I almost didn’t write this. It wasn’t from not wanting to. I cradled my head in my hands, desperate to contribute to the reams of social media positivity I had seen surrounding Mental Health Awareness Week.
I almost didn’t – couldn’t – because I was depressed.
There came a certain point in my experience of being LGBT where I accepted that I had to be strong and uncompromising in the face of disapproving glances and withering remarks. I made a pact to throw myself into my community with zeal, no matter how exhausting, and to make full use of the privileges I was afforded in the tolerant metropolis I’d landed in.
And yet, for some reason, I find this an incredibly difficult attitude to transfer over to my struggle with depression. I will share with my co-workers that I am going on a date with a man or going to an LGBT-themed event with an almost belligerent pride, but am overwhelmed with fear in having to admit to those same people that I’m leaving slightly early to see my therapist or that I need to take some time off due to another episode.
Indeed, the word “depression” still has a bite to it, in the way that the word “gay” did when I first dared to say it to someone else in reference to myself. The tone of my voice takes on an odd quality as I approach it in a sentence, to the point where I sound intolerably meek by the time “depression” tumbles out.
The thing is, in many cases, mental illness and being queer go hand in hand. It’s an uncomfortable but important reality that LGBT youth are four times more likely to kill themselves than their heterosexual counterparts. More than half of individuals who identify as transgender experience depression or anxiety. Even among Stonewall’s own staff, people who dedicate themselves to the betterment and improved health of our community, 86% have experienced mental health issues first-hand. It’s a morbid point to make, but it makes perfect sense that we, as a community, struggle disproportionately.
At a recent event I attended, set up to train LGBT role models to visit schools and teach children about homophobia, no one explicitly mentioned their struggles with mental illness. We told one another stories of how we had come to accept ourselves in the face of adversity, talking in riddles about “dark times” or “feeling down” or being a “bit too much of a party animal”. But these problems have other names – depression, anxiety, addiction – that we consistently avoid, despite being in a community in which a large percentage of us will have undergone similar experiences.
And this phenomenon replays itself over and over. Despite there being a common understanding between me and my queer friends that we’ve probably all been vilified in the same way and made to feel a similar flavour of inadequate, we will rarely acknowledge, even within the safe boundaries of friendship, that this has had a lasting impact on our ability to maintain a healthy self-image.
But part of being proud of who we are as LGBT people is being able to be open about the struggles we’ve faced. It’s in naming and wearing the uncomfortable badges of anxiety, depression and addiction that we take the first step towards fully accepting mental illness as an important part of our collective identity. After all, how can we be true role models to the next generation if we refuse to tell the whole story?
And so, this Mental Health Awareness Week, I’m issuing a challenge to my community. If you are LGBT and suffer from a mental illness, be defiant in your acceptance of it in the same way that you would about your sexuality or gender identity. Bring it up, speak it out and feel sure that your voice, however seemingly small or insignificant, is a valid one. After all, we have been, and will always be, a community of fighters – it’s about time we dared to show our battle scars.
For all the benefits to mental health a digital world can bring, such as a sense of belonging and information and support for those with problems, there are also myriad dangers associated with online activity. In the very worst cases, people have live-streamed their suicide and had people cheer them on in the comments section.
Meanwhile, cyberbullying and trolling, along with communities and groups on social media that foster, glamorise or even encourage self-harm are pervasive. Stephen Buckley, head of information at the charity Mind, acknowledges these risks: “It is vital to recognise the huge danger created by any site or social media trend that promotes self-harm, suicide or eating disorders. They can be hugely damaging and possibly dangerous to someone in a crisis.”
This has come to the forefront over the past decade as more and more children use smartphones and tablets. A Young Minds report, Resilience For the Digital World, says half of Europe’s nine- to 16-year-olds now own a smartphone; the vast majority go online at least once a week, and most daily.
Buckley says that people are now used to following their friends on social media and sharing news of a new job, relationship, or a holiday presented in the best possible light. But this can have an impact on individual self-esteem. “While low self-esteem is not a mental health problem in itself, the two are closely linked. If lots of things are affecting your self-esteem for a long time, this may lead to depression or anxiety,” says Buckley.
Pressure on young people may also come from situations where they are being bullied in daily life that then cross over into their digital lives, says Marc Bush, chief policy adviser at Young Minds. “For instance, victimisation in the school playground is replicated on their Facebook pages or their WhatsApp or Snapchat groups, so they relive the distress they’re experiencing in real life on the digital platform.”
So, what’s to be done? Bush says industry has an important role to play. Today, if you search certain hashtags on Instagram, for example, a helpline pops up. He also cites the report from the House of Lords communication committee, Growing Up With the Internet, which calls for a national digital champion who can look at the rights of young people online, educate parents and teachers on how to look out for warning signs, and support young people to understand the consequences of bullying someone online.
The greater part of the solution, though, lies with young people themselves. “Ultimately,” says Bush, “young people are active in the creation, consumption and distribution of these images or forms of behaviour, so they have to be part of the solution.”
Tamanna Miah: ‘I developed severe anxiety after being bullied online.’
Tamanna Miah is now a prominent anti-bullying activist
Tamanna Miah, 23, is a campaigner and public speaker from Kent. She describes how she coped with being bullied on social media and what it has been like to grow up in a digital world.
“I grew up in Sevenoaks, Kent, which is a very conservative, middle-class area. I suffered from severe bullying and racism from primary school to my all-girls secondary school until university. When I went home, the abuse continued online. It happened on my social media networks – Facebook, Bebo and MSN. People would comment on photos, status updates, anything that I was doing. Sometimes it was racist or Islamophobic, or attacking my appearance or the way I acted – anything. People would find a fault and take advantage of the situation.
I was a very shy, quiet child, I couldn’t stand up for myself, or look people in the eye. I would be bullied at school, come home and log on to the laptop and it would continue. You wake up in the morning to check again and it’s never-ending torment and hate. I couldn’t escape. I hated school and my time in education. I was never happy.
I developed severe anxiety and depression as a result. I tried to get support from my school and was unsuccessful. I visited my GP and they dismissed me and didn’t take me seriously. They said nothing was wrong and told me to do some exercise. It wasn’t until university that I was diagnosed.
Now I try and be careful when using social media, but I also use it for networking and meeting people. I’ve been through bullying online and offline, but I’ve also had a wealth of opportunities through social media.
I make sure that my personal activity, photos and comments are restricted, to avoid anyone attacking me publicly or harassing me. I don’t want to experience more abuse so I’d rather keep personal things private. I’d say to others in similar situations to always be careful about what you post and where.
Your online life is always going to be present. Google yourself to see what’s out there so you can check your settings and change them if needed. If someone is bullying you, always tell a responsible person as soon as possible. Make sure you have evidence of everything. Take screenshots or make audio recordings.
Whatever happens, don’t give up – just keep going. We absolutely need to speak about these issues, because if we don’t, who will?”
A weekly phone call or visit from a volunteer are among the solutions to help ease the loneliness epidemic affecting 1.2 million older people in England, according to campaigners.
Age UK, says that 1.2 million older people are chronically lonely and that this has an adverse impact on mental health, and the challenge will increase as our population ages. In the next 20 years, England’s over-85 population is set to rise from nearly 1.3 million people to just under 2.8 million.
Caroline Abrahams, Age UK charity director says: “Loneliness can have an impact on older people’s health and wellbeing. And this is particularly true when it comes to mental health, with older people’s depression often brought on by, or exacerbated by loneliness.”
