This month saw World Mental Health Day. For the other 364 days of the year, we are forgotten. Austerity Britain has affected mental health services more than most. Despite promises to ringfence the NHS and bring parity between physical and mental health, this has not happened. Instead, beds have been cut, jobs have not kept pace with population growth, and my own trust, NSFT, has been placed back into special measures again, after being the first mental health trust in the country to be sanctioned in this way by the Care Quality Commission (CQC) in February 2015.
Mental health awareness and NHS service provision improvements are sorely needed as referrals have risen 20% in Norfolk and Suffolk, but staffing and beds have been cut. Complaints, locally, have risen from 430 to 592, 2013-16. The latest CQC report criticised inadequate staff and bed levels but praised staff the caring attitudes of staff as ‘good’.
2010-20 will be the most austere decade in NHS history
2010-17 UK population rose 5%, mental health staff up 0.87%
2011-14 33% rise in Police cases with mental health component
2010-13 56% rise in self-harm and suicide
Mental health at work costs UK economy up to £99bn
Entitlement to be seen <18 weeks applies to mental health too
A week ago, BBC Radio Norfolk ran a mental health week focus with Stephen Bumfrey featuring it each afternoon, and coming together with Nick Conrad, Sue Tebble and myself, on Friday 20th, for an hour-long special. (iPlayer episode – 2hr 32m in)
“overall if you look across the country there is a good record of actually being able to move trusts out of special measures” – Theresa May
This makes the failure to resolve the local NSFT crisis all the poorer. Patients, or the politically correct – ‘service users’, have complimented the staff but criticised the system, waits, and other failures. Patient deaths and out of hospital suicides have increased whilst beds and budgets have been cut. Hundreds of patients were sent out of county owing to the lack of beds, up to 225 miles away!
In 2012/13 the trust reported 53 unexpected deaths, 105 in 2013/14 and 14/15, 139 deaths, rising again in 15/16 to 158, and 140 in just 9 months of 16/17. When standardised for age it is above the average for England. The figures have risen across all regions during NHS austerity under this government, from 47 per 1,000 to 59 in England – up 25%, but from 44 to 66, a rise of 50% in Norfolk & Suffolk.
Jeremy Hunt, the Health Secretary, has boasted that provision for mental health has “got better” and that he has increased staffing by 30,000 posts. The reality of the lie, and statistics do indeed damn him, is that 4,100 mental health nurses, 4,596 mental health trust beds, have been cut, and just 692 extra staff employed – an increase of just 0.87% over seven years, despite population growth of 5% during that time – so, in other words, a cut!
“Although NHS funding is rising in real terms, current plans mean that 2009/10 to 2020/21 will be the most austere decade in NHS history. Total spending on the NHS in England increased by an average of 1.2% a year under the 2010-15 coalition government (0.9% for the UK), and is set to increase at the same rate under the current Conservative government. Between 2009/10 and 2015/16, spending increased from £109.1bn to £119.0bn and is planned to rise to £123.2bn in 2020/21. This growth rate of around 1% is below the historical average for the UK of 3.7% per year.” – The Health Foundation
Norfolk has a pioneering mental health within Police HQ service, but nationally, there has been a 33% increase in cases with a mental health component 2011-14. As much as 40% of Police time is spent dealing with mental health-related issues.
Eighteen Weeks, as if!
Under the NHS constitutional pledge, patients have a right to be treated within 18 weeks of referral, including mental health.
“the new waiting time standards will be as follows: 75% of people referred for talking therapies for treatment of common mental health problems like depression and anxiety will start their treatment within 6 weeks and 95% will start within 18 weeks.” Pledge of 2014 to be delivered by April 2016.
Yet, the wait for some treatments can be more like 18 months. Just try requesting something more complex than CBT or other less time-limited ‘quick-fix’ therapies. IAPT referrals seen within 6 weeks were apparently 93-96% in Norfolk and Suffolk.
My personal experience, and that of several friends, has been of much longer waits. Calling the acute care line at weekends can result in complete ignorance or lack of access to your medical records. Support lines have historically been cut. People fall between the cracks, and I know too many people no longer with us due to mental health funding and systemic failures.
Discovery or Recovery
Discharge centred mental health, is solution based, with as much an an economic imperative as a wellbeing focus.
“securing a minimum of 50 per cent recovery rate from treatment” – NHS
Mental health in Norfolk has a Recovery College, a course-based approach to improving wellbeing. I prefer to see it as a discovery-centric way of improving self-management with community support. Some mental health issues do not just resolve, yet the NHS insists on “developing a recovery culture” (p13) in mental health which fails those with long term or lifetime conditions.
74% of NSFT patients represented with mental illness symptoms within 6 months, compared to a national figure of 63% (2015 data).
IAPT (Improving Access to Psychological Therapies) approaches such as CBT serve best those with mild to moderate conditions, whereas moderate to severe need additional and more specialised help, as e.g., with OCD.
Between 2010-13, there was a 56% rise in self-harm and suicide across 52 NHS mental health trusts. It has been suggested that the over-capacity of up to 138% and staffing cuts has increased the risk of incidents.
I find the language, even if it has a clinical meaning, and the reality of response to people at risk of suicide, horrifying. The provision of “low level psychiatric support” was referenced in a Norfolk and Suffolk response it its higher than average suicide rate:
“There is a gap between the Wellbeing Service, the counsellors employed by GP practices and what is on offer via the mainstream mental health services. Suicide rate in Norfolk & Suffolk is high. GP referrals to MH are only accepted 20% of the time. GPs are left to manage risk the rest of the time.” – NSFT, pp11-12
The apparent aim is a “reduction in referrals to mainstream mental
health services by offering more low level psychiatric support in primary care.”
Care not Cuts
What worries me, is the low level of funding, of staff, of beds, and the cure rather than care attitude of the system. In contrast, the caring attitude of the staff is to be praised, and they need additional in-work support themselves to be able to deliver services under such tight austerity conditions.
The shift from pathologising terms like mental illness, disorder, nervous breakdown, has been gradual, and we are seeing more reference to mental health and wellbeing, differences, spectrum diversity etc. This has been a long time coming, since from 1-in-4 to 1-in-3 of us will experience a mental health condition or episode in our lives, if not more of us.
What keeps us from giving up?
The very tools of survival that I’ve learned to use to attempt to thrive rather than just die or dive back under the duvet covers actually aid all of us. They’re very basic, and not pharmaceutical, though some are chemical – or at least release the endorphins (endolphins as I like to call them) and oxytocin type chemistry that aids wellbeing.
When speaking at an event in London last weekend, I was asked how, “how do you keep going, how do you remain strong?” The answer, for me at least, is that I’m stubborn! Practically speaking, though, I talk and walk, and when it’s going well, I walk the talk.
Caring Talk Saves Lives
I talk to people, I talk to myself, to my thoughts – giving them voice and an opinion (but no power) at the table in my head, and I talk to my diary. Well, I write, I reflect, I repeat – yes, I realise that circumstances, feelings, moods, anxieties, they come round in repeating circles, and I begin to recognise that I survive, that I’m still here, despite my best efforts to end that.
I also walk, I get outside as often as I can. Although, that’s not often enough as insomnia and mood disorders often keep me in bed half the day. Inertia destroys all my best intentions. Last weekend, though, I managed something rare, to swim twice and walk 5 miles in a day, taking in my environment and the beauty of the world around me. Fresh air and exercise help, if only we can kick the black dog off long enough to get outside.
Being bipolar, my mood can shift drastically and quickly in the same day. I’ve learnt to be kind to myself, and to forgive, be in the moment, and treat or reward myself for getting stuff done that would otherwise pile up and compound my anxiety.
