Impact News

Responding to Violence, Suicide, Psychosis and Trauma

Difficult, Disturbing & Dangerous Behaviour – London, 15th September 2017

Places are still available on this unique and explosive “fringe theatre” style training workshop. Mosaic Training are hosting it as a “Special Event” and making it available for individual applicants to apply. The cost is only £89.95 and you can find all the details HERE

Filed under: Impact Training, Other Mental Health, Uncategorized, Violence, , , , , ,

Dangerous Behaviour: Open Workshop – West Midlands, 20.03.2017

As I’ve said before, it is very difficult for individual participants to access this kind of training as it is almost exclusively delivered “in-house” to closed groups. Thankfully Mosaic Training & Consultancy are staging the dramatic “Fringe Theatre” style “Difficult, Disturbing and Dangerous Behaviour” workshop in Alvechurch next March and making places available for the remarkably cheap price of £89.95 pp. You can find the details HERE

Places may be at a premium so do book early to avoid disappoinment…

Filed under: Impact Training, Other Mental Health, Uncategorized, Violence, , , , , , , , , , ,

Dangerous Behaviour Workshop: London, 24th October 2016

Mosaic Training are again staging an open access opportunity for individuals to attend the “Difficult, Disturbing and Dangerous Behaviour” workshop in London on 24th October 2016. This workshop is almost always delivered to closed groups on an in-house basis – so this will be the only opportunity to experience this “Fringe Theatre” style training event this year. Roll up!

For further information click HERE

Filed under: Impact Training, Other Mental Health, Uncategorized, Violence, , , , , , , , , , ,

Dangerous Behaviour: Open Programme Workshop, London, 25.04.15

Due to the cutbacks it has become near impossible for individual applicants to attend the “Difficult, Disturbing & Dangerous Behaviour” workshop which is now almost exclusively an “in-house” bespoke programme. None-the-less, Mosaic Training are hosting an open course in London on 25th April. As this may be the only opportunity this year and you are interested, you should act quickly. The workshop costs only £89.95 and details can be found here

Filed under: Impact Training, Other Mental Health, psychosis, self-harm, Suicide, trauma, Violence, , , , , , ,

Suicide – a casual affair?

ken070912.001.003.FAIRFAX.melb.s/age news  CRYING.photograph by ken irwin  shows  generic single eye crying SPECIAL 111

ken070912.001.003.FAIRFAX.melb.s/age news CRYING.photograph by ken irwin shows generic single eye crying SPECIAL 111

Some while ago I was delivering a training course on “dangerous behaviour” to a housing association when a man popped his head around the door and enquired as to whether this was the “Ladder Awareness Training.” I have to confess, to my shame, I could not prevent myself from bursting out into laughter. Could there really be such a thing as a workshop for grown ups on how to use a ladder? Yet I was the one being silly – an organisation should discharge its responsibility to ensure the safety of its staff and the public.

Now compare this to what we do about suicide. Suicide is the most common cause of death in men under the age of 35 (Five Years On, Department Of Health, 2005) and it’s estimated that around one million people will die by suicide worldwide each year – a lot more than die falling off a ladder! Incredibly, many mental health professionals receive NO training in understanding, assessing and responding to suicidal behaviour. I recently reviewed a M.Sc Forensic Psychology course and, even though the suicide rate in prison is reckoned to be 12 times that of the general public, suicide did not feature at all on the syllabus.

Often friends and family have to wait for a loved one to make an attempt on their life before they get any help – the silver lining should be that at last they will be in the safe and competent hands of the professionals. Except they are not. Acute mental health units often do little more than observe, restrict and medicate – they do not even effectively assess risk even though that is one of their primary roles.

