The Australian Christian Lobby is wrong. Australians don"t support a gag rule | Rebecca Huntley

It’s the photo that launched a thousand memes. The freshly inaugurated Donald Trump, surrounded by a posse of white dudes signing a directive reinstating a “global gag rule” banning US-funded groups around the world from discussing abortion.

I saw the news about it on social media, shuddered, donated to Planned Parenthood and then felt just a little bit more grateful that I live in this country, a place where abortion and reproductive rights aren’t the hysterical hot button issues they are in the United States. I’ve only recently learned that while we might not share their toxic politics around reproductive rights, we have in the past taken America’s lead on the implementation of the global gag rule. It was last removed in Australia in 2009 by Kevin Rudd.

If the Australian Christian Lobby had its way, we’d follow America’s lead yet again. They are currently engaged in a pretty intense letter writing campaign calling for the re-instatement of an Australian global gag rule.

What is the ‘global gag rule’, and why does Trump support it?

Groups like Family Planning NSW are calling for funding to aid programs, specifically in Pacific Island countries, to be maintained in the May budget and with good reason. The Pacific has some of the worst reproductive and sexual health outcomes globally, with high rates of maternal and infant deaths, unintended and teenage pregnancies, sexual violence and unacceptably high rates of cervical cancer deaths.

Women giving birth in the Pacific are dying at 34 times the rate of women in Australia. Women in the Pacific are dying at up to 10 times the rate of women in Australia from cervical cancer. In developing regions, eight in 10 women with curable sexually transmitted infections do not receive treatment. Every two minutes, a woman dies in pregnancy or childbirth – the majority of these deaths are preventable. The main purpose of the global gag rule might be to stop aid agencies providing advice about abortion but the direct consequence is also to stop them providing a whole range of other services associated with sexual and reproductive health.

The people pushing for a gag rule in this country like to think they speak for the silent majority of Australians. Yet there is no evidence they do. Figures from last week’s Essential Report show Australians strongly support the nation’s commitment to providing important health services to women in Pacific Island nations.

In fact, 89% of Australians feel it is important women in Pacific Island countries have access to sexual and reproductive health services like contraception, cervical cancer screening and family planning. A strong majority of men (85%) and an even stronger majority of women (91%) support Pacific Island women having access to these services. There is very little variation in support across generations and party affiliation.

How important is it that women in Pacific Island countries have access to sexual and reproductive health services – like contraception, cervical cancer screening and family planning?

On the issue of whether our foreign aid budget should support the provision of these services in those countries, again there is strong support across gender and generation. This isn’t a women’s issue, it’s a community concern.

How important is it that Australia, through its foreign aid budget, supports Pacific Island countries to provide sexual and reproductive health services including contraception, cervical screening and family planning?

Finally, on the question of the global gag rule, 67% of Australians (64% men and 70% women) would be concerned if Australia also introduced this rule and stopped aid to groups that provide family planning and sexual and reproductive health services in Pacific Island countries. While opposition to the rule is highest among Greens voters, 62% of Coalition voters report being concerned about such a move.

How concerned would you be if Australia introduced a global gag rule and stopped aid to groups that provide family planning and sexual and reproductive health services in Pacific Island countries?

So much for the silent minority. Only 6% of those polled in the Essential Report would be unconcerned about a gag rule being reinstated. It’s clear that bringing vaccines, maternal health care, family planning and cervical cancer screening to the Pacific Island region is the intent of men and women across Australia.

Australians might be fascinated with Donald Trump. They might applaud his recent action in Syria and some of us might even sympathise with the idea of a ban on Muslim immigration. But the research shows there is no widespread support for a Trump-style gag rule that puts a rightwing Christian agenda before the health and wellbeing of Pacific Island women.

The Australian Christian Lobby is wrong. Australians don"t support a gag rule | Rebecca Huntley

Good social workers are invaluable. So let’s give them proper support | David Brindle

About three in every 10 people in Britain think social workers help with household chores like cooking and cleaning, with personal care like washing and dressing, and with childcare. Two in 10 reckon they will nip to the shops for you. Asked to choose from a given list of professionals they consider important providers of mental health support, 69% of people identify psychiatrists and 65% GPs – but only 41% pick social workers.

These findings come from a ComRes survey commissioned by Think Ahead, the fast-track training graduate scheme for mental health social workers, to mark this week’s World Social Work Day. As Lyn Romeo, England’s chief social worker for adults, comments with a certain understatement, “there is still more to do to communicate the crucial role of social workers”.

That was to have been the role of the short-lived College of Social Work, set up by ministers in 2010 with plans for it to grow to become a royal college on a par with those for the most esteemed professions, but shut down in chaos five years later. News that the College of Occupational Therapists is to become royal – richly deserved, by the way – has rubbed a good deal of salt into that wound.

There is a fresh plan, however. From 2018, part of the brief of a proposed new regulator for social workers in England will be “to promote and maintain public confidence” in the profession. The mandate for the organisation, provisionally titled Social Work England (SWE), is contained in the children and social work bill currently before parliament. After a rocky start, it enjoys broad support.

One reason SWE is being welcomed is that it will give social work its own regulator again after six years under the generic Health and Care Professions Council. A second is that ministers accept it cannot be self-financing, at least in the short term, and are underwriting it by £16m in its first two years. And the most significant reason is that an initial idea for it to be run direct by Whitehall has been ditched.

Just how independent it will be remains moot: a quango accountable to government, not parliament, it will need ministerial approval of the professional standards it polices. But the social work world sees the lifting of the spectre of regulation by a government department as a clear win.

Another success being celebrated is the withdrawal of clauses from the bill that would have allowed councils to seek exemptions from children’s social care law to test innovative ways of working. Critics saw the idea as erosion of vital safeguards and mounted a strong, successful campaign against it – but the issue was almost certainly settled when Eileen Munro, the leading social work academic often cited by ministers in support of professional reform, opposed it.

However, real tensions remain between the government’s social work reform vanguard led by Isabelle Trowler, chief social worker for children, and the bulk of the sector establishment, with plans for accreditation tests for children’s social workers looming as a new flashpoint. But there is a sense of a thawing in relations.

Herbert Laming, sector elder statesman and crossbench peer who led both the seminal inquiry into the death of Victoria Climbié, which published its report in 2003, and a review of child protection six years later following the Baby P affair, hopes the thaw continues. He tells me: “What social work needs above all at this time is a bit of tender loving care.”

In a lecture on Wednesday at the University of Suffolk, Lord Laming will spell out the enormously high expectations that society has of frontline workers’ skills and judgment when dealing with vulnerable children and adults. The task, he will say, has been made infinitely more difficult by austerity, which is why he joined the call for withdrawal of the exemption clauses at this point even though he understood and backed the case for innovation.

Social workers are crying out for support and encouragement, Laming says. He is surely right. There has been too much stick and not enough carrot in the mix of late.

Good social workers are invaluable. So let’s give them proper support | David Brindle

65% of British public support new Clean Air Act, says survey

More than half of the British public believe air pollution levels across the UK are damaging to their health and almost two-thirds back proposals for new laws to tackle the issue, according to research.

Canvassing the views of 1,670 adults, the survey found that 58% believed the current levels of air pollution in the UK to be either harmful or very harmful to health, a figure that rose to 73% among Londoners. What’s more, 65% of those polled said they would support a new Clean Air Act to tackle the issue.

The study, undertaken by YouGov, was commissioned by the environmental law organisation ClientEarth on behalf of the campaign for a new Clean Air Act.

Launched this week, the campaign is a coalition of organisations, charities and activists – including Greenpeace, the British Lung Foundation and Sustrans – calling for fresh legislation to reduce air pollution.

“This poll clearly shows that people across the UK want the prime minister to get serious about the toxic and illegal levels of air pollution,” said James Thornton, the chief executive of ClientEarth which is leading the coalition.