Laughter is good medicine
I’ve also learned to both respect my mental health conditions, and to healthily take the piss out of them – not others, not the suffering, not the issues, but to occasionally make light of them so that they have less of a hold over me.
Speaking of laughter – Stephen Fry has said of suicide:
“There is no ‘why’, it’s not the right question. There’s no reason. If there were a reason for it, you could reason someone out of it, and you could tell them why they shouldn’t take their own life”
He is spot on. Although every story is different, mine nearly ended 5 years ago, but I am happy to be here now.
Seeking help early before one is neither in the mood or position to seek help is important. Sadly, waiting lists are such that it can be a year or more wait for short dose CBT and that is often such a sticking plaster rather than a long-term improvement to wellbeing or coping.
I’m back in therapy for the second time in ten years, and it feels incredibly healthy. It’s not a sign of failure but of active involvement in one’s own health management.
MAD, BAD, GAD, and quite possibly SAD
I seem to collect three-letter-acronym conditions, so that I’ve been diagnosed with multiple Affective and Anxiety Disorders. Their intensity varies and sometimes I’m the boss, sometimes they try to be. Again, a diary helps me see that I do bounce (well hobble) back eventually, and they never, any longer, keep me down permanently.
Again, a diary helps me see that I do bounce (well hobble) back eventually, and they never, any longer – I hope, keep me down permanently.
Kurt Cobain, was born in 1967, and died 23 years ago today. He flitted between narcissism, empathy, love and pain, trying to enjoy his life and simply be himself, but not feeling it, instead feeling everything else instead. He’d have been 50 now, just a month older than me. 5 years ago, I also attempted suicide, after a lifelong struggle with identity and feeling too much.
Whilst Cobain is in nirvana now, where are we 20+ years on? Still struggling for identity, as individuals, and a generation? Cobain struggled with being seen as the voice of a generation. His band, Nirvana, was labelled “the flagship band” of Generation X, and Cobain himself proclaimed as “the spokesman of a generation”, something that did not sit well with him.
Faking it, Being Someone Else
“Wanting to be someone else is a waste of who you are.” – Kurt Cobain
Cobain was trying to work out how to be himself amidst the pressures of fame, parental divorce, love and loss, and mental health conditions including bipolar mood swings between depression and mania, as described by his cousin, a nurse, who noted his childhood diagnosis of ADHD and as an adult Bipolar (unconfirmed?). Several relatives had also committed suicide in the same way.
He struggled to feel what he thought he was meant to feel or enjoy. He couldn’t fake the enjoyment of fame, or life itself.
“I’ve tried everything within my power to appreciate it” – Kurt Cobain, suicide note
“The worst crime is faking it.” – Kurt Cobain
Empathy and Fame
He mentioned empathy four times in his suicide note, and the struggle between feeling too much and yet not feeling anything – or what he thought was the right thing, at all.
“I think I simply love people too much, so much that it makes me feel too fucking sad. The sad little, sensitive, unappreciative, Pisces, Jesus, man, ‘Why don’t you just enjoy it?’ I don’t know!” – Kurt Cobain, suicide note
Nirvana sold over 25 million albums in the US, and over 75 million worldwide, but fame and success do not fill the void. He hated the fame, and was envious of Freddie Mercury and how he seemed to relish it.
“We’re so trendy we can’t even escape ourselves…I really miss being able to blend in with people.” – Kurt Cobain
Reading, Writing & Lyrics
Cobain “occasionally took refuge in the counter-cultural writings of authors such as William S. Burroughs, Jack Kerouac, Samuel Beckett and Charles Bukowski”. Yet, described himself as having the “tongue of an experienced simpleton”, and hating the Freudian analysis that people subjected his lyrics to. Another reason, to explore him in his own words, not the interpretation of others.
“I’m not well-read, but when I read, I read well.” – Kurt Cobain
“I like to have strong opinions with nothing to back them up with besides my primal sincerity. I like sincerity. I lack sincerity.” – Kurt Cobain
Kurt Cobain was seemingly bisexual, though gave mixed interviews on that side of his personal life, calling himself “gay for a while” yet “more sexually attracted to women”. As a teen he was arrested and fined $180 for graffitiing “Homosex Rules” on a wall. He once said, “I started being really proud of the fact that I was gay even though I wasn’t.” It is not clear if he ever consummated this part of his persona, despite saying:
“If I wouldn’t have found Courtney, I probably would have carried on with a bisexual lifestyle.” – Kurt Cobain
Whilst Generation Y, born early 80s to 2000, followed Cobain’s Generation X, we are now on the Gen Z cohort, born since the Millennium. A group happy to be neither gay nor straight, to question gender and express it fluidly.
Cobain wrote about women’s rights in his songs, including concerning the rape of a 14yo girl after a concert (not one of his).
“I definitely feel closer to the feminine side of the human being than I do the male – or the American idea of what a male is supposed to be.” – Kurt Cobain
“He was himself”
Canadian musician and writer, Dave Bidini, in an article for the National Post entitled “Kurt Cobain, who died 20 years ago today, wasn’t a hero, martyr or vampire. He was himself” ended with this comment:
“He looked like he didn’t care (because he didn’t) … His arms hang down and he turns sideways from the crowd, as if he’s trying not to be seen, even though 20 million people have their eyes trained on him. In a society where ‘bringing it’ and ‘all or nothing’ and ‘going for it’ are sicknesses pumped by fools who aspire to drive people apart rather than draw them together, Cobain’s sense of oblivion was, in a way, brave and confrontational, and that’s why he cracked even the hardest edifice and ate through misplaced pop culture like a creeping disease. In the end, he made an enormous impression for someone who wasn’t even there.” – Dave Bidini, National Post
Cobain did escape, “Rather be dead than cool”, others need not take that route if they can follow his other wisdom, to be yourself and find someone you can be yourself with and talk to.
Remember him alive though, here’s an awesome unplugged hour-long Kurt Cobain MTV concert in NYC November 1993 just months before his suicide, my favourite line of which was “like this is my third cup of tea already” – how Rock’n’Roll!
I will remember him, as much for the angst music of a tortured soul, as the desire to find and be himself, a journey I am also on, aren’t we all to a degree?
“I’d rather be hated for who I am, than loved for who I am not.” – Kurt Cobain
Carrie Fisher will be mostly remembered for being Princess Leia in Star Wars as the Space Western princess with a gun and rapid riposte to Harrison Ford’s Han Solo when he needed a put-down. It didn’t stop them having a recently revealed off-screen romance. Also, off-screen was her battle with the darker forces of addiction and bipolar mental health. Her website records her in the way she’d prefer to be remembered as an “actor, author” and shamelessly, a “mental health advocate”, her site listed mental health resources, and she was active in promoting mental health awareness.
For the record, she starred in 44 films from Shampoo (1975) to Star Wars: Episode VIII (2017), wrote 7 books, and well over half-a-dozen plays, scripts and screenplays.More a signature action than her Leia buns and Avenger/Charlie’s Angels-style with
Even more a signature action than her Leia buns and Avengers/Charlie’s Angels-style gun-aloft pose, her middle finger was often shot up at the press. She was a hero for her honesty, humour and heart, the media needs to treat mental health better.
As someone who battles and “sur-thrives” with Bipolar Affective Disorder, aka manic depression, myself, I find so many echoes in her statements on mental health, and her activism in helping others through honesty and sheer guts – or clitzpah, female “courage bordering on arrogance”, as a friend puts it.
RIP Carrie Fisher 4 fighting the patriarchy, sexism, #bipolar#mentalhealth, addiction & Darth Vader, may the force be with her in death
A fitting tribute is, therefore, to remember her in her own words:
Carrie Fisher Quotes – In Her Own Words
“I really love the internet. They say chat-rooms are the trailer park of the internet but I find it amazing.”
