Author Joanna Cannon: why I’m going back to the psychiatric wards

Joanna Cannon’s to-do list for next month includes attending the British Book Industry Awards in which her bestselling debut novel has been shortlisted, and pouring tea for people with dementia and their carers in a village hall.

Cannon, author of The Trouble with Goats and Sheep, who quit psychiatry more than two years ago to concentrate on writing, is returning to the NHS as a volunteer with Arts for Health. Its programme, run by South Staffordshire and Shropshire Healthcare NHS foundation trust, brings creative arts to patients. Tea-making aside, she is keen to help patients understand their own life story through “reading for wellbeing” groups and creative writing.

Cannon once retreated to read for two weeks solid after her mental health deteriorated while working as a junior doctor, and she started writing “for therapy” on a blog. “I wrote that blog to understand myself more,” she explains. “If you read some of the early entries they’re all full of doom and gloom because I was trying to process the things I was seeing as a junior doctor. Not by talking directly about them, obviously, because that would be unethical, but by talking about my reaction to things. I think reading and writing is the best way of understanding your narrative from a safe position… reading is also an escape more than anything else. When I had that two weeks off and read books I felt as though I’d left my own life for a bit and just enjoyed being somewhere else, and I think that’s important for patients. Also creative writing will give them an outlet to talk about how they feel without actually having to talk about how they feel.”

The only child of a plumber and a giftshop owner, Cannon grew up in Derbyshire and left school at 15 with one O-level. It wasn’t until her 30s that she took her A-levels, spurred by her resolve to become a doctor. She qualified in her early 40s but became very stressed during her first stint as a junior doctor in general medicine.

“I thought, ‘yes, I can do this, it’s fine, I know what to do,’” she recalls of her first job – to certify a death certificate. “But when I got there it really impacted on me being in the room with relatives and talking to them, so I just went to the loo and cried. And I thought, ‘that’s fine, this is my first time and it will get easier’. But it didn’t, it got worse. I spent my whole weekends going over and over everything that happened.”

At the time, she told no one how mentally unwell she felt. “It’s very difficult to talk to a consultant you don’t really know that well and admit that you’re struggling, because everyone else appears to be coping … and the consultants clearly cope … so to hold your hand up and say ‘actually, I can’t deal with this’ – you feel weak and stupid and a failure that all this money has been poured into your education to get you to this point and you’ve squandered it by not coping.”

She lauds Prince William and Prince Harry for talking about mental health as part of the Heads Together campaign. “People say the stigma is lifting, but I don’t think it is. You talk to somebody with schizophrenia or bipolar or depression or anxiety and I don’t think they would think it was lifting. The NHS does try and encourage people to talk more, but you are only reflecting the general attitude that it’s just too difficult to admit to it sometimes. I’ve so much admiration for Prince Harry. It’s amazing to have such a massive public platform and get on that platform and speak about something like that.”

Cannon is all too aware that encouraging people to speak up needs to be matched by services to meet need. As the general election looms, this former NHS worker echoes the call for more funding so that mental health services don’t “bend and break”.

“The lack of funding is unbelievable. You will get people admitted as an emergency and the only bed available for them is 200 miles away. And these people are perhaps psychotic, so being taken to somewhere they don’t know, and looked after by people they don’t know, is not going to be very helpful to their recovery. In community mental health, you get community psychiatric nurses who have got hundreds of patients on their caseload; how are they supposed to spend quality time with all of them? They can’t possibly do it. And they burn themselves out and they leave. It’s tragic, really.”

Improved investment in the wider social fabric is also needed to promote good mental health, she argues. “One of the biggest risk factors for mental health is social isolation, so now where do people go for that community? Where do they go to socialise when you are cutting all these services in the community?”

For Cannon, the stress she experienced in general medicine evaporated when she joined a psychiatric team. It felt like “coming home”, she says. “I felt truly useful for the first time in my life.”

Working with mental health patients was also the inspiration for her novel, which is about prejudice towards people who are a little bit different. It took just nine months to complete – a feat accomplished by writing at 4am before her shifts began and in NHS car parks during lunch breaks – and has sold more than 100,000 paperback copies in the UK.

She secured a six-figure deal for her second novel, due out next January, and will be working on her third when not volunteering in her old professional stomping ground. “Every day in psychiatry I felt as though I’d made a difference to somebody, I’d made them feel a little bit better about life – and I miss that feeling,” she says of her decision to return to the NHS. “It’s not at all altruistic me going back on to the wards because I get as much benefit out of it as they hopefully will get out of me. I love the people, I love hearing the stories, I love the teamwork. Writing is very isolating sometimes. I miss the camaraderie of being on the wards and of being with a team.”

Has she kept the door open to being a doctor again? “I would never say never, but if I could do this,volunteer and do my writing, that would be perfect – the best of both worlds.”

Curriculum Vitae

Age: 40s.

Lives: Ashbourne, Derbyshire.

Education: Denstone College, Uttoxeter; University of Leicester Medical School (graduated 2010 with a degree in medicine).

Career: 2014-present: author, 2010-2014: NHS doctor specialising in psychiatry, South Staffordshire & Shropshire Healthcare NHS foundation trust; bar maid, kennel maid, pizza delivery expert.

Public life: Volunteer, Arts for Health (South Staffordshire & Shropshire Healthcare NHS foundation trust)

Interests: Reading, walking my dog through the fields, medical humanities, the bridge between art and science.

