Do you work in mental health or are you keen to know more for another reason? Are you frustrated at not being able to get on group training without travelling miles and paying through the nose? Look no further.
If you have an hour to spare and access to a pc or mobile ‘phone then you can join our 1 hour seminars with an experienced mental health nurse and trainer. For just £12.50 you can have a PDF booklet and access to an online presentation and question and answer session from the comfort of your own home.
Late last week I delivered training in Kent on schizophrenia and psychosis for a brand new client organisation. The very next day they booked 3 more sessions! Here’s a little sample of the feedback they wrote.
“This has been enlightening, inspiring and thought provoking. I would highly recommend. Really felt my learning was Stuart’s priority.”
“Really informative and interesting mix of practical and background. Thankyou.”
So insightful and enjoyable. Really engaging. Have learnt so much.”
“Thankyou so much. Some of the best and most engaging training that I’ve had in a long time.”
“Memorable and easy to apply”
“High engagement. Willing to answer all questions.”
“Stuart in general. Amazing. The way he explained things to make sure they were understandable for all.”
If you would like to book training for your group of mental health and/or social care workers please get in touch using the form below or visit the ‘Training courses’ page here.
I’m fed up of coming across people, often with serious psychiatric or medical conditions who stop taking their evidence-based, imperfect but at least understood medications in favour of misunderstood, useless and even harmful ‘remedies’ from elsewhere. I’m sick and tired of reading adverts in theatres, hotels and social clubs advertising psychic mediums, faith healers and other woo practitioners who promise, without even a hint of embarrassment to be able to talk to dead people, to angels, to clean your soul, rebirth you, even to steam your womb, all for a small fee, of course.
My original plan was just to rant on my Youtube channel about it all but that seemed unfair. So I’ve come to the South West of England, to ‘woo central’ as one of my respondents described it to see if any of the practitioners here can convince me that what they do really is useful.
Even though I was very up front that I’m sceptical if not actually hostile to the very idea of alternative medicines because it either hasn’t been tested or has been shown not to work most people were friendly and had a great deal to say about their beliefs and in defence of the treatments they offered, although only 4 agreed to be interviewed on camera.
It was fascinating to see what many Glastonbury people thought of as adequate evidence. For many it was merely to make a claim. If you can say it, if you can think it, that’s evidence.
For others, such as the lady I met on the street, simply stating the obvious was evidence enough.
One man in particular, Eddie the potter, whilst still having faith in some alternative therapies was clearly sick and tired of the woo merchants who spend their time ripping off ill people who really need help instead of exploitation.
I couldn’t help feeling that many of the people I spoke with, especially many of those who wouldn’t agree to be filmed are only too aware of the scam they’re engaged in. I won’t say all the healers are deliberate con artists. I met several who seemed sincere although their logic when trying to explain their work seemed confused. But I don’t doubt their sincerity.
Stoicism isn’t only an antidote to anger and emotional distress. It’s a recipe for genuine joy – the kind of joy and wonder that comes from endless discovery and the satisfaction that ensues ‘just because’.
Stoics don’t need a reason to be joyful. It’s enough that we’re alive and able to be joyful.
Regular followers of my stuff might be forgiven for thinking that I’m opposed to psychiatry and the biological model. After all I regularly complain about the standard medical approach with its reliance upon medication to treat mental disorder – especially relating to antipsychotics for people diagnosed with disorders like schizophrenia and bipolar disorder. But that doesn’t mean I’m ‘antipsychiatry’ – just that I’m cautious. This is especially true where medications are concerned.
The list of side effects (otherwise known as undesirable consequences) that accompany psychotropic drugs can be a major problem but the same is (and has always been) true of all medications from AZT to aspirin. If a particular person suffers side effects from a particular drug then there’s a case for trying a different drug or even a different dose but that, in itself, isn’t really a case for scrapping all antipsychotic medication. All we can really say is that we need to be cautious about medication and avoid the ‘hammer to crack a nut’ approaches of the past.
Medications are biological tools. They are chemical preparations designed to make chemical changes in the physical body. This is because of an assumption that mental disorders are caused by physical (specifically chemical) problems. But is this always true?
