Your just a drunk

And

No body cares about you.

Two comments I need to get over because they're really affecting me.

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What if what happened to a person in life changed their brain?

Its not really a what if. Its true.

Childhood abuse is associated with brain differences. So is mental illness and driving a London cab.

Okay let's start at the beginning instead of at a question...mental illness is defined by a biological brain difference and a prognosis, I.e. a negative set of outcomes.

What if the brain differences didn't cause most of the pathologised behaviours which define the diagnosis and what if it was the impact of the behaviours as well as neuropsychological influences which account for a large part of the brain differences?

The brain science usually comes later for behavioural and emotional disorders. The primary thing is the abherrance from this socially constructed temporary standard of normal. It doesn't start with brain investigation and there is no scientific concept of a normal brain nor normal brain action.

There are many studies which show differences in brain volume. Almost invariably reduced brain volumes are the route to pathologisation of type though more advanced techniques are looking at small structural differences across the brain to pathologise different human types, types in the past which have included single mothers, homosexuals and slaves who kept on running away.

Of course they don't bother to study depathologised types with these new techniques. It would make interesting science. One bit of science is certainly interesting. People who have a different gender identity to their biological identity have brain differences, specifically in the size of their corpus callosum, however they are not treated in the same way. Their choice is exercised to change their body if deemed fit. A half century ago they would have received healthcare to change they way they thought and behaved rather than have their wishes regarded and made possible by doctors.

And what of London taxi drivers? Mentally ill? A study shows that after 15 years of cab driving many have differences in their hippocampal volumes. They must be crazy....or their life experience changes them.

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What is mental health and mental illness?

I've spent so long thinking about this question it has driven me mad.

It is easier to say what it isn't and communicate this than it is to say what it is.

It isn't something doctors should have purview over. Its not an illness for a start. But that's not the important reason. The important thing is the privilege and protection of the medical paradigm.

Doctors are seemingly untouchable. Their profession comes with a high degree of trust and respect from the public. Decision makers, I.e. politicians, don't understand much about doctors and medicine but trust the profession to get it right.

It is, after all, the expectation that doctors always do the right or positive thing. This is why there is little oversight of psychiatry except by lay people who've either been through bad experiences or know someone who has. There is no oversight or checking in the same way there is for prisons where it is assumed that bad things will happen.

Human rights campaigners often fight for the oppressed. They lobby for monitoring and aginst coercive or inhumane actions. And yet so few of the mainstream human rights organisations pick up the banner for the rights of the mentally ill. But of course why would they need to? Doctors look after the ill and doctors do good things....right?

No. It my opinion it is wrong. The mentally ill are just people. They're not ill. They're different. They're considered abnormal in their emotions and behaviour. This is fundamentally what psychiatry does: it presides over these social judgements in the way religions used to. It judges and explains the human condition and its vagries.

The fundamental of medicine is biological deficit or difference and these can be found using objective techniques but the mentally ill are different in a different way. Their different because they exhibit behaviours and emotions which are different from temporary and cultural judgements of this thing which people term normal but don't really think what it means in practice.

As the opposite of mentally ill, normal is docile, emotionless adaptability as a perfect concept. In practice it is people who have a little emotion but not a lot, who react a litte to life events - as one should to social norms - but not too much. It is a person with little anima, few eccentricities and who is as bland as bland can be.

Extreme and undesirable differences are called mentally ill. Labels and systems of labelling are used to categorise these differences into different types of people and human experience and externalisation. Studies are done to show brain differences and this is how human difference is called an illness. Prognosis or outcomes studies are done to show just how poorly people who are different do in life in this shit of a world where only docile, lifeless machines can prosper adequately and difference entails stigma and discrimination. Epidemiological studies are done to show how many of the human population are different in a certain way. Economics assessments then put a price tag on solving these problems using mental health and social care systems and say things like "the burden of mental illness costs society X billion a year" without any consideration of the suffering of the individual because of society's burden.

