Informative Health Articles And News: services

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12 Mayıs 2017 Cuma

Global cyber-attack: NHS services among victims – live updates

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• This is not targeted at the NHS, it’s an international attack, says Theresa May

• NHS England declares major incident after ransomware blocks access to patient records, internal phones and emails

8.34pm BST

More than half of Scotland’s health boards have been affected by a large-scale cyber attack on NHS computer systems. GP surgeries and dental surgeries were among some of the locations hit by the ransomware attack on IT networks, the Press Association reports.

NHS Lanarkshire said only those patients requiring emergency treatment should attend hospital while they dealt with the issue on Friday.

7.50pm BST

The Agence France-Presse news agency reports that, in Spain, employees at the telecom giant Telefónica were told to shut down their workstations immediately through megaphone announcements as the attack spread.

Forcepoint Security Labs said that “a major malicious email campaign” consisting of nearly 5m emails per hour was spreading the ransomware.

7.44pm BST

Some more quotes from the prime minister. She has told reporters:

I think what is important is that we have recognised that increasingly we need to be aware of the need to address cyber security issues, that’s why the National Cyber Security Centre has been set up. It is now able to work with the NHS to support the organisations concerned and to ensure that patient safety is protected.

7.36pm BST

After the prime minister said she was “not aware of any evidence that patient data has been compromised”, Ross Anderson, a professor of security engineering at Cambridge university, advises caution.

The NHS are saying that patient privacy hasn’t been compromised, but if significant numbers of hospitals have been negligently running unpatched computers for two months after the patch came out, how do they know?

7.24pm BST

Some more on that statement from the prime minister, Theresa May, who says:

We are aware that a number of NHS organisations have reported that they have suffered from a ransomware attack.

This is not targeted at the NHS, it’s an international attack and a number of countries and organisations have been affected.

7.21pm BST

There are reports around that as many as 40 NHS organisations have been hit by the cyber-attack. NHS Digital says it is not going to confirm the number until tomorrow.

7.08pm BST

The cyber-attack that has hit the NHS is part of a wider international attack, the prime minister Theresa May has confirmed.

She said there is no evidence that patient data had been compromised.

7.02pm BST

One expert who has worked closely with law enforcement says this would be seen as an attack on critical national infrastructure. He says investigators will be examining systems affected by the ransomware to see how badly they are affected and whether they, in turn, can or already have infected other computer systems connected to them.

He adds that the fear is that the ransonware cannot be broken and thus data and files infected are either lost or that the only way to get them back would be to pay the ransom, which would involve giving money to criminals.

7.00pm BST

One question arising from the attack on a sector of critical national infrastructure is whether the government has a policy on paying ransom to cyber hackers.

British government policy in the case of a terrorist attack or of the taking of a person hostage is clear: ransom will not be paid. But it is not clear if a policy exists for the 21st-century cyber equivalent. The lead agency dealing with the attack on the NHS is the National Cyber Security Centre, an arm of GCHQ.

6.57pm BST

The New York Times is reporting that 12 countries, including the UK, have been affected.

It reports that the attack struck “computers across a wide swath of Europe and Asia”, saying that Japan, Russia, Turkey, Vietnam and the Philippines are among those affected.

6.51pm BST

Prof Alan Woodward, a security expert from the University of Surrey, says the attackers appear to have taken advantage of a chink in the armour of Microsoft XP that was exposed in a recent leak of CIA hacking tools.

He says the problem may have been exacerbated because organisations have not updated their software with the fixes made available, or are using outdated versions.

From what we can see, it is a piece of ransomware called wanna decryptor. It goes by other names but it emerged in February 2017. Since then, it has been modified and there is evidence that it is spreading using a flaw in the Microsoft network protocol called SMB, which was exposed in the recent dump of exploits that were allegedly from US intelligence agencies.

It is not just the NHS affected: reports suggest it is a global problem. The virulence is likely to be because some organisations have either not applied the patch released by Microsoft, or they are using outdated operating systems (such as XP) that are no longer supported by Microsoft and hence no patch exists.

6.34pm BST

NHS England have released an updated statement. Dr Anne Rainsberry, the NHS incident director, said:

We’d like to reassure patients that if they need the NHS and it’s an emergency that they should visit A&E or access emergency services in the same way as they normally would and staff will ensure they get the care they need.

More widely, we ask people to use the NHS wisely while we deal with this major incident, which is still ongoing. NHS Digital are investigating the incident and across the NHS we have tried and tested contingency plans to ensure we are able to keep the NHS open for business.

6.31pm BST

Here’s a little background from my colleagues Damien Gayle, Alexandra Topping and Sarah Marsh. They report the situation as it stood at about 5pm today:

Hospitals across England have been hit by a large-scale cyber-attack, the NHS has confirmed, which has locked staff out of their computers and forced many trusts to divert emergency patients.

The IT systems of NHS sites across the country appear to have been simultaneously hit, with a pop-up message demanding a ransom in exchange for access to the PCs. NHS England has declared a major incident. NHS Digital said it was aware of the problem and would release more details soon.

6.25pm BST

The NHS has declared a major incident after it was hit by a cyber attack that is thought to have affected services across England and Scotland. Staff have been locked out of their computers and many trusts have been forced to divert emergency patients.

We’ll be updating you here as this story develops.

Global cyber-attack: NHS services among victims – live updates

9 Mayıs 2017 Salı

Undocumented immigrants avoid vital nutrition services for fear of deportation

The phone calls began in February: “I’m not coming back.” “It’s not worth the risk.” “Erase my name from your records.” One person brought in a sheaf of vouchers and insisted on returning them.

All over the US, undocumented immigrants were calling the offices of the Special Supplemental Nutrition Program for Women, Infants and Children (Wic) and begging to drop out.

Since Donald Trump assumed office with promises of a fierce crackdown on unauthorized immigrants, the fearful response has spawned a hundred stories like these, of people withdrawing into the shadows to avoid unwanted detection.

But the defections away from Wic, a federal program that helps more than 8 million low-income children and mothers purchase formula and nutritious foods, offer some of the first concrete evidence of the far-reaching and potentially devastating consequences for the welfare of people at risk from Trump’s deportation promises.

Of the 90 local agencies that manage Wic, about a quarter have told the national association that undocumented clients are skipping appointments and foregoing benefits.

Many offices have recorded a sharp drop in caseloads. And in areas with a high proportion of immigrants, some clinics stand nearly empty.

“This is happening across the United States,” said Elisabet Eppes, a senior public policy associate at the National WIC Association. “We are extremely concerned.”

The benefits at stake are very modest; most participants receive roughly $ 45 in vouchers a month. But decades of research have linked the program to declines in early childhood obesity, low birth weights, premature births and infant deaths, and an increase in childhood immunizations.

The children and mothers who qualify for Wic are at risk of not only poverty but also malnutrition, because of a poor diet or a health condition.

