Musings of a phenomenologist

Science, psychiatry and random musings

Posts Tagged ‘mental health’

Is it ethical to lie to patients?

Posted by soveda on October 8, 2009

I ask this question because a number of people have spoken to me about SPECAL care (Specialised early care in alzheimer’s… erm… care- it’s like PIN number). Back in August 2008 there was this article in the Guardian by media psychologist Oliver James. Author of this book: Contented Dementia, which discusses SPECAL and he thinks it is great.

Hang on a mo, have a look at the 4th paragraph:

“There is a desperate need for an alternative form of care. Believe it or not, my mother-in-law has discovered it. I must be the only man in Britain who would like my mother-in-law to look after me if I had dementia. She is called Penny Garner and her method enables family members or professional carers to deliver 24-hour wellbeing to people with dementias. Amazingly, we are still on good terms after spending a year producing a book that now makes her method available to everyone.”

The interesting article he wrote in August 2009 has been commented on by the mental nurse blog which is well worth a read, I have tracked down a copy of the RCN report on SPECAL so I thought I’d blog a bit on the evidence base.

Now read on:

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Posted in media, Medicine, mental health | Tagged: , , , , , , , | 4 Comments »

Suicide isn’t painless

Posted by soveda on September 4, 2009

Sorry for the punning title, I know Painless was the name of the dentist in M.A.S.H. but I couldn’t resist.
I was just pondering suicide and euthanasia, this was triggered by world suicide prevention day and the lack of coverage in the media.

Now suicide is a bad thing isn’t it?

It’s one of the targets the UK government has for mental health services – to reduce the rate of suicide and undetermined injury by 20% by 2010 (document here)

There are guidelines about reporting suicide (see here), and for good reason. When the media in Hong Kong reported a suicide by a novel and previously unknown method that method increased rapidly (see here).

Suicide is a symptom of mental disorder – however some people who complete suicide have no history of mental disorder.

The national confidential inquiry into suicide and homicide makes for interesting reading (link) The press release states:

The number of people killed by individuals suffering from mental illness in England and Wales increased between 1997 and 2005, figures released today show.  The rise occurred in people who were not under mental health care and was not found in mental health patients.

The annual report by the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness also found:

  • a fall in suicide by mental health patients overall and a continued fall in suicide by in-patients
  • suicide following absconding from the ward remains a serious problem
  • however, few serious incidents occurred following absconding from secure units

Of note “patient” means: having had contact with mental health services in the last 12 months.

So it’s clear cut …

Is it possible to wish to end your life without suffering from a mental illness? Now there’s a thorny question, if you asked most psychiatrists I suspect they would tell you that thoughts of suicide and a wish to die were not in and of themselves a sign that someone was mentally ill. Someone would likely be in some degree of distress, either mental or physical, but not necessarily mentally ill. Bit how about those individuals who wish to end their lives on their terms rather than letting a terminal illness make the decision for them (please forgive the anthropomorphising of a process), are they mentally ill?

Some would argue that they are by definition because they wish to end their lives, even if it is a rational decision.

Is that paternalism or realism?

By condoning suicide in those cases are we encouraging people to look at suicide rather than other options in managing disease. especially if you start including mental illness in the diagnoses that are “allowable” in assisted suicide. (BJPsych editorial)

Given that there is to be new guidance on assisted suicide this question will not go away. (BBC report)

For what it’s worth, physician assisted suicide/euthanasia does not sit well with me ethically. I want people to have a god quality of life and I don’t want people to feel pressurised into ending their life because they are a burden. Given the probable high numbers of people who have undiagnosed cognitive impairment/dementia who are vulnerable to this very thought process I think PAS is too risky a proposition.

Now that was the most unfocussed and self contradictory I’ve been in a while but hey, I’m human too.

Posted in mental health | Tagged: , , , | 1 Comment »

Chiropractic for mental health, Bogus*? Updated

Posted by soveda on May 22, 2009

[BPSDB]

*Deliberate deception not implied

In light of other bloggers looking at chiropractic treatment I thought I’d have a look from my perspective. According to the BCA chiropractic can be used to treat many conditions beyond back pain but does not appear to mention mental health symptoms specifically.

I thought I would find out if individual chiropracters did suggest they could treat depression and this is what I found:

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Posted in bad science, bpsdb | Tagged: , , , , , , | Leave a Comment »

The BBC being accurate again

Posted by soveda on April 25, 2009

I know I haven’t been terribly active in blogging recently but this story on the BBC website raised an eyebrow. The story in question is about a crop of daffodils being grown in Wales as a source of Galantamine crystals.
For the uninitiated, Galantamine is an Acetlycholinesterase inhibitor, one of the medications used in Alzheimer’s, more specifically it is one of the three medications that doctors in the UK are allowed to prescribe. It says it right in the NICE guidelines, not according to the BBC’s reporting though. Apparently it is only available in Scotland and then only privately…
I’ve blogged repeatedly about the quality of facts on the Beeb and I will again, hopefully by the time you read this the article will be accurate but I’m not holding my breath.

Posted in bad media, Medicine | Tagged: , , , , | Leave a Comment »

MMR again

Posted by soveda on January 23, 2009

So the Lancet have published another paper on MMR, and this time it’s not Wakefield, well sort of. Read the rest of this entry »

Posted in Uncategorized | Tagged: , , , , , , , | Leave a Comment »

It’s all in the mind surely?

Posted by soveda on January 5, 2009

[BPSDB]

I was navel gazing and having a look at which of my rants was the most read, it seems that it was the one on electrosensitivity. So lets have a talk about medically unexplained symptoms shall we? Read the rest of this entry »

Posted in bad science, Medicine | Tagged: , , , , , , , , , , , , , | 5 Comments »

But she’s a professor!

Posted by soveda on December 19, 2008

Thanks to Ben Goldacre’s mini blog I came accross this story. It’s a worrying story for me in several ways, the diagnosis by letter being one. Read the rest of this entry »

Posted in bad media, Medicine | Tagged: , , , , , , , | 11 Comments »

Not smoking can kill

Posted by soveda on November 26, 2008

Another day, another bit of advertising billed as reporting on the BBC website.

To be fair they do aknowledge that this is linked to a programme being broadcast on the 26th November (Today).

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Posted in Medicine | Tagged: , , , , , | 4 Comments »

Are you sure you really want to do that?

Posted by soveda on November 25, 2008

Or: Do we have the right to make bad decisions for ourselves?

Yes I’m going to start talking about the Mental Capacity Act 2005.

It’s a great piece of legislation, not really it is and here is why:

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Posted in mental health | Tagged: , , , | Leave a Comment »

Itz just a little drinkie

Posted by soveda on November 22, 2008

Browsing the BBC website today I came across this article, which states that drinkers lie about how much they drink.

Goodness me, I am surprised, only 2 out of 5 people lie about their drinking. I thought the rule of thumb was:

Double what the individual says they are drinking and halve what their relatives say.

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Posted in Churnalism | Tagged: , , , | 7 Comments »