Then politicans, journalists, judges and who ever else believe this shit.m

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A measure of poorer outcomes which is related to disability and inequality

Right now I have to separate the two concepts. Inequality is not the same as disability. It should be though in practical terms. I mean it. The priviledge of the invalid is what is extended to the disabled but not other disadvantaged groups.

Of course without a hierachy of inequalities, analogous but not akin to disability hierachies, then this couldn't work but disability without hierachy doesn't work anyway. A psychiatric patient or expatient suffers significantly worse life outcomes tyhan the individual who had depression once twenty years ago. The person with gluten allergies has less problems than thalidomide babies.

Disability law is meant to be creating equality but it seems it has lost the goal of its mission. In practice its application falls short. The legal system currently advantages this with lower levels of disability to rectify the problem, I.e. people with common mental disorders are well protected and have a better outcomes compared to those with severe psychiatric illness which continue to have very poor life outcomes.

The equality level for the worst off continues to be very bad whereas the the disadvantaged but less so can easily show a trend of improvement when, in fact, the worst off are still doing very poorly.

This would suck if this were the present reality.

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Is the equality movement driving the reduction of disability?

Yes, no and maybe.

Yes. Of course. The problems of disability becomes less as technology advances make breakthroughs possible and there are changes in society which bring about improvement for those worst off.

No. There are many disability issues which the equality movement doesn't touch upon. There are many disadvantaged groups not protected in the same way the disabled are but still suffer worse outcomes in life because of a characteristic, e.g. Children Looked After. Continuining health and social care and other support offered to the mentally ill must be offered to help these groups because they suffer the prognosis of disability without the label or catgorisation, nor the privilege of the invalid.

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How might an antistigma programme do more to promote equality

Healthcare professionals can have high levels of stigma towards the mentally ill and certain preconceptions. Some studies show higher levels of stigma in doctors.

A study has shown the mentally ill get the same number of contacts but worst quality physical healthcare. Think it was a review paper in the british journal of psychiatry. Professionals may need a tailored antistigma programme.

Hm...more later.

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Equality, antistigma and notes

I'm puzzling how to communicate something which hasn't properly crystalised as a concept. I'm a pretty slow learner in this way but once I've got a concept sorted it becomes easier.

I'm thinking about stigma and discrimination and its link to inequality and disability. Stigma is perceptions and discrimination is action, at least in my simplistic reduction. They are most or all of the cause of disability and inequalities. Inequality and disability may be conceptually the same thing but they're definedly strongly linked.

Rectification of disability is a goal of the nhs and uk government. It feels like less of a priority than tackling inequality but they might be the same thing or so closely aligned that in practice there is no difference between inequality issues and social disability in most if not all cases. The impacts of inequality are seen but not labelled as the outcomes and exclusion of social disability. Social disability exists because of inequality.

Is any of this true? I don't know but I think so. Being poor comes with a poor prognosis, i.e. the label of poor can lead to worse outcomes in some measures, for example life expectancy. Equality reduces disability, e.g. lifts and ramps in all public buildings reduces mobility disability and exclusion.

This example of lifts and ramps is a discrimination issue. Stigma may not affect physically disabled groups in the same way as those with mental disability.

It's all rectifiable inequality though. And, as lifts and ramps enforced by legislation has proven, if there's a will there's a way.

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Sob sob or ha ha

I caught myself trying to remember what it felt like to be happy.

It's a pretty dark thought to have and I paused as I searched for the memory of what it actually feels like.

Its sort of funny in a way. At the moment I'm not unhappy. I have been but this has lessened a lot. My mood, my emotions, have returned to a better state over the last week or two. I want death but this is not a product of low mood. It is a desire and a wish but if your desire is to wish I reason and rationalise it to you then I will if you will give me what I desire and wish.

But no one will.

Anyway, its funny because its hard and its been hard for a long time. I'm sure it will get better but that's not the point. The point is how I've had to develop a sense of humour about this. It is my substitute for tears.

