Posts by Neil
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Access: Fighting seclusion with…, in reply to Joe Wylie,
The next paragraph in realation to Andrew Peacock reads:
"I should acknowledge these organisations do deal with complex individuals but overall on balance between individual need and staff needs - and fear- it was always staff safety or perceived safety that seemed to take precedence."
It will not just be staff safety but the safety of other patients and members of the population that the treating team will have to manage. These are not just "perceived" they are real and the "fear" that staff have is also very real.
Safety does take precedence - people have to be protected from harm. In a very small number of complex cases that may mean that person will have restricted access to others. (I'm referring to acute mental health, not other areas the report covers).
It's important I think to understand the great difficulties faced by treating teams in these rare complex cases. They are experienced professionals who do not take restricting someone's freedoms lightly.
In the vast majority of acute mental health cases things are far less complex.
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Speaker: The Brexlection, in reply to martinb,
Mombiot pays out Blairite hypocrisy in rather compelling terms
Blair hasn't been PM for quite some time. I'm not sure that Corbyn will get any more votes by attempting to exorcise a ghost that most voters don't really care about.
It seems more to do with Labour infighting which probably isn't going to attract voters.
And putting up a supporter of Chavez and the IRA might not be a particularly effective way of dealing with whatever Blairite past needs to be reckoned with.
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Speaker: The Brexlection, in reply to BenWilson,
Anyone who isn’t some kind of neofascist wannabe does cast a ray of hope to those who aren’t treating it as a spectator sport that would be incomplete without a serious villain.
It seems to be a growing trend. Hard to know how much influence it has but it played a part in the rise of Trump and the defeat of Lionel Jospin In 2002.
The "Hillary is an evil warmonger wall street stooge but I don't suppprt Trump" and "Macron is a elitist blah blah bringing on the victory of the FN but I don't support Le Pen" is a peculiar form of kabuki that has real world consequences.
I don't know if anyone else has noticed but in the US the alt world has Chelsea(!) Clinton in their sights.
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Speaker: The Brexlection, in reply to Tom Semmens,
Since the evisceration of Corbyn by the establishment media…
There might be other more significant reasons for him being unpopular -
He and Mélenchon share a hostilty towards NATO and a great reluctance to criticise Putin. It could be Labour might do better with a leader with less authoritarian instincts.
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In my experience people with autism who have been admitted to an inpatient unit have been admitted because something else is going on rather than just the features of autism.
And I haven't notice that they do any worse from being in an inpatient setting where it is a non ideal environment for everyone.
Are you referring to cases where people with autism and no other complicating factor are admitted to an inpatient unit because of a lack of alternative settings?
One thing that concerns me about calls for a review of mental health is an over emphasis on resources - spending more money will solve all the problems - at the expense of more complex more dilemmas.
Eg suicide - every suicide is a tragedy but in terms of how well mental health services are going it's hard to measure the success - all the instances where suicide is prevented - but easy to measure the failure. And inpatient units are now terrified of letting anyone have leave off the unit for fear of the consequences. It's a difficult balancing act.
But one of the big issues is an issue of resources: adequate social housing. In patient units and respite services in Auckland find it hard to move people back into the community due to lack of accomodation resulting in difficulties admitting those requiring an inpatient setting.
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Hard News: Media Take: the poor health…, in reply to Hilary Stace,
Ashley Peacock is autistic and he has a psychotic disorder. He is one of the very rare, very complex cases where there are no good alternatives. His risks are on-going and unlikely to diminish.
Autism is quite distinct from psychosis and they can happen independly or they can happen together. I have met a number of autistic people who also have a psychosis and the autism in most case does not complicate things to any degree. But for some very small number the combination does make treatment decisions very difficult.
I think there is a conversation to be had over risk vs rights. If society would accept more risk then treatment in some cases could be less restrictive. Acute units are locked to mitigate the risk of self harm and harm to others that is posed by a small number of people.
But whenever someone from an acute unit commits suicide there are demands for more restrictions. If no one could get leave from a unit then there would be less risk.
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Hard News: Media Take: the poor health…, in reply to Hilary Stace,
Mental disorder isn’t intended to be a diagnosis, it’s intended to be a description of a mental state that for some reason has shifted from some one’s baseline. A diagnosis may result after the assessment period.
But that isn’t sufficient to lead to the MHA being enacted, there has to be risk to the person and or to others. So someone who’s severely depressed – has a mental disorder – but who poses no risk to themselves or others cannot be placed under the MHA. And no clinician would consider putting them under the act unless there was a risk such as suicidal ideation with a plan.
It’s not possible to put someone under the act just because they are on the autism spectrum. But people on the autism spectrum can also have mental disorders such as depression or psychosis and they would come under the act or not just as some one who wasn’t on the spectrum.
It’s true that being under the act means having some rights taken away. But this happens in a small proportion of mental health related situations and only when there is risk. And that balance of risk vs rights is constantly being assessed by clinicians.
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In what ways do you feel the expression mental disorder to be problematic?
In terms of the initial implemention of the mental health act it's intended to not presuppose a diagnosis but rather a broader loss of mental stability that could be caused by a range of circumstances.
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Today it is all powerful, overrides our Bill of Rights Act and international rights Conventions, and is way out of date.
In what ways?
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Have Hager or Stephenson given any indication as to why their coordinates were inaccurate?
It’s a relatively minor error in a sense but they offered this information as an indication of precision in their overall argument.
Perhaps someone just transposed a few numbers.