Mad At Work

Madlove Designer Asylum project madlove.org.uk

Workplaces blame or punish individuals for madness, exclude mad people from work, and fail to recognise the role of work in making people mad in the first place. This is true even of measures supposedly designed to enable accessibility or promote mental health. Sick of this, I asked some members of radical and peer-led mental health groups, along with some friends and fellow weirdos, what they think would make it better to be ‘mad at work’. I collected all the responses, merging duplicates and re-writing stories into demands, to make the list below. 

Of course one of the best things workplaces could do for mad people would be to improve their economic conditions. Many folk brought up precarious employment as especially harmful, including short-term and zero-hour contracts, as well as people having to re-apply for or apply for funding for their own job. As long as there is capitalism there will be suffering for mad people at work, exclusion of mad people from work, and madness as a result of work. Although this list is not primarily about economic conditions, is not intended to justify wage labour or erase the harm it causes. 

Yet many of the suggestions made below are perfectly compatible with the logics of capitalism. Some mad people just want to get through the day however they can. They want to have a nap sometimes, dress more comfortably, mask less, not get lied to and – perhaps most of all – be subject to less surveillance. These things are cheap, straightforward, and would even enable mad people to ‘more productive’ workers within the grim logics of capitalism. So why are most items on our list still completely unimaginable?  

OUR DEMANDS

  1. No glass walls or doors for maximum privacy and minimum surveillance 
  2. All toilets to be accessible and all-gender
  3. Provision of private nap cubicles
  4. Abolition of gaps around toilet doors to allow for privacy for purging and panic attacks
  5. Provision of luxury harm reduction rooms, including beautiful soft furnishings, safety equipment (wipes, clean needles and razors, sharps bins), and gold boxes for everyone to keep their individual stuff in
  6. No dress codes or norm of dressing gowns, blankets, pyjamas, slippers, bare feet 
  7. No more defining mental health as the ability to work
  8. Abolition of counselling as gatekeeping for jobs
  9. End of the use of health and safety and risk assessments to punish and restrict autonomy of disabled people
  10. Abolition of small talk (replace with standard red/yellow/green communication badges every door) 
  11. Police uniforms for Human Resources & Occupational Health staff to make their roles clear
  12. Paid time in all workload models for collective organising (including but not limited to trade unionism, direct action, feminist consciousness raising and zine-making)
  13. Free workers’ canteens (with no coercive ‘health’ or ‘normal’ eating) 
  14. All contracts mandatorily available as job share 
  15. All workplaces to circulate and commit to Recovery in the Bin principles
  16. Worker feedback forms to be located over the shredder for clarity around purpose
  17. No more macho pretend-its-fine culture
  18. Actually flexible working hours
  19. Recognition of workers as humans for whom work is only one part of life 
  20. Abolition of workplace communication by whatsapp, ‘fun’ group chats that include bosses and all social media (except personal or political social media use at work)
  21. Time in all workload models for private, skilled, on-demand clinical supervision for anyone who works with ‘vulnerable’ groups
  22. Recognition that learning, not-knowing and lack of enjoyment are inevitable elements of work and not signs of unprofessionalism
  23. Resources to support working from home (e.g. printer and scanner)
  24. Option to get paid based on hours or on task, your choice, with no reduction in pay (maximum 25 hour work week either way)
  25. A sensory room with sensory toys AND integration of those things into rest of work place
  26. No forced disclosure ever
  27. Sound proofed screaming cubicles
  28. Screaming normalised everywhere, ear defenders supplied at all entrances
  29. Employers to pay employees’ union membership 
  30. No more suffering as a rite of passage
  31. Education for all employees about madness BY mad people
  32. Abolition of the idea of ‘professionalism’ (otherwise known as ableism, racism, misogyny, etc) 
  33. Abolition of ‘reasonable adjustments’, replacement with actually accessible workplaces including accessibility budget for all workers with no monitoring
  34. Wages for housework, care labour and all social reproduction 
  35. No more rest or breastfeeding areas in stationary cupboards 
  36. Repurposing of ‘common room’s for crafting, animal therapy, prayer, dart boards and punch bags with bosses faces on, meditation, etc. 
  37. No more token wellness activities or ‘pledges’
  38. More sharing of unsantized stories (NOT ‘it all got a bit tricky but I’m totally better and promotable now’)
  39. Abolition of requirement to perform trauma and healing for job 
  40. No more blaming our mental health for impossible working conditions

By Darcy Leigh.

