This Week in Mentalists – Duvet Day Edition

Morning all. It’s a cold Saturday morning, so I am having a duvet day while typing up TWIM. This week’s edition contains possible triggers for suicide.

Fear and Loathing in Bioethics makes an eye-opening observation on drug company sponsorship in academentia.

But it’s not just academic psychiatrists who are on the take.  Academic bioethicists have been on the Lilly payroll for years – namely, Georgetown’s Tom Beauchamp and Yale’s Robert Levine.  Beauchamp and Levine were hired after Lilly was busted for testing the safety of new drugs on homeless alcoholics.  (Which is ethically just fine, in case you were wondering.)

Homeless alcoholics? Seriously?

Mental Health Cop has a guest post from Professor Louis Appleby, talking about Section 136 of the Mental Health Act, which empowers police to remove a person having a mental health crisis in public to a place of safety.

Section 136 is a shared problem for the police and mental health and it must have a shared solution.  That means joint planning of services, training and troubleshooting in individual cases.  Commissioners of mental health care must ensure there are adequate s136 facilities available in health settings.  Mental health professionals should assess patients promptly, to prevent the hanging around that frustrates police colleagues.  The Care Quality Commission should insist on better data and closer monitoring.  Both police and mental health have a professional duty to understand each other’s perspective and not to denigrate each other’s practice.

Behind the debate about s136 lies a more fundamental question: what are the mental health responsibilities of the police?  How much mental health work should they do?  Many police officers I have met are clear that dealing with mental illness is a natural part of their modern role.  Others believe the opposite, that it gets in the way of “real” policing.  But that cannot be right.  Mental illness is common, as is substance misuse and personality disorder.  Society is finally facing up to how common mental ill-health is.  People whose work is with the public – teachers, housing staff, prison officers, politicians – need to see mental illness as within their remit.  Anything else is discrimination.  The police meet people with mental illness as suspects, witnesses, victims and – let’s not forget – colleagues, and with the right skills this part of the job can be a source of reward and pride.

The wonderfully-named Too Long for Twitter, Not Hip Enough for Tumblr admits to having difficulty taking her medication regularly

I try to be good. I have a rather sweet (if not inappropriate) Miffy pillbox from Japan to carry pills with me when I’m out, and I’ve made a wall chart. Effexor (x2), Ritalin (x3), iron pill, inhalers. When I take a pill I write in the time I took it; I was finding myself forgetting if I’d just taken them or not – to risk double dosing or go without? When I haven’t taken a dose, I draw in an accusatory red X. There are a lots of Xs. The chart has been up for 13 days, and there are only two “gold star” days so far (all 7 boxes ticked). I haven’t yet decided what the reward for those will be (but there will be a reward, oh yes).

(I should add that it’s not just the psych meds that suffer from my apathy. I am constantly being told off by the asthma nurse for not using my steroid inhalers and then ending up with lungs that sound like a broken accordion.)

The HR Juggler discusses the heartbreaking aftermath of a suicide.

There is so much I haven’t told you about Roger. In the same way that people do not wish to be defined by their mental health conditions, he would hate to be defined in your minds by his death. He was thirty years old when he died and he was clever, thoughtful, kind and considerate. He was exceptionally well-read, intelligent, funny, hard-working, proud, stubborn, physically strong and fit. He had good friends, many of whom he had known most or all of his life, a good job and a loving family. He was interested in politics and history, patriotic, highly knowledgeable about many subjects and had a great sense of fun. He is greatly missed and will always be so.

If I leave you with any points, it is these: firstly, that depression remains deeply, dangerously hidden in some people, who walk and live amongst us. Unless we do more to talk about it, they will continue to feel alone and isolated. Suicide has such a stigma: we need to understand more about how to give people the tools to talk about it, to offer support, to not be frightened or to condemn what we don’t understand. Secondly, that the ripples from those in the 25% club extend far beyond their membership and that we have a duty of care to support the carers and others who are affected in the workplace and out of it.

The Samaritans are available on 08457909090 or jo@samaritans.org

Sectioned asks what advice you would give to someone admitted to a psychiatric ward for the first time.

• Are you a patient on ward now? What questions do you have? What advice so far has been helpful to you? Perhaps you wonder why your phone charger has been taken. Or why there’s someone watching you and making notes on a clipboard several times an hour. Or how to get hold of tampons and a toothbrush.

• Have you been an inpatient on a mental health ward before? What would you have liked to know when you first arrived? What tips would you like to have been told? What advice do you have for someone who’s being treated on a psychiatric ward for the first time?

• Are you a member of staff – a health care assistant, nurse, occupational therapist, cleaner, doctor, advocate? What advice would you give to patients on their first stay on a psychiatric ward that would help them understand the experience and get the most from it?

• Are you an AMHP or police officer who takes people to psychiatric wards or places of safety? What would you like patients to know?

There was a rather silly conversation on Twitter this morning about the perils of leaving your duvet on a cold Saturday morning.

Purple Persuasion discusses the thorny topic of disclosing a mental health issue in work.

My attitude as an employee has always been that my line manager is my first port of call, and that the best thing for both of us is for me to be completely honest. This gives my manager plenty of notice that even if I seem OK at the moment, at some point I might need extra support. My belief – and this has only been strengthened by a period of 18 months working as a line manager myself – is that most managers would rather hear this:

“Hi… you know that mental health condition I mentioned, back when I first starting working here? The one you did some reading about, in case I ever needed support? Well, I’m just a bit worried it might be recurring and I wondered if we could put my support plan into effect before things get too bad.”

than this:

“Hi…look, I know I’ve been working here for a year and I never said anything, but I have this mental health condition…I don’t know if you’ve ever heard of bipolar affective disorder? Thing is, I’m not feeling too well right now, and I know we’ve got a big inspection coming up and everything, but I really need some time off.”

I’ve been accused of displaying a thinly-veiled contempt for the UK Independence Party. This is deeply unfair, because I would never make any attempt to veil it. This week’s Wildcard is the hilarious Meerkats That Look Like Nigel Farage.

It’s uncanny.