Stigma

As if you needed another reason not to buy The Sun...

As if you needed another reason not to buy The Sun

I talked a lot about love, peace, tolerance and empathy yesterday. I think it’s important to point out that pacifism does not mean cowardice; compassion does not mean leniency; peace does not mean inaction. If you care about something, then that means you will not back down to challenges either. It isn’t aggression, it’s resolve.

Right now, even though it is looking further and further beyond doubt that Jo Cox MP’s death was politically motivated, there is a rising chorus repeating a familiar mantra: mental health issues. “Mental health problems“. Some have said it is deflection from the alleged political links of the accused – noting that they didn’t ask for such measured responses in the aftermath of other attacks. I, on the other hand, think it is quite in keeping with their ideology to blame the infamous Lone Wolf Gunman. Conservatives claim to champion personal liberty and individual freedom, after all, so from their perspective, they can then hold up their hands and say “not my fault, gov” without contradiction when something like this happens. (That Conservatives are very selective over who gets to enjoy liberty and freedom is by the by, of course.)

However, I’m not going to talk about Thomas Mair’s first words in court being “my name is death to traitors, freedom for Britain.” Nor will I talk about the prosecutors telling the court that Mr Mair was heard to say “Britain first, keep Britain independent, Britain always comes first, this is for Britain.” Nor that Mr Mair described himself as a “political activist.” Nor that the police investigation found material from extremist white supremacist organisations. Nor that he had bought manuals on gun and bomb construction.

Let’s talk about mental health instead. It’s what you want, isn’t it?

Jo Cox shooting: Alleged shooter with extremist right-wing ties charged with murder
Thomas Mair, 52, is due to appear in court on Saturday, says police
Police investigating the killing of British member of Parliament Jo Cox said Friday that the mental health and possible links to right-wing extremism of Thomas Mair, the man charged with her murder, are both important lines of inquiry for detectives.
Associated Press, 17th June, 4:19 PM

CLEANED HIMSELF WITH BRILLO PADS ‘Mental illness’ of loner arrested over murder of MP Jo Cox
Thomas Mair, 52, described as a “loner” by locals on Yorkshire council estate where he had lived for 40 years
THE man arrested over the murder of Jo Cox was last night revealed to be a “quiet loner” with a history of mental illness.
Tommy Mair, 52, who lived alone following the death of his nan 20 years ago, was said to have been on medication and receiving psychotherapy for prolonged periods.
The Sun, 16th June 2016, 8:44 pm

Suspect in MP’s killing described as quiet, polite and reserved
Neighbours say suspect, named locally as Thomas Mair, would help them with gardening and did voluntary work
The Guardian, 16th June, 23:48

We know from a number of sources that Mair has had a long history of mental illness. We have heard from his half-brother that he has an obsessive compulsive disorder and cleans himself with Brillo pads because he is “obsessed with his personal hygiene” and that “he has never expressed any views about Britain, or politics or racist tendencies.” (The half brother, Duane St Louis is himself mixed race and reports they “got on well”).
It’s quite possible that more details will emerge showing that he did have political sympathies of one kind or another – even that in his confused way he imagined he was advancing a cause. (Though, if you think about it, you’d need to be seriously mentally ill to imagine that killing an MP in cold blood was going to advance that cause, whatever it was)
But suppose he did? Are we seriously being expected to believe that this act of violence by a deranged loner represents a statement on the political climate of Britain of which we should all take note?
– “Project Grief: Remain’s Dirty Politicking Has Hit A New All-Time Low,” Breitbart London, 17th June

Tommy Mair: Scottish gunman held after Jo Cox murder was ‘a loner with mental health problems’
Thomas Mair gave his name as “Death to traitors, freedom for Britain”
The man being held after the murder of Yorkshire MP Jo Cox has been described as “a loner” with a history of mental health problems. Thomas Mair, who was born in Kilmarnock, is also believed to have sympathies for far-right politics after investigators found he had previously subscribed to S.A Patriot, a pro-Apartheid South African magazine…
The Press & Journal, 17th June

Jo Cox killing: Scot held over MP’s death had a history of mental health issues
A SCOT held over the killing of Labour MP Jo Cox had a history of mental health issues and was described by neighbours as a “loner”.  – The Herald, 17th June

Helpful and polite loner with history of mental health issues
Tommy Mair did voluntary work but has never had full-time employment
The suspect in the killing of Jo Cox is a loner with mental health issues.
The Times, 17th June, 12:01 AM

