptly and effectively when people report "low level" incidents.
But in characterising what happened to the Pilkingtons as merely "antisocial behaviour", Alan Johnson implied that these are not serious crimes. And it is not right to place the blame in allowing the harassment to continue solely with the police. Ms Pilkington was known to the police and to social services, but many people also knew of the crimes. In our communities, we all need to take responsibility for the people around us, and be prepared to speak out against crimes and offer support to the victims.
Mind will be sharing good police practice from around the country, to ensure police responses to so-called "low level" incidents improve and everyone is granted their fundamental right to equal access to justice.
But equally, we need to improve community relations, dispel myths about mental health and disability, and challenge the "just ignore the abuse and the perpetrators will get bored" attitudes that still exist, and suggest disabled people should expect to encounter victimisation and deal with it as part of their condition.
Amy Whitelock, Policy and Campaigns Officer
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19 October 2009
Vicious attack on people experiencing mental health problemsLast Thursday's vicious attack on people experiencing mental health problems in the Daily Express has shocked me. In a piece about the new assessment process for benefits claimants, Leo McKinstry disputes whether people receiving welfare benefits for a mental health problem are legitimate.
I don't believe it represents the views of the majority, and regret that any national newspaper should publish inaccuracies of this nature, which are based on prejudice and ignorance.
His figures are incorrect - the Government's statistics relate only to new claimants, rather than all people receiving incapacity benefit.
Even more worrying, is his cynical view of mental health. He says,
"It is telling that more than1.1million incapacity claimants are not suffering from any physical disability at all, but get their handouts by moaning about problems like 'stress' and 'depression'."
Mr McKinstry equates mental distress with malingering and sponging off the state. That's not my experience. My work brings me into frequent contact with people with serious mental health problems who want to work, and who are frustrated by the judgement handed down on them by people like him, that they just need to pull themselves together and stop living the life of Riley.
Of course there are always some people who will play any system for what they can get out of it. But for the vast majority of people with mental health problems, the welfare system is not about free handouts, but about negotiating the support and time they need to get ready for work, and providing a financial safety net where work is not a viable option.
I would be pleased to provide Mr McKinstry with an opportunity to meet people with depression or stress who have lost their jobs and are unable to work, so that he could be better informed about this issue. I only hope he will be willing to take up my offer.
I do agree with him on one thing. Those statistics are telling indeed. What do they tell me? We are not doing enough to prevent mental distress from spiralling out of control, leading to debt, family breakdown, disability and loss of employment. We can do more to inspire hope of recovery.The tried and tested ways of supporting people with mental health problems to return to work are not being used. And we need to challenge the pervasive stigma that denies people with mental health problems the same employment opportunities as anyone else.
Anna Bird, Policy and Campaigns Manager (Social Inclusion and Rights)
16 Comments -
15 October 2009
Get well soon....I've got a cold and am oscillating between coughing loudly in the hope of garnering sympathy, and pretending I'm fine due to the embarrassment at feeling so lousy with something so commonplace.
What then, to make of the recent report from the Royal College of Psychiatrists that half of people in hospital due to mental health problems do not receive any gifts or cards during their time in hospital, compared to a third of people in hospital due to physical health problems? If it is hard to admit to being laid low by the common cold, how much harder to try and explain about a mental health condition?
A British study found that psychiatric patients were significantly less likely than other patients to inform friends and family that they had been admitted to hospital, despite spending a significantly longer period of time in hospital.
The study found that the psychiatric patients received fewer cards and gifts. Further, patients with mental health diagnoses tended to receive toiletries, food and cigarettes as gifts, while other patients receive flowers, balloons, magazines and chocolates.
Another British study confirmed the finding of fewer greeting cards for patients admitted to psychiatric wards. There seems to be a combination of people in hospital due to acute mental distress being unwilling to tell people about their problems, and others not knowing what to say or do when people are admitted to hospital due to a mental health condition, so end up doing nothing. What could people need more during a time when they are on a hospital ward, feeling vulnerable and distressed, but to know that others are thinking of them?
It can be easy and inexpensive to show that you care. Some hospitals, such as the North West Wales Trust allow people to send an email to a patient that will be printed out and handed to the patient. The Royal College of Psychiatry has launched their own get well soon cards that are on sale via their website.
You could also make your own, and getting the family involved in creating or writing in a card could be a good way of having a conversation about why someone is in hospital and what they might be experiencing.
Bridget O'Connell, Head of Information
6 Comments -
9 October 2009
The Conservatives Get MovingAnd so to Manchester for our third week of party conference work, this time with the Conservatives, the current favourites to form the new Government at the next general election.
This week is of course Get Moving week, and up and down the country hundreds of events are taking place to encourage people to improve their physical activity to improve their mental well being.
The Conservative conference was no exception. Mind pedometers were the must have item of Conference, and once we'd explained to some slightly bemused delegates how they worked, many were to be seen frequently checking them to find out how many steps they'd taken.
