Disabled people are confronting the spectre of social death | Jane Campbell

On Monday, disabled representatives from disability organisations across England, Scotland and Wales presented reports to the UN Committee on the Rights of Persons with Disabilities in Geneva. It is now eight years since the UK ratified the UNCRPD with cross-party support and this is the committee’s first full examination of the UK’s performance.

So how are we doing? The government is fond of claiming that the UK is a “world leader” on disability rights. Superficially, this claim remains fairly accurate. We have the most comprehensive and proactive equality law anywhere in the world; social care legislation and practice that embodies the principle of choice and control; a social security system that claims to recognise the extra costs of disability; and law and regulations to advance accessibility. It is important to remind ourselves of what disabled people have achieved over the past 30-40 years of disability rights activism, as we have charted our journey from objects of care and charity to becoming active, contributing citizens. But any assessment of progress cannot be confined solely to what we now have, or where we were in the past. And judging by the UK’s direction of travel, the government’s claim of world leadership quickly unravels: we are seeing big cuts to services and watering down of rights and opportunities of disabled people.

Last year, I served on the House of Lords select committee, reviewing the impact of the Equality Act on disabled people. We found that this government’s deregulatory zeal and spending cuts significantly undermined the intended effect of the act. Employment tribunal fees, legal aid cuts and loss of advice services have put the act’s protection beyond the reach of most disabled people. And colossal cuts to the Equality and Human Rights Commission’s budget have left the act under-promoted and unenforced.

The UK’s mental health and mental capacity laws fail to comply with the CRPD, which stipulates that disability cannot be grounds for denying people equal recognition before the law or for depriving people of their liberty. Yet in England, there has been a 10% rise in detention each year for the past two years. More than half of these cases related to people with dementia, and a significant minority to adults with learning disabilities. The sanctioned use of restraint, seclusion and anti-psychotic medication remains commonplaceon mental health and learning disabilty wards, violating people’s rights to physical and mental integrity and to live free from torture, inhuman or degrading treatment. NHS benchmarking data revealed that there were 9,600 uses of restraint during August 2015 in mental health wards in England, while the Learning Disability Census 2015 found that one-third of patients with a learning disability were subject to the use of restraint in 2015-16.

Unexpected deaths of mental health in-patients, or those cared for at home in England, are up by 21% yet, unlike deaths in police, prison or immigration detention, there is no system of independent investigation. Since 2011, hospitals in England have investigated just 222 out of 1,638 deaths of patients with learning disabilities. Among deaths they classed as unexpected, hospitals inquired into just over a third.

The Care Act fails to ensure disabled people’s right to independent living, and swingeing cuts in health, social care and benefits are eroding the availability of support and people’s right to exercise choice and control. Disabled people are confronting the spectre of re-institutionalisation as councils and clinical commissioning groups limit the amount they spend on individual packages of support.

The UN disability rights committee has already reported on the negative impact of the UK’s measures to cut social security spending. Yet further disability benefit cuts continue to be implemented and the extension of punitive sanctions to those hitherto assessed as unable to work is being proposed on the back of declining investment in employment support.

“Nothing about us without us” is the international motto of the disability rights movement, but there is little evidence of disabled people being involved in policy development. The last 10 years have seen the proportion of public appointees with a self-declared disability halve in number, while helpful measures to support more disabled people into politics, such as the Access to Elected Office Fund, have been suspended in England.

Advancing the rights of disabled people requires good leadership to establish coherence and coordination in Whitehall, and in devolved and local government. The Office for Disability Issues was set up for this very task, but has become a shadow of its former self. But in Wales and Scotland, things are more positive, with the convention firmly embedded in policy and strategy.

If the UK wants to maintain the mantle of world leader on disability rights, it must see the forthcoming examination as an opportunity to listen and take stock. If it fails to do so, current and future generations of disabled people face the slow, inexorable slide back towards social death once again.

Disabled people are confronting the spectre of social death | Jane Campbell

Worried your partner might have a bisexual history? Why? | Phoebe Jane Boyd

“Use a condom, the pill, or get an IUD – avoid pregnancy” was the drill from sexual health practitioners who came to speak at my comprehensive school in Kent. There wasn’t much detail or thought beyond, “Some of these boys are going to get some of these girls pregnant before they hit 16 – let’s try to get that down to a lower number than we had last year.”