“This is an urgent public health crisis over which the prime minister must take personal control,” he added. “She must listen to the country and come up with a credible plan that will reduce air pollution as soon as possible, so we are not choking on illegal levels of pollution until 2025 or beyond. The time for excuses is over.”

Poor air quality is a growing issue in cities around the world and is linked to a host of health problems, including heart failure, strokes and dementia.

“It’s no exaggeration to say that air pollution is a public health crisis. It contributes to up to 40,000 early deaths a year across the UK,” said Dr Penny Woods, chief executive of the British Lung Foundation. “Toxic air is a risk to everyone but hits those with a lung condition, children and the elderly hardest.”

The problem is acute. Last month it was found that parts of London had exceeded their annual legal limits for nitrogen dioxide (NO2) in the first five days of the year, while January’s cold, still weather exacerbated problems across swaths of the UK, with multiple regions rated as having high or very high pollution levels, and the capital put on high alert. Last week, the European commission announced it was escalating action against the UK for its failure to keep to agreed limits on air pollution.

‘The poll shows people want the prime minister to get serious about the toxic and illegal levels of air pollution,’ said James Thornton, CEO of ClientEarth. Photograph: Philip Toscano/PA

But while the study suggests the majority of Britons would back attempts to improve air quality, the fervour appears to be split along Brexit lines. Those who voted to leave the EU were less concerned about air pollution, less likely to support the banning of diesel vehicles in areas of high pollution, and were less inclined to place the burden of addressing the problem on the government’s shoulders; while 67% of remain voters held the government among those chiefly responsible for keeping our air clean, only 47% of leave voters felt the same. By contrast both camps strongly believed the motor industry and other businesses linked to air pollution should lead the way.

What’s more, while half of remain voters said air pollution had worsened over the last eight years, those who voted leave were more sanguine, with only 36% believing the problem had grown.

Although 57% of leave voters support a new Clean Air Act, with mooted measures including reducing traffic and shifting to low-emission vehicles, only 33% felt that when Britain leaves the EU, there should be stronger laws on air quality in Britain. More than half of remain voters said they supported stronger laws.

Simon Birkett, founder and director of Clean Air in London, part of the new coalition, stressed the need for action, adding that any legislation should ensure powers and responsibilities are given to the mayor and local authorities to tackle the problem.

“Sixty years after the first Clean Air Act, which fought respiratory problems from short-term exposure to visible air pollution from coal and wood burning, we need a new Clean Air Act to address newly understood health effects that include heart attacks and strokes from long-term exposure to invisible air pollution from diesel fumes,” he said.

A government spokesperson defended current plans to tackle the issue. “We are firmly committed to improving the UK’s air quality and cutting harmful emissions. We have committed more than £2bn since 2011 to increase the uptake of ultra-low emissions vehicles, we support greener transport schemes, and have set out how we will improve air quality through a new programme of clean air zones.

“In addition, in the autumn statement, we announced a further £290m to support electric vehicles, low-emission buses and taxis, and alternative fuels. We will update our air quality plans in the spring to further improve the nation’s air quality.”

Guardian Cities is dedicating a week to investigating one of the worst preventable causes of death around the world: air pollution. Explore our coverage in The Air We Breathe and follow Guardian Cities on Twitter and Facebook to join the discussion

65% of British public support new Clean Air Act, says survey

Healthcare Fraudulent Profits Put The ‘Gift Of Life’… On Life Support!

Profits, Frauds And Insurance Premiums

In the West, there is a widespread consensus that costs of living and social status always mirror one another. The more one can afford the wealthier one is. If this adage is no longer true, maybe was it never true at all. Many among the middle class, who still can purchase some form of healthcare insurance, have realized that their security hangs by a thread. Each year health insurance premiums are set to further skyrocket. The average employee receiving benefits through an employer doesn’t feel safer either as the out of pocket (before the insurance kicks in) ever increases. The out of pocket for a minimum coverage varying between 5,000 dollars and 2,500 respectively.

If getting health insurance through the employer is a big plus, a 2,500 dollar expense for family of four still represents financial stress. In 2013, a CNN analysis estimated that 76% of Americans were living from pay check to pay check. Considering that the average household has a mere thousand dollars in savings and credit cards close to being maxed out, financial flexibility has become elusive.

Overbilling Is Only A Fraud Among ‘Many’ Others

Although many have access to programs such as medicare, the latter are such in deep red ink. Medicare liabilities amount to $ 30 trillion. Obamacare did more harm than good. Though realistically speaking, the Trump administration won’t be able to fix anything. Such programs have been the main drive behind healthcare costs and insurance premium increase for many decades. They have fueled the dynamics of demand and supply and reversing the trends is practically impossible. Any new policy attempting to lower the costs in favor of the patients will send the healthcare industry into a tailspin.

Many hospitals and medical professionals have overbilled insurances for quite some time now. The whole industry is inflationary. So on one end, we find that bad health is often linked to bad eating habits, a stained food chain and various chemical invasions; and on the other end, we have a sector profiting from sickness as if there were no tomorrows. One doesn’t need to be a PhD – nor a prophet – to predict how this will end.

There have many articles lauding the efficiency and affordability of the Swiss healthcare system. Though even Switzerland has a massive pension fund headache to resolve within 4 years from now. The country could just go under if nothing is done, contended a Financial Times article in 2010. Aging population is a dire problem because the birth rate in the West went drastically down compared to 70 years ago. Financial projections were based on 3 or 4 kids per household. Today the birth rate is about 1.2 or three times less. It is not just Switzerland but the entire West that should be extremely concerned.

Major Economies As Health Hazards.

America and Europe being major economies, money printing to delay the day of reckoning remains a solution. The Federal Reserve has already done that several times since the 2008 crisis. Unfortunately, the price tag has still yet to come. Switzerland and ECB will also have to resort to the printing press. However, we can always cynically speculate on a war causing mass casualties to fix this mathematical equation. While this really sounds like an absolute worse case scenario, world tensions are rising. Something is definitely brewing.

The majority assumes that assessing the quality of healthcare systems is a tricky business. That all methods and prognostics have their own flaws. Well, if one is going to monetize the ‘gift of life‘, there are more incentives to profit from diseases to start with. On the other side of the Atlantic, the U.K seems to have the worst healthcare system by far. The latter could collapse at any moment as over 3 million people are on the NHS waiting list. According to the telegraph.uk, hundreds unnecessarily died between 2006 and 2009 waiting to see a doctor! But here comes another aberration. Instead of improving services at home, the U.K is currently projecting to support ‘care in the community for elderly’ people in China stipulates the Telegraph.uk again. In Canada the state of affair isn’t better at all and care rationing begins to look much like that in the UK.

Capitalism and Socialism Banding Together

By now the trend should rather be obvious: socialized healthcare wouldn’t go anywhere without capitalism and otherwise. Both are putting the Gift Of Life on life support. It all becomes crystal clear when probing the overbilling disaster. Capitalism is antagonistic to efficient treatments. And socialism seeks to further regulate, all of which gives the industry and big-pharma alike more power. According to Malcolm Sparrowd, a mathematician at Harvard, the overbilling fraud estimate adds up to a minimum sum of $ 270 billion a year or at least ten percent of all health care expenses. Regulations never work because there’re drafted by the one-sided profits hunters themselves and a bunch of aggressive lobbyists buying politics. Any genuine action to fix the mess will destroy healthcare as we know it. Meanwhile corruption continues unabated.

