MENTAL ILLNESS and SUICIDE

Mental illness and suicide.

According to the Experts on such matters: "One in four of us will experience some form of mental illness problem in the course of a year."

Most of us will go on to make a full recovery and some of us will simply learn how to cope. Leastways, this is the usual sanitised view. It may then be a surprise to learn that the main cause of premature death amongst those of us stigmatised as being mentally ill is actually suicide.

"I am still more frightened by the fearless power in the eyes of my fellow psychiatrists than by the powerless fear in the eyes of their patients".

                                                                          R D LAING

Mental Health in any form can change the perspective of even the most caring individual. They no longer see the person within but perceive you as a contagious, troublesome, untrustworthy, childlike, sometimes dangerous      individual. They see you as someone who no longer has any feelings or emotions in regards to how they are spoken to or treated, when in fact having any mental health 'problem' probably gives you a higher intelligence and makes you more empathetic than ever before.

We are not toys that can be picked up and played with for novelty's sake and then disposed of because we are worn out, 'damaged', or no longer favourable. We are as they say, 'for life' and life, and no matter what the circumstances should be cherished and treated with fairness, dignity and respect (not ridiculed) because you only get one chance at it.

Many people have to cope with the ignorance and stigma alone, or at least they feel alone because of it. I am extremely lucky to have someone special in my life who loves and respects me, but even l feel desperately alone at times.

I think what I am trying to say is don't listen to people who put you down or 'label' you because of your illness, because in reality they are the ones who need professional help not us. Mental health is only really a problem for those who choose to be ignorant and not try to understand it.

Stay strong and be positive and together we can beat the 'bullies' who give mental health a bad name.

Carmen

'Crisis in mental hospitals revealed'

A SHOCKING portrait of Britain's mental health service - highlighting the constant fear of violence in run-down, often dirty psychiatric hospitals - is to be unveiled this week in a hauntingly honest new book.

Cathy Wield, a specialist registrar in emergency medicine who spent seven years battling mental illness, suffered severe depression that deepened until she had continuous suicidal thoughts while deliberately harming herself. In the book, Life after darkness, she exposes the horrors of the archaic hospitals where she spent much of her time. In a remarkable account, she writes of 'seven years lost. Seven years of being a prisoner, not just of my mind but of a run-down health system, to a large degree still in existence'. She wanted to reveal 'a little of what people still suffer, along with our families, in this first world educated society.

Weild, who has four children, describes a dreary hospital with stained carpets and old furniture where violence was common. Most of the synthetic blue velvet on 'not terribly comfortable'chairs was stained. 'There was that indescribable hospital smell pervading every area of the ward. There were drug ausers, alcohol abusers, those with psychotic illnesses all thrown in together. The lifts were often dirty. The inside walls were covered in grafitti, even etched on the metalwork of the doors.' But the main reason that Weild used the stairs was fear of being shut in with one of her aggressive, abusive fellow patients. Some lashed out, swearing constantly. Worse was a lack of sympathy from some staff. 'Care seemed to be a forgotten word'

Weild's revelations come just days after a Mental Health Act Commission report exposed severe funding shortages in mental institutions. The study, 'In Place of Fear?', said half of all wards were overcrowded and some services could not provide 'acceptable levels of security, care, or a sense of being treated as someone who matters'. Chris Higinbotham, the commission's chief executive, said: 'The need for additional resources has never been greater'. Only last month a Healthcare Commission report on cleanliness said mental hospitals performed particularly badly.

Weild's depression was finally cured by pioneering brain surgery. In Life After Darkness, she calls her illness 'a dark mist that clung to every part of my body and mind. I lived it and breathed it. It prevented me from moving because my arms and legs were so heavy, and it shrouded my mind with a deel anguish that gnawed within. It hurt so much'. She 'lost' years of her life as memories clouded over, leaving dark holes. When she looks at photographs today she cannot remember the events involved. 'I was reaching out to anyone who would take my hand and pull me free,' she writes.

In her book she recounted some of her lowest moments, such as being given electro-convulsive therapy - in which an electric current is sent into the brain when 'the anaesthetist made the mistake of giving me the paralysing drug before putting me to sleep,' she said 'It seems the needle in the back of my hand had ceased to work, so I was left paralysed, unable to move or communicate, knowing what was about to happen, scared witless, praying like crazy. In my mind I was shouting at them,"I'm awake. I'm awake, don't do it, please don't do it"

Experts say Wield's experiences are not unique. Marjorie Wallace, head of the mental health charity Sane, said: 'Something needs to be done urgently. The strains and the squalor are the visible signs of the invisible neglect of patients'

The Observer: 15.01.2006

Trying to understand mental illness

The psychiatric profession pronounces itself to be the sole arbitor on the issue of mental health and 'diseases of the mind' But what if they are wrong... ? After all, we are only human and as such none of us are infallible.

