Impact News

Responding to Violence, Suicide, Psychosis and Trauma

Mental health and offending: One man’s prison experience

A new report today by Lord Keith Bradley says offenders with mental health problems are being failed by the criminal justice system. David Smith, who suffers from schizoaffective disorder, explains why prison wasn’t the right place for him

* Mary O’Hara
* guardian.co.uk, Thursday 30 April 2009 16.47 BST

Like many people who run up against the criminal justice system while dealing with a serious mental health condition, David Smith [not his real name] felt that neither the police nor the prison service were equipped to deal with him. Smith has schizoaffective disorder. He manages his condition with fortnightly injections but in early 2008 he missed a series of appointments for medication, and became unwell.

By April his symptoms returned. These included hearing voices. David went to speak to his mother, with whom he had a fraught relationship, about his problems but the encounter turned into a confrontation that frightened her. At 2am the police arrested him on suspicion of common assault. He was locked in police cells for four days.

When he finally went to court they asked for a psychiatric report. The judge recommended that Smith receive hospital treatment but in the absence of a bed in a secure mental health unit Smith was instead sent to Wormwood Scrubs prison and spent a total of four months there.

“I have difficulty remembering my appointments; I never intend to miss any, I just find it difficult to remember when they are,” David says, explaining his state of mind at the time of his arrest. “My regular CPN [community psychiatric nurse] understands this and she gives me a ring the day before to remind me. When she went on leave I got a new CPN. He knew I couldn’t remember my appointments but he wouldn’t ring me with a reminder.

“I must have missed more than one injection,” he concludes. “My friends tell me there’s a pattern when I’m getting unwell. My symptoms came back and when I was at home one day I heard my mum screaming, ‘I’m going to kill myself’. I went to speak to her. I tried to talk to her. Mum just got frightened. I didn’t get anywhere with her so I went home.”

When he was arrested, Smith says, he did his best to explain himself to police officers but what happened was unsettling and frustrating. He recalls: “At the station another police officer asked me exactly the same questions; they didn’t look at any of the notes that had been taken. The policeman was trying to wind me up. I was so pissed off, I just said ‘yeah, whatever’ and sat down. They knew I had a mental illness as my mum phoned the hospital before she phoned the police. I was interviewed and put in a cell for four days. When I went to court the solicitor explained about my condition. One of the first things they said was that they needed a psychiatric report. Then the judge said I should be in hospital but there weren’t any secure beds so I went straight to Scrubs.

“When I got there I was very unwell but I didn’t know I was so I told them I didn’t have a mental illness and they put me on a general prison wing. They did put me in a single cell so I guess they had my [medical] notes. On my first day someone took the TV out of my cell. I thought to myself they’ll take anything, so I sat in my cell for two weeks. For those two weeks I was probably getting worse, more unwell. No one noticed, they [the prison] haven’t got the staff to notice.”

After throwing a chair and wardens intervening because his behaviour became so erratic, Smith was put in the hospital wing of the prison but was soon transferred back into the general prison population.

He reacted by throwing a chair.

“I spent the last two months in the general wing. I was well then. I talked to staff a lot. They were good to me. When I’m well I’m very polite so I was no trouble.”

Smith says that most of all he felt unlistened to, as if what he was going through was misinterpreted and that the prison wasn’t equipped to deal with his problems. He decided to write to a judge to see if he could get his point of view across.

“I wanted the judge to know what happened from my point of view. I felt I hadn’t been heard in court,” he explains. “Everyone talked about me and not to me. I wanted to say I was sorry. My case came up again and the judge said that I had clearly stabilised, I understood what had happened and that I had already served the time I would have done on a guilty plea while waiting for a bed in a secure hospital so I could go.”

Prison life is simply not the right environment for people like himself, Smith believes.

“If you can handle yourself when in prison you’re OK, if not it’s all over,” he says. “I managed but I met guys who came in after me and they tried to commit suicide or burn down their cells. It’s a 23-hour lock down. I spent most of my time pacing in my cell. I can still remember the pattern my pacing took, the same one over and over again. I never want to go back. I’m doing everything in my power not to go back. I’m keeping myself busy.”