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Nice and impact on equality

First of all, get your house in order. Nice staff levels of people with disabilities is below par. Equality is clearly very poor apart from gender at the high pay grades. What this actually requires is a shift in organisational theory. Nice recruits their highest paid staff because they fit in with the organisational culture. It may be worth considering those who have equally or better abilities than those recruit but fit in less.

This observation about talent or potential and this difficult to appreciate concept of fitting in as being valued is a challenge for organisations and their recruitment practices, as is the issue of a person's ability to persuafe an employer of their talents versus those who have high ability and potential but don't either fit in or communicate well or simply perform poorly in conventional application and interview procedures.

These are factors in the prognosis associated with disabilities like depression or anxiety. A person with low self esteem will not communicate well nor interview well however could be more capable in delivering on the role they applied for or even a higher grade job. Their capablity is not recognised because it depends on self report and communication, I.e. an attitudes based quality, rather than what they can actually do which is a far more complex thing to measure, as is potential.

This is all a long explanaton for something simple. I can't be arsed.

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Notes on nice equality forum

The current structure and systems of the quality standards can do little more than if they didn't exist in terms of equality.

They're limited to a few statements about expected patient care and the only way I can seeing this help equality is ensuring a basic standard of service is offered to all patients.

The problem is when the qofs aren't meant. What I mean is the disadvantaged groups will still be over represented when it comes to those who failed to get a basic standard level of care. They'll also be under represented in the unmeasured quantity: those who got above the basic level of care.

I've already mentioned two opportunities to alter the current qof based on existing documents and proposals. The first relates to problems in the diagnosis of depression which is skewed to not recognise common behaviours and self reported symptoms in men. This was argued in Mind's men and mental health campaign. The other was the lack of mental health screening in the alcohol dependence qof. Self medication is common. Many addicts do not receive appropriate mental health (or likely physical care). The dual diagnosis strategy suggests joined up thinking is a way forward and addiction services and treatment should link with mental health. Mind's men and mental camapaign may also touch on this subject.

Both are equality issues. The first is hard to reduce to a qof but the second isn't. Addicts should have mental health screening and involvement as a standard part of their care pathway.

So, in my opinion, there are already problems with the current qofs and the equality duty.

It sort of goes further. What is most important is impact. This requires monitoring. What I mean is there's no point monitoring qofs without being able to see which groups and types aren't getting the basic standard. Then there's the other problem of affecting poor performance, the far greater challenge in my opinion.

The list of electronically recorded patient characteristics needs to be suitable to encompass the list of equalities act protected characteristics and nices protected groups. This also needs to provided in conjunction with full records for their treating physician.

This creates a powerful data set for monitoring and research into healthcare inequalities. The physician information is necessary to identify biases and, where necessary, identify exceptionally poor performance. These are basic standards which should be offered to everyone and if this doesn't happen then the systems to rectify the problem need the data to do it right.

It is important this data is highly secure and unavailable to any entity other than a computer or a law court at patient level. Physicians and patients shouldn't be allowed access to this information in any way just like any other information about equal ops is protected by the highest levels of confidentiality.

In the modern age knowledge is power and if the aim is to really shift then inequalities then without the data there is just guesswork involved and therefore little impact.

If surmounting health inequalities and inequality in general is a priority for nice then let me begin to talk about the issue and solutions.

First and foremost, equality is about a sort of judgemental blindness. As a principle equality means the worst types of people are treated the same as the very best and in practice it means a minimum standard is offered to absolutely everyone.

It means the Queen gets the same basic level of whatever as a convicted serial mass murderer and rapist. At least in practice. What I believe is the measure of equality is the life experience and outcomes of the worst person, rather than the average being raised. I feel the valuation is important to discuss in a little more detail in how that's relevant in the new nhs and in regard to nice.

This relates to the measurement system. Performance managment theory comes out of practices used in for profit businesses with simple bottom lines and measures. Its still relatively new in health and social care and it requires a little fine tuning in practice.

I worked in performance management in childrens services. An important quantity was the stability of a child's placement and more than 2 changes in a year for a lot of children was a bad thing. I instituted a simple system where the children on the cusp of being moved more than 2 times in a year were checked on about this issue by their social worker. This was great for impacting a key performance indicator and used the system to genuinely help children.