The making of this list was inspired by the Mad Love Designer Asylum project, in which mad people design their own asylum.

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

When The Cure Is Always Worse Than The Complaint…

The following is a preamble for Blog as a memoir of sorts – not a rant – to hopefully go towards improving things for BAME survivors (victims?) of psychiatric torture…and to also, hopefully, help to prevent atrocities of this nature from being so free to occur in times future for others.

Racism in the Bin !

I thought it would be useful to start by writing about my own years long ordeal…and I would advise others not to share their stories at this stage in the game or to comment either using your real name…fear of reprisal and/or guilt by association is well founded/understood.

I am informed and aware enough (I think) that there are some good psychiatrists out there but unfortunately we cannot assume that they have enough humility, autonomy or freedom from the herd/autocracy/hierarchical forces to not otherwise be what I call ‘psychiaracists’ such as the ones who said to me years ago :”you do know that you have a black gene, don’t you, which is causing you to be mentally ill”…Glory!

Whatever a person’s colour or tribe might be this doesn’t automatically stop him/her from subjecting a person to ‘cruel and unusual punishment’…the so called nurses who physically tortured me were/are also ‘black’…

My ‘psychiatrist – elect’ is a Jungian analyst. Carl Jung was a Swiss psychiatrist and founder of analytical psychology. Jungian analysis isn’t so accessible unless a person pays privately here in the UK. His opus or great work was/is dismissed by so called normal people who put so much store by ICDeologyconformity/mediocrity/ignorance (?).

Furthermore, I was very surprised to hear that the consultant psychiatrist who diagnosed me as Bipolar when I was about 39 years old hadn’t even heard of Jung – the same psychiatrist who said that I ‘have a different kind of brain’ which according to him ‘lacks the foundations of an ordinary building’…whatever next ?

“Show me a sane man and I’ll cure him for you” – Carl Jung 🙂

No one knows everything there is to know about the mind – fortunately ! – just as no one can predict the future in life. Jung was a gnostic – didn’t fight shy of the ‘mystical element’ …and his writing – as with anyone else’s – has to be seen/evaluated fairly with respect to time of writing and so on…

He was slated by the herd recently enough, too, for being racist…my late former Jungian analyst who was a Jewish woman said he was not ‘racist’ – that he was exploring the collective unconscious, the shadow and his own. Jungian analysts have to know themselves – including deeply understanding prejudices, projections and dark side or shadow – very well before and as part of being/becoming an analyst. I have sampled other schools of psychotherapy/psychoanalysis and found the Jungian school suited me best – not because I am a racialised human being…more to do with having such an expanded consciousness – propensity for ‘manic phases’ – and/or my falling into the unconscious and the ‘numinous’ or ‘mystical’ realm, even, which was initially triggered by my drink being spiked unawares with an hallucinogenic drug at a party many years ago. I also read quite a lot of his writing in my early twenties…beginning with his autobiography titled: “Memories, Dreams and Reflections”…

There would appear to be little or no room for the ‘mystical element’ here in the UK..ICDeology is so reductive – limited/limiting, isn’t it?

“All thought is limited” – Jiddu Krishnamurti

I experienced ‘flashbacks’ which can look like hypomania but is not the same thing…it would appear that drug -induced psychosis and the damage to /impact on the brain of this isn’t actually very well understood. It’s highly dishonest to claim that an hallucinogenic drug triggers an underlying condition…this writer was ‘normal’ or ‘neurotypical’ enough beforehand.

My current analyst has a different approach…he recommended reading “The Drama of the Gifted Child” by Alice Miller…and has helped/helps me to see and understand enough to confront the cruel and unusual position I have found myself in…he said that therapy is about feelings. And. yes, unlike state – funded biomedical psychiatrists whose preoccupation is about control and limitation, really, he gave me a tissue for my tears…instead of dismissing my feelings as ‘lability’ and a reason or excuse to give me even more drugs.

