Present: Dave Harper; Hermione Thornhill; Audrey Amiss; Jay Watts; Peter Kirk; Steve Halperin; Brian Chanel; Carla Willig; Daphne Milioni; Christine Nugent; Philip Dixon-Phillips; Jeff Thomas; Mike Slade; Martin Bloom; Josie Bloom; Ange Drinnan; Toby Williamson; Wendy Lee; Sybil Ah-Mane; Jeremy Laurance; Kerry Scutts; Janet; Emma Jacobs; Tom Bilton; Christina Hibbins; Sara Stanton; Chris Freudenberg

Apologies: Mark Bertram; Paul Ellis; Linda Fernardo; Esther McCalden; Jan Weaver

Adverse reactions to psychiatric drugs.

This conference was run by an organisation, APRIL, headed by a mother who lost her daughter because the doctors were unaware of the degree of side effects experienced on anti-psychotics. One member of CMHF described how information from this conference on prescription of benzodiazepines for older adults allowed him to challenge prescription practices on an older adult ward and educate the nursing staff.

Attention was also drawn to the unethical practices of pharmaceutical companies.

Organization contact details: APRIL – Adverse Psychiatric Reactions Information Link (charity regd.in England no.1072305) Contact: Millie Kieve: mobile 07949 005360 office 01992 813111

Mind conference (Scarborough). A couple of members of the critical psychiatry network gave talks at the Mind conference including Rachel Perkins.

Jackie Smith, the minister for mental health, gave a talk that seemed to imply more compulsory medication in the community (rather than in hospital). The current funding going to crisis intervention was discussed. It was suggested that the emphasis on crisis may produce a lack of funding for continuing care.

Sara Stanton gave a talk on compulsory treatment which was followed by a group discussion, then discussion within small groups.

The topic arose given concern about the review of the Mental Health Act. Mental Health legislation is often the worst sort of discrimination for example employment, insurance, and other residual legislation, and it was suggested we need a climate change. However, a member questioned whether we can slate the system and also blame it when things go wrong. One member stated individuals have responsibility for behaviour; if someone presents in a certain way, the system is set up so that the professional has to react in a certain way. How can we take back control? Advanced directives can be used, but few people have met a psychiatrist they can trust. Further, it was felt that staff do not recognise the long-term implications of compulsory treatment, for example splitting up families when carers support the Mental Health Act assessment.

All individuals have personal resources, which are separate to compliance with medication. These are not always appreciated. Further each individuals threshold for distress is often ignored, with professionals overreacting to things they, as individuals, might not be able to cope with such as hearing voices. There is also routine medicalisation of emotions.

Services were also discussed as perpetuating their own myths. For example, one member stated if you become ‘stable’ it is described as accepting the biomedical model of ‘schizophrenia’. Apparently some professionals justify compulsion as they have met clients who thank them later. It was felt that though this may be true for some people, this is not true for everyone and that clinicians only see the first set of people who are still in contact with services. There was also a discussion about what mental ‘health’ is, and how the idea that there is such a thing reinforces the use of compulsion to try to recover it, rather than seeing mental health as a continuum.

It was felt there should be a move away from treatment as medication. Ways of keeping people safe that don’t involve compulsory treatment were discussed. One member discussed how straightjackets, rather than medication, were used in the past and how, in their view, this was less coercive as these could be taken off (whilst the effects of medication continue). Why is that bungee jumpers are brave, but voice hearers are feckless?

It was recognised that psychiatry involves hard choices (if there were no compulsions, there would be tragedies) and a member pointed out the whole field involves existential questions. There should be Crisis centres, and safe houses to offer safety and sanctuary. Most seem to be linked into the psychiatric system in some form.

It was also suggested that all psychiatrists should try anti-psychotics at some point in order to understand what effects they had. However, one psychiatrist was noted as saying he only had such an awful time on them because he had a normal brain!

The majority of patients should only be treated with informed consent.

Conference announcement: The British Psychological Society, The Sainsbury Centre for Mental Health, and the Department of Health are having a conference on social inclusion models of mental health provision on 8^th February 2002. There will be bursaries available for people who could not otherwise afford to attend. Contact Hermione Thornhill for details.

• User-led research (eg Alison Faulkner from Mental Health Foundation)
• Drugs and drug companies

After January the next meetings will be on Wednesday 20 February and Wednesday 20 March.