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Mental Health - Are we getting better?


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6 hours ago, BallaDoc said:

I would be interested in a comparison between mental health on the island in the 1980s, and mental health on the island now. 

There indeed was a survey of the prevalence of mental illness on the island using F coding - it was sent to every GP, Community Psychiatric Nurse and every Psychiatrist, who, as it was part of the data collection to underpin the establishment of the Community Mental Health Practitioner Team (then North and South completed and returned the data. That survey data was poo poo'd by the new "Director" a couple of years ago iirc. 

4 hours ago, quilp said:

There existed a considerable amount of mental health staffing though, plenty of Consultants, RMN's and Nursing Assistants.

Not as far as I can remember. Costain and Chinn were the two main Psychiatrists and Ard Aalin was run on three staff per shift (often 2 RMN's and a HCA, who were sometimes better than the RMN's) unlike like the currently reported 7 staff per shift on Mannanan Court. If anything kicked off on AA then staff from the rest of the hospital had to be telephoned to attend, often arriving breathlessly when things had been calmed down. 

 

1 hour ago, Roger Mexico said:

You're more likely to suffer from depression and anxiety if you've got more to be depressed and anxious about.

Whilst that is invariably true some conditions have been generally medicalised unnecessarily in my view. ICD 10 shows that there are now several 'syndromes' like sex addictions which are described under addictive behaviours which could also apply to drug and alcohol addictions. Psychopathy / personality disorder still causes controversy as it is now deemed to be treatable up in Mannanan Court (by DBT and CBT therapies) , one of the issues that contributed to some staff concerns last year I gather.

 

On a personal note I appreciate the difficulties faced by the Mental Health Services in these last 5 years or so , especially after all the staff have been put through. I am often regaled of tales of  good staff have been tossed aside, organisational memory being erased, complaints being ignored, lack of communications and poor record keeping, near enough scrapes with capacity and the mental health act etc. Farming out future services on a private non-statutory basis such as the ones described in the article will never be as good as the statutory services could and should be providing if better leadership had been available in the past few years.

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It’s just that kind of comment that adds to the huge suicide rate in the young. If you don’t understand then educate yourselves. This isn’t a them and us situation, this is about all of us caring for

I don’t agree.  There were plenty of stressors in my life time Suez Cuba missiles Cyprus Decimation of the North by Thatcher, mass unemployment Miners strikes and riots

I disagree. I would say that there is far more stress related and anxiety issues now, especially in the young. The stresses they are under to conform and to perform, in the main due to social media an

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2 hours ago, Apple said:

There indeed was a survey of the  Psychopathy / personality disorder still causes controversy as it is now deemed to be treatable up in Mannanan Court (by DBT and CBT therapies) , one of the issues that contributed to some staff concerns last year I gather.

 

 

What? Psychopathy and personality disorders (Cluster B) are not treatable. In some (rare) cases where Cluster B disordered individuals are able to experience some self awareness, it is possible for them to recognise their traits and with a degree of self control moderate themselves, but, as I said, these cases are very rare, even less so with psychopathy. What on earth are they doing to 'treat' them?

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8 hours ago, wrighty said:

 

There were different stresses then, but not perhaps any more or less than now.  I suspect if an objective test were possible levels of mental health would be pretty much the same.

I disagree. I would say that there is far more stress related and anxiety issues now, especially in the young. The stresses they are under to conform and to perform, in the main due to social media and peer pressure are enormous.  They may be more emotionally literate than their elders but they have few mechanisms in place to deal with stressors.  I think if you spoke to educational establishments they would tell you that anxiety disorders are far higher than they have ever been.

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27 minutes ago, Roxanne said:

I disagree. I would say that there is far more stress related and anxiety issues now, especially in the young. The stresses they are under to conform and to perform, in the main due to social media and peer pressure are enormous.  They may be more emotionally literate than their elders but they have few mechanisms in place to deal with stressors.  I think if you spoke to educational establishments they would tell you that anxiety disorders are far higher than they have ever been.

I don’t agree. 

There were plenty of stressors in my life time

Suez

Cuba missiles

Cyprus

Decimation of the North by Thatcher, mass unemployment

Miners strikes and riots

poll tax

Gulf war

Then there have been economic cycles

my personal view is that

1. the stressors have become much more widely available, TV, 24 hour rolling news, social media

2. the poor, unemployed, workers and marginalised have become much more visible, through welfare state, equality, breaking down of barriers. Before 1960 the middle class and political class weren’t bothered about the mental health of the working class, other than if they were really seriously ill, a danger, or to use the mental health system as a social control mechanism, pregnant singles, non compliant, the “feeble” minded - who got locked away in huge sanatoria.

3. as a society we’ve medicalised much mental health, believing we should be able to diagnose and use drugs to cure. I’m not sure that the medicalisation and drugs model is necessarily the be all and end all. There’s much room for talking therapy ( although not necessarily the analysis therapy prevalent in the states ) both professional and voluntary, and even more importantly amongst friends and family.

4. as a society we’ve become much less tolerant to difference and divergent “nuisance” behaviours. We demand they be punished and/or treated. Bizarre when we talk about equality and inclusivity and how the LGBTQ+ community has moved into the mainstream of society from the fringes. Perhaps we’ve found other scapegoats. BAME, religions, opposing political views.

5.  I think we have raised expectations with mass media and social media. They may be unrealistic and unachievable. That in itself may give rise to stressors, a recognition by some that they’ll never get there. I know from my interaction with clients at the police station or duty advocate court that few have aims or ambitions or, if they do, the means to achieve them. Very different to wanting to be an engine driver or astronaut, but even then there were very few opportunities for all the ones who dreamed.