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

What’s it like to be a young person with mental health issues?

Three teenagers who have found it hard to forge their sense of identity as young people with mental health issues
guardian.co.uk, Wednesday 15 April 2009 00.05 BST

Rachel Haddon, 21, Preston, Lancashire

Who am I? A 21-year-old female? Student? Mental illness and eating disorder sufferer? Self-harmer? Vegetarian? Or an animal lover? I am all of these things, yet none of these things. I am just me. If diagnoses were put on the end of your surname, like qualifications, I would look rather qualified! But these labels don’t aid and benefit me like qualifications would. It is time professionals stopped treating people as disordered statistics, and instead saw us as people. Ordinary humans, who just happen to have problems. After all, everyone has problems, don’t they? Perhaps our problems just affect us a little more than normal. But what is normal? The only normal I know is the setting on a dishwasher. Over the years I have met many so-called “professionals” – doctors, nurses, social workers and psychiatrists who apparently excel in their field. But most have actually made me feel worse. I don’t doubt that on the majority of occasions their intentions have been good, but instead of helping me, they have just diagnosed, medicated and hospitalised me. Of course, that is often necessary and beneficial, but the most important and helpful “treatment” is to be listened to, and believed. Sadly, many professionals seemingly fail to do this. The attitude of these professionals and the general public is obviously influenced by the media to some extent. It’s not rare to see a headline such as “Prisoner with personality disorder attacks staff”. Is it any wonder that the majority of people think having a personality disorder indicates that you are a dangerous, reckless, violent criminal? Some could argue for freedom of speech, but for those like me who happen to be diagnosed with a personality disorder (regardless of my opinions on the use of this “label”), such statements and in­accurate beliefs only add to our problems. The hope of recovery sometimes seems impossible in a world that functions on stereotypes and stigma.

Saad Butt, 21, London

It has been six years since my father died of a heart attack. Being the eldest, I looked after my mum and my younger brother and sister, as well as myself. I was 15. My GCSEs were a pressurised time and things weren’t easy. I had to grow up fast. My father and I didn’t always have the best of times. Why was it that we were so close and yet so distant? Why is it we wait so long to tell those close to us the way we feel about them? To lose someone close and still live and breathe each day was a big struggle. I had attacks of depression, identity crises and suicidal thoughts. There didn’t seem to be anyone who could help and it didn’t feel like counselling services were available either. But I kept on going, suffering in silence, living in the hope that one day things would be better. Before my dad died, I was involved in my community with the local youth parliament. That kept me going, but when I found a mentor through my community work to talk things through with, things started to change. At 18, I found in him the dad I never had. He became my guardian, had a deep-rooted concern for me, and took an interest in my studies and my extracurricular life. My emotions started to become a positive driver in my life. I love him more than anything in the world. Now I never take anything for granted; I’ve become more focused, more concentrated on what I want in life. My relationship with my mother has become closer. I’m studying for a law degree and I’m still involved with local youth issues – for example, as a member of the British Transport Police youth board. I’m getting married in the summer and looking forward to that and the new life that comes with it. I’ve also learned that it’s important to get help and talk to someone you trust. Above all, have faith, stay positive and cool about life, and go with the flow – it isn’t always as bad as it may look.
Celeste Ingrams, 24, Southampton

The most difficult thing is how people have reacted to my mental health problems. It made me think I was dangerous due to what was going on inside my head. This perception became almost a sense of identity that made me feel secure and reaffirmed my belief that I was “crazy” and uncontrollable. It took me a long time to realise that my “craziness” was my mind coping with the emotions that were reactions to me feeling unsafe and anxious. It is hard to admit vulnerable emotions and this denial came out in my behaviour, which I’m not proud of, but I couldn’t communicate my feelings in any other way. I often kicked against everything, which was self-destructive and led to people being hurt. Although I feel guilty about this, if I’d not gone through this process then I wouldn’t have been able to learn from my mistakes. How I manage is I don’t get too caught up in what’s wrong with me or how others make sense of what I do, but I stay in touch with my emotions. I use coping skills to steady myself, and prevent things getting out of control, often by spending my time expressing myself in more creative ways with art and writing. My experience of living in institutions – NHS or local authority psychiatric units, or residential therapeutic communities – was about feeling controlled and not supported. I think this affected my ability to believe or trust in myself. I try now not to feel caged by stigmas and stereotypes. I know it can be extremely difficult to do this in our society.