But I failed when it came to what children's social care exist to do, in my opinion. It exists to help the worst off be less worst off.

Changing placements more than 2 times in a year is bad, just as being a looked after child is bad. But moving placements 14 times in a year is a lot worse. That kid... she had a bad life. Childrens social care exists to help people like her but the performance management reporting system didn't capture her experience. The KPI only looked at the average disadvantaged person, not the experience of the most disadvantaged.

I may be an idealist in this respect but sometimes this is the only mentality which will affect equality. Ultimately equality is about reducing the outcome difference between advantaged and disaqdvantaged groups. It is homogonising outcomes against a trend of widening diversity of life opportunity and other outcome measures.

The advantaged do so much better today than ever before. Though the worst off are hopefully doing better than the worst off a century ago the difference between their outcomes and those who are significantly advantaged has grown significantly. This is very well evidenced.

Therein lies the challenge of equality and meeting the duty. There's a problem but how can it be impacted upon?

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"Nobody cares about you."

My dad said this to me a few days before my last birthday. He has a special ability to make me unhappy.

His comment has really stuck in my head. He's right too in spirit. Few people care for me.

As anyone might imagine, taking this comment onbaord has made me unhappy. I've started smoking skunk again and have been drinking heavily. There's been some internal sobbing as the comment bore through my psyche.

It was the last thing I needed to feel about my life and my self but, perhaps, it was important that it happened. The worst of the misery: I'm still alive.

Why was it important? It makes me question myself and my being.

I don't have a lot of positive feelings about myself. I seek evidence and the evidence is I'm a poor, lonely failure who's basically a useless addict most of the time. What little good I do is a pathetic attempt to overcome the abject futility of my life.

Why does no one...welll....few people care about me and why am I so alone? This is an important question to ask, as is the question of why I want to be cared about and not alone however I'm chosing not to explore this second question.

I could simply answer "because I'm mentally ill" but that's a weak answer. It too easily leads to giving up. It doesn't explain enough nor drill into the useful information.

I am suicidal. This has changed me. It makes any sort of connecting harder. It means I've also gotten used to hiding what's inside me. A suicidal person can't live in this world as they are because of the taboo of suicide and the deep rooted dismissal of a person's individual suffering as either a mental illness and therefore something to be dealt with by a doctor or too time consuming and emotional to bother with.

I am an intense person under my veneer. The veneer was much thicker before and fooled lots of people until they got to know about my depths. The facile, jokey and fun person some people know me is as is sometimes a genuine presentation of who I am and how I feel but at other times it's just a facade to get along in this world.

It probably looks false when I don't feel the way my facade displays and this may alienate people because they see me as false, difficult to understand or some other negative caused by having to act rather than be.

Perhaps its because I'm hard to care about. I am bloody minded. I take risks and often don't listen to advice in the rare occassions I ask for it or help of any form. My pride and my resilience mean I'm not good at accepting help and value battling it out alone, no matter how hard it is nor what little positive reward I get from this way of being. This is a difficult way to be if a person wants to be cared about.

I'm also boring. This has become more of an issue lately. I talk about boring stuff. In the right company this can be okay but out with friends on a Friday night it can be difficult. While they're joking away and talking about frivilities I'm talking about stuff which is more like work than play. The deep intensity can also be difficult for other people do they enjoy social contact with me less than if I was like them.

But, perhaps, the hard truth is that I don't care for many other people. I'm selfish and inward focused. I care for abstract labels of groups and types, for example the poor or homeless or disabled or whatever, but am poor at connecting with and caring for real people.

The next step, I guess, is change.

The question I didn't answer was why this matters. For me it is simple in that it doesn't need to be answered more than to say I love company. I love been with people and feeling like part of something.

Instead I spend my days drinking alone in the park.

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To know what it is likr yo want to die

There is a school of learning which, at the moment, surpasses any other when it comes to understand the true spectrum of suicidality.

I have that priviledge and curse. It makes me feel good.