The Trouble with Goats and Sheep is published by Harper Collins (£7.99). To order a copy for £6.15, go to bookshop.theguardian.com or call 0330 333 6846

Author Joanna Cannon: why I’m going back to the psychiatric wards

Prince Harry shows how NHS psychiatric services could move on | Letters

While experts are right to congratulate Prince Harry (Harry praised for telling of ‘chaos’ over Diana’s death, 18 April), and call for more spending on mental health, there is an elephant in the room. Mental health services are dominated by an outdated, simplistic medical model of distress that is rather at odds with the prince’s views. While he makes the obvious link between painful life events and mental health difficulties, our services are still telling distressed people that they have illnesses, like major depressive disorder, caused by chemical imbalances – an unsubstantiated drug company creation – and by inferior genes that make them more vulnerable than others to depression, anxiety, psychosis etc.

Unlike Harry’s psychosocial approach, this socially blind bio-genetic model actually increases prejudice, by using stigmatising labels and exaggerating differences. It has also led to over 62m prescriptions of antidepressants annually in England, at a cost of about £800m a day to the NHS. Our children too are being labelled and drugged at an equally alarming rate. Time for psychiatric services to move on from the failed diagnose-and-medicate approach and start asking us what happened to us, and what we actually need.
Professor John Read
University of East London

• Is bereavement a mental illness? Does grief require medical treatment? It is a profound mistake to treat such essential aspects of the human condition, and our responses to them, as purely personal “in-the-mind” medical crises, evidence of “ill-health”.

It is the overwhelming assault of our culture on our sense of personal space, time to be, not just to do; that generates much of the distress. The shame and stigma won’t be removed from this distress until we realise that it is not simply an individual, personal illness – though sometimes it becomes that – but a social, cultural malaise that will be deepened, not alleviated, by pills or sometimes misdirected talk therapies.
Keith Farman
St Albans, Hertfordshire

• Although Prince Harry’s revelations have rightly been praised by mental health experts, it would be helpful to focus on the particular issues surrounding those of us who have been bereaved in childhood.

First, the adults around us do not know how to approach us; second, we are commonly isolated in terms of the experience within our peer group; third, we have not yet developed the means to express our feelings effectively to the adult world around us. Add to that the “scorched earth of English repression”, as Richard Beard so brilliantly described it (Family, 8 April), and the fact that you miss out on natural processes in relationships that are part of growing into adulthood, and you may well finish up with a toxic foundation of anger within you.

Those bereaved in childhood have been widely misunderstood and ignored; the prince’s remarks allow us at least to start a debate as to how we should treat this most vulnerable group.
Alison Sesi
Billericay, Essex

• Suzanne Moore writes (Harry got help. Many others deserve it too, 18 April) that no one touched the two young princes during their mother’s funeral service. But why would anyone want to display public emotion, knowing that columnists were looking down on them? The family she saw that day was no different to other families who do not show their emotions at a funeral. Many people, frozen in grief, cognitive processing and exhaustion, are paralysed when it comes to being on display while they deconstruct and reconstruct what is in the coffin in front of them.

One message of the royals’ Heads Together campaign is not to judge other people, because you don’t know their circumstances.
Miriam Fitzpatrick
Dublin, Ireland

• Prince Harry is fortunate to have had what is increasingly being called “real therapy”, meaning in-depth and enjoying a trusted relationship with the “shrink” (to use his word). This kind of private practice therapy has almost completely vanished from the NHS and the public sector because all funding is being sucked up by the Improving Access to Psychological Therapies scheme. In this manualised and medicalised state therapy system, with economic rather than psychological goals, it takes a long time and much judgmental evaluation before a few get even cognitive behavioural therapy. We can be pretty sure that CBT is not what was offered to the prince.

It is time for the Department of Health to acknowledge that the old-style psychotherapy and counselling did a lot of good, and that it is still possible to restore it.
Professor Andrew Samuels
Centre for Psychoanalytic Studies, University of Essex

Non-contact boxing can help people with mental health issues, says Martin Bisp. Photograph: VisitBritain/Getty Images

• I read, with interest and admiration, Prince Harry’s comments regarding how boxing helped him (Report, 18 April). This is something we, at Empire Fighting Chance, already know. We have had massive success with our own non-contact boxing programme for people with mental health issues, often engaging those that traditional services fail.

My co-founder and I have spoken at numerous all-party parliamentary groups about how it is possible to help those most in need by offering something different. However, there seems a real reluctance to invest in and integrate credible, community-based programmes.

Yet everyone can benefit from a community intervention: treatments are not class, race or postcode dependent. Deprivation is a huge factor for poor mental health and the poorer you are the less likely you are to know about or access services. Having something based in your community, provided by a name you know and trust, works. People are not embarrassed to attend – in our case they are proud to say they are going to the boxing gym. Once in it, they train like everyone else, they are not “on display” in some sterile leisure centre, so we get better results.

