RC Psych (Royal College of Psychiatrists) Chronic fatigue syndrome: helping your child to get better (note: Disclaimer This is information, not advice. Please read our disclaimer.) https://www.rcpsych.ac.uk/mental-he...r-parents-and-carers/chronic-fatigue-syndrome (not surprised to see them linking to AYME for further info, but I was surprised to see Tymes Trust there also; wonder if Jane Colby is aware?) https://www.rcpsych.ac.uk/mental-he...r-parents-and-carers/chronic-fatigue-syndrome
Medically unexplained symptoms https://www.rcpsych.ac.uk/mental-health/problems-disorders/medically-unexplained-symptoms
The Biopsychosocial model revisited; myth and reality https://inpponline.com/the-biopsychosocial-model-revisited-myth-and-reality/
I sense a new re-branding. I'm sorry, I meant a re-re-re-branding, give or take. The model is dead, love live the same model!
The Philosophy section of the Royal College of Psychiatrists When all else fails, call in the philosophers.
Sad thread from Twitter ( see comments) Seems plausible deniability defence being rolled out .... https://twitter.com/user/status/1575450402962771968
"Health anxiety (sometimes called hypochondriasis) - where someone worries a lot that their symptoms mean they have a serious physical illness, despite reassurance that they are not physically ill." Which could be paraphrased as "when the patient doesn't trust their doctor's 'reassurance" --> must be a problem with the patient. Insightful that focuses on that term/action rather than a more specific term relating to appropriate level of investigation Then under 'what tests should I have': "Your doctor can discuss with you what investigations you need for the symptoms you have, and when enough tests have been done, to look for anything important. It is often unhelpful to have investigations that are unlikely to show anything: Tests may be painful and carry a risk of harm. Unnecessary investigations that don’t show anything are often not reassuring. They can make someone worry even more that there is something still to be found and that more tests are needed."
"The philosophy SIG focuses on a central aim, which is to encourage philosophical thought and conceptual analysis amongst psychiatrists." Under development bullet: So I wondered what is values-based practice? From squirrelling round it seems that it is all about the 'compromise' idea, like the guideline and 'it's a debate'. And this whole centre and section is based on 'training' people in defined development to allow them to make their decisions in this way (what happened to the science?): "Balanced decision making means decision making that is based on a balance between the (often complex and conflicting) values of those concerned in a given clinical situation" On the following page: https://valuesbasedpractice.org/ Anyway just having a bit of a look at the glossary page with lots of terms it seems to be the most useful one as it actually has to define rather than repeat the same phrases that don't give much certainty to me: https://valuesbasedpractice.org/more-about-vbp/resources-2/ one example here is Is this something to be concerned about? SHould have I have heard of values-based before, is it describing something 'inane' that happens anyway, or is it a new pushing us further down the EBM issues route where methodology gets less and less concern in things?
One has to wonder how this came to the attention of the BBC before the medical and administrative staff. Is the BBC the first point of contact in the complaints procedure?
Hmm Zimbardo springs to mind: https://en.wikipedia.org/wiki/Stanford_prison_experiment - there might be certain questions about it years on but I don't believe anyone doubts the idea of this being the general gist of how you can pretty much set-up a situation that is bigger than the free-will and individual personal qualities of the actors dumped into it. Unsurprising corporate-type response. Definitely smells of distancing strategy. You'd think the few people who can't claim 'deniability' in such situations are if you are at the top of the tree, with power, voice at the table and in charge of decisions for those patients - so the elements that create said situation - and are the very business where qualifications and competence to practice implicitly mean you should understand this. Whatever you prefer to believe. And of course should be very aware of the damage it causes (and take responsibility for it - 'trauma' as they seem to like to label it doesn't come from within the person being given it).
For non UKers - the Panorama programme is the oldest documentary format on the BBC - highly respected and generally of sound, and frequently of excellent quality. I watched the Mental Health Unit exposé in full on the day of broadcast - it is available on the BBC website for streaming Edenfield Centre: Hospital's 'toxic culture'. I did ponder posting it here - but decided against because I thought it too grim -- without wanting to patronise anyone, I think discussing it in detail should carry a trigger warning. What was shown is sadly not new to the UK but there had been hope in recent decades that this kind of treatment of 'locked up' people was a thing of the past - there are very strong overtones of "One Flew over the Cuckoo's Nest" - albeit without lobotomy. A similar case of institutional abuse was seen in adults with learning impairment also exposed by the BBC 10 years ago: Winterbourne View abuse scandal although the legal cover of having someone locked up was not relevant in that case. My view of the current case is that while senior Psychiatric staff have questions to answer at a management level, there was no evidence that Psychiatry has a case to answer, the ward level care staff behaviour was below any acceptable standard and the question is "where was management and why were staff not corrected or simply sacked and/or prosecuted for clearly criminal acts ?". Panorama didn't explain the full hospital management hierarchy so I'm unclear who was responsible for what in the management chain - it may be that psychiatrists and psychologists were sidelined. Again my personal take, not a wholly evidenced view, is that what was shown was a collapsing system where historic underfunding has been exacerbated by post 2008 Financial crisis austerity, leading to a service where the least capable staff are retained because there are no available replacements, where 'warehousing' of seriously ill people is cheaper than providing proper care, and where management is so overwhelmed by firefighting that everyday issues are lost in perpetual crisis management. None of which excuses the abuse and sheer unprofessionalism of nurses and care staff that Panorama exposed. For patients with ME/CFS and other non psychiatric illnesses which psychiatry and psychology seek to offer solutions, I think the question we might reasonably have for Psychiatry and Clinical Psychology is "if we are not asking for your help, and things clearly within your own immediate purview are such a mess, why are you insisting on focusing on us ?" I'm afraid the honest answer, at least in part, is that ME/CFS offers a softer option than the seemingly intractable problems of profound psychiatric illnesses which are simply not very 'sexy' to work with. Edit to add link and sort some words
still on their website site info is from 2015 and says due to be updated 2018........ https://www.rcpsych.ac.uk/mental-he...d-carers/chronic-fatigue-syndrome-for-parents @adambeyoncelowe
https://meassociation.org.uk/2023/1...egarding-their-website-information-on-me-cfs/ The ME Association writes to the president of the Royal College of Psychiatrists regarding their website information on ME/CFS
Thanks for this. I see Charles is on it, as usual, but I'll add this to my list of relevant examples. If it helps, I know there are people working behind the scenes to provide new educational materials that will have pretty wide reach and supercede this sort of stuff.