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Archive for September, 2010

Mental Health and Young People

The charity YoungMinds has called on the Government to spare children’s mental health services from forthcoming budget cuts.

They argue that it is right to support children who suffer from mental health issues, and also point out, quite correctly, that untreated childhood issues will only become worse in adulthood. They also believe that teachers and health professionals, and most importantly parents, should be better prepared to assist young people.

But how prevalent are mental health diagnoses amongst young people?

The Office for National Statistics (ONS) reports that one in ten children and young people aged between 5 and 16 years of age has a clinically diagnosed mental disorder: The figure is even higher amongst children from lone parent families and those at the lower end of the socio-economic scale.

And the stigma of a mental health issue can be made far worse for young people than adults. They are often rejected by peers, which can lead to isolation, strong feelings of shame and a sense of hopelessness. These feelings can increase the chances of self-harm and suicide in young people.

‘see me’, the Scottish anti stigma campaign found that 40% of children would not want anyone to know if they had a mental health problem. The survey also showed that one in five young people say they would find it hard to talk to another young person with mental health problems

The quantities of antidepressants prescribed by the NHS have almost doubled overall in the last decade, and figures released under the Freedom of Information Act last year showed that more than 113,000 prescriptions for antidepressants were issued to under-16s in 2007 alone.

It should be noted that doctors are rightly reluctant to prescribe such drugs to young people. There are clear Nice (National Institute for Health and Clinical Excellence) guidelines. Treatment should range from counselling sessions, to more prolonged periods of treatments such as Cognitive Behavioural Therapy and other counselling and, finally, antidepressants.

Diagnosing mental illness in young people is notoriously difficult. Hormonal changes can mean that mood swings are common in young people, and they are generally not good at sharing feelings and problems with adults. They don’t end to refer themselves to health services in the way that adults might.

This all indicates that there may be many cases of untreated depression, which is a fear of many mental health professionals.

The mental health charity Sane believes that the typical onset of depression is now coming earlier in life. They report that the numbers of teenagers calling for help suggests the rate of depression in the under-14s has doubled in the last four years, and in the 15-24 age group it has increased by one third.

The stresses teenagers have to deal with have generally increased. They often have to deal with breakdown in family life added to increased academic expectations, peer pressure and all of the stresses associated with growing up in the modern world.

I’m sure we all remember how difficult teenage life can be. But it can be made even worse if the support is not there for those who are unfortunate enough have mental health issues.

Very simply, more money needs to be invested in mental health services for young people. They deserve the support.

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New figures released by the Scottish government show that more antidepressants are being prescribed than ever before. The statistics showed a 7% increase in daily use of the drugs over the past year.

The SNP had pledged in its election manifesto to reduce the yearly increase in antidepressants to zero by 2009 and bring it down by 10% a year after that. The figures show a clear failure for the government.

Progress in health against key objectives is measured against something called HEAT targets – it stands for Health improvement, Efficiency and governance, Access and Treatment.

But the original HEAT target for reducing antidepressant prescribing, based on the SNP manifesto pledge, is now seen as too simplistic. The idea was that a lower number of prescriptions would show that other treatments were being used instead. However proxy indicators don’t always work.

We now know that the number of prescriptions is still increasing. But does this mean that more people are being diagnosed with depression?  Or that higher doses of antidepressants are being prescribed? Or even that patients are now taking antidepressants for longer?

The target simply doesn’t give us the answer. So, at the end of 2009 the government changed the HEAT target. It now reads:

“During 2010/11 the Scottish Government will work with NHS Boards to develop an access target for psychological therapies for inclusion in HEAT in 2011/12.”

The daily use of powerful medications is a reality for many people who have mental health conditions. But it is not the only possible treatment for depression, and often not the best approach to take. For many people a programme of structured counselling, such as Cognitive Behavioural Therapy (CBT) can be far more beneficial.

So why are doctors not referring more patients to these psychological services rather than reaching for the prescription pad?