Finally in a time where funding is hard to come by, budgets are stretched and the health service is under tremendous pressure, we must recognise the role within that sports-led community projects can offer and look to innovate delivery. Resourcing them adequately appears to make sense from a business and, much more importantly, human angle.
Martin Bisp
Chief executive officer, Empire Fighting Chance

• Today’s underfunded NHS is unlikely to increase access to the support needed by those processing emotional trauma. I and many others, in UK and internationally, have found help from co-counselling, a peer-support system that, after a 40-hour training course, gives access to lifelong listening support that is comfortable with emotions. Pills and professionals have their place, but, as Harry said, listening is more helpful than advice for working through emotional issues that are an inherent part of being human.
Jean Brant
Birmingham

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Prince Harry shows how NHS psychiatric services could move on | Letters

Revealed: dozens of children still treated on adult psychiatric wards

Dozens of children and young people with mental health problems are still being treated on wards containing adults with sometimes severe psychiatric problems despite ministers having supposedly outlawed the practice in 2010, the Guardian can reveal.

Mental health campaigners condemned the persistence of the problem and said it was “completely unacceptable” for vulnerable minors to be subjected to what many find a “terrifying” experience. The Liberal Democrat health spokesman Norman Lamb, who was the minister for care, including mental health care, in the coalition government, said putting children on adult wards was “scandalous” and must be ended at once.

Official figures from mental health hospitals collated by NHS Digital, the health service’s statistical arm, show that in July 47 children and young people aged 17 or under were treated on adult psychiatric wards. Of those 21 were aged 17, another 18 were 16-year-olds and the other eight were aged 15 or under. There is particular anxiety that under-16s are still receiving treatment in adult settings as the government made clear six years ago that this should never happen.

Gordon Brown’s Labour administration placed the “age-appropriate environment duty” on NHS mental heath trusts in April 2010 in a bid to end a practice that parents, charities, MPs and the children’s commissioner for England had criticised as unpleasant and traumatising for children.

“The simple truth is that this has to end completely. It’s scandalous that the practice continues. It is unsafe and wrong. There must be a clear and unequivocal commitment from this government to eradicate the practice completely without delay”, said Lamb.

The duty legally obliges managers of mental health units, under section 131A of the Mental Health Act 1983, to ensure that “the patient’s environment in the hospital is suitable having regard to his age (subject to his needs)”. While it allows 16- and 17-year-olds to still be looked after on adult wards occasionally in “exceptional circumstances”, such as if they need to be admitted as an emergency, it forbids totally under-16s ever being treated there.

The figures, which the Guardian requested from NHS Digital, cover January to July this year. A total of 39 under-18s were treated on adult wards in that time, though some may have shown up in the figure for more than one month, NHS Digital said. One hundred and thirty 17-year-olds and 90 children aged 16 were also treated during that time. If the same trend is maintained in the rest of the year that would result in a total of 446 under-18s being treated there, which would the highest for many years. A total of 391 children were treated in such wards in 2014-15.

Under-18s spent 1,938 days on adult mental health wards between them during April and June, almost double the 1,102 days they spent there from January to March. Most of those occurred in the north of England, which saw such bed days soar from 35 in the first three months of the year to a massive 1,405 in the second quarter. In that same period there were 225 such bed days in the Midlands and East of England (down 650 the previous quarter), 185 in London (down from 220) and 125 in the south of England (down from 195), NHS Digital’s data show.

Responding to the figures, the health secretary, Jeremy Hunt, said the number of children in psychiatric wards had fallen by 60% since 2010 and such places should be used rarely. He is set to make a major speech on children’s mental health care on Tuesday, weeks after condemning adolescent and child mental health services as the NHS’s most glaring area of failure to meet need.

“However, this type of care should be an absolute last resort, once all other avenues have been exhausted,” Hunt said. “But to help ease demand, we recently opened 50 new beds, increasing the total number to the highest there has ever been.” Those 50 took the NHS’s supply of beds in children and young people’s mental health services up to 1,442, though the continued use of adult wards suggests that is not enough.

Sarah Brennan, the chief executive of the charity Young Minds, said: “It’s completely unacceptable that vulnerable children are still being treated on adult mental health wards, six years after the government changed the law to stop this from happening. Young people often find it terrifying to be placed alongside much older patients, and say that it adds to their distress rather than helping them.”

Meanwhile, new research to be released on Monday reveals huge frustration among parents of children and young people with mental health conditions at the difficulty of obtaining help for them.

Two-thirds (66%) of such parents surveyed by Young Minds complained that their child had to wait a long time to get treatment, and almost half (49%) said no one believed them when they first raised concerns about their offspring’s mental welfare.

Two in five (41%) of the 316 parents said thresholds for accessing treatment were too high, which meant their child was deemed not ill enough to warrant NHS care, while 36% had paid a private counsellor, psychologist or other therapist to help their child because NHS care was unavailable.

“Not only are many thousands of young people suffering with mental health problems but their parents are suffering too. They feel helpless, unheard and are desperate to help their young people but don’t have the knowledge or tools”, said Emma Rigby, chief executive of the Association for Young People’s Health.

Revealed: dozens of children still treated on adult psychiatric wards

Neglect contributed to teenager"s death in psychiatric hospital, coroner rules

The lack of resources for children’s mental health services in the UK has been described as a “national scandal” after a coroner ruled that neglect and “continuing failures” at one of the largest mental health trusts in England contributed to the death of a teenage boy.

Christopher Brennan, 15, died after being found unconscious at Bethlem Royal hospital in south London in August 2014. He had been admitted to the psychiatric hospital’s adolescent unit six weeks earlier as his family and local mental health services felt unable to keep him safe at home.