Lanie Smith, a Wic dietitian in Kansas, recently treated a young boy with epilepsy, a condition that is made worse by a poor diet. As Smith sat with the boy, his mother, who has undocumented family members, debated with Smith whether to withdraw her son from the program.

“We’ve heard a lot of stories about people who either wouldn’t show up for appointments, or who wanted to withdraw from the program, cancel their benefits and be scrubbed from the record,” said Douglas Greenaway, the president and CEO of the National Wic Association. “We’ve had people offer to pay back any benefits they might have utilized: ‘Hang in there, I’ll find money to pay you back.’”

Wic agencies and employees first started having conversations like these in February, after rumors spread that the Trump administration would focus on deporting immigrants who accept public assistance.

The rumors were untrue. But the White House is considering executive action to make them a reality. In February, a draft leaked of an executive order that would encourage the removal of immigrants, including those with legal residency, who received public welfare.

That was enough for thousands of undocumented immigrants to question if Wic was worth the risk.

As fears have mounted, Wic agencies have desperately tried to convince undocumented participants to keep using the program. It is not against the law for undocumented immigrants to participate in Wic, they remind clients, and Wic doesn’t ask about or track its participants’ immigration status.

But panic can outpace policy. When fear of deportation runs high, research has found, unauthorized immigrants become less likely to use the public health benefits for which they’re eligible. Even immigrants with legal status will avoid entitlements if members of their family are undocumented.

Public health advocates worry that Wic may not be an outlier, but a bellwether for the potential consequences of driving undocumented immigrants into the shadows.

Other health and safety advocates are starting to measure similar trends. On Monday, the National Domestic Violence Hotline, the country’s most prominent resource for victims of intimate partner abuse, reported that it fielded more than 7,000 calls related to immigration status in 2016 – a 30% increase from 2015.

The hotline, which was established by Congress in the 1990s with federal funding, responded to 323,660 calls last year.

Supporters of Trump’s crackdown argue that undocumented immigrants shouldn’t be entitled to use public benefits provided on taxpayers’ dollars.

US law already bars immigrants from using many welfare programs designed to benefit the poor. The leaked executive order argues it is necessary to expand and enforce these exclusions because immigrants are more likely to rely on public assistance than legal residents.

But that claim is not backed up by the evidence, which suggests that immigrants are less likely than people born in the US to use welfare programs. The order also ignores the fact that many immigrants – undocumented or otherwise – have children who are US citizens but cannot access public benefits on their own.

If undocumented families continue to flee Wic, most of the consequences will probably fall on very young children, including an untold number who were born to undocumented parents but have US citizenship.

“As pediatricians, we should be trying to encourage families to access all the programs that they’re eligible for, regardless of their immigration status,” said Dr Lanre Falusi, the president of the Washington DC chapter of the American Academy of Pediatrics. “It’s heartbreaking to hear a patient say that even if their child is entitled to use this vital program, even if their child was born here, is an American citizen … they are too scared.”

What would a city look like without undocumented immigrants?

Smith, from the Wic agency in Kansas, said more than 100 people have stopped coming to her clinic in Kansas City – or, as many people as her clinic sees in a single day. Many of those clients called the clinic to say they were simply too scared.

The fears were even more pronounced in California, where numerous local agencies have received pleas from clients who want to be purged from Wic’s record-keeping system. At least one parent called an agency to ask if children on Wic would have to pay the government back someday.

“There are citizen children who aren’t going to receive benefits that they are entitled to because their mothers are too afraid to come in,” said Karen Farley, executive director of the California Wic Association. “Never mind that their parents contribute to the local economy – these are children and babies we’re talking about.”

Undocumented immigrants avoid vital nutrition services for fear of deportation

19 Nisan 2017 Çarşamba

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

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

17 Nisan 2017 Pazartesi

The lesson of Prince Harry’s grief? We need mental health services for all | Suzanne Moore

One of my strongest memories of attending Princess Diana’s funeral is of sitting up high in Westminster Abbey and looking down on her young sons. During the long service no one touched them or hugged them, though everyone was moved by the handwritten “Mummy” card on top of her coffin. The much reviled Sarah, Duchess of York leaned over to see if they were OK. Otherwise, nothing. They were to be “brave”, I suppose. They had walked behind that coffin for a very long way, their heads bowed, impassive. Why had they been made to do that?

The dysfunction of the first family was challenged and disrupted at the funeral by Earl Spencer’s speech. The public grief was dismissed by much of the establishment – as Diana was herself – as hysterical, and it proved the polar opposite of the royal reaction. The family holed up in Balmoral. Charles could now work to get everyone to accept Camilla as his partner, which they largely did. And the boys? It seemed they must just get on with it.

Twenty years later, in a lovely interview with Bryony Gordon in the Telegraph, Prince Harry has now spoken about his grief and how it affected his mental health. The stiff upper lip and the repression required to keep it so is not the way forward. Acknowledging the problems and talking about them is.

The loss of his mother when he was 12 was at the root, Harry says, of his feeling of anxiety, which manifested itself in “fight or flight” responses when in public. He talks of his aggression – he found boxing helped with this – and the feelings of internal chaos and breakdown that come after a deliberate shut-down of emotion. He didn’t want to think about his mother as it would be too sad. Yet, of course, not thinking about loss does not mean its effects go away. Harry was supported by his brother, William; “shrinks” helped as well; and finally, being open helped too.

Seeing fellow soldiers with PTSD from serving time in Afghanistan made him realise that actually this was not the root of his mental health issues. Rather, he had pushed away emotions, shoved them right down, always saying life was fine when it wasn’t at all. “And then I started to have a few conversations and actually, all of a sudden, all this grief I had never processed started to come to the forefront and I was like, ‘There is actually a lot of stuff that I need to deal with.’”

Alongside this, he, William and Kate saw that in much of their charity work, mental health was intrinsically bound to many other issues, but not always addressed. They decided to work on this.

Harry has rightly been praised for talking personally and thus destigmatising mental health issues. This is no doubt excellent. The normalising of mental health problems, which it is estimated will affect a quarter of us at one time or another, is necessary, but so too is funding. Mental health services are in a very poor state and it is almost impossible to get help. Many people in Harry’s situation would not get access to counselling and would be offered antidepressants and possibly a short course of cognitive behavioural therapy, as this is considered most cost-effective. In acute cases, people in a state of severe breakdown are now forced to go to hospitals far from their homes because there are no beds to be found nearby. This is a real crisis, and it is more visible by the day on our streets.

Royals doing charitable work can help, but we need to think about how the whole of society copes with an epidemic of mental health problems in our young people.

Harry’s likeability and frankness, alongside William’s, have helped to rehabilitate the royals’ image: a facade of modernisation. Remember that at the time of their mother’s death the family was viewed as out of touch, anachronistic. Their lack of emotional engagement seemed to belong to another era. Charles’s treatment of Diana, and her refusal to accept the script that had been written for her, threatened their popularity. Lessons were learned and the princes have been part of this PR.