Combat veterans are known to develop psychotic disorders as a result of their experiences spending time in active service. It seems ridiculous to assume that all these men and women (who had passed psychological evaluation before entering the battlefield) suffer from organic brain disorders. Yet their symptoms are similar, if not identical to those experienced by many of their civilian counterparts who are diagnosed with major psychotic disorders and treated with chemicals.
Combat veterans suffer a form of psychosis that is caused not by biology but by stress.
For these people I think that there is an excellent case for using medication to treat their distress and to provide a degree of respite from their symptoms but that’s not the same as cure. That’s one thing I do disagree with traditional psychiatry about. I believe that recovery is attainable for many more people than the drug companies would have us believe. Happily though, so do many modern psychiatrists. People like me who advocate recovery aren’t so much joining the mainstream as the mainstream is catching up. That’s a nice feeling.
There are, of course many people who argue vehemently that psychiatry is flawed and that medication should never be ‘used on’ mentally ill people. However, sincere though I’m sure these people are, they may well fall into the same trap as the overly zealous arguments in favour of using too much medication. They may be too general.
Just as not all cases of psychosis seem likely to be chemical, so not all cases need necessarily be purely stress related. Whether the argument is in favour of medication or against it there is a real problem with polarisation and over-generalisation in mental health care. The disadvantage of these ‘black or white’ arguments is that they assume that everyone is the same and that everyone needs the same sort of intervention.
This sort of one-sidedness can feel easy and comfortable for those doing the arguing but there’s a price to be paid for superficial reasoning. The price is poor treatment because of flawed assumptions that compare chalk and cheese and assume that they are the same thing.
And that price is not generally paid by the individuals doing the arguing. It’s paid by the mental health service-user whose options for recovery are limited not by lack of knowledge but by stubborn refusal on both sides of the argument to look beyond their own, pet theories.
If I seem a little hard-nosed about this it’s for good reason. I was trained in the traditional way where medication and unquestioning acceptance of the biological hypothesis were everything. I was at the extreme ‘medical’ end of the continuum.
Then I was lucky enough to be selected by the NHS for further training at the Post Graduate level. I spent two years part time being exposed to the other side of the argument and, like many of my peers, became just as rabid in my defence of social and psychological perspectives instead. I was for a while the typical antipsychiatrist (or more accurately ‘antipsychiatric nurse’). And that felt good.
Today I’ve moved on a little from either of those two positions. Now I am able to see past the partisan posturing of either side and I try to walk the middle line. It seems to me that balance is everything. Isn’t that usually the case in the real world?
I no longer see much of a place for extremism in mental health care – especially when those who pay the price are not the ones making the arguments.
Please don’t misunderstand me though. I am far from an apologist for the biomedical status quo. I believe that medicine may well have something very positive to offer in relation to symptom management but in most cases that’s about all. I think that true recovery is generally achievable in other ways. But that’s for a later video.
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What’s important in your life? What are you involved in that’s more important then you are yourself?
Thousands of years ago our neolithic ancestors came together to create collective tombs and monuments that were far more important than any of the individuals who helped to construct them.
Here at Weyland’s Smithy we see the remains of one such structure. The now exposed chambered tomb, once covered by a mound of earth, stands testimony to the human need to achieve something bigger than ourselves.
In the modern consumer-driven world we’re encouraged to believe the lie that happiness comes from what we own, what we can afford to buy, how much money we have in the bank and how our stuff compares to the acquired stuff of our neighbours. But that’s not the path to mental health – it’s the path to mental disorder, to neurosis, self-loathing and petty jealousy.
True happiness comes not from what we have but from what we do. When we commit to something bigger than ourselves we leave a lasting impression on our world. We touch others in unexpected ways and our own mental health benefits as a result.
As I was filming I came across a fellow lover of all things Neolithic called Gary. He too understands the importance of monuments like the Smithy and the pull that they can have across the ages. He explains his reasons for visiting sites like this in his own words at the end of the video.
What’s important in your life?
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However we look at it mental health care has had a chequered past. From early demonization of anyone who was ‘different’ to the passive acceptance of ‘lunatics’ and ‘village idiots’ and even the high status of ‘Shamans’ and ‘seers’, society’s responses have been varied to say the least. Even today the social standing of those who hear voices differs greatly depending upon just whose voice the person claims to hear.
The voice-hearer who reports communing with aliens from Venus will be treated very differently from the medium who claims to interact with the dead. Yet their experiences may not be all that different – except, of course in the way that society responds to them.