• Rachel, Saad and Celeste are all members of mental health charity YoungMinds

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

Mentally Disordered More Likely To Become Victims Of Violence When Showing Increased Symptoms

Article Date: 16 Apr 2009 – 0:00 PDT

Contrary to common stereotypes, individuals with major mental disorders are more likely to become victims of violent crimes when they are experiencing an increase in symptoms than they are to commit crime, according to a new study by Brent Teasdale, an assistant professor of criminal justice at Georgia State University.

Teasdale found that patients experiencing delusions, hallucinations and worsening symptoms generally are most likely to become victims of violence. In addition, individuals with mental disorders are particularly vulnerable for victimization during times of homelessness and when suffering from alcohol abuse.

“They actually have higher rates of victimization than they have of violence commission, which I think is counter to the stereotype that highly symptomatic, obviously delusional, visibly mentally disordered people are dangerous, unpredictable and violent,” Teasdale said. “There’s no one size fits all approach to these delusions, but the odds of victimization are multiplied almost by a factor of two when a person experiences these delusions.”

Teasdale analyzed data from the MacArthur Violence Risk Assessment Study, a longitudinal study of psychiatric patients released from three psychiatric hospitals in Pittsburgh, Pa., Kansas City, Mo., and Worchester, Mass. During the MacArthur study, participants were interviewed every 10 weeks for one year about violence committed against them, stress, symptoms and social relationships.

When individuals with mental disorders experience increases in delusions, symptom severity and alcohol problems they may be more focused on their internal states and have fewer cognitive resources available to devote to interactions with other people, Teasdale said. Other research suggests that victimization happens because caretakers may be driven away, leaving the disordered unprotected.

“If the stigma is that those are people we need to protect ourselves from, one of the ways in which we might do that is self defensive violence. We might strike first and that would lead to the victimization of these folks,” Teasdale said. “If there’s a person that could intercede before that happens, that may be one strategy for reducing victimization risk.”

The findings of the study are important for clinicians who must pay attention to warning signs of worsening disorders as potential risk markers for violent behavior committed by their client, Teasdale said. They could also aid in the creation of assessment tools that focus on victimization risk and classes that better educate families about caring for the mentally ill.

Clinicians also could provide clients suggestions for reducing victimization risk when they notice patients exhibiting greater than usual symptoms, Teasdale said. For instance, during these times clinicians may recommend spending less time in public spaces, increases in guardianship or mandated community treatment programs.

“Most of us know people who have mental disorders. These are our family members and our friends and so we should care about their victimization experience,” Teasdale said. “The stereotypes persist because people are unaware of the victimization risk to people with mental illness. If they learned that victimization risk were higher than the violence commission rates, I think that would help alleviate some of that stigma and help people think about people with mental disorders in a different way.”

Notes:

The study, “Mental Disorder and Violent Victimization,” was published in the 2009 edition of Criminal Justice and Behavior.

Source:
Leah Seupersad
Georgia State University

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

Women’s mental health deteriorates as one in five experience common disorders

An NHS report has found a significant increase in the number of women suffering from depression, anxiety and suicidal thoughts

* Ali Ahmad
* guardian.co.uk, Wednesday 28 January 2009 15.31 GMT

Women’s mental health is deteriorating according to an NHS report that has found that more than one in five of the adult female population experiences depression, anxiety or suicidal thoughts.

The report found the proportion of women aged 16-64 with common mental disorders (CMDs) increased from 19.1% in 1993 to 21.5% in 2007, whereas the rate in men did not alter significantly.

The largest increase in CMD rates, up 20% between 1993 and 2007, was among women aged 45-64. The proportion of women aged 16-74 reporting suicidal thoughts also increased from 4.2% in 2000 to 5.5% in 2007.