To read this long investigation into the monetization of the Gift Of Life further and learn about  The Earth Custodians Movement, please go to:

earthcustodians.net/blog/2017/02/08/healthcare-profits-put-us-all-on-life-support/

Some of the sources (and many more at the original link)

The Crime of Overbilling Healthcare https://blog.nader.org/2014/08/29/the-crime-of-overbilling-healthcare/

How doctors and hospitals have collected billions in questionable Medicare fee https://www.publicintegrity.org/2012/09/15/10810/how-doctors-and-hospitals-have-collected-billions-questionable-medicare-fees

Healthcare Fraudulent Profits Put The ‘Gift Of Life’… On Life Support!

Using Animals For Emotional Support

All of us need time on our own away from the world and other people to recharge our minds and wind down. There are also those which spend the majority of time alone due to emotional or psychological disability’s which prevent them from interacting properly with other people, this prevents them from going outside as they have no reason to and they tend to become very lonely, this is why emotional support animals are available!

What these people have found is animals can provide enough interaction and friendship to support their day-to-day lives, especially those with social anxiety and other emotional disabilities.

What Is An Emotional Support Animal

In my view there are two kinds of emotional support animals, there are those that you can purchase from a pet shop or a reputable store, then there are those that are actually trained to deal with certain emotions a human shows. This mean that just by the very presence, it mitigates the emotional and psychological symptoms associated with the owners condition or disorder, these animals soothe their owners upsets.

They are their friend and companion, they also help cope with a lot of stress and emotional upset, this means it is less difficult to cope with day-to-day issues. These animals do not have to undergo the high training that guard dogs or blind dogs need because dogs especially, have the ability to read human emotions, therefore they do not require large amounts of training.

Let’s See What Is Possible….

Some psychiatric disorders can be so severe that it interferes with a person to live a normal life and basic ability to function and survive on their own, with a little more training it is possible for certain dogs to…

• Finding – These animals are trained to find a special place or a certain person, for example, they are trained to navigate around crowded areas and locate the exits – such as if the handler is having an anxiety or panic attack.


• Searching – If the person has anxiety about entering certain establishments such as local shops, businesses or certain rooms in their home, the dog will enter and search all of the rooms and spaces – if the dog finds someone they will bark to warn the owner.


• Interruption –  An obsessive-compulsive owner can be helped by the dog, since the dog can detect when the owner is doing something that is repetitive, this means the dog will act on this and redirect the owner to help them onto more productive tasks, like brushing the dog.


• Help – When their owners are having a serious panic attack, the dog will be trained to direct help to the owner via a signal that the owner must give – this brings help to the owner.

There are so many options when going for an emotional support animal and they really do help people – they help many to get out of their homes and walk with their dogs. Thousands of people from all over the world are reaching out for this type of support.

Additional Support

Animal Support For Anxiety – Anxiety.org, A real good article I found on-line about animals for Anxiety support.

Emotional Support Animal Letter – OnlineDogtor.com, For those with landlords that do not allow pets.

Emotional Support Animal – Wikipedia, for more reading about Emotional Support Animals.

Using Animals For Emotional Support

Abortion in Pakistan: struggling to support a woman"s right to choose

Sonia woke up in dingy room with searing pain in her stomach. All she remembered was being accompanied by her husband to a clinic for an ultrasound. She’d recently found out she was pregnant; her husband had often been abusive and didn’t react well to the news. Today was supposed to be different: he insisted on going to the clinic so he could see the scan and Sonia hoped that reflected a change of heart.

However, slowly Sonia realised she had been drugged and given an abortion without her consent at a private clinic. It took years for her to come to terms with the violence she suffered.

Islamic scholars permit an abortion within 120 days of pregnancy in Pakistan. But despite this framework for permitting abortions, health professionals are reluctant to carry out the procedure. Many women resort to ingesting drugs, using sharp objects, or physically abusing their body resulting in long-term health complications. In 2012, an estimated 623,000 Pakistani women were treated for complications resulting from induced abortions. In Sonia’s case, her ex-husband was able to pay an unqualified provider to conduct a procedure she hadn’t not consented to. Her story highlights the danger to women’s health when the only option for is an unhygienic facility clinic with untrained staff.

In such dangerous circumstances, who is filling the gap? Saba Ismail, co-founder of the Pakistani women’s group Aware Girls, launched an abortion hotline in June 2010.

Aware Girls has received US Aid funding in the past but now will have to depend on grants from European foundations after President Trump reinstated the global gag rule which prohibits US funding to NGOs which provide information about abortions.

“We have not heard any donor withdrawing our funding on this basis yet, but we will become automatically ineligible for US Aid and other state department grants on this basis, and that’s the challenge,” says Ismail. “We fear that Trump’s decision will affect Pakistan because any organisation, hospital or clinic working on abortion will not be able to get any US funding.”

A woman told us to stop talking about abortions or contraceptives and instead educate women on how to be better wives

Saba Ismail, co-founder of Aware Girls

US Aid spent $ 54.1m dollars funding family planning and reproductive health in Pakistan in 2015 and Marie Stopes International, the family planning NGO which receives funding from US Aid says that its work in Pakistan over the past decade has “averted 4.6 million unintended pregnancies, 1.9 million unsafe abortions and 6,000 maternal deaths”.

Aware Girls provides an anonymous toll-free service called “Saheli” (Urdu for “friend”) to educate on abortions and contraceptives: “When we first launched the helpline we were told that we were promoting murder; that abortion wasn’t about choice but about murder. This stigma and taboo is what bothered us the most.”

Over the course of six years Ismail and her colleagues have faced harsh criticism and threats. “In the beginning we started with 30 calls a month and now we average about 180 calls,” she says. “This is because we went into the communities and spoke to women about their health informing them about the helpline. At one of the events a woman approached me, identified herself as a representative of the Taliban, and told us to stop talking about abortions or contraceptives and instead educate women on how to be better wives to their husbands.” This didn’t stop her, although threats forced them to temporarily close down for six months in 2014.

Ismail’s helpline follows the World Health Organisation’s guidelines on safe methods of abortions that can be performed at home for women under nine weeks pregnant. Misoprostol, a drug used to induce abortions, is available over the counter in many countries including Pakistan because it is also used to prevent stomach ulcers. Ismail’s staff asks women to provide details about their health and verify the length of the pregnancy, and takes them through the process of abortion.

“People think that most women that call us are sex workers or unmarried women. While we do not judge and only ask reasons for abortion for our research purposes, I can tell you that the we get a large diversity of calls. From women aged 17 to 50, women that are married, who have recently given birth, who already have a lot of children and even women who have been raped by their own family members,” Ismail recalls the story of 21-year-old Sameena who was raped by her own cousin and was refused help at a hospital.

An extensive women’s health report conducted in 2012 found that of the 9 million pregnancies in 2012, 4.2 million were unintended; 54% of these unintended pregnancies resulted in induced abortions and 34% in unplanned births.

I attend to calls even when I am in a family gathering, in a funeral or anywhere, I never miss a single call

Tahira Khan, helpline counsellor

The vast majority of the helpline’s calls are about abortions, only 4% of the callers ask about contraceptives. Nonetheless, each caller receives information on the use of contraception. The contraceptive prevalence rate is low in Pakistan – out of a population of more than 190 million, only 35% of women aged 15–49 use it. The reasons for this range from lack of sex education and awareness, and the fact that contraception is still considered a taboo and, in some places, seen as a western concept. Last year, Pakistan banned advertising for contraceptives.

The counsellors on the helplines are young women with no medical background who are trained with the WHO’s clinical handbook [pdf] on safe abortions. Tahira Khan says the helpline has now become more than just a job: “This hotline is a part of my life now, I attend to calls even when I am in a family gathering, in a funeral or anywhere, I never miss a single call, I always call back. When I help women, I feel satisfaction and happiness. Before starting counselling, I thought I could never do it, but with the passage of time, I am now an expert.”

The hotline has received over 25,000 calls so far and this is increasing by the day. Ismail’s organisation can only help women who are under nine weeks pregnant, but in some cases they have to provide referrals for surgical abortions at selective clinics that conduct these procedures under hygienic and medically approved conditions.

