Do you have lived experience? Charity Body have a priceless opportunity

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Researchers with lived experience – opportunity!

Do you want to help shape a new national strategy for physical health research?

Do you have experience researching anything in physical health? Anything at all. Salmonella. Botulism. Tuberculosis of eye. Ingrowing toenails. Flatulence.

Do you have personal lived experience of physical health problems? Rabies. Man flu. HIV. Death?

We can pay travel expenses and you’ll receive £50 to thank you for your time solving all problems in physical health.

We aim to recruit participants who will formulate a holistic strategy in three hours.

– Communicated by RITB Intern and Dog Walker

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Discussion of harm minimisation for self-harm in Recovery in the Bin

http://www.independent.co.uk/life-style/health-and-families/health-news/allow-self-harm-mental-health-patients-researcher-patrick-sullivan-reduction-university-of-a7572136.html

“Harm-minimisation is about far more than clean blades which has a place but I can’t support what Sophie Corlett of Mind says about DBT being a method of harm-minimisation. Cessation of self-harm is often the overt or covert aim of DBT, harm minimisation was never pioneered through service user/survivor activism as a professionally devised behavioural treatment as DBT is.
Professional allies such as the late Chris Holley (fab mental health nurse) also didn’t promote harm minimisation via DBT. She led the Royal College of Nursing debate on ‘safer self-harm’ 11 years ago and consulted activists who had initiated harm minimisation work, their thinking was in unison”.

“For me harm minimisation about recognising that it’s not a standalone approach, it’s not a substitute for emotional/psychological/social support. It should never be forced but offered, as no approach suits everyone. It can cover a wide number of areas such as; exploring our own ways of how we look after ourselves, what constitutes care to us (self/others). What presses on us to SH. Plain language & diagrams of anatomy & physiology – to attempt damage limitation you have to know what you’re looking at & basic function ie tendons attach muscle to bone. ‘Safer’ SH such as direction (deep latitudinal injuries can be riskier than longitudinal), blunt implements on leather-like scar tissue can be more dangerous with increased pressure, slowing down, being sober.
Knowing the limits of harm minimisation i.e. with overdoses there’s no ‘safe’ amount, sometimes people are not aware of cumulative damage or lack of symptoms & potential life changing/threatening damage occuring. First aid, wound care, blood loss, infection, temporary makeshift dressings, knowing when it really is advisable to get medical attention”.

“Scar minimisation with wound care, after care, scar minimising products, Skin Camouflage makeup (making it clear that the option doesn’t mean we shouldn’t feel OK about and wear our skin however it looks), creative dressing for scars for people who want options for concealment. Managing others reactions to scarring in social situations and especially with health profs as they tend to be the most judgemental. Scarring in relation to further injuries and the options & limits of surgical scar revision. Crisis planning (for A&E, MH), the use of harm description and treatment and needs proforma’s, and exploring potential personal compromises with one’s self-harm ie placing blade other side of visible structure which if damaged could mean surgical repair or worse. These are a few example areas”.

“For professionals, harm min is not throwing dressings at people and telling them to get on with it, everyone has the right to have their wounds (regardless of surgical severity) to be medically attended to”.

“Harm min has no age or diagnosis limit, the principles are the same whether a person has a diagnosis of depression, BPD or psychosis. Self-harm occurs in people of ALL diagnoses (or none). Obviously with a child it has to be age appropriate. A psychologist once referred to the need to ‘give permission’ to a boy under 10 who was harming his genitals which is of course very dangerous, to harm elsewhere.
I remember her also referring to changing a teenagers ligature to stretchy socks & support workers being taught how to cut them down, so she was not prohibited from harming but assisted to stay alive with practical and psychological support”.

“Even with suicide, harm minimisation has a place, most people whether they’re self-harming or attempting to die don’t typically want to be left with life changing disability such as loss of mobility”.

“No self-harm is risk free but harm minimisation can assist some people in having increased choices without prejudice or judgement as to where they are and where they want to be. Demanding cessation is unhelpful because unless we have something better to offer what right do we have to make that demand. The lifesaving function of self-harm is often overlooked, as in self-harm can prevent suicide, but equally people who self-harm do die by suicide and can be left with no support despite the high correlation between experience of self-harm and suicide. There’s also ‘overlap’ between self-harm and suicide, and there is often ambivalence even with the most (expected) lethal methods”.