NHS figures reveal that depression affects around 22% of men and 28% of women aged over 65 in England, but, according to the Royal College of Psychiatrists, 85% of older people with depression receive no NHS help at all. The spotlight on older people initiative – a group of nine older people’s organisations led by the Jo Cox Commission on Loneliness – says that more than half the users of over-50s social networking site Gransnet who say they are lonely have never discussed loneliness with anyone.
But solutions do exist, says Abrahams: “There is no quick fix or single policy solution to eradicate loneliness but there are reasons to hope that we can change things for the better.” An Age UK and Campaign to End Loneliness 2015 report, Promising Approaches to Reducing Loneliness and Isolation in Later Life, reveals good practice. For example, it says interventions involving help with transport or technology “can be the glue that keeps people active and engaged”.
The report highlights successes such as face-to-face or telephone befriending projects, including the Royal Voluntary Service’s Dorset Befriending Service, offering home visits to older people. The project began after a local GP’s concerns that older patients would visit the doctor primarily because they were isolated. Another initiative, The Silver Line, is a 24-hour, free helpline for information and companionship. In addition, British Red Cross community connectors are volunteers who identify and attend local activities with lonely older people.
The Campaign to End Loneliness is developing a national initiative to tackle loneliness through community collaboration. Laura Alcock-Ferguson, the campaign’s director, adds: “At a local level across the UK, health authorities should be developing clear plans to reduce loneliness and social isolation in their local areas.”
Dr Amanda Thompsell, chair of the old age psychiatry faculty at the Royal College of Psychiatrists, says organisations developing support projects must also include older people and carers as well as psychiatrists, GPs, and the social care sector. Thompsell suggests awareness of loneliness could also be incorporated into the school curriculum: “Inter-generational contact has been shown to be particularly effective in combating loneliness and we often forget how much children can learn from older people.”
Ignoring the challenge is not an option, as Thompsell says: “Failure to tackle loneliness will lead to more pressure on services which are already overwhelmed.”
Roy Warman: ‘I met the daughter I never had through a telephone befriending service. It changed my life’
Warman credits Age UK with helping to turn his life around Photograph: Amanda Searle
Roy Warman’s wife, Phyllis, died in January 2015. Buoyed by well-wishers in the first few weeks of bereavement, the visits and telephone calls gradually dwindled, and he felt increasingly alone. Many of his friends have passed away, he does not have any family nearby and the couple never had children. He explains: “The longer it goes without speaking to someone, the harder it gets.” He describes loneliness as “one of the hardest things that you will encounter in life”, likening feeling low to “living in a void”.
The 84-year-old from Wiltshire spotted information about Age UK in a local magazine a few months after Phyllis’s death. He got in touch and was referred to an Age UK telephone befriending service that matches older people with like-minded volunteers for friendship or phone calls.
He recalls the first time he spoke to a companion on the phone: “It opened a new door. It was so nice to think that someone might listen … a voice at the other end who could sympathise.” Today he has weekly phone calls with a volunteer he describes as “like the daughter I never had” and he also has regular visits from another volunteer as part of Age UK’s face-to-face befriending scheme.
The impact has been extraordinary, says Warman, describing the experience of support as “like being in a desert and coming across an oasis”. He has joined a singing group and developed his IT skills: “I think it partly affected my decision to join a local choir. And Age UK introduced me to the tablet, it’s like a giant library.” Crucially, he senses his self-confidence has returned: “I feel good about myself and feel able to cope now.” SS
I have Down’s syndrome and I live in supported housing. Today a parliamentary select committee has put out a report on the government’s planned changes for supported housing that could force people such as me with a learning disability out of our homes.
Last year the government said it wanted to make changes to funding for supported housing that would limit payments to the local housing allowance rate and let local councils have control over the extra money needed to give people supported housing. This would mean people such as me could lose our right to have our housing paid for and that there could be a lot less supported housing available.
Both these changes would obviously be really bad. Thankfully today’s report agrees, which is good to hear as it is what me and other people in supported housing have been saying for a long time. But I’m still very scared the changes could happen.
In March I gave evidence for this report. It was a historic event as I was the first person with Down’s syndrome ever to give evidence to a select committee. I was very proud to be taking such a big step for people with a learning disability, especially as I know these changes could mean that thousands of people like me lose their homes and independence. As a society, we’d be going backwards.
Before supported housing, people with a learning disability had to live with their families or live in institutions. Most care professionals think institutions are not the best place for people with a learning disability; in some cases people end up having to live far away from everyone they know, and sometimes too, without proper support, people can even be in danger of abuse and neglect. I don’t think that’s a life anyone would choose.
I moved into supported housing when I was 30. Before then I had lived with my parents. I love them but I wanted to be independent. Nobody wants to still be living with their parents at 30! After a lot of talking, my parents agreed and I now live in a house run by Golden Lane Housing, with Elizabeth and Katie, two other ladies who have a learning disability. I love living with them – we’re like family.
I couldn’t live on my own without support, but I don’t want full-time care, because I’m not a child. Supported housing means I can be independent but have day-to-day support from Mencap. My support worker Jeanette helps me get out and do the things I love, which include volunteering at Oxfam, my local bookshop and the Cancer Trust. I make my own choices and I get to live the life I want, something everyone has the right to do.
But this will all change if the government’s planned changes happen. A cut could mean that I couldn’t afford to pay my rent any more. I wouldn’t be able to live with Katie and Elizabeth and I might lose my day-to-day support. It makes me scared for my future because I’d have to move away from my home, my friends and my voluntary jobs and go and live with family. It could change my whole life in a way that I don’t want.
But I’m lucky. A lot of people with a learning disability don’t have family who can support them, so they could be forced to live in an institution, where the support and accommodation might not be right for them. They could away from everything they know and they would lose all their independence. This would be a huge step back for everyone with a learning disability.
I make my own choices and I get to live the life I want, something everyone has the right to do
It is a scary thought and I think it’s clear the government isn’t thinking about all the people who use supported housing. So I’m glad that the select committee report has said that these changes could lead to a really bad situation. This is also what a lot of supported housing providers and Mencap have said and it’s what I think as well. But I don’t know if the government will listen to this new report.
I think things would be very different if people such as me had more of a voice, more power. I don’t think changes like this would be happening. That’s why it’s important that the government listens to us.
I would say to the government: “Stop and think about what you are doing!” It’s good to save money; I am not against changes. But things have to be fair for everyone, and until you can guarantee that changes won’t take away people’s homes, independence and happiness, then these are changes that the government can’t afford to make.
People at risk of HIV in Scotland are to be given drugs on the NHS that will protect them from infection, it has been announced, in a move that Aids campaigners say will put pressure on the authorities in England to end delays in providing the same medication despite two major court rulings.
In a major victory for campaigners, the Scottish Medicines Consortium (SMC) said pre-exposure prophylaxis (PrEP) would be free on the NHS to those who need it because they are at risk – for instance, if they have a partner with HIV. Access to the drugs could begin within weeks.
NHS England resisted rolling out PrEP due to its cost, although it is a lot cheaper than a lifetime of HIV treatment which could cost £360,000. It lost to campaigners in the high court and then the court of appeal, but those who want to take PrEP have been told they must wait for a big new trial to answer “significant outstanding implementation questions”.
The National Aids Trust (NAT), which funded the court battle in England, said it was delighted PrEP would shortly be available in Scotland. “This game-changing prevention tool has the potential to massively reduce HIV rates and turn Scotland into a model internationally of how to do HIV prevention well. The speed and decisiveness of the Scottish process contrasts starkly with delays in the other three UK nations,” said Deborah Gold, NAT’s chief executive.