On Writing as Therapy
“I have a mess in my head sometimes, and there’s something very satisfying about putting it into words. Certainly it’s not something that you’re in charge of, necessarily, but writing about it, putting it into your words, can be a very powerful experience.”
“I always kept a diary – not a diary like, ‘Dear Diary, we got up at 5 A.M., and I wore the weird hair again and that white dress! Hi-yeee!’ I’d just write.”
“Writing is a very calming thing for me.”
I can echo those thoughts, totally! Writing slows my racing pacing thoughts down, coming up with the language that accurately and emotional reflects my thoughts on myself, life, the universe and everything, is a process that is cathartic, creative, and better than CBT.
Whether scripted stand-up comedy or unscripted ad-lib, Carrie was quick witted, sharp, funny and could turn the tables on an interviewer. A vital skill in the harsh world of Hollywood and media criticism.
“I brought along Gary” (Carrie Fisher’s dog) “because his tongue matches my sweater” … “I think in my mouth so I don’t lie” … “what music makes [weight loss] worthwhile?” Not to mention some beautiful flirting with “DNA jackpot”GMA’s Amy Robach!
The humour, the jokey OCD matching, the flirting, she was my kind of inappropriate unboundaried, humourous getting-into-trouble, woman.
“There’s no room for demons when you’re self-possessed” via Twitter (2014)
“I googled myself without lubricant. I don’t I recommend it.” on David Letterman (2009)
“Sometimes I feel like I’ve got my nose pressed up against the window of a bakery, only I’m the bread” – Postcards from the Edge (1987)
“I am a spy in the house of me. I report back from the front lines of the battle that is me. I am somewhat nonplused by the event that is my life.”
“I don’t want my life to imitate art, I want my life to be art.”
Again, one feels like an actor in one’s own drama, there is sometimes a feeling of distance from the actions one takes, as if one were only playing a part, however grand a role.
On Body, Weight and Aging
“I don’t like looking at myself. I have such bad body dysmorphia.”
“I think of my body as a side effect of my mind.”
“I’m in a business where the only thing that matters is weight and appearance. That is so messed up. They might as well say ‘Get younger,’ because that’s how easy it is.”
“There were days I could barely struggle into a size 46 or 48, months of larges and XXLs, and endless rounds of leggings with the elastic at the waist stretched to its limit and beyond – topped with the fashion equivalent of a tea cozy. And always black, because I was in mourning for my slimmer self.”
“…when I do lose the weight, I don’t like that it makes me feel good about myself. It’s not who I am.”
“Along with aging comes life experience, so in every way that is consistent with even being human.”
On Mental Health & Bipolar Mood State
“I’m very sane about how crazy I am.” – Wishful Drinking, (2008)
“I now get awards all the time for being mentally ill. It’s better than being bad at being insane, right? How tragic would it be to be runner-up for Bipolar Woman of the Year?” – Wishful Drinking, (2008)
“Anything you can do in excess for the wrong reasons is exciting to me.”
“I have a chemical imbalance that, in its most extreme state, will lead me to a mental hospital.”
“Drugs made me feel more normal.”
“I went to a doctor and told him I felt normal on acid, that I was a light bulb in a world of moths. That is what the manic state is like.”
“I have two moods. One is Roy, rollicking Roy, the wild ride of a mood. And Pam, sediment Pam, who stands on the shore and sobs… Sometimes the tide is in, sometimes it’s out.”
The manic mood ride that is Roy and the pessimistic panic that is Pam, is very familiar. I’ve not heard anyone else echo my experience of drugs making one feel normal. I tried weed, ecstasy and minor drugs like that, even smoking and drinking, but they didn’t do anything for me, indeed ecstasy made me responsible, hyper-sensible!
On Surviving and Thriving
“Ive [sic] stopped trying to take things a day at a time. I now take 2 or 3 days at once—hoping it’ll cause a blur effect & I might look younger.” via Twitter (2015)
“I don’t want to be thought of as a survivor because you have to continue getting involved in difficult situations to show off that particular gift…”
“If anything, my mother taught me how to sur-thrive. That’s my word for it.”
“The world of manic depression is a world of bad judgment calls.”
“I’ll never be known for my work with boundaries.”
“Mistakes are a drag, because you get in the area of regret and self-pity.”
Fortunately, it’s not all bad boundaries and manic mistakes, and the following day come-down into reality and realisation that one has overstepped, overdrawn, overdone it, and occasionally overdosed. Manic can be fun, or at least hypomanic can, with just enough awareness to feel empowered, energied, extrovert and not yet into the territory of relationship, finance and employment self-destruction.
“The manic end of is a lot of fun.”
She was the brightest, funniest, bravest, kindest, cleverest and sweetest person I ever knew. A crushing blow to lose @carrieffisher
“One of the great things to pretend is that you’re not only alright, you’re in great shape. Now to have that come true – I’ve actually gone on stage depressed and that’s worked its magic on me, ’cause if I can convince you that I’m alright, then maybe I can convince me.”
“Stay afraid but do it anyway. What’s important is the action. You don’t have to wait to be confident. Just do it and eventually the confidence will follow.”
“I’m fine, but I’m bipolar. I’m on seven medications, and I take medication three times a day. This constantly puts me in touch with the illness I have. I’m never quite allowed to be free of that for a day.”
She is free now, “drowned in moonlight, strangled by my own bra“. Whilst she was “nonplused” about her life, we are far from nonplused at her death and feel the disruption in the force in 2016, which has been a traumatic year of loss. RIP Carrie, Princess, Queen, General and very human being, “May the Force be with you.”
Postscript: Carrie Fisher’s mother, Debbie Reynolds, star of Singin’ in the Rain, died aged 84 of a stroke within 24 hours of Carrie.
Yesterday was #InternationalMensDay (IMD) – not a simple awareness retaliation day to Women’s Day but an acknowledgement, since 1999, that privilege and difference are often relative and contextual. Society does make it harder for men to talk, share, open up, acknowledge depression, career pressures etc. Men’s mental health is such that suicide can be their biggest killer, indeed, silence kills. Yes, feminists can argue that every day is men’s day, but in the particular sphere of suicide, there needs to be a spotlight on men and the fiscal and fragile crises that so often masculinity prefers to conceal. Similarly, whilst young LGBT people have high suicide risks, one group most prone to it is white men aged 85+ whose suicide rate in the US is six times the national average, closely followed by Native American males.
World Suicide Prevention Day, 10 Sep
Men are more than 3 times as likely to take their lives as women (4 times in the USA), with rates of 16.8 per 100,000 for men and 5.2 per 100,000 for women in the UK. Women try suicide more than men, but male suicide methods are more likely to result in death.
The highest suicide rate in the UK in 2014 was for men aged 45-49 at 26.5 per 100,000 with the North East of England most vulnerable. Whilst the overall suicide rate fell 1981 to 2007, austerity and cuts to services have seen annual rises since with the male rate last year, the worst since 2001.
385 men-a-month take their own lives in the UK; it is even worse in the USA, at 2759, 1.5x more likely per capita. In Japan, it is the leading cause of death in men aged 20-44.
Even so, Japan is not the worst. Lithuania is twice as high at 51 per 100,000 and Guyana at 71 per 100k is ashamedly the world ‘leader’. The USA ranks #46 and the UK #101 for male suicide.
Not a laughing matter
Men’s mental health is not a joke. November 19 was also World Toilet Day, and whilst jokes about leaving the toilet seat up abounded on twitter – including by me, whilst not directly aimed at men’s health, sanitation and sanity are not laughing matters when one billion lack a toilet and half-a-million men each year die by suicide and many millions more try. Whilst depression and mental health issues account for the majority of cases, for men in particular, financial and career pressures are significant factors. Education, because it brings with it greater economic opportunities and perhaps better communication skills, is a reducing factor, except among certain professions whose jobs give them access to pharmaceutical drugs.