“Harm minimisation is NOT the holding of ice cubes or Dialectical Behaviour Therapy (DBT). DBT is a spurious diagnosis specific behavioural intervention which can seek cessation as a goal.I resent DBT being framed as a form of harm minimisation, and mental health services are now driven by an approach of endless ‘distraction lists’ as a ‘therapy’, standalone intervention, or in the name of harm minimisation. This has influenced service user groups”.

“Harm minimisation also isn’t ‘method sharing’ or promoting self-harm as a ‘lifestyle choice’ or ‘sitting in a sick role’. There are examples of harm minimisation within addiction services although I wouldn’t personally define self-harm as addiction, be that psychological or endorphin provoking (which makes unevidenced assumptions about intent and experience of pain)”.

“Thank you I really appreciate your sharing this. It’s empathetic, de-shaming as far as possible ,if that’s a word, fact-based and responding in detail to people’s actual needs. What I got from the article was business-as-usual, but replacing confrontations with offers of clean blades. Not acceptable clearly”.

“Yes I think just dishing out clean blades is a travesty. That has a place (secure services/prisons notably) but WITH an awful lot more around it!”.

“To me harm minimisation is a very personal and progressive process where someone is supported to think about what they want to change/stay the same and then time taken to explore what self-harm means for them and what if anything they would like to do differently and can this be done more safely. Only agenda to support and validate, no mention or aim of stopping”.

“Yes, that’s it!
I really hope we never go back to “no self-harm contracts” ever again where support was withdrawn or forced if the service user self-harmed”.

“Treating the person with respect and never making them feel ashamed might help reduce harm escalation?”

“Most definitely, I’ve always felt that poor or punitive responses actually increase the risks”.

“I think this is so important – providing information so people can make informed choices which might be to SH, to SH more safely or not”.

“A&E tend to see cutting as performing some kind of hobby. I think as well as the physical wound care we also deserve to have the psychological support that tends to be withdrawn where there is repetition of self-harm. The original article and research paper doesn’t make clear that self-harm, and to a severe extent, does happen outside of inpatient settings and there is next to no support for this let alone an admission where anyone stops or allows self-harm”.

Some further reading:

https://www.selfharm.co.uk/get/staying_safe/harm_minimisation

http://www.selfinjurysupport.org.uk/docfiles/Harm-Minimisation-Teaching-and-Learning-Guidance.pdf

http://journals.rcni.com/doi/abs/10.7748/ns.20.28.8.s9?journalCode=ns

http://news.bbc.co.uk/1/hi/health/4942834.stm

http://www.arwtraining.com/wp-content/uploads/2015/02/02-Cutting-the-Risk-Practical-Harm-Minimisation.pdf

http://www.arwtraining.com/wp-content/uploads/2015/02/01-The-Hurt-Yourself-Less-Workbook-Self-Harm-Self-Management.pdf

LOOKING FOR ADVOCATES FOR ADVOCACY

Guest Post by Lucy Costa

What does advocacy mean? Advocacy is about speaking or acting on behalf of a disadvantaged person (or group), defending their wishes or rights, and remaining loyal and accountable to them despite pressures to do otherwise. Advocacy is also about changing systems for the better by influencing policy, practices, or laws in ways that will benefit people in our community and protect their rights. It requires commitment, focus, and skillfulness.

Advocacy is about speaking or acting on behalf of a disadvantaged person (or group)… Advocacy is also about changing systems

If you are a person with “lived experience,” a “peer,” or a “consumer” then please understand that this, in and of itself, is not valid enough

Photo: Marchers carrying signs, walking down Queen Street. Text:
Mad Pride Bed Push 2017

criteria to be a good advocate. While your identity and your experiences (especially as related to mental health) matter, they alone are not sufficient to challenge some of the tricky and complex institutional and governmental powers influencing our understanding of psychiatric disability and the distribution of resources (e.g. housing, services).

If you are a person with “lived experience,” a “peer,” or a “consumer” then please understand that this, in and of itself, is not valid enough criteria to be a good advocate.

I start with this controversial point because over and over again, the most popular advocacy “line” people offer at consults, focus groups, proceedings, etc. for ethical dilemmas and problems with the mental health system is to ask whether “peers were included,” or if, “peers gave feedback.”

Lately, I have challenged this knee-jerk response, because it is predicated on an assumption that if “lived experiencers” were involved in complex systemic issues, they would somehow be offering substantive or innovative feedback for change. Sometimes yes, but often no – not without research into a problem, or speaking with people most impacted, or developing relationships with supportive allies.

