In a question of mental capacity a woman known as C has been ruled the right to refuse life saving treatment following a paracetamol overdose.
Your Dad picks you up from Uni for the Christmas holidays. You get in the car, he asks how you’ve been, you say fine. He knows you’ve been finding things tough but it doesn’t seem like he really wants to hear about it. Sound familiar?
Dr James Halcrow, 34, had been told not to drink by General Medical Council (GMC) following his self referral for “other issues he was having”.
He was found dead by friends in his flat in Manchester’s Northern Quarter on June 24. An inquest heard he had hanged himself due to fears he would fail an alcohol test.
Since his death it has come to light he had won the national award ‘Trainee GP of the Year’. The note which was found with his body read: “I’m sorry.”
At the inquest into his death Ian Halcrow, his father and former soldier, said: “He had an amazing number of friends. He thrived on friendship and had a very close family as well.” According to the Manchester Evening Standard.
He added: “He chose to refer himself to the GMC off his own back. He was a very honest person and felt it was the correct thing to do as a responsible individual and medical practitioner.”
Dr Halcrow had attended two interviews with the GMC both leaving him hopeful of getting the restrictions lifted. However he felt the final interview had gone badly after he said he would drink socially once the GMC had finished their investigation.
Coroner Dr Jean Harkin said of his death: “It is clear James was an excellent doctor, so much so he was given an award. He was very sociable and this restriction affected him deeply and affected the social side of his life also”
Doctors at Risk
In 2014 a doctor under investigation by the GMC was 20 times more likely to commit suicide than a member general public according to figures from the Department of Health.
South London GP and blogger Dr Una Coales, who has herself faced investigation from the RCGP said:
“The GMC must reform and ensure they arrange counselling and support for any doctor they are investigating or putting under restrictions that may affect employment and pay.”
If you feel affected by any of the issues raised here and need someone to talk with the Samaritans are always happy to listen. They provide a 24 hour, free and confidential service:
Call 116 123
Featured image accredited to DarkoStojanovic
The Full Monty tells the story of a six unemployed men from Sheffield who decide to form a striptease act in an attempt to change their fortunes. But they confront a number of mental health issues along the way.
The film was a major critical success grossing over $250 from a budget of less than $3 million. This made it the highest grossing film in the UK until it was outsold by Titanic.
The Full Monty gathered critical acclaim in a number of fields winning 35 awards including recognition for choreography and an Oscar for best music:
But looking back it’s down to earth discussion of male mental health issues also deserves recognition.
On their journey the six former steelworkers confronts depression, suicide erectile dysfunction (ED), and body image in the wake of redundancy.
However light hearted, the film normalises mental illness by demonstrating it’s frequency. It shows that ‘blokey’ men can have non judgmental conversations about mental health. It also highlights the value of peer support but doesn’t shy away from how difficult men find it to talk about these issues.
Although peer support is advocated by the Royal College of Psychiatrists it isn’t always enough. From a mental health perspective, the most frustrating element of the lovable characters stories is their failure to seek professional help.
The effects of Unemployment
The Full Monty also tackles the impact of unemployment which has a huge effect on psychological well-being. So much so research indicates unemployed people are two to three times more at risk of death by suicide than fully employed people.
A study looking at the effects of unemployment in Bradford took people who lost their job during the 2009-2010 economic recession. It found three main experiences that made involuntary unemployment a serious detriment to mental health:
- Inability to pursue goals: Immediately people are unable to save, buy/do the things they want. In the long term career is damaged or lost.
- ‘Spoiled identities’: People suffer an identity crisis during the image transition from someone who works to someone who doesn’t. They may experience ‘unemployment stigma’ and ‘welfare stigma’.
- Destruction of routine: People suffer a loss of structure and motivation in their lives.
If you feel affected by any of the issues and need someone to talk with the Samaritans are always happy to listen. They provide a 24 hour, free and confidential service:
Call 116 123
Featured image accredited to C Jill Reed
Deep brain stimulation (DBS) is the surgical procedure of implanting a neurostimulator AKA ‘brain pacemaker’ deep in someones head. The device gets it’s nickname because it releases electrical impulses, like pacemakers used in the heart.
DBS is most commonly used in Parkinson’s disease. But it can also be used number of other psychological and neurological conditions including: Chronic pain, major depression , obsessive compulsive disorder (OCD)
The procedure involves implanting very fine wires with electrodes at their tips into the brain.
Wire extensions go under the skin behind the ear and down the neck. They are connected to a pulse generator, which is placed under the skin below the collar bone or the chest area.
Andrew Johnson’s DBS
Andrew Johnson lives with his wife and two children in New Zealand. He was diagnosed with Early Onset Parkinson’s in 2009. At the time he was only 35 years old. In November 2012 and February 2013 he underwent the surgical procedure. Here he talks about his experience:
How is it fitted?
A hole is drilled in the skull known commonly as a burr hole. It is usually around 14mm wide. Then through the burr hole the lead, with an electrode at its tip, is inserted.