Suicide and Insanity

In early modern times “self-murder” was viewed as the most mortal and despicable of all crimes against God, the King and self.

In those days there were many types of suicide: Insanity. Possession by Demons. Self Murder. Would be Martyrs. Lovelorn / Unmarried Pregnant / Debtors. Accidental. Criminals escaping Punishment. Murder made to appear like Suicide.

         Coroners were local well-to-do men who had no medical training.

       Successful suicides were put on trial and if found guilty were buried facedown at a crossroads with a stake driven through their body. This legal “nicety” continued in England until around 1823.

       The "lucky ones" were buried at the northern area of the churchyard which was unconsecrated and reserved for babies who died before baptism.

         Those found guilty of self-murder forfeited the usual rights of inheritance. This meant that their property was taken by the Monarch; condemning the deceased’s family to a life of poverty. If found not guilty of self murder the normal rules of inheritance stood.

         Possible verdicts included: Self-murder. Insanity. Accident. Natural causes. Murder by another person or persons. Misadventure. Or simply a very vague “Found dead”

In a study of Norwich, the rate of insanity findings in Suicidal Verdicts increased from 6% in 1660 to 90% by 1710 and 100% by 1770.

In Early Modern thinking insanity and sin were inextricably entwined: Sin led to insanity and insanity led to sin . This mediaeval attitude is clearly reflected in the resultant hybrid which was Early Modern psychiatric medicine: The widespread use of praying cures, sacramentals (amulets to prevent suicide etc) herbalism, bloodletting, purges and confinement, (often under physical restraint) laid the foundation for modern psychiatric treatment.

Statutes allowing magistrates to detain mad people where passed early in the 18th century.

William Blackstone (1728-1780) in his Commentaries on the Laws of England, wrote that: "It was the doctrine of our ancient law, that persons deprived of their reason might be confined till they recovered their senses."

Blackstone is also quoted has saying that madmen should not be allowed out to the terror of the King's Highway. It does appear that Blackstone's main concern was the protection of gentile society and not care nor compassion for the "mad person"

Whilst it is important to stress that suicide is not a mental illness - 10% to 15% of all suicides occur in the 4 week period following discharge from psychiatric institutions.

New prescription for mental health: read a good book
Doctors usually send patients to the pharmacy to get medication, but from tomorrow GPs in one county will be packing people off to the library with prescriptions for self-help books.

Those with symptoms of depression, anxiety or eating disorders will be referred to clinics where they will be prescribed books to read alongside support sessions with graduate mental health care workers.

society.guardian.co.uk 9 Jan

The scheme in Devon, which is the first of its kind in the UK, aims to cut waiting lists for more serious cases, reduce over-prescription of drugs and offer some form of treatment for patients who may otherwise receive none.

'This is needs driven,' said Paul Farrand, a senior lecturer in health psychology at Plymouth University, who developed the scheme. 'Nine out of 10 people with mild or moderate depression do not receive any treatment at all. Others are put on long waiting lists or are given medication that may be unnecessary.'

Farrand said the scheme was developed following recommendations in a government report, Self-help interventions for mental health problems. By the summer there will be 80 self-help clinics in Devon, all using books based on cognitive behavioural therapy.

'This is not for those with chronic problems,' said Farrand. 'But it could reduce waiting lists for those patients to receive the treatment they desperately need.'

Jan Ap-Thomas, from Derby, welcomes the move. The 53-year-old began suffering from severe depression 14 years ago. Overcoming Depression, by Professor Paul Gilbert, was one of the books recommended in the Devon scheme and played a large part in her recovery.

'A book doesn't go on holiday or have bad days,' she said. 'It is always there for you to pick up when you need it and for me it was my depression bible.'

Jan used to cry all the time and would spend days in bed. She even started to lose interest in her three daughters. She was treated by Gilbert while he wrote the book and has since used the literature regularly.

'The best thing about these books are they are full of case studies that make you realise you are not alone,' she said. 'Depression means you feel extremely isolated. [The books] also remove the stigma as you can do it in the privacy of your home. For me, the antidepressants stopped working but the book did not and it meant I was making myself better instead of relying on someone else.'

She now enjoys life again and is planning a holiday abroad with her family, something she would never have done before.

Dr Richard Byng, a GP based in Devon, with a special interest in mental health, will be referring patients to the scheme. 'Anything that can broaden the options that GPs have is a good thing,' he said. 'There is good evidence to support the use of books and the graduate workers will help motivation.'

