Sunday, 25 June 2017

"Would you like to join me?": Dr Peter J Gordon, Martyrs Monument 21Aug17

"Would you like to join me?" on Hole Ousia

INVITATION:

This is an invitation to join me on a peaceful protest to be held on Monday 21st August 2017 at the Martyrs Monument, Calton Hill Burial Ground, Edinburgh.

WHAT THE PROTEST IS ABOUT:

It is a protest for anybody who has had difficulty communicating with high public office in Scotland. For some this may have been with the Scottish Government – but it need not relate to any particular institution.

This protest is for anybody who has felt that those in a genuine position of power may have acted unfairly.


Professor Walter Humes, writing in Scottish Review, 21st September 2015:

“For some time I have been copied into email exchanges concerning how complaints against public bodies are dealt with. I have no personal stake in any of the specific sources of concern (which include patient care in the NHS and responses by Police Scotland, the Scottish Government and the Crown Office and Procurator Fiscal Service (COPFS) to requests for formal investigations). I do, however, have a long-standing interest in issues of public accountability and am familiar with the various techniques used by bureaucratic organisations to avoid responsibility when things go wrong: these include silence, delay, evasion, buck-passing and attempts to discredit complainants.”

THE FIRST MINISTER’S “INTENTION”:

The First Minister for Scotland, Nicola Sturgeon said: “I intend that we will be an open and accessible Government” 26 November 2014

Prof Walter Humes, 21 September 2015:

“Those who hold high office in public bodies are very adept at defending their own interests. They may claim to support openness and transparency but those principles are not always translated into practice. Bureaucratic Scotland often falls short of the democratic ideals which are said to underpin civic life”

WHY GATHER AT THE MARTYRS’ MONUMENT:

This film by me, “The Friends of Liberty“, explains why the Martrys Monument has been chosen for this protest. The location is next to St Andrew’s House, the seat of the Scottish Government. The Martyrs Monument rises higher and has a wider view than St Andrew’s House. The Martyrs Monument was raised through public donations.


The Friends of Liberty from omphalos on Vimeo.


WHY the 21st of AUGUST ?:

Reason 1: The foundation stone of the Martyrs’ Monument was laid on this very day, 1844.

Reason 2: on the 21st August 2017 there will be a full solar eclipse (sometime just before 8pm) revealing the power of one orb over another and our shared need for light.

THE PERSONAL STORY MATTERS:

Here is my experience with Scottish Government. I have been, and continue to be, an active advocate for ethical considerations in all aspects of healthcare in NHS Scotland. I am proud of what I have done and of who I am.
So if you have your own story please come along and share it. Together we can make a difference. 




Saturday, 24 June 2017

#HunterWatson Petition PE01667: Review of mental health and incapacity legislation @ScotParl

PE01667: Review of mental health and incapacity legislation

Petitioner: W Hunter Watson

Closing Date for Online Petition: 03 August 2017 

"Calling on the Scottish Parliament to urge the Scottish Government to conduct a wide review Scottish mental health and incapacity legislation and, when doing so, to take due account of recent developments in international human rights law."



Background Info

"In 1997 I began writing to my MP in an attempt to persuade Parliament to legislate to ensure that antipsychotic drugs were not concealed in the food or drink of elderly care home residents. After the establishment of the Scottish Parliament in 1999, I began writing to MSPs in an attempt to achieve the same aim. When it became apparent that this approach was not going to be successful I submitted a petition to the Public Petitions Committee. This petition, number PE867:
http://archive.scottish.parliament.uk/business/petitions/docs/PE867.htm

generated great media interest because it had not been generally realised that drugs were being concealed in the food or drink of some care home residents: I was interviewed on both radio and television and the story was covered in the UK press. Regrettably, this petition was unsuccessful. It was assumed that my concerns would be addressed by revising the Code of Practice for the Adults with Incapacity Act. Basically, the revision implied that covert medication is permissible provided that it is done in accordance with the provisions of the Adults with Incapacity (Scotland) 2000 Act (the AWI Act). However, given developments in the field of human rights since the passage of that Act, it would seem to be now appropriate to review it.

In 2008 I was made aware of one particular case which made it clear that the Mental Health (Scotland) Act 2003 (the 2003 Act) was not working as well as the Scottish Parliament had expected. Basically, it suffers from the same flaw as does Part 5 of the AWI Act. In each case, too much power is given to health professionals who, like the rest of us, are not infallible. Nor do they always adhere to the laudable principles which are supposed to underpin both the AWI and the 2003 Act. As a consequence, many of the people who are treated under the provisions of those Acts have their human rights violated. Because of my concerns about the 2003 Act, and the absolute refusal of the Scottish Government to act to address those, I submitted petition PE01494 which called for the Scottish Parliament to urge the Scottish Government to amend the Mental Health (Care and Treatment) (Scotland) Act 2003 to ensure that it is compatible with the European Convention on Human Rights. Although I and the person who seconded my petition were both permitted to address the Public Petitions Committee and although that Committee gave various bodies and individuals an opportunity to submit evidence, the Committee agreed to close my petition without discussing it. I was informed that it agreed to do this as the consequence of an instruction from a senior official or civil servant.