Indeed, Harry is not the first royal to go public with such issues, although I am very glad he has. His mother talked, after all, of her struggles with bulimia and her suicide attempts. She spoke of difficulties with self-esteem and how bulimia gave the illusion of comfort, followed by disgust. She talked of feelings of self-revulsion and the compulsion to “dissolve like a Disprin” back in 1993. Many dismissed her then as unstable, attention–seeking and manipulative as a result.

Twenty years after her death, the fact that her youngest child can open up in such a way and be widely praised for it shows, I hope, that the world has moved on. Now it’s time to make the help and support that was available to a prince available to all.

The lesson of Prince Harry’s grief? We need mental health services for all | Suzanne Moore

21 Mart 2017 Salı

Yet more research shows chronic fatigue syndrome is real. When will health services catch up? | Naomi Chainey

When the New York Times publishes a piece on the glaring flaws in a large study conducted on the effectiveness of recommended treatments for chronically ill people, saying claims of recovery are “overstated” and “not justified by the data”, I can’t imagine that’s a good thing. However, as someone who has been ill with chronic fatigue syndrome (also called myalgic encephalomyelitis or ME/CFS) for over a decade, the article represents hope.

The authors, Julie Rehmeyer and public heath expert David Tuller, refer to the Pace trial, a publicly funded study conducted in the UK comparing the effectiveness and safety of four treatments for ME/CFS. The authors of the study were recommending two of the treatments, cognitive behavioural therapy and a program of gradually increased exercise, long before the trial commenced, on the assumption that patients with the debilitating condition were plagued with “unhelpful beliefs” about the organic nature of their illness. If we can overcome those beliefs, the theory goes, we should be able to reverse our physical deconditioning and exercise our way back to health.

In the published results, the authors claimed a modest recovery rate of 22% with the favoured therapies (other therapies were found to be comparatively ineffective). However, when patient groups gained access to the data from the trial through freedom of information requests, it was eventually revealed that the definition of “recovered” had been altered partway through the trial to include people who were still relatively ill (some with physical function on par with class II congestive heart failure patients), and had this not been done, none of the recovery rates would have been statistically significant.

As it turns out, exercise and positive thinking are not a panacea. In fact, when surveyed, 74% of people with ME/CFS who have attempted the recommended exercise program report that their condition worsens, some losing significant function in the fallout.

There is now a wealth of research on the biology of ME/CFS, discrediting the idea that we are merely “deconditioned”, but the theory that our beliefs hold us back remains persistent, both within the health care system and the media.

For example, Queensland’s Griffith University recently released a groundbreaking study confirming that people with ME/CFS have faulty calcium receptors in their immune cells, and various media outlets claimed this meant that the debate over whether or not the illness was “all in our heads” was finally over.

Never mind that the same claim was made back when studies on our metabolisms, our gut bacteria, excess molecules regulating inflammation, reduced white matter, unusual gene expression and lowered oxygen uptake were published, now our illness was real.

One wonders how many times an illness must be shown to exist before up to 250,000 chronically ill Australians (one in four of whom are too ill to leave their homes) will no longer be accused of maintaining a collective delusion.

While the research is very promising, realistically we are years, possibly decades, from the development of effective treatments for people with ME/CFS, and, in the interim, little has been done to alleviate the scepticism of the health professionals tasked with our welfare. The Pace trial remains the official touchstone for treatment recommendations and no specialist field has officially adopted the condition. Finding a doctor who is willing to take the illness seriously, and make appropriate recommendations to disability service providers, remains extremely difficult, and continues to cause great distress and financial hardship for Australians with the condition and their carers.

Penelope McMillan, president of ME/CFS Australia, believes more accredited training for GPs is in order. McMillan, who has been ill herself for 19 years, says training has already been developed by Bridges and Pathways, an organisation dedicated to building collaborations between researchers and medical professionals for the benefit of people with ME/CFS. “PHNs [primary health networks] are funded to manage and support primary healthcare services in their region,” she says. “Our task now is to get those organisations to agree to offer the training.”

But support organisations such as Penelope’s are currently bidding farewell to their own funding as government grants are redirected toward the NDIS, which is expected to take up the resulting slack in service provision. For people with ME/CFS, who are already being found ineligible for the scheme, this is hardly reassuring.

“We have members who are bed-bound and they can’t access the NDIS,” says McMillan. “It’s just heartbreaking … We have people in distressing circumstances and there’s just no help. The legislation was quite clear that the NDIS should be based on need, but the NDIA [National Disability Insurance Agency] has created a procedure that discriminates.”

McMillan refers to a list of conditions produced by the NDIA, intended as a guide for assessors. If your condition is not on the list (as ME/CFS is not) you have almost no chance of being approved for the scheme, regardless of need. In effect, the NDIA has granted privileges to those lucky enough to be represented by well-funded lobby groups at the time the list was created.

Kristel Wood struggles to work eight hours a week (though she tells me four hours is more realistically sustainable) and requires support from her family and a home care service for basic housekeeping and meal preparation. She has been rejected for the NDIS three times. “I could focus more on work,” she says, when I ask her how the NDIS would change her life. “I could get regular specialist home visits from a physio. I wouldn’t have the constant stress of playing catch-up with basic medical expenses. I’d be able to try treatment options that are currently inaccessible to me. Right now I’m barely coping.”

Wood’s third application was rejected on the basis that ME/CFS is not a “permanent illness” and “exercise and cognitive behavioural therapy are effective treatments”, a clear reference to the Pace claims, and incongruent with the established recovery rate of 5% in adults.

“Despite the study being well and truly debunked, traces of it will stay in the health system for a very long time. To weed it out is going to be quite a challenge,” says McMillan.

Perhaps that challenge should start with the Royal Australian College of General Practitioners(RACGP) who still advise GPs to recommend exercise therapy, leaving already exhausted patients to deal with their doctors’ insistence that recovery is not only possible but likely. It’s a rare GP who will trust a patient’s knowledge over the recommendations of the RACGP, and there’s an unfortunate power dynamic between doctor and patient that tends to make attempts at education uncomfortable.

So while the new research is very exciting and validates our experiences, what we very desperately need right now is services, and updates to the resources health professionals use to decide our fates, because we don’t have the energy to be battling healthcare providers for our dignity.

Yet more research shows chronic fatigue syndrome is real. When will health services catch up? | Naomi Chainey

20 Mart 2017 Pazartesi

LGBT seniors marked for removal from survey on elder care services

The US Department of Health and Human Services has proposed the elimination of data collection for LGBT seniors from an annual survey that helps determine how billions of dollars are allocated for vital care services.

The National Survey of Older Americans Act Participants (NSOAAP) collects information about services including senior centers, home-delivered meals and transportation. The proposed 2017 survey is missing a question about the sexuality of respondents, which has been included since 2014.

“It’s a very bad sign because to strip LGBT older adults out of the survey suggests that the federal government believes that the needs of this elder population do not matter,” Michael Adams, chief executive officer of Services and Advocacy for LGBT Elders (Sage), told the Guardian.