Ismail is determined to continue her work but she knows she is treating a symptom rather than a root cause. “My fight is against the taboos that tell women that their bodies aren’t theirs,” she says. “Unless women are seen as human beings who have a choice and right to their own body nothing will change.”

Some names have been changed.

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Abortion in Pakistan: struggling to support a woman"s right to choose

Secular groups fight exclusion from AA: "The best support system in the world"

The Almighty plays a central part in the hallowed 12 steps of Alcoholics Anonymous. Six of them make reference to God, Him or Power. In one step, members vow to hand “our will and our lives” to God while another implores Him to remove their shortcomings.

Now the organisation’s religious undertone – and its utility in fighting alcoholism – has come under fire in Canada, where an atheist has lodged a human rights complaint alleging AA discriminated against him.

For more than two years, Lawrence Knight has watched his complaint snake through the Ontario Human Rights Tribunal. Earlier this year, the tribunal said the complaint raised a number of complex legal issues and recommended it go to a full hearing.

More than 23 years sober, Knight says he always found that the world of AA was an uneasy fit. “I come from a long line of humanists,” said the 59-year-old.

We Agnostics, a Toronto secular AA group created in 2010, seemed the perfect solution, offering all the support and companionship of AA but without the trappings of God. Here the 12 steps were still followed – each carefully rewritten to scrub out any mention of God or prayer.

But the group’s separation of church and sobriety didn’t sit well with some. In 2011, We Agnostics and Toronto’s other secular AA group, Beyond Belief, were delisted from the Toronto AA website and directory, in effect removing them from the city’s network of 500 weekly meetings.

The decision prompted tears and shock among the three dozen or so people who had embraced the secular groups. “It was painful. It’s shunning,” said Knight. “It was unbelievable that an organisation that can’t kick anybody out, and that prides itself on that, had kicked us out.”

Members of the secular groups – worried that their hard-won efforts at staying sober were now in jeopardy – vowed to push forward. What emerged was a parallel system of sorts, one that has today swelled to about 350 members in 12 secular AA groups across Toronto.

As the secular movement grew in numbers, Knight and others continued to push to be brought back into Toronto’s AA fold. They appealed to the city’s coordinating body, urging them to reconsider the decision. “We ran into a brick wall,” said Knight.

Frustration drove him to lodge a human rights complaint two years ago, claiming that AA had discriminated against his group on the basis of creed. While directed at Toronto’s coordinating body, the complaint also names the highest levels of the organisation in North America. “They didn’t make any decisions directly,” said Knight. “But there is something that they did do, in my opinion, and that is the fact that there have been agnostic meetings for 40 years, but they haven’t clarified anything; they didn’t have any human rights protocols in place.”

The result is a scattered approach to secularism around the world. In some places, such as New York City, secular groups are allowed to operate freely and under the umbrella of the local AA hierarchy. Other secular groups – from Des Moines to Vancouver – have been treated similarly to those in Toronto, pushed out and left to their own devices over their rejection of God.

Knight’s complaint will head to mediation in the coming weeks. To date, AA has argued to the tribunal that it is a special interest organisation, a status that affords it the right to restrict its membership.

The dispute hints at a broader question being asked among the group’s two million members worldwide as they seek to incorporate 12 steps first penned in the 1930s into modern times: How important is God and religion in AA’s quest to empower people to fight alcoholism?

Some, like Knight, argue that AA’s curative power lies not in religion, but instead in the fellowship it fosters. A growing body of research, he pointed out, now suggests that the roots of addiction are tangled in isolation and loneliness.

The argument clashes with the Toronto coordinating body, which has argued to the tribunal that a belief in the higher power of God is a bona fide requirement for groups in Toronto.

Officials in Toronto declined to comment, while a spokesperson from AA World Services in New York City said the organisation was unable to comment as the matter was before the Human Rights Tribunal.

Knight is hoping that the human rights complaint will force the organisation to definitively address the long-simmering issue. “Alcoholism kills more people than it saves. It’s killed a lot of my friends, it’s killed a lot of my family, it’s an insidious thing. And the best support system in the world is AA.”

But the strength of that support hinges on AA being accessible to all. “The point is that anybody should be able to go to a meeting and not feel intimidated, not feel forced out or that they have to believe in something that somebody else believes,” he said. “Because that’s just ludicrous in this day and age.”

Secular groups fight exclusion from AA: "The best support system in the world"

How to Support a Loved One Who Has Alzheimer’s

How to Support a Loved One Who Has Alzheimer’s

British women, please rally to support decriminalisation of abortion | Letters

In Poland mass protests have forced the government to drop plans to tighten its already draconian abortion laws. Yet here in Britain most people are unaware that women still live under the threat of being sentenced to life imprisonment if they end their own pregnancies by buying pills on the internet. Doctors also face harsh penalties if they do not fill in the correct forms before terminating a pregnancy.

Back in 1967 our law was changed to allow the legal ending of pregnancies if certain conditions were met. Otherwise the 1861 Offences Against the Person Act remained in place; and so it still is today – nearly half a century later.

On Wednesday 24 October a ten-minute rule bill is to be introduced to the House of Commons proposing that abortion in Britain is decriminalised. To do so would not only allow speedier and much less bureaucratic use of modern medical procedures, but would save a huge amount of NHS money while bringing us into line with countries such as Canada where medical abortion was decriminalised nearly three decades ago.

In Britain one in three women will have an abortion. Yet the views of the small but vociferous anti-abortion lobby garner most of the publicity and continue to dominate public argument. If only a small proportion of the millions of women who have benefited from the 1967 Act were to write to their MPs now asking them to be in the Commons on 24 October and to give support to this proposal, perhaps this punitive Victorian legislation would have a chance of being brought up to date.

Back in the 1960s when I was an abortion law reform activist, the Guardian and its readers did much to facilitate the liberalisation of the law. They now need to mobilise again so that their children and grandchildren can benefit in the same way that they already have from the activities of my generation.
Diane Munday
Wheathampstead, Hertfordshire

• Join the debate – email guardian.letters@theguardian.com

British women, please rally to support decriminalisation of abortion | Letters

Tobacco sponsors may support snooker abroad: archive, 11 November 1986

Cigarette firms may be considering sponsoring snooker tournaments abroad to get round the BBC’s new advertising curbs, it emerged yesterday. They could pull out of Britain because the restrictions would cut the air time given to their brand colours, sources said.

The BBC is tied by the advertising rules of the countries in which events are filmed. This weekend’s Mexican Grand Prix, for example, will be screened complete with advertisements for Marlborough and John Player cigarettes on sponsored cars.

Tobacco firms may switch sponsored snooker tournaments to countries with little or no advertising restrictions. Brazil is considered a tempting venue.

The BBC has told snooker’s governing body, the World Professional Billiards and Snooker Association (WPBSA), that the sponsor’s brand colours must not be reproduced in the playing area; signs bearing the sponsor’s name must not be cited behind players’ seats and health warnings must be legible – if they are not the BBC retains its right to put a warning caption on the screen.

Mr Bill Cotton, BBC’s managing director, has said he is concerned that air time is being used to sell cigarettes. This follows a Health Education Council complaint that sports sponsorship was giving the tobacco industry the equivalent of 500 30-second TV advertisements a year.

The curbs will come into force at the £275,000 Rothman’s Grand Prix snooker tournament later this month. The firm had just spent £2,000 on building a set in its brand colour, Rothman’s blue, when it was told of the new curbs.

Rothman’s three-year sponsorship agreement with the WPBSA runs out next month, and renewal is in question. ‘We won’t be taking any decision until we sit down in November and judge from market research the effectiveness of sponsorship,’ said Mr Roach.

