Sunday, 30 November 2014

Know mental health and what you purport to represent (esp you @#£% at Mind)


In short, the dual continua of mental health. Psychopathology and distress. Understand?

Psychopathology is the remit of psychiatry. Distress is different and there's no science for it.

The psychopathology model of depression has a precise definition used to diagnose "clinical" depression. The cluster of symptoms approach. This is essential to scientific validity and reliability. However, its use in clinical practice means not all people suffering are diagnosed as depressed and if they are anyway (eg depression not otherwise specified or something) there is no scientific truth to treatment. It's just guesswork.

Why is this relevant? For a start it isn't what patients expect. They expect depression to be misery but this isn't what psychiatric research focuses on. Psychiatry is an old style, undemocratic power structure. Patient expectations are irrelevant, but not to you. Especially Mind because the dual continua model was promoted by one of the organisations which came together to found it after WWII. Mind (used to?) teach this dual continua theory in its mental health training.

What can be done? This is the hard bit. Basically psychiatric science needs to be adapted. It has to adapt to people showing only 1-4 symptoms or ones which fall outside the list of standard symptoms. This is challenging but, I'm afraid, absolutely necessary.

Without this adaptation to the diversity of distress psychiatry is failing the public and so are you. You're using psychiatric evidence to make false promises of successful treatment otherwise. This is a travesty.

Another example of the absence of consideration of patient expectations is the lack of a meta analysis of major tranquillisers looking for the effect on hallucinations alone. This might exist now but didn't a few years ago. This is a similar travesty which is simple to fix but wasn't in the half century or so of the use of these drugs. It shows if these drugs are just a chemical cosh or have a genuine effect on the quantity which patients expect to be being treated.

Without doubt there are other examples of this flawed, undemocratic approach. Chronic suicidal ideation for example.

You folks are paid well. Earn it. This debarkle of scientific practice is something your stakeholders/members expect you to campaign and lobby against. Don't @#£%ing tell me this isn't Mind's @#£%ing mission.



- sent from a tablet

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We It comes in part from an appreciation that no one can truly sign their own work. Everything is many influences coming together to the one moment where a work exists. The other is a begrudging acceptance that my work was never my own. There is another consciousness or non-corporeal entity that helps and harms me in everything I do. I am not I because of this force or entity. I am "we"