Tag Archives: Police

Lies, Damned Lies & Tory Jeremy Hunt’s Mental Health NHS Statistics

Lies, Damned Lies & Mental Health Statistics

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’.

The recent Stevenson/Farmer ‘Thriving at Work’ report has demonstrated the need to promote mental health at work due to its annual near £99bn cost to the UK economy.

  • 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

On Radio Norfolk’s Matthew Gudgin programme, the BBC’s Bob Carter challenged Theresa May to apologise to the people of Norfolk and Suffolk for having the worst mental health trust in England. Listen to the interview below:

Theresa May

During a recent visit to Archant, home of the EDP, in Norwich, the Prime Minister said:

“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

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

In Norfolk and Suffolk, primary care mental health referrals rose 20% between 2013-16, nearly 7 times faster than the population increase.

Wider Societal Impact

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.

Suicide Risk

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.

Norwich Reclaim the Night 2017 Poetry & March for Safer Streets

Norwich Reclaim the Night 2017

The night began with poetry and speeches from a dozen poets, the NUS Women’s officer – Hareem Ghani, Helen Burrows of Leeway Domestic Violence and Abuse Services, the Lord Mayor of Norwich – Marion Maxwell, and Blur’s drummer, Dave Rowntree. Organised by UEA student union officers Jo Swo and Abbie Mulcairn, and compered by Maëlle Kaboré the event was attended by around a 100 people. UEA Union has established its own anti-sexual harassment campaign,
Never OK.

Reclaim the Night March through Norwich, photo by Katy Jon Went
Reclaim the Night March through Norwich, photo by Katy Jon Went

The march to make the streets of Norwich safe for all sought to raise funds for Leeway, end harassment, slut-shaming and victim-blaming in sexual assault. In addition, it was campaigning to Light Up Norwich – a petition to end the austerity cuts to public lighting and thereby public safety.

Prince of Wales Road, Norfolk’s most dangerous street

Norfolk is one of the safest counties in England, yet also contains one of its most dangerous streets, sometimes ranked as high as 23rd worst (2010) with over 50 violent or anti-social behaviour crimes in a single month (Dec, 2010). On a Friday night, thousands pour into its nightclub district around Riverside and Prince of Wales Road, requiring dozens if not on occasion, hundreds of police officers to be on duty, along with the SOS bus. It also ranked 4th out of 50 cities for harm to self and other after excessive alcohol-related drinking injuries resulting in hospital admissions.

“statistics show that since 2005, when pubs and clubs were allowed to open longer, there has been a 210pc increase in violent crime in Norwich between 3am and 6am and an increase in police hours of 12,000 per year.” – EDP, 2013

It’s a street that has been highlighted and visited by TV’s Jeremy Kyle and then, too, by Police and Crime Commissioner, Lorne Green. Two nights after the march and Police around Prince of Wales Road had a busy night with 21 detentions and arrests

CK from Norfolk, writing in Vagenda magazine, 2013, described the differences between sexual harassment in Norwich and London, thus:

Prince of Wales Road, Reclaim the Night
Prince of Wales Road, Norwich, Reclaim the Night 2017

“…lascivious comments are infrequent, especially if you avoid the many delightful establishments on Norwich’s Prince of Wales Road, known as one of the country’s ‘most dangerous streets’. What I was not prepared for was the sheer volume of street harassment that has become a near daily feature of my glamourous London life…

The tone here is different too. Men call out at all times of the day, not just when they’re drunk on a Friday evening and don’t realise that their ‘inside voice’ has become their ‘outside voice’. And for better or for worse in Norwich, you would often have the opportunity to interact with the gentleman clucking at you…

In Norwich’s Mischief pub, I once hit someone with my handbag after they decided that my arse was the ideal hand-rest, their wrist presumably tired from a strenuous day of wanking. I don’t condone violence, but I was tired and wanted a gin and for fuck’s sake, touching is verboten unless I specifically say otherwise.”

“Fuck Harassment” Public Order Offence

Reclaim the Night March Fuck Harassment
Reclaim the Night March photo by Katy Jon Went

Apparently, “Fuck Harassment” on a handmade sign is a public order offence but “Fuck the Patriarchy” wasn’t.  One female student was told by a police officer monitoring the march to put her sigh away or her details would be taken and a possible offence logged. As the sign was anti-harassment, I fail to see how it could be harassing!