The chosen books aim to help those suffering from depression, anxiety, bereavement and eating disorders, as well as victims of child abuse. The initiative, which has been welcomed by some charities, will begin in Devon tomorrow but is likely to spread across the country.

'While we recognise there is often a place for medication in treatment, the NHS relies on it too heavily,' said Sophie Cortlett, director of policy of Mind, a mental health charity. 'The self-help scheme looks like a possibly useful way of broadening patient choice.'

GPs have been criticised for over-prescribing anti-depressants, some of which carry side-effects.

Samantha, a 24-year-old Londoner, suffered a difficult relationship breakdown two years ago. She started to experience mood swings and felt down a lot of the time. When she went to see her GP she was immediately put on anti-depressants.

'They really helped at the time,' she said. 'But when I tried to come off them I started having panic attacks. I stayed on them for a year longer than I needed to because I was so scared. I would have much preferred to be offered some sort of supported self-help solution. Coming off the antidepressants was hell for me.'

Though the scheme has been welcomed by the Department of Health, others warn it could have problems.

Phillip Hodson, a fellow of the British Association for Counselling and Psychotherapy, said: 'If patients go to their GP and are prescribed a book they feel a huge rejection because no one is giving them any time.'

Marjorie Wallace, director of the charity Sane, which campaigns on mental health issues, has written the foreword for a self-help book, Beat Depression and Reclaim Your Life .

She said: 'Obviously we are very glad the doctors are thinking of this and there is some value in people reading self-help books. However, I would be very worried if the government were to see this as an alternative to much-needed investment in professional counselling.'

Way with words
Overcoming Depression by Paul Gilbert

Gilbert, professor of clinical psychology at Derby University, tried out draft chapters of this book on his patients to check their effectiveness. The book looks at the evolution of depression and how to cope with it, and includes exercises. 'One of the common things about depression is that people feel bad about themselves and think they are weak to be depressed,' said Gilbert. 'When people recognise they condemn themselves to depression by bullying themselves then they can start to cope with it.'

Overcoming Binge Eating by Professor Fairburn

Fairburn is one of the world's leading experts on eating disorders. This book explains how the illness works and how to treat it. Trials in the UK, America and Australia showed that in up to a third of cases people recovered with the help of the book. 'Guided self-help is best,' he said.

Mind Over Mood by Dennis Greenberger and Christine Padesky

This was voted the most influential cognitive behavioural therapy book of all time in 2002 by the British Association of Behavioural and Cognitive Therapies. It aims to build self-esteem by showing readers how to rate mood reactions, become more balanced in their thinking and do behavioural experiments.

Self Esteem for Women by Lynda Field

Field, a well known self-esteem expert, has been a therapist for nearly 20 years and is the author of 12 self-help books that have sold 500,000 copies. This five-step programme aims to show women how to discard negative patterns, succeed in love and be assertive at work. 'Everyone can improve the quality of their lives,' said Field.

NHS faces mental health ethnic survey
The government will this week order the NHS to introduce comprehensive ethnic monitoring of all mental health patients in England after evidence of persistent racial discrimination against black and minority ethnic groups.
Rosie Winterton, the health minister, will publish a long-delayed response to an official inquiry into the death of David "Rocky" Bennett, a 38-year-old Jamaican-born Rastafarian who died in a psychiatric ward in Norwich in 1998.

The inquiry, under Sir John Blofeld, a retired high court judge, found in February last year that Mr Bennett was killed by being held face down on the floor for 28 minutes by at least four mental health nurses.

The judge blamed the Department of Health for the poor standard of treatment offered to patients from ethnic minorities and accused it of "institutional racism". He described the problem as a "festering abscess" and a "blot on the good name of the NHS".

The government's response - originally promised for last May - will be given tomorrow by Ms Winterton.

She is expected to order all primary care trusts in England to conduct an ethnic census of mental health patients and compare the results with the ethnic make-up of the local area. Each trust will be required to produce an action plan to tailor mental health services more closely to local demographic needs.

Her initiative comes in response to evidence that young black men are six times more likely than their white contemporaries to be sectioned under the Mental Health Act. When undergoing treatment, they are more likely to get anti-psychotic drugs and less likely to be given psychological therapies. Ms Winterton is expected to commit the government to reduce the disproportionate rates of compulsory detention of black and minority ethnic patients.

She will call for action to prevent deaths while patients are being restrained, but will reject the Blofeld inquiry's recommendation for an absolute limit of three minutes on holding a patient face-down on the floor. Last year the government called for all NHS psychiatrists and mental health nurses to go through a national retraining programme to eradicate racist attitudes.

guardian.co.uk 10 Jan 06