I was rereading A&E Charge Nurse’s comment about the justification of ‘medically’ treating certain mental health issues. I have not quite got my head around what I want to say. Hopefully I will at some point.
Anyway I came across this at the BBC web site.
Physical problems ‘often mental’
I do love the headline.
The true burden of mental ill health is unrecognised since many “physical” problems, like cancer and obesity, are really “mind” problems, say experts.
Got that.
It goes on.
Most lung cancers are caused by addiction to smoking, and some obesity by a brain-driven compulsion to eat, says UK psychiatrist Dr Peter Jones.
And to tackle such problems experts need to go back to delving the mind.
I can sort of see the point they are trying to make. The problem is that it is an incredibly stupid point. Why are these people trying to to make themselves look dafter than they have to in public?
He and other leading mental health experts are calling for a trebling of funding to £200m a year for research.
Ah. An Institute heavily involved in research thinks there should be more money invested in research.
Hmm.
Now I can see why someone dealing with cancer could well be feeling depressed. Makes sense to me. Surely the best way to treat this problem is to 1) Treat the causative agent and strongly as possible, 2) Offer support from people well versed in working with those with cancer. Both of which are being done extremely well.
Getting fat from eating too much is not a ‘mind’ problem (except in cases of hyperphagia and the like). The equation is pretty simple eat too much and avoid exercise and fatness and early death is likely to result. Also your personal relationships may potentially become a little disturbing.
There are plenty of good justifications for increased funding of actual mental health research. This is not one of them.
The article seems to be ignoring the fact that physical ailments often result directly from purposeful behaviour. Mental illness as a concept denies that purposeful behaviour is the reason for “mental symptoms”. The article clearly highlights the absurdity of mental illness as a concept. And it shows that power-hungry psychiatrists are keen to expand their field.
Meanwhile: “Mental illness … receives just 5% of total health research spending.”
*Just* 5% That figure is appalling. Not only are people forced to accept sub-standard healthcare from a monopoly provider, but they must also accept that money which could have gone into researching their [insert physical illness] has been instead given to psychiatrists. There are no good justifications for funding a field which systematically violates the human rights of people receiving its interventions.
Ted!
And what’s with the new site design anyway? I was just getting used to the previous one! I’m sure you have your reasons, but because I don’t know what they are I’ll assume you are insane.
Changed it since the old one was cutting the edge off the forums.
Ted,
You fail to understand the subtle difference between ‘mental ill health’ and ‘mental illness.’
As I’m sure you are aware, individuals can suffer ill physical health without being diagnosed with a specific ‘illness’. One can be unfortunate enough to suffer many symptoms, for example repeated sore throats or headaches, yet never be diagnosed with a specific ‘illness’.
This also applies in mental health. One can smoke or eat too much, thereby exhibiting problems that are related to the mind, however I don’t see any evidence in either the BBC article or MNs blog which relate these issues to a ‘mental illness’ in the sense that you are using the phrase.
So, grandoise as your statement which reads ‘ The article clearly highlights the absurdity of mental illness as a concept’ is, it is wrong. The article highlights nothing of the sort.
Also FYI, you should note that here in the UK, no-one is ‘forced to accept sub-standard healthcare from a monopoly provider’. Just like in the US, and other countries where people are forced to pay for their treatment (if indeed they can afford it), here in the UK we have private healthcare as well as public. So I guess you could say that patients here have MORE choice.
Finally, your comment about human rights is, at best, misjudged. You will be aware that human rights, as enshrined in both custom and legal documents, are very rarely non-derogable. Specifically, I will draw your attention to the right to life. This is probably the right that most people would consider should be absolute, but of course it is often violated in the name of self defence or defence of a country. In a lot of cases this violation is rightly used as a last resort to ensure protection of the innocent or to fight dangerous regimes.
Violations of human rights are not in themselves wrong. There is not a human rights document in common use today that does not allow for derogations. Human rights are designed to react to situations. Why should an individual whose thought processes have been severly affected by mental illness/ill mental health not be granted the right to get better when they can no longer get better by themselves?
It would be a violation not to intervene.
Not so fast, Posey.
“One can be unfortunate enough to suffer many symptoms … yet never be diagnosed with a specific ‘illness’.
Yes.
“This also applies in mental health.”
So what?
“One can smoke or eat too much, thereby exhibiting problems that are related to the mind.”
They are “related to the mind” in that people are not minding their weight, and so on.
“The article highlights nothing of the sort.”
I was offering my opinion.
The article shows that not only does mental illness negate the fact that people do things for reasons, but it also shows the concept can be expanded as far as you want.
“Also FYI, you should note that here in the UK, no-one is ‘forced to accept sub-standard healthcare from a monopoly provider’. Just like in the US, and other countries where people are forced to pay for their treatment (if indeed they can afford it), here in the UK we have private healthcare as well as public. So I guess you could say that patients here have MORE choice.”
This is very naive comment, and telling that you think I do not reside in the UK. I am well aware the UK has some private healthcare. What you fail to mention is that the government forces up costs via regulation and forces potential buyers to pay for the NHS whether or not they use it. So yes, I am forced to accept sub-standard healthcare from a monopoly provider.
