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Archive for the ‘Bipolar disorder’ Category

I don’t often get upset by what’s written in the tabloid press. I’m used to the nonsense the Sun et al produce on a daily basis to sell their nasty little right wing rags. But today’s Sun headline has got me angry.

According to the Sun. 1,200 people have been killed by “mental patients” in the last ten years. Now to read the full story you have to buy the paper (no chance) or sign up on line for something called Sun+, and I’m certainly not giving them my money or my e-mail address.

Instead let’s look at some facts. (Note for any Sun journalist reading: a fact is defined as, ”knowledge or information based on real occurrences”.)

Ten minutes of internet research tells me that there were 8,091 recorded murders during the last ten years. That’s 6,743 in England and Wales (figures from ONS), 1071 in Scotland (figures from Scottish Government) and 277 in Northern Ireland (figures from PSNI).

Were 1,200 of these really were committed by “mental patients”? 15% of the total? Mind you, we don’t know how the Sun defines a mental patient. Do they mean anyone who has ever been treated for a mental illness – which could be around a quarter of the population.

So the rate of offence by “mental patients” could actually be lower than average.

Coincidently, another report was published today. And it showed that people with mental illnesses are three times more likely to be victims of crime than the general population.

Now this one didn’t come from a tabloid newspaper. No, this was a proper piece of research carried out by academics from Kings College London, Kingston University and St George’s University of London, in collaboration with University College London. A slightly more credible source then …

The report shows that almost half of people with some form of mental illness had experienced a crime in the last year. People with severe mental illness were five times more likely to experience assault, while severely mentally ill women were 10 times more likely to be assaulted. Six out of 10 women in this group reported being victims of sexual violence as adults.

And what are the police doing about this? Interviewees said that when they sought help, they often found they were treated unfairly by the police and other agencies. Victims said they found it difficult to convince police to take their reports seriously. And of course some people won’t report crimes out of fear of being detained themselves under mental health legislation.

Paul Farmer, Chief Executive of the charity Mind, said: “Being a victim of crime is a horrible experience for anyone to cope with but when you have a mental health problem the impact on your life can be even worse.

“People with mental health problems have an equal right to justice, yet this report reveals that this is not the reality for far too many of us.”

So once again the Sun is promoting a stereotype that simply isn’t supported by the facts. They demonise and stigmatise large sections of the population based on nothing more than prejudice. People with mental illness are actually far more likely to be the victims of crime than the perpetrators.

But then that probably doesn’t sell newspapers, does it?

 

 

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Scotland has a new Mental Health Strategy.

The Scottish Government’s strategy for the period 2012 – 2015 was launched earlier this month. There was none of the fanfare that usually accompanies these launches, although that might be due to the timing: mid summer, in a parliamentary recess and post Olympics.

The document was finalised following extensive consultation with user and carer groups, and the Scottish Government is to be commended for producing a strategy that takes on board many of the issues that were raised. User and carer involvement is, quite rightly, at the centre of the strategy, which is very much a working document rather than a lofty statement of ambitions.

The overall tone is of building on successes while recognising that there are also weaknesses to be dealt with. It is realistic, and in times of declining resources it simply had to be. There are no promises of massive new investment in mental health – but then did we really expect there to be?

There is a lot about self management and preventative action, what people can do to improve their own mental health and the challenges that issues like unemployment and poor physical health can play. The recovery approach and anti-stigma work will also continue.

The strategy recognises that measures to improve quality of life can also improve the mental health of many people. It sees that medical treatment is only one part of the fight against mental illness. And it also accepts that government is not the only agency with a role to play here: many of the services that play such important roles are delivered by other public sector bodies and often by the voluntary sector.

The Strategy outlines 36 Commitments from the Government across seven key themes, which emerged from the consultation process. These are:

  1. Working more effectively with families and carers;
  2. Embedding more peer to peer work and support;
  3. Increasing the support for self management and self help approaches;
  4. Extending the anti-stigma agenda forward to include further work on discrimination;
  5. Focusing on the rights of those with mental illness;
  6. Developing the outcomes approach to include personal, social and clinical outcomes; and
  7. Ensuring that we use new technology effectively as a mechanism for providing information and delivering evidence based services

So what will we see happening in the world of mental health over the next few years?

