This Week in Mentalists (55)

The mental health blogosphere seems particularly exercised by dead babies and TV shows this week.

Let’s get the ball rolling with a few comments on the Baby P case.

Social work blogger Fighting Monsters reviews some of the press reactions.

The Independent also runs comment piece on the support that is needed for social work and some of the shortcomings in the system.

Social work has always been a Cinderella service, underpaid, understaffed and under-resourced. Social work does not enjoy the reputation and intellectual standing of medicine nor the national pay scales and career path of teachers. A social worker with 10 years’ experience will be lucky to earn over £30,000. The result is that the most difficult and damaged children end up being looked after by the least able and worst paid staff.

I wasn’t sure whether to leave that last line in. It grates a little to be classified as ‘least able’ but I then considered that all opinions are valid and I shouldn’t be too defensive in the face of errors having been made.

I don’t always disagree with Dr Crippen. I wholeheartedly agree with his call not to demonise social workers.

When did you last read an article in a newspaper saying that social workers did a brilliant job, saving the lives of countless at risk children? That article does not exist. When did you last read an article in a newspaper about social workers removing an “at risk” child and then being over-ruled by a court? It happens all the time.

Useless CPN condemns the blame culture.

For the record: What happened to ‘Baby P’ was awful, and should never have happened, but you cannot account for the tiny minority of people in this world who will commit evil acts like that. The Social Worker (like every other professional involved) had very tough decisions to make in extremely challenging circumstances.

The culture of blame against professionals we have in this society really worries me. Yes, someone was to blame for this child’s death – HIS MOTHER. The Victoria Climbie case was exactly the same, I was discussing it with my partner last night and neither of us could remember the name of the woman who Victoria was living with, and who actually perpetrated the abuse against her, but we both knew the name of the SW who was vilified during the inquiry.

One of these days we will get to the stage where no-one wants to work in Paediatrics, CAMHS or Child Protection. Then what would happen?

Mentally Interesting: The Secret Life of a Manic Depressive reviews the Horizon “Big Brother with mental illnesses” show How Mad Are You?

The game format is jarring. The bloke who hates cow shit has an OCD! Whodathunkit? Maybe that was the viewer freebie. I really hope that the confident bloke doesn’t have bipolar disorder and that the pessimistic girl doesn’t have depression. The participants are stable, they’d have to be or else it would raise ethical eyebrows about this programme. You couldn’t cram a castle with suicidal depressed people or schizophrenic people suffering from negative symptoms. Confidence is only a symptom of hypomania, it’s not a character trait associated with bipolar disorder, if you see what I mean. You probably don’t, I’m struggling myself here.

I do understand the point they’re trying to make, that people with mental illness are just that, people with mental illness (it’s true!). It’s an admiral point to make but it also featured my pet hate: dismissive use of the word “labels”, which made me grit my teeth.

So, does anyone want to hedge their bets on who has what? What about Yasmin? I bet she’s had anorexia or something. That would be a coup to show that you don’t have to waiflike to have been hospitalised three times for anorexia. I’m also hoping, in a strange way, that whoever has schizophrenia is a woman, because schizophrenia seems to be seen as a man’s disease.

Anyway, it was alright! Certainly intriguing.

Reviewing the same show, Aethelred the Unread spots a flaw in the format.

When the subjects were preparing for the stand-up comedy task, the narrator said in a voice-over that ‘one of these people suffers from social anxiety.’ Well, I’m sorry, but they don’t. They’re in an unfamiliar situation, meeting an entirely new group of people, and doing it all under the gaze of cameras and a TV crew. Anyone who was actually suffering from social anxiety wouldn’t even have been in the room, they’d have been a small blur of dust disappearing over the horizon. What they actually mean is that one of these people has suffered from social anxiety in the past.

At one point one of the panel (I think the psychologist, but don’t hold me to that) said about one of the subjects, ‘well, all we can say is that she’s not suffering from a depressive episode at the moment.’ For me, that got straight to the heart of the problem with this programme. All of the subjects taking part are not currently unwell. Some of them may have been unwell in the past, some of them may be controlling their illness with medication, but all ten are currently in good health. Essentially the panel are being asked to spot five healthy people who are mixed in with another five healthy people. It’s not so much a question of looking for a needle in a haystack as it is looking for a needle in a box of identical needles.

Life With Aspergers discuesses the difficulties caused by a simple question like “How was your day?”

Problems with the Question
There are a lot of problems with this question. For a start, how do you describe a day. It wasn’t my day… it was everyone’s day. We all shared it. Then of course, there’s the problem of “what answer could actually fit the question?”. The best one word answer I can find is; “Good.”

The problem with this answer is that it often provokes further open-ended questions; “oh…, what was good about it” or even worse, it encourages the initial “how was your day?” question to be asked several more times during the course of the afternoon, or dinner.

Problems with my Day
Most days, are unremarkable for me. I go to work, do mostly dull work and come home. Don’t get me wrong, I enjoy my job. It’s just that the things I find interesting or funny (an unexpected pattern in computer code, a silly comment by a Microsoft reviewer or a passer by whose umbrella blows inside out) aren’t funny or interesting to most other people.

Sometimes I’ll say something about my day, expecting it to be dull and lifeless and my wife will give this little excited response. I’ll look at her quizzically (not so that she’d notice) and then expand on what I’ve said, realising that she actually found something interesting. The problem is, that I really don’t know which parts of my day are interesting to people and which aren’t. All I can say for certain is that most of what I find interesting – isn’t and some of what I find uninteresting – is.

Marine Snow comments on a report that oral surgery may cause eating disorders.

When I was a kid I had my tonsils and adenoids removed. I remember being in no small amount of post-operative pain, and refusing to eat anything at all for about two weeks afterwards. The only way my parents could get me to consume anything, was by my Dad sitting me on his lap, and coaxing me into eating some soft bread and drinking some warm milk.

Huh. If that’s not an ED in the making, I don’t know what is. I’m not sure about the “mouth being associated with trauma” theory, but the “getting attention by refusing to eat” hat, seems to fit.

Writing in the the Margins of My Mind has a crisis out-of-hours.

Today, I went to the walk in centre to get some steri-strips and a dressing, and told the truth when asked about how I was feeling. The ENP phoned the on-call psychiatrist at the local hospital and asked what to do about me. They said call the Crisis Team, which she duly did, but 3 messages and an hour later, there was no response. I doubt I qualify to use them, even if they had time to answer the phone. She called the Out of Hours GP. He wanted me to go to A&E (seeing as being admitted to A&E is the only way to access ‘on-call’ mental health services at the hospital), but that wasn’t happening after last week’s experience. I’m not psychotic or likely to hurt anyone else, so I wouldn’t qualify as a psych emergency, and being treated like a waste of time isn’t going to make me feel better. Eventually the ENP gave up, but wouldn’t let me leave without someone with me, so I had to call a responsible-looking (and tall, tall is always reassuring in these situations) friend to duck out of work for half an hour to come in so they’d let me go.

This cannot be a unique problem. I can’t be the only person that wants to be able to get help before I take it too far and do something potentially fatal, rather than after. I’m trying to do the responsible thing and keep myself safe and it’s like hitting my head against a brick wall. CAMHS don’t provide an out of hours service, and whilst I’m with them I can’t use the CMHT one, so unless my crisis occurs 9-5 on a week day, I’m on my own.