“Though we were jubilant when, following our two successful court cases, NHS England agreed steps to fund PrEP, we remain concerned that since that date, progress towards the ultimate goal of PrEP in England has been slow. It is difficult not to think of the possible thousands of HIV diagnoses that could have been prevented had the NHS in England not prevaricated, and we urge them to pursue the promised trial with appropriate urgency.”
The PrEP4Scotland Coalition (made up of HIV Scotland, Terrence Higgins Trust Scotland, Waverley Care and NAT) which has campaigned and negotiated with the Scottish authorities on the introduction of PrEP, said: “We applaud the SMC for taking this bold step to tackling HIV in Scotland. PrEP provides opportunities to reinvigorate how people at higher risk of HIV exposure engage with testing and prevention opportunities, and it is a vital opportunity to make a real reduction in the number of new HIV transmissions.”
Trials in several countries around the world including the UK have shown beyond doubt that PrEP works. The drug used is Truvada, which is one of a cocktail used to treat people infected with the virus and keep them well. PrEP has been hailed as one of the tools that could help end the Aids epidemic and efforts are being made to get it introduced into high-burden countries such as South Africa.
Every year about 5,000 people become infected with HIV in the UK and the rate among men who have sex with men is rising fastest. This was the group in whom the trials in the UK were done and where the evidence is strongest.
But NHS England dragged its feet because of the cost – estimated at potentially £20m a year to treat everyone who could benefit. It attempted to shift the bill to the local authorities, who are now responsible for public health, including HIV, obesity and smoking.
The local authorities said they could not afford to pay either. NAT sued NHS England in the high court and won last August. NHS England took its case to the court of appeal and lost again in November.
In December, NHS England said it would make the drugs available through a trial, which would enrol at least 10,000 people over the next three years.
NHS England said there were issues that needed addressing in a trial – which may include how consistently people take the daily tablets and how long they stay on the regime. But a trial also allows the NHS to obtain cheaper generic versions of the drug, rather than paying the market price to Gilead, the manufacturer and patent holder of Truvada. NHS England has already asked various companies to tender to supply the pills.
Prof Noel Gill, head of Public Health England’s HIV and STI department, said: “All the detailed work underpinning the clinical trial of PrEP is well under way and we expect it will commence by the summer 2017.”
Scotland’s decision to part with the NHS in England follows a huge community effort and years of campaigning, said HIV Scotland. “In 2016 HIV Scotland published a PrEP good practice guide, and administered Scotland’s expert group which produced prescribing criteria, cost assessments, and mapped information and training needs of workers and the community,” said its chief executive George Valiotis.
“Today, Scotland has made history in the fight against the HIV epidemic,” said Robert McKay, national director for Terrence Higgins Trust Scotland. “PrEP can now be used as a vital tool – alongside condom use, regular testing and early treatment – to help bring an end to HIV transmission in Scotland.
“Not only will this make a life-changing difference to individuals by protecting them from a lifelong and stigmatised condition, but for every person who would have become HIV positive without PrEP, NHS Scotland will save £360,000 in lifetime treatment costs.”
Peter (not his real name) has been a paramedic with an NHS regional ambulance service in the south of England for almost 20 years. He took two months’ sick leave because of stress in 2015.
I once turned up at a house where a woman and her daughter were crying hysterically because her husband – a man in his 30s – had passed away from a heart attack. And then the couple’s son came home from school to find his dad lying there and his mum and sister in that state. It was awful. I ended up crying with the family while we waited an hour for the police to arrive.
You do become emotionally involved. You end up putting things like that, which you have witnessed or dealt with, into a filing cabinet in your head, but over the course of a career that filing cabinet fills up.
Paramedics get stressed for many reasons and the dramatically increased demands on NHS ambulance services in the last four or five years have only made that worse.
The job can be stressful and upsetting anyway, given you’re treating an injury or illness or dealing with someone who might die. You’ve got to treat the patient, and deal with anxious relatives. That’s all very tiring and pressurising and very stressful.
And we’re under growing stress because there are too few paramedics to deal properly with the number of people calling 999 and then being sent an ambulance. We’re busy all the time. The response times we’re meant to stick to are a big part of that.
The bosses transfer the pressure they’re under to meet those performance targets on to us. We’re micro-managed by people who spend all day looking at computer screens, checking how response times are going.
We’re supposed to answer Red 1 and Red 2 calls – the most urgent ones – within eight minutes. But the reality of an understaffed service that hasn’t invested in more staff to keep up with growing demand means that that can take 20-30 minutes.
My ambulance service covers a rural part of the country. I’ve ended up driving 50-60 miles to respond to an urgent call, because there was no one else nearer to attend. Driving all that way at high speed, with a blue light on, is very stressful, believe me.
Then there’s the hours. We’re meant to work 12-hour shifts. But it’s never just 12 hours; it’s usually 13, 14 or 15. And we do four shifts in a row. The closure of ambulance stations is a massive issue too. Traditionally paramedics have seen them as almost their homes and the other people working there as like their family, but closures mean we have fewer and fewer of such places that we can come back to and discuss the ups and downs of the day with people who understand.
Stress is very common, especially among those who’ve been on the job for 15-20 years; their coping mechanisms aren’t as fresh as among the younger paramedics. Four of the 30 paramedics at my ambulance station have been off with stress over the last few years. They just couldn’t face coming in for another run of 14- or 15-hour shifts.
I’ve had time off myself for that reason. Two years ago I needed almost two months off because I was so stressed from the demands of the job. The pressure on me had become unreasonable. My stress was quite severe and I’ve never fully recovered, to be honest. My family say it’s really aged me. It’s taken a massive toll.
I’ve seen colleagues with 30 years in the service suddenly decide that they can’t do the job any longer because they can’t cope with all the different demands on us. I’ve got to the point where I don’t want to put my green uniform on any more.
Holly, 22, Sydney, Australia I have suffered from depression and suicidal ideation since I was about 12. If my parents did not have private healthcare, I would probably be dead.
Vulnerable young people shouldn’t have to wait for months to see a psychiatrist, or to compensate for the lack of communication between specialists. Help-seeking behaviour should be supported and encouraged.
Young people in distress presenting to emergency rooms and hospitals should not be viewed as a problem. You don’t want us to kill ourselves, well, here we are. Mentally ill kids are often really intelligent. We can sense when you feel we are being a burden. Saying there are not enough beds, putting us in wards with elderly dementia patients or adults with drug-induced psychosis will ensure we do not ask for help again.
Malcolm Turnbull and Theresa May have the chance to make a real difference in the lives of vulnerable young people, who have a lot to offer the world in return. Don’t let us down.
Lindsay, London, 24 I am currently detained under section three of the Mental Health Act, and have been in hospital since 22 July 2016. Before this, I had a full-time job and always managed to keep my mental distress under control. I never imagined I would become a person to whom the psychiatric ward was home.
Amy-Hannah Charman, Cheltenham, studying A-levels This poem was written in 2014 between two stints in psychiatric hospital with psychosis.
I want you to cry, I want you do die,
I don’t want to get hurt, I want to fight’
You need to hurt yourself so you can be free,
You need to ignore him, or in sin you will be,
If you don’t do what I say, I’ll make life hell,
You don’t want to slip; you’re doing so well,
Do this do that, you will be happier then,
Please just draw on yourself in a sharpie pen,
Arggg! Arrg! Cry cry cry,
Please! Please! I want to live life!
