The Horrors of Economies in Mental Health Treatment

Today The Guardian reported: The Care Quality Commission (CQC, the NHS care watchdog) said in its annual review of mental health services that it was a "serious cause for concern" that so many of those admitted informally for care and treatment, mainly in hospitals, were then detained. They said: There were 50,408 cases of people being detained for compulsory treatment under the Mental Health Act in England during 2012-13; the total topped 50,000 for the first time and marked a 12% rise over the previous five years, from 44,093 in 2008-09.

However over recent years the number of available beds has been reduced because (in an ideal world with plenty of money) most mental health patients are best treated in the community rather than in hospital. The current economic situation means that more people are under the kinds of stress which triggers mental illness, so the need for community treatment is increasing. At the same time government imposed economies are resulting in reduced community services and so the waiting times for treatment (for those lucky enough to get it) are increasing. This means that more and more people are not getting the early treatment they need until too late - and they have become desperately ill. The whole thing can develop into a vicious spiral when more serious (and expensive) patients means less resources are available to stop people becoming seriously ill.  

I find this news very disturbing as it brings to mind images which still, on occasions, return to haunt me, as the sort of thing that was happening 40 years ago is still happening now - with our prisons taking more and more mentally disturbed prisoners, many of whom are only there because they did not get proper medical support in time.

So what happened 30 years ago that makes me think of the small flap in the front of a prison cell door.

One of my Hertfordshire Photo was Picture of the Day on Geograph

As you may have noticed, from the box in the right hand column, I occasionally post photographs of Hertfordshire, parts of Buckinghamshire, and occasionally other places, on the Geograph web site.

Low Water at Startops Reservoir, near Tring, in 2012

It seems somewhat ironic that on January 23rd Geograph chose one of my pictures of the effects of drought on the Tring Reservoirs to be their "Picture of the Day" when a visit I made a few days earlier had shown that all the reservoirs in the area were filled to capacity. This picture shows (not very clearly) part of the medieval ridge and furrow area I reported on my other blog on December 3rd 2011 and March 11th 2012.

One of the frustrating things about Geograph's "Picture of the Day" is that the photographer is not told when one of his pictures has been selected and it sometimes appears years after the picture had been added to the web site. (I posted the above picture on January 24th 2012).

I know two other pictures of mine have been selected in the past - but there may have been others.

The first was this picture of tulips round a war grave in the churchyard at Halton, Bucks, near Tring, which I took in 2009, together with other pictures of the church and village.

The other was this view of  barges moored on the Grand Union Canal at Marsworth on a frosty winter morning in December 2012.

I don't “do” Poetry – but now I've written a Limerick.

Many scientists are illiterate and I am sure this is a result of their education. In my case bullying was an important factor. By the age of 13 I had been to six different school and had been bullied at three of them for a total of about six years. Much fiction concentrates on personal relationships and ends up happily ever after and I knew life was not really like that. Bullying meant my view of life as a young child was of misery was piled onto misery, apparently without end. Apart from some science fiction (mainly Azimov) and The Lord of the Rings, I don't think I have read a work of fiction in the last 60 years. This approach has also affected my choice of TV watching – and I avoid soaps and plays because they are a “waste of time”. As a result I have very little knowledge of the classical literature or modern fiction.

My attitude to poetry was undoubtedly influence by an incident when I was 8. During the winter of 1946/7 there was heavy snow in Devon and I was confined to bed with some childhood illness. So I started to write a poem – “I wish I'd seen the snow fall” which was terrible doggerel – with dozens of rhyming couplets interspersed with the theme line repeated again and again. I was caught writing an extra verse during school prayers by the headmaster and ridiculed in front of the class (which of course included the regular bullies). Clearly writing poetry was not a clever thing to do.

Two schools later a trainee teacher got into trouble. He had tried to get us to learn Wordsworth's “Daffodils” and had been singularly unsuccessful – at least with most of the boys in the class. So the next poem he set us to learn was Harry Graham's poem which starts “Broad is the gate, and wide the path, that lead man to his daily bath”. We all learnt it, clearly demonstrating that our problem was motivation and not stupidity. Of course the headmaster received a number of complaints from prim and proper parents who thought that their children should not be exposed to such unsuitable nonsense - so classes returned to uninspiring conventionality..

However in 1952 I moved to Dartington Hall School where things were very different. In particular Raymond O'Malley inspired me to think creatively about language but failed miserably in trying to get me to improve my dreadful handwriting. Chaucer's Prologue intrigued me and helped me to understand how language developed with time while an in-depth study of T. S. Eliot's Journey of the Magi and The Wasteland made me realise how powerful language could be if creatively used. I was also encouraged to write a limerick involving word play, triggered by Flaunder's and Swann's The Gnu Song and my amateur effort was published in the School's magazine, Chanticleer.

There was a young man at the zoo,

Who allowed penny rides on his gnu,

      But the gnu was too old,

     And at last caught a cold ,

And a new gnu was needed, he knew.

Needless to say I haven't written any more poetry since then, until a couple of week's ago. But over the intervening years O'Malley's inspired teaching has stood me in good stead. My first job was as an information scientist writing managerial research and development reports. Later I wrote various pieces for the New Scientist, such as Why Gebius is nipped in the bud. What I had learnt forty years early greatly helped when I came to write “The London Gunners come to Town.” The unusual structure of this book, in three parts telling the story from three different points of views, was probably inspired by my refusal to accept to establishment norms, an approach which I picked up at Dartington.