In fact, sometimes the very problems occurring in the system are reproduced via individuals who identify as “peers” or people with “lived experience.” Sometimes these peers adopt excessively cheerful or optimistic views of healthcare system delivery as opposed to critiquing it.

They contort themselves to accept clinical or policy justifications and in so doing become extensions of the system through their actions, words, and ability to be socially acceptable and conformist. I have seen examples of peer workers counselling hospital patients on their “best interests” as opposed to listening or following a patient’s instructions and hearing what would allow them to feel they have more control over their lives. There are very few advocacy and human rights campaigns being spearheaded by peer labourers though I think there is powerful potential for organising for change if community capacity were prioritized in this direction.

Thankfully, there are however a number of individuals and small organisations doing collaborative and innovative work to improve the lives of people who are on the margins and addressing advocacy issues related to violence, housing etc. There are smart, organized, coordinated and focused efforts that work to change and improve specific problems thanks to thoughtful planning, thorough research, and earnest selflessness.

We need more strategies like this which are focused on understanding how the system makes economic and policy decisions and directions. It would be great if younger activists and individuals interested in advocacy would create support groups looking at how to better understand the system, what ethical principles we should collectively adopt going forward, and more importantly how to meaningfully evaluate what has worked and not worked in the past for us – by us.

…create support groups looking at how to better understand the system, what ethical principles we should collectively adopt going forward, and more importantly how to meaningfully evaluate what has worked and not worked in the past for us – by us.

I also suggest that our community develop an extremely inquisitive appetite for scrutinizing anything that sounds like “inclusion.” The system knows it is supposed to be “inclusive” – that is not news to people in power, but what kind of inclusion is happening? We consumer/survivors advocated for inclusion years ago, and now we (to some degree) have it, but at what cost, and what kinds of identity and ideas are being included? An advocacy issue that currently needs attention is the Ontario government’s recently passed Bill 41, also known as the Patients First Act on December 7th, 2016.

This Patients First Act aims to ensure patients are at the centre of the health care system. Are there any consumer/survivor groups organising around this? Probably not. Who will monitor advocacy and the new discussions about accountability in a changing landscape within healthcare? The Psychiatric Patient Advocate Office, which is no longer at arm’s length from the Ministry of Health, is going through re-evaluation of its services to better align itself with Ministry initiatives such as the Patients First Act. What will this mean?

If we are to re-invigorate a movement that believes in justice, advocacy, and the protection of rights, we need a new approach that understands that while some gains have been made, there are many other losses we have not even begun to process—let alone respond to intelligently. The landscape of advocacy is changing and the fire of the past has dwindled.

We have fewer advocates. This is true amongst different groups and social movements looking for change.

The pendulum has definitely swung in disturbing directions, but it will swing back. In the meantime, we must be more aware of the losses of certain rights and be more resolute in our efforts to critique “inclusion,” especially the ways it has been used by neoliberal agendas that expend with both advocacy and individuals who cannot thrive in capitalism.

Written by Lucy Costa

This article was originally published on Toronto Mad Pride  http://www.torontomadpride.com/article/looking-for-advocates-for-advocacy/

Stepford Recovery College

Where Alternative Facts are Not Just for Americans

rc-cover

Dontcha wanna learn how to jump while wearing super colourful clothes?

 

 

Turning Binners into Winners since 2015
 

Introduction

Welcome, and congratulations on taking this brave first step towards your recovery.

Your Future Starts Here! We’ve made a college just for Mentals: prepare to be patronised! You can pretend you are going to college just like the Normals!

RC’s are really universities, with campuses, curriculums and graduation ceremonies. Thankfully you don’t have any student debt and no certificate of any value. (Try presenting your ‘Finding Happiness’ course attendance to UCAS.) You’ll meet the Mayor at your faux-graduation; we don’t mind if you wear mortar boards and take photos. Alongside your studies you will find many vocational opportunities and get invaluable, real life experience for your future zero-hours career and destitution by volunteering for us and providing unpaid peer support.

Take charge of your mental health! Challenge those self-defeating beliefs! You too can recover! (And if you don’t it is your fault and you can’t say we didn’t try to help you).

We provide the classroom, set the schedule, define the time limits – all you need to do is comply.  We have pictures with uplifting words on them like “HOPE” and “EMPOWERMENT”. Our fast-paced, shallow and fully self-contained courses have been designed to leave no need for further reading, questioning or dissent.