Very simply, there is a shortage of psychologists in the NHS. I have been told that in Glasgow the waiting time from referral is around six months and anecdotal evidence would suggest that this is fairly typical throughout the country. This leaves GPs with little to offer patients in the short term other than a prescription.

If the government is serious about reducing the amount of antidepressants prescribed then it must invest in psychological services. Will they do so given the current budgetary situation?

This is the key question that Public Heath Minister Shona Robison and Health Secretary Nicola Sturgeon have to answer.

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Ed Miliband’s key message in his first leader’s speech was a simple yet powerful one: a new generation is in charge of the Labour Party and it has a new message of optimism.

With rows of young people behind him and a lectern bearing the slogan “A new generation for change”, Ed Miliband took to the stage to make the most important speech of his relatively short political career.

As the newly elected Labour leader he had to be aware that he was speaking to two distinct audiences: the party members in the hall and the voters outside of it. And he also had to balance his views on Labour’s general election defeat with a positive message, distancing himself from the past but also setting out his stall for the future.

Ed Miliband pitched his lengthy address perfectly in a composed and polished performance from a confident leader.

He began slowly, thanking well wishers and those who had offered him advice. The new leader looked relaxed, throwing in a few joke. There were kind words for his brother too, as Ed described David as “an extraordinary person”. And he also praised his deputy Harriet Harman for her strong contribution as acting party leader.

There was a mention too for those standing down from the front bench. Alastair Darling was thanked for his role as Chancellor and Jack Straw for his many years of service to the party.

The tone then became serious as the speech proper started with Miliband setting out its key themes: a new generation, change and regaining the trust of the country for his party.

He used the story of his parents’ escape from wartime persecution and the welcome they found in Britain to stress his love for his country. Praising their courage, Miliband stressed that his upbringing taught him to fight against injustice and for the values of freedom and opportunity.

After thanking party members for their work in the election, Miliband stressed that the result had been a poor one. His message of humility was strong: the party had lost trust and had to admit to its failings. And as leader he would ensure that the lessons would be learned.

“Labour needs to ensure the coalition is a one-term government. That’s the purpose of my leadership.”

He emphasised that New Labour had achieved change, but by challenging and innovating. There had been successes, he said: the minimum wage, lifting many people out of poverty and improving public services, particularly in health and education. The Labour Party had saved the NHS after years of Tory cuts.

Miliband also touched on the equality agenda, talking of changing attitudes through the introduction of civil partnerships for gay and lesbian couples and the use of all women shortlists to work towards a more representative parliament. There was praise too for the Scottish and Welsh parliaments and for the peace process in Ireland, which he cited as a great achievement by Tony Blair.

Miliband then turned to the failure of Labour as the party lost support. He argued that New Labour had turned from innovator to establishment, losing its radical edge. “I understand,” he said repeatedly, citing issues raised by the public in areas such as immigration and MPs’ expenses where Labour had failed to listen.

The new generation would listen, he pledged. It would be radical and forward thinking, take back the centre ground and work towards an election victory. It would make the economy work for all, value community and family and pursue an ethical foreign policy.

Miliband stressed the need for a new politics, not bound by fear but challenging old thinking to build the economy again. He was clear that a reduction in the deficit was required and that cuts would have been made had Labour won the election. But it had to be done in a way that was fair, promoted growth and at a pace that didn’t threaten economic recovery.

The key pre-requisite for Labour to win the next election was to re-establish its reputation for economic competence, Miliband proclaimed to loud applause. He also called for the bankers who had caused the crisis to pay more while middle class families were protected from its effects. Again this went down well.

Understanding public anger at the economic impact of immigration was important, the new leader argued, stressing that while immigrants had make a great contribution they shouldn’t be exploited in order to drive down wages.

Miliband sought responsibility from trades unions, clearly keen to tackle head on the argument that he is the creature of the unions. While stressing the positive role that the unions have to play in society he also called for restraint. He will have “no truck with overblown rhetoric about waves of irresponsible strikes.” And he committed the party to campaign for a living wage.