“You will be aware that human rights, as enshrined in both custom and legal documents, are very rarely non-derogable”
You assume that I was referring to legal rights as defined by government. Says it all really. Your comment displays an ignorance of political philosophy and a happy assumption of the integrity of the concept of mental illness.
“It would be a violation not to intervene.”
Sadly, there are enough people on this site who will agree with you. The matter is a political one, and not a medical one.
Posey, you said human rights are not non-derogable and that it would be a violation not to intervene when someone is acting on notions that are a product of their mental illness. Is that intervention a non-derogable right? I would suggest that it is no more written in stone than any other human right, like the right not to be coerced into treatment you do not want.
‘Getting fat from eating too much is not a ‘mind’ problem (except in cases of hyperphagia and the like). The equation is pretty simple eat too much and avoid exercise and fatness and early death is likely to result. Also your personal relationships may potentially become a little disturbing.’
Wasn’t he referring to binge eating disorder.
And in light of recent debate…
‘Getting thin from eating too little is not a ‘mind’ problem’
I can think of many reasons why people may become overweight as a result of mental health problems.
Getting fat from eating too much in absence of something that limits ability to make meaningful choices is not a ‘mind disorder’.
On a related topic.
Overweight ‘should be protected’
Time to start picking on the Speccy Four Eyes as no doubt ginger people will be protected.
I prefer Myopic Person Of Equal Value. Thankyou.
There are, of course, there are things that limit the ability to make meaningful choices without being mind disorders, also.
‘speccy four eyes’ would be a tautology though, wouldn’t it?
as for gaining weight while being treated for a mental illness – one word: zyprexa.
“’speccy four eyes’ would be a tautology though, wouldn’t it?”
Certainly, yes.
“as for gaining weight while being treated for a mental illness – one word: zyprexa.”
Two words against weight gain: Hospital Food.
And those two words against weight gain highlight one ironic part of eating disorder treatment. They try to get me to eat food, try to get me to like the taste of food that I have ignored for so long, but then they feed me hospital food. Who thinks that is a good idea? Why aren’t they being slapped in the face? (Although, one of the therapists gave me a bit of slack, didn’t make me completely finish my plate, when my “pasta primavera” came with gray sauce. She didn’t talk about it to me or fuss about it. I said, “can I be done now?” with half my meal left, she said, “yes,” and made sure no one else noticed.)
Two words against weight gain: Hospital Food.
Except it doesn’t work. Most people I know inpatient and on Zyprexa end up gaining weight.
There’s a reason I don’t keep food in my flat.
“They try to get me to eat food, try to get me to like the taste of food that I have ignored for so long, but then they feed me hospital food. Who thinks that is a good idea?”
Accountants.
Accountants
Fill in the gaps with Complan and Build Up
Those accountants need a slap in the face, the staff needs to stand up for their patients, or the accountants and the staff need a slap in the face.
You don’t like the new design, Ted?
As for overeating and smoking being a mental health issue…A bunch of people with no cognitive impairment make a decision to eat Big Macs instead of salad, a decision that they’re well within the Mental Capacity Act definitions of competency to make. The MCA makes it clear that just because somebody makes an unwise decision doesn’t mean they’re not competent to make that decision. Otherwise we’d be declaring people mentally incompetent for reading the Daily Mail.
So where’s the mental health issue? I’m all for health promotion, but health promotion is not a branch of psychiatry.
@Rielouise
‘Getting thin from eating too little is not a ‘mind’ problem’
As with many of these things, it’s a matter of degree. If somebody’s under or overweight because of lifestyle issues, then I wouldn’t call it a psychiatric problem.
However, if someone experiencing deep psychological turmoil were to escalate into either anorexia or binge-eating disorder, then it comes within the realm of psychiatry. If we’re talking about anorexia, then as their BMI drops then their mental state will alter due to the psychological effects of starvation. Their mood goes through the floor, cognition slows down, thinking becomes more black-and-wite, and so on.
Facetious as you may mean it, your comment that “Otherwise we’d be declaring people mentally incompetent for reading the Daily Mail,” does raise a question: just how far do they intend us to take this? Mental illness as defined in diagnostic criteria and mental capacity as defined in things like the MCA are already slippery enough. Now they want us to try to distinguish “lazy”, “poorly thought-out”, and “just doesn’t care” from “mental ill health”?
True, the norm is not always indicative of good mental health, but this would be the tyranny of “good mental health”. I feel incredibly inarticulate about this, but this tyranny of “good mental health” scares me. I’m imagining a world where “good mental health” has been defined very narrowly as whatever most epitomizes good mental health in every situation, and anything less is called “mental ill health” and subject to treatment. There would be no allowance for “average mental health” or “values something higher than mental health in this situation.”
zarathustra,
“You don’t like the new design, Ted?”
I wasn’t sure at first, but now I’ve had a better look I concede I do not. Out of interest, did I miss a discussion of the isssue?
“The MCA makes it clear that just because somebody makes an unwise decision doesn’t mean they’re not competent to make that decision.”