Section 5 of the Public Order Act 1986 says than an offence comprises two elements:
 
A person must (a) use threatening, abusive or insulting words or behaviour, or disorderly behaviour, or (b) display any writing, sign or other visible representation which is threatening, abusive or insulting; and
 
The words or behaviour, or writing, sign of other visible representation must be within the hearing or sight of a person likely to be caused harassment, alarm or distress thereby.
 
Norwich Reclaim the Night Fuck Harassment
Norwich Reclaim the Night Fuck Harassment

Yet, no evidence of distress or intention to cause alarm is required to merit an offence.

The irony – that saying “FUCK harassment”, is anti-harassment by street harassers seems to have been lost on the police who made sexual assault victims into aggressors by their PC actions.

Poetry on the night

The poems, some old, some new, some about dangerous grannies with Uzis, contained raw, personal and often political (isn’t the personal, political?) stories of assault, violence, homelessness, gender dysphoria, rape and suicide, and not a few mentions of Donald Trump.
 
Katy Jon Went her reading poetry
Reading my first poem in decades, wearing ironic pink!

I hadn’t written a poem, successfully at least, since I was 15, when I think I got a ‘C’. I’m happier with political speeches, social commentary, or stand-up comedy, so when asked to write a poem, it was quite a challenge. The text of my poem can be read here.

Among the many great performances, perhaps standout were Ella Dorman-Gajic and Elley Tourtoulon, as well as punk poet & activist, Josh Chapman. Other poets and speakers included Charlotte Earney, Sophie Robinson, Jan McLachlan, Eli Lambe, Joe Collier, Nicholl Hardwick, Alison Graham,  Alicia Rodriguez.
 
Elley Tourtoulton poetry at Reclaim the Night, Norwich
Elley Tourtoulton poetry at Reclaim the Night, Norwich, photo by Katy Jon Went
 
Although, to be honest, the diversity and equality of quality of the poetry, speaks to the inclusivity of the event, particularly with two trans poets, and considering other Reclaim the Nights have witnessed trans-exclusive behaviours from some radical feminists.
 
The Reclaim the Night evening in Norwich, like the city itself, was inclusive and friendly, but that doesn’t mean it can’t be made safer and more welcoming to all people, irrespective of gender, sexuality, faith, or attire, whether by day and/or especially at night.
 
Norwich Reclaim the Night outside Flaunt
Norwich Reclaim the Night outside Flaunt bar & club, photo by Katy Jon Went
 
 
 
 

Novel Gender Twists in Debut Crime Fiction Book He’s Gone by Alex Clare

Alex Clare, He’s Gone

Hidden under the surface of an apparently everyday, even mundane at times, police procedural whodunnit, by new author Alex Clare, lie a handful of neat twists. The cleverest twist, encountered on its front cover, is the book title itself. The intentional double meaning of “He’s Gone” describes both the disappearance of a young kidnapped or killed boy, and the gender dysphoria and real life experience of a transitioning male-to-female lead detective.

“The double meaning in the title is quite deliberate. It’s meant to show that Robyn is here to stay.” – Alex Clare

He's Gone, Alex Clare, p4Robyn was Detective Inspector Roger Bailley, that is, until the day they return to work as Robyn. Then, on their first day back at work, facing every trans person’s “Real Life Experience” (it used to be called a test) nightmare, they are launched into a missing persons case and on day two, a body is found. Now, that is not every trans person’s typical transition at work scenario. These two clashing worlds, Roger/Robyn’s inner one and the outer reality of a serious crime, are blended together well in this debut novel by, sometime corporate commuter, Alex Clare.

The focus on day-to-day details of police procedures, internal force politics, in-tray and waste bin descriptions, and fears of your boss and Professional Standards constantly checking your progress on both the crime(s) and your own transition at work, rooted Robyn in reality, not fantasy.

At times, that reality, as someone all too familiar with being transgender, was painfully raw and depressing. Being one of the first books to tackle this subject in fictional form with sensitivity, rather than exploitation as crossdressing serial killer or exotic sex object, makes it groundbreaking. Although there have been others such as Gore Vidal’s Myra Breckinridge (1968) and Patrick McCabe’s Breakfast on Pluto (1998), among a few more, they have tended to concentrate more on sexuality and the erotic rather than the practical dilemmas of transition itself.