Our curriculum is brought to you with a total lack of evidence base – in the age of austerity we no longer need an evidence base, we just need to cut costs and get you pesky Mentals off our books. We can guarantee a 100% success rate – as long as you don’t ask to see the RCT’s. You will find many opportunities on your recovery journey to share your talents widely and publicly with Non-Mentals. This may involve art exhibitions, drama productions, or musical numbers. Unfortunately as funding is tight we can’t pay you. By knowing that you have challenged stigma and provoked discussion among regular folk you will be more than satisfied without need for monetary reward. Please don’t think of this as exploitation, you are giving back after years of receiving.  Recovery College is the alternative to actual support and SO MUCH CHEAPER. We have the technology, we can instruct you on how to recover in twelve easy sessions. No, wait – the funding has been slashed. Six. Yes, as long as you’re committed you can recover in six. Well, perhaps you don’t really want to get better.

Choose acceptance. Choose compliance. Choose someone else’s perfect life. Choose to recover. Choose it NOW.

We take pride in helping you learn that, quite frankly, you do not matter. Your life does not matter. Your experiences do not matter (unless they conform to our stereotypes and help fill our classrooms and coffers). We specialise in breaking your spirit and making you a willing slave to neoliberalism, and importantly, not bloody moan about it (or it’s off back to happiness class for you!)  We’ll blame your mental distress on you. YOU just have to DO BETTER.

Recovery is an individual journey with unique personal meaning. We will tell you which way to go and what it means, and how long you’re allowed to take.

There are so many opportunities for you at Recovery College: Become self-determining and self-reliant by joining our synchronised self-harming and sewing yourself-up group!  Mindful medication-taking – you too could learn the ancient art of accepting a depot up your bum! Straightjacket hindering your recovery? Why not join our colouring in with your mouth classes? Only biddable Mentals need apply. Mentals who think and ask questions don’t have sufficient INSIGHT for Recovery College and anyway you’d screw up our outcomes.

I will end this introduction with an inspiring quote from a DWP assessor:

“What’s that? Did you attend Recovery College?” *removes PIP*

 

Courses

Special Introductory Course in Form Filling  

Before we even get to any mindful shenanigans you will learn the art of the outcome measure so that we can demonstrate outcomes and get paid in full. You get bugger all. Though maybe it’s mindful form filling.

Access to Work

On this course you will learn to love zero hour contracts, no job security and no sick pay. You too have the RIGHT to work.

Finding Happiness

Lost your happiness? Join our happiness location course. FREE colour it yourself map on course completion’. Sign up for a happy, healthy new you. We will teach you to laugh in the face of poverty, oppression and abuse. (Prohibited topics: poverty, welfare, shit working conditions and JCP bullying, food banks, discrimination).

Learn to sing this! https://www.youtube.com/watch?v=gLaToGfEaOg *Anti-emetics will be provided*

Equality for All

Are you failing to reach your full potential? Underpaid? Unpaid? Verging on destitute despite working for us? We have just the course for you: ‘Equality For All’ (Staff only, service users excluded).

Mindfulness

Bored of your regular toolkit of hammer and screwdriver? WE CAN EQUIP YOU WITH AN EMOTIONAL TOOLKIT to keep in your mindfulness toolbox. Mindfulness is proven to help you silently, repeatedly, re-experience all that long-repressed trauma. (Bring your own raisins.)

Activation Therapy

Learn how every action (walking, breathing, shitting) can be a therapy! It’s simple: just add therapy on the end and we have walking therapy, breathing therapy and shitting therapy. (Note: this therapy is not to be performed with words such as ‘smashy’ or ‘murder’.)

DSM 5 Class

Learn all about your psychiatric diagnoses and pretend it’s not a medical model. You will also learn to stop fighting your psychiatric diagnosis and just be it (whilst pretending to be recovered because it’s medical dx with recovery wrapped around it #ReBrand).

Recovery Porn

Join us for our inspirational class ‘Writing Your Recovery Narrative’ and see your life story used fee-free in our promotional literature to help us obtain more NHS contracts. When you recover you can come back and tell your story, thus joining the recovery porn industry. One student said of this course:

“Finally, I understood I had an mental illness and some of us have a genetic predisposition and I learned that I could recover by challenging my distorted thinking patterns and being mindful and distracting myself and ignoring the obvious bullshit inherent in these explanations and by ignoring anything that happened to me in the past because that makes MH staff look all awkward and cross with me and the staff were all really supportive and I think I’m ready to get a job now and maybe become a peer supporter because I’d like to help people like me who have a mental illness that just happens because they are a bit genetically broken to learn that their recovery lies in their own hands and not to think about this too much because it’s proper science and everything. Is that ok? Did I do well?”