Learn to Talk & Listen
The old Second World War adage and poster campaign that “Careless talk costs lives” could be turned on its head – “Learn to talk and save lives”. Partners and friends of men in crisis, similarly, need to learn to listen and not diminish the pressures that drive them to drink, depression and suicide. Suicide, at one every 40 seconds and on the rise (predicted to be one every 20s by 2020) is preventable is we make it ok for everyone to talk about mental health, men in particular, and we also end the worst effects of austerity where health and welfare cuts are exacerbating the problem and denying access to solutions.
The West London Mental Health Trust (WLMHT) has issued a statement and then after mass trans patient panic (well a few of us!) has clarified it. The Gender Identity Clinic at Charing Cross Hospital (CX GIC) is not to close but to seek new NHS England oversight, preferably not under the auspices of mental health care. This is both unnerving for existing patients on the long waiting lists and potentially radical.
We are committed to running the Gender Identity Clinic until @NHSEngland find a new provider for the service. It will not close.
The Charing Cross Gender Identity Clinic is, in their own words, “the largest and oldest clinic of its kind dating back to 1966”. The same year that Harry Benjamin published “The Transsexual Phenomenon“.
UPDATE: It has been confirmed that from April 2017 the Tavistock and Portman NHS Foundation Trust will take over the management and funding of the Charing Cross GIC, without its location changing. The T&P NHS FT also run Tavistock GIDS, London (child and adolescent service).
NHS Hospital Cuts
All this comes the same day the NHS has announced further cuts in a spiralling financial crisis – the biggest in its history, requiring the euphemistically named “sustainability and transformation” plans, in other words, “cuts”.
“We are seeing more and more pressures on staff trying to run harder and harder. We are reaching breaking point.” – Chris Hopson,Chief Executive ofNHS Providers
West London Mental Health Trust statement
The Gender Identity Clinic at Charing Cross plays a leading role nationally and internationally in helping people experiencing gender dysphoria to feel more comfortable in their own bodies.
West London Mental Health Trust (WLMHT) is incredibly proud to have been at the forefront of developing gender identity services during a period in which societal attitudes and understanding of this issue has improved so vastly, and that the Charing Cross GIC and its staff have, since 1966, helped nearly 7500 people to lead happier, healthier lives.
Demand for gender identity services has risen sharply in recent years as society has grown more understanding and awareness of NHS services has developed. This has been challenging for the clinic and resulted in waiting times that are longer than we would like. However, the clinic’s staff have continued to invest huge amounts of energy and, working with NHS England, have made great strides in bringing these waiting times down while still providing a service which is rated highly by patients.
However, as WLMHT moves forward it is necessary to refocus the services that we provide. The Board has made a decision that the medium-term strategic focus for the Trust will be to develop mental health services, physical care and integration between the two.
As a result, the Trust has come to the conclusion that patients requiring gender identity services would be better served in the long term by another provider, and has therefore served notice on our contract to NHS England.
We know that many of the patients we see at the GIC are at difficult times in their lives and that this announcement may cause alarm; we would therefore like to offer the following reassurances:
This does not mean services are stopping now – we will continue to provide services as normal until such time as a new provider is able to take over; this is likely to be at least six months.
Patients from London and the South East will not be left without services or have to travel much further – NHS England as the commissioner for gender identity services will find a suitable alternative provider as quickly as possible.
Patients will not have to start their treatment all over again – continuity of care for our patients is the number one priority for clinic staff. GIC staff will work closely with NHS England and a new provider to ensure disruption to treatment is kept to an absolute minimum.
This does not mean we will let services deteriorate – WLMHT and the GIC will continue to deliver on plans we have developed with NHS England to improve access to and quality of services while it continues as the provider.
We will not reduce staffing levels – while we remain the provider of this service we have an obligation to ensure there are sufficient qualified staff to maintain and continue improvements in access and quality.
We will ensure a smooth handover to the new provider, working closely with our colleagues at the GIC and NHS England
Dr James Barrett, Lead Consultant at the Gender Identity Clinic (GIC), on behalf of GIC clinicians, later clarified:
“The gender identity clinic is not closing. To clarify, we clinicians have long felt that West London Mental Health Trust is not a good fit for the unique and specific service we provide (the vast majority of those we see are not mentally ill).
“Increasingly, we feel our patients would be better served by us if we worked somewhere better able to support and develop a more tailored approach to gender.
“There are a number of options in terms of alternative providers. We would not make any move unless confident that patient care would be markedly improved.
“Until that point, current arrangements will still apply. Our aim is for any change to be a positive one, and any transition to be as seamless as possible.”
CX GIC psychiatrist, Dr Stuart Lorimer, sought to reassure people:
Okay, so Charing Cross GIC is *not* closing. It’s about the gender clinic preferring to be hosted by a non mental health provider.
Waiting times for first appointments at the Charing Cross GIC are currently around 12 months from the initial referral but can often take 3-7 years in total, when you include surgery which only takes place after two psychiatric approvals and a pre-surgical assessment.
Referral times are not only a postcode lottery but constantly change – both up and down, according to staffing, and ever-increasing transgender service user demand. Norwich, alone, refers 50-60 adults a year not including the dozens of trans teens not yet in the adult system. It recently shifted its gender dysphoric population from Charing Cross to Nottingham GIC, having also, in the past, used Dr Richard Curtis’ TransHealth in London.
UK Trans Info has an excellent resource offering waiting times and estimated trans population surveys of all the GICs every three months. Last year Leeds were quoting 4 years for first appointments and Sheffield over 18 months! Nottingham’s 8 months has risen to 12 and now 18-19 months.
“Nottingham’s GIC saw the most marked growth, with a 2800% increase from 30 referrals in 2008 to 850 in 2015. More than 1000 are expected this year.” – Pink News
UK Trans Gender Identity Clinics
There are 7 adult and 1 adolescent-teen GICs in England, serving England and Wales – Wales has none of its own and London’s Charing Cross GIC also serves them. The Tavistock and Portman is the sole young person clinic in England, based in London, but with clinics in Exeter and Leeds.
Scotland has 4 adult and 1 adolescent clinic. Belfast Health and Social Care Trust runs an adult and separate “Knowing Our Identity” (KOI) service for children and teens.
For a full list and contact details see GenderAgenda’s UK GICs page.
Monday evening, just as the heavy rains stopped, 200 people – LGBT and allies, gathered on the steps of Norwich City Hall, to stand with the 100 fallen, killed or maimed in a hail of hate and bullets at Pulse, Orlando. The Vigil against hate was organised by Norwich Pride and featured speakers: Katy Jon Went, Julie Inns for Norfolk Police and the Chair of Norwich Pride, Andy Futter.
Norwich again shows its support for diversity and freedom of expression, as it did with its Charlie Hebdo vigil, demonstrations against the EDL and many more political but peaceful assemblies. The Norwich vigil was marked by a minute’s silence and the lighting of candles on the steps of City Hall. [See below for the texts of the speeches or photos of the event]
Norfolk local and LGBT poet laureate, Trudy Howson, at the Soho event, told Sky News:
“It is very important to show solidarity … we’re all part of the same community and it’s very important that we show love and solidarity. We’ve all been victims at some point of homophobia – we need to stand up to hate and evil and fight for respect.”
One woman held up a sign that said Every Life Matters: “Queer, Black, Muslim, Latino.” Next to me in the crowd a white man in his forties held a sign that said “I’m Gay And Religious – Get Over It.” Squeezed in beside him was a young man in a taqiyah, standing with a girl. “My friend is Muslim,” said the girl.
