Tagged: Psychiatric

Recession ‘led to 10,000 suicides’

The economic crisis in Europe and North America led to more than 10,000 extra suicides, according to figures from UK researchers.

A study, published in the British Journal of Psychiatry, showed “suicides have risen markedly“.

The research group said some deaths may have been avoidable as some countries showed no increase in suicide rate.

Campaign groups said the findings showed how important good mental health services were.

The study by the University of Oxford and the London School of Hygiene & Tropical Medicine analysed data from 24 EU countries, the US and Canada.

It said suicides had been declining in Europe until 2007. By 2009 there was a 6.5% increase, a level that was sustained until 2011.

It was the equivalent of 7,950 more suicides than would have been expected if previous trends continued, the research group said.

Deaths by suicide were also falling in Canada, but there was a marked increase when the recession took hold in 2008, leading to 240 more suicides.

The number of people taking their own life was already increasing in the US, but the rate “accelerated” with the economic crisis, leading to 4,750 additional deaths.

The report said losing a job, having a home repossessed and being in debt were the main risk factors.

However, some countries bucked the trend. Sweden, Finland and Austria all avoided increases in the suicide rate during the recession.

One of the researchers, Dr Aaron Reeves, of the University of Oxford, said: “A critical question for policy and psychiatric practice is whether suicide rises are inevitable.”

‘Policy potentially matters’

He told the BBC:There’s a lot of good evidence showing recessions lead to rising suicides, but what is surprising is this hasn’t happened everywhere – Austria, Sweden and Finland.

“It shows policy potentially matters. One of the features of these countries is they invest in schemes that help people return to work, such as training, advice and even subsidised wages.

“There are always hard choices to make in a recession, but for me one of the things government does is provide support and protection for vulnerable groups – these services help people who are bearing the brunt of an economic crisis.”

Andy Bell, of the Centre for Mental Health, said: “The study says what we feared for some time: that unemployment, job insecurity and many other factors associated with the recession are associated with poor mental health and suicide.

“It reminds us how important it is to respond to that need and take preventative action where we can, and that primary care is properly resourced and able to identify people who are at risk.”

Beth Murphy, of the charity Mind, said: “Since 2008, we’ve seen an increasing number of people contact the Mind Infoline concerned about the impact of money and unemployment on their mental health.

“Redundancy and other life circumstances brought about by the recession can trigger depression, anxiety and suicidal thoughts for anyone, whether they have previously experienced a mental health problem or not.

“For some people, these factors can become so difficult to cope with that suicide may feel like the only option.”

Source –  BBC News,  12 June 2014

http://www.bbc.co.uk/news/health-27796628

Fears raised over planned changes to North East mental health services

Scores of beds are set to be cut in a major overhaul of mental health services in the North East.

Radical changes will see the merger of two psychiatric intensive care units, a reduction of in-patient beds and the axing of 22 frontline nursing posts.

Fears have been raised over how the changes could affect some of the most vulnerable patients in the region.

But health officials at Northumberland, Tyne and Wear NHS Foundation Trust insisted their Transforming Services Programme will improve quality of care for patients, while delivering efficient cost savings.

Patients and staff in the South of Tyne area are being affected by the proposals, and the trust says it has future plans to look at the way services are delivered North of Tyne.

Under the trust’s plans, two psychiatric intensive care units will merge into one. The services at Greentrees Ward at St Nicholas Hospital in Newcastle and the Dene at Cherry Knowle Hospital in Sunderland both have 14 beds.

It is proposed to merge those wards into a single 14-bed facility at a new hospital at Hopewood Park, Sunderland, which is due to open later this year.

Meanwhile, a overhaul of in-patient care will see more services delivered in the community, resulting in the reduction of about 90 beds across the trust’s South Tyneside, Gateshead and Sunderland sites.

Staff are currently going through a consultation process as it is proposed to reduce the number of nursing posts, across all staff banding levels, from 64 to 42.

Last night, union officials and MPs raised concerns that the move will hit those in need of mental health care.

