Impact News

Responding to Violence, Suicide, Psychosis and Trauma

“Outsiders”

A new “fringe theatre style” workshop by Dr Iain Bourne using drama and narration to explore the world of personality disorders. Full details to follow – in the meantime send an email enquiry to Iain

The term “Personality Disorder” has infiltrated common parlance and is often used with great laxity in professional circles to refer to “bothersome people like that.” To do so, however, not only displays a lack of knowledge but is discriminatory and prejudicial. Even those with a more informed understanding of the concept often struggle to articulate the difference between personality disorder and mental illness.

A simple comparison may help. Many consider Obsessive-compulsive Personality Disorder (OCPD) to be a less serious form of Obsessive-Compulsive Disorder (OCD) – when in many ways they are polar opposites. People with OCPD tend to be unemotional and detached with a strong liking for order and precision in their life, are fussy, inflexible and strongly dislike change – and that is the way they prefer to be! People with OCD have a distinct mental illness with a clear neurological component in which their life, against their will, is overrun by unwanted and often distasteful intrusive thoughts and an inability to refrain from rituals and checking behaviour that they acknowledge as pointless and irrational. People with OCD are often very emotional, acutely aware of their disorder and desperate to change. Similar differences are seen in other conditions such as schizophrenia vs schizotypal personality disorder.

Actually when most people refer to “PD” they are not usually referring to OCPD but either Borderline Personality Disorder – a very real and distressing condition – or Antisocial Personality – a much vaguer condition that attempts to medicalise the criminal mind.

Both conditions are explored in “Outsiders” alongside other PDs to:

* Aid our understanding of the condition from the service user’s perspective
* Address our own biases and prejudices
* Feel more confident in challenging other professionals whose use of the term may be discriminatory
* Identify targeted strategies to assist service users in developing more fulfilled lives

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Violence in Social Work

Senior people in the Social Work and Social care comment on their own experiences of violence.

http://www.communitycare.co.uk/blogs/social-work-blog/2013/08/tackling-violence-against-social-care-staff-i-wish-there-was-a-simple-answer/?cmpid=NLC|SC|SCDDB-20130822

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Managing Dangerous Psychotic Behaviour – On YouTube

Iain Bourne discusses the principles underpinning Psychosis Containment Skills – or the interactive, face-face professional skills used in responding to immediately dangerous  psychotic behaviour. Features include the relationship between psychosis and violence; dysphoric vs reactive drivers; how to spot whether the psychosis is driving the behaviour; the differential role of hallucinations, delusions and paranoia; the involvement of persecutory and command auditory hallucinations; the psychotic vs non-psychotic world; changes in the sensory filtering system; personal space and catastrophic reactions.

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YouTube Video for “Facing Danger in the Helping Professions”

 

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Suicide Rates Rise in UK

According to the Office of National Statistics the suicide rate for men aged 45-59 in the UK is now the highest since 1986. Against a trend over the past two decades that has seen suicide rates gradually falling, suicide rates are now rising again for both men and women wih highest suicide rates being among men aged 30-44. According to stephen Platt at Edinburgh University disadvantages midlle aged men face a perfect storm of “unemployment, deprivation, social isolation, changing definitions of what it is to be a man, alcohol misuse, labour market and demographic changes that have had a dramatic effect on their work, relationships and very identity.” Next month the government will award research contracts worth £1.5m to develop new initiatives as part of a “refreshed” suicide prevention strategy.

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Bipolar disorder, creativity & writers

here is an interesting study from Sweden investigating the link between mental illness and creativity:

http://www.nhs.uk/news/2012/10October/Pages/the-price-of-genius%E2%80%93creativity-linked-to-mental-illness.aspx

 

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Razor’s Edge: Suicide & Self-harm Workshop in Nottingham

Nottingham HLG are putting on an open access workshop delivered by Dr Iain Bourne on 27th November 2012. For further information and booking details visit:

http://www.hlg.org.uk/training/quarterly-training-schedule

If you would like this course to be delivered in-house visit www.dangerousbehaviour.com or email impact@dangerousbehaviour.com

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Nepotistic patterns of violent psychopathy: evidence for adaptation?

I’ve seen a number of articles along similar lines of late. The argument seems to be that psychopaths rarely harm close family, while those with mental illnesses sometimes do. As a result, psychopathy could be seen as adaptive rather than disordered. On the other hand I have heard that in the US some judges are viewing psychopathy as a mitigating factor in sentencing. Strange, since most would hope that psychopaths, with full access to their faculties when they perpetrate atrocities should be locked up for longer?!

http://www.ncbi.nlm.nih.gov/pubmed/22973244?dopt=Citation

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Bullied children more likely to self-harm

Unsurprising, but with 25% of UK children reporting that they have been bullied, it does suggest that unless more is done to reduced bullying, the self-harm epidemic will continue to grow.

This is based on research by  Fisher HL, Moffitt TE, Houts RM et al. Bullying victimisation and risk of self harm in early adolescence: longitudinal cohort study. BMJ 2012; 344, and reported by the NHS.

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Suicide rate masked by coroners’ verdicts

By Martin Beckford, Health Correspondent
07 Oct 2011, Daily Telegraph (http://www.telegraph.co.uk/news/uknews/law-and-order/8811351/Suicide-rate-masked-by-coroners-verdicts.html)

Many more inquests are ending in “narrative verdicts” rather than a ruling that someone killed themselves, often because of caution over their intention.

But it is feared that this may mean up to 6 per cent of suicides being wrongly classified as accidents, which could be “masking the effects of the economic crisis on suicide”.

In an editorial published in the British Medical Journal, Prof David Gunnell at the University of Bristol and colleagues said: “This increased use of narrative verdicts has important effects on the estimation of national suicide rates because these verdicts present coding difficulties for the Office for National Statistics – when suicide intent is unclear such deaths are coded as accidents.”

Official figures show there were 4,648 suicides in England and Wales in 2009, based on the verdicts given by coroners after inquests into unexpected deaths.

But many hangings, overdoses and poisonings are being treated as possible accidents, with coroners ending inquests in narrative verdicts that give an account of how the death occurred in a few sentences.

The number of narrative verdicts has risen from just 111 in 2001 to 3,012 – more than one in 10 inquests – in 2009.

This is despite the fact that suicide is sometimes strongly implied in the verdict, with phrases used such as “deceased took his own life with an accidental overdose”, according to the BMJ study.

If all deaths from hanging and poisoning were classed as suicides rather than given narrative verdicts, the suicide rate would be 6 per cent higher.

This would account for almost a third of the National Suicide Prevention Strategy’s target of reducing suicides by 20 per cent.

But even this figure could be an underestimate because the ONS did not include all common methods of killing oneself.

The academics warn: “As the use of narrative verdicts rises, so too may the underestimation of suicide.

“The consequences of this could be incorrect rate estimates, misleading evaluations of national and local prevention activity, and masking of the effects of the current economic crisis on suicide.

“Furthermore, because coroners vary greatly in their use of narrative verdicts, suicide rates may (falsely) seem to decline in areas served by coroners who make most use of such verdicts.”

But Prof Louis Appleby, chairman of the Government’s National Suicide Prevention Strategy Advisory Group, insisted: “There is nothing new in finding that some probable suicides are omitted from official statistics because of doubts about the person’s intent.

“Coroners used to record verdicts of accident or misadventure in many such cases, now they may record a narrative verdict.

“There is no reason to doubt the fall in suicide in England in the last decade, though of course we should continue to examine how narrative verdicts are used.”

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