Tobacco sponsors may support snooker abroad: archive, 11 November 1986

Doctors would all support Obamacare if they saw the vast inequality that I do | Celine Gounder

When Americans head to the polls in November, they’ll be deciding the fate of the Affordable Care Act, what Barack Obama has called “the most important healthcare legislation enacted in the United States since the creation of Medicare and Medicaid in 1965”. Over the past decade, healthcare providers have observed the rollout of Obamacare and its net-positive impact on their patients and their practice of medicine.

But how will they vote? Data reported by the New York Times last week suggests that different kinds of doctors tend to have very different political views. My experiences lead me to believe that this empathy gap can be traced to the mix of patients that clinicians care for. The more doctors get out of their privilege bubble, the more likely they are to support keeping, and strengthening, the ACA.

All doctors bear witness to the lives of others. But whom we meet depends in part on what insurance we accept. Medical specialists including cardiologists and orthopedic surgeons and are less likely to take patients on Medicaid than are primary care doctors, pediatricians and infectious-disease docs.

Poverty, discrimination and other social factors also increase the risk of certain diseases such as HIV, hepatitis, childhood asthma, obesity, high blood pressure and depression. So certain medical specialists, like me, see a higher proportion of patients from backgrounds vastly different from our own. Call it empathy boot camp.

One of my patients has been to the hospital six times in as many months because her asthma flares up every time she smokes crack cocaine. She lives with her elderly mother and can’t move, and it’s hard for her to quit when most of her neighbors smoke crack too. Another of my patients had PCP, a severe pneumonia related to HIV/Aids, which required treatment with multiple medications. She left the hospital against our advice because she doesn’t feel comfortable asking family, friends or neighbors to look after her kids.

I have another patient who bounces around from hospital to hospital looking for safety from her abusive partner. Another patient with advanced Aids refused to go to a nursing home where he would have gotten help taking his dozens of medications, three square meals a day, substance abuse treatment services and physical therapy. He was afraid of losing the apartment he shared with his HIV-uninfected girlfriend, leaving her homeless. He died. This is just a sample of patients I saw in one month.

My patients have shown me it’s nearly impossible to get someone healthy when they don’t have stable housing. I’ve learned that if my goal is to help people get better, I’ve got to be pragmatic. I’ve realized that most people with an opioid addiction will never be opioid-free. But with medication-assisted treatment (using substances like methadone, buprenorphine and naloxone), they can become functioning members of society, return to work and resume their roles as caregivers of children or ageing parents.

I’ve even come to believe in safe injection sites, where people can use heroin and cocaine under the supervision of healthcare workers. Not only are they less likely to overdose, but they’re also channelled into testing and treatment. I used to think it was unfair for transgender women to want their breast implants covered by insurance when equally flat-chested cisgender women have to pay for their own cosmetic surgery. But then I saw the harm that comes from injecting industrial grade silicone.

As doctors, we have the privilege of crossing social divides when most others don’t. With that comes a responsibility to our patients and our country that goes beyond our vote. We know all too well what’s at stake.

Doctors would all support Obamacare if they saw the vast inequality that I do | Celine Gounder

We need mental health support at work – and every employer should commit to it | Norman Lamb

We all have mental health, just as we all have physical health, and in both cases we are on a continuum, where our health can vary day to day. It is estimated that one in four people experience a mental health issue in any given year, and that one in six employees is depressed, anxious or suffering from stress-related problems at any time. However, many of us know little about mental health. We often don’t spot the signs that a colleague, employee, or we ourselves are struggling, and this delays help and recovery.

Last week Business in the Community (BiTC) released the most comprehensive report of its kind, called Mental Health at Work. Worryingly, the report uncovered the fact that over three-quarters of employees have experienced poor mental health, and almost half of workers would not talk to their manager about a mental health issue. And while employers are talking more about it, words are not translating into action.

There is a disconnect between the ideals of company bosses and the reality of employees when it comes to mental health. Most board members believe their organisation is supportive on the issue, but 56% of people who have disclosed a mental health issue at work said their employer took no mitigating actions, found BiTC. How can we close this gap between perception and reality? A vital and practical step employers can take, and a key recommendation of the BiTC report, is investment in first-aid training in mental health for staff.

Mental health first-aid is the mental health equivalent of a physical first-aid course. It teaches people the skills and confidence to recognise the signs and symptoms of common mental health issues, listen empathetically and effectively guide a person towards the right support.

Recently, I became a mental health first-aider myself, and now have the tools to start a meaningful conversation on the issue, something most of us would struggle to do. Could you think of the right words to say to someone who may be feeling suicidal? Having experienced loss in my family the training allowed me to reflect on what I might have done differently.

We spend a considerable amount of our lives at work and with more of us working longer hours, under more pressure, having mental health first-aid support in the workplace is critical not just for employees, but for businesses too. As it stands, mental health issues (stress, depression or anxiety) account for almost 70m days off sick per year, the most of any health condition.

Today, on World Mental Health Day, with support from Mental Health First Aid (MHFA) England and Mind, I am calling on the government to act and bring parity to mental and physical health in the workplace. I’m submitting an early day motion on the issue as the first step towards amending the current legislation, which requires employers to train staff in physical first aid, to in future include mental health first aid.

How can we possibly justify leaving the law as it is? So far as the NHS is concerned the government has committed to the principle of “parity of esteem” between physical and mental illness. Surely they must apply the same logic to the workplace.

Put simply, this is a call for every workplace to have trained mental health first-aiders just like they have physical first-aiders. A number of employers are taking action. WHSmith has committed to match the number of staff that are physical first-aiders with mental health first-aiders over the next 12 months.

There’s a growing momentum for change, and hundreds more businesses across a range of sectors are implementing mental health training for staff from Unilever and Crossrail to Channel 4. Employers have a duty of care to their workforce, and with the scale of mental issues in this country much more needs to be done. The government must act now to ensure every employee has access to mental health support at work.

We need mental health support at work – and every employer should commit to it | Norman Lamb

Shaping mental health support through data

If you’re experiencing a mental health issue, one of the people you probably least want to speak to about it is your employer. Disclosing depression or anxiety has long been seen as the last workplace taboo, for fear of repercussions. This is despite the existence of the Equality Act 2010, which protects employees with physical and mental disabilities from discrimination.

But just over a third of workers with a mental health condition discuss it with their employer, according to a survey of 1,388 employees carried out by Willis PMI Group, one of the UK’s largest providers of employee healthcare and risk management services. The research found that 30% of respondents were concerned that they wouldn’t receive adequate support, 28% believed their employer wouldn’t understand, and 23% feared that disclosing it would lead to management thinking less of them.

A culture of fear and silence can have a huge impact on productivity – the charity Mind estimates [pdf] that mental ill health costs the economy £70bn a year. The challenge is that seeking help involves taking ownership of the problem, says Mark Brown, development director of social enterprise Social Spider and founder of the now defunct mental health and wellbeing magazine One in Four. And finding support online can be a time-consuming and frustrating experience.

“Just serving up ever great slabs of information – the internet is awash with it – isn’t going to help anyone to know what to do,” says Brown. “We often confuse the provision of information with the solving of problems. Knowing information is different from knowing how to put that information into action.”

Brown believes that bringing together information with public and open data into a single digital space is one way that could innovate how advice is delivered.

Plexus is aiming to achieve just this. Built by the digital studio M/A, with funding from the Open Data Institute, the knowledge base is being used to design resources for people with mental health conditions, their families, and even employers, to find support available in local areas, seek advice on how best to cope with returning to work after a period off and understand employee rights and employer responsibilities.

Plexus has pooled data from a couple of dozen organisations including NHS Choices, Department for Work and Pensions, the Office for National Statistics and Citizens Advice. In some cases the information has been pulled from APIs; in other instances it has been scraped using web data platform import.io.

