YOUNG, FREE AND MENTAL

Two reports published within 24 hours of one another have yet again highlighted that, for all the heightened public awareness of mental illness in recent years, it remains socially stigmatising and seriously underfunded. The first report, ‘Thriving at Work’, commissioned by Our Glorious Leader no less, was a review of the way in which the workplace responds to those members of the workforce afflicted by various mental health symptoms. One sufferer of chronic depression, interviewed by the BBC in the wake of the report’s publication, was advised to look elsewhere for employment by her boss when she admitted her condition and was made to feel increasingly uncomfortable once it became common knowledge in the office; she left the job not long after, as do around 300,000 a year for similar reasons, costing employers upwards of £42bn.

The findings of the experts who compiled the report on behalf of the PM confirmed beliefs that mental illness has yet to fully shed its taboo status. At a time when the cry for an end to all discrimination based on race, religion and sexuality is at its loudest, it’s ironic that those whose needs are deemed most worthy of attention are those whose otherness is blatantly obvious in either the colour of their skin or the clothes they’re wearing – whether a lady in a burqa or a feller in a dress. Their ‘diversity’ is a virtual sandwich board of personal advertising, something that makes it easier for the majority to discern the difficulties of the minority.

By contrast, mental health symptoms being invisible to the naked eye always present its sufferers with a problem as to how it relates to those around them, unlike any physical illness. If the symptoms aren’t visible, it’s as though others are unconvinced there’s any sort of problem because they can’t see it like they can an arm in a sling or a leg in a cast, like they need to have it simplified in the most basic manner as proof the sufferer isn’t acting up. Mental illness is more challenging to the non-sufferer and can often spawn a sceptical attitude towards the condition as a consequence, almost forcing the sufferer to convince the doubters as if they were faking insanity to get out of the army. I’ve been confronted by it myself. ‘There’s nothing wrong with you; you’ve got two arms and two legs – what’s the problem? Depression is just another word for laziness.’

This attitude is in place from an early age. The second report into mental health to have appeared this week concentrated on the youth experience and how poorly served young sufferers are by the system. This review discovered almost 40% of services exclusive to children and adolescents in England were in desperate need of improvement. ‘The World at One’ covered the report by making a Freedom of Information request on the subject and discovered some children were having to wait up to 22 months before seeing a specialist mental health professional. I must admit these revelations didn’t strike me as particularly revelatory, however; anyone who has followed my regular posts on the severely mentally-handicapped child I’ve christened X probably won’t be surprised to learn X herself has endured gaps of a similar nature between such appointments.

The report was compiled by the Care Quality Commission, whereas earlier this year, NHS England published its own suggestions for improvement; ‘Five Year Forward View for Mental Health’. Claire Murdoch, head of mental health for NHS England claimed there has been an increase of 15% of spending on mental health services for the young over the past twelve months. ‘Without a doubt, after years of drought,’ she says, ‘the NHS’ mental health funding taps have now been turned on.’ As ever with the NHS, though, one wonders where the money goes; or, to maintain Ms Murdoch’s watery analogy, which plughole it’s destined to disappear down.

‘The World at One’ spoke to 22-year-old Alice Gibbs, who was diagnosed with anorexia at 12 and, after a six-month wait to see a specialist, received four years of treatment in her home city of Leicester, despite its limitations. There was an eating disorder unit in London she now reckons had the facilities to accelerate her recovery, but as a physically and mentally fragile 16-year-old, being away from the support of her family probably wouldn’t have helped either. Had somewhere of that unit’s calibre been closer to home, she surmises she wouldn’t have lost a decade to such a debilitating condition. Her experience seems to back up the ‘postcode lottery’ theory when it comes to healthcare.