The Mental Health (Scotland) Act 2015 reflected a limited review of the 2003 Act that was based upon the 2009 McManus Report and which was concerned largely with administrative rather than with human rights issues. In spite of calls from the General Assembly, from the Labour Party's health spokesperson and others, the Scottish Government declined to widen the scope of that legislation. It is noteworthy that the Scottish Government chose not to give due consideration to the submission made by the Scottish Human Rights Commission (SHRC) to the Scottish Parliament’s Health and Sport Committee:  http://www.scottish.parliament.uk/S4_HealthandSportCommittee/Inquiries/MHB027_-_SHRC.pdf 

In that submission, it is stated that the relevant law includes the "Scotland Act 1998 which requires that all legislation of the Scottish Parliament must be compatible with ECHR rights. It also requires that Scottish Ministers must observe and implement the UK's other international obligations, which includes obligations under international human rights treaties the UK has ratified. There are several international human rights treaties that have application to mental health and mental disorder. This submission focusses on the UN Convention on the Rights of Persons with Disabilities". (My italics).

The Scottish Government should examine the possibility that if Scottish mental health and incapacity legislation is not amended to take due account of those judgments of the European Court of Human Rights to which I make reference in my paper entitled "Important Court Judgments 2" then it will not be ECHR compatible as is required by the Scotland Act.

My paper also contains relevant judgments of domestic courts. These have established case-law which makes clear that an adult with capacity can only be treated with that adult's informed consent and that there must be a presumption of capacity. Among the cases to which reference is made is Montgomery v Lanarkshire Health Board, 2015. Comments on this case appeared in the May 2017 edition of the BMJ. Among those comments is the following: "The doctor might think that disclosure of certain information could lead the patient to a decision that is not in their best interests, as was true in the Montgomery case. But the ethical and legal position is clear: doctors must not withhold information simply because they disagree with the decision the patient is likely to make if given the information".

The need to provide full information about risks and to not assume that there is a complete lack of decision-making capacity is of particular importance when a doctor prescribes an antipsychotic drug for a person with dementia. The administration of an antipsychotic drug to such a person, especially if carried out for a significant period, increases the risk that that person will die prematurely or have a stroke.

In a 2009 report by Professor Sube Banerjee about the use of antipsychotic drugs for people with dementia it was stated "The use of these drugs in those with dementia has substantial clinical risk attached, including a conservative estimate of 1,800 extra deaths and 820 extra serious adverse events such as stroke per year". (Numbers presumably referred to England and Wales.)

In a 2014 report prepared by the Mental Welfare Commission for Scotland (MWC) it was noted that of the 336 dementia patients in the 52 NHS units surveyed 166 patients (49%) were being given antipsychotic medication. The MWC commented "While this might be helpful in relieving symptoms such as hallucinations, delusions, agitation or aggression there are known risks for people with dementia. All antipsychotic medications increase the risk of stroke or death, many can impair mobility and increase the risk of falls".

In June 2010 there was published Scotland's National Dementia Strategy. In section 97 of the strategy it is stated "This strategy is making a commitment to a reduction in the level of prescription (of psychoactive medication) during 2011 and a further reduction for future years".

Regrettably the production of strategies is totally ineffective if they can be ignored with impunity: the document entitled "Medicines used in Mental Health" reveals that for the period 2009/10 to 2015/16 all NHS Boards showed an increased prescribing of antipsychotic drugs. Although the data does not indicate whether this increased prescribing applied to those with dementia, there can be no assumption that it did not.

In May 2017 there was published a report entitled "Scotland's Mental Health and Capacity Law: the Case for Reform". It was produced jointly by the Centre for Mental Health & Capacity Law and the Mental Welfare Commission for Scotland. This report notes that," ... in order to ensure compliance with developing international human rights standards ... there is a need to revisit and, where necessary reframe, our mental health and capacity law". The report draws attention to the possibility of small changes being made to the existing legislation prior to the production of a completely new and unified Act.

Account should also be taken of the UK submission to the committee which monitors compliance with the Convention on the Rights of Persons with Disabilities (CRPD) within those countries which have ratified and hence which agreed to comply with that international human rights treaty.  Among the issues raised are the use of chemical restraint and the abuse of people in residential care.

If legislation were enacted which took full account of recent relevant developments in the field of human rights then it is likely it would follow that:

  • doctors could no longer prescribe that unwanted drugs be concealed in the food or drink of care home residents;
  • care home residents could no longer be given potentially harmful drugs as chemical restraint;
  • mental health patients could no longer be held down and injected with psychiatric drugs against their will; nor could they continue to be given ECT even though they resist or object to that treatment.
  • non-consensual treatment would be kept to an absolute minimum."

