Moving on to Prof Johnson’s second idea to debunk is ‘that community care policies result in high levels of antisocial behaviour and failure to sustain community living.’
High is an elastic term if you don’t provide a scale and ‘failure to sustain’ can mean absolutely anything. If a community patient doesn’t achieve a Masters in Media Studies, is that an example of failing to sustain community living? Or did you mean multiple crisis admissions after playing suicide chicken with A&E and Crisis?
Let’s have a close look at her ‘challenges’. Liberal use of these phrases ‘have tended to’ ‘suggests’ and ‘most of…’ tell me there aren’t any data backing her up. ‘Most people with significant mental illnesses live peaceful lives in the community most of the time…’ Remember CNN’s ‘fiery but mostly peaceful protests’ report on the rioting, looting and violence of the Kenosha riots?
And this pearler. ‘The second idea, (yes, the one she started off by saying was only ‘that community care policies result in high levels of antisocial behaviour and failure to sustain community living’ has been ramped up somewhat) that deinstitutionalisation has unleashed a cohort of mentally ill people who are a threat to others and incapable of sustaining acceptable community functioning, is familiar from the media.’ Well, I’m convinced alright. Those pesky media. Obviously, no further debunking of that idea is necessary once you mentioned them. Especially that ‘and’ which means to have failed, the patient must meet both conditions, not just one. Um, you couldn’t just explain it one more time, could you Prof?
Point 3.‘…third, that inpatient wards are an environment conducive to addressing the major problems associated with severe mental illness,’ Hmm. Prof, you may have gone a few leagues off-piste here. You were supposed to be arguing that bed closures haven’t gone too far in England. Have a private word with your hubby; ask him whether you hit him with the kitchen sink argument when you can’t get your own way fair and square. Saying ‘we must have more bed closures since the wards aren’t doing what (you say) they should be doing anymore’ (while using a textbook application of weasel words) (*) is rather like the man who trained his dog to live without food. Just at the point he managed it, the damn thing died!
Would you say it’s dishonest to state since acute wards are now primarily for containment of immediate risk (a good thing, wouldn’t you say? Who’s going to do that if you get your way and shred even more beds?) but then follow that by rubbishing them for not also doing what a well-funded community service does, e.g. helping the patient with those long-term problems that remain even after they’ve recovered and are discharged?
Like isolation, stigma, persistence of residual symptoms, negative symptoms, getting out of the house, doing activities and social engagement, monitoring and maintaining their physical health and those chronic physical conditions psych patients have more of, staying off drugs and alcohol, collecting and taking their meds, not becoming hopeless and suicidal and more.
You wouldn’t? Oh. I would.
*) Weasel words example 1 = ‘…are good environments for addressing…’ I’ll be writing some posts asking and telling what a good acute inpatient ward looks like, is set up to achieve, how it should be designed and built and staffed (nurses, doctors, occy therapists, psychology etc), along with what it can’t do. I’ll do the same for PICU’s and locked rehab and all the other levels. You didn’t do that.
British mental nurses have seen, for decades, more and more demands (I’m sick to the back teeth of managers sending me emails prefaced with ‘it is now a requirement…) that eat into our time, focus and energy to do the basics of our job. No-one can become an expert under those conditions. Some of us were lucky enough to become expert before idiots overloaded our jobs. Acute wards can do so much and no more. If our glorious leaders were to stop overloading us, staff would actually become highly skilled at doing the basics; taking a depressed or psychotic or dysregulated or withdrawing (etc) patient and helping them reach a place they can start moving forward from. Acute wards used to be good environments for achieving exactly that and more. Now they are environments where overworked staff do nothing but keep scores of management mandated plates spinning, running from one to the next until their shift ends. And they’ll remain that way for as long as muppets shred our funding, tie our hands behind our backs, steal our time and waste it on forcing us to complete the e-forms that keep their bullshit QA jobs a-rolling.
Continues in ‘There aren’t anywhere near enough…’ Pt 3
Leave a Reply