Alice Gibbs is still receiving treatment, saying she has ‘managed’ her condition rather than cured it, something that anyone who has experienced mental illness will recognise; it’s always a case of management rather than cure, because there isn’t a cure. Alice Gibbs’ treatment could well be an obstacle to any career ambitions she harbours, though ‘Thriving at Work’ makes 40 recommendations to encourage employers to help their employees with mental health issues stay in their jobs. But it would seem it depends on who you work for. The insurer Aviva received special praise in the report, yet they seem to be the exception rather than the rule. On the whole, both of this week’s reports into mental illness don’t paint a very rosy picture of this country’s care for and treatment of those unfortunate enough to fall under its devastating shadow.

And whilst it makes a refreshing change to commend Theresa May for something – ‘It is only by making this an everyday concern for everyone,’ said the PM, ‘that we can change the way we see mental illness’ – we cannot neglect the callous disregard for sufferers of mental illness that her Government and its predecessor has presided over via its continuous use of Atos to decide whether or not someone is ‘faking it’ for benefits. The toxic legacy of the IDS era is still with us in the shape of Universal Credit, after all; and Mrs May won’t budge on that one. Giving with one hand and taking away with the other yet again.

© The Editor

DR. DIVERSITY’S CASEBOOK

Although I haven’t broadcasted it on here before, around two months ago I belatedly bowed to financial pressures and switched from smoking to vaping. My opinions on the rights of, and discrimination against, smokers haven’t altered; the decision wasn’t anything to do with me meekly surrendering to the fanatical anti-tobacco lobby, an admission that they were right and I was wrong all along; the simple fact is I couldn’t afford it anymore. The rising cost of a packet of fags – £10.50 for 20, last time I looked – hasn’t been in line with the price of everything else for a long time. The fact that, depending in which supermarket you shop, you can buy three bottles of wine for the same price as 20 cigarettes will cost you speaks volumes; and the drain on my finances was too much to sustain, so I stubbed out my final fag in August.

It helped that I instantly liked vaping and, as if to emphasise this, I still have a packet of Superkings containing four remaining fags that hasn’t been touched since the day I received my first e-cigarette; after almost 30 years of smoking between 30-40 cigs a day, I suppose that’s not bad going, and I can honestly say I don’t miss it at all. If the buzz from the drag is the key hook of the smoking process, I can get just the same nicotine hit from vaping and replicate the former gesture at a fraction of the cost. The vapours don’t linger in the room, they don’t discolour the fixtures and fittings, they don’t coat my clothes in a permanent odour, and they don’t dissuade non-smoking visitors anymore.

Immunity to the smell of cigarettes was a consequence of smoking them; only since I stopped have I become aware of it. It’s still entombed in my wardrobe because there are a lot of items on the coat-hangers there that haven’t been washed or worn since I ceased; but it’s amazing how strong the smell is on others now. When out and about, I can detect a cig from quite a distance, long before I see someone smoking it; and it’s remarkable how everyone I see with a fag hanging out of their mouth seems to be the most slovenly, scruffy slob imaginable; the archaic images of Marlene Dietrich or Lauren Bacall using cigarettes as a crucial element of their effortlessly cool personas aren’t being matched by the smokers I’m seeing. By contrast, the e-cigarette is a rather sexy, stylish object and, frankly, superior in all respects.

Not that the proven health (and financial) benefits of vaping deter the tobacco prohibitionists, who see it not as an escape route from smoking but as a gateway to the practice, the fools; the same limitations on ordinary cigarettes have been unfairly superimposed onto the e-cigarette, and I’m wondering when I’ll encounter opposition to it from the medical profession. I say this because the first time I remember being singled out by a GP for smoking was in the early 90s. I can’t remember the reason for being at the surgery, but I recall the doctor asking me if I smoked; when he received a reply in the affirmative, he placed a little sticker on the front of my file, which he presumably did for all smokers. Perhaps afterwards my file was slotted in a drawer along with the rest of his smoking patients, segregated from the non-smokers and downgraded in the case of an emergency when a choice might have to be made between the two groups.