Based on the results of a study of over 7,000 households carried out by the National Centre for Social Research together with researchers at the University of Leicester, the Adult Psychiatric Morbidity Survey is the latest in a series of surveys conducted at roughly seven-year intervals, with previous surveys carried out by the Office for National Statistics in 1993 and 2000.

Its key findings have already sparked debate among experts and mental health charities about the relationship between gender and mental illness, focusing on likely explanations of these trends.

A spokeswoman for the mental health charity Mind said: “One of the reasons that might explain the increase of common mental health problems in middle-aged women (45-64 years) could be the heavy burden they face as primary carers. Having children later in life means today’s women in their 40s and 50s face numerous responsibilities such as caring for elderly relatives, looking after young children or teenagers, and managing a full-time career. Wearing all these different hats can be very stressful and leaves little time for women to concentrate on their own mental wellbeing.”

Emma Seymour, service manager at Threshold, a Brighton-based organisation, which runs a mental health service for women says she “is not surprised by the figures”. Seymour speculates that the reasons for the deterioration in women’s mental health could include increased financial pressures, especially for lone parents, whose circumstances may well harshen in the current economic squeeze. For those who cannot afford adequate childcare provision, she points out, accessing mental health support services can be difficult, “with negative consequences for wellbeing”.

The report also found that age was a significant factor in determining the way CMDs are experienced by individuals. For instance, one in five women aged 16-24 screened positive for an eating disorder, but the figure dropped to just one in 100 among women aged 75 and over. And while men were more likely to gamble than women, the highest rate of gambling was observed in men aged 25-34 (75.4%), whereas for women it was 55-64 (69.5%).

Filed under: Other Mental Health, ,

Football Foundation project sees mental health sufferers coping through football’

press release   date 02/12/2007

 

Project to be launched by Sports Minister at Emirates Stadium uses sport to address symptoms, avoiding over-reliance on drugs and potentially saving NHS money

An innovative new project which uses football to alleviate the symptoms of mental illness is to be launched by Minister for Sport Gerry Sutcliffe MP next week at the Football Foundation Mental Health Summit.

Coping Through Football is funded with a £212,034 grant from the Football Foundation, the UK’s largest sports charity, and managed by the London Playing Fields Foundation. It will be formally launched at the Football Foundation’s Mental Health Summit at Arsenal Football Club’s Emirates Stadium at 10am, 5 December.

Key facts about mental health:
• Suicide caused by depression is the biggest killer of young men aged between 18-to-25
• It is estimated that mental health affects up to one in four Britons at some point in their life
• Estimates also show depression costs the UK economy about £8bn a year in medication, benefits and lost working days
• There is currently a reliance on drugs to treat mental illness
• Coping Through Football is a new sport-based mental health initiative that is being launched
• It has potential to save NHS money through reduced hospital bed/clinician and medication bills.

Coping Through Football seeks to reduce the isolation and discrimination faced by one of the most marginalised groups – the mentally ill. It uses football as a tool to engage 18-35 year old men who are within the mental health care system but prefer not to attend the typical therapy sessions on offer. It is delivered in conjunction with the North East London Mental Health Trust, Waltham Forest Primary Care Trust and Leyton Orient’s Community Coaches.

It provides clients with football coaching sessions and other football-related activities. Healthcare specialists will work alongside the football coaches enabling aspects of the clients existing programme of care to be delivered simultaneously. This will increase the accessibility of their current care programme and heighten the ability of the healthcare providers to deliver their health services.

Coping Through Football harnesses sports’ best attributes to help build the self esteem of mental health service users. The football sessions are designed to improve the physical fitness of participants, who often have high rates of heart disease, strokes, cancer and diabetes. It introduces a routine into daily life and provides them with an environment they can be comfortable socialising in, preventing isolation and exclusion.

The scheme provides an alternative to the traditional reliance on medication as a treatment for depression. The endorphins produced whilst playing football also provide a natural sense of wellbeing to the group, who previously may have had drug or alcohol issues.