Blaydon MP Dave Anderson said: “Mental health services should be protected. We are in the situation where mental health issues are getting more awareness and it’s not good to hear that services are being affected in the region.

“It is ludicrous if these changes are being made to save money, and patients will understandably be concerned at what the proposals mean for them. Mental health services are very much needed.”

Greg Canning, Royal College of Nursing Officer said: “This is one of a large number of areas where the trust is currently consulting on reducing the number of posts.

“To cut the number of nursing posts in psychiatric intensive care from 64 to 42 is a huge reduction, and we want to see evidence that this will mean that the service remains viable.

“Patient and staff safety must come first. I’m meeting with Gary O’Hare, the director of nursing at the trust, and I will be raising the matter with him as a matter of urgency.”

It is expected that the changes will come into force within the next two to three years.

A spokesman for Northumberland, Tyne and Wear NHS Foundation Trust said: “For some time now we have been working with staff, service users, carers and partner organisations to look at ways in which we can redesign our service around the needs of the people we look after. This has included a formal public consultation in South Tyneside which has now come to a close.

“We are currently consulting with our staff on a number of changes to the way we provide services both inside and outside hospitals.

“The aim of these changes is to ensure that we look after people in the right environment for them, avoiding unnecessary hospital admissions. We are also working closely with our trade unions to ensure that no one loses their job through this process.”

As many as one in four people suffer from mental health problems at some point in their lives.

Earlier this year, deputy Prime Minister Nick Clegg launched the Government’s mental health action plan, setting out priorities for change in mental health care and support.

He said patients will have a choice of where to be treated and a right to minimum waiting times.

Source – Newcastle Journal   11 April 2014

The Psychological is Political

Socially, the dual strategies of exalting consumerism and increasing control have been central to the neoliberal project. Consumerism and control can be viewed as opposite sides of the same coin. People are encouraged to aspire to ever greater levels of conspicuous consumption, modelled after the lifestyles of a celebrity elite that is plastered all over the media and broadcast into everyone’s living room. Shopping, which was once a means to an end, has been transformed into the UK’s favourite leisure pursuit. At the same time, however, more and more people are excluded from the workforce (sometimes forever) by the movement of industry to areas of cheaper labour, and many others are stuck in low paid work with no prospect of advancement. Large portions of the population are only able to achieve the widely advertised ‘ideal’ lifestyle through illegal means. A highly unequal, consumer-oriented society entices people to break the law, which was illustrated dramatically by the riots in London and other English cities over the summer of 2011

 

Neoliberalism requires expanded mechanisms of social control to police the lawlessness and social fragmentation that its policies produce. Levels of imprisonment have been rising in many western countries, reaching staggering proportions in the United States in particular.

In 2011, 0.7% of the US population were in prison, with 2.9% in prison, on probation or parole. Among African Americans, almost 7% of adult men were in prison, and one in three African American men can expect to go to prison during their lifetime. ‘In the US’, comments David Harvey, ‘incarceration became a key state strategy to deal with the problems arising among discarded workers and marginalised populations’. Rates of imprisonment in the United Kingdom have also been rising, almost doubling since the early 1990s.

The dual drive to increase consumption and control the casualties of wealth redistribution is bolstered by modern, individualistic notions of mental wellbeing and mental abnormality. Even before the age of ‘neurobabble,’ ideas like ‘mental illness’ located problems with behaviour and emotions within the individual, usually in a defective brain, but sometimes in subconscious mechanisms or defective cognitive structure.

In this way the complex nature of how people relate to each other and to their environment was dislocated from its social context. In recent years, almost all human activity has been claimed to be explained by neuroscience – from economics to the appreciation of literature. These ideas sit well with neoliberal thinking, with its emphasis on the individual and its distaste for ‘society’.

The concept of mental illness is useful partly because it provides a conveniently elastic justification for control and confinement to complement the criminal justice system. Once someone is labelled as sick and needing treatment, almost anything can be justified. As soon as the bizarre, disturbing and occasionally disruptive behaviour we call mental illness is attributed to a brain disease, its origins and meanings no longer have to be understood. It simply has to be corrected, with drugs or Electroconvulsive Therapy (ECT) or whatever else it takes. Normal considerations of the autonomy of the individual can be dispensed with. ‘Health’ trumps freedom in mental health law.