He also sought to portray a fairer and more equal society. “What does it say about the values of our society that a banker can earn in a day what the care worker can earn in a year?” he asked, before arguing that fairness and responsibility went together to create a better society.

Benefits reform was required, but not in the manner proposed by the government, he said. Tackling the benefits trap is important, but must not be done purely to scapegoat and to make arbitrary cuts.

Foreign policy caused perhaps the biggest stir with Miliband asserting that the war in Iraq was wrong. There was applause from the hall but also stony glares from several of those who had been in the Cabinet at the time. He called for a line to be drawn under Iraq and for new alliances to be built in efforts for a lasting Middle East peace settlement.

Politics must change, said Miliband. The public has lost trust with politicians and the political process and reform is required. He said he would support the proposed change to the Alterative Vote, and called for an elected House of Lords and a strengthening of local government.

But mostly, politicians must change, he stated. Leadership was required and not focus groups. The public has to be engaged and not talked down to. And government must be responsible, he said, stating that he would not oppose on occasions where the government was right.

Miliband made great play of some of the names he had been called during the leadership campaign, calling for a grown up debate rather than childish name calling.

And he concluded by stating that he relished the opportunity to take on David Cameron. He stressed differences between Cameron’s approach and the optimism of the new generation, likening it to past Labour governments that had built the welfare state and reformed society.

“We are the optimists and together we will change Britain,” were his final words.

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This was a carefully crafted and skilful speech. Miliband knows he has to regain support among Labour’s traditional voters, but also needs votes from the middle classes. He got the balance right, concentrating on principles rather than detailed policy announcements.

Ed Miliband skilfully advocated for change, while acknowledging the mistakes of the past. While he does not have the rhetorical flair of some, it was a polished performance that ended on a strong forward looking message.

This wasn’t a left wing speech by any means; rather it was one that sought to regain the centre ground for Labour. He didn’t play political knock about by attacking opponents, but set out his own approach instead.

The new leader knows that the journey back to power for a defeated party can be a long one. This speech was very much a starting point, but it was one in which Ed Miliband set out a new approach and gave hope for the future.

It was a very good beginning to a leadership that promises much.

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Be Careful What You Tweet

Context is everything. A tweet that seems humorous when you write it might just be read differently. And if you post something extreme it might come back to haunt you, so be very careful.

Take the case of Paul Chambers, a 27 year old trainee accountant from South Yorkshire.

Young Paul met a woman from Ireland online and an internet romance blossomed. He decided to go visit Crazycolours, or Sarah as her friends probably call her, and booked a flight from Robin Hood Airport.

A week before the romantic rendezvous in January the British weather turned nasty and snow fell. The airport was closed and Chambers became anxious that his trip might have to be cancelled. Like many he expressed his feelings to his Twitter followers.

Crap! Robin Hood airport is closed. You’ve got a week and a bit to get your shit together otherwise I’m blowing the airport sky high!!

Now to me that seems like a joke. Not a very funny one admittedly, but a tweet with humorous intent nevertheless.

But a week later, Chambers was arrested, questioned for eight hours, had his computers and phones seized and was subsequently charged and convicted of causing a “menace” under the Communications Act, 2003. He was fined £1,000.

Chambers is now appealing his conviction, thought to be the first in the UK for the content of a tweet, at Doncaster Crown Court.

And the court case seems to have made interesting viewing. Firstly, barristers had to explain to the judge and magistrates exactly what Twitter was and how it worked. There were then learned arguments over freedom of speech and the meaning of double exclamation marks. And consideration of Chambers’ intent was to the fore. Was this a serious threat or, as the defence argued, merely “hyperbolic banter”?

The court was also told that a senior airport manager had been told of the threat but did not think it was serious and that Chambers had told police officers in interview that it was nothing more than a bad joke.

A ruling will be issued at a later date in this strange case.

But, you will be happy to know. Paul has now moved to Ireland to be closer to Crazycolours and their relationship is going very well.

I wonder exactly how this case ever came to court in the first place. Perhaps the computer geek in Spooks was alerted to this tweet by secret monitoring software. He then ran to Sir Harry to alert him to an imminent terrorist threat. And an operation was immediately launched.