The theme of work and worklessness was a major one at this conference, and David Cameron set the ball rolling by announcing that all people currently on Incapacity Benefit would be reviewed and many would lose some of their benefits as a result.Mind was quick to respond to this, reflecting the concerns voiced by many of this approach. So we were heartened to hear Theresa May qualifying their position on Channel 4 News and recognising the importance of providing the right level of support for people with mental health problems. This message was also reinforced by Tory Disabilities Minister Mark Harper.
There's no doubt that whichever party wins the election, change is coming, and the main question seems to be around the pace of change. We continue to call for a system which puts people with mental health problems at the heart of its approach and recognises their needs.Paul Farmer, Chief Executive
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7 October 2009
Thousands sign Disability Living Allowance petitionUPDATE: Disability Living Allowance will not be scrapped!
Over 12,000 people have now signed the petition on the Number 10 website calling on the Government to protect Disability Living Allowance (DLA) and Attendance Allowance (AA). The petition was launched by Mind in partnership with other disability charities and it's really great that so many people have signed up in just a month! It just goes to show how incredibly important DLA and AA are for people with mental health problems and other disabilities.
Now we really need to hammer home the message to this Government - and any future Government - that DLA and AA must never be scrapped as part of any reform of the social care system.
Please sign the petition now if you haven't already. You can also have your say on this issue, and the wider social care debate, by responding to the Government's consultation which runs until 13 November.
Please campaign with us and add your voice to the thousands already calling for the protection of these vital disability benefits.
Amy Whitelock, Policy and Campaigns Officer
7 Comments -
6 October 2009
Three peaks, 24 hoursAt the end of last week I left my desk in Mind's Partnerships team to join a group of trekkers on the last fundraising challenge of the year, the Three Peaks.
For the uninitiated, the challenge involves climbing the three highest peaks in the UK - Ben Nevis, Scafell Pike and Snowden. In 24 hours. Sounds daunting, doesn't it? But a band of brave souls took up the challenge for Mind, raising nearly £80,000 this year. This fantastic sum of money will enable us to continue our important work of providing information and support to people with experience of mental distress while at the same time challenging the stigma surrounding mental health.
Personally, I had an amazing experience climbing the three peaks. My highlight was climbing Scafell Pike in the Lake District in the dark - I felt like I was in the Lord of the Rings! My team and I managed to complete the challenge in 23hrs 10 minutes. A massive thank you and well done to the team for making it such a wonderful experience.
The events team are already taking bookings for next year's challenges so if you would like to join our team for next year and have the experience of a life time. Please contact Amanda Taylor on 020 8215 2257 or send an email to a.taylor@mind.org.uk.
Clare Nubel, Partnerships team
3 Comments -
5 October 2009
The elderly are the happiest...but badly servedThe Telegraph recently reported that the elderly are generally mentally healthier than younger people. This is apparently explained in part by their living for the present and not worrying about the future. In a past worklife, I worked for Help the Aged and we spent a lot of our time trying to publicise the fact that many people can and do have a very active, fulfilling and happy later life.
However, the images of a 'silver surfer' generation living in retirement bliss - relaxed happiness with a yacht here and a Spanish villa there - do not hold true for the entire elderly population. In stark contrast, one in four older people have symptoms of depression severe enough to warrant intervention. But even more worrying is the fact that people over 75 are sixteen times - sixteen! - less likely to be asked about suicidal thoughts than young adults.
Why the shocking disparity? Ageism clearly plays a large part, with many wrongly believing that depression is a natural part of the ageing process. A survey by the British Geriatric Society found that over half of respondents believed the NHS is institutionally ageist. The fact that this came from doctors specialising in the treatment of older people makes the findings all the more upsetting - they really know what they're talking about.
The consequences of older people not getting proper care can be fatal. In particular, suicide rates for older men are very high. This is often blamed on the isolation that many older men experience. Around 500,000 older men live alone and, sadly, one in five people with an elderly father is not in contact with him. Mind's Men and Mental Health campaign highlights the need to make mental health services more male friendly.
Something needs to change. Services need to take the needs of older people into account and not pass their symptoms off as 'old age'. Who knows, perhaps universal 'retirement bliss' - Spanish villa included - could become a reality for the future!
2 Comments
Mariam Kemple, Policy and Campaigns Officer -
30 September 2009
Is this discrimination of the first order?On the second part of Mind's journey to Party Conferences, we landed in Brighton for the Labour Conference. The question on our minds was simple - can Labour achieve a joined up approach for mental health - however everyone else wanted to talk about Andrew Marr's quizzing of Gordon Brown about his health and whether he was taking "pills to help him get through".