Thankfully, when it comes to the subject of sexual identity, there’s now more guidance than ever trickling down into the societal subconscious in the west – hopefully in schools, but certainly during publicity rounds for films starring Kelly Rowland and Cat Deeley. While talking about Love By the 10th Date to the New York Post last week, Rowland espoused the importance of knowledge when embarking on a sexual relationship with another: “I can’t tell someone how to feel about dating someone who is bisexual or had a past gay experience, but it’s proper to ask [if they have] in today’s times.”

Women who have sex with women are less likely to get a smear test, because many of us don’t realise we need to

It is “proper” to ask? Maybe it’s unfortunate phrasing, or maybe not being able to hear the tone of voice in which the opinion was offered gives it negative impact, but the sentence rings faintly of suspicion and mild disapproval: “Please submit your history of sex with people of the same gender, and it will then be decided whether or not you are too risky to be intimate with.” That’s how it comes across to this particular someone who is “bisexual or [has] had a past gay experience”, anyway.

Bisexuality just continues to have a bad rep, even though it’s on the rise (according to CNN) … or then again, maybe it’s not on the rise (according to the Verge). Statistics on the spread of sexually transmitted diseases, and which groups of people are spreading them, are easily found (and quickly wielded by those mistrustful of anything beyond heteronormativity), but they can obscure a simple and universal truth that applies to all groups, whether those groups are on the rise or not. And that is: whatever genitalia you and your partner(s) have, you should protect yourselves (condom/dental dam/wash your hands and accoutrement between uses, thank you). Ignoring that fact in favour of “it’s the bisexuals, mostly” is the source of so much harm.

You don’t have to openly identify as bisexual to get the bad side of bisexuality, because it goes beyond the myths of promiscuity, greed and dishonesty still held by some – biphobia also has an impact on physical health. Here in the UK, if you’re a man who’s had sex with another man in the last 12 months, you can’t donate blood (though that stance is currently being reviewed). Women who have sex with women are less likely to get a smear test, because many of us don’t realise we need to – we’re forgotten by the healthcare system, or our needs are misunderstood.

“Gay and bisexual women are at lower risk for HPV,” we confidently tell each other, “we don’t need a smear test.” A lot of us have heard that from our doctors, as well. It was only after seeing a leaflet about the issue from lgbthealth.org.uk during this month’s Cervical Cancer Prevention Week that I realised this was just ignorance.

In 2008, Stonewall released findings that one in 50 lesbian and bisexual women had been refused a smear test, even when they requested one. The 2015 survey on training gaps in healthcare, Unhealthy Attitudes, found that three in four patient-facing staff had not received any training on the health needs of LGBTQ people. Many women get variations of the “use a condom, the pill, or get an IUD – avoid pregnancy” mantra from our doctors to this day, if we don’t declare our gayness or bisexuality as we walk through the surgery door. Sometimes even a declaration is ignored by an uncomfortable practitioner. Straightness is still automatically assumed, unless you’re lucky enough to have a doctor who doesn’t see heterosexuality as the default for everyone they treat.

According to that 2015 Stonewall study, a third of healthcare professionals felt that the NHS and social care services should be doing more to meet the needs of LGBTQ patients, which is encouraging. Knowledge is wanted – needed – to undo the harmful myths that block help and prevent education. And that is what is “proper” (to quote the star of Freddy vs Jason and Love By the 10th Date) – fighting ignorance and biphobia, rather than continuing to be suspicious of sexual histories that might have featured people of the same gender. Whatever and whoever is in our sexual pasts, we must protect each other, and stay informed. That’s healthy.

Worried your partner might have a bisexual history? Why? | Phoebe Jane Boyd

So child mental health services are failing. Why’s that then, Jeremy? | Hannah Jane Parkinson

Actions speak louder than words is perhaps the maxim that governments should live by; that governments should have as their desktop screensavers or written on Post-its on ministerial fridges. It came to mind when Theresa May made her Milibandesque inaugural speech as prime minister, and it came to mind again last week when Jeremy Hunt told us that the NHS is failing Britain’s young people on mental health. “Too many tragedies” occur because of weaknesses in the children and adolescent mental health services (Camhs), Hunt said.

