are you scared of the mentally ill..and would you vote to keep them off the streets?

[zippitippitoes]

..the mental health Bill are you keen to see it enacted or not?

sunday times and it's mentally scarred leader

I have been very priviliged to work in a fnatstic unit that works very closely to some excellent services in my area. As we are near to a very well known private hospital which attracts very well known professionals i do fear that other service users throughout the country don't get the same support. that said there are many pitfalls still that need to be adressed but as i said earlier cuts in our town are always in these services.

I also think insititutionalisation is one of the biggest stumbling blocks for any sufferer on the road to recovery and have seen so many people relapse due to inability to survive out of this structure. This particularly seems to be the case within people who have been in such settings from an early age.

I have enjoyed this discussion Zippi thanks for starting this thread but lost is now calling I may just opo back later

clearly i meant pop!!

time i was going to bed too

glad to have so much response

I think mental health issues need as much discussion as possible

especially about lack of places and resources and cuts and the law and stigmatisation well anything actually

it's actually quite difficult to get people discussing mental health issues...finding the right peg to hang it on and get a response isn't that easy

I don't see any definition of 'mentally ill' in those articles, what do they mean by it? Does that 400 include, say, people with depression who decide to kill themselves and their children? I think the articles are scaremongering tbh.

I have no doubt more needs to be spent on mental health care. My mother's elderly neighbour was admitted to a psychiatric hospital after attempting suicide. He was promptly allowed to go for a walk. Twenty minutes later he was found hanged. That was mental health neglect, not care. It would also be nice to think that more could be done by the community at large in taking care of people but I don't think that's realistic nowadays.

I guess getting the community involved really depends on the level of the illness, its a very big resposibility.

My sister is "menatally ill". I'd do anything to get her onto the streets rather than keep her off them.
What, who are they classing as mentally ill. Another reason to loate umbrella descriptions. People shouldn't pigeon hole and lump groups together in this way, it's dangerous and unfair.

I just think if doctors have the power to force you to take medicine, at gun point metaphorically, it removes all incentive for cooperation. It's not about treatment any longer, it's about imprisonment. It's the mental health version of control orders.

It's not as simple as 'people will put up with awful side effects' - that assumes they have a choice. The whole point of the proposed legislation is that they won't have a choice. This is something the government has tried to bring in repeatedly, and failed, repeatedly, so now they are trying to outmanoeuvre the principled opponents by provoking a public panic.

And psychiatrists who are pushed for time will have no incentive to find something that doesn't cause awful - in some cases potentially life-limiting - side effects. The whole system risks being tipped into 'dose 'em up and ship 'em out and ignore them if they complain'. Do you really think a benign government will bother funding enough mental health professionals and enough facillities to give people the care and support they need to find the right treatment to help them live the best life they can? Bollocks.

Thing is if the people who this bill applies to are locked up anyway, which presumably they would have to be to enforce it, then why the need for medication anyway? I can understand it is necessary to comply if dangerous and in the community but presumably in a 'safe' setting then the choice should be there. I'm not saying that just because they are locked up they don't need it, but if they are not risking their own lives or the lives of others i'm not sure why they should be forced?

should check my links up to date link

Yes, I agree that the medication issue is very difficult. Have we got the right to force someone to take medication when they don't want to and when it is "hurting" them in some way to take it?

It is all very well to target these people as needing stronger supervision and diminished rights, but I feel they are an easy target. The reason these statistics cause such a strong response in the general public is that these crimes are seen as in some way preventable. You can see how the family and friends feel baffled as to why the person was "allowed" to commit a crime that could have been predicted.

But compare the human rights of someone with mental health to a person who has committed serious and violent crimes but has completed their sentence.

In the former case, we are talking about forcing them to take medication in order to contain the potential risk they present to society.

In the case of certain violent crimes, it is known that there is a very high rate of reoffending - one could argue much higher than the risk of a scizophrenic killing for example.

In the latter case, there are ways that say a sex offender can technically be "chemically castrated". Why should someone with mental health problems be forced to take medication if the latter is not?

and the briefings

I haven't had time to read all the thread but being a psychiatrist working in Australia, I have to agree and second all posts by WhenSantaWent QuietlyMad.

Statistically families of people with mental illness are at highest risk of violence. Most psych services are woefully underfunded and admission is determined by who is most at risk at a particular point in time (and this usually means discharge for someone who is not fully recovered, to make a place available). I have been in situations where suicidal patients are not admitted because they will not kill themselves at that very moment! This is incredibly stressful for psychiatrists working in the public system.

Ultimately it is balance between the patient's individual rights and those of the community and I think if the patient poses a high risk of violence then they need involuntary treatment.

you are assuming that people stop their medication because of the side effects (I'm sure it is one of many factors) - but one of the common problems with some serious mental illnesses (esp schitzophrenia) is that on the medication, they feel normal, so they start thinking they don't need it and that can cause a major downward spiral pretty quickly.