The daily facing of colleagues, public, family, and the media, are treated well, and resonated as closer to fact than fiction. The constant sniping, media intrusion, initial family rejection, even the workplace bullying and transphobic vandalism, none of these are sensationalised but instead rather realistically realised.

Alex Clare, He's Gone, Crime FictionThe inspiration came, in 2013, from the author’s watching of the UK Parliament debating the Equal Marriage Act and the intensity of feeling it created. She, therefore, invented a fictional literary world to explore some of the issues and attitudes:

“Some of the opinions horrified me, people being defined and condemned by a single aspect of their life. The character of Robyn Bailley formed quickly in my mind and I’ve really enjoyed telling her story and what she has to face to live a normal life.” – Alex Clare, author of He’s Gone

The dilemma, for me as a very much non-conforming non-binary trans person, was that at times it plays into the hands of stereotyped trans tropes – the obsession with time spent in front of the mirror, makeup, clothing, voice, tucking, pronouns, name and ID documents. These are less criticisms than my personal preference for a gender non-conforming trans role model, even a fictional one, as some comic books have done. It is understandable, however, why these features have been described, and, on the whole, embedded without taking over from the book’s plot.

I did wonder at a few things including why her police warrant card had not been updated speedily by the police as part of her transition at work plan, and similarly that her Gender Identity counsellor “insisted on skirts” and make-up to “demonstrate she was living as a woman” (p.80). Advice that seemed about 3-4 years out of date. Such is the pace of NHS GIC improvement that sourcing reference material and other trans people’s experiences may already be dated, however much “some of the scenarios, … comments people make … and their reactions are taken from real life.”

“There is an active trans community on Twitter and I have read there about real-life experiences and the discrimination suffered. I’ve tried to reflect these in the book, like the example where Robyn is asked for ID before buying alcohol and doesn’t have anything that gives her new name.” – Alex Clare, Interview in OmniMystery News

Other minor details, on the other hand, were eerily and sometimes humorously accurate, such as forgetting that women’s clothes tend to fasten and button the other way, or that their suits tend to lack pockets. These were gentle insights that I remember well. I’ve since made a point of buying women’s clothes with decent pockets as smartphones do not fit inside your bra these days!

I imagine, for many readers, it may feel as though turning the pages of this book gives insights into the lives and emotional discomfort of many trans people, and it does – but there’s not just one type of trans person, and there are, indeed, many trans police officers, as well as trans prison officers, fire and rescue officers, and perhaps up to 1% of people in all walks of life who experience some form of gender dysphoria that may lead to hormonal and/or surgical transition.

I would love to see Robyn’s character develop, for her to touch base with trans support groups and find peer advice. I certainly went through a phase of obsessing over hyper-feminine stereotyped presentation myself, fortunately for me it lasted barely six weeks before I discovered Dr Martens and comfortable clothes! Robyn’s own transitioning at work journey is just 10 days old by the end of the book so I am being somewhat hyper-critical in expecting much evolution of trans personal awareness or feminism 101 in that short timeframe.

The first plot twist, with respect to the crime itself, I didn’t see coming, but the second I guessed straight away, but then watching it play out and come up with the proof was interesting. I found the mid-book anti-climax like a reboot, and the second half more interesting than the first from a crime fiction point of view, and by which time characters were more fully developed. I particularly liked the allusions to a cultish religious group and its holier than thou attitudes to difference and morality. Having once been a part of such beliefs and then been on the receiving end of them, they resonated, painfully.

“How do you find a missing child when his mother doesn’t believe you have the right to even exist?” – He’s Gone, back cover

It was great to see a preponderance of female leads as victims, suspects, investigators, family members and secondary characters. It also made a change not to have a heterosexual partners sub-plot, whether as cop-buddies or romantic liaison constantly making it about sexual friction and frisson. Instead, it was about Robyn internal relationship with her trans self and her external dealings with fellow police officers and colleagues, not to mention the rather awful mother of the missing child whom you end up thinking doesn’t deserve to have her son back. As another reviewer described her, “singularly one of the most deeply unpleasant individuals that one could encounter”.