Christopher had a history of harming himself, and a deterioration in his mental health over the two years before his death led to repeated hospital admissions.

The coroner found that no formal risk assessment was carried out during his stay at Bethlem hospital, which is run by South London and Maudsley NHS foundation trust, and there was no care plan in place, according to the charity Inquest, which is supporting his family.

South London coroner’s court heard he was also allowed access to a number of items in hospital which he used to self-harm.

On 31 August 2014 Christopher was found unconscious in a communal toilet and later died after suffering a cardiac arrest.

Handing down her ruling on Wednesday, the coroner, Selena Lynch, said: “Christopher’s actions were in part because of cumulative and continuing failures in risk assessment and management. His death was contributed to by neglect.”

The hospital trust offered its “sincere apologies” to his family and said it had reviewed its practices. A spokesman said: “Areas of learning for the trust were identified through a serious incident investigation and we have carefully reviewed our procedures accordingly.

“More recently, the service has been inspected by the Care Quality Commission and care was found to be of a ‘good’ standard. We hope this offers some reassurance to the family that lessons have been learnt from this very tragic event.”

Following the inquest Christopher’s family said: “Losing our beloved son and brother when he was just 15 years old was so painful. Losing him as a result of the hospital’s failure to protect his life is unbearable.

“Chris will never be forgotten and no other child should be allowed to die in this way.”

Christopher was one of at least 11 young people to die in psychiatric units in England between 2010 and 2014, according to Inquest.

Deborah Coles, the charity’s director, said: “Sadly, Chris’s death is not an isolated one. Incredibly, we find that no single body is responsible for collating, analysing or publicising these deaths and that these deaths are not being independently investigated.

“The lack of resourcing of child and adolescent mental health services across the country is a national scandal. The only possible response to this case and the growing public outcry and disquiet around mental health services for children and young people is for an urgent independent review. We call upon the government to now take this necessary step.”

Neglect contributed to teenager"s death in psychiatric hospital, coroner rules

I fail patients in my job as a psychiatric nurse and leave them feeling worse

It’s 5am. An hour ago the bed manager called me and asked me to ask a suicidal woman, who had already been in a busy London A&E department for 11 hours, if she would agree to being admitted to a hospital in Manchester.

I didn’t think it appropriate to wake someone at such a time in the morning but allowing her to sleep was not an option because we need the bed space. I approach the patient; she’s already awake. “I haven’t slept all night, it’s so noisy here” she tells me. “I feel awful; can’t I just go home?” I apologise and explain that the only available psychiatric bed is in Manchester. “No, it’s too far from my family”. I tell her I understand. She starts to cry; I want to cry with her. She feels depressed and worthless and I haven’t been able to help. How am I, as a psychiatric nurse, caring for her and helping lift her out of the awful dark place she finds herself in? I think about people who are in physical pain and ask myself whether we would expect them to wait without any treatment for over 11 hours.

Related: Working in mental health is not like fixing broken legs

I remember a recent patient who had been in the department over 24 hours waiting for a psychiatric bed. He was socially isolated and was hearing voices telling him to end his life. We moved him to a noisy cubicle which made the voices worse. He was in distress, I tried to reassure him. He told me: “I just want to go home, it is making me worse being here”.

I was told later that he had left the department. I frantically called him and fortunately he answered to tell me he had returned home. He said he was frightened but that it was worse in the hospital. I felt immense guilt – this isn’t why I became a nurse. What if he becomes ill again in the future? He will feel reluctant to return to A&E, the place that his community mental health team tell him to go to be safe.

A young man with autism, who has been in our mental health assessment room over 24 hours, is suffering from psychosis. The walls are bare, the air conditioning has broken, the lights, which are movement sensitive and without a switch, remain on throughout day and night making rest impossible. He is covered in sweat and he is terrified. The long wait and his surroundings make him increasingly more distressed. He is eventually sedated – not for the treatment of his condition but rather to alleviate the stress we have caused him.

I tell both him and his mother that the nearest psychiatric bed is 200 miles away. His mother starts to cry; due to the nature of his condition, he finds change very difficult.

Some of the other nurses have children and start to cry themselves. The treatment and care we offer is not of the standard we would expect for our own family and loved ones. The patient’s mother tells us she doesn’t want to leave his side. We talk to senior management, but there is nothing that can be done.

Related: Working as a mental health nurse in today’s NHS drained me of compassion

I watch as the young man is separated from his mother and forced into secure transport – a cage in the back of a vehicle, with a narrow sideways facing seat, and without adequate leg room; it’s hardly fit for a brief journey, let alone one of four hours. I feel ashamed. We have failed this young man and his family.

We take a referral for a patient who wants to end their life. My heart sinks because the bed manager has told us there are no beds. I have to look the patient and their family in the eye and apologise over and over again. I see patients who are acutely disturbed, suffering because of our inability to provide them with appropriate care. We try our best, but there are only two of us on duty – sometimes we have four people waiting for an inpatient bed and 10 patients waiting to be seen. We have to rely on security, who try but are not trained in mental healthcare and sometimes add to the patient’s distress.

I witness human suffering every day and am often amazed by patients’ own resilience in the face of such adversity. Hospital staff are their family, their voice and if we don’t raise this issue for them, it will continue because it is those who speak the loudest in the NHS that are often heard. Our patients already feel worthless and as though they are a burden; if we continue to reinforce that, rates of mental illness and suicide will continue to increase.