“There’s a fine line between genius and madness”

Psychiaracists don’t acknowledge a person’s intelligence…or care about it either and hence the disproportionate labelling and over-medicating of black folk…a self-fulfilling prophecy perhaps ? Not possible to be or sound intelligent when a person has had a chemical lobotomy !’They’ have also inherited a shared delusion that ‘black’ people are dangerous as y’all know already I’m sure…when I recover the ability to act or appear dumb enough in a chemical straitjacket they’re happy to discharge me. Actually, this isn’t quite so since what typically happened was that they visited a section – legally or otherwise – on me for 6 months and then would discharge me just before the tribunal hearing date …in order to avoid the hearing no doubt.

The one and only tribunal hearing I have had in 20 years – a few years ago – I won…and against the odds if a person was to believe what is written in my psych notes…
White female Judge; “Are you saying that although Katy who is now in her mid fifties – has no criminal record and clearly respects the law – is a danger to others?”

Black male psychiatrist: “Yes”

I hope that I never lose the ability to cry – respond to sorrow and to care deeply about people and all the needless suffering arising from and caused by the psychiatric system in particular- even though my tears have been labelled and dismissed /diagnosed as ‘lability’ – where’s the humanity/compassion in that ?

Some of the cruel and dishonest things the psychiatrist said about me at the tribunal even though he’d only just met me made me cry. He then said : “Look, see – she is labile !”

More to say about this encounter/travesty …later…

My analyst said that he knows how dangerous it is for me to feel things…and yes it is such – I am a psychiatric torture survivor after all. I am not ‘free’…apart from being free to be a virtual recluse – free from the ‘usual reign’ as TS Eliot would put it at this great age…

Freedom of expression and/or speech is not a given or honoured as a human right – especially if a person is psychiatrised and/or happens to be from a racialised group – is a black or grey (mixed race) woman with no ‘tribe’ to protect and support her like this nobody-writer…and/or who like me has/had a ‘precocious intellect’ – I was a gifted child…I am not a precocious person though – attitudinally-speaking…am ‘little-headed’ /self-effacing (usually)…very good at humouring people who have/had the power to torture me and decide my fate. However, my grey matter and ability to think critically has been extinguished more or less by all those needless chemical lobotomies and prolonged hospital admissions though now…and all for what ?

“It’s you my love you who are the stranger” – Leonard Cohen

My psych notes made for dark and humiliating reading…and opened my eyes…misrepresenting and demeaning a person in writing is always deliberate. As is/was totally covering up the one and only planned serious suicide attempt on my part during those ‘torture years’- (1998 – 2014) – Not only did they omit it from the notes they didn’t write anything about the reason for my trying to take a fatal overdose either…! The reason/cause being that I didn’t think I could/would ever be free from the haunting/damage of being subjected to total deprivation/solitary confinement (in 2012)…(or free from the fear of further torture given what took place the following year ).. A policeman in the hospital said quite angrily that “Katy is not the problem – the hospital is the problem!”

What a cruel thing to do to a person who started to break down – couldn’t sleep for a number of days – a few months after losing her mother who died very suddenly…I was in that terrible seclusion room just terrified for so long that I lost track of time and hallucinated* for the first time which is a common reaction to this form of torture – it also triggered suicidal feelings and caused me to lose the abilty to connect with and/or recognise others… The psychiatrist worried that she couldn’t ‘bring me back’ and thought I would have to go into a care home…she also changed my diagnosis which I have since rebutted. There were/are many other forms (of torture) which I have been subjected to as an inpatient – ‘behind closed doors’ – which I will write further about later…

As my solicitor said to me years ago :”unlike most people , Katy, the cure for you has always been worse than the complaint”…and then …an inevitable/inescapable revolving door scenario…a person who cannot escape physically can only do so mentally at the end of the day – living in constant fear of a hospital of all places is/was no mean chalk…needing asylum from the asylum now ain’t that absurd !

I used to also have laughter in me too – was not short of a sense of humour…the joke is on me though or so it would appear. (Laughing is perceived as being high for a person who has been diagnosed as Bipolar).

As a worker in what was a kind of unofficial Soteria house or ‘retirement home’ for people who’d survived God knows what in the back wards in Friern Barnet hospital, I /we argued the toss with the survivors’ psychiatrists; questioning the usefulness of medication per se whilst respecting the right on an individual level of the people living there to take medication if they did or did not wish to do so – of course, people need(ed) the right attention and care in life – not just drugs.. .