The procedure can be performed under either local or general anaesthetic. This is because sometimes doctors need to ask the patient questions during the operation to determine optimal placement of the permanent electrode.
If the procedure is done under general anesthetic live MRI guidance is used for direct visualization of brain tissue and device.
Featured image accredited to Hellerhoff
Andrew Solomon, author of ‘The Noonday Tree’, said during his Ted Talks: “the treatments we have for depression are appalling… I hope people will hear about my treatments and be appalled that anyone endured such primitive science”
For many the drugs prescribed to treat psychiatric disease either do not work, have difficult side effects or both.
With that said the current treatments of mental illness compare favorably with the atrocities of the earliest state run institutions.
Bethlem Royal Hospital, better known as Bedlam, is widely considered the oldest psychiatric hospital in Europe. It was notorious for its inhumane and at times torturous conditions.
Historians say there are records of the mentally ill being confined there from as early as 1403. In that year a charity commission visiting the hospital reported 6 male inmates suffering from “mente capti” a latin term for insanity. The same report details four pairs of manacles, 11 chains, six locks and two pairs of stocks.
The original Bedlam was built over a sewer that served both the hospital and the nearby street. This common drain was infamous for overflows of waste that filled the entrance of the hospital.
Reports by Thomas Moore confirm that for the poorest inmates, family and friends were expected to visit regularly to bring food and clothes. At the same time wealthy individuals paid a fee to wander the corridors and view the sick inmates for entertainment.
According to Andrew Scull author of ‘Madness in Civilisation’ inspections throughout the 17th Century found patients starving and chained to the walls.
The death of Hannah Mills
Hannah Mills was widowed in her 20’s, she suffered from “melancholy” a term probably describing severe depression. She was admitted to the York Asylum, a similar institute to Bedlam on 15 March 1790.
Those in charge of her care refused to let her relatives visit. At the time it was a commonly believed madness could be cured by purges like vomiting, painful blistering and sudden immersion in cold baths. She died a month later on 29 April.
Hannah was a Quaker, a christian group involved in the abolition of slavery. This led fellow Quaker William Tuke, a businessman and philanthropist, to investigate the treatment of the insane.
Horrified by what he found William educated himself on contemporary research into the the treatment of mental illness and with his son Henry he founded The York Retreat in 1796.
Together they pioneered the principles of restoring self-esteem and self-control through attention and reward. In The York Retreat physical punishment and manacles were banned although in extreme cases straitjackets were used.
Activities included walks and farm work in the large and quite grounds. Treatment included a social environment where residents were part of a family unit.
People were accepted as potentially rational beings who could recover proper social conduct through self-restraint and moral strength rather than punishment.
Samuel Tuke, Henry’s son and William’s grandson, carried on the family interest in the treatment of the insane. In 1813 he wrote about the York Retreat, a report that was used to publicise the principles of this’moral therapy’, which were considered to be the basis of the therapeutic environment there. The report also focused on the condition of ‘madhouses’ of the time, and drew public attention to the urgent need for reform.
Featured Image: The Rake’s Progress. Accredited to William Hoggarth
The BMA has announced details of it’s plans for strikes if the ballot finds junior doctors in favour of industrial action.
The ballot, which closes on 5pm Wednesday 18 November, could see that junior doctors are involved in the “all out” strike the NHS has ever seen.
The strikes will begin with one day of emergency care only, the same level of service seen on Christmas day, followed by two days of full walk outs which includes emergency care.
- 2 December, 24 hour – Emergency care only
- 8 December, 8am to 5pm – Full walk out
- 16 December, 8am to 5pm – Full walk out
Health Secretary Jeremy Hunt has condemned the plans. He says: “Threatening extreme action is totally unwarranted and will harm vulnerable patients. Refusing to talk to a government that wants to improve weekend care for patients and reduce doctors’ hours can only damage the NHS”
Dr Mark Porter, BMA council chair and consultant anaesthetist, defends the decision. When he spoke to radio 4’s Today program he said: “The reason were giving the service this notice, which is three times the length of time required by law, is so that we can plan the service properly to be delivered safely”
He claims that the government has been unwilling to take part in negotiation: “Were doing this because the alternative to industrial action is to get round the negotiating table. But what we’re being told at the moment is unless junior doctors agree to every one of the proposals that are being put forward for a new contract then that contract will be imposed”
Dr Sarah Wollaston, who has was a GP before becoming a Conservative MP tweeted:
If industrial action does go ahead, one of the key questions is who will the public support?
The breakdown in contract negotiations led to a number of protests on October 17. In Waterloo Palace over 20 000 people demonstrated their support for junior doctors.
Before details of strike action were published, the Guardian Healthcare Professionals Network conducted a poll asking: Should junior doctors strike over the government’s proposed contract? 28,562 people took part. 95% answered yes, 3% said no and remaining 2% were unsure.
Featured image accredited to Kip Dudden