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Psychiatry in the news – 14 April 2009

The Observer front page on Sunday last ran the headline:

Four psychiatric patients dying every day in NHS care

In the safety conscious NHS culture, every time something untoward happens an incident form is filled in.  An incident form should be completed if, for instance, a patient was given  by mistake 10mg of Olanzapine rather than 5mg.  Sometimes the incident can actually be quite trivial.  I have filled in incident forms on three occasions, once when patient had a heart attack in my office, once when  patient scarpered before I’d finished assessing him and once when, on the side of a table, I ripped a brand new pair of trousers on the first day I wore them.

The National Patient Safety agency  collect details of these patient safety related incidents (my third incident wouldn’t be included in this).  These are published on their website on a trust by trust basis.  According to the Observer, The Liberal democrats have added up the number of deaths across the country 2007-08 and have come up with a figure showing that 1282 people died in patient safety incidents in mental health settings.  The Observer reports what Normal Lamb, the Liberal Democrats Health spokesman, has to say about their calculation:

These figures are shocking. It’s a scandal that four people a day are dying while under the care of the NHS, and nearly three a day are ending up seriously harmed. It’s an appalling indictment of NHS psychiatric care.

These deaths are the result of inadequate attention and resources being given to mental health, despite the patients being among the most vulnerable and needy in the whole health system

Now, I’m not about to argue that mental health care in the NHS is ideal, nor that it’s not underfunded.  However without further breakdown as to the circumstances surrounding each death or serious injury I don’t think that it’s fair to reach these conclusions.  A proportion of these deaths will be due to suicide and, although the numbers of these have reduced, they will be difficult to stop entirely.  But there will also be a large number due to natural cause.  A lot of people work within difficult mental health settings at only small personal gain; their care will not be perfect but this represents a disservice to their hard work.

Celebrity watch:

Ronny O’Sullivan who defends his world snooker championship title next week talks in the Guardian about the problems he has encountered with depression.  Seemingly an extremely intense man, he appears to have discovered that running helps him cope. 

O’Sullivan is a fanatical runner and its impact on helping him cope with depression is profound. “Running clears my mind, and gives me a reason to get out of bed in the morning. Once I’ve had a run I can hit some balls for a couple of hours and by then it’s the afternoon and I think, ‘Yeah, it’s been a positive day, really.'”

Sublimation was Freud’s name for it.

Phil Spector, 1960s pop supreme inventor of the ‘Wall of Sound’ and dubbed the ‘first tycoon of teen’ by Tom Wolfe has been convicted of the murder of B movie actress turned nightclub hostess Lana Clarkson.  Spector had a reputation for eccentricity and talked during his trial about being on psychiatric medication.  My web searches haven’t come up with anything particularly illuminating concerning his mental health, although these people claim him as bipolar with this quote from the Observer. 

I consider myself a disturbed human being, but I’m under control. I’ve been blessed with a genius, but I’ve been punished with insomnia and manic depression. I’ve fought the devil for 20 years

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  1. My most recent incident form was because my computer mouse did not have a roller wheel. i have been assured by the powers that be that a roller wheel mouse is on the way but 2 months and still waiting.

  2. The story about psychiatric patient’s deaths is sadly typical of the state of public discourse in this country. So 1282 patients died in 2007-08 in NHS care. The intelligent thing to do with that number would be to compare it, a) to the past and b) to the equivalent figures in other countries. Then, if you found that, say, the situation was worsening in the UK but Switzerland had managed to halve their death rate in the last 5 years, you could see what the Swiss are doing and copy them.

    That would be the intelligent thing to do but the Lib Dem’s don’t seem interested in doing it. Mainly because it’s not going to win them any more votes than they’ll get by just calling the figures outrageous and using them as a stick to bash Labour.

    Now personally I don’t blame the Lib Dem’s for that, they’re a political party, they exist to get votes. But the question is, if they’re not going to do it, who will? Is anyone – academics or thinktanks – going to give these numbers the attention they deserve?

  3. New national guidlines telling doctors not to prescribe diazepam or its likes short term to alcoholic or addicts has been a short sighted disaster. Not prescribing to people in crisis and puting them on a waiting list for psychiatric help that is often poor in its delivery is bordering on human rights violoations. Its not an easy job to offer help in crisis, but to deny it is indefensible.