I was naive about my being ‘tokenised’ essentially or ultimately by a local Mind group which was at the time the most ‘politicised’ arm of National Mind – mostly and openly ‘anti-psychiatry’ and committed, too, to SU involvement as a must…

How could I know that this good work would/could cause me to suffer so greatly later on as an inpatient myself? The house was the first place of its kind and served as a pilot for others…(before the Care in the Community Act)

In 1998 I broke down following a huge bereavement…before being transferred from a good hospital to Satan’s Inn (anagram of Saint Ann’s) where I was repeatedly physically tortured by the male so called nurses, a woman who worked in the Mind advocacy office in the good hospital said she had a note about me which said : “we have to look after this one”…but they didn’t or perhaps couldn’t when I was transferred. I had never before had to enlist a solicitor’s help to get out of what was supposed to be a hospital!

Taking a break from writing now…Thanks for reading, Katy

I’ll write further about what I mean by ‘hallucinated’ later on perhaps…
(Whilst it is not necessary or possible to include everything, some elements – especially those which illustrate the extent of iatrogenic injury – do deserve/need highlighting )

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On Admission To Wrekin

My admission was probably one of the lowest points at this time, I was pulled into an ambulance, by police officers who obviously had no idea how to handle a psychotic person. I was put in a small room with only my boyfriend there, three psychiatrists/psychologists came in and assessed me, I don’t remember much of the conversation apart from when one of them told me my parents didn’t want me and couldn’t take care of me. I was to be sectioned over the weekend. The first night I wandered around the ward crying, begging every nurse or doctor I could see for a second opinion. I just wanted to go home.

They gave me Lorazepam to keep me quiet and I didn’t sleep at all, I was on 1 on 1 for the first two days which meant I couldn’t be on my own, not to sleep, not to go to the bathroom or shower, not to cry or express the emotions I wanted to express. I felt helpless and the nurses would only tell me “they won’t let you out while you act like this”. When I couldn’t sleep I told the nurse watching me that I couldn’t sleep and all she said was “you slept”. So I got a coffee at 4am and waited for the day to pass. When your days start at 4am and you don’t get to go to bed until 9pm the days are pretty long and shitty. I’d been managing to quit smoking but when I got in there it was the only thing that allowed me to go outside for 5 minutes.

I was too anxious to shower with someone watching me and I was told me not showering would go against me and I would be made to stay longer. On one particular night they gave me Lorazepam, Zopiclone and Quetiapine all in one night and it made me hallucinate. My birth/dead name was used quite frequently until my named nurse took notice, however that didn’t stop some of the nurses from being ignorant. I was found crying by a nurse who had been extremely harsh and blunt with me from the start of my time there, she gave me no sympathy or advice, just another broken record “do you really think they’ll let you out while you’re acting like this?”. I was saddened to hear that it would go against me to portray my emotions.

I made friends on the ward, they were very good people and I still contact them to this day, I’ll always be grateful for them. One occasion that stood out to me was when I was taken into the office and told “some patients” were “unhappy” with me being on the male bedroom corridor, I was given a rape alarm but wasn’t told who would potentially be attacking me. I was offered food but was too anxious to eat in front of the other patients, the nurses refused to let me eat alone and I had to sit in between two armchairs in the corner.  I declined food for the first 3 days and lost weight drastically, I was malnourished, dehydrated and tired, but yet again I was told this was all going against me. I wasn’t offered any advice. A nurse came to me asking about what I wanted to eat, asked me if I wanted a vegan meal and I accepted, she then looked at the list of things and replied “oh well, we don’t have any” and I was forced to choose something else. I was even given meat at one point that I refused to eat.

On my last night I was kept up until nearly midnight because they were late doing night medications (meant to be given at 9pm), my friend and I were the last two to get ours. My review session was 5 days after I was sectioned, I was in the room for 15 minuets, lied through my teeth about feeling great and not wanting to die; I was let out immediately after. They told me I was going to be kept inside this place for all the times I fucked up that I couldn’t help because I was mentally ill. Then I was let out within 15 minutes of lying.

