If you remember, in Pt 2 I was correcting Prof Jonson’s use of weasel words when kitchen sinking inpatient wards for falling short of perfection.
*) Weasel words example 2 = ‘…addressing the major problems associated with severe mental illness.’
Severe mental illness. Is that all? Severe mental illness includes MDD, BPAD, the schizophreniform disorders and a few more. If only that was all. On top of that, acute units have to admit people detoxing from alcohol and drugs, and all varieties of PD. When the lying managers trick wards into admitting a dangerous patient (like a Calocane) because there aren’t any PICU beds available (They do this by lying about his dangerousness until he’s on the ward, ha, gotcha,) then you can forget about looking after the other patients. You’ll be lucky to feed them and get the tablets done while the men are fully occupied fighting him.
You know, I once worked a secure forensic ward within a medium sized bin that had a few acute wards down the corridor. All the serious and horrifying crimes and incidents – which included a murder, hostage taking and both successful and attempted suicide by self-immolation happened on the acute wards.
And you, Prof, want them to, inside an average of a fifteen day admission window, address all those ‘major problems of major mental illness’. Patients may have spent years wrecking their physical and mental health. It’s way beyond the scope of an acute ward to do what you demand. Addressing those ‘major problems’ was the job of rehab wards, when there was such a thing, including long-term rehab and I remember plenty of patients notching up years there.
It’s no surprise you are so down on inpatient wards when they can’t even turn lead into gold, make a silk purse out of a sow’s ear and invent a perpetual motion machine. Slackers.
The Prof offers even more damnation of inpatient wards as follows. Her list of those ‘major problems of mental illness’ that inpatient wards aren’t good environments for ‘include very low rates of employment (8), poor physical health leading to early deaths (9), high rates of drug misuse (10), and pervasive experiences of social isolation and stigma (11). Our patients certainly do have more than their fair share of all those. But what are you comparing against? They don’t manage these problems better out of hospital Prof?
NB. Reference 10 does NOT demonstrate high rates of drug misuse in mental hospitals. You’d think you’d know, Prof, since you’re its co-author.
Dear reader, yes, you read that correctly. Inpatient mental hospitals are no good because patients don’t get jobs when they leave, because their physical health outcomes remain poor (the cited study is only for cardiovascular and cancer mortality btw) and so on.
It’s funny Prof how you didn’t mention the patient’s diagnosis or the acuity of their symptoms and illness at the point of admission. How long they’d been deteriorating and neglected before bed managers found them a bed. Nor how long it took to assess, treat and stabilise them, whether their meds took or didn’t, whether the patient was compliant or not. Whether they’d fully recovered on discharge or were shoved out the door too early because managers have been incentivised (and probably bullied) to shrink admission lengths, to remove the MHA as soon as they can and discharge, discharge, discharge.
How silly of me, they’re irrelevant compared to your little list of how things should be in Paradise. Did I mention the kitchen sink argument Prof?
I might as well finish now I’ve started. Her last challenge (of her final straw man.)
and, fourth, that we have exhausted potential strategies for reducing reliance on beds.
How does ‘reducing reliance on beds’ = disproving bed closure has gone too far in the UK, ergo bed closure hasn’t gone too far and needs to continue. You went and moved the goalposts, you scamp. Did someone actually working in mhs really state that Britain must keep closing beds until we’ve exhausted all the other potential strategies? I didn’t think so. May I respectfully signpost you to this explanation of a straw man?
Concludes in ‘There aren’t anywhere near enough…’ Pt 4
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