• In the UK, the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Hotlines in other countries can be found here.

If you would like to write a blogpost for Views from the NHS frontline, read our guidelines and get in touch by emailing sarah.johnson@theguardian.com.

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I fail patients in my job as a psychiatric nurse and leave them feeling worse

Psychiatric help teams enhance patient care and conserve hospitals hundreds of thousands | Sarah Whitehead

Vicky Mason, 69, cares for her 94-yr-outdated mom, Jane, who was diagnosed with Parkinson’s condition a decade ago. In current many years, Jane has begun to present indications of dementia and delirium. “She has been deteriorating over the previous couple of years. She nonetheless understands who we are, but her memory is fading,” says Mason.

But a project to offer specialist psychiatric assistance to dementia sufferers although they are in hospital has the two stabilised Jane’s cognitive skills and enhanced the way in which her Parkinson’s is taken care of. On noticing a adjust in behaviour, the doctors treating Mason’s mum on the Parkinson’s ward in Heartlands hospital, Birmingham, referred her to the project’s speedy evaluation interface and discharge (Raid) team based in the hospital, for fast expert psychiatric support.

“The mental health teams were capable to give medicine to quit her from hallucinating and also provide assistance to help her deal with dementia – she is now capable to hold a appropriate conversation,” says Mason. The diagnosis of significant delirium also altered the clinical therapy Jane obtained, as some of her medicine for Parkinson’s would induce nightmares.

The undertaking was very first piloted in December 2009 by Birmingham and Solihull Psychological Well being NHS Basis Believe in in Birmingham City hospital. The aim was to assess the effect of on-website psychiatric care in acute hospitals, right after analysis recommended that much more than a quarter of sufferers in common hospitals had a psychological sickness in addition to their physical sickness. Any medical professional or nurse can refer patients to the Raid staff for evaluation.The team aims to assess patients referred by A&ampE inside of 1 hour, with a 24-hour target for those already admitted to hospital wards. When a diagnosis has been produced, individuals are either transferred to the out-patient clinic in the hospital or linked to neighborhood community psychological well being services.

The project proved so productive, all five acute hospitals in Birmingham and Solihull, as well as acute hospitals in Telford and Shrewsbury also introduced a Raid services, whilst the method has been defined “ideal practice” in the Joint Commissioning Panel for Psychological Health’s 2012 advice on commissioning mental well being companies. And interest in the task is growing, following final year’s report by the Royal University of Doctors, which warned that common hospitals are on the brink of collapsing under the mental well being issues of an more and more ageing population – similar solutions are becoming designed in Manchester and Wigan.

George Tadros, a advisor psychiatrist at Heartlands, which introduced its Raid group in 2012, says the undertaking has enhanced diagnosis and pace of treatment for individuals who have mental health situations. “Most acute hospitals in Britain are not equipped to deal with the vast sum of psychological well being disorders that come by way of their doors,” he says. “Just before we introduced the Raid team in City hospital, the mental well being signs and symptoms shown by numerous sufferers had been either not identified or doctors would have to speak to the liaison psychiatry team outside the hospital and it could get days or even weeks for the patient to be witnessed and by then the issue could have acquired significantly worse.”

The Raid group has expert psychiatrists, social employees and mental wellness nurses with knowledge in previous age, doing work age and postnatal psychological health and substance misuse, and it supplies typical instruction for acute hospital staff in the diagnosis of delirium, depression and dementia.

Tadros says the venture has also had wider positive aspects for the hospital: enhanced waiting times and diminished repeat admissions. “In the past, we have seen patients who repeatedly come to A&ampE with recurring difficulties, and in a lot of cases instant psychiatric support would have prevented this. 1 typical example is individuals who come with panic attacks, which might be presented as breathing issues. When the bodily problem is handled you do an ECG and then send them away. But the cause has not been addressed and so they come back.”

Analysis by Paul Kingston, director of the Centre for Ageing Studies at the University of Chester, which assessed the effect of the pilot Raid task, supports his view. Kingston’s report, published last year, identified that Birmingham City hospital, which has 600 beds, saved 43-64 beds per day by avoiding readmissions, although a separate 2013 audit by the London School of Economics estimated that the venture saved the hospital £3.5m.

“Occasionally physical issues cause mental overall health situations and other times mental well being situations are manifest by means of bodily signs and symptoms. For this cause psychiatric support is vital in all acute hospitals,” says Kingston. “Most of the diagnostics that take spot with mental overall health do so by means of conversation. You can’t see depression in a blood test or an x-ray. A lot of of the men and women coming into acute hospitals are, for various causes, unable to communicate a psychiatric difficulty to a physician or may possibly not realise they have one particular. So unless there is expert support they usually go unnoticed.”

For Mason, the task has also improved her own situation. “My mother now receives weekly help from local local community groups while continuing her Parkinson’s remedy. She is much less distressed now she has regular support and this has taken a massive burden off me.”

Some names have been altered

Psychiatric help teams enhance patient care and conserve hospitals hundreds of thousands | Sarah Whitehead

Revolution in the head: Kitten Pyramid carry rock to the psychiatric ward

A tin of chicken soup, a Kinder egg, a bag of salt and vinegar crisps, and a sponge. These are the things I am offered, in a carrier bag, when I arrive in Shrewsbury to set off on tour with Kitten Pyramid – Britain’s most current, and probably most surreal, purveyors of prog rock. “Your welcome pack,” says bass player Mark Hamon, who has a tufty yellow beard and a tattoo of an octopus on his proper shin. “What is the sponge for?” I request. Hamon’s smile broadens. “You will locate out.”