Neoliberal policies breed communities that no longer have the resources or the motivation to accommodate difference. As people are increasingly displaced from family and friends, as social support networks collapse and as work becomes casualised, the social integration that helped some people withstand emotional pressures in the past is often no longer available. Psychiatric facilities are in demand to manage the consequences, and the language of mental illness enables this to be done without revealing the social breakdown at its root.

In England, over 50,000 people were forcibly detained in a psychiatric institution during the year leading up to April 2013, which was 4% higher than the figure for 2010-2011 and represents an increase of 14% since April 2007. This is despite strong financial and political incentives to reduce the use of hospital beds.

The idea that mental disturbance is a disease that is easily amenable to treatment has also enabled the extension of control out of the hospital and into the community. In 2008, a ‘Community Treatment Order’ (CTO) was introduced in England and Wales that allows patients to be treated against their will while they are living outside hospital, even if they have no ‘symptoms’ at all. The orders do not require that people have a history of violence or suicidal tendencies. A CTO can be made simply on the basis that, without treatment, the person presents a risk to their own ‘health’.

When they were introduced, it was estimated that approximately 450 CTOs would be applied per year. In fact, over 6000 were made in a year and a half to April 2010. The use of these orders continues to rise, with a 10% increase during the year between April 2012 and April 2013. Community Treatment Orders almost always stipulate that the individual has to receive drug treatment that they do not want and do not like. Potentially, someone can be forced to receive these mind-altering chemicals for the rest of their life, even if they have full capacity to make decisions about their treatment.

As well as helping the prison system to deal with the fallout of neoliberal policies on individual stability and community cohesion, the more mundane medicalisation of unhappiness has also bolstered the neoliberal project. The promotion of the idea that depression is a common medical condition caused by an imbalance of brain chemicals has helped displace responsibility for suffering and distress away from the social and economic arena onto the individual and their brain. The mass prescription of antidepressants reinforces the idea that it is individuals who need fixing, but psychological solutions, such as CBT (cognitive behavioural therapy), can also perpetuate this way of thinking.

Some of the reasons so many people are currently identified as depressed likely stem from the same factors that have led to the rising prison population – that we are encouraged to want what we cannot easily get.

Sociologist Zygmunt Bauman talks of how consumerism is driven by producing and maintaining feelings of inadequacy and anxiety. People cannot be allowed to feel satisfied. There must always be a lingering discontent to drive people to consume more, coupled with the fear of becoming a ‘failed consumer’. Yet, for many, work has become increasingly pressurised, insecure and unrewarding and as demands for increased productivity and efficiency increase, more people are excluded from the workforce through sickness, disability or choice

Debt, as well as crime, is used to fill the gap between aspiration and income. But with debt comes stress, anxiety and feelings of vulnerability and loss of control. There are so many opportunities to fail, and ‘success’ is ever more improbable.

The proliferation and expansion of mental disorders creates myriad possibilities for failure. As varying moods, inadequate attention and excessive shyness are pathologised, more and more people are encouraged to believe they need to get themselves ‘fixed.’

Just as cosmetic surgery promotes the impossible ideal of eternal youth, so mental health promotion increasingly suggests there is a perfect state of mental health to which we all need to aspire, and which we need to work on ourselves to achieve. People are encouraged to exist in a perpetual state of frustration and disappointment with themselves, looking ever inward so they do not think to challenge the nature of the society they inhabit.

Ideas about the nature of mental health and mental abnormality are intrinsically linked to the social and economic conditions in which they emerge. Neoliberalism and its ‘no such thing as society’ champions have helped to produce a biological monster that subsumes all areas of human activity within a neuroscience paradigm and, by doing so, banishes the philosophical tradition that acknowledges human experience as irreducibly social. We can only begin to challenge this impoverished view of humanity when we understand its political functions and the ends it serves.

The psychological is political!

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@JoannaMoncrieff
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