Jo Cox murder: Thomas Mair asked for mental health treatment day before MP died
The man accused of murdering Jo Cox sought help for his mental health problems the night before she was killed – but was told to make an appointment and come back the next day.
The Telegraph, 17th June, 9:00 PM

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Justice First! Jo Cox’s Mentally Ill Killer Should Not Be Discussed in Parliament
Normally speaking a man who is arrested by police on suspicion of murder would enjoy both fair treatment from the press and a guarding of his rights by the BBC.
Not so the mentally ill killer of heroic Jo Cox MP.
Disgracefully, David Cameron and Jeremy Corbyn both imputed political motives to Thomas Mair, which could prejudice his trial.
– Louise Mensch, 17th June, 1:54 PM

Police probe MP killer’s mental care: Loner suspected of murdering Jo Cox was ‘in crisis’ and sought help from health counsellor just 24 hours before attack

  • Thomas Mair was arrested after allegedly shooting and stabbing the MP
  • Health counsellor said Mair appeared ‘deeply disturbed’ 24 hours before
  • Mair’s psychiatric history at the heart of the police inquiry into the attack
  • Officers are also said to be investigating links to far-Right extremist groups
  • David Cameron contacted by an MP over safety of female parliamentarians
  • More than £200,000 has been raised for charities supported by the MP

The loner suspected of killing Jo Cox appeared deeply disturbed just 24 hours before the attack, a health counsellor said last night.
Thomas Mair said after stumbling into a ‘well-being centre’ on Wednesday night that he was depressed and had been on medication for a long time.
Mair’s psychiatric history is at the heart of the police inquiry into the attack – and officers are also said to be investigating links to far-Right groups.
The counsellor who spoke to him for about 15 minutes on Wednesday said she realised he was in ‘some sort of crisis’ and there appeared to be a ‘real problem’.
– D***** M***, 17th June, 22:05

While I always welcome consideration of mental health issues in the public eye, there is a long history of linking mental illness to violence in a way that exaggerates the risk posed by those experiencing problems. A 2013 study showed that the mentally ill are more likely to be the victims of violence than the perpetrators:

“We hear about the link between violence and mental illness in the news, and we wanted to look not only at the notion that the mentally ill are a danger to others, but the possibility that they are also in danger,” says Dr. Sarah Desmarais, an assistant professor of psychology at NC State and lead author of a paper describing the work.

The researchers compiled a database of 4,480 mentally ill adults who had answered questions about both committing violence and being victims of violence in the previous six months. The database drew from five earlier studies that focused on issues ranging from antipsychotic medications to treatment approaches. Those studies had different research goals, but all asked identical questions related to violence and victimization.

The researchers found that 23.9 percent of the study participants had committed a violent act within the previous six months. The majority of those acts – 63.5 percent – were committed in residential settings, not in public. Only 2.6 percent of the violent acts were committed in school or workplace settings.

The researchers found that a significantly higher percentage of participants – 30.9 percent – had been victims of violence in the same time period. And of those who said they were victimized, 43.7 percent said they’d been victimized on multiple occasions.

“We also found that participants who had been victims of violence were 11 times more likely to commit violence,” Desmarais says. “This highlights the need for more robust public health interventions that are focused on violence. It shouldn’t just be about preventing adults with mental illness from committing violent acts, it should also be about protecting those at risk of being victimized.

“For one thing, it’s the right thing to do,” Desmarais adds. “In addition, while correlation is not necessarily causation, preventing violence against the mentally ill may drive down instances of violence committed by the mentally ill.”

Yet time and time again, mental illness is linked almost immediately to acts of violence, particularly gun violence. This is more prevalent in countries like the United States, but it occurs in the UK too. Some of these past news stories will be depressingly familiar:

Gunman Raoul Moat asked for psychiatric help
Social workers were told by gunman Raoul Moat that he wanted to see a psychiatrist in the months before he murdered his ex-partner’s boyfriend.
The former nightclub doorman said he wanted help in case he had a “problem”.
Moat, who died on Saturday, shot Samantha Stobbart, 22, killed Chris Brown and wounded Pc David Rathband.
Newcastle Council confirmed it had had “extensive contact” with Moat regarding two of his children. A psychological report did not recommend treatment.
– BBC, 15th July 2010

