Day 246

Posted by kidsaregifts20

“More Mentally Ill Persons Are in Jails and Prisons Than Hospitals” is the title of a survey that was published in the USA in 2010. It states that America’s jails and prisons have become its new mental hospitals, housing 3 times more seriously ill patients (3 million) than hospitals.

Almost 1 in 4 of inmates live with serious mental illness and their conditions are often under-treated or not treated at all. Harsh conditions, isolation and noise can “push them over the edge” into acute psychosis. An estimated 70,000 prisoners suffer from psychosis on any given day. Many of the sickest patients are not able to make any sense of orders screamed out at them. Here is a video that shows how inhuman the treatment of these inmates is. It is difficult to watch and I would not recommend it if you have the slightest worry of it potentially traumatising you.

A sheriff in 1973 said, “a good deal of mental illness is now being interpreted as criminality.” That seems to be the case even today, more than 4 decades later.

7 out of 10 youths in the juvenile justice system also experience mental health disorders, with 2 out of 10 experiencing disorders so severe that their ability to function is significantly impaired.

“The bedlam which ensued each time I walked out into one of those units, the number of people who were screaming, who were begging for help, for attention, the number of people who appeared to be disturbed, the existence, again, of people who were smeared with faeces, the intensity of the noise as people began to shout and ask, ‘Please come over here. Please talk to me. Please help me.’ It was shattering. And as I discussed this atmosphere with the people who worked here, I was told that this was an everyday occurrence, that there was nothing at all unusual about what I was seeing.” (Dr. Craig Haney, quoted in Elsner, Alan (2006). Gates of Injustice: The Crisis in America’s Prisons)

The situation in the UK is not very different as is apparent from the ‘Too little too late” report, an independent review of the unmet mental health need in prisons.

The lack of understanding of mental illness is rampant in all areas of life. How is it that we have advanced so little since the days of the infamous mental hospitals of the Victorian and pre-Victorian eras?

Day 243

Posted by kidsaregifts20

In Finland a national suicide prevention project was implemented in 1986-1996 to reverse the increasing trend of suicide mortality with the aim to decrease the suicide rate by 20 per cent in ten years.

The basic principle of the project was to build national prevention activities on reliable information of the current Finnish suicide situation. In collaboration with the mass media and by arranging local events, public awareness was raised. All suicides committed during one year in Finland were scrutinized by using a psychological autopsy method, combined with a normal and legal police investigation, and a routine medico-legal examination.

The key target groups of the programme were people with depression, substance use problems, in crisis situations, those in need of psychosocial support due to physical illnesses, and people who attempted suicide. The project focused mainly on actions that directly influenced the risk factors for suicidal behaviour. Alcohol was identified as a particularly relevant risk factor for suicide in Finland, and given priority in the suicide prevention strategy. Younger generations were the main targets of the programme. Mental health, depression and suicide awareness programmes were launched in the school system. The military, which evaluates all 18-year-old men as part of the national Finnish draft, received special instructions on the identification and referral of at-risk youths. Enhancing awareness and changing negative attitudes towards suicide were also in focus. The suicide preventive programme leaders trained the media on appropriate suicide reporting, so that suicides did not receive sensational coverage that might encourage copycat suicides.

A booklet “Suicide can be prevented” was distributed throughout the country to raise awareness among physicians, those working in health and social care, teachers, police officers, church leaders and other people, who all come in regular contact with potential individual at risk for suicide. The most important advice was to take early signs of self-destructive behaviour seriously, and to always consider the possibility of suicide among people with mental disorders. Health and welfare workers were also advised to pay close attention to the well-being of patients with chronic illness or disability, who may be depressed, but do not acknowledge it.

The programme was successful in reaching its’ aims. The suicide rate in 2005 was 40 per cent lower than in 1990. The external evaluation concluded that that the implementation was successful in putting suicide prevention both on the social agenda and at large in promoting development in the chosen areas.

In 2001, the Government of Finland developed a new public health policy which targets younger generations and aims to reduce accidental and violent death among young male adults by one-third of the level during the late 1990s, by 2015. This is being achieved through three new national programmes: “National plan for mental health and substance abuse”, “Reducing work-related disability” and “Preventing psycho-social exclusion of young men in Finland”.

It can be done. The government needs to prioritise it, focus on the details, set clear timelines and make it a major public health issue.

Day 238

Posted by kidsaregifts20

“Why don’t you do a crossword or something for the next 5 hours?” said the woman who answered the phone to a mental health patient in crisis. The call was made to Emergency services in the wee hours of the morning and the Mental Health Crisis team would come on 5 hours later. This is an excerpt from a CQC (Care Quality Commission) report on Emergency staff attitudes to patients in mental health crisis.

Here are some more observations:

Judgemental and unsympathetic attitudes of staff towards patients with injuries inflicted on themselves.

Unsafe, unfair and completely unacceptable level of care.

“Quite shocking”

Only one in seven (14%) of the patients surveyed said the care they received provided the right response and helped to resolve their mental health crisis.

Police and ambulance services were much better at helping them than the key types of NHS teams.

Increasing difficulty getting patients undergoing a crisis into hospital because of an acute shortage of beds.

Helpline staff were hanging up on mentally ill patients because they were seen as ‘difficult’ callers.

They constantly have to explain their circumstances to a chain of professionals because notes cannot be accessed out of hours.

They concluded, “It is clear that there is still a long way to go to make sure everyone is treated compassionately in the right place and at the right time.”

Yes. True. Yet we have been accepting this unacceptable behaviour for decades.
Nothing will change as long as public perceptions don’t.
As long as we, the people, continue to tolerate these intolerably intolerant attitudes, things will stay the same.
Awareness in everyone’s hearts and minds is the answer.
Education. Education. Education.

Day 234

Posted by kidsaregifts20

Our cats mean the world to us. They bring us tremendous joy with their distinct personalities and their playfulness. Once or twice a year they need to visit their doctors who always come across as happy, dedicated, empathetic and gentle people. They make the job look dextrous and fun. They remind me of James Herriot, the author of ‘All things wise and wonderful’, a book I loved as a child.

Today I was surprised and saddened to learn that veterinary doctors are at an exceptionally high risk of suicide: twice the rate of doctors and dentists and 4 times the general population.

Various causes have been stipulated for this, easy access to lethal drugs and guns being one of them. Mercy killing is an essential and accepted part of veterinary practice. That mindset could possibly make deciding to end ones own misery a smaller hurdle to cross. The challenge of constantly dealing with not just the animal but also its owner who might be under huge financial and emotional pressures must be massive. Working in isolation all hours of the day and night, exhaustion, stress and not knowing where to turn for emotional support must contribute to the problem.

Vets are vets because they care. They get to know their animal patients and owners over many years and work hard to keep the animals healthy for as long as possible. Having the power to “do the best thing” must be the worst dichotomy. Knowing that the owner will most likely be very upset, yet for the sake of the animal, having to end its life sounds simple but the emotional impact has to be absorbed somewhere. No wonder it overflows into tragedy for too many vets.

The next time I visit the vet, I will positively show my appreciation for what they do.

“Animals are unpredictable things, and so our life is unpredictable.” James Herriot