The London event took place outside the Admiral Duncan pub on Old Compton Street, Soho, where three people were killed and many injured in a nail bomb attack in 1999, just showing that homophobic terrorism need not be of religious origin. The perpetrator, David Copeland, was a far right BNP neo-Nazi extremist who targeted diverse communities in Black, Bangladeshi and gay areas of London in three bomb attacks. He was known to have mental health conditions including paranoid schizophrenia but insufficient, perhaps due to the public outcry, to warrant diminished responsibility as a defence plea.
Orlando Massacre explanations aplenty
As family, media, and commentators explore the reasons for Omar Mateen‘s mass killing spree, families and lovers mourn their dead, who no amount of analysis can bring back. It has been said that Mateen was bipolar, was a wife-beater, had joined several Islamist extremist groups including ISIS (at the last minute). His father says that Omar had recently witnessed two men kissing and had been disgusted by it.
The most recent reports suggest that he’s actually patronised the club and been drinking there – hardly very devout Muslim behaviour, indeed many said he was barely religious at all. Apparently, he’d also been seen on gay dating sites, so the possibility of internalised homophobia, self-hate, and sexuality identity repression seem very strong motives, with the tacking on of Islamic State, more of an afterthought seeking some kind of redemption and forgiveness in the afterlife for his, considered sinful by his faith background, sexuality.
Muslims, Gun Control and the Blame Game
Scapegoating and stereotyping have hit the headlines, making it all about IS or immigrants, religion or lack of gun laws. Some on social media have perpetuated the hate and homophobia by rejoicing in the slaying of sinners – sick! Yes, the US right to bear arms and easy access to not just a pistol or shooting rifle but an automatic weapon are accountable – but not solely responsible, for the extent of the massacre. Getting off 24 shots in 9 seconds was facilitated by the type of gun that was readily available. It was not purchased for self-defence, unless one was expecting a war. The AR-15 style assault rifle – the Sig Sauer MCX, is described by its maker as a “battle-proven weapon system”.
US Presidential candidate Donald Trump has adopted an “I told you so” type of approach, taking credit for seeing this coming and calling for an immediate suspension of Muslim immigration. Some are happy to label it terrorism, others a hate crime, yet more that it is a gun control or immigration issue. Not so many, focus on the fact that this was a very real attack on an LGBT safe space, a gay bar, some have even gone to great lengths to condemn Muslims and avoid reference to LGBT, how else can right wing nationalists stir up Islamophobia whilst avoiding any reference to their own homophobia? The crime does not fall into a neat explanatory box. Journalist, Owen Jones, walked out of a Murdoch-owned Sky News discussion because it failed to acknowledge it as a specific attack on the LGBT community.
FBI Report in US Mass Shooting Incidents
Between 2000 and 2013, 486 people were shot dead, and even more wounded in mass shooting attacks in America. The frequency of incidents has only got worse, more than doubling in the last 7 years of the analysed period, to more than 16 incidents a year. The Orlando attack was the worst mass shooting in peacetime American history.
A Mother Jones investigation going back 33 years shows 670 killed and 650 injured in 80 incidents, with mental health a factor in between 60% and 80% of cases.
The vast majority took place at commercial workplaces or schools, by disgruntled employees or students, or over things as irrationally minor as arguments over a CD player or driving ability. By far the majority were carried out by white males, not foreign immigrants or Muslim extremists. Out of 160 incidents, barely 2% could be described as Muslim perpetrators, a couple were clearly anti-semitic.
“You are no more likely to be shot by a Muslim than by a Christian or an atheist in America.”
If killing 50 LGBT people, and maiming as many, is your response to witnessing a kiss, an expression of love, between two people of the same sex, then you need help not hate, to get open minded not offended, and a change of religious interpretation. I can’t help but think there might have been some internalised homophobia going on besides mental health, anger and other issues already raked up by media, before this individual jumped on the ISIS bandwagon to tag his heinous act.
We forget that London, Brighton and elsewhere have had their own homophobic atrocities, that were not done in the name of ISIS, that Los Angeles Pride just had another violent attack on it averted, nothing to do with alleged Islamic extremism, that Prides in Israel have seen LGBT people attacked and killed by Jewish Orthodox extremism. There is no place for ill-informed Islamophobia now – people of all faiths and none, Communists and Fascists in recent history, have all targeted LGBT people.
Anger is no less a legitimate response than many others at this time. Forgiveness, albeit a healing one, can never be asked or expected of anyone unless freely given and only by the victims and their loved ones. Understanding, love, mercy, and worldwide calls for an end to homophobic judgement and violence are needed, people to challenge bad religious interpretation and attitudes, and show better alternatives. I’m pleased that many faith groups march with Pride, and historically just one small one, against it, here in Norwich.
Religious groups are all over themselves with prayers at the moment but no recognition of the hypocrisy that their slowness to accept LGBT people counts towards the fear and hate that drives confused and conflicted people to carry out these acts. The victims don’t need prayer they need acceptance, the only justice would be churches, mosques and temples overturning their hitherto homophobic attitudes, policies and doctrines. This may sound offensive but so was Jesus. Prayer without doctrinal change and better practice right now is like blessing the homeless with words but not with a blanket and some food. People of faith need to offer more than prayers right now.
I’ll put my hand up in the air, 30 years ago I was a fundamentalist Christian, opposed gay rights etc, years later several members of my University Christian Union, that I’d helped found, came out as gay or lesbian. My views changed, when I had my own coming out and Damascene conversion to LGBT acceptance. Others can too.
Will we see the same international condemnation and responses as in Paris? I doubt it, as the victims were LGBT.
Amidst the EU referendum debate, US presidential campaign and escalating immigration and Islamophobia issues, we don’t need blanket condemnations but change. People in the US and UK have hijacked Orlando as an excuse to condemn migrants, religion etc, but not to call it homophobia.
Hate and fear need naming but the responses need to be love and, ‘out and proud’ confidence.
As Martin Luther King said:
“Returning hate for hate multiplies hate, adding deeper darkness to a night already devoid of stars. Darkness cannot drive out darkness; only light can do that. Hate cannot drive out hate, only love can do that.”
Julie Inns, Norfolk Police
Good evening everyone it’s so wonderful to see so many people supporting this event tonight. I’m immensely proud to be standing here tonight; I stand here on behalf of Simon Bailey, Chief Constable of Norfolk Constabulary and Lorne Green our new Police and Crime Commissioner who unfortunately at short notice were not able to be here tonight, although they send their best wishes for a successful event.
I am very privileged to be standing in front of you tonight with so many familiar faces some of who I know quite well and some who will be new to me, supporting this Norwich Stands with Orlando Vigil to support our LGBT brothers and sisters across the pond who have suffered this weekend and for which there are no words to describe what went on in Orlando this weekend. I just can’t think of the words to describe it. But from the Constabulary and Police and Crime Commissioners Office our thoughts do go out to the family and friends of those effected but this atrocity.
Now we all know that Norwich is statistically a safe place to live, it’s a safe county and we encourage people to come here to live, to work or come on holiday and visit and we say to you, you can come and you can bring your religion, your sexuality, you can eat your food and wear your traditional clothes and come one come all and we are really accepting of that. However we must be mindful that unfortunately in this day and age that terror can strike anywhere.
But for this to happen to them during their PRIDE celebrations in a club where they should have felt free, welcomed and happy to be who they wanted to be, I don’t know about you guys but I find that even more heart-breaking and gut-wrenchingly awful that I have no words to explain it.