Alongside basic demographic data, NSOAAP respondents give information as detailed as how many servings of meat they eat per day and what level of help they need for activities such as walking, dressing and eating.

Such information is used to measure the impact of government-funded services and is included in a report in the annual budget.

Adams said it was important to identify LGBT seniors in the survey because they are underserved.

“It doesn’t matter, frankly, whether LGBT elders are eating chicken or steak or fish in a senior center,” he said, “but what does matter is: are they eating in a senior center at all? Are they receiving care management services? Are they receiving caregiver support?”

Sage and other groups lobbied the Obama administration to include a question about sexuality in the survey. One was introduced in 2014.

The surveys from that year, 2015 and 2016 asked: “Which of the following best represents how you think of yourself: lesbian or gay; straight, that is, not lesbian or gay; bisexual; something else [which respondents were asked to clarify later]; refused; and don’t know [which respondents were also asked to clarify].”

A notice to the Federal Register dated 13 March 2017 said “no changes” had been made to survey. However, in its draft form it does not include the sexuality question.

The health department’s Administration for Community Living (ACL) said on a link to the draft that it “does contain modifications from the currently approved collection”. The agency is accepting comments on the proposal until 12 May.

The health department did not immediately respond to a request for comment. Adams said he would welcome a dialogue with the White House.

“In recent years, we have made significant progress in including LGBT elders in federally supported elder services and we will be watching very closely for any efforts to roll that back,” he said.

The disappearance of the sexuality question comes after moves by the White House to eliminate two federal statistical programs, igniting fears among senior statisticians that data that does not fit with administration policy could cease to be collected.

Last month, the Trump administration rescinded an Obama-era protection that allowed students unfettered access to bathrooms and locker rooms that corresponded with their gender identity.

On Monday, Sage launched a campaign to get LGBT supporters to respond to the call for public comments on the survey draft. As of Monday afternoon, nearly 700 people had sent letters opposing the planned change.

LGBT seniors marked for removal from survey on elder care services

19 Mart 2017 Pazar

NHS services face "impossible" budget crisis, health trusts warn

Frontline NHS services face “mission impossible” in meeting next year’s targets, health trusts have said.

Longer waiting lists for operations and delays at accident and emergency departments in England loom under the present financial constraints, said NHS Providers, a trade association that represents acute, ambulance, community and mental health services.

Chief executive Chris Hopson said the government needed to “sit up and listen”, the BBC reported. “NHS trusts will strain every sinew to deliver the commitments made for the health service. But we now have a body of evidence showing that, with resources available, the NHS can no longer deliver what the NHS constitution requires of it.

“We fear that patient safety is increasingly at risk.”

NHS Providers predicted its members would receive £89.1bn in funding in 2017-18, an annual rise of 2.6% but less than the 5.2% demand is expected to grow by.

It warned the number of people waiting more than four hours in A&E would increase by 40% next year to 1.8 million, and the number waiting more than 18 weeks for routine operations would rise 150% to about 100,000.

The NHS is already under strain in the wake of the Brexit vote. The number of EU nationals registering as nurses in England has dropped by 92% since the referendum in June, and a record number are quitting the NHS.

Only 96 nurses joined the NHS from other European nations in December 2016 – a drop from 1,304 in July, the month after the referendum.

The service is also facing a long-term failure to hire enough people. Applications for nursing courses plummeted by almost a quarter in a year after the government axed bursaries for trainees in 2016. Numbers fell by 9,990 to 33,810 in 12 months, according to figures released in February by the university admissions service Ucas. Meanwhile, one in three nurses is due to retire in the next 10 years and there are 24,000 nurse jobs unfilled, Royal College of Nursing figures show.

NHS services face "impossible" budget crisis, health trusts warn

6 Mart 2017 Pazartesi

Tim Farron: We need a £4bn cash injection now to save the health and care services

The NHS and social care system are suffering a virulent illness and the cause is obvious: a chronic lack of funding. Yet the government is refusing to provide the treatment needed. Four in five hospitals are now not safe enough, we are seeing longer waits for operations, slower ambulance response times and patients delayed in hospital for days and weeks on end because the social care they need isn’t available. The sick note is a long one.

This shouldn’t really come as a shock – this ailment has been obvious to anyone who uses the system. We spend a lower proportion of our GDP on health than almost any of our European neighbours and the government propose to further slash spending, while demand continues to rise. How exactly do the chancellor, Philip Hammond, and the health secretary, Jeremy Hunt, expect services to cope? The chief inspector of the Care Quality Commission said just last week that the NHS “stands on a burning platform”. When he speaks this vividly, we should listen.

So there should be one essential priority for the chancellor when he delivers his budget on Wednesday. Save our most treasured national institution. Give the NHS and care systems the money they need.

The Liberal Democrats are calling for an emergency injection for 2017-18 of £4bn – to be split between health and social care – to bring these services back from the brink of real crisis. I don’t claim this will solve every frailty in our system, but it would be an urgent, short-term boost.

When the government faces a £100bn shortfall in public finances due to a Brexit squeeze, I realise the chancellor’s room for manoeuvre is limited; the economic situation is as grim as it is self-inflicted. But that doesn’t mean it is acceptable to leave the huge, gaping holes in our most essential social safety nets remain unrepaired. These are services we will all need, services that will be there for us when we are at our most desperate and vulnerable. We must do whatever is needed to safeguard them for generations to come.

Ultimately, we must find a long-term solution to the crisis in funding for the NHS and social care. Short-term injections of cash alone will not make services more sustainable indefinitely. That is why my colleague Norman Lamb, the former health minister, has assembled a commission of some of the country’s leading experts (don’t tell Michael Gove) to assess in more detail the scale of the financial need, and options for raising this revenue in the longer term – including through tax increases.

Surgeon in operating oom — ‘We cannot ignore a situation where NHS trusts are declaring services to be in a state of emergency.’ Photograph: Christopher Furlong/Getty Images

3 Mart 2017 Cuma

Life-saving alcohol services face devastating cuts

When a man in his early 20s, who was an alcohol-dependent heroin user, turned up at hospital with a gastrointestinal bleed, Helene Leslie didn’t think he had long left to live.

Yet three weeks later, Leslie, an alcohol liaison nurse at the Royal Infirmary of Edinburgh, saw him in intensive care and was tasked with trying to get him to give up drinking: “I was surprised that he was alive given how sick he’d been,” she remembers. “I thought I wouldn’t get anywhere, but amazingly, with support, the guy’s really turned his life around and hasn’t drunk for 10 years. People like that keep me going.”

Leslie, 53, who has been an alcohol liaison nurse for 24 years, was one of the very first. But in 2001, the Royal College of Physicians called for there to be an alcohol specialist nurse in every hospital in the UK. What has happened since then, and have they had an impact?