You’re a failure; this is not very hard,
Think of your friends, remember Mum’s card,
Cut cut cut, harm harm harm,
Relax relax, calm calm calm,
You need to scratch, you stupid cow,
Just go and find Mum she can save you now,
Cover your evidence, you must be sly,
Don’t do what he says, just look to the sky,
Listen to me, let me take over you now,
No I can’t, I need help, but how?
I hate you and you must hate yourself,
No I don’t want to get help,
You have nothing, nothing at all,
Actually I do like friends and all,
You don’t deserve to be happy like this,
Yes I do, think of that Taylor Swift gig,
You deserve everything I’ve done to you,
I don’t want this, I won’t listen to you,
I want to squish everything out of you,
Little, innocent me please shine through,
I will scar you and hurt you, I will do what I like,
I won’t let you win, I will always fight.
Caitlin Kitchener, 22, PhD student, York It took an attempted suicide to gain access to therapy. I had been taking antidepressants for a few months, but they weren’t particularly working. It happened during the first year of my undergraduate degree and I remember being picked up in an ambulance outside the halls of residence, with people having a peek to see what was occurring.
Things worked out OK for me, but they didn’t for one of my best friends. She was utterly wonderful, witty, sassy, an absolute star of a woman. After my suicide attempt, she didn’t let me sleep alone for a week and made sure I looked after myself. She even helped arrange a surprise birthday party just four days after my attempt. Underneath all this charisma and humour and kindness was someone who was dreadfully sad. In the third year, she killed herself. She had attempted before, gone to hospital, had a review with a therapist, but faced excruciating waiting times. During her four-month wait for therapy, while she was also waiting for access to university services, she killed herself.
No one from the university or the NHS should be blamed. Maybe reduced waiting times wouldn’t have stopped her. But I can’t help it when I sit on her beautiful memorial bench to feel anger towards Tories whose actions are having real-life implications.
Anonymous, 19 I’ve had depression on and off since I was 11. Over the years, I’ve tried various coping mechanisms: self-harm, restrictive eating, bulimia – you name an unhealthy coping mechanism, and I’ve tried it.
The one that’s been the most constant is alcohol. It’s now got to the point where I’m drinking a small bottle of vodka pretty much every day, sometimes as early as 9am. Needless to say, this doesn’t help my depression, but I’m too dependent on it to give it up. I know I’m in desperate need of professional help, but it terrifies me thinking of my friends and family knowing I’m depressed. I worry that people will be awkward around me, feel guilty for not being able to help me or utter the dreaded phrase: “What have you got to be depressed about?”
I hope that one day the stigma surrounding mental health issues will be non-existent and I will have the courage to deal with my problems in a healthy way.
Anonymous, 17 At secondary school I was taught about religious education, maths, science, English and a plethora of other subjects. But there was one thing missing. After countless sleepless nights, and episodes of self harm, depressive thoughts and suicidal ideation, I had no idea what was wrong with me. I went to the top of a car park and watched the people walk past below like nobody in the world cared.
A woman spoke to me and saved me. After that, I got a correct diagnosis. Learning about mental health and that it is OK to ask for help is important.
Anonymous, 23 Over the years my depression and anxiety has come and gone in waves. After a friend who was having similar problems was diagnosed with Asperger syndrome, I visited a doctor and told him my symptoms. He laughed at me and said I simply had social anxiety, and put me on beta blockers.
When I was at university, a different doctor suggested I see a counsellor. After the first session the counsellor said she’d follow up and make a second appointment, which never happened. My confidence was shook, and I tried a second service. The session went well, and she said she’d make a second appointment for me. She never did. I was convinced that they didn’t think I was worth their time.
I called a mental health charity, when my depression got particularly bad. They arranged a time for them to call back and do a full assessment. They never called back.
I have a great family, and got a first in my degree, and a distinction in my postgraduate degree. Still, I constantly feel numb and almost completely emotionless. My few friends have all cut ties with me for unknown reasons.
Dolly Z, New Jersey As a young adult, I wanted to share my life’s journey with mental illness in verse.
Dolly Z reflects on her mental illness.
Laura Vale, 18, student on a gap year “I’m so OCD about that, I have to have everything straight.” Or, “I’m such a clean freak, I’m so OCD.”
People don’t say these things maliciously, however, they do cause upset to actual sufferers of obsessive compulsive disorder. There are four main categories of OCD: checking; contamination/mental contamination; hoarding; ruminations/intrusive thoughts.
My OCD falls into the category of contamination/mental contamination. I cannot eat cold savoury food, and without medication I could not even be in a room with cold savoury food without having a panic attack. This is the main feature of my OCD, but I also can’t deal with foods touching, or sharing food and drink.
When it’s really bad, I cannot eat because I feel as though I am contaminating myself with food. I have to feel mentally clean, too, which kind of means mentally organised. This can be with relentlessly cleaning myself or tidying or harming myself because I was not clean enough.
Once (while taking Prozac, which really messed with me), I had to empty my room and paint it white. I knew this was illogical, I was crying because I felt insane, and yet I felt that this was the only way for me to be safe and comfortable. Intrusive thoughts control my life. From basic anxieties to more obscure ones, such as my absolute terror of ever having a child and then starving the child through my OCD. But it can be manageable and, for those who know me, since diagnosis I have taken massive strides.
The main issue with OCD is the lack of understanding in mainstream society. By making statements such as: “I am so OCD about that,” you are trivialising a mental illness that is so controlling, manipulative and horrible, and making the sufferer feel as though their struggle is not real and their feelings are irrelevant. Education is key.
In the UK, the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14.
Having a cold can be a miserable experience, but it turns out that the symptoms may seem worse if you feel lonely.
A study by a team of US researchers has found while loneliness does not appear to have any impact on an individual’s chance of falling ill with a cold, or the actual severity of the symptoms, it does seem to be linked to feeling more under the weather.
But results show that feeling worse was not linked to the size of a person’s social network.
“When it comes to our health it seems that it is the quality of our social relationships that may be more important than just the quantity,” said Angie LeRoy, a co-author of the study from Rice University.
Writing in the journal Health Psychology, LeRoy and colleagues from a clutch of US universities describe how they probed the link between cold symptoms and loneliness by asking 213 healthy adults to complete questionnaires related to loneliness, their social networks and their mood before being infected with the common cold through nasal drops.
The participants were quarantined for five days, during which time they were asked to record their symptoms, such as sneezing, a runny nose or sore throat, and log the severity of their symptoms on a five point scale. In total, 159 of the participants developed a cold and had complete data.
After taking into account factors including age, sex, the season, education, income and mood markers, analysis of results from these participants revealed that those who scored higher on loneliness were no more likely to get a cold than those with low scores, but they did report symptoms of greater severity.
Delving deeper, the team found that the link was not down to the size of individuals’ social networks. “It doesn’t matter if they had a large social network,” said LeRoy. “It mattered about how they felt about their social network.”
However, when the researchers looked at the weight of mucus produced by each participant in the study, they found that there was no link to loneliness, suggesting that while loneliness was linked to how rotten participants felt, lonelier individuals were not more physically sick.
“Loneliness wasn’t necessary associated to how biologically ill they were in terms of the severity of their cold but it was associated with how severe they perceive their symptoms to be,” LeRoy told the Guardian. The authors say that helping those who are lonely build ties to others could help to reduce how bad they feel when they catch a cold.
LeRoys admits that the study does not show that loneliness is causing the perception of worse symptoms – indeed the authors note that, for example, those who are lonely often have poorer sleep. But, she says: “We measured loneliness before we exposed them to the cold and then we measured their symptoms, which infers that the loneliness came first.”