Back then, it felt like a bit of an intrusion into my privacy, though smoking as heavily as I did was obviously a health risk, and I can understand to an extent that it would probably be in a GP’s remit to hint at what I already knew – i.e. smoking wasn’t good for me. What if it went further than that, though, into private areas that (unless the visit to the surgery was related to one’s ‘rude bits’) have no relation to one’s health in the same way? New NHS guidelines apparently imminent mean that health professionals will now be obliged to ask patients over-16 what their sexual orientation happens to be. It’s both a further extension of the nanny state’s nosy neighbour tendencies and the latest chapter in the ongoing ‘diversity’ agenda that has swept through every public body of late to seemingly appease a very small section of society with a very loud voice.

Doctors and nurses will now be recommended to inquire as to a patient’s sexual orientation at ‘every face-to-face contact with the patient, where no record of this data already exists’; what is horribly referred to as ‘sexual monitoring’ will be mandatory in England and Wales by 2019. Patients will be asked ‘Which of the following options best describes how you think of yourself – straight/gay or lesbian/bisexual/other sexual orientation’; presumably, the ‘other’ is paedophile or zoophile? Might I suggest an additional response on the part of the patient – ‘Mind your own f**king business’.

Thankfully, Dr Peter Swinyard, Chairman of the Family Doctor Association, was not impressed; in his opinion, the new guidelines were ‘potentially intrusive and offensive’, adding ‘Given the precious short amount of time a GP has with a patient, sexuality is not relevant’, rightly pointing out that sexual choice affected ‘relatively few medical conditions’. On the other hand, Paul Martin, chief executive of Manchester’s LGBT Foundation, says he is ‘so proud’ of the intrusion into patient’s private lives. His organisation has pushed for ‘sexual monitoring’, as it views the change as some kind of step forward to address perceived medical inequalities for those happy to be defined by the LGBT pigeonhole. Those patients who don’t want to disclose their sexual preferences – and why indeed should they? – will be placed in the ‘not stated’ category.

This compliance with the Equality Act 2010 by the medical profession is allegedly intended to ensure no patient is discriminated against; but if someone’s sexuality isn’t advertised on their file, no rush to judgement based upon it by a doctor who might hold prejudicial views can then be made – and doesn’t that make all patients equal? A doctor’s role is to treat whatever is wrong with the patient; a doctor doesn’t need further unnecessary data that bears no relation to the patient’s presence in their surgery – unless the patient smokes or vapes, of course; and then they deserve all the stickers their files can handle.

© The Editor

NO COUNTRY FOR SQUARE PEGS

wilf-lunnWhen people speak of the Great British Eccentric being a dying breed, most of the examples given of the species do tend to be over a certain age – 50, at least. Granted, there are a few defiant exceptions (certainly in terms of dress, someone like Paloma Faith, perhaps), though the famous names that spring to mind are usually past their half-century. I think the claims of the species bordering on extinction aren’t too far-fetched in that it’s hard to foresee another generation spawning any. It isn’t just the large-scale homogenisation of genuine individual thought and/or appearance within society that could be held responsible, nor the fact that every suspected ‘Paedo’ exposed by the press is painted as ‘a bit weird’ because he doesn’t adhere to an imposed dress-code (thus marking out sartorial originality as totally toxic); but when any potential eccentricities surface in children today parents, teachers and doctors alike are a tad too quick to diagnose a ‘syndrome’.

You may or may not have heard of Oppositional Defiance Disorder, but that is the tag that has now been attached to children who misbehave – yes, fancy that! Children misbehaving and refusing to do as they’re told! What an uncharacteristic behavioural trait! Children doing what children have always done can no longer be just that; there has to be a medical condition to cover all eventualities that can be tamed with both medication and counselling.

The feminisation of our leading institutions, along with the box-ticking bureaucracy that negates common sense, seems determined to prevent little boys in particular from being little boys. There is also the plethora of self-help ‘how to be a perfect parent’ publications, an entire literary industry that has had a pernicious influence on the attitude towards children and remains in perpetual denial of the fact that some of them are strange little bastards.

