I sincerely hope this offers a treatment option - anything is better than nothing - but I’m getting a serious flashback to the future about this one.

Things are settling down now (though growth in online networks is enormous), and I often wonder how t’internet could/will be used to enhance just about everything we do.

There are plenty of participatory self-help groups, there are even online counselling services. But what I’m highly interested in is how social networks might be used to effect change in policy or service provision.

In mental health, where current buzz words usually mean lots of theory - little reality, customer feedback, consumerism and stakeholder participation are more than familiar buzz words in the new-age of inclusive health care. I’ve been doodling in my head ever since the Bacon “I want great care” site drama and, not wanting to throw out babies with bathwater, thinking about such particpatory sites for patient feedback opportunities.

There are plenty of references to real-life social networking in mental health. Most of these refer to improving social functioning

In this new-age of the more participatory Web2.0 design - and the huge growth of online social network groups - what are the possible applications in utilising this as a valid source of consumer feedback?

A recent Foreign Office document “Engagement” [pdf] (pp121) reviews the application of participatory internet utilities:

A second generation of internet-based software, sometimes known as ‘Web 2.0’, has the potential to change fundamentally how foreign ministries manage knowledge and communicate with more connected, yet more diverse and fragmented, domestic and global publics. Web 2.0 applications – online collaborative working (‘wikis’), web logs (‘blogs’), and social networking sites such as Facebook, YouTube and Second Life – can reinforce existing relationships and build new ones by educating and mobilising citizens, and encouraging the co-creation of policy.

It further recognises:

The popular Second Life (with 13.5 million ‘residents’ in May 2008) is a virtual world containing digitally mediated ‘third spaces’ similar to real-life pubs, community centres and clubs where people can socialise, create and trade.¹⁰ Anecdotal evidence suggests that social networking sites may allow individuals (for example, women in closed societies) to use the anonymity of the web to communicate ideas and perspectives across traditional boundaries. What these developments portend is a growing global membership of online communities (especially as the costs in time and effort of joining decline), and a gradual increase in the extent to which people integrate their online activity into the rest of their lives, with online activity providing a direct stimulus for real-world decision-making and action.

So, and cutting to the chase - because I keep losing links and then the whole post disappeared….

Can mental health services not engage this modality of feedback?

Is it possible in this new-age of participatory online social networking to capture the opportunity and genuinely seek to learn from the patient just how it is, and how it could be better?

Within the commentary of this discourse, I believe it was firmly and established that this offer of…

I will bet you all a virtual pint that more than 75% of newly qualified nurses are under 25.

…was irrefutably and evidentially proven to be in err by Gallowgate and seconded by Zarathustra with this:

Gallowgate said…

According to the now defunct NMAS (Nursing and Midwifery Admissions Service) website: In 2007, 15226 of accepted applicants were 25 and under and 10260 were 26 and over.

It matters not a jot. Doctors, nurses, all ages, all shafted.
Do I win the virtual pint?

Thursday, April 24, 2008 10:44:00 PM

Zarathustra said…

So, by my maths that’s 59.7% who were 25 or under, well short of Dr C’s 75% claimed (and that’s 25 or under when they’re accepted for training, not when they qualify as nurses). I think gallowgate deserves the virtual pint.

Though this bit…

It matters not a jot. Doctors, nurses, all ages, all shafted.

…is sadly true.

Thursday, April 24, 2008 11:08:00 PM

However, despite this being proven, and the substantiated claims being laid to Doc C in order we might have our pint - he has thus far failed to deliver.

What a mendacious reneging welching bastard (..err.. of a suggestion).

A Mental Production

All seems to be just how I remember it.

I wanted to share it even further and decided to post the link here as well.

Who would have guessed that when you remove Garfield from the Garfield comic strips, the result is an even better comic about schizophrenia, bipolar disorder, and the empty desperation of modern life? Friends, meet Jon Arbuckle. Let’s laugh and learn with him on a journey deep into the tortured mind of an isolated young everyman as he fights a losing battle against loneliness in a quiet American suburb

Garfield is one of my favourite cartoon strips and I find this idea fascinating. It works so well, it’s often very moving.