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Measurement, performance management and people's lives

Modern performance management in mental health and social care is derived from practices used in the for profit sector.

Outside this domain performance management really works to deliver real improvement. By real I mean what the measures measure. In the for profit sector the system works well because the measures are often well established and qwuantify simple things.

Averages based measures are the core of this system in performance management, as they are in other fields, is the de facto standard of the application of the philosophy of science. Basically it is evidenced based hypothesis testing which brings empirical stuff to the performance of an organisation.

Science has empowered so much progress through this system which is why the techniques were then applied to the business world.

Progress meant the Third sector had to be truly accoubtable and measured too but in this area the techniques of science hit major obstacles.

Perhaps the least observed but thereby most important advancements when performance management is applied to soft things like people is the performance indicator which communicates the outcomes of those worst off.

This must be communicated though. It doesn't matter to for-profits. It matters to those organisations that really measure important things.

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Equality, disability, stigma and discrimination

These are all related but it might not immediately be seen as such.

Disability is as result of inequality. In a perfectly equal society there is no disability. The society and culture is designed to ensure everyone is equal and has equal outcomes.

Less inequality reduces the impact of disability. Let's take the example of mobility disability, the impact of technology and legislation.

Wheelchairs significantly reduce the impact of most mobility disabilities. The disability was reduced and more opportunities for an average life were made possible.

It then became legislation for every large building or workspace to have ramp entrances and lifts. This again reduced the disadvantage of disability but by changing society and the requirements for buildings rather than altering the individual.

In mental health the disability is associated with stigma and discrimination. There are other factors but these play a large part and perhaps more of a part than in other disabilities.

This force drives the prognosis along with other factors. The problem is reducing stigma and discrimination is not generally associated with mental healthcare.

That is, at least, until Time to Change. This is by far the largest antistigma and discrimination campaign in the world. It is measured on changes in stigma and discrimination and its first run saw it half meet and meet its objectives on these two measures respectively.

It is now funded by the Department of Health for its second run. It is pioneering a new direction in mental healthcare and it's directly attacking the causes of some of the inequality and associated disability.

It is worth considering the WHO IPSS result. This highly regarded study showed people in poorer nations with schizophrenia did better than those in either the US or UK. There are many interpretations of this study and mine is it is an impact of stigma and discrimination. I may be wrong though.

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Stuff for NICE quality

S sort of discussed one of the issues of gender and depression. It's
something which is confusing to me in that it strikes at the nub of what
depression is. My knowledge of psychiatric science leads me to believe
that from the biomedical perspective and with strict application of the
science the problem of the 'feminisation' of depression is not relevant
because the science matches the diagnosis to a prognosis whereas there
is no evidence base for the prognosis associated with masculine
symptoms. On the other hand a person considering depression as the
medicalisation of misery, irrespective of the model of the application
of the paradigm of medicine to human behaviour, would probably consider
the current gender equality problem in the clinical recognition of
depression an area which needs serious attention.

I did the review of literature for Mind's Men and mental health
campaign. The feminisation of depression is part is worth readin
http://www.mind.org.uk/campaigns_and_issues/report_and_resources/898_men_and_mental_health_get_it_off_your_chest

When I was reading into the literature on women's mental health for a
review of Mind's Women and mental health factsheet I stumbled across a
paper which graphed symptom count and gender. Unfortunately I don't
remember the title of the paper nor was the paper directly considering
what I saw in the data. I think the paper was written to show how great
the cluster of symptoms approach was (i.e. good validity qnd
reliability), but looking at the graph it was interesting to consider
what the operational diagnosis approach is trying to achieve. Both
genders reported similar levels of self-report of a period of subjective
unwellness. As objectivity was applied, i.e. as more symptoms were
required up to the minimum of 5 for a DSM-IV clinical diagnosis of
depression, fewer members of both genders were counted and the rate of
decrease was higher in men. This is the empirical proof (if I could find
the paper!) to support what Mind have already said.