It’s a popular opinion. So popular in fact, that people who work in Camhs have been saying it for years. Ditto the individuals who use the service, or would use the service if they were not languishing on waiting lists. Or those who are put off even trying to enter the system, or don’t know what help is available. Not to mention the parents and guardians of these young people.

Hunt says services need to intervene earlier. He is absolutely right. Will he tell us next that people need air to breathe and plants need water to thrive? And why then, has the government he is a member of, and the previous one, overseen the decimation of mental health services, and in particular, those dedicated to helping young people?

Earlier this month the Guardian revealed that 235,000 young people in the UK are receiving mental health care, and that’s a figure based on responses from 60% of trusts, so the real number will be higher. Figures released by NHS Digital show a shocking rise in young people self harming, including an increase of 42% over the past decade in the number of girls treated as inpatients after self poisoning. Almost two-thirds of headteachers are concerned about depression in pupils. One in 10 five to 16-year-olds are thought to have a mental illness. Time and again we are warned that young people’s mental health is an area that needs huge investment to prevent a generation of unwell adults. Prof Dame Sue Bailey, former head of the Royal College of Psychiatrists, has called the situation a “car crash waiting to happen”.

And yet freedom of information requests find that one in five local authorities have either frozen or cut their Camhs budgets every single year since 2010. From the same year to 2015, £50m was cut from Camhs across the board. Funding promises do not make it to the frontline. The NSPCC found that a fifth of young people are turned away from Camhs services for not meeting the threshold for help. Years and years of the falling axe; years and years of avoidable deaths and futures derailed.

Now Hunt has the gall to tell us that mental health services are failing children and adolescents. They are. But it’s not, for the most part, the fault of the psychiatrists, psychologists, therapists, community psychiatric nurses and all of the support and admin staff who make up the mental health services; they often work after hours and take on additional duties for no extra pay. Services are failing thanks to budgets being cut, departments merged or closed and a lack of staff, all courtesy of a government that seems to think the public will forget it has been in charge for this duration.

Teenage girls talk about anxiety: ‘It’s always linked to failure’

It is not uncommon for unwell youngsters to spend nights in police cells because of a lack of available beds. It is even more typical for young people to be offered inpatient beds many miles away from their homes, or on adult wards, or to turn 18 and slip through the gap between Camhs and the adult system.

Hunt’s rhetoric towards junior doctors will not help the dire take-up of psychiatry posts. And now Brexit will deter the overseas staff that large parts of the mental health services rely on.

Of course, episodes of mental illness are horrific at any point in a person’s life. Depression in older people has reached crisis levels too, but what is especially devastating about children and teenagers becoming ill is that it can knock them off course for life.

This happened to me, and is the sole reason I did not sit A-levels or earn a degree. Because I became ill at 16, and did not manage to access proper treatment until years later. I am, despite this, lucky. The kindness of people and their willingness to understand and appreciate the different road I have taken (unwillingly), and to spot potential, has meant that I, eventually, got to where I wanted to go – but it often didn’t look as though things would turn out this way and the effects are life-lasting.

So I agree with Hunt. He is entirely correct: Camhs is weak. But when you starve something, neglect it, take away everything that makes something strong, it will inevitably become weak. The truth is the UK could afford to give more money to the NHS, which spends less than many other countries on its health system. As Simon Stevens, head of NHS England, has said, even if the £1.25bn that has been “pledged” to young people’s mental health services is delivered, Camhs would still only be in a position to help one in three youngsters in mental health need.

After the leave campaign stood in front of its lie-on-wheels promising £350m per week to the NHS, to hear Theresa May point blank refuse the NHS the money it needs is enough to turn the stomach. Hunt may be a wealthy man, but to hear him cast aspersions on a service that the Tories have stripped of all resources and funding since it came to power? That’s rich.

So child mental health services are failing. Why’s that then, Jeremy? | Hannah Jane Parkinson

Advising females with depression about possessing children isn"t babying them | Hannah Jane Parkinson

If there is a single point that men and women with encounter of depression concern most in lifestyle, it truly is depression coming back. The thought of being dragged once again into a moribund swamp of emptiness, ennui and self-hatred is terrifying. Depression typically returns, so it is useful to find out how to fend off the black canine prior to you find oneself staring at the back of its open throat and currently being knocked to the ground. It can take a hell of a extended time to get up.