The very first Commitment is that the Scottish Government will commission a 10 year on follow up to the 2004 Sandra Grant Report, which reviewed the state of mental health services in Scotland. This will be carried out next year for publication in 2014.

The detail of who will carry out this major review and with what exact remit will come later. This is the strategy after all, and the fine print on how it is implemented is to follow. But we can expect service user and carer involvement in the review, and it will provide another opportunity for us to put forward our perspective.

There is a Commitment to involve families and carers more fully in policy development and service delivery. This is to be welcomed and discussions have already started on how best to progress this work. It is fair to say that many carers’ organisations are not experts in the mental health field and focus primarily on the carers of those with physical illnesses. It is also the case that many partners, parents and friends of those who have mental illnesses would not call themselves carers: they provide support and love but don’t necessarily see themselves as care givers. This all needs to be carefully thought through – but many of the national mental health voluntary organisations offer support to carers as well as to those with mental illness and are therefore well placed to help shape the discussion.

E-health is an area where much progress is being made and the Commitment to develop a Scotland-wide approach to improving mental health through new technology is to be welcomed. There is much that can be done through better use of technology and I look forward to seeing some innovative ideas emerge.

There are several Commitments relating to children and young people, including better support for parenting programmes, developing specialised services for children in care and reducing the number of young people admitted to adult mental health wards. These are all positive developments and the priority given to addressing mental health issues as early as possible is an encouraging step.

And Commitments relating to older people include greater use of psychological therapies and better integration with general adult services. While there is a necessary focus on tackling dementia in service delivery it is good to see a recognition that this is not the only challenge that older people can face.

Work to identify new models of crisis care is an important Commitment. This will involve investigation of home treatment and other service delivery models, recognising that hospital admission should not be the only option available. There are several voluntary organisations that will have an interest in this area of work, and several other European countries already offer a crisis house model.

There are also Commitments relating to specific areas like alcohol and mental health, work in prisons, veterans and also better linkage of mental health services to local government, which is especially important as health and social care systems are integrated.

The final Commitment made is that systems will be put into place to co-ordinate, monitor and performance manage progress against all of the commitments made. This is not to be a document that gathers dust on a shelf, but one which really does drive progress. The method by which this work is carried out, and of course how progress is reported, will be important.

My overall response to the Strategy is a positive one. The commitments on service user and carer involvement and the emphasis on self management are welcome. There is, of course, an important role for primary care services in mental health, but there is also a great deal we can do in communities to reduce the likelihood of hospital admissions.

Mental health issues blight the lives of many people, and can have a big impact on their families and friends too. There is much that can be done to make life better, and many of the positives from this new Strategy involve designing new services that better meet the needs of those affected.

I’m looking forward to seeing a great deal of progress being made over the next few years.

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It seems fairly obvious that rates of depression and anxiety would rise when the financial crisis hit. Unemployment, or fear of it, added to other financial worries can take their toll.

And now a report in the Lancet has used World Health Organisation data to confirm that the period between 2007 and 2009 saw increased suicide rates among working aged people in nine out of ten European countries studied.

The increases varied between 5% and 17% for under 65s. And this comes after a period of falling suicide rates, The Lancet reported.

Austria was the only country to see its suicide rates fall. This was put down to the country being less exposed to the financial crisis than the others. The UK saw a rise of 10% to 6.75 suicides per 100,000 people, while Greece had the worst record with a 17% increase.

Dr David Stuckler, one of the researchers, said: “There was a complete turnaround. Suicides were falling before the recession, then started rising in nearly all European countries studied. Almost certainly these rises are linked to the financial crisis.”

And Dr Stuckler also reported that that it was possible there would be other health consequences from the economic problems as the impact on heart disease and cancer rates was not likely to be seen for many years.
With unemployment rising added to attacks on terms and conditions and major cuts in many public services it is likely that the UK suicide rate will continue to rise.

Andy Bell, deputy chief executive of the Centre for Mental Health, said: “We know that unemployment and the fear of unemployment are major risk factors for poor mental health.

“This research shows how important it is that we treat the mental health of people who are not just out of work but also in work but fear losing their jobs as a major public health issue”.

Once again this research shows that in difficult times our mental health services need to be protected from public sector cuts. They have more to do, not less, as the recession continues.