Garfield Minus Garfield

When our self confessed troll announced the death of the good doctor I found the emotive reaction of some readers strange as though the good doctor was known to them personally and the announcement of his death an attack on them. But as the troll himself explained,

To anyone pointing out what a callous bastard I am, please remember this is the internet, we are not talking about real people - I have not hurt Dr.Crippen’s friends and family because they do not know who he (or she) is. All I have (hopefully) done is pissed off a bunch of people who take the web way too seriously

Some, Devils Kitchen and Wat Tyler claim know Dr Crippen in reality, but I only know them through the blogs they write so I don’t know them either and I find the idea of one blog knowing and having some sort of a realtionship with another blog strange. Perhaps Wat, the Devil and Dr C are one and the same. A holy trinity of the blog world perhaps?

Viewing Dr Crippen as Gods anointed may explain the reaction of some to his untimely demise. My point is this. Dr Crippen is NHS blog doctor and NHS blog doctor only exists, in as far as anything can be said to exist on the web, as an idea. I can no more morn for the death of Dr Crippen than I can mourn for the death of an ideal like justice or freedom or for someone who only really existed in the public imagination as an ideal, like Lady Diana.

So to those who morn the passing of Dr Crippen, get over it, it was only a blog and there are plenty more out there that are just as good to read. This one for instance

Dr Crippen is dead, long live Dr Crippen.

Bipolar blogger Seaneen is still struggling to get benefits.

Basically, because of a ridiculous benefit system, I’m screwed. After I pay my council tax today, I have less than £200. But if I don’t use that £200 to get home for Christmas, then I’m going to be spending Christmas day here. By then, I’ll be so broke I won’t have electricity. It’s great.

You can see why I am consistently forced into jobs I’m too unwell to do. The alternative is having nothing to live on. All I ask is for some help from the system I have paid my taxes into. Sometimes I honestly want to give up and move back to Belfast. But I can’t even afford the flights.

The Shrink is trying to work out which professions he needs more of in his team.

Within each CMHT at the moment we’ve got 1.8 to 3 qualified nurses (all at band 6 or band 7 with many having CBT and non-medical prescribing training), 1 Support Time Recovery worker, 1 social worker, 0.5 occupational therapist, 0.2 OT technical instructor and 1 Consultant Psychiatrist (potentially with some Staff Grade and ST1 junior doctor support but in practice they’re supranumerary and there just for training). One team has 0.2 of a pharmacist. We’ve access to a Nurse Consultant and to psychology who work more widely than just with the CMHTs. We’ve sessional input from a physiotherapist. We’ve service level agreements for dietetic and Speech Therapy input.

As activity rises and we’ve extra cash to invest in the community, what should we invest in?

I feel slightly for the 0.2 of a pharmacist. Fancy being sliced into five pieces, eh?

Maple Leaf Medic is finding child psychiatry stressful.

Seven year olds who run in front of cars because they want to join their dead sibling. Sixteen year olds on their fourth admission for psychosis, with who knows what life ahead of them. Parental neglect. Parental abuse. Every thing you could think of, it happens. It breaks my heart to hear it.

Bipolar Mo is finding that the stigma of mental illness is making him feel a tad misanthropic.

I really hate coming into contact with the human race nowadays. I am more than happy sitting at home, cooking for the missus, farting about on the internet and generally living the life of Reilly. This is where I am happy. Of course, you may be thinking, he could get CBT, or go for assertivness training to help him deal with these situations. But why? Why on earth would I want to go and put up with these twats if I don’t have to? It’s a bit like saying “through hypnotism and meditation we can help you endure ECT without an anaesthetic”… why would I want to?

On a more cheerful note, The Wife of a Schizophrenic is celebrating her 10th wedding anniversary.

Probably the thing I love most about Mr Man is the fact that he loves me, despite all my flaws and weaknesses. I’m still amazed by that fact every day, as he knows my flaws more than anyone else. Ten years on and he still tells me that he loves me every day. He still tells me that I’m special, beautiful, and how lucky he is to have me. He proves that he means it by the way he treats me. How could I not feel drawn to a man like that?

To nominate a blog for This Week in Mentalists, send the link to zarathustra at mentalnurse dot org dot uk

Doctors exist in a revered social class of their own: that of the caregiver. In society, there has always been the healer, the “Medicine Man”, the person with the funny beard or the squinty eye that lives in a bush and swear that dog poo is nutritious.

Nurses throughout history have comprised of doctor’s assistants, the ones who hold the scapels, mop the brow and take care of the emotional needs of patients. However, nowadays the nurse is far more than a doctor’s assistant and responsible for many things; overseeing wards, patient care, the general Making Sure Things Work in the medical world.