LeRoy adds that, combined with previous studies highlighting the link between loneliness and negative impacts on health, doctors and other medical professionals should take note of their patients’ mental state both when patients register and when they are unwell.
“How [patients] feel before [they are unwell] obviously could influence how they feel when they are sick, even with something as simple as a cold,” she said.
If you have an allergic reaction to one type of nut, you might be tempted to avoid eating all others. After all, symptoms like itchy lips, hives and face swelling aren’t pleasant, and food allergies can be life threatening in the worst-case scenarios.
But now, a new study finds that just because you’re diagnosed with a nut allergy doesn’t necessarily mean you’re allergic to it. In the research published in Annals of Allergy, Asthma and Immunology, at least half of people with a diagnosed nut allergy do not show allergic symptoms to other types of nuts—even when tests show that they are allergic. And nearly all of the people with allergies to peanuts—which are technically legumes—were able to safely eat tree nuts like almonds, walnuts and Brazil nuts, even though tests had suggested they might be problematic.
RELATED: 6 Surprising New Places Nuts Are Hiding
Researchers looked at data from 109 people who had tested positive for a tree nut allergy, according to blood and skin tests done in the past eight years. For example, if a person knew they were allergic to almonds and also tested positive for a cashew allergy—but had never eaten a cashew in her life—researchers fed her small amounts of cashews every 15 to 20 minutes to see if there was a reaction. (Don’t try this at home: doctors were standing by with life-saving medication, if necessary.) They looked for serious reactions, like hives or trouble breathing, but found that 50% of people displayed no allergic reaction, even though blood tests suggested otherwise.
That may be because some people have antibodies that react in blood or skin-prick tests, but they don’t necessarily have any symptoms when they eat the food. In other words, they’re sensitized to the allergen.
While most people with peanut allergies were able to eat tree nuts, that wasn’t true for everyone. “Some of the individuals tested in the study had peanut allergies but never tried tree nuts, and when they tried them, they turned out to be allergic,” says Dr. Christopher Couch, an allergist-immunologist and lead author of the study.
“If a person thinks they have a nut allergy, I suggest they speak to their doctor about the symptoms and why they are suspicious,” says Dr. Scott Sicherer, a professor of pediatrics, allergy and immunology at the Mount Sinai Icahn School of Medicine. An allergist-immunologist can use a person’s medical history and blood tests to decide if a nut allergy is really the problem, he says.
The Labour MP Dawn Butler made an unprecedented contribution to parliament last week by asking a question in sign language (Why I stood up for British Sign Language in parliament, 17 March). Demonstrating so publicly that the views of deaf people should be represented in the Commons is a valuable act in itself.
However, the rights of deaf people do not simply start and end with a single signed question. Deaf children all too often fall behind their hearing peers in school because of insufficient support. Councils are cutting vital services that deaf children rely on. The government’s NHS reforms have left audiology services uninspected and unaccountable. And as Butler rightly points out, British Sign Language – an indigenous language that has been in use for centuries in this country – does not have its own legal status in Britain. So while it is an important step for deaf people to see BSL being adopted by our parliamentarians, it also shines a light on how much work lawmakers still have to do to support the deaf community in the UK. Susan Daniels CEO, National Deaf Children’s Society
• Join the debate – email guardian.letters@theguardian.com
• Read more Guardian letters – click here to visit gu.com/letters
Almost three-quarters of older people in the UK are lonely and more than half of those have never spoken to anyone about how they feel, according to a survey carried out for the Jo Cox commision on loneliness.
The poll by Gransnet, the over-50s social networking site, also found that about seven in 10 (71%) respondents – average age 63 – said their close friends and family would be surprised or astonished to hear that they felt lonely.
Gransnet is one of nine organisations – including Age UK, the Alzheimer’s Society and the Silver Line helpline for older people – working to address the issue of loneliness in older people, which is the current focus of the commission, set up by Cox before her murder last June.
They are urging individuals and businesses to look for signs of loneliness and refer people to organisations that can help. But they also want people to take time to speak to neighbours, family, old friends or those they encounter randomly.
The chairs of the cross-party commission, the Labour MP Rachel Reeves and Conservative MP Seema Kennedy, said there was a stigma around loneliness that must be tackled.
“We all need to act and encourage older people to freely talk about their loneliness,” they said. “Everyone can play a part in ending loneliness among older people in their communities by simply starting a conversation with those around you.
“How we care and act for those around us could mean the difference between an older person just coping, to them loving and enjoying later life.”
Almost half (49%) of the 73% who described themselves as lonely in the online poll said they had been so for years, 11% said they had always felt lonely and 56% said they had never spoken about their loneliness to anyone.
Laura Alcock-Ferguson, the executive director of the Campaign to End Loneliness – another organisation working with the commission – said the percentage of lonely older people had stayed the same for five decades, but an ageing population meant the number was increasing in absolute terms.
“Loneliness is a serious public health issue and dealing with it will take the strain off the NHS and social care services,” she said.
Common trigger events said to have contributed to feelings of loneliness were bereavement, retirement and children leaving home. Being shy, living alone or far from family and low income were other commonly cited contributory factors.
The rise of social networking to the detriment of face-to-face interaction has been blamed for contributing to an “epidemic” of loneliness, but the survey of just over 1,000 people found it could also offer solace.
Almost three in five respondents (59%) said social media helped people feel less lonely and about eight in 10 (82%) said talking about loneliness was much easier when anonymous and online.
While the results indicate the potential benefits of online interaction, the older people are the less likely they are to have access to the internet, particularly women.
The commission is encouraging supporters and followers to post #happytochat on social media to create discussion around loneliness and for people to wear badges with the same slogan. Ultimately, they hope some customer-facing organisations will encourage their staff to wear the badges.
Respondents highlighted greater public awareness – a key goal of the commission – as the best way to combat loneliness.
Caroline Abrahams, charity director at Age UK, said: “There are reasons to believe that we can all do something to change things for the better: a simple thing like saying hello and having a chat can brighten up an older person’s day and do more good than most of us would ever guess.”
In coming months the commission will focus on loneliness in other groups, including men, people with disabilities, carers, refugees, children and parents.
The prison and courts bill has its second reading in parliament tomorow. For the first time, the purpose of prisons will be enshrined in law. We support the Royal College of Psychiatrists in urging the government to ensure prisons meet the mental and physical health needs of prisoners. Almost a quarter of the prison population suffers from personality disorders, bipolar disorder or depression. Prisoners will eventually return to the community. When they are released, any untreated mental illness is released with them. Prisons must be clearly responsible for tackling the mental disorders, which if left untreated, could cause prisoners to reoffend. The prison and courts bill is an opportunity to prevent prison suicide, reduce reoffending and foster rehabilitation. We urge the government not to waste it. Norman Lamb MPLib Dem health lead,Richard Burgon MPShadow secretary of state for Justice,Dan Poulter MP Former health minister (Conservative),Kate Green MP Vice-chair, all-party parliamentary group on penal affairs (Labour),Johnny Mercer MP Vice-chair, APPG on mental health (Conservative)
• There are several reasons which couldhelp the governmentto explain why England and Wales have the highest imprisonment rate in western Europe (Report, 15 March). There is shocking deprivation in many cities and ever-rising homelessness. The single adult unemployment benefit is £73.10 a week; it has reduced in value since 1979 and has not been increased since April 2015. That £73.10 a week is incapable of providing a healthy diet and other necessities for a woman during the development of a child in her womb. Poor maternal nutrition and low birth weight have, since 1972, been called he strongest predictor of poor learning ability, school performance, behavioral disorders and crime by the Institute of Brain Chemistry and Human Nutrition. Rev Paul Nicolson Taxpayers Against Poverty
• Join the debate – email guardian.letters@theguardian.com
• Read more Guardian letters – click here to visit gu.com/letters
In a 2003 report released by the National Commission on Sleep Disorders, it was found that over $ 150 billion was lost each year due to decreased worker productivity and other related issues due to a lack of adequate sleep. Now, five years after the release of the study, it seems that thousands of people are still having trouble sleeping. Trouble sleeping can stem from a wide range of problems and can make for a restless night or lead to major sleep deprivation which can be quite serious. Here are some of the common reasons why people are having trouble sleeping and what you need to know to deal with those problems (2).