Monday, 19 June 2017

toxic supervision

yesterday Teviot Place Edinburgh
Last night on twitter I was reflecting on the toxic nature of the PhD supervision at the University of Edinburgh Clinical Psychology department which I experienced over 9 months from September 2016.  It caused me physical health issues, gut problems, having to get blood tests and stool samples examined via my GP, and having to cancel a London trip, taking part in the Windhorse and Basic Attendance Workshop on 3 May.  I'd already bought the plane tickets so it cost me financially.

At the final supervision meeting on 2 May 2017, I felt ganged up on, undermined and bullied, my research proposal on evidencing Safe haven crisis Houses was questioned and criticised, and I was made to feel "less than".  This was particularly cruel because I'm a lone "worker", unpaid Carer, campaigner, writer, activist, with no team to back me up.  The only person who supported my academic quest from the offset was Prof Andrew Gumley, supplying a positive PhD reference and offering formal mentorship.

After the supervision relationship broke down I found out from a Clinical Psychologist, formerly employed on the DClinPsy programme at Edinburgh, that 8 others had been bullied in the department, including himself, trainees and other staff, some of whom resigned because of it.  This person had raised a formal complaint with the university but got no justice and had to leave because of it.  When I heard about the bullying culture I raised concerns with Judy Thomson, Director of Training for Psychology Services NHS Education for Scotland.  NES fund the DClinPsy training at both Edinburgh and Glasgow Universities.

Ms Thomson eventually responded saying: 

"I have consulted internally about the best way to respond due to the seriousness of the issues raised. We will not be investigating this as a formal complaint as the concerns relate to a service provided by the University of Edinburgh and by named employees of that organisation. Although NES has an interest in the quality of the learning environment, the primary governance responsibility rests with the University.  Therefore we are proposing that we pass the information you have provided to the University, requesting that they deal with the points that you have raised and advise us of the outcome – as well as liaising with you directly.  Please can you confirm that you are happy for your email of 23 May to be passed on to the University of Edinburgh and we will progress with this action?"

At first I wasn't keen to be taking forward another complaint, due to the remembered stress of having had to complain about human rights abuses in Stratheden IPCU, Fife, February 2012.  Which resulted in an apology from NHS Fife after my complaint was upheld by the Scottish Public Services Ombudsman. However I talked it over with my son and decided to proceed with the complaint, supported by NES.  This process is now ongoing.  [The University of Edinburgh's Complaints Procedure.]

I am very sad that my PhD hopes have been dashed, it's disheartening and disempowering, especially since I'm constrained financially, as an unwaged Carer, on a basic State Pension, no Carers Allowance.  At the November 2016 meeting with the Edinburgh University Clinical Psychology Professor I'd suggested that he could organise for me to undertake a few hours lecturing per week, enabling me to self fund the PhD.  However he wasn't willing or able to do this, although Ms Thomson thought this was viable when we met on 20 April 2017, prior to my PhD being withdrawn.

I feel bruised and battered after this toxic supervision experience.  It's very unfair, considering my situation and all the work I've done since 2008, voluntarily, to promote safer mental health services in Scotland, and Fife in particular.  Speaking out about human rights abuses and advocating for others who have been bullied for speaking out.  I deserve respect and recognition for standing up for, and with, others, at a cost to myself.

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PhD Clinical Psychology University of Edinburgh - Withdrawal of Offer 9May17

4 May 2017: "no way we can guarantee success": the breakdown of supervision; "slumbering time bomb"

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Cycling as therapy, yesterday on train to Edinburgh then cycling down Leith Walk, out to Portobello then round by Duddingston and down to the Meadows:


bike parked Teviot Place Edinburgh yesterday
 








Saturday, 17 June 2017

attachment: detachment

Dianthus back garden
Doing housework tasks & garden tidy-up today, reflecting on mental health involvement.  Thinking of attachment/detachment.  The latter I've found to be prevalent within some areas of Clinical Psychology (CP), ironically.  Much is preached about Attachment Theory yet what I've witnessed is detachment in practice by some, whether underpinned by Mindfulness or a reaction to it.  Don't know.

Lavender back garden
However I've seen some prime examples of academic and practice-based "detachment" in CP "professionals".  They seem to switch off in regard to the pain expressed by people who have been abused in psychiatric settings.  A clinical gaze [blog post from 2015] resulting in blank expressions, determined actions to make a patient or person conform to their "therapy".  I've noticed this since first engaging with a CP in Stratheden Hospital, Fife, and it has continued to be the case in my experience.  