From the ward to the ambulances to the GP’s office, we hold in the medical world in the highest esteem. These people are responsible for keeping us alive.

So it’s pretty awe-inspiring when they do Their Thing. It can be hard sitting in the GP’s office staring into the face of someone who knows what you’re going to say before you say it. (Sniffling, coughing, they’ve seen it all a million times). Without meaning to (and sometimes meaning to), they can be patronising. It is nervewracking to make the case of Why You’re Sick, scarier still to be unwell and find yourself in the care of others who seem to know everything when you feel in the dark.

So, in the first instance of what makes a good medical blog, I nominate Being Human.

From the perception of doctors as all knowing and infallible, to the perception of patients as nameless and faceless, there is nothing more refreshing and, dare I say it, comforting, than realising that there is a human being behind the name tag and a personal history behind the number on the chart. This is why I admire doctors, nurses, ambulance staff, patients and everyone else in the Medical Blog World who shy away from being just another cold collection of links to articles. Mental Medic is a good blog for this reason.

By the same token, honesty makes for a good blog. Honesty not only about your opinions and perceptions, but also about your frailities. For example, Mark Myer’s Neenaw blog could, if written in that dispassionate tone of many blogs out there, make him look like a blood-mopping, handset-barking, high-speeding casanova.

We’re all agreed he’s pretty dishy, but, given the hyped-up stories that portray ambulances drivers as having the attitude of taxi drivers (”We’re just turning your corner now, love”, they say, while smoking a fag back at the depot), he is honest not only about the shortcomings of the ambulance services (mostly due to bureaucracy) but also about his own fears, frustrations and shocks in his jobs that give a three dimensional and fascinating insight into his work.

Passion and enthuasiasm will also keep me hooked to the RSS feed. Many people in the medical profession will profess to sometimes hate their job and have crap days like anyone else. But what I love to read is that, despite that, they honestly care about what they’re doing. For this, I raise my glass to our very own Mental Nurse. This blog is full of righteous anger and frustration but the authors seem to geniunely care about what they’re doing. And, as a patient, that gives me hope in what is an inperfect system.

This also goes for patient and carer blogs. My favourite carer blog is the Wife of a Schizophrenic Blog. She is a passionate writer, and an also a passionate advocate of better mental health services. She never veers into self pity (something I am terribly guilty of) in what can be difficult circumstances. I have also learned more about schizophrenia from her than I have reading various mental health sites.

This brings me to my last point: great blogs are always informative and challenging. There is a ton of received opinion out there about the medical profession but moreso, if you want to name a stereotype about people with mental illness, well, pick your favourite.

I love blogs that challenge the stereotypes of people with mental illness. From being geniuses in waiting to being burdens to society, the stereotypes and clichés are rife and go from one extreme to another. People with bipolar disorder (like myself!) are variously perceived as minor eccentrics with the odd mild mood swing to violent psychotics who’d kill you as soon as look at you.

Someone who challenges both these perceptions is BBC Ouch! columnist, Liz Main, who writes a funny, honest and caustic column about her experiences with bipolar disorder and also her opinions on the culture of mental illness and media.

She fits the informative criteria too. Informative blogs aren’t just blogs that tell you about the latest treatment and “helpfully” provide a list of links to stuff with little explaination. They are blogs that tell you about things you didn’t know and probably wouldn’t have found out otherwise.

I had previously thought that psychiatrists got their job by being appointed by God, but from Trick Cycling for Beginner’s blog, I found out the whole sorry process for junior psychiatrists which gave me a whole new respect for the profession.

And! last not but least for being informative, the indispensible Furious Seasons.

Anyway, that’s it from me. Go forth and blog!

According to the website, it has been hugely succesful over the last 14 years.

 Everything I have written has come from the WFMH.

This years theme is Mental Health in a Changing World: The Impact of Culture and Diversity 

The 2007 document claims that there are more people living outside of their country of origin, than at any other time in history. The current number is 3%.

I shall let you read the rest yourself, rather than continue quoting from the website.

I have only been active in of Mental Health services for a few years now, previously having little knowledge of Mental Health problems/challenges/suffering/experiences.

I have only heard about Mental Health Day on the internet or seen a few small snippets in the press. I have seen and heard of nothing in the wards  I have worked on, or at my University.