In the globe of Kitten Pyramid, such a random assortment of objects tends to make a kind of sense. Formed in Burton upon Trent in 2010 by songwriter Scott Milligan, the band is a loose 5-piece, swelling to 14 for some gigs (when the core guitars, bass and drums are joined by trumpets and strings). Out this month, their very first album is called Uh-Oh! and is pitched someplace between Talking Heads at their most fractious and unusual, and Syd Barrett-era Pink Floyd.

Lyrically, Milligan’s songs are each hilarious and bizarre. “I want to see you naked in a caravan,” he reveals on Chester. Elsewhere, he sings the praises of “gorilla fajitas”, “ladybird jumpers”, and a “pyramid army with their bags of peshwari”. Clearly, Milligan is bored by typical pop. But significantly of Uh-Oh!’s freshness and richness springs from the fact that it truly is a concept album inspired by Milligan’s late Uncle Jarek, a Polish immigrant who had schizophrenia.

To launch it, and to draw interest to the issues all around psychological overall health, Kitten Pyramid have place together their personal idiosyncratic tour – of psychiatric hospitals, performing for sufferers and personnel, with each daytime hospital session followed by an evening gig in a pub. Their aim is to increase funds for, and awareness of, Arts for Wellness (AFH), an arm of the band’s local NHS trust, South Staffordshire and Shropshire, which organises arts events for sufferers.

All of which explains why, even now puzzled by my welcome pack, I am watching Kitten Pyramid complete in Redwoods hospital on the outskirts of Shrewsbury. The gig requires area in the vibrant, domed foyer, all around a splendid grand piano, with a string of fairylights marking out a makeshift stage. The band kick off quietly, strumming through Red Footwear, a song that traces feelings of alienation in a supermarket. “You can’t look down,” Milligan sings, “since she’ll consider you happen to be weird.” The lady sitting beside me has a complaint. “I can’t hear you!” she shouts. “Louder?” asks Milligan. “Yes!” the audience phone back as one.

John, sitting subsequent to me, tells me he lately misplaced his wife, Glenys, to early-onset Alzheimer’s. They employed to go to singing workshops run by AFH. “Even when she was hardly able to communicate,” says John, “she could even now sing total lines from her favourite songs. Music is incredibly effective for folks with dementia. It seems to stir up so many memories.”

Surely, one thing equivalent seems to be happening nowadays. As the band play Whale, a track that calls for the audience to shout the song’s title at standard intervals, even the most distracted patients look to sharpen their target. An elderly girl with a cotton cloud of white hair taps out a regular rhythm on the footrest of her wheelchair. “It was wonderful,” she tells me afterwards. “I used to be a ballet dancer. Listening to the music brought it all back.”

Jessica Kent, the AFH manager behind the concert, thinks the band went down properly. “Kitten Pyramid have a exclusive sound,” she says. “It really is like a musical patchwork, with some thing all ages seem capable to relate to. It’s so crucial to have occasions like this in psychiatric hospitals. The age of the asylum is in excess of. New psychiatric hospitals are really different areas.”

As we all sit down to post-gig fish-finger sandwiches in a nearby pub, Milligan tells me the album’s notion began with a bus. “Exactly where I used to live,” he says, “was opposite a bus-quit. I was sitting in my bedroom a single day, seeking out the window, when a bus arrived. I started thinking how weird it would be if I climbed into a bus with no driver, no passengers, and the bus took me to Burton, and there was nobody anyplace. Then I started to feel that possibly this was the type of issue my Uncle Jarek utilised to knowledge.”

Milligan fleshed out his daydream until he had a thorough therapy for a movie (his day work entails making lawyer education video clips). In the meantime, he set about bringing together musicians to function on songs he’d composed above the final decade. He soon realised most of them touched, to some extent, on Jarek’s condition. “One song, Fire, is about the time my uncle set fire to a brand-new mattress,” he says. “Not all the songs are that specific, but a great deal of them seem to relate to what my uncle went via.”

Kitten Pyramid have been born. Milligan secured a bank loan to record an album and, in January 2013, the core five-piece – Milligan, Hamon, drummer Rob Redfern, guitarists Chris Baldwin and Dan Baker – went into the studio with producer Nick Brine, best recognized for his work with Oasis, the Stone Roses and Super Furry Animals. Uh-Oh! was the result.

The difficulty with concept albums is that they can be a bit, effectively, conceptual: they can risk sacrificing musical coherence to higher-artwork pretension. But Milligan’s songs would even now make an affect without having any expertise of the underpinning concept. “What sets this apart from other notion albums,” says Baker, “is that we’re not ponces.”

Milligan is still arranging to make his movie. Every single band member has been assigned a character: Milligan a psychiatric nurse, the luxuriantly bearded Baker a bear. There is also talk of a musical. All this from a band that are unsigned. When I ask if they’re seeking for a significant label, Milligan looks anxious. “This way,” he says, “we have more freedom.”

