Apologies for the lateness of this post. This edition of TNIM may contain eating disorder triggers.
One piece of news that will massively affect UK mentalists is the controversial Health and Social Care bill. The Telegraph reports that a lot of professionals are unhappy about it:
The Royal College of Paediatrics and Child Health has called on the Government to withdraw the health bill after its president attended a Downing Street summit and appeared to back the bill.
Members who voted did so by almost four-to-one (79 per cent) in favour of “outright withdrawal” of the Health and Social Care Bill.
The decision is another blow to the Prime Minister and Andrew Lansley, the Health Secretary, who have vowed to press on with Bill, which is currently being debated in the House of Lords.
The paediatricians join – amongst others – the Royal College of GPs, the British Medical Association, the Royal College of Nurses, and the Faculty of Health, in calling for the Bill to be dropped.
Doctors are concerned it could harm patient care and lead to increasing privatisation of NHS services, fears dismissed by the Government.
Professor Terence Stephenson, president of the RCPCH, said: “It is clear that a substantial majority of our voting members believe that the Health and Social Care Bill carries risk for children and young people.
However, the Telegraph also reports a study by the LSE which it claims supports the proposed bill:
The meeting [between interested parties about the bill, held at Downing Street] coincided with the release of research from the London School of Economics showing that competition in the NHS – the issue that most agitates the opponents of reform – is actually a good thing. The study of two million patients found that if NHS hospitals are made to compete with one another, they save money and increase efficiency. Measures introduced by the last government six years ago to encourage competition between NHS hospitals led, the report concludes, to “moderate but statistically significant” reductions in patients’ length of stay in hospital. The gains in efficiency of seven to nine per cent produced what the report describes as “non-trivial savings”. Ironically, the subsequent decision – during Gordon Brown’s premiership – to allow NHS patients facing long waits to opt for private treatment did not have the same beneficial impact on efficiency.
The Guardian also reports that the health secretary, Andrew Lansley, will not say whether he will publish the details of the bill’s risk assessment:
The tribunal is due to meet following a dispute between the Department of Health and the information commissioner, who said last year the government should publish the “transition register”, which has assessed risks to the NHS and patients during the reorganisation set out in the health and social care bill.
As the Guardian reported last week, regional NHS risk assessments suggest wide-ranging concerns, including that patient care and safety could be damaged and that costs could rise, all such risks were assessed even after attempts to reduce the threat.
Speaking in a special opposition day debate organised by Labour, reiterating the call to publish the risk register, Lansley twice refused the opportunity to tell MPs that he would accept the tribunal’s judgment after it meets on 5-6 March.
Earlier this month, the economist was seeking support from clinical psychologists for his latest initiative, Action for Happiness. According to the movement’s website, there are 10 “keys to happier living”. These include taking a positive approach, having goals to look forward to and finding ways to bounce back. Downloadable posters feature slogans including: “If you can’t change it, change the way you think about it” and “See life as it is but focus on the good bits”.
This seems harmless (who can be against happiness?) but the approach is based on two flawed assumptions: that the source of unhappiness lies inside people’s heads – in how they see the world, and that the solution lies in change at the level of the individual.
Not everyone responds to the same situation in the same way, but although not all people living in poverty become depressed, a lot of them do. Evidence shows that a major contribution to serious emotional distress is income inequality – the growing gap between the richest and poorest people in society. Richard Wilkinson and Kate Pickett in The Spirit Level demonstrate that mental health problems are highest in those countries with the greatest gaps between rich and poor, and lowest in countries with smaller differences.
Meanwhile, Emily Willingham in Scientific American is frustrated with those who say ADHD is over-diagnosed. Personally, I liked the article so much I found it hard to pick a small piece to excerpt – please read the whole thing:
This latest backlash against ADHD relies on recycled “diagnosis du jour” tropes of subpar parenting and doped-up, misbehaving kids, but it makes no mention of the abundant science showing what really underlies and helps with this disorder. Worse, the perpetuation of myths about ADHD encourages the perception that children like mine, with their very real disabilities, might be diagnostic frauds. That’s a potential harm that deserves a backlash of its own.
In other news, it’s Eating Disorders Awareness Week. The Press Association reports a speech by the MSP Dennis Robertson, whose 19-year-old daughter Caroline tragically died after six years of anorexia:
He said: “It is a psychological illness, it is not one which is about an eating fad. It is not one which the person has the choice as to whether or not they can overcome it by sitting down and eating a healthy meal. We have to try as best as we can to get rid of some of the myths surrounding eating disorders, and we have to accept that it is an illness.
“It is an illness that requires early intervention, and to do is you have to be aware of the signs.”
The BBC also has another sad video story about a woman called Melanie Spooner who died of anorexia, whose doctors would not take her eating disorder seriously:
Melanie Spooner died from anorexia in 2011. Her family are now seeking to change the way people with eating disorders are treated.
Melanie was a talented student, attending Cambridge University before going on to work as a paediatrician.
But Melanie still couldn’t beat anorexia and when she died last year she weighed less than four stone.
Her father, Robert Spooner, described how difficult it was to get her the right treatment.
Ilona Burton has also published a series of posts on Independent Blogs this week discussing various aspects of EDs and their treatment. They are all worth a read, but especially her post entitled “Access Denied, Eating disorder Treatments”:
For months or even years before this appointment, your eating disorder tells you not to tell anyone, that it’s between you and it, that you need to push harder, that you need to go to greater lengths, eat less, throw up more, double the dose of laxatives, add an extra hour to your exercise, stay awake, never stop. This is constant, relentless pressure. You are never working hard enough, never thin enough, never burning enough calories and when it comes to telling a doctor, it will tell you that you are not ill enough to warrant help or attention.
It hits you like a tonne of bricks when these thoughts are confirmed. To be told, effectively, that you don’t matter, you don’t deserve treatment or that you’re not close enough to death’s door to need help is devastating. It isn’t easy to build up the confidence to open up and then to hear those words – it sends you into a whirlwind of negativity beyond any you’ve experienced before. It’s all true. Suddenly, you have back-up, real evidence that yes, you are too fat, you do need to lose more and it’s absolutely fine to carry on risking your life through indulging in whatever dangerous behaviour you were engaging in before – because the doctor said so. It’s basically a green light to self-destruct.
I have had more of these setbacks than I like to admit. I hate to damn the NHS or those who work so hard within it, but the truth is that unfortunately, the education, knowledge and training is obviously inadequate. I am not alone in being passed off with no support, and that is just not acceptable.
Finally, this week’s wildcard is a truly bizarre story from South Africa:
A South African man who claims to be a famous dead singer is in custody until DNA tests determine his identity, police say.
The man says he is Khulekani “Mgqumeni” Khumalo – an award-winning Zulu folk musician who apparently died in 2009.
He turned up at the family home last week, saying zombies had kidnapped him.
The family, including two wives, say he is genuine – but police say he will be charged with fraud if DNA testing shows he is lying.