This information wasn't in Mind's Men and mental health report but there
was a lot of other research in there whch supports the idea that men can
externalise their symptoms in different way to women. If I remember the
timeline right the NICE depression guidelines were revised before Mind's
Men and mental health campaign but the QOF was obviously produced after
Mind's campaign. I'm unaware of whether Mind were involved with the QOF
consultation but I'm pretty sure they'd be making this point about
gender equality and depression. This report received significant
political backing and was widely disseminated and publicised as part of
Mind's Mind Week so I'm surprised their concerns weren't taken into
account as part of the process to write the depression QOF.

It is, perhaps, a moot point because I don't see an easy way to
integrate all the equality considerations with the QOFs. The QOFs are up
to 15 simple, achievable treatment tick boxes. "Do mental health
screening" in the alcohol dependence one would be something which would
work however "Check men are depressed but don't use the cluster of
symptoms approach" might not really translate well into what the Quality
Standard is. However it is still important that men's depression, and
other groups too, are recognised and treated.

I hope this isn't a totally abstract discussion. It premises something
I've been thinking a lot about as part of my activism work. The AESOP
study notes schizophrenia is disproportionately diagnosed in black
people 9 times more than their white counterparts. This doesn't happen
in the West Indies. i would suggest this is a high priority inequality
area which needs to be tackled, especially considered the results of the
Count Me in Census which details the continuing bad experiences of
mental healthcare faced by minority ethnicities.

It is a serious issue and was recognised in NICE's revised schizophrenia
guidelines and in the New Horizons consultation document. There has been
a significant amount of research effort put into understanding the cause
of the problem and how to solve it, such that a fellow member of the
ENUSP email list noted, "Another local issue here - some years ago
ethnic minorities were fed up with research into their mental health
needs, a popular topic for researchers which did not however lead to any
change." It would be great if there was a QOF aimed at solving the problem.

I found a study done in 1999 where a Jamaican psychiatrist compared
inpatient schizophrenia diagnosis with UK psychiatrists and agreed with
them about half the time.
Hickling FW, McKenzie K, Mullen R, et al. A Jamaican psychiatrist
evaluates diagnosis at a London psychiatric hospital. Br J Psychiatry.
1999;175:283–285
http://www.ncbi.nlm.nih.gov/pubmed/10645332
"Of 29 African and African-Caribbean patients diagnosed with
schizophrenia, the diagnoses of the British and the Jamaican
psychiatrists agreed in 16 instances (55%) and disagreed in 13 (45%).
Hence, interrater reliability was poor (kappa = 0.45). PSE CATEGO
diagnosed a higher proportion of subjects as having schizophrenia than
the Jamaican psychiatrist did (chi 2 = 3.74, P = 0.052)."

In nother study which I came across (while looking into men and mental
health but can't remember the title of) the authors stated that the
largest factor in psychiatrists variance in diagnosis wasn't gender,
race or age. It was where the psychiatrist studied psychiatry. I looked
into this because it was suggested that the gender of the diagnosing
physician and the patient may affect the levels of recognition of
depression.

In short, a solution to this problem may be using West Indian and
African psychiatrists to train specialist psychiatrists in high BME
areas with the purpose of offering a non-culturally biased second
opinion diagnosis. As a long term solution psychiatry students would
require similar training.

A QOf could ask for a non-culturally biased diagnosis but this would be
meaningless in clinical practice. A QOF could ask for BME diagnoses to
be checked by UK-trained ethnic psychiatrists but this may be
ineffective because of the influence of formative psychiatric education.

To correct this problem of overdiagnosis would require a long term
solution akin to what I've suggested and then q QOF could be used but a
QOF on its own won't do anything to actually achieve on the equality
duty in this instance. It may be the same with the example of men and
depression. It may, again, require training.

When is it miserable to see a rainbow?

When all I want to do upon seeing it is reach into my bag and pull out a camera with which to shoot it. This is a special misery just for me. A reminder of all the hard work I started on this time last year to get the funds to buy some equipment and get my shit off the ground properly.

Continuation of life course as a stated objective of nhs mental health and social care

This should be implicit but its not.