Problem #1: Inability to Get Comfortable
Many people simply cannot fall asleep because they can never seem to get comfortable at night or they toss and turn a lot through the night. This can be due to a poor bed, inappropriate pillows, or pain.
Solution: If this seems to be your problem there are a couple of things that you can do to improve our quality of sleep. First, if you cannot seem to get comfortable due to back or neck pain, this may be due to the type of pillow that you are using. Try switching to something that gives you more support and a natural alignment during sleep such as a contoured memory foam pillow or adjusting the height and firmness of your pillows. If your pain does not subside or there seems to be other pain that is causing you to have trouble sleeping it may be a sign of a more serious problem that you may want to speak to your health care provider about.
Problem # 2: Stress and Anxiety
Stress is one of the most common contributors to why people have trouble sleeping. Stress causes a wide range of effects on your health from headaches to a lower immune system and many of the problems that result from stress can interfere with your sleep.
Solution: If you are having trouble sleeping due to stress or anxiety there are a few simple things that you can do. Learning stress management and stress reduction techniques can help you to reduce the amount of stress in your life that is causing you to have trouble sleeping. Meditating before bed can help you to unwind (1). And using aromatherapy is a natural way to help you to relax and soothe you off to sleep (3). Using bath oils or aromatic bath salts in a warm bath before bedtime, spraying your bed sheets with a lavender sleep mist, or using aromatherapy pillows are all great was to promote a relaxing night of sleep.
Problem # 3:Sleep Disorders
There are dozens of sleep disorders that can range from mild annoyances to serious, life-threatening conditions. If you have trouble sleeping that is continuous and ongoing and that does not subside when you try any of the other remedies, then your trouble sleeping could be a sign of something more.
Solution: Speak to your doctor or a local sleep center who can test for sleep disorders.
Problem # 4: Hormonal Imbalances
Hormonal changes due to pregnancy, menopause or PMS can also give you trouble sleeping.
Solution: Speak with your doctor about ways to balance your hormones and to see which herbal remedies may be safe for you to try. Also, any of the great aromatherapy choices mentioned above can also be helpful.
Dr. Serge is a clinical nutritionist. He owns a doctorate degree in nutrition from McGill University in Canada. In addition, he completed a 7-year postdoctoral training at Harvard Medical School in Massachusetts where he studied the impact of fat as it relates to heart disease.
He has authored a book on this topic that is awaiting publication with Edition Berger publishers in Canada. He holds an advance certification in Nutrition Response Testing (SM) from Ulan Nutritional Systems in Florida and he is a certified herbalist through the Australian College of Phytotherapy.
His personalized nutritional programs allow to help individuals with a wide variety of health concerns such as hormonal imbalance, digestive issues, heart-related conditions, detoxes/cleanses, weight loss, fatigue, migraines, allergies, among others.
On Monday, disabled representatives from disability organisations across England, Scotland and Wales presented reports to the UN Committee on the Rights of Persons with Disabilities in Geneva. It is now eight years since the UK ratified the UNCRPD with cross-party support and this is the committee’s first full examination of the UK’s performance.
So how are we doing? The government is fond of claiming that the UK is a “world leader” on disability rights. Superficially, this claim remains fairly accurate. We have the most comprehensive and proactive equality law anywhere in the world; social care legislation and practice that embodies the principle of choice and control; a social security system that claims to recognise the extra costs of disability; and law and regulations to advance accessibility. It is important to remind ourselves of what disabled people have achieved over the past 30-40 years of disability rights activism, as we have charted our journey from objects of care and charity to becoming active, contributing citizens. But any assessment of progress cannot be confined solely to what we now have, or where we were in the past. And judging by the UK’s direction of travel, the government’s claim of world leadership quickly unravels: we are seeing big cuts to services and watering down of rights and opportunities of disabled people.
Last year, I served on the House of Lords select committee, reviewing the impact of the Equality Act on disabled people. We found that this government’s deregulatory zeal and spending cuts significantly undermined the intended effect of the act. Employment tribunal fees, legal aid cuts and loss of advice services have put the act’s protection beyond the reach of most disabled people. And colossal cuts to the Equality and Human Rights Commission’s budget have left the act under-promoted and unenforced.
The UK’s mental health and mental capacity laws fail to comply with the CRPD, which stipulates that disability cannot be grounds for denying people equal recognition before the law or for depriving people of their liberty. Yet in England, there has been a 10% rise in detention each year for the past two years. More than half of these cases related to people with dementia, and a significant minority to adults with learning disabilities. The sanctioned use of restraint, seclusion and anti-psychotic medication remains commonplaceon mental health and learning disabilty wards, violating people’s rights to physical and mental integrity and to live free from torture, inhuman or degrading treatment. NHS benchmarking data revealed that there were 9,600 uses of restraint during August 2015 in mental health wards in England, while the Learning Disability Census 2015 found that one-third of patients with a learning disability were subject to the use of restraint in 2015-16.
Unexpected deaths of mental health in-patients, or those cared for at home in England, are up by 21% yet, unlike deaths in police, prison or immigration detention, there is no system of independent investigation. Since 2011, hospitals in England have investigated just 222 out of 1,638 deaths of patients with learning disabilities. Among deaths they classed as unexpected, hospitals inquired into just over a third.
The Care Act fails to ensure disabled people’s right to independent living, and swingeing cuts in health, social care and benefits are eroding the availability of support and people’s right to exercise choice and control. Disabled people are confronting the spectre of re-institutionalisation as councils and clinical commissioning groups limit the amount they spend on individual packages of support.
The UN disability rights committee has already reported on the negative impact of the UK’s measures to cut social security spending. Yet further disability benefit cuts continue to be implemented and the extension of punitive sanctions to those hitherto assessed as unable to work is being proposed on the back of declining investment in employment support.
“Nothing about us without us” is the international motto of the disability rights movement, but there is little evidence of disabled people being involved in policy development. The last 10 years have seen the proportion of public appointees with a self-declared disability halve in number, while helpful measures to support more disabled people into politics, such as the Access to Elected Office Fund, have been suspended in England.
Advancing the rights of disabled people requires good leadership to establish coherence and coordination in Whitehall, and in devolved and local government. The Office for Disability Issues was set up for this very task, but has become a shadow of its former self. But in Wales and Scotland, things are more positive, with the convention firmly embedded in policy and strategy.
If the UK wants to maintain the mantle of world leader on disability rights, it must see the forthcoming examination as an opportunity to listen and take stock. If it fails to do so, current and future generations of disabled people face the slow, inexorable slide back towards social death once again.
Tens of thousands of vulnerable people with dementia and learning disabilities are being detained unlawfully in hospitals and care homes across Britain, the Law Commission has said.