They are creating no cash from their tour: the hospital concerts are unpaid, and they are donating a pound to AFH from every single CD sale. What’s more, they’ve all had to consider time off from their day jobs, which assortment from teaching to construction. There is no tour bus both: sustained by Coca-Cola and elaborate in-jokes about dolphins, they are travelling in a Ford Emphasis and a Volkswagen Polo, despite the fact that occasionally they get to pile into the “jaffa cake”, Hamon’s orange and brown VW campervan. Their stimulants of decision are “dad naps” (they range in age from 31 to 45, and they all have younger youngsters) and vitamin drinks spiked with Solpadeine.

It is all really un-rock’n"roll – and rather refreshing and cheering, specially when it’s clear how nicely the band’s gigs go down, the two in and out of psychiatric hospitals. Following Redwoods, they hit an open-mic night in the Wrekin Inn in Telford, in which the walls are lined with posters for the 1960s psychedelic band the Groundhogs (its founding member Tony McPhee’s spouse, Jo, runs the open mic). Kitten Pyramid blow the spot away, with shouts of “Whale!” threatening to lift the roof. By the end of the set, two locals (“Juke Joint” John and “Dead Hand” Terry) have joined them on harmonica and kazoo.

The subsequent day takes us to St George’s in Stafford, where Milligan’s uncle was once admitted. Kitten Pyramid are playing two concerts. The very first is on a ward filled largely with elderly sufferers. Amongst songs, an previous man in a hospital gown shouts huskily: “Brilliant!” His name is Tony and he loves the blues. “Loved this, also,” he says. “They blew my head.”

Later, in a treatment room, the band carry out shoeless and cross-legged beneath a board advertising lessons: Monday is rest, Wednesday coping abilities. I am not confident which category Kitten Pyramid fall into, but their flight-of-fancy lyrics and helter-skelter guitarwork go down a storm. After the concert, one patient comes above. “Hopefully I’ll get out quicker now,” he says with a grin. “You’ve put me back on my feet.”

It is this kind of response that makes all the hassles – the lengthy drives, the dad naps, the Solpadeine cocktails – worthwhile. “Which is what it really is all for,” Hamon says as we load the products back into the vehicles. With my relatively surreal stint as roadie now at an end, I seem yet again within the bag they gave me. I never got the opportunity to eat the chicken soup – and I nevertheless have no notion what the sponge was for.

• Uh-Oh! is out on 26 Could. Kitten Pyramid play Newhall Social Club on thirty May possibly and the Alsager Music Festival in Milton Park on twelve July. Particulars: kittenpyramid.squarespace.com

Revolution in the head: Kitten Pyramid carry rock to the psychiatric ward

Psychiatric medicines are performing us much more harm than excellent | Peter Gøtzsche

‘More than 53m prescriptions for antidepressants have been issued in 2013 in England alone.’ Photograph: travel-and-far more/Alamy

We appear to be in the midst of a psychiatric drug epidemic, just as we have been when benzodiazepines (tranquilisers) had been at their height in the late 1980s. The decline in their use right after warnings about addiction led to a large boost in the use of the newer antidepressants, the SSRIs (selective serotonin re-uptake inhibitors).

Figures released by the Council for Proof-based mostly Psychiatry, which was set up to challenge a lot of of the assumptions commonly manufactured about contemporary psychiatry, show that much more than 53m prescriptions for antidepressants have been issued in 2013 in England alone. This is nearly the equivalent of a single for every guy, woman and little one and constitutes a 92% enhance since 2003.

Revenue of antidepressants have skyrocketed everywhere and are now so substantial in my very own country, Denmark, that – if the prescriptions were equally distributed – every single citizen could be in therapy for six many years of their existence. The predicament is even worse in the US, in which direct promoting of prescription medication to the public is permitted and in which more psychiatrists had been “educated” with sector hospitality than any other health-related discipline.

I began to realise the scale of the dilemma when I was persuaded seven many years ago to grow to be a tutor for a PhD thesis on no matter whether history was repeating itself, by evaluating benzodiazepines (“mother’s little helper”) with SSRIs. This study has established that people get as hooked on SSRIs as they did on benzodiazepines, and 37 of 42 withdrawal symptoms were the same for SSRIs as for benzodiazepines.

It is challenging to think that so a lot of individuals have become mentally disturbed and that these prescription increases reflect a genuine need, so we require to look for other explanations. There look to be three principal reasons for the huge development.

Initial, the definitions of psychiatric ailments are so vague that several healthy individuals can be diagnosed inappropriately. Second, some of the psychiatrists who wrote the diagnostic manuals have been on the industry’s payroll, and this might have also led to significant diagnostic inflation. Third, the companies’ behaviour has been worse in psychiatry than in any other spot of medication, with billion-dollar fines paid for the unlawful advertising of psychiatric drugs for non-approved uses. The rise in sales reflects patient dependency on these SSRIs: they may possibly have excellent trouble stopping even when they taper off the drugs slowly. Withdrawal signs are typically misdiagnosed as a return of the disease or the commence of a new one particular, for which medication are then prescribed. More than time, this prospects to an boost in the number of drug-dependent, lengthy-term users.

One more significant difficulty with psychiatric medication is that they can trigger the signs they are supposed to alleviate. Unfortunately, psychiatrists tend to boost the dose or include another drug when a patient reports damaging effects.