To this finish, the National Institute of Clinical Excellence (Good) has issued new suggestions to GPs treating girls with depression. It suggests doctors request female patients whether or not or not they want kids as a prelude to discussing the problems which can arise when ladies with depression – or history of it – become pregnant.

The tips, nonetheless, have been deemed a violation of privacy an NSA-design eavesdropping-through-the-bellybutton on likely daily life. 1 in three ladies are affected by mental well being problems, in accordance to the Globe Wellness Organisation (WHO). We know that a sturdy hyperlink exists among females with prior mental health problems and both antenatal and postnatal depression (although postnatal is the more publicised) and the risk of mental wellness relapse in pregnancy is substantial. For that reason I do not agree with Roger Goss of Patient Concern that GPs need to “mind their very own business”. Their company is our overall health.

Dr. Shoshana Bennett talks about prenatal depression

Indeed, something that helps broaden women’s understanding of the risks of pregnancy relative to their psychological wellness is optimistic. One of the initial items a psychiatrist mentioned to me when explaining my diagnosis of bipolar disorder, was that I would have to assess elements of my life style and reasonable them to best deal with the lifelong illness. He reeled off a checklist of items that would have to be looked at in order to live a steady existence: “Alcohol consumption, caffeine consumption, the selection of whether or not to have young children or not …”.

“What do you suggest about the alcohol intake?” I asked, wide-eyed and panicked, having to pay no consideration to the bit about children. “I can nonetheless drink, appropriate?” (Reader, I was 20). The truth is, residing with depression, bipolar disorder or any other psychological health condition is hard. And pregnancy is the most significant change a woman’s physique will undergo. The probability of the two collectively is not anything to be ignored, and it would be remiss of psychological overall health specialists and care suppliers to not raise this.

Suicide is a foremost lead to of death to ladies close to childbirth in the Uk, India and China, and most other developed nations. In the 2008 BBC documentary The Secret Daily life of the Manic Depressive, the late Gaynor Thomas, a bipolar and puerperal psychosis campaigner, was filmed in conversation with professional Dr Ian Jones, who explained the serious risks of relapse during pregnancy. Gaynor was proven choosing against having a 2nd youngster.

Gaynor Thomas, puerperal psychosis campaigner, talks to Dr Ian Jones (excerpt from the documentary Stephen Fry – The Secret daily life of the Manic Depressive).

There is also the issue of specific medicines affecting pregnancy and fertility. Females in their 20s are not suggested to take the anticonvulsant mood stabiliser sodium valproate, for instance, as it is acknowledged to reduce fertility (I was not prescribed it for this purpose). Antidepressants are usually not advised in the course of pregnancy, due to backlinks with miscarriage and foetal heart circumstances, particularly with older tricyclic medication which preceded SSRIs. There is evidence which suggests a mother’s depression although pregnant may possibly impact the brain framework of her youngster, in certain development of the amygdala, accountable for emotional control. And as we know, mental well being problems have traceable genetic causation (in distinct bipolar disorder and depression).

These guidelines are not about warning girls off having youngsters, or about getting nosey, patronising or scaremongering. They are about “spotting what is not normal for each and every person female and making certain she receives the treatment that is proper for her”, as Prof Mark Baker, director of the Centre for Clinical Practice, put it.

Ought to I ever want to start off a family members, I know that there would be a good deal of things I would have to take into account. Coming off my medicine would be a large deal for me relapse would be a grave concern. I would also fear about passing on the situation. I would come to feel guilty: who wants to hand down hell? I would also be anxious about not currently being able to search after my kid in times of my personal sick-health. These are all factors that girls with mental overall health troubles should be encouraged to go over, in order to make an informed determination. I for one feel it is wonderful that Great are carrying out just that. More than great, in truth. It will save lives.

Advising females with depression about possessing children isn"t babying them | Hannah Jane Parkinson

Advising girls with depression about having kids isn"t babying them | Hannah Jane Parkinson

If there is one thing that men and women with knowledge of depression worry most in existence, it’s depression coming back. The imagined of becoming dragged again into a moribund swamp of emptiness, ennui and self-hatred is terrifying. Depression frequently returns, so it’s handy to learn how to fend off the black puppy ahead of you find by yourself staring at the back of its open throat and becoming knocked to the ground. It can get a hell of a lengthy time to get up.