Replacing the “administrative and bureaucratic nightmare” system of deprivation of liberty safeguards (DoLS) would speed up checks and allow care workers to concentrate on those most at risk, the legal study recommends.
The report, laid before parliament on Monday, is an attempt to relieve pressure on the overburdened care system, which has been put under strain by the UK’s growing elderly population and a recent human rights court victory.
Individuals who lack sufficient mental capacity are subject to movement controls, usually for their own safety, which prevent them wandering off and getting into danger.
In 2014, a supreme court judgment dramatically expanded the definition of those who should be subject to DoLS checks beyond hospitals to care homes and other types of accommodation.
As a result, while there were 13,700 applications for deprivation of liberty in England in 2013-14 by 2015-16 that figure had risen to 195,840. The massive increase meant overburdened local authorities were unable to carry out checks within the period required or even at all.
The Law Commission, an independent body, was approached by the Department of Health to find a legal alternative. Its report cautions: “Local authorities are, in most cases, currently not issuing standard authorisations within anything like that timeframe, leaving people unlawfully deprived of their liberty and care homes exposed to civil liability.” A similar problem was found to exist in hospitals.
The DoLS system, if it worked, should enable patients and families to challenge any deprivation of freedom they believe is unjustified or excessively restrictive.
The commission proposes replacing DoLS with a liberty protection safeguards scheme. A draft bill implementing the legal changes is included in the report. It would allow previous assessments made in care plans to be relied on rather than requiring six sets of fresh assessments for each patient.
The report argues this would give “greater prominence” to individuals’ human rights at the initial stage at which care arrangements are being devised and reduce the number of costly applications to the court of Protection, which handles cases involving those deemed not to have mental capacity.
The liberty protection Safeguards scheme would cost about £236m a year, saving about £10m on current costs. The commission estimates, however, that if the DoLS system was working properly and every referral completed within time it would cost up to £2.2bn annually.
The commission found that in some cases vulnerable people were being deprived of liberty in their family home, although local authorities rarely have the capacity to carry out checks. In one case, door keys had been put into a safe and alarms rigged by the family to alert them if an elderly parent wandered out of the house.
Nicholas Paines QC, a law commissioner involved in drawing up the report, said: “It’s not right that people with dementia and learning disabilities are being denied their freedoms unlawfully. There are unnecessary costs and backlogs at every turn, and all too often family members are left without the support they need.
“The deprivation of liberty safeguards were designed at a time when considerably fewer people were considered deprived of their liberty. Now they are failing those they were set up to protect. The current system needs to be scrapped and replaced right away.
“We know there are enormous pressures on health and adult social care at the moment and our reforms will not only mean that everyone is given the protections they need, but could also deliver a saving to the taxpayer. That’s cash that can then be directly reinvested to support those most in need.”
A Department of Health spokesperson said: “This government is committed to protecting the rights of vulnerable people, that’s why we commissioned this review. We also gave local authorities £25m to help them manage pressures following the 2014 supreme court judgment.
“We thank the Law Commission for its detailed work and will be responding to these constructive recommendations in due course.”
Mental health charities have called for an immediate end to the face-down restraint of patients, which is being used disproportionately on women and girls.
Organisations including Mind, Rethink Mental Illness, YoungMinds and Agenda say the practice is “frightening and humiliating” and “re-traumatises” female victims of violence and sexual abuse.
In an open letter to Jeremy Hunt, the health secretary, the charities point to evidence provided by Agenda, the alliance for women and girls at risk, revealing that patients are regularly restrained in some mental health units but others deploy non-physical means of calming patients or stopping acts of self-harm.
The letter states: “Given that more than half of women who have mental health problems have experienced abuse, restraint not only risks physical harm and can be frightening and humiliating, but being restrained, particularly face-down, can also re-traumatise those with a history of violence and abuse. Mental health units are meant to be caring, therapeutic environments, for people feeling at their most vulnerable, not places where physical force is routine.”
The latest government guidelines on restraint, from 2014, suggest face-down should not be used and that all other forms of physical restraint should be a last resort. But Agenda’s research found that one in five women and girls admitted to mental health units had been physically restrained and that they were more likely than men to be subjected to such treatment. Some trusts reported an average of more than a dozen face-down restraints per female patient.
In adult services, more than 6% of women – nearly 2,000 – were restrained face-down a total of more than 4,000 times. The figures exposed wide regional variations in the use of the practice.
Philippa Lalor has suffered mental health problems for more than a decade, with spells in several hospitals and units. She said that in some units, staff would subject her to face-down restraint two or three times a day. “I became extremely angry – it affects your relationship with the whole mental health system,” she said. “I felt worthless. I have a life and friends and all the normal things – people know I have mental health problems but I would never tell people I have been restrained in the way I have, it sounds so awful and it is so shameful. It’s only in the last year that I have started to recognise that I can’t blame myself.
“It can be mental health-trained nurses along with healthcare assistants, anyone – up to a team of eight people. It’s used to prevent self-harm and suicide. It is very painful. When you are face down you have only two options: your head goes into the floor, painfully; or you twist your head round 90 degrees, to an angle your head isn’t supposed to go. I have lifelong neck pain from it. I was once subjected to it because I threw an orange on the floor.
“Interestingly, when I had perhaps my most severe [problems], I was in an acute ward where they didn’t use restraint, they de-escalated the situation without restraint and did it professionally and properly.”
Agenda produced last week’s report after freedom of information disclosures from 51 of the 58 mental health trusts in England. Director Katharine Sacks-Jones said that trusts were clearly using restraint when alternatives were viable.
“Face-down restraint is something that is raised again and again as a traumatic experience by women we speak to,” she said. “We have cases of it being carried out by male nurses, in cases where a woman doesn’t want to take medication. If you are a woman who has been sexually or physically abused, and mental health problems in women often have close links to violence and abuse, then a safer environment has to be just that: safe and not a re-traumatising experience.
“Of course, there may be extreme situations where physical restraint needs to be used, of course there may be incidents where it is the only option, but there are trusts where it is used hardly at all and places where it is seemingly routine. Face-down restraint hurts, it is dangerous, and there are some big questions around why it is used more on women than men.”
A month into 45’s presidency, and the ways in which Trumpism is a threat to lesbian, gay, bisexual and transgender existence are almost too many to count. However, those most vulnerable to HIV/Aids will be hit the hardest.
The threat of actually losing health insurance due to the president’s promise to repeal the Affordable Care Act is making millions of Americans so terrified, even his own voters are increasingly warming up to Obamacare.
But the ACA’s death is still a real possibility, and it would take a particular toll on queer Americans. According to a Yahoo investigation, “Before the ACA was passed, only about 13% of people with HIV had private health insurance and 24% had no coverage at all.” Indeed, the ACA has been a lifesaver for many people living with HIV: its subsidies for private insurance and its robust expansion of Medicaid in many states have greatly increased their access to medical treatment. If you doubt the scale of the continuing epidemiological emergency, consider that only about half of African Americans with HIV have access to continuous medical treatment, according to the Centers for Disease Control.
One way the ACA has addressed the crises is by funding the prevention efforts of Aids service organizations. Beyond people living with HIV, this work is helping to keep the transmission of the virus from further harming the most vulnerable communities, such as transgender women of color, or the one in two black gay men the CDC predicts may become HIV positive in his lifetime unless radical action is taken.
But if “silence equals death,” as the ACT UP slogan says, then loud protest is needed to keep people living with HIV from losing access to medication.