The first tool Plexus developed is a chatbot called Grace, which is currently in beta testing. It enables users to record thoughts and feelings anonymously, receive feedback in the form of a newsletter and log in to an online dashboard to see a more detailed analysis, including whether there are any patterns in mood emerging over a period of time. The tool also offers guidance from the various governmental and charity websites under easy-to-navigate sections, such as legal rights and preparing for work.

“Through machine learning, Grace will intuitively know when our users are mostly likely to want to speak with us, be able to see the positive and negative nature of the user’s reply, and adapt the questions to encourage more positive responses,” explains Martin Vowles, creative director and co-founder of M/A. “We’re hoping this approach will allow us to offer a unique tool to each user which helps them understand and develop their mental wellbeing.”

Brown says that the potential for machine learning to tailor information and services is exciting. “It’s very good at looking at big piles of data for patterns. When we know certain things to be correct from one dataset, it can begin to make guesses about lots of other things based on what the machine is being fed.”

The sensitive nature of data being submitted by users on a platform like Grace, though, means many people are likely to be uneasy about their data being made accessible. To get round this, Plexus allows users to decide how their data is shared, with data licences lasting between 13 and 26 weeks. Vowles hopes that “as users become more trusting of Grace and what it can do for them, they’ll become more trusting with [us] using their anonymised personal data.”

Plexus aims to release a series of open datasets, including qualitative, quantitative and information on resources accessed by Grace users, to enable NGOs and local authorities to understand the country’s mental health provision. It’s hoped that they’d then use the knowledge to devise new strategies and ensure targets are met and resources and services available in local areas are of an acceptable standard.

There are also plans to make certain data available to employers, but “this has to be on the employee’s terms”. Vowles imagines that involving employers in the process of receiving support could allow them to get a clearer picture of mental health in the workplace. They could then adapt to make employees feel more comfortable and ensure their business has adequate support in place.

The potential to use open data to shape how future mental health support is delivered is an area that has been underexplored. At the end of last year, the Royal Society of Arts launched an interactive platform with Mind that allows members of the public to find out how well local health providers are looking after people with mental health conditions. The full dataset is available to download and includes data extracted from Public Health England, as well as metrics such as percentage of people with a mental health condition in employment in local areas. Plexus, however, is the first tool to use open data with the aim of providing people with a holistic view of their mental wellbeing.

Brown supports the idea of using open datasets and combine them, but stresses that any tool or platform has to benefit users. The data and information must be digestible and it needs to help them understand and take away from it what they need.

“It’s often extremely easy to forget that people with mental health difficulties are people first and foremost – not objects or problems.”

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Shaping mental health support through data

Pregnant and diagnosed with HIV: the group providing support for mothers

Thirteen years ago, when Babalwa Mbono was eight months pregnant with her second child, she went to her clinic in Cape Town, South Africa, to have a routine HIV test.

“I went with confidence because my first child was negative and I was negative then,” she says. When the test came back positive, Mbono couldn’t believe it. “When the counsellor who tested me showed me the results I thought, ‘you’re joking!’ I even asked her if she was sure.”

Mbono left the clinic in a daze and went home to reflect on the news, still in denial. She looked healthy and well, unlike her sister who had died three years previously from Aids-related tuberculosis. “For me, [the result] was something that was not real,” Mbono adds.

Nowadays many people in South Africa know about HIV. The country has the biggest and most high-profile epidemic in the world, with an estimated 7 million people living with the condition, according to UNAids figures. But in 2003 it was not a big topic, and discussions usually revolved around death, says Mbono. The fear of what having HIV might mean for her unborn child started to creep in, and she worried that she would not live long enough to care for a baby who might be infected.

When Mbono found out that she had HIV, South Africa’s government was still deciding whether to make antiretroviral treatment (ARVs) available to all, despite a third of pregnant women testing positive. Today, 48% of infected South African adults are on ARVs.

Back at the clinic, Mbono was linked up to a mentor mother through Johnson & Johnson’s mothers2mothers (M2M) programme. The scheme started in 2001 and has helped 1.4 million HIV-positive mothers in nine sub-Saharan African countries. It currently operates in Kenya, South Africa, Malawi, Lesotho, Uganda, Swaziland and Zambia – seven countries where it has virtually eliminated mother-to-child transmission (MTCT) among its patients, with a 2.1% transmission rate (the UN classifies virtual elimination as less than 5%).

Mbono’s HIV-positive mentor allayed her fears about death and her anger towards her husband, whom she blamed for giving her HIV after he tested positive with a much higher viral load. Through M2M,Mbono learned about taking ARVs to reduce the risk of MTCT in the womb and during breastfeeding, and about how to change her lifestyle to live a long and happy life with her children.

Last year, South Africa was one of six priority countries (all in sub-Saharan Africa) to meet a Global Plan target of reducing MTCT by 90%, with 95% of pregnant women with HIV on ARVs and an 84% reduction in new HIV infections among children.

Over the past year, Cuba, Belarus, Armenia and Thailand – non-priority countries – managed to eliminate MTCT altogether. In South Africa, mother-to-child transmission of HIV has fallen to 3.5%, putting the country within reach of eliminating paediatric infections, although maternal mortality remains high.

The M2M programme “makes the person feel supported”, Mbono says. “It’s a sisterhood, and it makes you feel like you have a family to cry on.” Through counselling, which helps to breaks down the stigma still attached to HIV/Aids in South Africa despite its high prevalence, Mbono also found the courage to confide in her parents and siblings.

And six months ago, she decided to disclose her HIV status to her daughter Anathi, who had just turned 13. “It really felt shocking,” says Anathi, who feared that there would be no one to look after her seven-year-old brother, who was born HIV negative. “I was afraid that she would leave us.”

Mbono reassured her daughter that she had tested negative when she was 18 months old, but Anathi decided to go alone to the clinic and be tested anyway, where she also accessed free counselling from health workers.

“I was so, so scared, but eventually they just sat with me and told me to not freak out and to not think negative things about my mum,” Anathi says. Over the two days she waited for her results, she spent time with her mother and learned more about M2M, even reading her mentoring books.

Mbono’s experience with M2M made her give up unhealthy habits, such as not eating properly and drinking alcohol, and inspired her to become a mentor mother in 2003. “The [programme] gave me the strength to go out there and tell people about HIV and correct the mistakes that people are making and [that] I also made when I didn’t have any information.”

She has gone from counselling others on HIV/Aids and family planning, to training other mentors and seeing them become nurses, social workers and students.

“What makes me most happy [is] when I see a woman who had broken up in pieces when she was told about HIV … and when you see her on the next visit she is much better than the day she left.”

Some 95% of babies in M2M’s South Africa programme test negative for HIV at 18 months, and that also makes Mbono proud. “That makes me feel that I’ve done my job, because 18 months is a long time for the mother to be supported and to be educated. There are so many challenges that they come across, and we are there [for them].”

Anathi set up a counselling group at school to discuss HIV and sex with 18 girls and five teachers, as well as a drama group to perform plays to parents and pupils that discuss staying HIV negative and breaking down stigma.

“Most people don’t talk about it … Young people are not getting enough information about HIV,” she says. Anathi has a friend who she says became a recluse after she found out she is positive, and she knows two girls who have gone off the rails since their mothers recently died of Aids.

But for Anathi, dealing with her mother’s HIV has made them stronger and brought them closer together.

She still worries about how well her mother has slept or eaten when they are apart, even though learning about ARVs has lessened her fears of her mother falling ill and not recovering. “I just worry too much and I call,” she says. “She is like my daughter.”