The last few hundred years have seen massive changes throughout Europe and the rest of the Western world. The ‘asylum era’ operated a policy of ‘congregate and segregate’ in which people who didn’t quite ‘fit’ were segregated by sex and congregated in large, purpose built buildings away from the rest of society. The basic idea was ‘once a lunatic, always a lunatic’ and many people who would be fully integrated into modern society were written off as ‘hopeless’. But then it was only the middle of the nineteenth century.
The end of the asylum era really came about after world war one. Injured and shell-shocked troops needed hospital beds and the asylums were all but emptied to make room for them. The move back to the community had begun. The evidence of traumatised soldiers recovering (in part or on full) and returning either to active service or to civilian life changed the popular hopelessness about mental health to one of cautious optimism. Society began to rediscover the possibility of recovery. It was a beginning. It wasn’t the end of the journey – but then it was only 1918.
Not that everyone had entirely forgotten about recovery. Beginning in the late eighteenth century William Tuke, a Quaker philanthropist founded The York Retreat where he advocated Moral treatment with apparently remarkable results. Moral treatment was based upon the idea that dignity, social value and community involvement were the most important parts of rehabilitation. So everyone was given good food, clean quarters, fellowship and a clearly defined job, either on the retreat’s farm, helping to maintain the accommodation or some other worthwhile occupation. Tuke and others like him were rediscovering the value of social role in recovery.
By the mid twentieth century however our understanding of mental health had taken a very different tack. Social inclusion was still present but it had largely taken a back seat behind the biomedical model of mental health – the idea of the chemical cure or ‘a pill for every ill’. Unfortunately, in the case of the most severe mental disorders such as schizophrenia and bipolar disorder this much sought after chemical cure remained out of reach for most people. Medication could certainly relieve distress and other symptoms but recovery statistics in UK are not much better today than they were in 1952 when the first antipsychotic was developed and they weren’t brilliant then. But it was only 1952.
Today we take a more inclusive approach. It’s clear that neither social concerns nor medical interventions are enough by themselves. True recovery involves a combination of different strategies, some medical, some social, some environmental and some psychological. That’s why we talk about ‘stress’ and ‘vulnerability’. Different people have different vulnerabilities and need different approaches to overcome their problems. For some that means medication. For others it means social value and meaningful occupation. For most it means both.
The World Health Organisation’s International Study of Schizophrenia made it clear that those countries with the greatest degree of social inclusion also had the highest recovery rates. Social care and social acceptance matter just as much as medication and psychotherapy.
That’s where social care comes in. Support workers’ role is not to become too distracted by medical concerns about a pill for every ill. That’s what the psychiatrist does – and psychiatrists do their jobs extremely well as it is. The task of social care is to work alongside the psychiatrist to help fulfil the social care needs of the individual. Social care workers create a safe and positive environment with opportunities for meaningful activity and they help people to find a valued place in the world.
I believe that the next few decades will see even greater emphasis upon collaboration between medical and social care workers. I believe that social care workers will continue to grow beyond the image of the doctor’s assistant in the community. They will develop into a clearly defined specialty in our own right, separate from doctors, nurses, psychologists and even social workers. And as the specialty of social care develops, service users’ prospects of recovery from serious mental disorder will develop along with it.
We haven’t finished the journey toward the perfect service yet but we’re working on it. After all – it’s only 2017.
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It’s good to be appreciated. Having restarted my mental health blog last March after a relative absence of several years I didn’t expect to get any sort of recognition so soon. When ‘The Care Guy’ fell victim to austerity back in 2010 I more or less stopped mental health blogging and focussed upon other things instead.
My previous mental health blog awards were all years ago so it was especially lovely this afternoon to receive the vuelio 2017 top 10 mental health blog award. In my head I’ve been back on the mental health online scene for a while but now, it seems others have noticed too.
Definitely time to celebrate this evening, I think. Is it beer O’Clock yet?
Complete the contact form below to arrange training for your staff.
It’s good to be appreciated. Having restarted my mental health blog last March after a relative absence of several years I didn’t expect to get any sort of recognition so soon. When ‘The Care Guy’ fell victim to austerity back in 2010 I more or less stopped mental health blogging and focussed upon other things instead.
Mind The Care Training 