So I’d like to think that we would be lucky enough in Norfolk never to have to experience anything like what happened in Orlando over the weekend and our county will never see such an atrocity. But we have to remember that it does go on and we all have a part to play in keeping all our citizen’s safe. So with that in mind let’s not blame the actions of a small minority of the people who commit these acts on the majority. And when we talk about what happened in Orlando and bandy the word hate crime around it doesn’t quiet cut it for me, it just seems to be a bit beyond that. But I want to be really really clear on this and this is important for me. Norfolk Constabulary is absolutely committed to the LGBT community in Norfolk that we will keep you safe and we will shield you from harm wherever possible. But in order for us to do this, people have to come and talk to us and sometimes that can be difficult. But we want you to be who you are, to be authentic at work and out in the community and to be safe while you are doing that, but for us to do that if there is a problem you need to come and tell us about it and I know for some of you that is going to be difficult so I’ll be here afterwards if you would like to come and talk to me or take my contact details so we can talk in private, that would be really great.
The one thing I would like to reassure you on is that when anyone reports incidents of hate to us whether it be about your sexuality, your race, which religion you follow or if you live with a disability, whatever the issue is I can assure you now, we will believe you, we do take it seriously and with your help do whatever is possible to pursue the perpetrators through the criminal justice system until we get a conviction and that is my personal promise to you on behalf of Simon Bailey and Lorne Green. So I’d like to say that Norfolk Constabulary and the Police and Crime Commissioner wholeheartedly support this vigil tonight and say no to hate. But not just no to hate, No to hate in our county, No to hate in our fine city, No to hate across the world and finally we believe in hashtag #loveislove.
Andy Futter, Chair of Norwich Pride
In the early hours of yesterday morning, at the Pulse Nightclub in Orlando, Florida, a 29-year-old man carrying an assault rifle and a handgun and began shooting and murdering individuals before taking hostages.
Once the horrific event had played out, fifty people lay dead and a further fifty-three were hospitalised.
These people were a part of the lesbian, gay, bisexual and transgender community. They were enjoying a weekend night out with their friends at a venue in which they should have been safe.
I ask those of you who do not have to experience this particular brand of hate to understand that – despite it being 2016 – the LGBT+ community – my community – still needs these spaces.
They are our sanctuary.
And if you can’t understand the concept of a bar or nightclub being a sanctuary, then be grateful. It means you’ve probably never been afraid to hold someone’s hand in public. It means you’ve probably never been afraid to tell people that you met someone new – simply because of the gender of that new partner. It means you’ve probably never been afraid to leave your house for fear of being mistaken for another gender and the violence that so often goes hand in hand with that ignorance.
I mean that utterly sincerely. Be grateful if you have experienced none of those things. But try to reflect on the experiences of those who have and understand that we need those safe spaces – just like the Pulse nightclub.
That should have been a safe space. But yesterday, that peace; that sanctuary, was shattered in the most brutal way.
Those individuals were no longer safe. They were targeted for being lesbian, gay, bisexual or transgendered; or for being a friend of the LGBT+ community.
Being gay or lesbian or bisexual or transgendered is not a choice. Getting out of bed and deciding to walk into a bar to target those of us who are lesbian, gay, bisexual or transgendered is most definitely a choice. But so is being an ally.
So for those of you here tonight who are not L,G,B or T, I thank you for your support.
Our community is strong and across the world right now and the coming days, you will see how just strong this worldwide family is; but we are all the stronger for having you on our side.
We are all the stronger for you understanding that despite huge legal steps forward – lesbian, gay, bisexual and trans people still face hate on a daily basis, for simply loving the people we love and expressing our true selves.
We are all the stronger for you understanding that, so I would ask you to understand something further. Yes – every life matters; every act of terror and murder should be condemned; but make no mistake: this was an attack directed squarely at the LGBT+ community.
Right now we are scared.
But we are also empowered by our love and solidarity.
Right now we are vulnerable.
But we are also strong in ways which may surprise many – including ourselves – and we will not be beaten.
Right now we are upset.
Right now we are angry.
So when you reach out to your LGBT friends, loved ones, brothers, sisters, colleagues: hold us closer and hug us tighter than before.
Right now, we need it.
Every one of us here tonight owes it to every one of those who died at the Pulse Nightclub in Orlando to stand taller. Be prouder.
We will not hide in the shadows.
We will not quietly clamber back into the closet. We will not stop living our lives.
So for all of those who died on Sunday in Orlando; to those who still lie bleeding in hospital; to those who have had loved ones ripped mercilessly from their lives, I say this: the people of this fine city stand with you.
Today and everyday is bipolar day for 2-3% of the population who have a Mood Affective Disorder including Cyclothymia and Bipolar I & II. A day to recognise the issues, struggles, and occasional joys and spurts of creativity – sometimes manic, experienced by people with bipolar, was created to coincide with Vincent van Gogh’s birthday, 30 March, since he was posthumously believed to have had a bipolar type condition. World Bipolar Day aims to:
Whilst 1-in-100 or 2.6% are commonly cited figures, some studies have shown wide variations, ranging from 2.6 to 20.0 per 100,000 per year, in the incidence of bipolar affective disorder (Lloyd & Jones, 2002). These variations have been e.g., regional, SE London is twice that of Nottingham and Bristol, or by ethnicity, by socio-economic class, by childhood intelligence – especially high verbal IQ, or by hormones and gender – some studies show a much higher incidence in the female population.
“estrogen fluctuations may be an important factor in the etiology of bipolar disorder and it is obvious that more research on this topic is needed to clarify the role of estrogen in women with bipolar disorder…Why is it that rapid cycling occurs more often in women?” – http://www.ncbi.nlm.nih.gov/pubmed/23510130
It also alleged that among artistic and creative types there is a higher incidence of bipolar mood disorders, that may be genetic. Indeed, as many as 40x the national incidence, among a group of 30 American authors, studied over 15 years:
“43 per cent of them had bipolar disorder compared to only 10 per cent of the control group and 1 per cent of the general population.” – Bipolar Disorder and Creativity
A further survey of 47 British authors and visual artists from the British Royal Academy found that 38% had been treated for a mood disorder.
“A recent study carried out at Stanford University by Santosa and colleagues found that people with bipolar disorder and creative discipline controls scored significantly more highly than healthy controls on a measure of creativity called the Barron-Welsh Art Scale. In a related study the same authors sought to identify temperamental traits that people with bipolar disorder and creative people have in common. They found that both shared tendencies for mild elation and depression with gradual shifts from one to the other, openness, irritability, and neuroticism (roughly speaking, a combination of anxiety and perfectionism).” – Bipolar Disorder and Creativity
Vincent van Gogh
The famous Dutch post-Impressionist painter, Vincent van Gogh suffered quite wild swings in his mental health and many paintings were produced from his asylum room. Van Gogh is thought to have shot himself, after struggling with declining mental health in his mid-30s. He had spent most of the last 18-months of his life in an asylum, but two months later was dead as the result of a presumably, though not proven, self-induced shooting incident or suicide attempt.
Ironically, it was a period when he produced many iconic paintings, some en plein air. His famous image titled ‘The Starry Night’ was a pre-sunrise nocturne as seen from his East-facing asylum window, but finished in the asylum studio, as he was only allowed to draw in his room, not paint. Van Gogh’s beautiful and happier ‘Village Street and Steps in Auvers’ was painted just days after release from the asylum:
Barely weeks later, and days before his death, he was painting several large wheat fields canvases and in a letter to his brother Theo, he wrote:
“I have painted three more large canvases. They are vast stretches of corn under troubled skies, and I did not have to go out of my way very much in order to try to express sadness and extreme loneliness….I’m fairly sure that these canvases will tell you what I cannot say in words, that is, how healthy and invigorating I find the countryside.” – Vincent van Gogh, Letter to Theo van Gogh, 10 July 1890
His late paintings demonstrate an artist at the height of his talent, yet also the depths of his troubles, for whom art and the outdoor landscape was creative catharsis and therapy. What would the art world have witnessed had he lived on?