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Pregnant and diagnosed with HIV: the group providing support for mothers

Corbyn’s support for my NHS reinstatement bill was not inept | Letters from Caroline Lucas MP and others

I have no wish to intrude on the Labour leadership debates and I have no idea whether former shadow health minister Heidi Alexander is right in her critique of Jeremy Corbyn’s leadership style, but for her aides to pick out Corbyn’s support for my NHS reinstatement bill as evidence both of his “ineptitude” and of his shadow chancellor’s “undermining” her strikes me as both desperate and depressing (Shadow cabinet inept and shoddy, says MP, 20 August). My private members’ bill, drawn up after extensive consultation with health experts and health service users, would have reversed the creeping marketisation of the NHS – under both New Labour and the Conservatives – and stripped away the costly market mechanisms that waste NHS money and lead to inefficiencies and the fragmentation of services.

Perhaps a more interesting question is why the rest of the Labour party didn’t join their SNP, Plaid and Lib Dem colleagues in giving it their backing too. With a few honourable exceptions, they chose to abstain instead. Yet this is precisely the kind of policy a successful Labour party would surely be expected to promote – as well as demonstrating a greater willingness to work alongside colleagues from other parties on those areas where there is common ground between us.

Overcoming party tribalism and finding practical ways of working together will be crucial to any hope of progressive policies finding a majority at the next election – whether that be on the NHS, tackling inequality, putting rail in public hands, or seriously addressing the climate crisis. Real leadership means being bold and honest enough to recognise that there’s far too much at stake to refuse to cooperate for the common good.
Caroline Lucas MP
Green, Brighton Pavilion

• Heidi Alexander’s self-justifying piece would have made David Brent blush. Alexander had perhaps the easiest job in Labour front-rank politics – defending a properly funded, publicly run health service free at the point of use – yet she managed to reduce her portfolio to dull, uninspiring managerialism. On every count she flings at John McDonnell for “undermining” her – his joining a junior doctors’ picket line, his gathering the views of frontline health activists and his support for Caroline Lucas’s NHS reinstatement bill – McDonnell clearly spoke for the vast majority of Labour supporters and members.
John Medhurst
Hove, East Sussex

• Jeremy Corbyn’s support for a National Education Service is welcome but hardly “courageous” (Zoe Williams, 15 August). None of his statements to date have spelt out the urgent reforms needed to England’s segregated and hierarchical system of secondary schools. He could confront the need for an integrated 14-19 curriculum and discuss the future of the GCSE. He could propose new forms of local and regional accountability. He could discuss fair admissions, measures to reduce religious segregation and how to end, not extend, the 11-plus. Without more detail Labour’s policy on secondary schools will, sadly, remain an empty space. Even more courage is needed, Jeremy.
David Chaytor
Todmorden, West Yorkshire

• It is a sad day for British democracy that Momentum – the left-wing ginger group active within the Labour Party – has seemingly turned its back on non-violence (Momentum no longer rules out acts of violence, 20 August). Momentum’s unwillingness to sustain its previous principled opposition to violence is because some of the fringe groups who are associated with them want a licence from the left to face down neo-fascist groups fist-by-bloody-fist. Aligning this sort of macho political posturing with what the brave men and women who resisted the Nazis did is an insult.
Martin Jones
New Barnet, Hertfordshire

Corbyn’s support for my NHS reinstatement bill was not inept | Letters from Caroline Lucas MP and others

Struggling students are not "lacking resilience" – they need more support

Resilience has been a buzzword in education for years now. Advocates say that young people need to develop the ability to cope with difficulties themselves, rather than expect others to solve their problems. But critics argue that it is used as a catch-all term that removes responsibility from institutions and fails to address the problem of worsening mental health in students.

Related: Tuition fees ‘have led to surge in students seeking counselling’

I have been working as a welfare officer for the past year, and I have rarely seen the term used to encourage self-improvement in an effective way. I have seen students told by their tutors, counsellors and other support staff that they just need to become more resilient. Yet there is little advice on how to do this, or why it will help.

Students often see the word as a synonym for strength, and therefore feel that lacking resilience is a sign of weakness. A professor could be saying “be more resilient” and mean that a student shouldn’t take critical comments on their work personally. But what a student hears is something like, you aren’t strong enough, or you need to man-up, or you lack backbone.

It’s too ambiguous

The word resilience is used too frequently and applied to vastly different situations.

A first-year student at the University of Edinburgh told me she would always ask her professors for feedback about a bad grade, wanting to know how to improve for the future. In response she was told to become more resilient and stop asking for feedback after every assignment. Surely it takes resilience to embrace negative feedback and address mistakes?

Students need to be equipped to bounce back from tough situations or those where they didn’t achieve perfection.

I’ve heard an employer complain that they were being asked for feedback about applications more often, because students “weren’t resilient”.

Times have changed

Problems are often discussed with an “it was different back in my day” attitude. So if students are accessing university counselling services more, it’s because the entire student population is losing its resilience. If disability services are overstretched, the same reason is given. And when tutors are asked to provide pastoral support – historically always a part of the personal tutor role – they feel it’s because these “modern students” need extra help.

Students might be asking for help earlier and for problems that they once might have kept to themselves. But to dismiss an entire generation isn’t fair.

Students are coping with all sorts of factors that make their lives a challenge: the worry about tuition fee debt, an intensely competitive graduate jobs market and the pressure of social media. By recognising this, university staff can start to support their students to become more resilient.

Impact on mental health

The most worrying aspect of this trend is the frequency with which resilience is referenced in discussions about mental health. It is not appropriate to tell anyone suffering with mental illness – be it anxiety, depression, an eating disorder or something else – that you can recover by becoming more resilient.

Doing so strengthens the notion that mental ill-health equals weakness, and can make people feel that they would not be ill if they had only been tougher. A runner with a severe ankle sprain would not be told to fight through the pain and continue training, so why would we tell someone who has panic attacks the same thing?

Related: No one sees how hard it is for students with an invisible illness

How to make it work

Resilience is a great concept. Learning not to be discouraged by past failings and recognising shortcomings is an extremely useful skill. Students need to be equipped to spring back from tough situations, or times when they didn’t achieve perfection – this is vitally important in universities.

As support staff we need to enable students to learn the skills of resilience. We need to standardise what we mean by it. And we should never use the term when discussing mental health.

Being resilient doesn’t mean never asking for help or never being affected by difficult situations. We need to focus our discussion on boosting wellbeing, and teaching a set of skills that help students bounce back from setbacks in life and academia.

Join the higher education network for more comment, analysis and job opportunities, direct to your inbox. Follow us on Twitter @gdnhighered. And if you have an idea for a story, please read our guidelines and email your pitch to us at highereducationnetwork@theguardian.com

Struggling students are not "lacking resilience" – they need more support

GPs should be a gateway to social care and support services

The main role of GPs has always been treating common medical conditions and referring patients to hospitals or other services for urgent and specialist treatment.

But gradually the role of GPs and primary care teams are changing. Driven by the integration agenda – which seeks a greater level of collaboration across frontline services – but also by the changing nature of the population’s health needs and rising demand on the NHS, new kinds of primary care services are being established.

Related: Doctors should prescribe gardening for patients more often, says report

Increasingly, patients are able to access GP-led hubs offering a range of services, or are given a social prescription that provides them with access to non-medical support, such as social clubs, peer networks or arts therapy and gardening. However, even with growing evidence that these models of care can reduce long-term demand on acute services, we have not yet seen a major shift in this direction.

That is why the recently published General Practice Forward View report is so welcome. As well as setting out detailed plans for the recruitment of more GPs and the improved use of technology, it argues for a refocus of the GP’s role on to prevention rather than cure, and the promotion of community-based care and support.

More specifically, the report calls for more areas to incorporate the multi-specialty community providers (MCPs) model of care – a programme of integrated primary, out-of-hospital and preventative care that is being piloted in 14 regions of the UK. Social prescriptions should also be more frequently used, it adds, to provide patients with access to organisations that can provide advice on employment, housing, debt and other support services.