A woman, following a suicide attempt, is admitted to hospital on a Section 2 of the Mental Health Act. A nurse asks some questions to help ascertain whether she really wished to die (she does). During her time in the acute mental health unit no further formal assessment of suicide risk is made and as she declines medication no treatment is offered. Her suicide attempt is viewed as a response to “situational stress” and yet no-one investigates whether her situation was getting better or worse while in hospital (it was getting a whole lot worse). None-the-less, the psychiatrist says she looked happier and told him she wouldn’t hurt herself (an unexplained improvement is an indicator of acute suicide risk and 50% of in-patients dissemble prior to taking their lives) – so takes he her off the Section and allows her leave. She doesn’t return on time and eventually she is found by a helicopter rescue team by a railway track. Still there is no re-assessment of suicide risk and she is allowed to continue taking leave from the ward – despite the the fact that best predictor of future behaviour is past behaviour and it is well-known that suicide risk varies enormously over time. She starts making a list of her possessions (putting things in order?) and tells friends and family not to visit (another indicator of suicide risk), but does check that they are coping with her dog. Prior to the current crisis she had always said that the one reason she would never kill herself was her dog – and yet during her whole time on the ward she never once asked to see him (the primary protective factor). The following day she had an important appointment and yet 15 minutes before she was allowed to leave the ward – no-one asked why. She failed to return on time and only did so after frantic calls from her mother. Still there was no re-appraisal of the situation. Later that evening she again asked to leave the ward and was again allowed to do so. This time she didn’t return …

The point is that less training and less skill was applied to keeping this woman alive than was offered to the man hoping to use his ladder. Why?

You might also be interested to read this Poor mental care blamed as mother burns herself to death. Whatever this is about its not lack of resources.

Filed under: Other Mental Health, self-harm, Suicide, Uncategorized, , , ,

Skills in Managing Dangerous Psychotic Behaviour – Part Two

The second part to my YouTube discussion of Psychosis Containment Skills is now available at

Enjoy!

Iain

Filed under: Other Mental Health, psychosis, Violence, , , , , , , , , , , , , , , ,

Professor helps train mental-health workers in Iraq

July 04, 2009

Victims of traumatic events sometimes get so hung up thinking about what happened to them that they can’t let go of their torment.

Rigid, “black-and-white kinds of thoughts” play over and over in their minds and keep them from moving forward in life, says University of Richmond researcher Kristen P. Lindgren.

“Those kinds of thoughts can keep people stuck in their lives,” she said.

A licensed clinical psychologist, Lindgren has studied a technique called cognitive processing therapy that helps people escape those thoughts.

She worked at the Department of Veterans Affairs hospital in Seattle with veterans of wars from Vietnam to Iraq. They suffer from post-traumatic stress disorder and depression, and Lindgren says the therapy was so helpful that the VA plans to use it as a treatment model nationally.

And now, it might also help victims of torture in Iraq.

Lindgren, an assistant professor of psychology at UR for the past year, recently spent eight intensive days training mental-health workers in the Kurdish region of Iraq.

Their goal is to help victims of the violence waged against the people of Kurdistan during the 1980s and 1990s.

It was the most attentive class she has ever had, Lindgren said. The workers, primarily physician assistants at community clinics who have limited opportunities for advanced training, were eager to learn new techniques.

“I’ve never had a group of students who were so focused and literally writing down every word,” she said.

Lindgren describes herself as “very much the junior partner” on the pilot project organized by Johns Hopkins University. The team included Johns Hopkins researchers Paul Bolton and Judith K. Bass, as well as Debra Kaysen, Lindgren’s mentor when she did postdoctoral studies at the University of Washington.

Lindgren hopes that if the mental-health workers find that the technique helps their patients, she can return to Iraq within the year to expand the training.

The therapy technique encourages people to identify thoughts that are stuck in their minds and to challenge that way of thinking, she said.

The patients learn to come up with thoughts that are more flexible but believable.

“It’s not about thinking with rosecolored glasses,” she said.

Lindgren is optimistic the treatment will help the Kurds. In Iraq, the technique had to be adapted to account for cultural differences. Self-esteem, for example, didn’t translate very well. “The closest we could get was respect,” Lindgren said.

They also had to account for illiteracy because the technique involves written homework for patients.

If the therapy with those adaptations proves successful in Iraq, that should help answer lingering questions about its worth back home, she said. Because the technique is research-based and developed in university settings, some still question how well the therapy works in the real world, she said.

“If this is not the real world, I don’t know what is in terms of getting outside the ivory tower.”

——

Contact Karin Kapsidelis at (804) 649-6119 or kkapsidelis@timesdispatch.com. To see more of the Richmond Times-Dispatch, or to subscribe to the newspaper, go to http://www.timesdispatch.com. Copyright (c) 2009, Richmond Times-Dispatch, Va. Distributed by McClatchy-Tribune Information Services. For reprints, email tmsreprints@permissionsgroup.com, call 800-374-7985 or 847-635-6550, send a fax to 847-635-6968, or write to The Permissions Group Inc., 1247 Milwaukee Ave., Suite 303, Glenview, IL 60025, USA.