“On the whole, it’s been a success,” says Prof Sir Ian Gilmore, ex- president of the Royal College of Physicians and chair of the Alcohol Health Alliance. “They keep patients out of hospital. There’s good evidence that the nurses are able to send patients home. They can deliver interventions that have been shown to be highly cost-effective.”

Dr Kieran Moriarty, consultant gastroenterologist at Bolton NHS foundation trust and alcohol lead for the British Society of Gastroenterology, did an evidence-based review looking at the impact of specialist alcohol workers. It cited a study at St Mary’s hospital in Paddington, London, which showed that for every two referrals to an alcohol health worker, there was one fewer reattendance to A&E the following year.

Gilmore says that in 2000 there were fewer than 10 alcohol care teams, whereas now the majority of acute hospitals have some sort of service.

Alcohol-related admissions are still rising – more than 1 million were related to alcohol consumption in 2013-14 – despite a fall in per capita consumption in the UK in the past few years. And it’s not just people getting drunk and fighting, says Gilmore. The NHS estimates that about 9% of adult men and 4% of adult women in the UK show signs of alcohol dependence. Alcohol is also a contributing factor in many diseases, including cancers – and the number of people with alcohol-related brain damage is rising.

Amid this pressure, however, cuts are being made to public health budgets responsible for alcohol services. In 2015-16, 46% of local authorities implemented cuts in alcohol services, and this has risen to 72% for 2016-17.

Moriarty is concerned: “A lot of the good is going to be lost. Alcohol nurses can play a major role in prevention and identification of alcohol problems at an early stage.”

Gilmore is keen to emphasise their impact: “A brief intervention – a semi-structured interview of up to 20 minutes by a health worker – is highly effective in changing behaviour even six months down the line.”

Join the Healthcare Professionals Network to read more pieces like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views.

Life-saving alcohol services face devastating cuts

CQC warns online doctor services may pose risk to public

Patients could be at risk from online companies offering doctors’ services, the Care Quality Commission has said.

The warning comes after investigators found two firms were putting patients at risk by failing to examine their medical history before prescribing medicines. There were also questions over whether clinicians had the relevant skills or qualifications to prescribe or diagnose illnesses.

The inspectors found there were no processes for contacting a patient’s GP, including when medication was prescribed that required monitoring or a follow-up. The medics failed to check patient identity before prescribing online and there was no way of checking if people lacked the capacity to consent to treatments.

The two online firms were MD Direct (which had traded through the website assetchemist.co.uk) and HR Healthcare Ltd (treated.com). The CQC said its inspection of HR Healthcare was influenced by an investigation by BBC Radio 5 Live, which looked at the site’s online sale of antibiotics.

Following this, the CQC suspended the registration of HR Healthcare Ltd. MD Direct voluntarily cancelled its registration; the site assetchemist.co.uk now uses a different online GP provider for its prescription service.

As well as these two inspections, a review of all 43 online services registered with the CQC revealed others were potentially posing a risk to patients.

The CQC has now brought forward a programme of inspections. It is particularly concerned about sites where patients can choose their own drug and select their symptoms or diagnosis from a drop-down menu. The prescription is then reviewed by a medic and passed to a pharmacist who processes it.

Steve Field, the chief inspector of general practice at the CQC, said: “The growth in online technology presents a real opportunity to improve people’s access to medical advice and treatment. It is important that healthcare services continue to innovate. However, in some cases we have found websites which in effect allow people to select their own medication, including medicines restricted as prescription-only, with little or limited clinical oversight.

“Patients can go online, self-diagnose their condition, order their own medicine and obtain a prescription from the online doctor service, with minimal checks on [their identity] and whether the medication is safe or appropriate for them, often within a matter of seconds. We know there are often inadequate identity checks, no checks on patient history or suitability, no checks with patients’ GPs and no follow-ups or monitoring.

“Following our review of all online services registered with CQC, we will now visit each provider, working closely in partnership with the relevant regulators and checking that providers are following the appropriate professional guidance. We will take action to cancel or suspend the registration of providers who are putting their patients at risk.”

Field said that, as with conventional GP surgeries, online companies and pharmacies were required to provide safe, high-quality and compassionate care. “They must not cut corners,” he said.

A further joint statement from four regulatory bodies – the CQC, the General Medical Council, the General Pharmaceutical Council and the Medicines and Healthcare products Regulatory Agency (MHRA) – reminds firms and their medics that they must provide safe and effective care, and follow professional guidelines.

Lord O’Shaughnessy, the health minister, said: “We have empowered the CQC to run a tough and comprehensive inspection regime and commend their work to uncover failings in digital care provision. Online providers can be a convenient option, but patient safety must always be the priority and we urge the public to follow CQC’s advice when buying medicines online.”

Gerald Heddell, the director of inspection, enforcement and standards at the MHRA, said: “Prescription-only medicines are prescription only for a reason and should only be taken under the supervision of a healthcare professional. A proper consultation with a medical professional is essential to ensure that an appropriate diagnosis of your condition can be made, your medical history can be reviewed, your recovery can be monitored and any adverse reactions can be dealt with.”

CQC warns online doctor services may pose risk to public

2 Mart 2017 Perşembe

Have you been affected by NHS hospital closures and cuts to services?

There’s no more controversial decision the NHS makes than removing services from hospitals, or even closing them. To investigate the causes and consequences of that kind of change, on Friday the Guardian is spending the day at the Royal Brompton hospital, where NHS England has said that, subject to public consultation, it will stop paying for congenital heart disease services.

The hospital and its supporters say that it makes no sense to close the service, which it describes as among the best in the country. But advocates of the change say that concentrating services in fewer locations makes for better care, and that the Royal Brompton doesn’t meet agreed standards.

The Royal Brompton isn’t the only hospital affected. Newcastle, Manchester and Glenfield hospital in Leicester are facing the same proposals. More generally, NHS England’s sustainability and transformation plans (STPs) are likely to mean the closure of 19 hospitals, including five major acute hospitals. Some experts say that this is an essential part of moving the fulcrum of the NHS from hospitals to a new set of community services integrated with social care – a move they say is vital for the health of patients and the NHS alike. But others say it’s just cover for swingeing cuts.

As part of our coverage on Friday, we want to hear from our readers. Is your hospital being affected? What are your concerns? Can you understand the rationale behind the plans? Do you think you or your child could have received better care, or do you worry about the loss of local services? If you work at a hospital, are you worried about the plans, or do you believe they will raise the standard of care?

Share your stories and concerns.

Have you been affected by NHS hospital closures and cuts to services?

24 Şubat 2017 Cuma

How can health services keep pace with the rapid growth of cities? | Richard Vize

The relentless growth of urban populations is driving city and national governments to increase access to healthcare while tackling the root causes of poor health.

According to Oxford Economics [pdf], the world’s largest 750 cities will be home to 2.8 billion people by 2030 – more than a third of the global population. They will account for almost a third of the world’s jobs and more than half its consumer spending. More than a dozen cities will have populations greater than 20 million.