Ever since the recognition of dyslexia as something to be distinguished from basic stupidity, there has been a conscious rush to judgement on classic childhood symptoms that veer from the desired ordinariness that is a by-product of perfection. All the numerous minor strands of autism are examples of this, and Attention Deficit Hyperactivity Disorder is another that has now become utterly accepted as a bona-fide syndrome, a condition that is hastily diagnosed and in many cases treated with a course of medication. In recent years, the transgender issue has also reared its head, especially amongst right-on parents who seize upon any indication of effeminacy in their little boy as a sign his ‘true’ sexuality must be determined by them before he’s even hit puberty.

The dangerous fad for labelling every aspect of a child’s natural behaviour a syndrome is a panicky response when so many are afraid of standing out from the crowd and expressing any notion of individuality that contradicts the consensus. The ghastly competitiveness of parents that rests on one-upmanship faces a severe threat if their little angel is exhibiting any signs of being ‘different’, so a convenient pigeonhole that is accepted as a syndrome by the teaching and medical profession is an easy solution to a problem that doesn’t actually exist.

Like most of us, I grew up around many children who displayed personal eccentricities that would now probably have a ready-made diagnosis on hand. One girl I was at primary school with used to bite her toenails. I wonder what that would be categorised as today? Keratin Carnivore Disorder? And I suspect we all knew one or two who would eat their own bogies. Mucus Consumption Disorder? Keeping children on a tight leash and denying them the freedom to express themselves through the kind of behaviour adults aren’t able to get away with is a modern trend that only has a few caveats, such as when it comes to ‘artistic’ expression – which basically amounts to those bloody awful pictures proud parents stick on their fridges as a sign of what creative geniuses they’ve spawned.

But genuine creativity often goes hand-in-hand with unconventional outlooks and attitudes that are commonplace amongst children and rare amongst adults; the adults that retain them are ones that resisted having them drilled out by the educational system. It must be harder than ever to uphold such resistance and be a little Winston Smith today, however.

Not only does one have to risk being diagnosed with a syndrome and being forcibly drugged to wash the nasty thoughts away, but there is also the league table-obsessed educational system itself, which like all institutions – whether the NHS, DWP, police force or legal profession – has become a training camp for the appliance of politically-correct robotic responses in which impromptu personal judgment not listed in the script has no place. The fear of litigation or ostracism enables such Orwellian Ministry systems to flourish unimpeded by common sense and ideas that risk being labelled that most dreaded of contemporary ailments, eccentric.

That each new crop of recruits to these institutions now instinctively follow the rulebook to the letter of the law (and probably had early resistance suppressed by a syndrome diagnosis and accompanying medication) means the likelihood of the Circumlocution Offices the institutions have gradually evolved into ever reverting to what they were before virtually zilch. Anyone at the frontline of having to deal with said institutions will know what an uphill struggle it is to make representatives of them understand that everything they’ve had programmed into them is counterproductive to an actual result. Add the inherent conservatism of social media as a further tool for falling into line and it would seem any future eccentrics that are lucky enough to slip through the net will be few and far between. And our society will be all the poorer for their absence.

© The Editor

CARRY ON DOCTOR

KildareThere aren’t many professions that could be called honourable, though it is ironic that one of the most discredited in recent years – that of Member of Parliament – should have all those who belong to the club dignified with the prefix ‘honourable’. It is these far-from ‘honourable’ gentlemen and ladies who have recently been exercising their recurring habit of trying to squeeze as much as they can out of another profession whilst parting with the minimum amount of money, in this particular case junior doctors. That rather misleading term doesn’t mean they’re making impossible demands on Doogie Howser M.D., but on any doctor, from those who’ve just graduated from medical school to those who’ve been in the business of saving lives for a decade. Yesterday, junior doctors embarked on a further 24 hours of strike action in protest at the Government’s obstinate refusal to budge on their new ideas for the NHS.