We are beginning to see how exciting this future could be. In West Wakefield, the MCP has trained more than 60 people to be care navigators, who can direct people to alternative sources of community-based care and support.

In York, they are seeing increased patient satisfaction and a reduction in hospital costs as a consequence of implementing GP-led multi-disciplinary integrated care hubs that a providea single point of access to a full range of health and social care services. In Rotherham, a social prescription initiative is connecting the most deprived communities to support and keeping people healthy and independent for longer.

Of course, GPs will always be the first point of access for many into the NHS, but they have the potential to act as a gateway to other care services, saving the NHS money and improving outcomes for patients.

Ewan King is the director of business development and delivery at the Social Care Institute for Excellence (Scie)

Join the Social Care Network to read more pieces like this. Follow us on Twitter (@GdnSocialCare) and like us on Facebook to keep up with the latest social care news and views.

GPs should be a gateway to social care and support services

Getting an emotional support animal is as simple as clicking a mouse

Everyone seems to have a story about seeing an emotional support animal out and about these days. That pig inexplicably sitting next to you on your flight. That little dog, yipping away at a restaurant. Once rare, emotional support animals now show up everywhere, including apartments with strict no-pet policies.

Unlike service animals – those well trained fuzzy companions that assist the blind or turn on light switches for people with cerebral palsy – emotional support animals aren’t trained for any specific tasks. The job of an emotional support animal is simply to be present for their owner’s wellbeing.

There are very few rules governing emotional support animals, and there is no official registry, so it’s hard to establish how many there are. To present a pet – whether a dog, a ferret or a snake – as an emotional support animal, all one has to do is provide a letter written by a licensed mental health practitioner attesting to the psychological benefit of that pet’s presence. Though emotional support animals sometimes show up at restaurants and other public places, unlike service dogs, the Fair Housing Act and the Air Carrier Access Act limit them to housing and air travel only.

While the spirit of the law may have been intended to allow mental health professionals to better serve the needs of their patients, it has also enabled a whole new business to flourish. Multiple online companies now provide these official letters without ever seeing anyone in person.

Related: The day I met Arthur, the dog who walked through the jungle to stay by me

Simply pay them a fee in the $ 150 – $ 200 range, fill out an open-ended questionnaire online and within 24 hours, your ferret could be sitting on your lap during that Thanksgiving flight home, with no extra airline fee.

Since these services provide an emotional support letter without meeting the patient, it is relatively easy for anyone to obtain one.

One of the most popular online companies, CertaPet, bills itself as top rated among online emotional support animal certification services. It lists skipping an animal fee when flying with your pet and avoiding a pet surcharge in your apartment building as two of the top three reasons to get an emotional support animal prescription.

In addition to websites offering a therapist’s letter, there are now a number of websites offering to register your emotional support animal with their company. The official sounding National Service Dog Registry, which allows you to register your furry companion as an emotional support animal for the low price of $ 64.99, sends you a certificate of registration and some tags to identify your dog in exchange for the fee. There is no such thing as a support animal registry, however, and the National Service Dog Registry even states in small print that such registration is not needed. Emotional support animal dog tags are also offered by many sites, but ID tags are not required by law.

While there are laws in a few states against misrepresenting a pet as an emotional support or service animal, there are no federal laws against it.

Presently this area is a free-for-all

“Presently this area is a free-for-all,” says Rebecca Johnson, director of the Research Center for Human-Animal Interaction at the University of Missouri College of Veterinary Medicine. She suggests this lack of regulation may eventually hurt those who actually need support animals to function.

“It makes it difficult for people who truly need an emotional support animal to travel,” says Rebecca Huss, an animal law expert and law professor at Valparaiso University. “Everyone looks at them as a fraudster.”

I decided to see just how easy it is to be a fraudster and get approved for an emotional support letter by applying to a few of these online services.

First, I needed justification for my emotional support animal. The list of disorders that are approved for an emotional support animal are broad. Everything from depression, anxiety, PTSD – and, according to some websites, even stress – can qualify.

The Queen of England’s dogs leave an aircraft at Heathrow Airport after flying from Balmoral Photograph: Tim Ockenden/PA

I chose to highlight symptoms most of us living in a big city experience: anxiety and trouble sleeping. On top of that, I added the true story of a close family member’s death.

The portrait I painted was of an anxious woman, tired from lack of sleep, who avoids parties where she does not know everyone but still functions in her everyday life, with family, friends and a spouse to support her. She gets a little depressed on some days but not others, and recently had a tragic family death.

The websites allow you to choose different plans – a letter just for flying or a letter for housing and flying – for different fee structures. I chose the flight letter option simply because it was the cheapest, and if I was going to waste the Guardian’s money on an imaginary dog, I figured it was best to go with the bare bones package.

The process for getting an ESA online is remarkably similar from company to company. I chose two of the most popular companies: The Dogtor and CertaPet.

The Dogtor requires no human interaction, but the form, which the company says takes 30 minutes to fill out, took me over an hour. Almost all the questions are open-ended and you are given a lot of space to write in detail about your mental health issues. If you are not approved, the company will refund your fee.

Related: Falling in love with Pete: there’s never been a better time to rescue a dog | Steph Harmon

At CertaPet, I was required to fill out the form for a specific animal and explain how it helps me. (I used the family dog, Roscoe, as a proxy for my non-existent pet.) The form CertaPet had me fill out online was half open-ended questions and half survey, with questions that focused on everything from schizophrenia to manic episodes to the standard issues of depression, anxiety and PTSD. Like The Dogtor, if you are not approved, they will refund you.

Seven-month-old golden retriever “Tim” waits patiently for his flight to Las Vegas Photograph: Toru Kawana/AP

Unlike The Dogtor, CertaPet had a remarkably kind sounding social worker call me within two hours of filing the form. We chatted for about three minutes, after which she kindly told me she would approve my letter. She also told me to save her phone number and call or email her if I needed anything, which I found oddly moving.

The Dogtor simply sent me an email from a therapist about 8 hours after I had filed the form. In the email, the therapist focused on the family death, saying a few kind words of sympathy and advised me to see a psychiatrist.

Just like that, in less than 12 hours, I had two emotional support animal letters in my inbox. According to the letters, I was also now the patient of each of the therapists who had signed off on my letters.

A proper emotional support animal prescription should come from someone who is treating the patient and knows their mental health condition, according to Philip Tedeschi, executive director of the Institute for Human-Animal Connection at the University of Denver. It should also take into consideration the living circumstances of the animal. If the emotional support animal is living in circumstances it is not suited for – like a dog that is left alone all day – it can become a health issue for the animal and a source of stress for both the animal and patient.

The way the system is set up presents a challenge for businesses. No one wants to get sued for mistaking a pet for an emotional support animal or a service.

Related: Doggy delights: delivering bespoke meals for hungry hounds

Businesses that don’t want to accommodate animals have little recourse at the moment, says William Goren, an attorney specializing in disability law. Though, if an animal eats a table leg or poops on the carpet, businesses can still ask them to leave.

So far, the government has not pushed back against these online services and the proliferation of fuzzy companions skipping over housing and airline restrictions. Awareness of how easily people obtain these pet prescriptions online, however, is rising. When emailing me my letter, The Dogtor noted that United Airlines and American Airlines require extra forms to be completed by a mental health professional in addition to the emotional support animal letter. Businesses can’t question a prescription, but they can make it a little harder to cheat the system.

Changes to the rules around what constitutes a proper prescription are not likely to come anytime soon, so the online emotional support animal prescription services are here to stay for now. While that might lead to some people gaming the system, imposing more hurdles can be an issue too, leading to a delicate balancing act. When it comes to those with real disability, “we want to encourage access, not discourage it,” says Huss. Even if that means someone without disability getting a free flight for their ferret.

Getting an emotional support animal is as simple as clicking a mouse