Rapid, uncontrolled urbanisation strains many aspects of city life that determine health. Traffic, factories, generators and construction poison the air, meanwhile water supplies can become contaminated, poor housing harms the health of children, and food supply and quality can be compromised.

Unplanned urban growth drives poverty. About 900 million people worldwide live in urban slums, where overcrowding encourages the spread of infectious diseases such as tuberculosis, dengue fever and cholera. The United Nations estimates that by 2030, roughly 60% of city inhabitants will be under the age of 18, which puts huge numbers of children at risk from illnesses such as diarrhoea and pneumonia, the leading causes of global childhood death.

Health services, particularly in developing countries, are concentrated in cities. As Mark Britnell notes in his study of global healthcare, many developing countries such as China, Indonesia and India suffer from a chronic shortage of health workers. This creates big disparities in care between cities and the countryside; doctors are reluctant to work in rural areas because pay is poor, career choices are limited, hospital facilities are often inadequate and primary care tends to be underdeveloped.

Meanwhile, in the cities, hospitals become overcrowded because patients know that is where the best doctors, research and technology are found. The dominance of hospital care in cities often means primary care is neglected, which according to the World Health Organisation (WHO) [pdf] can lead to unregulated, unsafe and ineffective private services. In some African cities, public primary healthcare has almost disappeared.

Britnell highlights some of the efforts being made to bridge the shortfalls. Brazil has announced new medical schools to train thousands of additional doctors, and training is being extended to include two years working in public service posts. This could add up to 36,000 working students to the system by 2021. Compulsory training in public hospitals was inspired by the NHS.

In addition, Brazil has recruited at least 10,000 doctors from Cuba to work in the poverty-plagued favelas on the peripheries of cities, as well as in remote areas.

The chronic shortage of clinicians is encouraging countries to make better use of volunteers and community workers. India is trying to boost its services in slums through the National Urban Health Mission, which emphasises reproductive health and works with women’s health committees.

Toronto [pdf]has been trying to bring together its primary and hospital services to provide joined-up care for patients with several health conditions. This includes individual care plans, one point of contact, and multidisciplinary teams supporting high-risk patients after they have been discharged from hospital. The city’s Ageing at Home programme aims to make it easier for older people to continue to live at home after illness.

Toronto also provides impressive support for people living on the streets with mental illness. Its Streets to Homes programme includes incentives for private landlords to offer accommodation. Several thousand people have moved into their own home since 2005, and about 80% of them remain there for at least a year.

Yet for many people, access to healthcare depends on the ability to pay, which excludes swathes of the population. Increasingly, countries such as China, Thailand and Indonesia are addressing this problem by pursuing universal healthcare. At present around two in five countries have some form of universal healthcare.

Britnell argues that its expansion is being driven by two opposing forces: capitalism and globalisation have grown a middle-class demanding more from governments, while about 1 billion people lack access to basic healthcare and 100 million are impoverished every year through catastrophic healthcare costs. Providing more equal access to health services strengthens social cohesion and promotes economic growth.

But while developing countries are increasing the proportion of their wealth spent on healthcare, urban populations are expanding so quickly that it is all but impossible to provide the health infrastructure and staff to keep pace.

Faster progress can be made, however, in improving the environment, such as providing cleaner air and water. For this reason, the WHO believes local government – and particularly executive mayors – are central to improving city health.

Beijing and Shanghai, for example, have introduced tough anti-smoking laws. In 2013 Mexico City became the first in the world to levy a tax on sugary drinks, which had been a factor in Mexico having among the world’s highest obesity and diabetes rates. Kuwait City has reduced salt content in bread to tackle high blood pressure. London and Paris were among the first cities to attempt to cut traffic pollution and increase exercise by offering free bicycle use.

Poor road safety takes many urban lives. Fatal traffic accidents [pdf]cost about 21 lives per 100,000 population annually in Brasilia and 18 in Nairobi, compared with 1.3 in Tokyo. Cutting road deaths depends on many factors – higher population density actually reduces deaths compared with sprawling areas. São Paulo (Brazil), Bogotá (Colombia) and Accra (Ghana) are among cities pursuing safer road design.

The health of city populations is becoming a central concern of local and national governments and international institutions. Affordable access to health services is just part of the story. Local government in particular recognises that improving the health of city populations depends on everything from ensuring water quality to designing safe roads and controlling air pollution.

But there is a chasm between cities where growth is controlled and those where the relentless quest to find work is creating polluted, overcrowded slums.

Richard Vize provided editorial support to Mark Britnell for his book In Search of the Perfect Health System, which won the health and social care prize at the BMA Medical Book Awards 2016.

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How can health services keep pace with the rapid growth of cities? | Richard Vize

20 Şubat 2017 Pazartesi

NHS admin staff keep services running - but we"re being hit by cuts

Secretaries, waiting list and medical records clerks, clinical audit facilitators, business analysts and IT technicians and other support staff pull together to keep essential lifesaving NHS services running smoothly. To a staff nurse, the help of a ward clerk to retrieve a patient’s medical history can be just as crucial as that of a senior consultant. Data quality officers ensuring patients are properly admitted and discharged on computer systems can have an immeasurable impact on the management of bed capacity.

Yet those of us in NHS support services work in less-than-ideal circumstances. I work in an office that is a converted ward. Save for wheeling out most of the medical equipment, it remains an abandoned clinical area. I’m always wary when manoeuvring around our cramped kitchenette – imagine the embarrassment of accidentally leaning on one of the emergency call buttons and having the rapid response CPR team come crashing in.

Plates and cutlery stand stacked precariously atop the tiny dining table and fridge (kindly donated by another admin department, who were throwing it out). A locked walk-in cupboard adjacent to the kitchen would be ideal for storing these. However, due to budget and staff restrictions, logging a job with estates to get a new Yale lock installed has proven fruitless on several occasions. Jobs deemed non-essential are often cancelled. With a leaking radiator pipe, broken window and an unexplained beep from above the ceiling tiles failing to see a quick response, reporting anything else can make one feel rather hypercritical.

The already cramped office still holds a partly dismantled bed hoist, condemned imaging machines and a box of surgical tubing, seemingly forgotten. We have jokingly discussed eBaying the lot to raise funds to buy desk lamps; dim strip lighting doesn’t quite work in an office.

I was lucky enough to suffer a full-scale-beyond-repair PC meltdown one day, so IT had no choice but to provide me with a reconditioned model from their storeroom. However, some of my colleagues are working on machines so old they take upwards of 20 minutes to boot up in the morning. The high-pitched whine of the struggling fans is maddening. Stretched IT staff struggle to keep up with demand. While problems with direct patient impact understandably take priority, waiting three days for a simple but essential fix is excessive.

For a team dependent on computers for their jobs, this can mean time wasted recording information on paper, only to have to transfer it to a digital source once systems are back up and running. It’s easy to see how this can contribute to huge backlogs and missed deadlines. Panicked managers pleading staff to take budget-stretching overtime is often the result.