Fortunately not all are like this or it would feel hopeless in regards to shifting an abusive paradigm.  I've seen in other CPs a reflection of my pain, an understanding and a solidarity.  Which gives me hope and confidence that positive change will happen despite those who have retreated into detachment, for whatever reason.


Friday, 2 June 2017

FOI Request ESTEEM Early Intervention #Psychosis Service @NHSGGC

On 28 May 2017 I sent this FOI Request to Ivano Mazzoncini, Team Leader, ESTEEM Early Intervention for Psychosis Service, NHS Greater Glasgow & Clyde:





"Dear Mr Mazzoncini

This is an FOI Request about the ESTEEM project, NHS GGC.  Please can you forward to the appropriate person in your health board area.  Thank you.

Here are the questions I have, so far:


Can you please send me all the information that is available about the ESTEEM Project in the last 5 years, including annual reports with details of finance (amount awarded each year, spent etc), budgeting, cost per patient/service user, medications used, types of psychological therapy given, testimonies of service users/patients, and any other information which will help me to be informed about ESTEEM.

I would like to know how referrals to ESTEEM are made, who makes them, can people self-refer?  How long does it take for referrals to be acted upon?  Have you got service user/patient/carer feedback about your service?  I'd like details from the last 5 years, preferably in the person's own words if possible.

I would like to know the "make-up" of the ESTEEM team eg psychiatrist, psychologist etc.  Who is the first port of call when a referral is made?  What is the assessment process for a person/patient?  

I would like statistical reports of the ESTEEM service from its beginning until now, showing numbers of people referred, worked with, avoiding psychiatric inpatient treatment etc.  To understand the cost-effectiveness of ESTEEM compared to inpatient treatment which I know will be in the ballpark of £3000/person/week (which is approximate figures for NHS Tayside and NHS Fife psychiatric inpatient treatment).

Does ESTEEM support coercive drug treatment?  Eg depot injections or acuphase clopixol.  Does ESTEEM offer only psychological therapies to patients/service users who express a wish for this?  Or are medications/antipsychotics the first port of call when a person is psychotic?

I am very interested in the availability of choices for people who are referred to ESTEEM.  Is there CBT for psychosis on offer?  I would like any reports on the effectiveness of CBTp for ESTEEM clients/service users.

Other questions:
  • are there any independent assessments of ESTEEM?  monitoring and evaluations done by other NHS GGC departments or external agencies
  • have there been any critical incidents to do with ESTEEM?  eg suicides, accidents, failures in care
  • how long has ESTEEM been ongoing?  how was ESTEEM set up?  has the management and organisation of ESTEEM changed since its early days?  if so, how?
  • how does ESTEEM advertise its service?  [I ask this because it's difficult to find anything about it and when I've contacted you for information you haven't responded]
  • what are the aims and objectives of ESTEEM? 
  • how do you promote ESTEEM beyond your health board area?  share good practice and mentor other mental health professionals; I'm interested in what you're doing to encourage other Scottish health boards to practice EIP.

I look forward to receiving a response to my FOI Request about the ESTEEM project.  So as to be more information about this early intervention psychosis initiative in the North area of Glasgow.

Regards, Chrys"




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7 April 2016: The Glasgow ESTEEM early intervention service #Psychosis #Recovery


“I intend that we will be an open and accessible Government” #NicolaSturgeon 26Nov14




Part of the debate – in the Scottish Parliament on 26th November 2014: on theyworkforyou.com

-----------------------

"I am planning to arrange a ‘demonstration’ at the Martyrs monument, Edinburgh.

My idea is to recreate a gathering around the Martyrs Monument on Calton Hill which stands next to, but taller than, St Andrew’s House (the seat of power). I will prepare invites for this gathering to be held on Monday 21st August 2017.

The foundation stone of the Martyrs Monument was laid by Hume on 21 August 1844, with 3,000 people gathered for the occasion. This year, on the anniversary of this, a total solar eclipse will take place

This shared backdrop has been described by Prof Walter Hume in the Scottish Review, 21st September 2015:

“For some time I have been copied into email exchanges concerning how complaints against public bodies are dealt with. I have no personal stake in any of the specific sources of concern (which include patient care in the NHS and responses by Police Scotland, the Scottish Government and the Crown Office and Procurator Fiscal Service (COPFS) to requests for formal investigations). I do, however, have a long-standing interest in issues of public accountability and am familiar with the various techniques used by bureaucratic organisations to avoid responsibility when things go wrong: these include silence, delay, evasion, buck-passing and attempts to discredit complainants.”

Prof Humes went on to say:

“Those who hold high office in public bodies are very adept at defending their own interests. They may claim to support openness and transparency but those principles are not always translated into practice. Bureaucratic Scotland often falls short of the democratic ideals which are said to underpin civic life”

Ever aye

Peter, Little Sparta

Dr Peter J Gordon 

1 June 2017"


The Friends of Liberty from omphalos on Vimeo.