Coping Through Football is also a recovery model which aims to take the end user on a journey from secondary care to the relative normality of primary care. This project will not only exploit football’s capacity for bringing people together, but will also be used as a part of their therapy. This will include training, playing matches, discussions on football related topics, attending FA coaching and refereeing courses, volunteering and watching professional fixtures.

Coping Through Football’s sophisticated bespoke monitoring and evaluation software has been endorsed by the Institute of Psychiatry. It will capture data not just on the improvements in participants’ health and wellbeing but also on the savings to the NHS created through fewer admissions to hospital for mental health treatment.

Minister for Sport Gerry Sutcliffe said: “In Coping Through Football, the Football Foundation and London Playing Fields Foundation are using the national game’s best attributes to address a serious health problem that can be very debilitating to sufferers.

“This is an exciting pilot initiative which draws on football’s qualities such as team-bonding and exercise, which can build self-esteem and help a person get back on track and achieve their full potential.”

Jason Kelvin, 36, a service user on Coping Through Football described the dramatic impact that taster sessions have had: “My anxiety is like being imprisoned.  Yet I am both the inmate and jailor.  Instead of being in a 6×4 cell, my walls are all encompassing, like an invisible force field continuously pulling me down emotionally, and it is my thoughts that keep me here.

“It is a debilitating condition and not a happy place to be. My natural inclination is to avoid places, people and situations that can arouse my fear. My answer for years has been to hide away, to stay indoors creating a comfort zone that I could live with. This only exasperates the problem as the isolation fuels my anxiety, creating panic, paranoia and inevitably depression.

“Thanks to Coping Through Football I have been able to pierce some of this destructive emotion. I’ve always enjoyed sport and not only has this helped me regain some of my fitness but I’ve made new friends from different walks of life; yet with similar situations to mine.  Making these contacts helps you realise you’re not alone. I’ve built up a lot of my lost confidence, and broken many of the shackles that were holding me in my self-imposed prison.

“I might still be an inmate, but during my Coping Through Football time, I feel like I’m on day release!”

Paul Thorogood, Chief Executive of the Football Foundation, added: “The Coping Through Football initiative is an innovative way of helping people who suffer from mental health issues. It is the latest example of how the Football Foundation is harnessing our national game as an important vehicle that can help support individuals and deliver benefits to society in a wide range of areas.”

Alex Welsh, The Operations Director for the London Playing Fields: “Through the Coping Through Football project the London Playing Fields Foundation has demonstrated that protecting playing fields can have a dramatic impact on the quality of life of those who use them.”

For more information ring Rory Carroll (Football Foundation) on 0845 345 4555 ext. 4280 / 07710 274 285 or rory.carroll@footballfoundation.org.uk

Filed under: Suicide, , ,

Mental Health Service User Involvement – Community Care 27.09.2007

Providence Row’s Mental Health Co-ordinator, Kelvin Barton, has been taking user-involvement to a new level. Usually user-involvement refers to increased levels of consultation and representation in decision-making processes. Sometimes users can “graduate” into helpers or even become staff. Many MIND groups even make their staff training sessions available to the more able of their service users.

Kelvin’s idea, however, is that the people who would benefit most from mental health training are the users themselves – not only do they have the greatest curiosity about their own condition, but they also have the greatest need to understand the issues faced by their service users. Kelvin invited us to deliver this training – professional training which cuts out the professionals and goes straight to the service users. This is a quite different concept to that of group therapy or self-help groups (e.g. Hearing Voices, Depressives Anonymous, etc.) and takes the copncept of empowerment to another level.

 So far there have been courses on “Experiencing Mental Health Issues”, “Anxiety and Depression”, and “Anger and Iritability.” Essentially these are the same courses that would have been delivered to professional groups except instead of giving advice on helping others, there is a much greater emphasis on self-help.

 The article appers in CommunityCare on 27th September 2007

Filed under: Impact Training, psychosis, Uncategorized, , , ,

Community Care Feature Article: 12 July 2007

Hi,

I have no idea what the article will be like, but Simeon Brody is writing a feature on Social Workers and Dangerous Behaviour in the July 21st edition of Community Care. You may even see a few ugly mug shots of me there!

Iain

Filed under: Impact Training, Uncategorized, Violence, , , ,