To this finish, the Nationwide Institute of Clinical Excellence (Nice) has issued new recommendations to GPs treating women with depression. It suggests medical doctors inquire female sufferers whether or not or not they want youngsters as a prelude to discussing the complications which can come up when women with depression – or history of it – turn out to be pregnant.

The tips, even so, have been deemed a violation of privacy an NSA-design eavesdropping-via-the-bellybutton on likely daily life. A single in 3 ladies are affected by mental health difficulties, according to the Planet Wellness Organisation (WHO). We know that a powerful hyperlink exists amongst ladies with prior mental well being problems and both antenatal and postnatal depression (even though postnatal is the much more publicised) and the risk of psychological well being relapse in pregnancy is substantial. Consequently I do not agree with Roger Goss of Patient Concern that GPs should “thoughts their personal organization”. Their organization is our wellness.

Dr. Shoshana Bennett talks about prenatal depression

Indeed, anything that helps broaden women’s understanding of the dangers of pregnancy relative to their mental well being is constructive. One of the 1st things a psychiatrist mentioned to me when explaining my diagnosis of bipolar disorder, was that I would have to assess aspects of my way of life and moderate them to best deal with the lifelong illness. He reeled off a listing of things that would have to be looked at in order to live a steady daily life: “Alcohol consumption, caffeine consumption, the selection of regardless of whether to have youngsters or not …”.

“What do you indicate about the alcohol intake?” I asked, broad-eyed and panicked, having to pay no focus to the bit about little ones. “I can even now drink, right?” (Reader, I was 20). The truth is, living with depression, bipolar disorder or any other psychological overall health condition is tough. And pregnancy is the most significant modify a woman’s entire body will undergo. The chance of the two collectively is not one thing to be ignored, and it would be remiss of psychological well being pros and care providers to not increase this.

Suicide is a top result in of death to ladies all around childbirth in the United kingdom, India and China, and most other created countries. In the 2008 BBC documentary The Secret Life of the Manic Depressive, the late Gaynor Thomas, a bipolar and puerperal psychosis campaigner, was filmed in conversation with expert Dr Ian Jones, who explained the serious hazards of relapse for the duration of pregnancy. Gaynor was shown deciding towards obtaining a 2nd youngster.

Gaynor Thomas, puerperal psychosis campaigner, talks to Dr Ian Jones (excerpt from the documentary Stephen Fry – The Secret daily life of the Manic Depressive).

There is also the problem of specific medications affecting pregnancy and fertility. Women in their 20s are not recommended to take the anticonvulsant mood stabiliser sodium valproate, for instance, as it is known to reduce fertility (I was not prescribed it for this explanation). Antidepressants are generally not recommended in the course of pregnancy, due to hyperlinks with miscarriage and foetal heart situations, specifically with older tricyclic medicines which preceded SSRIs. There is evidence which suggests a mother’s depression whilst pregnant may well influence the brain structure of her youngster, in distinct advancement of the amygdala, responsible for emotional management. And as we know, mental overall health conditions have traceable genetic causation (in distinct bipolar disorder and depression).

These tips aren’t about warning girls off possessing children, or about currently being nosey, patronising or scaremongering. They are about “spotting what is not standard for each individual girl and guaranteeing she receives the therapy that is appropriate for her”, as Prof Mark Baker, director of the Centre for Clinical Practice, put it.

Ought to I ever want to start a household, I know that there would be a whole lot of factors I would have to think about. Coming off my medicine would be a large deal for me relapse would be a grave concern. I would also worry about passing on the situation. I would come to feel guilty: who needs to hand down hell? I would also be anxious about not currently being capable to look following my little one in instances of my very own ill-health. These are all things that women with mental wellness issues ought to be encouraged to go over, in purchase to make an informed decision. I for one consider it is good that Good are undertaking just that. Far more than great, in reality. It will conserve lives.

Advising girls with depression about having kids isn"t babying them | Hannah Jane Parkinson

Advising girls with depression about getting young children isn"t babying them | Hannah Jane Parkinson

If there’s a single factor that individuals with encounter of depression worry most in lifestyle, it’s depression coming back. The believed of currently being dragged once again into a moribund swamp of emptiness, ennui and self-hatred is terrifying. Depression typically returns, so it’s useful to learn how to fend off the black puppy prior to you find your self staring at the back of its open throat and becoming knocked to the ground. It can consider a hell of a prolonged time to get up.