Last November, the Government promised an 11% pay-rise for junior doctors, but soured the pill in the small-print with plans to increase the working hours, especially at weekends. Cutting corners in a time of ‘austerity’ has become a hallmark of Cameron’s reign, though patients whose lives are in the hands of overworked and underpaid medical men aren’t receiving much in the way of consideration, particularly when the uniquely charmless Health Secretary Jeremy Rhyming-Slang Hunt starts spouting his spiel.

He was confronted by emails from junior doctors during his appearance on the Andrew Marr Sunday morning show last week, but remained resolute in shifting the blame onto the BMA. ‘Mr Hunt has made me feel demoralised, insulted and cheap; he implies we are the problem,’ said one of these emails. ‘It’s so grim on the frontline now; I sometimes work 14 or 15 hours straight without a second even to eat.’ The starting salary for a doctor is just under £23,000 a year – top end of the scale nearer £70,000. For an MP, let alone a Cabinet Minister such as Mr Hunt, the average annual salary is £74,000. All aboard the Westminster gravy train!

The average salary in the UK is £27,000 a year, reduced to under £22,000 once the likes of National Insurance, taxes and student loan payments are taken into account. Police officers earn under £25,000, below the national average. Teachers fare a little better at just under £34,000, though which is the most stressful profession of the two is arguable: coming into daily contact with criminals who can at least be put behind bars or coming into daily contact with surly adolescents whose most severe admonishment is suspension.

And talking of stressful jobs, fire-fighters earn an average of between £21,583 and £35,664 depending on rank. Nurses start on a salary of £21,692 and can progress as high as £34,876. Still pales next to the salary of an MP, doesn’t it. Remember – £74,000 a year. Which provides the most necessary service to the public? It’s evident from the statistics alone that those within society whose professions can contribute towards the saving of lives – doctors, nurses, fire-fighters and the police (on a good day) – earn a pittance in relation to the vital importance of the job they actually do.

By contrast, bankers in the City of London can earn upwards of £550,000 a year, depending on how long they’ve been in the business (and that doesn’t include bonuses). These men were more responsible than anyone else for the economic meltdown of 2008, yet they seem largely immune to the cutbacks imposed on professions that play a rather significant part in the continued running of society.

Mind you, some men who kick a football around a pitch for 90 minutes at Premier League grounds every weekend earn more than all essential professions are paid over twelve months in the space of a week. In this country’s top ten of highest-paid players, Chelsea have a trio of footballers whose weekly wage is between £185,000 and £200,000. Yes, that’s what they take home a week. Chelsea are currently 13th in the table.

Junior doctors haven’t gone on strike at the drop of a hat; the vast majority have done so out of sheer desperation. They’re not led by some self-aggrandising bolshie 70s throwback looking for a fight. Negotiations between doctors and government have been ongoing ever since the proposals for a seven-day NHS were first mooted three years ago, but yesterday’s 24 hour strike has now resulted in a threat from the Government that they will impose their contract if this goes on. The BMA were prepared to accept half of the 11% pay rise offered on the condition that extra payments for working on Saturdays were retained; the Government rejected this proposal and have continued to badmouth the BMA and dispense disinformation within the media to support their stance ever since.

However, just as cutting police numbers and proposing the reduction of street lighting seems an odd way to go about crime prevention, expecting junior doctors to work longer hours without additional pay appears a curious strategy on the part of a government professing to care about the wellbeing of patients. The situation appears to have reached an impasse. Doctors who are enduring 14 or 15 hours without a break from a job in which a clear head and the ability to concentrate are crucial qualifications should be top of the list when it comes to the PM’s favourite phrase, ‘Hard Working People’. Put your money where your mouth is, Mr Cameron, and reward that hard work.

© The Editor