By Jason Lewis @ag0ny_in_vain

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Positivity, Terrorism, & Neorecovery

clown happy

The imperative to be positive, to have what is lauded in the workplace under neoliberal capitalism as a ‘Positive Mental Attitude (PMA)’, has seeped into every area of human life, and it is terroristic. The obligation to wrap up one’s distress in a gift box with a pretty ribbon, to mask the absolute horror show that can be bestowed upon some of us in the form of mental torment, is nothing less than a violence. As we have learned from those who are subject to racism and intersecting oppressions, it is what these things do to the psyche, the way they get under the skin, into the marrow, and woven into the very fabric of our selves, that does the most damage. It is a colonization of the mind.

The positive police have set up shop in every mental health service. We should write gratitude lists, mindfully eat raisins, HOPE (help other people every day), list our strengths on care plans, and think about where we might want to be in five-year’s-time when the next hour feels unsurvivable. My current care plan asks me to document my long term goals and how I will achieve them; the boxes to fill in read like an appraisal form, or something to put in a personal statement in which I try to convince someone I deserve a particular position. The form used to be about the difficulties we experience, what help we need – not an instruction to account for oneself and how we might materialise the things we want out of thin air, driven by pure (and probably literal) hunger for it.

I run a writing group for people who experience ‘psychosis’. Last week one of the members was trying to write something based on a prompt I gave them and said, apologetically, that she had nothing positive to write. I was a bit startled because I have never asked them to write in a particular way, and certainly not to write with their positive pants on. I said that the group wasn’t a space that demanded positivity, but was a space in which to be real with yourself and others, to the degree with which you are comfortable. Her reply? “That makes me want to cry”. Her response made me want to cry. And shout. What are we doing to people that we feel that unless we can speak positively we shouldn’t speak at all, particularly about the reality we experience? This violence rips words from throats; puts a sterile spin on the diverse range of human experiences; whittles us away to silt; isolates; individualises; and expects us to swallow patronising platitudes in the name of ‘recovery’ so that we may be deemed worthwhile (read: productive) subjects.

I don’t want to go all John Lennon on you, but imagine if we let people be. Imagine if we accepted that it isn’t wallowing and being resistant to treatment to be honest about how we feel? Imagine if we were willing to hold that space for people with care, and to sit alongside them in it. Imagine if we decolonised the narrative, stopped asking people to superficially cover wounds that need suturing and healing from the bottom up. Contrary to neoliberal propaganda, of which the recovery discourse is fast becoming a sacred part, this doesn’t cause people to be stuck in a sick role and too dependent (whatever that means given we are all dependent on others), but allows for the possibility of being seen, being accompanied, and possibly moving through it with help.

Interestingly, the group member I mentioned above, though speaking of her fears and upset of the previous two weeks, wrote a very positive poem. I am not convinced this is because she miraculously felt that way, but because the obligation to be positive has hijacked her from the inside. Violence isn’t always bloody.

– Eleanor Higgins

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The Invisible Prison – Panopticon Of The DWP

Invisible prison 1 art

One of the things I’m feeling a lot at the moment is the massive divide being successfully constructed between:

1. Those of us who are long-term dependent on state disability benefits to live.

2. The rest of society.

This is absolutely deliberate.

People who aren’t dealing with the DWP for disability benefits have no idea how traumatic and violent and all-encompassing it is. It is an ongoing trauma for a lot of us.

Pretty much everyone I know who, like me, relies on disability benefits for rent/food/bills/life money, has had multiple traumatic experiences. And that’s on top of the GIGANTIC amount of work that the assessment process involves: do to it successfully requires a lot of specialist knowledge, writing skills, capacity for loads of admin, having to contact people, arrange medical appoints which are a total waste of patient and NHS resources, attend horrific ‘assessments’ , try to find advocacy etc

And being forced to do this all to the tightest timescale possible.

We deal with a level of surveillance and arbitrary punishment that, rightly,
has been judged by multiple independent analyses to be a state driven deliberate breach of the human rights of disabled people who have the fucking gall to be poor and/or unable to work.

Loads of the techniques of psychological pressure were developed first in one of the home office/ foreign office/ DWP, and then exported to the others. Nice, huh?