To this end, the National Institute of Clinical Excellence (Good) has issued new suggestions to GPs treating ladies with depression. It suggests medical doctors ask female sufferers regardless of whether or not they want youngsters as a prelude to discussing the issues which can arise when girls with depression – or history of it – become pregnant.

The recommendations, even so, have been deemed a violation of privacy an NSA-style eavesdropping-via-the-bellybutton on potential daily life. One in three girls are impacted by psychological well being problems, in accordance to the World Well being Organisation (WHO). We know that a powerful link exists among women with prior psychological well being circumstances and the two antenatal and postnatal depression (although postnatal is the more publicised) and the threat of mental wellness relapse in pregnancy is substantial. Therefore I will not agree with Roger Goss of Patient Concern that GPs need to “thoughts their personal company”. Their business is our well being.

Dr. Shoshana Bennett talks about prenatal depression

Indeed, anything at all that aids broaden women’s comprehending of the hazards of pregnancy relative to their psychological overall health is good. One particular of the first items a psychiatrist mentioned to me when explaining my diagnosis of bipolar disorder, was that I would have to assess facets of my life style and reasonable them to ideal deal with the lifelong sickness. He reeled off a listing of things that would have to be looked at in purchase to dwell a secure daily life: “Alcohol intake, caffeine consumption, the decision of whether to have children or not …”.

“What do you suggest about the alcohol consumption?” I asked, wide-eyed and panicked, paying no attention to the bit about youngsters. “I can nonetheless drink, appropriate?” (Reader, I was 20). The truth is, residing with depression, bipolar disorder or any other mental health condition is tough. And pregnancy is the largest change a woman’s body will undergo. The possibility of the two collectively is not one thing to be ignored, and it would be remiss of psychological well being professionals and care companies to not increase this.

Suicide is a leading cause of death to women around childbirth in the United kingdom, India and China, and most other developed nations. In the 2008 BBC documentary The Secret Life of the Manic Depressive, the late Gaynor Thomas, a bipolar and puerperal psychosis campaigner, was filmed in conversation with professional Dr Ian Jones, who explained the serious risks of relapse throughout pregnancy. Gaynor was shown deciding towards possessing a 2nd youngster.

Gaynor Thomas, puerperal psychosis campaigner, talks to Dr Ian Jones (excerpt from the documentary Stephen Fry – The Secret life of the Manic Depressive).

There is also the concern of particular drugs affecting pregnancy and fertility. Ladies in their 20s are not advised to get the anticonvulsant mood stabiliser sodium valproate, for instance, as it is known to decrease fertility (I was not prescribed it for this reason). Antidepressants are typically not suggested for the duration of pregnancy, due to backlinks with miscarriage and foetal heart circumstances, particularly with older tricyclic drugs which preceded SSRIs. There is evidence which suggests a mother’s depression whilst pregnant may influence the brain construction of her child, in particular advancement of the amygdala, responsible for emotional management. And as we know, mental health circumstances have traceable genetic causation (in specific bipolar disorder and depression).

These suggestions aren’t about warning ladies off getting kids, or about becoming nosey, patronising or scaremongering. They are about “spotting what is not normal for each individual woman and ensuring she receives the treatment method that is proper for her”, as Prof Mark Baker, director of the Centre for Clinical Practice, place it.

Ought to I ever want to start off a family, I know that there would be a good deal of issues I would have to take into account. Coming off my medication would be a enormous deal for me relapse would be a grave concern. I would also worry about passing on the issue. I would feel guilty: who would like to hand down hell? I would also be anxious about not getting in a position to search right after my kid in instances of my very own ill-well being. These are all factors that ladies with mental wellness problems ought to be encouraged to talk about, in buy to make an informed decision. I for 1 consider it’s great that Nice are carrying out just that. Far more than nice, in truth. It will conserve lives.

Advising girls with depression about getting young children isn"t babying them | Hannah Jane Parkinson

The Fault In Our Stars: "Jane Eyre does not usually go swimmingly"

Theirs is a textbook teen romance, only here the verbal interplay is cancer slang – his pet name for her is “Nosetube Girl” and losing their virginity is less a case of bra-strap fumbling than getting tangled up in oxygen tubes.

The Fault In Our Stars may be good, but it’s far from being an easy read. So bleak and unflinching is the subject matter that it has even been criticised for augmenting a new genre of “sick lit.”