You are right, there are zillions of reasons people stop taking their meds: they feel OK again, they get side effects etc but a really big one is that some people have no insight into the fact they are unwell and don't believe they actually need medication. This is a huge problem and means chasing people around which is a bit difficult for rapport (as someone mentioned earlier)

sorry polecat, I hadn't aimed that post at you - I'm sure as a psychiatrist, you're pretty well versed in all medication matters

I think it is very sad about the underfunding and I only hope that even just by debating the bill in Parliament (even if it isn't passed), it will bring out the critical need for further funding in this area.

I just think it is great that people are debating this and obviously thinking about it - maybe if enough people did this the government couldn't just sweep it under the carpet again and again.

It's been really interesting to hear the side of people with first hand experience of the issue...the media do like to exaggerate for a good story. I also saw the S/Times headline about 1 murder a week by the mentally ill.

I know it is rare, but I was aggressively hounded by an obviously mentally ill guy who was commuting alone from Berks into C.London.

It was the scariest period of my life because I knew this guy was not only aggressive, but clearly not rational. I was terrified of my journey to work because this guy would target me specifically. if he saw me on the platform, he'd storm up to confront me. And it was escalating from aggressive gestures to cornering me in tube carriages and verbally abusing me. His fists were clenched so tight...he could barely contain his anger.

I reported it to the Transport police and felt like a complete idiot until it was clear I wasn't the only woman who had reported this. It got written in a log book, presumably with the other incidents, and that was it.

I changed my travel habits, but that guy continued unsupervised on his daily journeys.

It may be rare, but for 'unconnected' members of the public it is terrifying. And more terrifying was the idea that there was clearly NOONE supervising this guy, and no mechanism to alert his carers about his behaviour.

I do believe that broadly speaking, the decision to close the old institutions was correct. I used to work in one (principally for learning disabilites) and it was really great to see people who had been abandoned by their families decades ago starting to play a part in the community.

However, I do believe there is a very small section of the previous population of those places that needed greater support and supervision than was available in the new model.

IMO the main problem is that there are inadequate places in the secure acute psychaitric intensive care units. And they are unbelieveably expensive, literally hundreds of pounds per day.

The old institutions were owned by the NHS, so although they were an expensive resource, they had been paid for decades/centuries ago. Now they have sold off the land and the money has been spent, the ongoing funds need to be found to support the full cost of providing the places. And unsurprisingly, it is difficult to ring fence enough money to provide this facility.

the mentally ill are far more likely to be the victim of crime rather than the perpertrator. Cannot not believe some of the attitudes held on here. Is frightening that some can be so narrow minded.

Of course there are people who are so unwell that they should receive inpatient care and at times against their constent as they are deemed to not be able to give consent due to their illness. THe majority of indivudulas who suffer from mental illness do not pose a threat.

Mental illness is commen and stigmatised.. those with these lock 'em up attitudes.. I sincerely hope that should you experince mental illness or those close to you they recieve more compassion and understanding.

Are you sure you have read the thread awen? I didn't read any attitudes like that on here!

Fox and Polecat, I know there are lots of diverse reasons people stop taking their meds. But the point of this repressive legislation is that it treats people as objects to be ordered around. It doesn't take into account the fact that they may have good reasons for wanting to change their meds - I brought up side effects as an example because psychy drugs can have frightening side effects in some cases (although obviously they can be life saving).

It's really hard to generalise obv. because every person is an individual with their own needs and state of health. And you are right that sometimes people stop taking the tablets because they feel better, when their health actually depends on that medicine. But the legislation tries to generalise and in the context of scarce resources, fear and discrimination, could be very dangerous.

Why would someone have mixed feelings about this?

I do because it is a bit like being permanently on parole for a crime you haven't committed. Well possibly an exaggeration but in reality someone who doesn't fit in soon becomes a bit picked on and it would be relatively easy to find that that individual was being driven through fear to move on or damage themselves because they are afraid of being locked up. A person with mental health problems like schizophrenia can be coping but still be the subject of pressure from the community and this may be a source of further anxiety.

Wouldn't there be a temptation to use the legislation to be on the very safe side rather than allow an individual his or her freedom? Once the legislation was enacted it will be harder for people who have certain problems to live outside institutions, an increased tendency in a locality to be intolerant of difference.

I can see people saying more frequently when they feel a neighbour "should be locked up"

I'm scared of my mum. She is a manic depressive and has been ever since she was 12yrs old.
Since she turned 61 she has become very " manic" and since April this year she is under section for harming a 6yr old girl by trying to drown her in the local swimming pool in front of the poor girls mother!!
Of course she was arrested and put in the care of the local mental health depart.
WHO by the way are not helping her in any way.
She is just getting worse and worse and hardly communicates to anyone.
She is allowed to chain smoke all day long- Hardly ever smoked before.
They let her out a few hours once a week in the care of my dad.
But he finds it very stressfull as she just wanders and wanders aimslessly for the whole visit and she gets violent and hits him and lights candles all over the house, nearly set fire to the sofa last week.
NOW to top it all, they want her to go home as they can't do anymore.
I ASK YOU what is my dad supposed to do with her?!!
He is going to have a mental breakdown over this, he has told me he is going to convert one of the bedrooms to a "cell" to keep her locked up as she is too dangerous to let out.
There is NO WAY in hell that i'll EVER look after her, she used to hit me as a child she has already hit my 4yr old last year and anyway she is a fire risk.
The whole country is going mad.
AB