Nhs care simply does not focus on the disability aspect and rectifying it. Psychiatric crisis is a powerful indicator of reduced life course and this is inherently part of the process which creates the negative prognosis. Along with other stuff relating to stigma and discrimination which also factor into the disability.

Fuck.

How to communicate the illegality and immorality of chemically coshing the elderley in just a few words

I often say too much. My answers can be too detailed and my explanations lengthy. I'm often dealing with complex concepts I barely understand but can visualise structurally in my mind. I also have a lot of odd ball opinions which can take time to explain their sanity.

So I'm stuck now trying to convey, effectively, the ire I feel about the deaths of the elderly.

Over a hundred thousand elderly people were drugged with antipsychotics. These drugs do not treat the illness of dementia other than to suppress undesirable or challenging behaviours.

The drug does not heal the brain nor regrow damaged tissue. What it achieved, in this instance, is the effect achieved by making a personal docile or quiet. They become easy to manage and less hassle.

It is a convenience to have this power over the elderly. It could be achieved by using gags and straitjackets thought I don't advocate this. It would be immoral to gag or restrain our elders as they near the end of life. It is as equally immoral and significantly less harmful to the patient than antipsychotics but the lesser of two evils, in my opinion, is still evil.

There are better solutions though and these have been focused upon after the mass slaughter of the elderly on antipsychotics was discovered.

But the drugs aren't banned for this use. Doctors are still using these drugs on the elderly. They don't heal dementia but they suppress the expressions and behaviours of the elderly, and kill them quicker in the process.

Mental health as a religion

I thought of this because I was thinking about part of my childhood.

I lived in what is quite a strict religious family but from the age of 10 I was an atheist. I didn't believe god existed for many reasons.

Though an atheist I loved reading mythology and religious material. I read hundreds of Indian comic books which were all about the mythology of Hinduism. There were many wise teachings, teachings which ic ould not find in my science books. I loved science but I was also interested in what it couldn't offer: answers weren't available for the human condition, at least the stuff I learned in school.

Eventually I found myself knowing a lot about mental health and it is this aspect where science is applied where I've found the part of human life which religion used to have purview over.

Unhappiness and strange behaviours were explained bu churches and other religious or spiritual establishment which offered the consensus explanations, labels and solutions.

The power of god's word is replaced by science and medicine...but it is as equally apt at offering answers and, perhaps, worse.

I've made this point quickly but its something which could easily be a thesis or something.

I think people can understand how a depressed person in the past may have ended up seeing a priest rather than a doctor. Its possible certain rituals may have been used, from exorcism or confession (like counselling...).

For some these may have worked because of the power of the placebo effect, or god depending on your perspective. After all, psychiatry shouldn't dictate upon what it should know it shouldn't know: we can not yet prove or disprove the existence of god using scientific methods. The effect is so powerful a high quality review showed ECT and sham ECT to be as effective on followup yet this is an extreme treatment for extreme cases and only justified for use because of its harm and risk of death.

But that's not what I'm talking about. Im talking about how mental health replaces religion in ways such as labelling and controlling social behaviour and human types, but priests and bishops are replaced by doctors and psychiatrists. Science replaces god but the dogmatic frameworks and power structures within society have changed little.

Unmarried mothers a century ago were so sinful....or mentally ill....ir mentally unhygienic which is another term from that era...would be locked up and their children taken away. Frequent masturbators too. Gays, lesbians and anyone brave enough to be transgendered also.

Things have gotten better as a result of social progress but ultimately this sibjective quality has the attempt of the application of science to say a group. Or a type...is somehow inferior and needing to be changed to be more normal without any objective scientific constant for what is normal.

Science and religion do different things but they're still similar modes of operation to regulate the psychosocial...to regulate people and identity and explain the things which science has no answers to, yet.

If I do die and you know who I am..

...then understand this is the best thing for me. It's what I've wanted
for such a long time. An end at last. A light at the end of the darkest
tunnel which is my life.

My reply to the Baroness;s reply about the NHS reforms

Many thanks for your response, especially on a Sunday.