“It’s hard to take that personally when some of the things that have been said about the book didn’t even line up with the plot line,” shrugs Indianapolis-born Green, who points out that, in any case, adults make up a huge percentage of its readership. “I don’t buy the idea that things are made worse by reading about illness or violence. As long as those subjects are treated honestly and authentically, I don’t see that we have to protect teenagers from the reality of them. They are living in the same world as us, after all, and while I understand that urge to maintain their innocence, I don’t think that there is any way to do that.”

Today’s young adult readers certainly don’t seem inclined to be spared the harrowing details of real-life tragedy. Jenny Downham’s 2007 novel Before I Die, which tells the story of a 16-year-old British girl dying of cancer, sold 70,000 copies in its first four months and has been made into a film, Now is Good, starring Dakota Fanning. Never Eighteen by Megan Bostic, published last year, features a leukemia-stricken hero in a race against time to tell his best friend he loves her. And Jay Asher’s Thirteen Reasons Why – about a teenage girl who leaves 13 recordings explaining why she killed herself – was also a bestseller.

“I haven’t read Thirteen Reasons,” says Green, when I ask whether such subject matter is irresponsible, “so I can’t speak to it directly. I do think that romanticising illness is dangerous and that novels about illness can be exploitative, but I tried very hard not to do that.

“Plus,” he adds sardonically, “I don’t think these books are among our larger social problems. I’m encouraged by teenagers reading for pleasure: I don’t think that books are going to make their lives worse. And isn’t it a bit odd to talk about contemporary literature that way when these kids are in school reading Dickens and Austen and Charlotte Brontë? I mean Jane Eyre doesn’t go so swimmingly all the time.”

With teenage fiction sales up almost 150 per cent in the past six years, Green feels that any kind of censorship wouldn’t just be unnecessary but harmful. “I feel it has been pretty destructive for films, actually – and counter-productive. Because instead of getting the most honest, interesting movies, we get movies where they’re very careful to use the word f-word only once, where they’re allowed to use lots of violence but no breasts. I’m very troubled by that. And I’m far more worried about what kids are seeing on the internet than by what they’re reading. The internet is a tool – I don’t think it’s good or evil in itself – but if you feel what’s being sold in a bookstore is the most problematic thing around, then you should think again.”

An ability to tap into the emotional intensity and curiosity of teenagers is just one of the qualities behind the praise ladled on Green for The Fault In Our Stars. Far from being a “kidult”, however, this father of two describes himself as “living a very able, slightly pear-shaped middle-aged life in Indianapolis – the 137th nicest city in America.”

He does, however, “remember being a teenager very well”, first in Orlando, Florida, and then Birmingham, Alabama, where he asked his parents – Green’s father was the director of a nature conservatory and his mother worked with underprivileged children – to send him to boarding school. Like the protagonists of his earlier books, An Abundance of Katherines, and Paper Towns – as well as Hazel and Gus in The Fault In Our Stars – Green was “a misfit”.

“I was a bad student and a miserable presence in the classroom and at home,” he says. He began to suffer from depression as a child and lives with it to this day. “Back then, I was never diagnosed. Now, although I would never say that I am in remission, I am able to manage it.”

The idea for The Fault In Our Stars sprang from Green’s work as a chaplain in a children’s hospice when he was 21, having studied religion at Chicago’s Divinity School. “I suppose I felt useful,” he muses, “but to be fair I have great admiration for people who do that and don’t, like me, leave after six months.”

It was, he explains, “unbearable, being confronted by kids dying from illness and serious accidents. It’s a very difficult thing to be a witness to every day and not take home with you. I would get home and just stare at the ceiling.” Green had been thinking of getting ordained, but the experience made that impossible. “All the pseudo fancy ideas that I carried with me into that hospice were completely irrelevant in the face of actual children actually needlessly suffering and then dying. I emerged from it very angry and very annihilistic.”

It wasn’t until years later when he became a father that the author was able to draw on the experience in The Fault In Our Stars. “From the moment my son Henry was born, I understood that as long as either of us were alive – and beyond – I was going to be his father and he was going to be my son. And in that way love really is stronger than death. I found a lot of comfort and hope in that. And it seemed like the kind of hope that wasn’t cheap.”