In this class you will also learn how to look down on and judge fellow Mentals who fail to recover.

Gratitude Class

Learn how to be thankful for all psychiatric staff, and to reward them with good behaviour. Gain joy from fulfilling what you never before knew was your true role, because to feel joy when incarcerated for six months against your will is truly the first step in your recovery. You didn’t need that job, or that husband or home, because what you found by being denied human rights is how damn thankful you are to the psychiatric system for saving you.

Modified Behavioural Modification

Learn to desensitize yourself with modified behavioural modification and psycho-mechanism-schemata, where no one is responsible for the others’ emotions, and with strict boundaries of total lack of response to anyone who is upset. Learn about your limbic system and Inner Chimp. Learn to TAKE CONTROL and completely ignore the world around you (cos it’s all about your shit).  Learn to take control and personal responsibility for those things over which you have no control and are not responsible for.

Wank Your Way out of Sexual Dysfunction

Drug-induced impotence? Develop a more resilient wrist so you can wank for longer. You will come if you have hope, and a stronger wrist.

When to Call the Crisis Team

You will learn everything you have ever needed to know about how to engage with this elusive, nay, mythical mental health service. Hint: the answer to the title of this course is ‘never’. Advanced lesson: join us for our extra short 1 minute course on ‘How the Crisis Team Can Help You’.

How to Budget Successfully whilst Destitute

This course includes the award-winning class on ‘How to Make Delicious Milkshakes from Medication-Induced Lactation’.

Patronisation for Beginners

Have your photo taken for our brochure for an Inspiration Photo. NB: Only photos of Mentals who conform to western attractiveness ideals will be printed in brochures.

Special Guest Lecture from a Famous Mental

Topic: ‘How to be Successful and Mental’. Special lecture by rich, outgoing, ex-mental person who has been to university and never set foot in a Recovery College in her life. She works hard for her money *despite* being mental.

Lying on Your CV

Learn how to explain hospitalisations, extended unemployment, psychiatric meltdowns and the odd arrest for your own safety in ways that will sound attractive to any employer.

How to Gloss over Socioeconomic Oppression as the Root Cause of your Mental Distress

Tutor: a middle class theorist/academic with no lived experience.

Other Courses Include:

How to Be a Better Jesus

Work Will Set You Free is now rebranded as: Work for Wellbeing and Be Too Exhausted to be Depressed

Nipple Tassel Dancing for Recovery

How to Be Assertive but Not Too Assertive – we would still like to control you

Sleep Hygiene for Filthy Insomniacs

 

 

 

Coproduction

Learn the art of quashing service user dissent. Get paid less as a peer trainer than professionals teaching with you being treated equally – you’re giving back and contributing, you know.  Increase your skills and confidence through helping us co produce our courses – we would particularly like to hear from service users who would like to obtain advanced skills in ‘sit down and just shut the fuck up’. ‘Peer’ co-pro means we look great plus we’ll give u a service if you’re good. In the Netherlands peers are called “folding chair clients”. When needed, take 1 from storage, fold them out, and then back into storage.

Coming Soon: Recovery College Student Loans. Be in debt like a Normal! Please note Recovery College Student Loans will eventually come into place following the phasing out of all sickness and disability benefits. You might not value your recovery if you got it for free. We’re being kind. Really. We think. With interest rates this low (19.9%APR Terms and Conditions apply) you’d be mad not to!

Outcomes (also known as hidden agenda)

The required outcomes are: not using services; bugger off somewhere else, anywhere. To be viewed as properly recovered: go to a real university or get a job (any will do).

Job Opportunities

On successful completion of your studies you will be invited to join us in a paid or unpaid role as a peer support worker, peer buddy, or co-trainer. Earn less than your professional colleagues (but it’s better than zero hrs in a supermarket).  Earn less than the professionals because you might be equal under employment law but no matter how ‘recovered’ we say you are, you are still mental and will never be worth as much to the college as us.

Remember kids: Recovery is the new black.

Recommended Reading in Preparation of your Studies:

Ruby Wax

Stephen Fry

“Recovery has always only ever been an empty word that refers to whatever agenda or ideology anyone chooses.” Robert Dellar

 

© 2017 Recovery in the Bin, All Rights Reserved