Cheap or outdated equipment with a tendency to crash or throw up errors only adds to the problem. False economy reigns supreme, when an inadequate version is eventually replaced with the one we should have had all along. An ancient printer once cost my department half a day of productivity, as IT spent hours searching for a withdrawn ink cartridge so we could run off essential documents.

A friend in another department is responsible for requesting essential office supplies. To ensure he’s not buying luxury items the trust can’t afford, all orders are approved by executive-level staff. A recent attempt to gain a few pencil sharpeners saw 12 members of staff told to share three. Mouse mats are definitely off limits.

Understaffing is not just a problem on the frontline. Although there have been cuts and restrictions to what is made available, access to support and training for admin staff is still admittedly good, and it’s not uncommon to hear of a new recruit using NHS resources to gain experience and qualifications before handing in their notice to take a similar role in the private sector. Vacancies are often not re-advertised. While the wary jump ship, those left behind are expected to absorb the roles of colleagues, often without a wage increase.

I am proud to say I work for the NHS. It means much more to me than private sector benefits like a shiny new Apple Mac to work on or an all-expenses paid Christmas do. I enjoy knowing that I am, albeit in an indirect way, contributing to saving people’s lives. There is a sense of community in the health service I don’t sense in corporate organisations; we still join unions, strike together, are aware of each other’s problems.

Yet, just like the healthcare professionals feeling the stress and strain of the continued NHS cuts, we support staff feel we can do only do our best when we’re comfortable at work and morale is high. Since beginning my NHS career, although I’ve advanced and been promoted, I also feel that things are sliding backwards. While frontline medical staff are still undoubtedly in the most direct line of fire, we feel the impact under the surface too and there’s a definite feeling that things are getting worse.

Some details have been altered to protect the identity of the writer

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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NHS admin staff keep services running - but we"re being hit by cuts

23 Ocak 2017 Pazartesi

"Global gag rule" reinstated by Trump, curbing NGO abortion services abroad

In one of a number of sharp reversals from the Obama era, Donald Trump on Monday signed an executive order banning international NGOs from providing abortion services or offering information about abortions if they receive US funding.

The rule will put thousands of international healthcare workers in the difficult position of deciding whether to continue to offer family planning care that includes abortion at the expense of a critical funding stream.

The US is the single largest donor to global health efforts, providing nearly $ 3bn toward health efforts through the United States Agency for International Development (USAid) alone. The state department and groups like the Peace Corps offer additional funding.

Many international health advocates insist that their efforts are not comprehensive without abortion services. Unsafe abortions are a major cause of maternal mortality and kill tens of thousands of women every year.

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

“President Trump’s reinstatement of the global gag rule ignores decades of research, instead favoring ideological politics over women and families,” said Senator Jeanne Shaheen, a New Hampshire Democrat who serves on the foreign relations committee.

“We know that when family planning services and contraceptives are easily accessible, there are fewer unplanned pregnancies, maternal deaths and abortions.

“And when women have control over their reproductive health, it improves the long-term health of mothers and children and creates a lasting economic benefit.”

Trump’s signature reinstates a Reagan-era rule that was not in effect for most of the Obama administration. The order does not eliminate international aid for abortions, which is already prohibited by federal law under the Helms amendment. Rather, the gag rule takes the Helms amendment one step further by preventing NGOs from using private funds to offer abortions or even refer women to groups that provide abortions.

The gag rule also prevents health workers in foreign countries from advocating for abortion rights, which includes testifying about the impacts of illegal abortion.

The rule does not enjoy uniform support along party lines. In 2015, Senate legislation introduced by Shaheen that would have made the gag rule impossible to reinstate by executive order attracted support from several moderate Republicans.

Still, the reinstatement of the global gag rule, also known as the Mexico City policy, has been long sought by opponents of abortion rights. To their eyes, funding groups that perform or even discuss abortions is tantamount to funding the procedure.

“President Trump is continuing Ronald Reagan’s legacy by taking immediate action on day one to stop the promotion of abortion through our tax dollars overseas,” said Marjorie Dannenfelser, president of the anti-abortion political advocacy group Susan B Anthony List.

“President Trump’s immediate action to promote respect for all human life, including vulnerable unborn children abroad, as well as conscience rights, sends a strong signal about his administration’s pro-life priorities.”

Trump is not the first president to reinstate the rule after it was suspended. George W Bush signed a similar order when he entered office in 2001.

As a result, more than 20 developing countries in Asia, Africa, and the Middle East lost access to contraceptives provided by the US and many NGOs were forced to shut down or lay off staff, according to EngenderHealth, a global women’s health organization that supports abortion rights.

EngenderHealth observed the impact in three places – Kenya, Nepal and Zambia – and found that in these countries, the gag rule reduced the availability of family planning services, HIV programs and maternal and child health programs.

"Global gag rule" reinstated by Trump, curbing NGO abortion services abroad

18 Ocak 2017 Çarşamba

Young people’s mental health services need cash not empty promises | Clare Allan

It’s good to talk, and at the moment there’s a lot of talk about mental health and, in particular, about the mental health of young people.

I’m thinking, of course, of Theresa May’s recent speech, in which she announced a government green paper on children and young people’s mental health services, mental health first aid training for schools and a few other measures – to be funded apparently out of thin air – because mental health has been “a hidden injustice in this country” for far too long. From whom this injustice has been hidden was not specified.

BBC Radio 1, 1Xtra and Asian Network on Wednesday launched a year-long campaign “to encourage young people to explore issues surrounding their mental health”. My Mind and Me aims “to get young people talking about mental health, to reduce stigma around mental illness, and to raise awareness and understanding of mental health issues that affect young people”.

To assist them in this, they have partnered with the National Citizen Service (NCS) to create a group of “social action champions”, a group of young people from across the UK, who will work with the stations to help shape the campaign, sharing their own experience and leading discussions on “the key issues around mental health”.

Giving young people a platform to discuss these issues is certainly important. There is nothing more powerful than hearing directly from people about their experience, especially from people who are far too often stereotyped or simply ignored altogether. To hear an individual talk on their own terms and in their own words allows for a human-to-human connection that cuts through cliches and stereotypes. The result can be transforming. And as Ben Cooper, controller at Radio 1, 1Xtra and Asian Network, put it:“From prime ministers to our young listeners, we all recognise the need to change attitudes to mental health.”

It’s good to talk, but I cannot help feeling there is something of an elephant in the room. I confess that I listened to Theresa May’s speech, and much of the discussion that followed it, with my jaw hanging apishly open.

This government and the previous one have presided over the decimation of mental health services – “a car crash”, according to Prof Dame Sue Bailey, former president of the Royal College of Psychiatrists, speaking in 2014. She was just one of a chorus of voices, from patient groups to professional bodies, carers and mental health charities, all shouting the loudest, most urgent of warnings – it certainly wasn’t hidden from the government.

And between 2010 and 2015 funding for Child and Adolescent Mental Health Services (Camhs) was slashed by £50m, despite massively increasing demand.