I wondered if anyone who visits this site has any more information (other than that on the WFMH website), or any suggestions of what I, or anyone else could or should do with regards to Mental Health Day?

 I would also like to hear any opinions or stories relating to it. Do you think it makes any difference?

“I’m More Bipolar Than You”

I managed to get myself into a fight on my Livejournal last night, which started with my saying I didn’t like wearing my sleeves up (obvious reasons) and ended with abuse being thrown at me, variously calling me a slut and a prostitute and saying I wasn’t bipolar- you can look for yourself if you’re interested.

Go read it. Go read it now.

Been there ? Jolly good.

This post is not about SecretLife’s scrap, just inspired by it and then gone off on a tangent.

I am sure this kind of thing has been covered on Mental Nurse before, a long time ago; a shiny farthing to anyone that finds it ¹.

[Found it We’re All Mad I Tell You. Mad !]

We quite often hear that people with mental health problems can best be helped by those that have also had problems.

Client: Why should I listen to you? You have never been schizophrenic / bipolar / abused / anorexic.

We will ignore the stupidity of that. It has often been mentioned on the site that many mental health nurses become so because of these very reasons.

There are a few less obvious undercurrents to the above kind of statement:

1. That there is some kind of magic insight gained by being mentally ill. That this magic can be used to aid others.
2. That there is a wonderful loving community of service users all willing to help one another because of their shared experiences.

Point 1: I am tempting to just dismiss with some kind of Mo zenlike witticism. Sadly though I am not Mo.

Weak on a few fronts. One things drummed into us as nurses, at the insistence of mental health organisations etc, is that each persons experience of mental health problems is very individual. Given 50 people with a diagnosis of manic depression the only common experience they are likely to share between all of them is being told by some medical type person that they have manic depression. Lifestyles, personality, environment all of these things will make the effects different for each.

There are support groups and organisations where groups of people can get together, share common experiences and help one another. These by all accounts are excellent.

But. If I develop a nasty case of classic Paranoid Schizophrenia in later life I do not think another Paranoid Schizophrenic is likely to be able to help me simply by virtue of diagnosis. I would much rather be assisted by someone who had a broad range of experience working with lots of different people in my situation. Was able to bring this experience to bear on myself and tailor it just for me.

If they were to say:

I am a paranoid schizophrenic. Some of my advice helped me but your mileage may vary

That would just be an added bonus.

Point 2: Another statement that needs Mo.

I was told by … someone. years ago, that there was some research about attitudes to mental illness. This research stated that one of the groups with the worst attitudes about others with mental health problems were people with mental health problems themselves. I have yet to actually find a reference. I thought I had posted the following conversations before but I do not seem to be able to find it:

Setting: Three anorexic patient leaning up against the radiator. Chatting away.

Three Patients: chatter chatter chatter

*Another anorexic patient walks past*

Three Patients: *give evil eye*

One Of Them: Fat cow !

Patients, being individuals, are just like everyone else. All nurses do not like one another, all doctors do no like one another (apart from Dr Crippen who is loved by all and is filled with love) and some patients, irrespective of patientness, are just downright unpleasant people.

In my time I have had to deal with clients telling other clients they should ‘go away’ and take an overdose, getting into fights over relationships, coming into hospital so they could have an affair (from their own lips), slag one another off in the lounge, wind others up to watch them get IM’ed and more.

Sadly, as most of us know, just because someone shares a diagnosis does not mean they will be any more positively disposed to another with the same diagnosis.

Do not get me started on their families …

Must go and do washing up.

¹ Would just like to point out I have no farthing. Shiny or otherwise.

Rules are as follows.

1. If, and only if, you get tagged, write a post with links to 5 blogs that make you think,
2. Link to this post so that people can easily find the exact origin of the meme,
3. Optional: Proudly display the ‘Thinking Blogger Award’ with a link to the post that you wrote (here is an alternative silver version if gold doesn’t fit your blog).

My first is The Wife Of A Schizophrenic. A wonderful blog and one of the few I read regularly. Always thought provoking and has given me new perspectives on they way I work.

Next is DominoCat Panics. Who in her own words:

dominocat is 35ish, and lives with a husband, three cats, agoraphobia and panic attack disorder. dominocat contains traces of nuts

Next Creating Tomorrow’s Unemployed Nurses Today.