Creating swaths of uninsured people living with HIV who will likely lose access to viral suppressing medication (which makes HIV almost impossible to transmit) will also increase the likelihood of transmission to others. We know that when people in prison who are HIV positive are released with little medication, they often stop taking it altogether when they run out; their viral load then becomes very high and, research has shown, their sex partners are more susceptible to becoming HIV positive. (And if Republicans failed to keep the Obamacare provisions which allow people with pre-existing conditions to buy insurance without discrimination, it would be even worse.)
Remember, when then Indiana Governor Mike Pence presided over one of the worst HIV outbreaks in the history of the country in 2015, he first turned to prayer before then turning to Obamacare to ameliorate the outbreak (and the latter worked).
But as Vice President, Politico reported this week, “Pence is helping to lead the Republican effort to dismantle the program that helped him halt the deadly outbreak in an impoverished swathe of Indiana.” Pence wants to end what he knows worked. His horrific HIV record, steeped in heterosexism, racism and Christian supremacy, is going to hurt people living with HIV, queer people, ethnic minorities and the poor the most.
Advocates of science were alarmed when the Environmental Protection Agency was told it could no longer talk to the public because, among other reasons, the EPA protects the public from environmental harm by giving information and guidance. Similarly, LGBT Americans should be very worried that the Trump administration seems to be dialing back on providing information on HIV/Aids and LGBT health to the public. The website for the White House Office of Aids Policy is now blank and the office’s future is unclear. A CDC summit in the works to address LGBT youth health (meant to address pressing issues a CDC report exposed such as how “young gay and bisexual males have disproportionately high rates of HIV, syphilis, and other sexually transmitted diseases”) was infinitely postponed after Trump was elected.
In funding prevention programs, the ACA still remains an important channel of government information about HIV/Aids. But if it disappears, the loss may be especially harmful in states which only teach “abstinence only” sex education.
As an LGBT community (and this applies to our supporters too), we cannot be focused simply on the Trump administration’s conservative stance on our civil rights. We must be vigilant about how HIV/Aids stands to harm the most vulnerable among us first, do all we can to protect the 1.2 million people in the US already living with HIV, and insist that the government keep the epidemic from getting even worse.
People across the UK are underestimating the impact of the air pollution crisis in their local areas, according to a new survey.
Almost two thirds of respondents said they were concerned about the issue of air pollution, but only one in 10 said they thought the air they breathe is bad.
Last week the Guardian revealed that there are 802 educational institutions in the capital where pupils as young as three are being exposed to illegal levels of air pollution that can cause serious long term health problems.
And government statistics show 38 our of 43 UK “air quality zones” breach legal limits for air pollution.
Friends of the Earth, which carried out the latest survey, said that despite the growing evidence many people – particularly outside London – were still unaware of the dangers of air pollution.
“With only 1 in 10 British adults rating their air quality as poor despite swaths of the country breaking legal limits for air pollution, it seems the message about the scale and danger of air pollution isn’t getting through,” said Oliver Hayes, a Friends of the Earth air pollution campaigner.
“Often you can’t see it or smell it, but it’s there – and air pollution is risking the health of an entire generation of children.”
To coincide with the findings Friends of the Earth has launched what it says will be the “biggest ever citizen science air pollution experiment”. People can apply to the charity for clean air kits, enabling them to test the air quality where they live, and FoE will provide tips on how to avoid air pollution and what people can do to help support the campaign for clean air.
Hayes said: “Our clean air kits help people to find out about the air quality in the places they care about most: on the street where they live, where they work, where their children go to school and at the heart of their communities.
“The results will help us build up a localised picture of the state of our nation’s air to really bring home why everyone, from individuals to businesses and politicians, must do all they can to make the air we breathe safer.”
Air pollution is linked to heart disease, lung cancer, worsening asthma and poor lung development in children and leads to the premature deaths of around 40,000 people every year in the UK.
The Friends of the Earth report coincided with a separate study for the Greater London Authority which found a much higher awareness of air pollution in the capital.
It found that nine out of 10 people in London believe air pollution is at crisis levels and two thirds describe air quality in their local area as bad.
It also found that every London borough has recorded illegally high levels of air pollution in the last two years.
Hayes said: “Whilst Londoners are starting to understand the air pollution crisis, in part due to welcome attention from politicians and the media, outside of the capital it’s a very different story.”
Friends of the Earth said it hoped thousands of people will join in the charity’s experiment so it can create a comprehensive national air pollution picture. It said the data generated will feed into a national map which will help create a “state of the nation” report on air pollution.
GPs are routinely failing to provide adequate care to patients with eating disorders, with one in three not referred for specialist assistance, a leading charity has warned.
Beat, the UK’s primary eating disorder charity, found that half of people with some experience of the condition rated GP care as “poor” or “very poor” and 30% were not referred to mental health services after their appointment.
The charity polled 1,700 people, the majority of whom had sought medical help for an eating disorder. Of the 1,267 who had gone to a GP for help, only 34% said they felt their doctor knew how to treat them.
This is despite National Institute for Health and Care Excellence (Nice) guidelines that say patients should “receive treatment at the earliest opportunity”.
It comes amid growing concern about eating disorder services in general and the help available for patients once they are referred. NHS data shows a 36% drop in the number of hospital appointments for eating disorders in England, leaving thousands of children and teenagers forced to wait months for help. Charities warned that some patients were essentially being told they would not get help unless they starved themselves further.
Beat’s warnings will add more pressure on the government to improve care for patients. The charity has called for better training for medical students specialising in general practice, as well as more funding for mental health services once referrals are made.
Andrew Radford, the chief executive of the charity, said: “Unfortunately many of our respondents identified poor care, with many GPs not knowing what the real signs and symptoms are.
“This isn’t about blaming GPs, it’s about enabling the 50% of GPs who didn’t provide good care to be as supportive of eating disorder sufferers as the 50% who did.”
Elizabeth McNaught, 25, a junior doctor who had eating disorders when she was younger, agreed training was not good enough. “Many doctors do not know enough about eating disorders because they don’t feature very highly in medical training. We had just two hours on the subject throughout five years of study.”
Eating disorder numbers among the young have risen over the years. While 658 under-19s in England needed a spell in hospital in 2003-04 to treat an eating disorder, by 2013-14 that number had increased to 1,791, up 172%.
At least 725,000 people in the UK of all ages, genders and backgrounds now have an eating disorder. Research has found 20% of anorexia sufferers will die prematurely from the illness.
Prof Helen Stokes-Lampard, chair of the Royal College of GPs, dismissed claims that family doctors were not trained to identify and treat eating disorders. She added that Nice guidelines did not recommend immediate referral for all patients who might have an eating disorder. “In some cases the condition can be dealt with effectively in primary care,” she said.
Stokes-Lampard said the figures did show the intense pressure GPs were under. She added that it was not always possible to assess the needs of complex patients in a 10-minute appointment, calling for more investment and longer consultations. She also said better mental health services in the community were needed.
The Guardian heard from several people who had trouble with their GP, including Matt Foster, 28. He said: “I had spoken to my GP before about mental health issues and they were unsympathetic.” Another person, who wished to be anonymous, said: “When I first asked my GP for help, he sounded bemused. He said throwing up your food is bad for you and you are hardly fat, so what do you have to worry about?”
Rhiannon Lambert, a nutritionist, said: “Approaching a GP will always be a vital move in treatment and more needs to be done to support patients. Eating disorders need to be taken seriously. While recovery is possible, they often last a lifetime or sadly take a life.”