The scores of letters from terminally ill children that Green has received since the book was first published in 2012 would imply that the chord he has struck rings true. “As a result of the book, I’ve become friends with young people who are sick or dying. On a few occasions, people have made it their ‘wish’ to meet me and I will always accommodate that.

“But I also get letters and emails almost every day from kids who say, ‘I’m just like Hazel but without the cancer’ – which is a strange thing to say because cancer defines her life. But by the end of the book, although cancer is part of her, it’s not all of her.”

He may be living every writer’s dream, but as the countdown to the film’s release begins and Green-mania is at its peak, the author isn’t so much in a permanent state of jubilation as extreme caution. With depression, he says soberly: “All change is bad. The brain isn’t very good at differentiating between good and bad stress. And, of course, it is hard to write in the shadow of something like The Fault In Our Stars…” Which is perhaps why Green remains vague on the subject of his next book. “Hopefully there will be something in 2015…” he says. “And no, it won’t be a prequel. I want to try not to claim ownership over Fault. I think it should live with its readers now.”

‘The Fault In Our Stars’ by John Green (Puffin, RRP £7.99) is available from Telegraph Books at £7.99 + £1.10 p&p. Call 0844 871 1514 or visit books.telegraph.co.uk

The Fault In Our Stars: "Jane Eyre does not usually go swimmingly"

Why we need to know that bad people are more probably to be bitten by dogs | Jane Dudman

You are 3 times a lot more probably to be bitten by a canine if you reside in the most deprived locations of England. Photograph: Xavi Gomez/Getty

Canine bites man has by no means been a headline, but the reality that 3 times as several folks residing in the most deprived regions of England are bitten by canines as in the least deprived regions is an eye-catching statistic.

That fact, from the Overall health and Social Care Data Centre, is one particular of the pieces in an more and more complicated, but potentially hugely strong mosaic of information about our well being and wellbeing. Public managers and government bodies, as well as academics, are commencing to realise the value of placing together various bits of the jigsaw to attain far more joined-up pondering about public wellness policies in neighborhood areas.

A single conclusion that is already inescapable is the part of alcohol in endangering public well being. Even though the leads to of the big fall in crime in England and Wales, reported last week, are complicated, researchers at Cardiff University highlighted the decline in binge drinking and growing alcohol charges as a single element: proba tion solutions were urged to pay out far more focus to alcohol misuse to aid lessen reoffending. Paul McDowell, chief probation inspector, stated progress on cutting down offending had been “let down” by lack of focus to tackling alcohol misuse.

Men and women living in poorer neighbourhoods are still considerably a lot more very likely to suffer an assault – by puppy or human – than these who dwell in more affluent regions, but Manchester University academic Ian Warren, has discovered that living in an ethnically diverse location lowers the affect of poverty on levels of violence. This suggests that there is far more violence in bad white neighbourhoods.

Warren unearthed this obtaining by pulling with each other statistics from the North West Ambulance Support and from hospital admissions information in Better Manchester. His analysis also reveals that residents in quick-changing neighbourhoods are more most likely to be assulted, specifically in areas with huge numbers of college students.

Details like these are gold nuggets of data for councils and public managers trying to assistance healthier and safer communities. They supply a worthwhile counterbalance to distrust of some official figures, most notably crime data.

Creating for the Whitehall Watch website, Warren says public overall health information offers a far more extensive and reliable image of the impact of violence on local communities than official crime statistics.

“These of us who research interpersonal violence have recognized for numerous many years that police-recorded crime statistics are a poor signifies to measure the scale of violence,” says Warren. Rather, researchers, which includes the violence and society research group at Cardiff and the trauma and damage intelligence group at John Moores University, in Liverpoool, are making use of public well being data to provide new and dependable details.

A violent incident, for instance, could result in a single man or woman becoming charged with a crime and yet another person going to hospital. There’s no way, at the minute, to website link individuals two pieces of information. Warren and other researchers want that to modify. By linking public health data with police information, there could be a richer comprehending for policy managers about what is really going on – and the complex connection amongst crime and overall health.

But whose task is it to delve into and place collectively these types of statistics? A survey by Colin Talbot, professor of government at Manchester University, about how senior civil servants are making use of academic analysis highlights the reality that extremely small is recognized about just how academics and policymakers interact. Time to place that right.

Why we need to know that bad people are more probably to be bitten by dogs | Jane Dudman