Lee Rigby murderer Adebowale ‘is borderline schizophrenic recommended for Broadmoor’
One of the two Muslim extremists who murdered soldier Lee Rigby is a borderline schizophrenic who hears voices in his head, the Old Bailey heard.
Michael Adebowale, 22, has a history of serious mental illness and was recommended for treatment in Broadmoor shortly before his trial.
He was examined by a series of doctors and made a dramatic confession to the killing which was never revealed to the jury.
Evening Standard, 19th December 2013

Louise Mensch says 20-year jail term handed to Ann Maguire’s schoolboy killer is ‘not just’
The former MP says she is “very disturbed” about the term given to the “clearly psychopathic” 16-year-old Will Cornick by Mr Justice Coulson
Man convicted of sending abusive messages to Louise Mensch tells court his computer was hacked
“It’s perfectly clear he was irrational and psychopathic. Sentence is not just or scientific. Photo: REUTERS
Former MP Louise Mensch has claimed the 20-year jail sentence handed to Ann Maguire’s teenage killer is “not just” and he should have been sent to a secure hospital instead.
Speaking on Twitter, Ms Mensch said she was “very disturbed” about the term given to the “clearly psychopathic” 16-year-old Will Cornick by Mr Justice Coulson.
She said: “How can a 15 year old be sentenced as an adult and why is he not to be in a secure hospital. Obviously he is deranged.
“Fifteen is a child under age of sexual consent and it’s perfectly clear he was irrational and psychopathic. Sentence is not just or scientific.
The Telegraph, 3rd November 2014

Mentally ill man killed his mum after being let out of psychiatric hospital
Gilbert Corette’s family say he should never have been granted unsupervised leave from the unit
PA Gilbert Corette, who has admitted at a hearing at the Old Bailey, London of battering his mother to death with a bottle while on day release from hospital
Corette admitted battering his mother to death with a bottle
A mentally ill patient should never have been allowed out of hospital on the day he battered his elderly mother to death with a bottle, her grieving family has said.
Gilbert Corette has admitted killing 81-year-old Marie Elcie Florise Corette and also attacking his sister Patricia after being let out of Lewisham Hospital’s Ladywell Unit on July 8 last year.
The 44-year-old, who has autism spectrum disorder and a major depressive disorder with psychotic features, had been referred there by his family and then further detained under the Mental Health Act.
– The Mirror, 11th March 2016

NHS ‘failed’ man accused of Donald Lock A24 roadside murder, court hears
Donald Lock, 79, was a retired solicitor who had been driving back from a cycling meeting
A mental health trust admitted failing a man accused of murdering a motorist by stabbing him 39 times on a road in West Sussex, a court has heard.
Matthew Daley, 35, denies murder but has admitted attacking 79-year-old retired solicitor Donald Lock claiming diminished responsibility.
Mr Daley’s father told doctors without proper care, his son would “hurt someone or worse”, the jury was told.
Mr Lock was killed while driving on the A24 at Findon, near Worthing last July.
Defence counsel David Howker QC said Sussex Partnership NHS Foundation Trust apologised to Mr Daley’s family for having “failed” him in his care and treatment.
Relatives were “constantly on the case” of clinicians for a “thorough diagnosis” of Mr Daley’s mental condition, Mr Howker told Lewes Crown Court.
– BBC, 3rd May 2016

Left and Right often trade barbs when something like this happens: Left accuses Right of ignoring Christian extremism while screaming about immigrants, Right accuses Left of ignoring Islamic extremism in the name of multiculturalism while screeching about gun laws. Here, Left accuses Right of scapegoating mental illness to cover up anything linking the murder to right-wing politics, while Right accuses Left of falsely politicising the killing of a wife and mother.

At the risk of courting the Golden Mean fallacy, is it possible that both are wrong – and right? Could it be that these murders are actually mental health issues as well as political, religious and cultural isues?

The science of public health allows us to assess what happens when harms threaten society, and to try to identify risk factors and resilience factors. We can then target those factors to improve health. This has proved to be a powerful route to a safer world, and has already been applied with some success to preventing suicide, violence and mental illness. Could we do the same thing with radicalisation?

Research in the US following the 9/11 attacks suggested that having sympathies for terrorist acts and violent protest is a sign that people are susceptible to future radicalising influences. We took that as our starting point and assessed these kinds of sympathies in men and women of Pakistani and Bangladeshi origin living in the UK.