Marr put the question to the PM after a number of bloggers had speculated that as Gordon Brown restricts chianti and cheese from his diet he may be taking MAOIs, an outdated category of antidepressant. The PM denied taking any pills and focussed on policy. End of story? Not quite, as the interpretation of the issue raged around the Conference floor.
I was amazed by this. There are almost 36 million prescriptions for antidepressants in the UK, so by definition thousands go about their daily work while on antidepressants.Winston Churchill, voted the "greatest Briton" in a national poll, struggled with his "black dog" of depression for years (for more on this, see the Time to Change campaign's A World Without report). And former Norwegian Prime Minister Kjell Magne Bondevik took a sabbatical to recover from his mental health problem and then went on to win re-election. Why should this be such a big deal?
We still want our politicians to be strong and superhuman. Yet it's a stressful job. We found that 1 in 5 MPs had experience of mental distress, but very few have talked about this openly. There is still stigma on this issue, and this is something the Time to Change campaign is tackling.
Our mission at the conference was to encourage Ministers and their departments to fully engage with the Department of Health's New Horizons consultation, which I urge you to comment on.
At first the signs were not good. Many MPs we spoke to were unaware of New Horizons. But as we discussed this with Ministers in the Department of Work and Pensions, the Ministry of Justice, Department of Communities and Local Government and elsewhere, it became clear that mental health policy already goes way beyond the Department of Health and mental health services. Now there's a chance for the government to follow a more joined up approach, with departments working together to create a clear sense of purpose for putting mental health at the heart of society.
As we head towards an election, we'll carry on pushing for a better chance for all.
Paul Farmer, Chief Executive
4 Comments -
29 September 2009
Tall storiesThere is no hope! I'm doomed to a life of misery, all because I am, as my mother never tires of telling me, "knee high to a grasshopper". That translates as "I am short", to those of you not familiar with my mother's turn of phrase.
According to a study widely reported in the media, people who are taller are more likely to report that they lead happier lives. Not having a spare US$30 to purchase the paper published in Economics and Human Biology, I turned to NHS Choices' health news to see what they had to say.
They summarise that men and women who reported that their lives were the worst possible were more than 2cm and 1.3cm below average height respectively. "However, those people who reported that their lives were the best possible were also shorter than average."
The study found that the link between happiness and height was "almost entirely explained by the positive association between height and both income and education."
As it turns out, this study isn't that much different to many previous studies that show that taller people are more likely to be in better paid jobs.
Phew! I'm going to be unhappy not because I'm short but because being short means I'm more poorly paid. Oh. Wait...
Bridget O'Connell, Head of Information
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24 September 2009
Experts by experienceAs I gathered information for my new book, Psychiatric Drugs: Key Issues and Service User Perspectives, I became aware of how research trials of psychiatric drugs don't reveal the whole story.
Research intended to establish whether drugs are effective compares them with placebo (dummy pills). If their effect on relieving symptoms is greater than that of placebo and they are not considered to be too harmful, then they are passed as suitable for treatment for people with the diagnosis they have been tested for.
What this process misses out is the wide variety of responses people have to psychiatric drugs, and this is what emerges so clearly from surveys such a All you need to know?, a survey by the Scottish Association for Mental Health (you can download this as a PDF).
One example from this survey was the range of responses to the drug Risperidone, prescribed to people with diagnoses such as schizophrenia. Nearly a third, 30 per cent, said they found it "very helpful" but nearly as many, 28 per cent, reported that it was "very unhelpful". Comments ranged from "I don't know what I would do without my paroxetine [an antidepressant] and risperidone" to "being forced to take risperidone had an entirely negative effect on me and made me more ill than I have ever been in my life."
I found a similar range of experience when people talked about coming off psychiatric drugs. For example, some people coming off the antidepressant venlafaxine (Efexor) experience a particularly nasty sensation which is sometimes called brain shivers. But the Mind survey, Coping with Coming Off, revealed that of thirteen people trying to come off venlafaxine only two experienced this particular effect and five found coming off the drug fairly easy.
Taking and coming off psychiatric drugs is an unpredictable business. Assumptions based on generalised data cannot be relied upon. I suggest that prescriber and patient adopt an approach of cautious experimentation. Feedback and discussion are necessary to establish if the person taking the drug is benefitting sufficiently to justify the inevitable risks. Coming off psychiatric drugs should be approached in the same spirit.
I have some hope that we are moving in this direction. Guidance from NICE, Medicines adherence: involving patients in decisions about prescribed medicines and supporting adherence, effectively condemns the term 'compliance' and the one-sided practice that goes with it to the history books. The recovery approach places an emphasis on what works for the person rather than treating their diagnosis.
I hope this book can play some part in bringing the experiences and views of "experts by experience" - people who have taken psychiatric drugs - into debates about their effectiveness and good practice in prescribing them.
Jim Read is author of Psychiatric Drugs: Key Issues and Service User Perspectives and Mind's report, Coping with Coming Off.
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