Or maybe it was simply the result of a sense of humour failure somewhere.

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Labour has a new leader, and it is the younger of the Miliband brothers.

As expected, the final result was very tight and the second preferences of votes from the other three candidates told in the end. Exactly as he had in the campaign as a whole, Ed started behind David and gradually caught his brother, going ahead only on the very final round of votes.

At the start of this long, and eventually enthralling, campaign David Miliband was the clear favourite. When Ed decided to stand against his older brother it was seen as no more than something of a fraternal oddity, and the bookies made him a 33/1 shot.

But over the past few weeks Ed Miliband’s message of the need for change and his desire to reconnect Labour with its core support had resonated with party voters. The talk has been of the lead narrowing and over the past few days it became clear that there was a real chance of an upset.

In his acceptance speech the new leader heaped praise his opponents for the manner that the contest had been conducted. Perhaps it is a sign of a new responsibility within the Labour party that the acrimony normally associated with such contests was missing this time around.

Ed Miliband also spoke of the need for the party to engage with young people, perhaps an obvious move from one of the youngest leaders of a major political party in modern times. But he knows that Labour must appeal to all voters and that includes many whom he hopes will become radicalised as campaigns against government cuts take shape.

At 40 years of age, Ed Miliband is certainly not an established political figure. He has only been an MP for five years, although does have Cabinet experience behind him. In comparison, Tony Blair who was 41 on becoming Labour had been an MP for 11 years. But this means that Miliband is not an establishment figure and can represent a break from the past for Labour.

Sections of the media portrayed Ed Miliband as a left wing figure during the campaign, and they will certainly now talk of a move from the centre position of New Labour, while the Tories are known to be ready with an epithet of Red Ed. And they will also play on the union backing that ultimately made the difference in the election.

But the younger Miliband is not a left winger by any means. He stands for a fairer society and this will appeal to many of the Labour supporters who didn’t come out to vote for the party in the last election. And his support in the trades union section of the electoral college came not from their leaders but from individual members – which actually demonstrates that he can gain the support of working men and women across the country.

Ed Miliband is very much his own man. He is not the creature of the trades unions. He knows Labour needs to have humility after its election defeat but must also look ahead in a positive fashion.

The new leader will want to turn the attack on both the Tories and their government partners, the Lib Dems, as he aims to attract voters back to Labour. But he must provide alternatives as well as carrying out the role of leading the opposition.

Miliband will be keen to be rid of talk of new or old Labour, right or left. He will want to establish a credible alternative to the coalition government’s policies, particularly on tackling the deficit and managing public services. He knows that the deficit must be tackled but must lay out plans to do so in a fashion that does not hit the poorest in society.

He will use his Conference speech on Tuesday to set out his stall as leader, and must carefully balance his message to maximise the impact of his victory. It must appeal to both internal and external audiences alike. A living wage, taxing the rich and the introduction of a graduate tax have all been features of his campaign. And as a former Climate Change Secretary he will have an eye on the green agenda too.

Ed Miliband will also have a real challenge ahead as he puts together his shadow cabinet team. Once the election amongst Labour MPs decides the names, he will have to match them to jobs. And there will be some difficult decisions to be taken.

Will his brother David continue as Shadow Foreign Secretary or take on the key role of Shadow Chancellor? Will Ed Balls be rewarded for his strong performance in the leadership contest? How will he balance the team in a way that is acceptable across the party?

The election of Ed Miliband as its leader marks the rise of a younger generation in Labour politics. Blair and Brown are gone from the top table. Mandleson will not be as influential. A new era has begun.

Ed Miliband fought a fine leadership campaign, being rewarded for concentrating on the issues and speaking to the party’s voters in a way that they could clearly relate to. This was a stunning victory and it demonstrates the political skills and courage that the younger of the Miliband brothers possesses. He took on not only the clear favourite but his own older brother – and he won.