So why have I returned to writing limericks after so many years? I am currently trying to teach myself Windows 8 and I started to set up a diary for 2014 – and made a silly mistake. A few days later the computer reminded me to go to the Archaeology group meeting of our local U3A group and, because it was the wrong day, I walked into the Poetry group by mistake and decided to stay. Not only did I enjoy it but I discovered there was a limerick writing competition and decided to have a go.

Memories of how to do it came flooding back. I not only needed  to get the verse structure right. My limerick would need to tell a topically interesting story, and end with a suitable punch line. I also felt that if it was to be read out the way it was presented could convey added meaning without the need for extra words. The first line was given so I had a mere 28 syllables to play with. I was used to writing to a target – although with the New Scientist this was usually 400 or 1000 words – so it was going to be a challenge. The following was the result

"Dedicated to the losers in this limerick competition"

Narrator: Normal voice	A member of Tring U3A Expected to win here today
Poet: Excitedly with pride and flamboyant gestures expecting to win	“With a limerick fine      The prize should be mine.
Poet: Descent into bathos on discovering he had not won.	But the judge must have thrown it away”

In planning this I decided to look online to see what I could find about writing limericks. After looking at two or three sites I decided that writing limericks should be fun and while the pages I saw included examples of interesting and amusing limericks the connecting text was boring. Perhaps there are better sites – but I decided that what was needed was a limerick to tell you how to write limericks – and this is the result:-

A limerick's distinctive metre

Means you do have to know where the feet are

     And of course the fourth line

     With the third line must rhyme

While the last line can be a repeater.

I feel I ought to have been able to come up with a better last line – but of course Edward Lear's limericks, and others in the same style, do use repetition. Of course some purists will complain that I have added an unstressed syllable at the end of lines 1, 2 and 5, and that “line” and “rhyme” don't rhyme. But many poets, and anyone who has benefited from a Dartington education, knows that the appropriate breaking down of establishment boundaries is a very effective tool in getting a message across.

How Accurate are Police and NHS Statistics?

This morning the BBC Breakfast Program said that later today the National Audit Office would raise questions about the accuracy of NHS waiting time lists while the News web pages reported similar questions about police crime statistics

I am not surprised - for many years I was a public representative on committees relating mainly to mental health in Hertfordshire and I never believed a lot of the statistics - but I knew enough to know why the local figures were likely to be only approximate and I also knew that the officials who presented the statistics also knew of the limitations - but it was necessary to present them with a straight face. [Some examples below the fold.]

Future Plans - and how to get a working up-to-date CODIL system

One of the problems I face is the lack of an up-to-date working CODIL simulator which will run on modern computers and a short history of the various experimental CODIL systems is appropriate, followed by a note on continuing the research. For details of the many original publications click here. More information is given below the fold.

If you feel you are stuck in a box ...

I really like this one - which I found on God on Facebook

Rural Relaxation: Mallard Ducks at Ashridge

Mallard Ducks in Clickmere Pond close to the Bridgewater Monument, on the National Trust Ashridge Estate. The pond is a former dew pond - and originally there were a number in the area, probably built for the cattle on the drove roads that crossed the Chiltern Hills.

Where do nonhuman mammals fit in our moral hierarchy?

Michael Shermer recently posted Confessions of a Speciesist on his web site which raises the question about how we should think about animals and their suffering. I have replied posting the following comment.

I am currently exploring the idea that the brain's neural code is a protocol which is resistant to evolutionary change and at the biological level works in the same way in all mammals. The model predicts failings in human intelligence such as confirmation bias and the tendency to behave like dwarfs standing on the shoulders of giants (whether the giants be religious leaders or famous scientists) and unquestioningly accept too much of what we are told as true.

What humans appear to have done is to weaken the power of the neural code to work things out for itself - and instead used language to allow the brain to fast track cultural information without any "security checks". This works because cultural information is much more "intelligent" than  the biological intelligence of the neural code. It has the interesting side effect that, at the genetically controlled level, we may actually be less intelligent than animals - who have to think for themselves - and are unable to fall back on cultural knowledge supplied by others.

If my model can be substantiated it makes one think about animals and animal suffering in a very different light.

I plan to post full details on my blog www.trapped-by-the-box.blogspot.com later this month.

This post was accidentally blocked as spam by an automatic moderation package and I had another try ...

I read Joe's comments about the moderation with interest as my contribution has not appeared, despite the fact that if did not breach the comment policy. Perhaps I did not make my views clear enough – so lets put the argument in a different form.

Religious people believe that God did something special to make humans different, and many scientists are busy looking for that critical genetic change (the philosopher's stone of intelligence) that makes us different. Anyone who believes that humans think in a fundamentally different way to animals is less likely to treat animals as sentient beings which deserve respect. This means that in discussing morality we clearly need to know more about the evolution of the differences between human and animal brains.

One possible model starts from the assumption that the neural code (the brain's internal communication language) is part of the mammal body plan which evolution finds difficult to change. Provisional research on this basis suggests that our apparent greater intelligence evolved because of the ability to fast-track cultural learning (via language) and not by evolving a more powerful genetically controlled neural mechanism. While faster uncritical learning may have significant overall advantages there are also some important disadvantages. The model explains why human thought suffers from confirmation bias and also makes it easier to accept nonsense, such as religion, as fact. As a result we know much more, and can do much more, than animals but the way we do it has some unintelligent flaws.

One consequence is that some animal species, which have to live by their wits because they lack a reservoir of cultural knowledge, may well be more intelligent than we would be if we were denied the benefits of cultural learning. If research shows that some animal brains are inherently more intelligent at the genetically controlled level it becomes very hard to justify treating them as second class creatures. 

The problem has now been corrected, and an apology given, and both messages are now visible.