Next Pole to Polar: The Secret Life Of A Manic Depressive.

I will leave the last one for Zarathustra, OldSchoolBaby or Flowergirl.

All the blogs above are far better than my posts here and are well deserving of a ego boosting meme award.

A Guide to Being A Mentally Interesting Girl Navigating the Labyrinth of the NHS Mental Health Services.

[Image Deleted - server load too high - Mental]

I am a mental health nurse. I am a graduate of the Project 2000 brand of claptrap which apparently makes me useless at anything practical but very good at filling in paperwork.

Mental Nurse is currently on holiday. A long holiday. A very long one. Actually I have given up active involvement with the site and now only provide technical support.

[Why Blog ?]

There are hundreds of blogs dealing with mental health issues. Hundreds of blogs by people that have experienced mental health problems, blogs by people that care for them, many by doctors and psychiatrists. None by nurses. Also I had a domain name and wanted to use up the last month or two. Turned out the time wasting project became quite popular.

The prime purpose of Mental Nurse is to have a place on the Internet where mental health nurses, and students, can get together, have a laugh, let off steam and sometimes discuss something to do with psychiatric nursing. Though the last tends to be frowned upon as it reminds us of work It has also developed into a wonderful place for informal dialogue between patients and staff. If it has any other porpoises I am very happy.

[Are You Not Just A Moaning Ninny ?]

According to the Nursing Standard, yes.

[Is It All True ?]

Not in detail. All the stories are true in spirit. Opinions expressed may not be mine. Post by others are entirely their own responsibility. Things may even just be made up at times.

[Copyright ?]

All my stuff is under this license.
This work is licensed under a Creative Commons License.

For anything else please contact the author of the piece.

[Disclaimer ?]

Anything I can deny responsibility for I do.

[Submissions ?] (This section no longer updated. Replaced by The Team Page)

If you are a mental health nurse worker, of any description, and feel you have something you want to contribute to the world via the Internet just leave a comment. If we think the site is right I’ll set up an account that will be able to post new entries. Just leave a comment with some details.

Currently there are six regular and semi-regular contributors.

• Mental Nurse: That’s me. Here is what I am like. I have stepped down from active involvement in the site.
• Flowergirl: Flowergirl is busy currently. I imagine she reads this.
• Malcolmroff: Our resident intellectual. Here is what he is like.
• Oldschoolbaby: Our voice of the common man person Here is what he is like.
• Zarathustra: A nurse working in Child and Adolescent Mental Health Services (CAMHS). Here is what he is like.
• Azulinebloo: A newly qualified nurse working in an acute psychiatric ward, trying hard to stay out of the office. She also happens to be A Girl, which results in lots of embarrassed sniggering, awkward shuffling and generally wondering if she’d be interested in our World of Warcraft collection. Anyway, she is like this.
• Beakie: Formerly a deputy manager on an acute ward, now a nursing lecturer at Too Posh to Wash University. This is him.
• Mr Ian: A nurse working in secure forensic services. For the time being he has deserted this green and pleasant land for Australia, where he lounges on a beach eyeing the bikinis and sipping on an ice-cold glas of Milo. For the record, he is like this.
• EBPhobe: A recently-qualified RMN on an adult psychiatric ward. He is like this.

I am sure they may use the comments to describe themselves further.

[Contact ?]

All authors listed above can be reached at username [at] mentalnurse [dot] org [dot] [uk]. Some of us are technically deficient and it may take some time to get to your email. Everything will be read though.

Many others have contributed to the site in many ways and it is this that help me keep the site running. Thank you to all the commenters and lurkers and other blogs that have linked to us.

If you have any other questions please read the FAQ, soon also to be updated and turned into a post.

Expect to see it tomorrow April the 11th. My impression is that we will actually be in print !

The will be using an extract from Zarathustra’s post.

Food Inglorious Food

They offered a small payment. I have suggested they sponsor Helen.

Must go warn the hosting company.

Mental

You have no idea how much I am struggling to write this letter. I want to write to you about the issue of cut backs in mental health services in our area, but it’s very difficult to find the words to express how I feel. However, I feel compelled to at least try, after someone recently said to me: “You might only be one voice saying what needs to be said but there are lots of people in the community that share the same problems that may not be able to speak out.”

Read the rest here. Please leave comments expressing your great Love for Mr Mans Wife and keep your fingers crossed for a positive response.