Ed Miliband knows he must make a strong start in his new job. He will tackle the role of Leader of the Opposition with the same energy and imagination that he has already shown. He will strive for a party that looks forward in a united campaign for change and for fairness in society.

And his sights will be firmly set on the ultimate prize: a victory for Labour come the next general election.

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The Queen Pleads Poverty

It has been revealed that an unusual request was made for grant funding aimed at reducing the energy bills of low income families.

In August 2004, officials at the Department for Culture Media and Sport were asked by royal aides whether the Queen would be eligible to apply!

But, in an apologetic email sent back to the Palace, it was explained that the grants were aimed at schools, hospitals, councils and housing associations for heating programmes which would benefit low-income families.

The e-mail also indicated that officials were cautious of the “’probable adverse press coverage” that would certainly have resulted from any award. So they didn’t consider that the whole idea of a multi millionaire applying for this grant was totally obscene, then?

Royal aides complained to ministers that the Queen’s gas and electricity bills, which had increased by 50 per cent, stood at more than £1m a year. Now, it is true that the Queen has slipped down the league table, being ranked at just 245th on the UK’s rich list, but with a fortune estimated at £290m she can surely afford to keep the heating on in her palaces.

A spokesperson for the anti-monarchy campaign Republic said: “These documents are clear evidence of the contempt the Palace has for ordinary people in this country.

“We have our head of state demanding cash that has been set aside for low-income families, for the most vulnerable in our society.”

For the record, the money went instead to some far more deserving causes.

Fife Council was the biggest single recipient gaining £1.5M for a community heating scheme that uses waste heat from the Lochhead landfill site to supply heat to 300 households and four public buildings.

Birmingham City Council got £1.3M for a new heat network linking six public buildings including Aston University, a children’s hospital and court buildings. And Highland Council secured £800,000 for a new heat network serving a primary school and over 200 homes.

I simply can’t see any good argument for having an outdated institution like the monarchy in a 21st century democracy. But surely even those who do support the privileged position of Mrs Windsor and her family must be appalled by this attempt to snatch yet more public money.

And at a time of spending cuts in the public sector, perhaps a closer look at the amount we spend on the monarchy is required.

After all, they are part of the dependency culture that our political leaders seem so keen on tackling.

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How Big Is The Gay Community?

New survey results from the Office of National Statistics suggest that the number of gay, lesbian and bisexuals in Britain is much lower than previously thought.

The survey puts Britain’s gay community at 1.5% of the total adult population – far below the most common estimate of 6% which is routinely used by equality organisations.

The results come from the Integrated Household Survey, the second largest after the census. One key difference though is that the HIS asks questions of individuals while the Census return is filled in by one person on behalf of a household.

This is the first time the survey has asked about sexual identity and the ONS stressed that the question was “experimental”. As is often the case with surveys though, the way a question is phrased can have a dramatic impact on the results.

The ONS said it had used a question on self-perceived sexual identity. Respondents were provided with a showcard containing four options: heterosexual/straight, gay/lesbian, bisexual or other. They were asked which option best described themselves.

96% of those surveyed provided an answer. ONS stated that it would be wrong to assume that the other 4% were secretly gay, but you do wonder what other reason someone would have for refusing to answer. And the rate of refusals is much higher amongst younger age groups, which may indicate teenagers unwilling to identify themselves as gay.

Some argue that sexual identity is different from sexual orientation. Their argument is that some people may be celibate and not see their identity as gay even if they are not actually heterosexual.

Press reports of the survey’s results range from the factual to those indicative of the right wing attitudes they portray. The Daily Mail revelled in talk of myths and assumptions being debunked, quoting a spokesperson for something called the Christian Institute who called previous higher estimates “a lie”.

The Chief Executive of the gay equality charity Stonewell, Ben Summerskill, suggested that the survey underestimated the true figure. He said: “data collection happened on doorsteps or over the phone, which may deter people from giving accurate responses – particularly if someone isn’t openly gay at home”

Arguments will rumble on about the exact size of the gay community, although the very fact that the discussion is taking place shows that some progress in the fight against discrimination. But there is still a very long way to go.

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