The problem with using that argument is that it simply assumes one official definition of competency and rejects all others. In the more honest “good old days”, to be declared mad was to be declared legally incompetent. Today mental patients have “rights” and are allowed to vote while an inpatient. It is clear that legal competency is a difficult issue. But it remains just that.. a matter of law and not medicine.
In the more honest “good old days”, to be declared mad was to be declared legally incompetent. Today mental patients have “rights” and are allowed to vote while an inpatient. It is clear that legal competency is a difficult issue. But it remains just that.. a matter of law and not medicine.
In the UK if you’re sectioned under the mental health act you are not permitted to vote. (although tbh there doesn’t seem to be much they can do to stop you if you’re on the electoral role).
And how many people on psychiatric wards are sectioned under the MHA? Not many, because most patients know they can only leave when they are given permission. The idea of some people not being entitled to go about their business free from psychiatric coercion (whether helpful or otherwise) but at the same time being entitled to vote in elections which decide the rules for everyone is a *little bit* suspect.
“Out of interest, did I miss a discussion of the isssue?”
Nope.
“Out of interest, did I miss a discussion of the isssue?”
“Nope.”
Just curious!
That is Ok
Looking pretty inoffensive now.
On an unrelated topic anyone else watching Question Time tonight? I enjoy a good rant at the TV.
‘Otherwise we’d be declaring people mentally incompetent for reading the Daily Mail.’
I’m not sure that’s such a bad idea
I’m talking as a bulimic who can no longer purge b/c my teeth will fall out. I’m terrified at the way I am going to be treated. (if I gain weight).
I just noticed something else: Dr Peter Jones said ‘SOME obesity’ not ‘ALL obesity’.
Psych nurses hate fat people as much as everyone else does shocker!
surely it’s a scientific fact that mental processes are a result of physical processes ie. chemical reactions within cells? In that case everything has a physical basis firstly then a mental one. If a person is dead then they can’t even think about eating or smoking, let alone do it, so it’s a physical cause, but the physical state of the brain is being affected by some kind of feedback response ie. (somewhat simplified) someone is has some loss in their life so they eat lots of food to comfort themselves or they feel uncomfortable socially or wan’t to be accepted in certain circles so they drink or smoke…it begins as something physical, the need for acceptance, comfort etc. that is deeply chemically based in human physiology, it has a genetic and environmental basis which is all physical. To think of something beyond the physical (although the physical is far more complex than scientists will ever be able to examine due to human’s limited senses) is based in religious and supernatural ideas of something beyond the physical and I think anyone of intelligence will appreciate that everything is made of the same ‘thing’ (this thing is beyond out physical comprehension) and that it is this ‘thing’ acting in different ways that creates the illusion of the physical, mental etc.
Are you suggesting a rather extreme treatment option
Love the comment N-C.
there was a great programme on bbc 2 last night, Horizon, about conciousness, well worth watching if it’s on the i-player, ann odd coincidence after my post. The most disturbing finding was that one of the scientists could see that that the presenter was going to choose to push a left or right button 6 seconds before he was conciously aware of it himself. I remember reading about nuerons years ago and how groups of them ‘compete’ in a darwinian or ‘meme’ like sense and the one with the group firing the largest amount wins ie you see an apple and all the neurons for ’round’ fire and ‘fruit’ and ‘apple’ etc. so many different groupings, all competing until you are concious that it’s an apple. In psychosis I’m sure that it is these neurons getting somehow scrambled and giving off signals to you individual (whatever that is, and last night’s programme was a quest to find the ‘I’). It’s all chemical based, atom based, particle based and whatver lies beyond the particles scientists can currently detect (I’m sure they have names for smaller ones or waves or energies etc. but I don’t know them!)
One of my posts is missing. Does anyone know why?
It was this:
“Are you suggesting a rather extreme treatment option
Love the comment N-C.”
I wouldn’t mind that option.
Erm…dunno.
I can’t find it in the spam or moderation queues, and I certainly haven’t been deleting any comments.
Maybe it got eaten by the Internet Monster.
Internet monster, it must be. Only comments I have deleted recently have been piano selling spam. Yours would not have tripped any of the filters.
The equation is pretty simple eat too much and avoid exercise and fatness and early death is likely to result.
Fat=lazy is a stereotype. I’m not surprised to hear it, but I’m surprised to hear it from a nurse.
Many people:
Can’t afford halthy food.
Work long hours in sedentary jobs and have no spare time for excercise
Have physical disabilities which make excercise impossible
Have hypothroidism
Have Binge-Eating Disorder
Have Praeder-Willi Syndrome
Have Down’s Syndrome
Gain “post-baby” pounds
Gain weight due to the menopause
Gain weight due to medication side-effects
Gain weght due to depression (weight gain is on the DSM criteria)
Have physical and/or mental disabilities that make it impossible to cook and have to rely on unhealthy ready-meals
Are uneducated about nutrition and excercise
Live in built-up areas with no green space to excercise and can’t afford gym memberships
Are so embarrassed about their fatness that they avoid excercise BECAUSE they hate their fat so much
Ok – I wrote that comment without reading the comment thread. Having read more carefully, I can see you don’t mean fat=lazy.
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