The problem is that many of these medication just do not perform as individuals suppose. The main result of antidepressants is not the reduction of depressive symptoms. They are no much better than placebo for mild depression, only somewhat greater for moderate depression, and advantage only a single out of 10 with serious depression. In all around half of all patients, they trigger sexual disturbances. The signs consist of decreased libido, delayed orgasm or ejaculation, no orgasm or ejaculation and erectile dysfunction. Studies in the two people and animals recommend that these effects may persist long after the drug has been discontinued.

The US Foods and Drug Administration has shown that antidepressants boost suicidal behaviour up to the age of forty, and numerous suicides have been reported even in wholesome people who took the medication for other reasons (for example, for tension or soreness). The identical report also said that, among individuals above 65 who are taken care of for one year, antidepressants are believed to destroy a single out of every single 28, because they lead to falls and hip fractures. Indeed, it is not clear whether antidepressants are protected at any age.

My studies of the research literature in this complete spot lead me to a extremely uncomfortable conclusion: the way we at present use psychiatric medication is creating much more harm than excellent. We ought to as a result use them significantly less, for shorter intervals of time, and often with a prepare for tapering off, to stop men and women from becoming medicated for the rest of their lives.

Psychiatric medicines are performing us much more harm than excellent | Peter Gøtzsche

NHS"s psychiatric stresses | @guardianletters

‘Richard Thompson’s description of overworked clinicians running close to like scalded cats sums up the pressure for doctors in the NHS.’ Photograph: Getty Photographs

Congratulations to Sir Richard Thompson, President of the Royal College of Physicians, on his frank diagnosis of the NHS and for telling it as it is (Report, 5 April). His description of overworked clinicians “operating close to like scalded cats” vividly sums up the sense of stress medical doctors are dealing with in the NHS. And he rightly highlights the reality that the NHS is underneath-doctored, below-nursed, underneath-bedded and beneath-funded.

Like physicians, psychiatrists are under pressure to provide top quality care with a minimum of sources. They witness the distress of sufferers and carers who are sent long distances to receive care because they are unable to accessibility local solutions. Youngsters as youthful as twelve are getting left on adult psychiatric wards – which is completely unacceptable. And the decline in previous age psychiatry as a consequence of “ageless providers” signifies older folks with mental health concerns are not obtaining the specialist care they need.

The actual threat in all this is finance getting to be a larger driver than care and compassion, which brings us back to what none of us want – a recurrence of what occurred at Mid Staffordshire.
Professor Sue Bailey
President, Royal College of Psychiatrists

NHS"s psychiatric stresses | @guardianletters

Shrien Dewani to be held in psychiatric hospital in South Africa before trial

Shrien Dewani is accused of arranging the murder of his wife Anni on their honeymoon in South Africa. Photograph: Ben Stansall/AFP/Getty Images

A British guy accused of organising his wife’s murder while on honeymoon will be detained in a high-safety psychiatric hospital with some of South Africa’s most notorious killers and rapists when he is extradited up coming week.

Shrien Dewani, a businessman from Bristol, faces months beneath surveillance at Valkenberg psychiatric hospital in Cape Town as he awaits trial above the death of his Swedish wife, Anni, in November 2010. He fought a court battle against extradition on the basis that he was struggling submit-traumatic anxiety disorder and depression.

South Africa’s Times newspaper reported on Friday that “protection has been beefed up and a new safety organization appointed” at Valkenberg just before Dewani’s arrival.

“When the Times visited the hospital yesterday five guards have been monitoring and searching vehicles coming into the premises, in contrast with 3 guards last week,” it continued. “A employee said staff had been advised of Dewani’s arrival this week.”

The hospital has a grim popularity. A 2006 article in South Africa’s respected Mail &amp Guardian newspaper noted: “Although hospital staff and provincial government officials are at pains to point out that it is a hospital, it resembles a prison, with its bleak buildings, visitor physique searches, the sounds of clanging steel gates and burly security guards.

“Staff are also quick to point out that the stark rooms accommodating some of South Africa’s most violent criminals – mainly murderers and rapists – are a enormous improvement on the previously overcrowded and filthy wards.”

Dewani, 33, is expected to arrive in Cape Town on Tuesday morning. Two senior officials from an elite police unit acknowledged as the Hawks and a South African medical professional and nurse will accompany him aboard British Airways flight BA0059 at Heathrow airport at 9.30pm on Monday, in accordance to the Occasions.

The Instances quoted a police source saying that information of Dewani’s flight had been blocked on the country’s border movement control program except to those with substantial safety clearances.

He will land at 9.55am on Tuesday in Cape Town exactly where, South Africa’s justice department stated, he will “immediately be escorted to Western Cape substantial court in which he is anticipated to make his initial look in a South African court of law”.

Dewani denies any involvement in the killing of 28-yr-outdated Anni, who was shot as couple’s taxi was apparently carjacked in Gugulethu township in Cape Town. He claims the couple were kidnapped at gunpoint and he was released unharmed.

A South African guy, Xolile Mngeni, was convicted of the murder and jailed for existence. Zola Tongo, a taxi driver, was jailed for 18 years following he admitted his portion in the killing although an additional accomplice, Mziwamadoda Qwabe, pleaded guilty to murder and acquired a 25-year prison sentence.

The pair testified that Dewani had organized the murder, but worries have been raised over the conduct of the police investigation, like allegations of torture.

Shrien Dewani to be held in psychiatric hospital in South Africa before trial