If you’ve a strong stomach and/or are not directly affected, more on that here.

Nudging conformity and benefit sanctions: a state experiment in behaviour modification

Basically the gist of this is, in which we discover until recently there really was a controversial government department which researched and tested “behaviour modification techniques” for implementation in aggressive state policy:

“Conservative anti-welfare discourse excludes the structural context of unemployment and poverty from public conversation by transforming these social problems into individual pathologies of “welfare dependency” and “worklessness.”

The consequence is an escalating illogic of authoritarian policy measures which have at their core the intensification of punitive conditionality. These state interventions are justified by the construction and mediation of stigma, which is directed at already marginalised social groups that the policies target. The groups, which include sick and disabled people, people who are unemployed, are painted with a Malthusian brush, as a “burden on the state” and a drain on what are politically portrayed and publicly seen as scarce resources in an era of austerity.”

Political processes of scapegoating, stigmatisation and outgrouping have been amplified by a largely complicit UK corporate media. Examples of its work are all over the DWP. PREVENT. The whole Hostile Environment project. There’s plenty more, I’m sure.

Which is why I’m not exaggerating when I name this as state terrorism.

A bunch of disability and civil liberties activists/campaigners/lawyers discovered  the existence of the ‘nudge unit’.  So they made Freedom f Information requests to try and find out what the hell government money is being spent on.

Government solution? To privatise the department and turn it into an ‘institute’ to avoid scrutiny. And to drain more state cash into private pockets.

Anyway, back to us, trying to survive in an increasingly violent and reactionary society with the vast machinery of the  right wing state bearing down on us.

This shit and much more stuff like it = many of us are scared to leave the house, post any pictures of us looking happy on social media, be photographed at events/protests.

We’re cut off from participating in civil society.

Police force admits agreement to share information about protesters with DWP

It’s absolutely deliberate: the more surveillance, the more the DWP poke their nose and disclosure agreements into every area of our lives, the scarier it is to be out in the world even when we aren’t disabled by society.

And – for many of us – there are multiple other oppressions we’re dealing with too. Disability is inextricably entwined with race, class, gender, gender id, immigration status, sexuality and poverty.

Our lives are FUCKING HARD.

The surveillance/sanctions regime is a deliberate tactic to put extra pressure on already vulnerable people. It’s punishment for being vulnerable and in need. It’s also eugenics: it’s about disabled people being regarded as disposable/barely/not human. It’s an idea with deep roots in British society.

And they’re only just getting started. Looking at Bloody Boris’ fucking cabinet terrifies me, eg right now the DWP is trying to get its hooks into NHS files. The proposal is dressed up in fake nicey language but basically it would mean that if you claim disability benefits, you have no privacy or confidentiality during medical appointments. It would be horrific. I know that there’s a lot of pushback against this from loads of NHS groups, thank fuck.

I don’t have much hope, and I feel a lot of the time the clock is ticking on how long I can survive before they break me, or make me homeless again or otherwise fatally fuck me up. That worry never leaves me. Which is another reason for stopping dealing with them for now.

Because I realise now: I’ve become institutionalised. I live inside an invisible cage built by the DWP (and social Scare, of course. Let’s not forget them. Bastards)

By institutionalised, I mean, for eg – I anticipate and strategise against DWP sanctions automatically whenever I think, open my mouth, and especially if I leave the house. Any time I think about doing anything out of the house that might improve my life, (eg an art class, or an event that a photographer is at) I freak out over whether it will trigger sanctions.

Because although it’s not likely, it does happen.

It’s a perfect panopticon. They fuck over just enough people to make all of us realistically terrified about it.

And it’s a deliberately and increasingly asymetric system.

Ie: getting the benefits takes huge amounts of work, and can take years. But the state can take them away in an instant.

There’s also the alienation: I deal with this monster that infests every area of my life. People who don’t deal with it mostly have absolutely no idea how hard our lives are. How we don’t go a week on social media without hearing about yet another death caused by the system we’re reliant on.

A system that is our right.

And it should be the right of anyone living here, btw. And isn’t anymore – that’s a whole other pile of DWP fuckery that’s been happening over the past decade or so.

Fuck borders and fuck nativist politics always.