I suppose what I’m saying is that it isn’t that there are more stressors, just that they’re more visible and we feel we must do something.

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12 minutes ago, John Wright said:

5.  I think we have raised expectations with mass media and social media. They may be unrealistic and unachievable. That in itself may give rise to stressors, a recognition by some that they’ll never get there. I know from my interaction with clients at the police station or duty advocate court that few have aims or ambitions or, if they do, the means to achieve them. Very different to wanting to be an engine driver or astronaut, but even then there were very few opportunities for all the ones who dreamed.

Totally agree and consider this as one of the main factors for our current situations. The pressures to not only conform but also to excel from teachers, peers and parents is too great for some individuals and lays open the way for the notion of dismal failure by self judgement and organisational and social media commentary.  

Re the topic, good effective mental health care largely involves a high degree of self awareness to better support people as individuals and also to protect and preserve carers integrity. That takes training and time to develop, or ones own needs and desires can get in the way (like it does in physical health care). Skilled counselling techniques can take years to master yet everybody thinks they have them - many do not.

1 hour ago, Roxanne said:

Psychopathy and personality disorders (Cluster B) are not treatable. In some (rare) cases where Cluster B disordered individuals are able to experience some self awareness, it is possible for them to recognise their traits and with a degree of self control moderate themselves, but, as I said, these cases are very rare, even less so with psychopathy. What on earth are they doing to 'treat' them?

Dialectical Behaviour Therapy, Cognitive Behavioural Therapy and now of course the development of Therapeutic Communities is considered the way forward. Of course I still remember the distinctions between inadequate psychopaths (those whose thought process largely determined antisocial behaviour and adequate psychopaths who were able to channel their needs into socially acceptable behaviours usually attributed to successful politicians or to rich business leaders at the top of their game. 

The study of psychopathy though is fascinating as to where it emanates from.

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2 hours ago, Roxanne said:

I disagree. I would say that there is far more stress related and anxiety issues now, especially in the young.

The young could do with bucking up

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Interesting comments above and some I agree with lots I don't. Are mental health services better than they were .?? Definitely no ! Demands are greater though due to people yearning for more and it creates so much pressure . Latest phone , new house , designer gear and new car are all high on the list of must have . All not important in the 60's and 70's . Peer pressure as mentioned above creates so much problems. The actual input from Mental health is to be honest not fit for purpose. Lots of reasons for this though . Too much reliance on prescribing meds as the answer when really its because of case loads and incompetant staff members. And yes I have been under the service in mid 90's and then up to last year for 6 years previous including th imfamous crisis team. When two  MH professionals make appointments and then fail to turn up on numerous occasions without any contact says it all when your in a really bad place and its your one possible light at the end of the tunnel says it all. When a MH nurse meets you for the first time and then lies openly with her report saying you agreed that you didnt need further input after discussing your past and current history in a 50 minute meeting says it all . The funding though is sadly lacking and it is a poorly resourced department but equally with some terrible staff. Not all though there is some good ones but not many in the Crisis team !! I was lucky as was always as proactive with my issues and worked hard to find the trigger with my problems but sadly lots are not able for so many reasons. And once they get you on the meds its not in lots of cases the best answer for the patient but sure is for the department . I could say so much more but for now will leave it . 

Edited by Numbnuts
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You’d have to be pretty old to remember and be stressed by Suez unless it happened twice and I missed the second one. Poll tax only really stressed Scottish people I recall as that’s where they tried it out. Generally I think world events only stress you if have the misfortune to be in the middle of it and be directly affected. I never worried for a second that the Cubans would fire a missile at my town and found the nuclear warnings around that time quite funny really , but I was very young then I suppose so did not take it very seriously. In the end the Russians did not bomb us.

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13 minutes ago, Anyone said:

You’d have to be pretty old to remember and be stressed by Suez unless it happened twice and I missed the second one. Poll tax only really stressed Scottish people I recall as that’s where they tried it out. Generally I think world events only stress you if have the misfortune to be in the middle of it and be directly affected. I never worried for a second that the Cubans would fire a missile at my town and found the nuclear warnings around that time quite funny really , but I was very young then I suppose so did not take it very seriously. In the end the Russians did not bomb us.

You need to re read what I posted. I didn’t say I was stressed by any of them. They all happened within my lifetime. And there was certainly media hysteria about all of them. And things like suez, Cuba and Cyprus had a very different meaning to a generation just out of War and with conscription, or discussion of its return.

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I was a Communist in those days, so the Cubans would not have bombed my house!!!

...but yes, there was a feeling of  danger, not that would have been a natural feeeling of being under threat, egged on by media reports but a general feeling that the USSR and the USA could drag us 'Socialist Europe' into 'their' argument!

That is well into the past and now we only have to worry about Trump dragging us into his World View!!!!

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16 minutes ago, Kopek said:

now we only have to worry about Trump dragging us into his World View!

Well, that and the threat of terrorism, war with China, war with North Korea, rapidly growing inequality and a pandemic.

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How many people on the IoM actually observe what's going on in world affairs or how it might impact on their lives? Precious few, most can't even name our own elected politicians, let alone what's happening in America, Russia, China or N. Korea. 

The only stressors are the MUA, MG and Rates Demands. And the price of shopping, beer and fags. And who's shagging who in the afternoon at No.24. With institutions like Manx Radio "dumbing down" to accommodate it.

Insular is not the word. And this borders shut condition is contributing to it, which suits a few quarters down to the ground too.

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