Even setting aside both of those things, consider how, as a society, we are failing our young people.

However inconvenient the fact may be, mental health is not some discrete entity. The mental wellbeing of young people cannot be considered in isolation from the issues that affect their lives: the education system, benefits, housing, employment practices. In all these areas, the needs of young people have been trampled on over and over again by the boots of political expediency. And now they are supposed to believe we care about their mental wellbeing.

It may be that My Mind and Me is going to address these issues and I very much hope it does.

In 2016, winners of Radio 1’s Teen Awards, which included a mental health category, were invited to meet the Duke and Duchess of Cambridge, who praised their “inspirational work”. All fine, except that mental health problems have repeatedly been shown to be most prevalent in those countries with the highest levels of financial and social inequality.

And I know it seems churlish to point that out, but it would really be the bitterest of ironies if raising awareness of mental health issues became a means of avoiding confronting the factors that contribute to them.

Young people’s mental health services need cash not empty promises | Clare Allan

13 Ocak 2017 Cuma

Library cuts harm young people"s mental health services, warns lobby

Public libraries’ significant role supporting the mental health of young people risks being undermined by swingeing budget cuts forced on local authorities, the head of their professional body warned this week. He added that, if funding is not protected, the work of libraries as frontline information resources for young people in need will be pushed on to the already overstretched police, health and social services.

It is estimated that one in 10 UK children experience mental health problems, as do one in four adults. Nick Poole, head of the Chartered Institute of Librarians and Information Professionals (Cilip) providers, told the Guardian that cuts to local library services would “continue to bite the availability of dedicated resources such as advice on anxiety, stress, exams and bullying”.

He warned: “Under-investing in our libraries simply pushes costs elsewhere and means that a young person growing up today has less help and is more vulnerable to the impact of mental health problems on their life.”

His comments follow prime minister Theresa May’s announcement this week of a raft of measures to “transform” attitudes towards mental health, including an extra £15m for community care, extra training for teachers and improved workplace support.

Wellbeing initiatives run by libraries around the country include the Association of Senior Children’s and Education Librarians’ autism–friendly libraries, the Cilip-backed reading for pleasure and empowerment scheme as well as yoga and mindfulness sessions run as part of Oldham libraries’ mental health and wellbeing support. Birmingham, Devon and Bolton city councils are also among library authorities that run dedicated mental health services.

I would like to think that the powers that be recognised the role of libraries in helping vulnerable people.

Sarah Lungley, Suffolk libraries mental health coordinator

The Shelf Help scheme, which is dedicated to children and young people and was launched in 2016 by the Reading Agency, provides a list of 35 books selected by mental health experts and young readers that range from self-help and information guides to comics, memoirs and novels including The Curious Incident of the Dog in the Night-Time by Mark Haddon and The Perks of Being a Wallflower by Stephen Chbosky. Subjects covered range from body image to depression and self-esteem.

Suffolk library authority said that 68% of the books on the scheme had a 30% or higher loan status than other stock. Last year, 10,000 wellbeing inquiries were handled by the county’s libraries. Although it did not have an official breakdown of who sought help through its branches, Sarah Lungley, mental health and wellbeing coordinator, said anecdotal evidence suggested that the majority of enquiries came from concerned parents of young people experiencing difficulties.

“We are in a really good position to connect people to the help and services that they need,” Lungley said. “I would like to think that the powers that be recognised the role of libraries in helping vulnerable people. A lot of people in the community who struggle with mental health will be left vulnerable and lonely if their local library shuts.”

Poole added: “Children, young people and their parents are simply going to find it harder to find a well-stocked library where they can find information about the issues they face.” Without access to professional librarians trained in mental health resources, he said, those struggling would be more reliant on unmediated internet searches to gain information. “As a parent myself, I would be worried about my children using Google like that.”

Public libraries have been caught in the crossfire of a ferocious funding battle being fought between local councils and central government. Official figures released at the end of 2016 revealed that library budgets had fallen by £25m in a year, as a result of councils raiding their resources to shore up frontline services such as social care.

According to an annual survey of library authorities in the UK undertaken by the Chartered Institute of Public Finance and Accountancy (Cipfa), total expenditure for the sector fell from £944m to £919m over the year, a 2.6% fall. Over the same period, 121 libraries closed, taking the total number open down to 3,850.

Before Christmas Poole predicted that over the next five years, a further 340 libraries will face closure if proposed cuts go ahead. Libraries in Warrington, Lancashire, Edinburgh, Denbigh and Swindon are among those facing the most severe losses.

Poole said: “We have to find a way of making our political stakeholders understand that a big part of what libraries do is making sure that people with a whole range of issues feel safe and can access information.

“If we remove that function from communities, all you are doing is pushing those library users on to the police and healthcare professionals. If Theresa May isn’t aware of that, her comments are nothing more than an empty soundbite.”

‘The library was a calm, quiet and safe place for me to be’

Fifteen-year-old Josh is adamant that his local library has saved his life. A year-and-a-half ago, school felt like a prison for him, as he struggled to keep up with his classmates due to a variety of issues including severe anxiety and Irlen syndrome, a problem that affects his ability to read and process information. He was also suspected to be on the autism spectrum.

Two years earlier, anxiety attacks and vulnerable feelings had begun to make him dread each school day. “School became an oppressive place to be,” he says. “I was scared and upset and everything just became too much. Everything made me worried and afraid.”

The troubled teen was not a victim of bullying, but the normal noise and chaos to be found in any classroom were a daily nightmare he had to confront.

Only one place made him comfortable: his local library. “The library was a calm, quiet and safe place for me to be,” he says.

Already a regular user, Josh welcomed the available support and guidance when he needed it. Based in a deprived part of Suffolk, his library benefits from a coordinated county-wide health and wellbeing policy funded by the Mental Health Pooled Fund, which is a combination of Suffolk County Council and Suffolk’s Clinical Commissioning Group.

He was eventually allowed to swap school days for days in the library – and the impact on his learning has been considerable: “Because I don’t have to go into school much, I use the library to do my revision. It’s quiet and I find it much easier to study. I am relaxed and calm when I am working because I can take as much time as I want without being constantly rushed.”

When stuck on a difficult maths or English problem, librarians are at hand to guide him towards answers. “They have really supported me,” he says. “They are always there to talk to and help me through a basic part of a question and then will find me a book to help me with the rest. It has given me a lot more confidence.”

A sign of how positive an experience it has been for Josh is that he has now begun volunteering, leading groups of eight to 12-year-olds who have been bullied by older children. “I wanted them to get off the street and come into the library and have a safe space to be,” he says. His idea was to set up an after-school club; by the end of 2016, 20 children were attending every Wednesday.

“It’s great,” says the teenager. “It has given them their own space where they aren’t being picked on by the older children. Before it was a struggle to talk to people because it really scared me. But now I am much more calm and confident.” He smiles: “I seem to be smiling a lot more and am feeling a lot better about life.”

Library cuts harm young people"s mental health services, warns lobby