I will endeavour to find an appropriate peer.

Please could I just reiterate my point. Drug pharmaceutical reps have
significant budgets to influence doctors. They didn't aim to influence
commissioners in the old NHS but my personal experience is they
attempted to influence doctors like my dad. They do it because they know
it works. They do it to boost their profits.

There are no protections to stop these drug reps buying influence in the
new NHS and as I've pointed out there can be dangerous consequences,
especially with the reduced accountability of the Secretary of State.

Psychological therapists and patients don't have these huge budgets nor
designed sales people to buy influence in the new NHS. All they have are
the poorly funded mental health charities. (I used to work at Mind so I
know just how poorly funded they are)

Patient safety must always be a priority but the pharmaceutical
companies aren't primarily driven by this goal. They're interested in
profit and they're always looking for new ways to doctors to use their
products. Unfortunately the drugs have have terrible consequences.

1,800 unnecessary deaths every year is a scandal in healthcare. Whatever
the NHS becomes this sort of disaster mustn't happen again. Patients
must be protected from these dangerous drugs which are used out of
convenience rather than for a genuine healthcare objective. The
antipsychotic does not heal dementia nor regrow the brain. In fact
there's evidence to show it reduces brain matter. All the drug did was
make the elderly docile and easier to manage - sort of like if they
gagged the elderly and put them in straitjackets. I believe this would
be immoral but it is effectively what the antipsychotic did, but it
killed many of them much earlier than those who weren't treated in this way.

The old NHS didn't prevent this disaster. Whatever the new NHS is there
must be systems in place to prevent this sort of mass manslaughter
happening.

I implore you to consider the risk to patient safety through the misuse
of mental health treatments.

Thank you again for taking the time to read my views

Please don't let doctors kill the elderly (The UK dementia scandal, the influence of drug companies and whether it will happen again in the new NHS)

Something I wrote to a Lord/Baroness.

"

I write with grave concern about the proposed NHS changes especially
with respect to their ability to deal with mental health problems.

A report from the Royal College of Psychiatry shows 1,800 elderly were
unnecessarily killed every year by doctors misusing psychiatric drugs in
the role of a 'chemical cosh' but there has been no accountability.

It was GPs who made this error. After the government review the misuse
of antipsychotics wasn't banned. GPs were simply measured on how few of
these drugs they prescribed, i.e. on how few elderly people they killed
unnecessarily.

Here is a link to the information.
http://www.nhs.uk/news/2009/10October/Pages/Antipsychotic-use-in-dementia.aspx

I don't think anyone should die because of their behaviour is considered
difficult to deal with, least of all our elders.

GPs aren't trained in mental health, not like psychiatrists, so they
don't understand what they're doing with these drugs and they killed
thousands of people every year as a result. Mental health is a deeply
complicated field where many immoral activities have happened under the
name of healthcare, for example the incarceration of unmarried mothers
in the early 20th century. Without specialist knowledge nor the
foresight to understand the dangers of modern treatments I fear the new
NHS will wrought even more of these crimes against humanity because GPs
are not suitably trained nor influenced by sociological or equality
concerns.

They're strongly influenced by medical sales representatives. My dad's
a GP and he's on friendly terms with the drug reps. I've been to a
lavish dinner with them at least once with everything paid for by the
drug company. The stationary cupboards in every GPs surgery is stocked
full of drug branded pens. The medical literature is littered with
advertisements for drugs. The drug reps are well funded to build
personal relationships with GPs to make more profit for their company.

These companies are driven by a financial bottom line and they will do
everything to guarantee profit for shareholders. This includes hiding
evidence which doesn't show the value of their drug - publication bias.
This also includes promoting off-license or immoral ways to use these
drugs, for example the unnecessary coshing of the elderly with
antipsychotic drugs to make them easier to deal with.

Thousands died ever year because GPs were prescribing these drugs
unnecessarily and drug companies need to find new markets for their
products.

This can not be allowed to happen ever again.

Thank you for taking the time to read my concerns."