Going beyond the norm

Anne Cooke

I’ve been a bit itinerant this year. The response to Understanding Psychosis and Schizophrenia, the report I edited for the British Psychological Society, has been amazing and I’ve been invited to speak about it in Washington, New York, Seville, Dublin and most recently Milan. So it was great to get an invitation to do something nearer home last month, in our local town of Tunbridge Wells.  I was part of a panel at the annual Critical Voices event. Critical Voices? To tell the truth I wasn’t totally clear about it either. It describes itself like this:

‘The space of medicine, health and wellbeing is one we all inhabit. It is at once complex, often highly technical and grounded in power, politics and debate. It is a space where we have made life changing advances. Yet it is also where we are at our most vulnerable, where our most intimate times of birth, illness, treatment, life and death are played out. Critical in every sense.  Critical Voices provides an opportunity for conversations that explore the voices in this space as we strive to bring together doctors, surgeons, psychologists, patients, carers, campaigners, researchers and academics - intertwined with the expressive insights from film, music, poetry and literature.’

As you might expect, it was a mighty interesting day.  I did a ten minute double-act with my friend and colleague Peter Kinderman, talking about our vision for the future of psychological health care when we stop dividing people into ‘normal’ and ‘mentally ill’. A video of the event is embeded below or you can watch it on Youtube here. 

Is Life a Disease?

Anne Cooke and John McGowan

The DSM makes a handy lectern
Photo: Maciej Janowicz

As regular readers of this blog know, we are very interested in the pros and cons of psychiatric diagnosis. We try to discuss this issue in an accessible way and reach as broad an audience as possible. It was a great pleasure, therefore, to be invited by Lewes Skeptics (a Sussex branch of the Skeptics in the Pub network) to give a talk about mental illness, diagnosis, and some of the controversies raised by the new version of the psychiatric classification manual DSM-5. We've since been asked to make the talk available more widely, so we've posted it below. It's a video of the slides, accompanied by a soundtrack recorded on the night.

It was interesting to see that the event sold out in a few days. Since we’re hardly big names, we hope this says something about the level of public interest in mental health. The same happened the last time that the Skeptics put on a mental health-related talk (by psychiatrist Joanna Moncrieff), so something clearly strikes a chord. On the night of our talk the room was jammed, the temperature was hot and the controversy even hotter! Actually that last bit isn’t true. The debate was conducted in the most civil and decorous manner - not always easy when passions on this topic can run high.

We’d like to thank Lewes Skeptics (and in particular Eugene Gill) for hosting the event, and for their commitment to promoting public engagement with important topics. If you want to know more follow them @LewesSkeptics on Twitter. We are also grateful to John Warburton man of many parts, two of which were his very strong forearms. The fortitude with which he acted as a human boom for the recording equipment was admirable. Thanks also to the audience. The pub patrons of Lewes are clearly a thoughtful lot.

You can view the video either in the embedded version below or via the direct link on YouTube. 

There is also a recording of the discussion following the talk. The quality is slightly more variable as questioners were sitting in different parts of the room. The Q&A audio is embedded below or you can listen to it directly on Sound Cloud.

How we understand recovery

Sue Holttum

Over the last 10 years NHS mental health services have become more and more focused on the concept of “recovery”. For whatever reasons (changing views of psychiatry, service user voices, or simply a change in the climate of healthcare) we seem less in the business of cure and more about empowerment.  But what is all this about and how does it apply to you if you have a mental health problem? And is it really happening or is the core business of mental health services still  drugs and hospital? In the following short feature (5 minutes or so of audio with slides) I consider two recent papers which may help in understanding these questions: one by Mary Leamy and her colleagues from 2011 and the other by Rachel Perkins and Mike Slade from 2012. The first paper looks at the concept of recovery as personal journey and how service users define it. The second considers how mental health services are trying to support recovery and what the challenges are. Both these papers offer a valuable contribution to the understanding of recovery and how we go about implementing it practice.

(Note: File is .wmv. There is also a transcript of the audio below).

TRANSCRIPT

Mary Leamy and her colleagues begin their paper,

Making sense of suicide

John McGowan

“I've danced with a man, who's danced with a girl, who's danced with the Prince of Wales” went the 20s song, written before Edward VIII became King and took a dip in popularity. The case of Jacintha Saldanha, who put through a call to someone who gave out information about the Duchess of Cambridge, ended far more tragically than for the flapper chanteuse. Our hunger for remote royal associations however, seems undimmed.

Speculation about Ms Saldanha (who did not appear to have courted any sort of publicity in her life) has been rampant on a global scale. Her suicide led to a huge array of responses: compassionate neutrality on the part of the royals, self-flagellating guilt from the pranksters, outrage about the lack of support for the family, and consideration of the limits of free speech. 

How are we to understand such an act? Not just in this case but whenever it happens? The possible risk factors for suicide are multiple. Also, as I have argued elsewhere, the potential motivations behind suicide and self-harm are manifold and complex. The act may be about escape, release, anger, revenge or a host of other feelings. It may be accidental, perhaps the seeking of care or an expression of desperation that has gone wrong. People’s motives can be shifting and not always evident, even to themselves. At this stage we don’t actually know if Ms Saldanha’s death was linked to the prank call.