But my one hope is that I see so many grassroots people/groups/organisations/communities doing mutual aid, advocacy, support, skill sharing etc. A lot of it is very informal and grassroots and it’s amazing. So you get people on random fb forums putting hours into helpful /detailed/informed responses to questions. You get people sharing often traumatic details of the assessment process because they care about someone else going through the same thing. It’s fucking amazing. But we shouldn’t fucking be going through this shit in the first place.

More specific stuff re the ”invisible cage’/panopticon:

CW: moar DWP ranting. Also, tho, theory.
Which isn’t actually fucking theory for me. It’s my daily life.

The DWP is absolutely a panopticon. I’m living in a fucking panopticon. Except it’s invisible. And specifically designed to marginalise already vulnerable people.

So most people don’t even know it exists. And often don’t believe you when you tell them. And it fucks you up so sometimes* you forget that you’re living in a panopticon and just blame/hate yourself.

I’m living in a panopticon in twenty fucking nineteen in a rich White Western country that likes to think of itself as:

1. Liberal (it isn’t. There are important  traditions of liberalism in this country. Traditions f radical internationalist anti colonial/anti racist socialism, communism, anarchism. Powerful histories of working class people of all races doing practical radical political work. And loads more. Britain’s dominant character as a ‘nation’ in general, in practice ends up  defaulting to English norms’ . Which prize conformism, hierarchy, subtle powerful coded signals.
Its all about us ‘knowing our place’.

Riz MC nails it in ‘Englistan’:
“God save the queen
Nah she ain’t mates with me
But she keeps my paper green
Plus we are neighbours see
On this little island
Where we’re all surviving
Politeness mixed with violence
This is England”

Track: Riz MC Englistan on Bandcamp
Lyrics: https://genius.com/Riz-mc-englistan-lyrics

2. Modern. Modernity isn’t inherently good – in English, it’s a category inseparable from white supremacy and capitalism and patriarchy and and and.

But my main issue is that the idea that the UK is modern is fucking laughable. UK = basically feudal neoliberal empire-hangover capitalism. Doesn’t that sound just GREAT?

If you think I’m exaggerating – bear in mind that our new Prime Minister is related to the royal family. in twenty fucking nineteen.

Thinking about the DWP as a panopticon also usefully reminds me that there’s a reason that a fucking White English public school-and-oxbridge man came up with with the panopticon. These same people still largely run the country OVER TWO HUNDRED YEARS LATER.

“Jeremy Bentham, an English philosopher and social theorist in the mid-1700s, invented a social control mechanism that would become a comprehensive symbol for modern authority and discipline in the western world: a prison system called the Panopticon.

The basic principle for the design, which Bentham first completed in 1785, was to monitor the maximum number of prisoners with the fewest possible guards and other security costs. The layout (which is depicted below) consists of a central tower for the guards, surrounded by a ring-shaped building of prison cells.

The building with the prisoners is only one cell thick, and every cell has one open side facing the central tower. This open side has bars over it, but is otherwise entirely exposed to the tower. The guards can thus see the entirety of any cell at any time, and the prisoners are always vulnerable and visible. Conversely, the tower is far enough from the cells and has sufficiently small windows that the prisoners cannot see the guards inside of it.

The sociological effect is that the prisoners are aware of the presence of authority at all times, even though they never know exactly when they are being observed. The authority changes from being a limited physical entity to being an internalized omniscience- the prisoners discipline themselves simply because someone might be watching, eliminating the need for more physical power to accomplish the same task. Just a few guards are able to maintain a very large number of prisoners this way. Arguably, there wouldn’t even need to be any guards in the tower at all.”

“Michel Foucault, a French intellectual and critic, expanded the idea of the panopticon into a symbol of social control that extends into everyday life for all citizens, not just those in the prison system (Foucault 1970). He argues that social citizens always internalize authority, which is one source of power for prevailing norms and institutions. A driver, for example, might stop at a red light even when there are no other cars or police present. Even though there are not necessarily any repercussions, the police are an internalized authority- people tend to obey laws because those rules become self-imposed.”

* ie almost all the time.

A final thought:

The tories are trying to kill me.
And a LOT of other people.
And they’ve already killed so many.