Bipolar Mood Scale Diary
It is typical for a bipolar diagnosis to take a decade and work through several misdiagnoses en route. I was first diagnosed with Cyclothymia over 4 years ago, but subsequently told it was Mood Affective Disorder and then Bipolar II, along with rapid cycling and mixed mode variations. CBT – Cognitive Behaviour Therapy, helped my management, but so did self-knowledge, awareness, and diarying. I enjoy my hypomanic periods, less so the depressions which I’ve fought for 12 years or so. Finding balance when you only exist at the poles is a tricky act to accomplish and may involve staying in when you feel like going out and going out when you feel like staying in!
Risks, when hypomanic, for me include inappropriate conversation, loss of impulse control, manic spending, flirting, obsessional behaviours, risk seeking. Yet, the benefits when high are hyperactive stamina and energy, stream of consciousness ideas flooding, huge reading and writing output, charismatic and entertaining confidence and loquaciousness.
“I managed to rack up £300k of credit, hardly average! I was, and indeed am, very convincing when hypomanic, it made me a good salesperson, deal-maker, innovator, public speaker but terrible at time and money management.” – May 2013
Having been in a balanced mood state for nearly 3 months now, a rare occurrence, possibly due to recent endocrine changes, I miss the hyper states. I also realise, however, how destructive they could be to life, economics, and relationships, whilst at the same time being a creative buzz. I don’t miss the lethargic, inactive, hopeless depressive episodes at all, although they were a great way of avoid life and its stresses.
The best advice I was given was to monitor my mood on a daily basis, as I was already doing with my insomnia diary and general personal diary. The catharsis of writing and recording also came with the recognition that moods, highs, lows, sleeplessness all came in phases, that changed – they got better, and they got worse. Unlike, when I suffered with depression for 6-8 years as that felt like nothing would ever get better. The Bipolar Mood Scale diary has helped me to hold out for the good days, and to manage my moods better.
Bipolar Mood Scale
Total loss of judgement, exorbitant spending, religious delusions and hallucinations.
Lost touch with reality, incoherent, no sleep, paranoid and vindictive, reckless behaviour.
Inflated self-esteem, rapid thoughts and speech, counter-productive simultaneous tasks.
Very productive, everything to excess (phone calls, writing, smoking, tea), charming and talkative.)
Balanced Mood (Euthymia)
Self-esteem good, optimistic, sociable and articulate, good decisions and get work done.
Mood in balance, no symptoms of depression or mania. Life is going well and the outlook is good.
Slight withdrawal from social situations, concentration less than usual, slight agitation.
Mild to Moderate Depression
Feelings of panic and anxiety, concentration difficult and memory poor, some comfort in routine.
Slow thinking, no appetite, need to be alone, sleep excessive or difficult, everything a struggle.
Feelings of hopelessness and guilt, thoughts of suicide, little movement, impossible to do anything.
Endless suicidal thoughts, no way out, no movement, everything is bleak and it will always be like this.
0-10 Scale of mood from depression to mania
Being or having bipolar – people’s attitudes to which verb to use varies, should not be romanticised. It is both a blessing and a curse, and for some is very hard to live with. I’ve made friends with mine, though it is still unpredictable. I’ve come to appreciate the moment, mindful that it can change, but I take the rough with the smooth now. Hopefully, I can look back on past suicide attempts as distant memories, and seize the creative periods to be productive and expressive, whilst trying to rein it in when it tips into hypomania.
The language of austerity and recovery (the Tory version or Labour’s “austerity-light”) has all been about working to pay off the deficit, whereas the reality of much of it was about cutting public sector jobs and the benefits of those out of work. The language of Ukip has been about preventing others coming here to work, or labelling migrants as “benefit/health tourists”. According to many international bodies the UK has done well – economically, but socially we are falling apart. Socially and in microeconomics terms, rather than the surface macroeconomic recovery, the Coalition isn’t working, also “Labour Isn’t Working“, the political opposition has been ineffectual.
Measuring the Health of a Nation
In health service resources terms we are 28th out of 30 OECD nations, 19th in terms of our actual health. The health of society should not be measured in mere economic terms. Education, welfare, mental health, attitudes to those that are different, migrants, or asylum seekers, are often a better guide to how we are really doing as a society. When a million people are using foodbanks, something is clearly wrong.
The language of Labour and Conservatives this election has all been about “hard working families“, with Ukip adding British-only workers to that, but then even Labour wanted to push for British jobs first. On paper, the unemployment rate is almost back to its 5.3% pre-crisis figure along with a massive shift away from public sector towards the private sector. After 5 years of austerity certain types of jobs are growing (self-employment, small business, zero hours contracts – 700k/2.3% of workers), but those without are being left behind – something Cameron promised not to do.
“I want to, if I’m elected, take the whole country with me. I don’t want to leave anyone behind. The test of a good society is you look after the elderly, the frail, the vulnerable, the poorest in our society. And that test is even more important in difficult times, when difficult decisions have to be taken, than it is in better times.” – David Cameron on the Andrew Marr Show, just before the 2010 General Election
Whether disabled, unskilled, mentally ill, being a carer, or struggling with some other difficulty that makes the 9-5 “Arbeit macht frei” ethic not appropriate or possible for all, many are being abandoned, and forgotten. The very purpose of the modern state, the welfare state, even something once quoted but not fulfilled by David Cameron, is to care for the weakest and neediest in society – without scapegoating them as sick scroungers.
Ed Miliband and the #EdStone
Even Ed Miliband in his Cecil B. DeMille Mosaic stone Tablets announcement this weekend put the economy as the number #1 priority and “higher living standards for working families” as number #2, apeing UKIP and the Tories at number #4 is “Controls on Immigration“.
What no welfare?
Nowhere among Labour’s 6 priorities were people in need, on welfare, even mentioned. For welfare to remain a “dirty” word even with a so-called socialist party shows how times have swung and the extent to which a party will spin and abandon its principles in order to regain power.
“Cuts” has been the message of austerity and debt reduction. But those cuts have fallen on the neediest in society, those on disability or welfare, not those most able to pay, or indeed – such as the banks, most responsible for the economic collapse in the first place. In 2012 UK Uncut protested the March budget with a “queue” outside Downing Street and an “Austerity Isn’t Working” poster campaign mimicing the 1978/9 Saatchi poster done for Margaret Thatcher and the Tories.
The verdict of a successful government is not just something measured in economic terms but also in moral and social ones.
Is the economy the only measure of a successful country? If I starve my kids to pay off my overdraft am I a great parent? #BBCDebate
David Cameron’s Easter message interview with a Christian magazine summed up Christianity as about “hard work and responsibility“, not Christ’s work on the Cross, meaning that, soteriologically, everything was actually already done for mankind.
Jesus said that the “truth would set you free”, the truth seems to be the thing furthest from modern politicians, with all their spin and question-dodging. No wonder 35% of the electorate don’t vote.
Less about Economic Wealth what about Mental Health?
The real hard truth is that “Britain isn’t working”. Inequality is increasing. Our communities are fractured and our countryside fracked. Those not in work are being punitively capped and cut until they can take it no more.
The irony of a government forcing state-funded CBT onto the unemployed yet unable to deliver self-requested CBT via mental health services for those that want to work is clearly lost on the Big Brother worker state. Hundreds of therapists, counsellors, and mental health experts, have written to outline their fears about the emotional and psychological toxicity of austerity and how it is being carried out. Suicides have increased over the last 5 years, especially amongst men.
Big Society or Broken Society?
Is the Big Society broken? Does society even exist or matter? Thatcher’s “there’s no such thing as society” is falsely interpreted though under a Tory-LibDem watch has been almost a self-fulfilling prophecy.