And money invested in services that can help those with mental health conditions at an early stage can help to avoid more costly hospital stays in the longer term. There is an economic as well as a human argument for the maintaining of services.

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News reports that actress Catherine Zeta Jones is having treatment for bipolar disorder have led to a number of very positive press stories about living with the condition.

Zeta Jones showed considerable courage in making her bipolar diagnosis public, and I wish her well in her treatment. Stresses in her life have affected her mental health, something that I can very much relate to.

There is still considerable stigma relating to mental illness. Many people continue to see it as a sign of weakness – look at some of the recent coverage of the England cricketer Michael Yardy’s battle with depression. And mental illness often features in the media in cases of horrific crimes.

So any opportunity to get the facts behind the condition into the public eye is very much welcomed by those of us non-celebrities who suffer from conditions like bipolar disorder.

Around one in four people will suffer from some sort of mental health condition during their lifetime. That means that pretty much everyone will have some experience from within their own family. And bipolar disorder is estimated to affect at least 1% of the population.

In the Guardian, Alastair Campbell wrote a fine piece suggesting that the media should concentrate more on the millions of “ordinary” people who learn to manage and to live with mental health conditions.

Whatever you might think of Campbell’s politics, he is a good advocate for those with mental health conditions. He understands the issues and puts forward reasoned arguments. He finishes his article by arguing that:

“ ..there are people with the same illness who cannot get the support they need, who still feel they have to lie about their condition to get or keep a job, and who really worry about the impact of government cuts and reforms that will fundamentally change the way mental health services are run. Those issues should be getting an airing regardless of celebrity support or involvement.”

Closer to home the Daily Record and The Herald both ran helpful articles.

In the Record my friend Michelle Howieson was given space to talk about her own battle with bipolar disorder over the past twenty years. She was frank about her battles, but finished on a typically positive note.

“It is a terrible illness to have and coping with it can be difficult but, with the right support, sufferers can come through the other side and lead normal happy lives. I’m a testament to that,” she said.

And The Herald concentrated on the fears of many people that forthcoming changes to welfare benefits could increase stress and exacerbate their conditions. Another friend, Alison Cairns who is Chief Executive of Bipolar Scotland, is quoted.

“People are being assessed as fit for work and later having these decisions overturned on appeal. The process itself has caused anxiety, stress and a worsening of their conditions for many.”

The BBC website also carries stories of those with bipolar disorder and how they can learn to live with the condition while holding down relationships and jobs.

This is the message that we all need to understand. That mental health conditions are serious and may need a variety of treatments including medication and counselling.

But by learning self management techniques and with the support of friends and family we can survive. And with the skills we learn and the strength we gain we can be positive and productive members of society.

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It is a myth that depression affects women more frequently than men. The truth is simply that women are far better at seeking treatment.

So how can men be encouraged to come forward in order to receive the help they need? And can GPs do more to make it easier?

These issues will be discussed at a conference to be held in Glasgow in December. The “Men and Depression” conference is being organised jointly by the Men’s Health Forum Scotland and Bipolar Scotland.

Speakers from the health services and the voluntary sector will discuss the reasons behind the situation and a carer will give a female perspective on the issue. There will be a number of workshops before a final plenary discussion, where the results of a survey on the subject will be announced.

Men are just as likely to suffer from mental illness as women but are far more likely to kill themselves: the highest suicide risk group in the UK is now men aged between 40 and 49. And three quarters of those who commit suicide are male.

The current economic situation could well make the situation worse, with job losses and financial pressures adding to the stress that many men already experience.

Men also react differently to depression. While depressed women can turn in on themselves, men suffering from the illness can become animated, aggressive and angry.

Middle-aged men are also far less likely to talk to friends and relatives about their feelings. Real men don’t cry, after all. Many rely heavily on their partner, which can push them towards marital breakdown and further isolation.

Research carried out in England by the mental health charity Mind also concluded that many men see doctors’ surgeries as “feminised” premises where they felt unwelcome.

The growth of well woman clinics and highly successful campaigns on breast and cervical cancer has had beneficial effects on women’s health. But perhaps the down side is that men are now losing out.

The chairman of the Royal College of General Practitioners, Professor Steve Field, has said that doctors are aware of the problems. “I don’t think it is GPs missing the symptoms, as much as people not coming forward, he said.