Filed under: Other Mental Health, trauma, , , , ,

Black & Minority Ethnic Groups: Concern over mental health training in public sector

Educating police and teachers on early signs of mental illness could be catastrophic for black and minority groups, say critics

A mental health group has criticised a report recommending police, teachers and other public sector workers should be trained to spot early signs of mental illness, saying it could marginalise those of black and minority ethnic backgrounds.

Black Mental Health UK (BMHUK) has accused the report’s authors, which includes a group of prominent mental health charities, the Royal College of Psychiatrists and the Association of Directors of Children’s Services, of ignoring black and minority ethnic (BME) communities’ views on the possible fallout of their proposal.

The group claims that, if implemented, the recommendation could increase the chances of people from black and minority ethnic backgrounds being misdiagnosed by amateurs with no professional mental health credentials and lead to further stigmatisation. People from black African-Caribbean backgrounds are more likely to enter the mental health system through the criminal justice system than any other group, and campaigners are worried that encouraging police officers to try to “spot” signs of mental distress could exacerbate the problem.

“There are grave concerns over the suggestion that the police or teachers should be trained in spotting signs of mental ill health,” said Matilda MacAttram, of BMHUK. “Currently black men are six times more likely to be stopped and searched than their white counterparts, as such it is unwise to suggest that the police should be responsible for spotting signs of mental ill health. It could lead to catastrophic results.”

The Future Vision Coalition, the umbrella group behind the report, risks losing credibility if potentially negative fallout of such a policy is not fully assessed, claimed MacAttram. The “labelling” or stigmatising of young people is a particular area of concern. “There is a real danger that cultural norms could be misconstrued, which could have disastrous consequences for a child’s educational career,” she added.

Steve Shrubb, the coalition’s chair, insisted that, far from being damaging to people from BME backgrounds, the proposed training would directly benefit marginalised and “diverse” groups. He said the number of organisations involved with the coalition had doubled since it first started and that many of these represented the views “of a range of vulnerable” groups.

“What we are saying is that mental health awareness training should be included in induction programmes for public sector workers.” he said. “People who work in public services often come into contact with people with mental health difficulties, and we are saying that helping them to identify how to direct someone to the assistance they need is very worthwhile.”

The police and teachers are “a special case”, Shrubb suggested, and should be provided with extra mental health training. “This is not about creating amateur psychiatrists. In our report we talk about how we can improve services for lots of vulnerable groups and BME [individuals] are one of those groups,” he said.

The aim, Shrubb said, was to improve services from local authority housing departments to jobcentre plus, as well as from teachers and the police. The views of BME groups had been put forward in discussions, he added.

As well as mental health awareness training, the report – A Future for Mental Health – makes a number of recommendations including the appointment of a “champion” for mental health issues in government at Cabinet level, and the widening of access to “talking therapies” beyond working age adults to children and older people.

Angela Greatley, chief executive of coalition member the Sainsbury Centre for Mental Health, said too little was being done to promote good mental health in schools, workplaces and communities and that the 10-year agenda laid out in today’s report would contribute to “better life chances” for a wider range of people.

According to MacAttram, the views of BME campaigners were not adequately canvassed before the report. “This could have done with input from black groups who could speak out on behalf of those who will be directly affected by these suggestions,” she said.

Filed under: Other Mental Health, , ,

Trust ‘sorry’ for murders by patients in its care

• Reports criticise Humber mental health trust for failure of care
• Mother of five and elderly woman died in separate incidents

* Sam Jones
* guardian.co.uk, Wednesday 6 May 2009 00.30 BST

A mental health trust has apologised to the family of a pregnant woman who was killed by a paranoid schizophrenic man, and to the relatives of an 82-year-old woman who died at the hands of her mentally ill son.

New reports into both cases have criticised Humber mental health teaching NHS trust for failing to provide better care for the two men.

Tina Stevenson, a 31-year-old mother of five, was on her way home from an ante-natal class in Hull on 5 January 2005 when she passed Benjamin Holiday. The 25-year-old man, who had missed his medication the day before, stabbed Stevenson in the back. Neither she nor her unborn twin boys could be saved.

Holiday admitted manslaughter during his trial in May 2006 and was ordered to be detained indefinitely at a secure mental hospital.

An independent report into his care and treatment published by NHS Yorkshire and Humber concluded he had been “under-treated” by the trust.