“There is no such thing as society. There is living tapestry of men and women and people and the beauty of that tapestry and the quality of our lives will depend upon how much each of us is prepared to take responsibility for ourselves and each of us prepared to turn round and help by our own efforts those who are unfortunate.” – Margaret Thatcher, 1987
Saatchi and Saatchi designed the 1978 poster that helped Thatcher win the 1979 election with the tagline “Labour [Still] Isn’t Working“. The Labour Party has spoofed the self same poster nearly 4 decades later. It is time to think outside the box not just rattle and rebrand it.
The truth is society is more broken than 5 years ago even if the economy may be on the mend. Austerity has been toxic. Our health, transport, housing, and education sectors have declined after being starved of resources or sold off to the private sector. Now it is society that needs rebuilding, not the economy. That is the true measure of recovery.
With the Conservatives returned to power, not just coalition but a slim but workable majority, and achieving a rare (once in a century) feat of increasing their vote share, how much did their victory owe to spin and emphasis on the economy not those in need? Are the democratic majority simply selfish? The majority view does not mean it is the right view – ethically, morally, socially. In the meantime the 37 year-old poster image is still doing the rounds with Daily Telegraph cartoonist BOB re-posting “Labour isn’t working” with a queue of unemployed Labour MPs snaking back from the dole office.
Tom Sosnik comes out as Trans citing Leelah Alcorn as inspiration
An apparently confident young 13yo Jewish teen living in Oakland, California, has come out as trans with the full support of his sister and parents. Tom Sosnik comes across as mature, self-assured and brave, but in no doubt of the hard path ahead. He cites Leelah Alcorn at the beginning and end of his coming out speech and both, thanks, and calls for the support of, his peers and community.
His YouTube video, published 16 March 2015, comes with the following statement by him:
This is how I came out to my community as trans.
Please share my story and my message with your loved ones.
To all those struggling to embrace their true and authentic gender or sexuality, I want you to know that if no one else accepts you, I always will. Rest in power, Leelah.
Full text transcript of Tom Sosnik’s coming out video
“On December 28, 2104, Leelah Alcorn a 17 year old trans woman committed suicide because her family didn’t accept her. This made me want to act on a subject that has been bothering me for quite a long time.
All of sixth grade I struggled with my gender identity and I’m now embracing my truth. For a while, I dismissed the fact that I hated my body, I pretended to be content with what I was assigned until at a certain point I broke. I went through a series of horrible breakdowns and I would stand under the water in the shower crying. I knew I wasn’t happy but it didn’t seem fair to me that everyone else around me was. They didn’t spend all their time thinking about how much they hated being categorised as a woman. I didn’t share that same feeling, in fact, I felt the opposite.
For some of you, this may come as a shock and for others, well you knew or thought I was transgender, well here’s your reassurance – I am no longer Mia, I never really was and now I finally stand before you in my true and authentic gender identity, as Tom. I stand before you as a 13 year old boy.
I understand that this will be a difficult adjustment but I hope and trust that you will treat me with respect and thoughtfulness. So for those of you who are having trouble that is completely understandable. You have known me as a girl for over a year and it is hard to understand that I never was that girl. I want to tell you as a I consider you all my friends, well most of you – no I’m kidding. In my heart I am still the same person, whether you like that person or not, it’s me. So here I am, no longer Mia Sosnik, a 13 year old girl, that you thought you knew, but Tom.
I imagine that some of you will have questions and I am open to answering them at any time they come to you. I trust that you are all mature enough to understand which questions are inappropriate, disrespectful or hurtful. Please feel free to ask me because after all I know the most about my transition. Please talk about this with your parents and your family but I ask of you really not to talk about it with your friends, it’s not – gossip worthy.
If there’s something you want to say I’m happy to talk with you and I really hope that you all will support my decision to embark on a harder route in life as the boy I truly am. Any form of support I receive with much gratitude and I hope that everyone can really support me because you guys are like my second family. And if you support me, I will feel like the luckiest boy in the world. Thank you for letting me share my story.
I want to just tie it back to what I said at the beginning. After reading Leelah’s suicide letter I came to really appreciate the support I have in my family in my community that she never got. Thank you all for making me feel safe enough to openly be myself.”
Risk of Copycat Suicides
The positive references to Leelah Alcorn are all the more uplifting given the spate of US trans teens suicides recently, and the lack of recognition even in death by many of their families. Overnight, it was desvestating to hear of yet another suicide as 18 year old Blake Brockington took his life. He was the first Charlotte, NC trans homecoming king last year. This, only weeks after Ash Haffner, another Charlotte trans man ended his life.
Furthermore, some have argued that the sharing of Leelah Alcorn’s suicide letter would inspire copycat suicides, rather than in the case of Tom Sosnik, an inspired coming out, in part, because of her.
Both of Tom’s sisters have been “meaningful members of his support system“, and one of them, Gil Sosnik, shared his story and video on facebook:
Last week, my 13 year old brother came out as trans to his school and community in a really moving naming ceremony and we were able to capture it on camera. Seeing how much his words have inspired and touched the family and friends in his own network, Tom began to see that there was something about his speech that was universal and humanizing, something that could empower trans* and otherwise gender nonconforming folks while also conjuring empathy and understanding among allies. Watch and share if you are moved by his story.
It has been clearly demonstrated that family support has a huge impact on the mental wellbeing of transgender youth and according to a 2012 Canadian report, can lead to a:
“93% reduction in reported suicide attempts for youth who indicated their parents were strongly supportive of their gender identity and expression”
Without that support, some 57% of young trans people attempted suicide, even higher than the averaged-out figure for trans of all ages and domestic backgrounds. (See more on suicide risks)
Another LGBT suicide has recently been put down to religious non-acceptance in the harrowing story of gay repression and rejection in the life of a successful Muslim Doctor in the UK.
More positively, Tom’s family and religious background is in complete contrast to the religious home life of Leelah Alcorn which saw her sent to Christian therapists and undergo conversion therapy to try and stop her being trans. A path which was no doubt a contributing factor to her suicide and is categorically dismissed as psychologically sound or helpful by the APA.
Reparative Conversion Therapy
Reparative or Conversion Therapy seeks to turn someone from their innate sexuality or gender identity by positively encouraged, aka forced, heterosexual and birth sex gender “appropriate” roles. Of course the concept of appropriate comes from stereotypical concepts of socio-familial and sometimes all-out religious traditional understandings. This kind of aversion therapy, whether of LGB or Trans people, is more likely to increase suicide risk than prevent it. The APA argues that:
“reparative therapy poses a great risk, including increasing the likelihood or severity of depression, anxiety and self-destructive behavior for those undergoing therapy.”
Dr Kenneth Zucker
Dr. Ken Zucker is Psychologist-in-Chief and Head of the Gender Identity Service in the Child, Youth, and Family Program at CAMH, Ontario. The American psychologist and sexologist, and GIC head at Toronto’s Centre for Addiction and Mental Health, is also on the APA’s DSM-V committee. Just last week CAMH suspended all trans admissions and treatments by Zucker and has put the whole programme under review.
“The APA, responding to criticisms by LGBT activists, point out that Zucker does not advocate reparative therapy for teens and adults, not for gays and lesbians at any age, but only for the trans community.”
Well that’s ok then – “only for the trans”! This is 2015 and being trans is still considered a mental illness, a mental struggle – yes, but it is not something that is aided by disparaged and unethical reparative therapy and pathologising treatment.
How Trans Support should be done
Tom’s own family is Jewish and seems to have positively supported his coming out, posting nothing but proud affirmations on Facebook whereas Leelah was banned from using social media and cut off from her friends and support network.
Tom Sosnik, his family and community, are an example of how coming out as trans, and/or LGB, should be handled – with bravery, acceptance, and support. He and his family embody the “fixing of society” that Leelah Alcorn called for.