The “Men and Depression” conference will take place on 9 December in the Radission Blu Hotel on Argyle Street in Glasgow. It should be an interesting and informative day.

For further details, and to register for the conference, go to http://mhfs.org.uk/

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The myth: People with a severe mental illness are likely to be violent.

The truth: Those of us who have a mental illness are no more likely to be violent than anyone else.

The stigma associated with conditions like bipolar disorder is, unfortunately, still strong.

81% of people with lived experience of mental ill-health told the Scottish campaign group ‘see me’ that they had experienced stigma. And many people still believe sensationalist reporting that portrays knife wielding maniacs or crazed gunmen as the true face of the mentally ill.

But a new study has confirmed what many of us have always known: the truth is that mental illness does not lead to violent crime.

The research, led by Oxford University’s Department of Psychiatry, examined the lives and behaviour of 3,700 people in Sweden who had been diagnosed with bipolar disorder over three decades.

They compared the experiences of this group with those of 4,000 siblings of people with bipolar disorder and of a control group of 37,000 people selected from the general population.

They found that the rate of violent crime within the bipolar group was no different from that within the general population.

People with mental illnesses who abuse substances were found to have violent crime rates which are six to seven times higher than the general population – as do people with no mental health issues who have similar drink or drugs problems.

Dr Seena Fazel, a clinical senior lecturer in forensic psychiatry and consultant forensic psychiatrist at Oxford University, said, “The relationship between violent crime and serious mental illness can be explained by alcohol and substance abuse. If you take away the substance abuse, the contribution of the illness itself is minimal.”

Dr Fazel also pointed out that you are more at risk of violence outside a pub late at night than outside a mental hospital which is releasing patients.

So there you have it. Proof that mental illness does not inevitably lead to violent behaviour. But the link between violence and substance misuse is shown to be significant once again.

It can be argued that people with a mental illness are more likely to abuse alcohol or drugs. In the case of bipolar disorder it is estimated that the rate of addiction is around ten times higher than that of the general population. And research has shown that this may be partially because of a linked genetic predisposition to addictive behaviour. So it would seem that more support and treatment is required to address these issues.

Once again a myth about mental health has been disproved. If you read of the dangers associated with mental health conditions you will now know that there is no truth behind it.

Changing public attitudes and tackling preconceptions is not an easy thing to do, especially when the tabloid press still seems to frame so many people’s views. But perhaps if we all work together to challenge and to educate we can make a difference over time.

Living with a mental illness is difficult enough without trying to cope with society’s misconceptions as well. Next time you hear someone repeating these myths, I would ask you to point out the facts to them.

You will be doing many of us an enormous favour.

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A friend told me earlier this week that Adam Ant is in hospital. Not because I am a particular fan of his music, but because Mr Ant suffers from the same condition as I do: bipolar disorder.

The eighties star, famous for songs such as Stand and Deliver and Kings of the Wild Frontier, spent many years concentrating on his acting career, but has been working on a new album and recently played his first live shows in several years.

But his health has now led to another hospital stay. Adam Ant was sectioned after displays of bizarre behaviour at a number of public events. Sectioning is a legal process of confinement where a person can be locked up for their own safety.

This is not the first time that the condition has resulted in Ant (real name Stuart Goddard) being hospitalised. And he has also had several brushes with the law over the years.

Bipolar disorder can affect anyone. Around one in every hundred people has the condition – and that would suggest around 600,000 sufferers in the UK alone.

The press, of course, only picks up on the story when someone in the public eye is involved. But many of us battle the condition every day through a combination of drugs and self management techniques.

Major episodes are not inevitable. But when they do strike they can be absolutely devastating. Mania brings excessive energy and a dangerous loss of judgement. In extreme cases it can result in psychosis. I know: I’ve been there.

I don’t have the medical details of Adam Ant’s case. But I do understand the demons he is fighting. So I wish him well in his recovery. Time in hospital can be absolutely the best thing when a manic episode strokes: time out from everyday life to gain strength and to get well once more.

If you want to do something to help, why not send Adam Ant a postcard? I’m sure he would appreciate the support.

Adam Ant c/o 1 Nightingale Place, Mulberry South Ward, Chelsea and Westminster Hospital, 369 Fulham Road, London SW10 9NG.

Get well soon Adam!

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