Holiday, who had been suffering mental health problems since 2001, spent a fortnight in a secure unit in 2004 but was later discharged and treated in the community. The report admitted that Holiday, whom it referred to as “B”, was a difficult patient to engage with and was skilled at masking his symptoms.

It concluded: “The root cause contributing to B’s continuing severe mental disorder was that of ‘under treatment’. B’s situation and condition could and should have been more assertively managed.”

The chief executive of the Humber trust, David Snowden, apologised to those affected by the case and promised lessons would be learnt. He said his trust “fully accepted the recommendations, which we are taking very seriously”.

The trust also apologised to the family of Ivy Torrie, 82, who was killed by her mentally ill son, Michael, in Pocklington, East Yorkshire, in 2003.

A separate report attributed Michael Torrie’s actions to the “rapid reduction of medication and the way this was managed in the absence of a risk assessment”.

Marjorie Wallace, chief executive of the mental health charity Sane, said that although such events were rare, they did not “come out of the blue”.

“It is not an expensive revolution in care we need but common sense,” she said. “You do not leave an 82-year-old mother alone to care for her mentally ill son whose medication has been radically changed, with no support.

“Nor do you allow someone who may be becoming severely disturbed to dictate their own care and treatment without rigorous assessment of the risk they may pose to themselves or others.

“We have had 15 years of independent inquiries all exposing the same fault lines in the care and treatment of people with serious mental illness.”

Filed under: Other Mental Health, psychosis, Violence, , , ,

Untold stories set to tackle stigma

* Fay Wertheimer
* The Guardian, Wednesday 6 May 2009

Profesor Protasia Torkington, director, Granby Community Mental Health Group, Liverpool.
Protasia Torkington has edited a book by black users of a mental health centre in Liverpool.

A rundown four-storey Georgian terrace in the Toxteth area of central Liverpool, probably built on the back of slave trade money, couldn’t have been the most propitious location for a day centre for black mentally ill adults. But 18 years after it opened its doors, Granby Community Mental Health Group’s drop-in and advocacy project, at the now immaculate Mary Seacole House, offers rights advice, recreational activities, care and a calming environment to 90 people, six days a week.

And to ensure that its legacy endures, seven members’ life stories have been documented in a book called Their Untold Stories, to be launched later this week at a black mental health conference at Liverpool Convention Centre.

Edited by the centre’s co-founder and Hope University emeritus professor Ntombenhle Protasia Khoti Torkington – known as “Pro” for short – the book features clients’ histories in the form of artwork, poetry and prose, which are cathartic and morale-boosting exercises.

Torkington, born in South Africa, qualified as a nurse and midwife and then came to the UK to get specialist paediatric training at Alder Hey Children’s Hospital, where she worked as a ward sister before going back into education.

She says of the book: “I asked people when they first realised they were ill, and then to what they attributed their illness. What unfolded was often rooted in serious sexual violence, long-term physical abuse and racial discrimination. I also encouraged contributors to consider the voluntary and statutory sector services available to them, and to suggest solutions for their own individual needs. Our book concludes by pinpointing key issues that providers should consider when delivering services to mainly black and racial minority communities with mental health needs.”

It logs Mary Seacole House’s success in keeping members out of hospital and endorses the links between a childhood in care and poor mental health. It also supports the request by staff – the nine full-time staff and part-timers are supported by Liverpool primary care trust, the city council and Mersey Care NHS mental health trust – for extra premises to cater for the centre’s 20 daily visitors.

Two weekly art sessions in a small basement, which is also used for IT and snooker, aren’t enough to nurture members’ burgeoning artistry. But this hasn’t deterred 56-year-old Kojo Udarku from attending the centre four days a week since 2005. Following years of discrimination, illness and prison, he found understanding at Mary Seacole House.

“Dictating my story and having my pictures in the book gave me confidence and greater self-trust,” Udarku says. “But those negative feelings from the past never go. My mother, being a white woman in Liverpool with five black kids, had it very hard. And being black in Liverpool in them days was always bad. I was illiterate too, years before they called it dyslexia and gave you help. I experienced prisons, hospitals and sectioning, and I still avoid authority.”

The book presents guidelines for running a non-medical drop-in for mainly black mentally ill adults, as well as displaying their talents – which Torkington hopes will help to tackle the stigma these people face every day.

• Their Untold Stories, edited by Protasia Torkington, can be ordered from Waterstones, price £19.99. maryseacolehouse.com

Filed under: Other Mental Health, , ,