We found that these views were uncommon – they were held by just 2.5 per cent of our sample – and were unrelated to poverty, political engagement, or experience of discrimination and adversity. However, we did find a correlation between extremist sympathies and being young, in full-time education, relative social isolation, and having a tendency towards depressive symptoms.

In contrast, we found that being born outside the UK, general ill health or having large social networks were all associated with moderate views. We also found that women were as likely as men to hold extreme sympathies, although the association with depression was stronger in men. Frequency of religious worship and attending a place of worship were not correlated with extremist leanings.

Such findings challenge many of the pervasive ideas about what drives radical beliefs, including the notion that religious orthodoxy fuels extremism.

Such nuance can be difficult in a media that’s often more interested in selling copy than informing and educating the populace in a responsible manner. Indeed, I think it is quite clear that a distinction should be made between the perpetrators of these crimes, and the architects of extremism who cultivate and facilitate them. The very worst sectarian, extremist, and dangerous groups are very much the fruit of cold, calculated, concerted planning – that they exploit and recruit the vulnerable to their cause is what marks them as enemies of humanity, be they radical terrorist organisations or state governments.

It’s just unfortunate that most of the calls for understanding and acknowledgement of mental health issues in horrendous crimes are the same people who are resolutely failing the people who need help the most:

Mental health trust funding down 8% from 2010 despite coalition’s drive for parity of esteem
Research suggests that NHS trusts’ income for mental health services has dropped by 8.25% in real terms over past five years despite rising demand

  • Figures from 43 trusts show real terms cut in mental health funding of 8.25% over course of parliament
  • Community teams cut 5% while referrals up 20%
  • Senior coroner issued warning on crisis team funding after patient suicide
  • Some teams handling caseloads double recommended levels
  • Experts say commissioners ‘ignoring’ government’s parity of esteem pledge
  • Government says budgets are ‘not full funding picture’
  • The Samaritans’ 24-hour helpline is 08457 909090 or email jo@samaritans.org

Funding for NHS trusts to provide mental health services has fallen by more than 8% in real terms over the course of this parliament, according to research by Community Care and BBC News.
Figures obtained from 43 of England’s 56 NHS mental health trusts through Freedom of Information requests, an analysis of financial reports and other research, show that total funding for the trusts’ mental health services dropped in cash terms from £6.7bn in 2010-11 to an expected £6.6bn in 2014-15. The figures amount to a real terms reduction of 8.25%, or almost £600m, once inflation has been accounted for.
At the same time referrals to community mental health teams, the services designed to stop people’s mental health deteriorating to crisis point, have risen by nearly 20%.
The funding pressures have left some community services handling caseloads double the recommended levels and several are falling short of Department of Health (DH) staffing guidelines.
Official figures show the pressure on inpatient services has also risen. Mental Health Act detentions to hospitals hit a record high last year while bed availability dropped to its lowest level in four years of data collection.
One mental health chief executive called the situation “a car crash”.
Care minister Norman Lamb said the budgets did not represent “the full picture” for mental health spending.
He added: “Mental health care is given through a range of services including the voluntary sector.”
A consistent official dataset on mental health funding trends has not been available since the government axed its national survey of spending on mental health services in 2013.
Community Care, 20th March 2015

Mental health services take a ‘leap in the dark’ on patient care
Large-scale changes to mental health services are a ‘leap in the dark’ and are having a negative impact on patient care, says a briefing published today by The King’s Fund.
The briefing, Mental health under pressure, shows that the sector is under a huge amount of strain, with around 40 per cent of mental health trusts experiencing a cut in income in 2013/14 and 2014/15. This is in marked contrast to the acute sector, where more than 85 per cent of trusts saw their income increase over the same period.
The briefing shows that, driven by the need to reduce costs, trusts have embarked on large-scale transformation programmes aimed at shifting demand away from acute services towards recovery-based care and self-management. This has seen a move away from evidence-based services in favour of care pathways and models of care for which the evidence is often limited. There has also been little formal evaluation of the impact of these changes.
One example cited in the briefing is the merger of specialist crisis resolution home treatment teams (CRHTs) and early access to psychosis services into generic community health teams. Evidence suggests that these teams are often unable to provide the level of support required by patients, reducing quality of care and increasing pressure on inpatient beds.
Drawing on a range of sources, the briefing highlights widespread evidence of poor-quality care:

  • only 14 per cent of patients say that they received appropriate care in a crisis
  • an increase of 23 per cent in out-of-area placements for inpatients in the year up to 2014/15
  • bed occupancy rates routinely exceeding recommended levels.