As a character, I felt Robyn needed an ally, someone to confide in and talk to about her feelings and struggles. The dialogue, advice, emotions and humour that that might provide would supply some relief from her inner torture and the laboured process of the Police investigation. Her relationship with her daughter, though, was well portrayed as she struggled slowly to accept her father’s transition. Perhaps, she might become an ally in future books, along with a work colleague? I look forward to reading their future character arcs and seeing how DI Robyn Bailley develops.


For further details about gender identity dysphoria and transgender workplace issues visit www.genderagenda.net and also the National Trans Police Association (NTPA). Thanks to the publisher Impress Books for the ARC review copy of the book which you will find available from 1 August on Amazon and in book stores. A couple of other reviews from the Blog Tour can be found here.

 

 

Gun Violence in America endemic, bigger threat to US Safety than ISIL

USA Gun Violence contrasted with UK

US Gun Violence 2015 incidents map
US Gun Violence 2015 incidents map – Gun Violence Archive

Whilst the British police managed to arrest a machete wielding youth in a shopping centre, in the US a domestic disturbance armed only with a bat saw the offender shot dead along with an innocent bystander. Gun violence in America has seen over 13,290 gun-related deaths recorded so far in 2015: 331 in mass shootings, 980 by police (91 unarmed of whom 37 were black), 25% showed signs of mental illness, over 46% were non-white, and 3,371 were teens or children, injured or killed. America has way more to worry about from its own gun culture than international terrorism or ISIL/Islamic State.

The figures for 2015 are up on nearly all counts from 2014 – Police Officer-involved incidents constituted 4,344 of the 52,324 total shootings up 35% from 3,213.

Chicago Police Department Officer Incidents

On the day after Christmas, Chicago Police were called to a domestic incident by the father of a 19 year-old black youth armed with a bat and on medication for known mental health issues. Somehow, 7 bullets later, Universtity student home for Christmas, Quintonio LeGrier, and 55 year-old, mother of 5, Bettie Jones were both dead. Such a contrast to British police gun violence where most years see zero fatalities and any unjustifiable exception to this results in public outcry.

Gun Violence in America Archive Toll 2015
Gun Violence in America Archive Toll 2015

Chicago suffers the worst figures of any US city (New York is now 6th), some 240 police shootings between 2010 and 2014, 70 deaths, mostly black men. This is despite new training and measures that have resulted in “Police-involved shootings [being] down by double digit percentages”. New York is surprisingly safe these days and police self-control such that just 41 were shot dead by police in a population 3 times that of Chicago. Still too many though. Phoenix and Philadelphia are proportionately worse with 57 and 54 fatal shootings from populations half the size of Chicago.

Chicago PD alleges nearly all are justified. Despite 410 investigations since 2006, only one was found to be unjustified, though some are still pending. Most reports ends with the trite phrase:

“This investigation found that Officer A’s use of deadly force was in compliance with Chicago Police Department policy.”

A far larger number must surely be seen as disproportionate? Gun versus bat? Armed adult vs teen? White v black? For example, over 90% of those investigated in 2014 were Black and/or Hispanic.

Laquan McDonald Investigation

Chicago Police Department Officer
Chicago Police Officer Badge

Chicago’s Mayor Rahm Emanuel recently removed the city’s police superintendent and head of the Independent Police Review Authority and the CPD remains under review following the year-long belated charge of first-degree murder against Officer Jason Van Dyke for the 16-shot fatal police shooting last October of Laquan McDonald and attempts to prevent the public release of officer-incriminating vehicle dashcam footage.

In a recent series of studies, adults who were shown pictures of children of different races labeled black children as several years older then they actually were. They were considered “less innocent than their white same-age peers” – Education Week

Mass Shootings and Domestic Terrorism

With 2015 nearly over America has seen 329 people killed and four times as many injured – 17% up on 2014’s 281. That’s considerably more than acts of terrorism. Chicago with 1% of the US population also has 3-5% of its mass shooting victims.

Wider Issues of US Gun Violence Prevalence

The bigger issue is how endemic gun ownership and gun crime are to America, that recourse to a weapon for self-defence, arrest, or to settle scores, is the first resort not the last, and that those most affected by disproportionality and/or unreasonable use of force are people of colour. Whilst America claims or has been called upon to “police the world” it should sort out its own back yard first before any attempt to be the “world’s policeman”.