The briefing finds that, as their financial situation deteriorates, many trusts are considering a further wave of large-scale changes, which could further destabilise services and reduce the quality of care for patients. It calls on the sector to focus on using evidence to improve practice and reduce variations in care, but says it is essential that this is underpinned by stable funding, with no more cuts to budgets.
– The King’s Fund Press Release, 12th November 2015

Sanctions against claimants with mental health problems
Analysis by the mental health charity Mind and the Independent newspaper shows that the number of benefit sanctions imposed on people with mental health problems has increased by over 600 per cent over the last four years.
Their analysis of Department for Work and Pensions statistics found that 19,259 people with such conditions had their benefits stopped under sanction in 2014-15 compared to just 2507 in 2011-12 – a 668 per cent rise.
Professor Jamie Hacker Hughes, President of the British Psychological Society, said:
“These worrying figures provide further  evidence that the Work Capability Assessment is failing to assess people’s fitness for work accurately and appropriately. People who are seriously ill, both physically and psychologically, are being found fit for work, and those with acute, transient episodes being assessed as lacking capacity and treated in the same way as those with a long-term condition.
“We have repeatedly asked the Department for Work and Pensions for a meeting to discuss our concerns and will continue to press for it.”
British Psychological Society, 13th November 2015

Mental health nurses under ‘intolerable pressure’
We are returning to caseload figures and demands on services not seen since the 1980s, says Professor Alan Simpson
Mental health nurses are facing huge pressures because cuts and merging of services are causing a strain on services not seen since the 1980s, according to Alan Simpson, a Professor of Collaborative Mental Health Nursing at City University London.
Mental health services are under increasing strain with recent findings by The Guardian showing that the number of specialist mental health nurses has fallen more than 10% over the past five years. Recent reports have also highlighted that a spike in mental health patient deaths shows that NHS ‘struggling to cope’.
City University London, 26th January 2016

 96% say support for children after abuse “inadequate”
It’s time to demand that every child receives vital help
All too often therapeutic services are only offered to children after abuse if they’re suicidal, self-harming or developing chronic mental health problems.
In a survey of more than 1,000 professionals working with children after abuse, over 50% said that tight criteria to access local NHS mental health services means these children are increasingly struggling to access vital help.
In many cases, children have to wait over 5 months to get specialist support. And some of those surveyed said that help for children who had been abused was not seen as a priority.
NSPCC, 27th January 2016

It strikes me as deeply hollow for people in the UK Government to express concern over the mental health of a murder suspect given their criminal negligence of thousands of other British citizens with mental health issues – the vast majority of whom have never so much as been accused of a crime.

It would be one thing if those highlighting the suspect’s mental health now act upon their failures. But why would they? Raoul Moat shot three people (killing one) and himself in 2010, yet charities are saying mental health services in England & Wales are in a worse state now than they were 5 years ago. How much further do we dare look back, to see if there was even the possibility of prevention through putting more emphasis on mental wellbeing?

Mental Health Analysis

We can continue to wring our hands, talking about how we’ve collectively failed not just the victims, but arguably the perpetrators themselves, in failing to prevent these tragedies. Or we can do something about it. The Scottish Government has set out mental health strategies for the next parliament. Organisations like Breakthrough, the Centre for Mental Health, the Mental Health Foundation, Mental Health Research UK, Mind, Time to Change, SAMH, SANE, and Together continue to do great work. I’ve personally been involved in local charities and volunteer services which co-ordinate with mental health groups.

So, to all those who urge the media and the public to remember that Mr Mair had mental health issues: I invite you to help. Government Ministers and Members of Parliament: take the pleas from charities regarding the serious pressure of the NHS, and do more to improve mental health services in your area. Journalists, commentators and editors: reject the lurid sensationalism of caricature in your coverage of mental health issues. The rest of us: acknowledge that whatever the cause or motivations behind the murder, please recognize that people with mental illness in the UK need our help. Not to be used as convenient excuses; not to be fodder for newspaper sales; not to be burdens on the state to be suffered.

One in four of us will be directly affected by this. It’s up to all of us to be there for each other.

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