Black people. Muslims. People of Colour.
Migrants, particularly guess what, black people, muslims, people of colour.
Disabled People. Mad people.
Trans* people
Queers
The ‘wrong kind’ of women.
Working class people

*

Think about what it’s like for those of us who tick most or all of these boxes.

Try to conceive of the firestorm that we’re living in.

quotes are from here Internalized Authority and the Prison of the Mind: Bentham and Foucault’s Panopticon

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Mental Health Professionals Are Asking People To “Take Responsibility” For Surviving Their Suicidal Crisis – Even When Sectioned In Psychiatric Hospital

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Ella and I were patients on the same psychiatric ward. We were both detained under section two of the Mental Health Act. She was perhaps the quietest and most withdrawn patient on the ward at the time. She seemed deeply depressed.

We all felt very protective towards her, because she seemed so young and vulnerable. Indeed, on the day I was discharged, I recall hugging her tightly and wishing I could take her with me.

A few weeks later, Ella took her own life. She was still sectioned in the psychiatric hospital at the time.

Ella had been allowed to gain access to items which she used to end her life. At her inquest, the psychiatrists said they had not restricted her access to them because they wanted her to “take more responsibility” for her own safety. But surely the state had taken responsibility for her safety at that point – she was detained under the Mental Health Act.

It is known that restricting access to lethal methods reduces the number of suicides: https://www.psych.ox.ac.uk/publications/168536.

I run a Suicide Crisis Centre which is independent from mental health services. Clients often tell us that mental health teams are emphasising that they need to take personal responsibility for managing their own crises. Perhaps the teams feel that this will discourage service users from becoming dependent or expecting that a service will “save” them.

It’s possible to argue that we should all take responsibility for trying to stay as mentally well as possible and use as many strategies as we can in order to do that. Indeed, that can feel very empowering. But we may all reach a stage when our strategies no longer work, and we need significant help. When we reach that point of crisis, it may be the least appropriate time to expect someone to be able to “take responsibility”.

When a person is in mental health crisis, their ability to think clearly is very often impaired. That’s the nature of crisis. Our thinking may be chaotic at that time. It is not always going to be possible for someone to think clearly enough to take steps by themself to start to navigate their way out of the crisis.

At the point of crisis, it is the time when you are least likely to be able to see a route forward, without support and care to do so.

There are ways to help empower people who are under the care of a service so they do not become dependent on it. These alternative methods do not involve telling someone in crisis to “take more responsibility.” Giving people more control over their care at an earlier stage, when they are not in crisis, can be an effective way of doing that.

As I wrote last year: “Our approach is to give clients as much control over their care as possible, but to actively and tenaciously work to protect them and help them to survive, when they are in crisis and at risk of suicide” (“Suicide Prevention Techniques: How A Suicide Crisis Service Saves Lives”).

Requiring someone in crisis to “take more responsibility” may heighten their despair, because they simply cannot do so at that point.

They have taken the step of asking for help, but have been told instead that they need to find their own resources. Surely they need to feel reassured that if they seek help, there will be support, kindness, empathy and care.

I know that the other patients on the ward continued to wrap Ella in care and kindness. They watched over her and alerted staff to the fact that they were extremely concerned about her suicide risk. But that responsibility of watching Ella should not have fallen on other patients.

Ella’s death should make us question to what extent the emphasis on service users “taking responsibility” has gone much too far, and risks causing a failure to adequately protect life.

As Ella had died while under the care of the state, in a psychiatric hospital, there was a jury at her inquest. The jury concluded that her death was a suicide which was “contributed to by her ability to gain access to items to aid suicide”. They took a very different view from the coroner, who in my opinion accepted too readily the mental health service’s justification for not restricting access to certain items. The coroner commented that such restrictions would be “draconian.”

Please also see this article which challenges the approach of clinicians who tell patients that it is their “choice” or “their decision” to end their life : Suicide: why do mental health professionals tell patients ‘It’s your decision’?

In memory of “Ella”. Ella’s name has been changed.

Joy Hibbins is the CEO of the charity Suicide Crisis: www.suicidecrisis.co.uk

Republished by kind permission from Saving Live Blog

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Fake News: What Psychiatric Wards Aren’t Telling You On Twitter

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Did you know that psychiatric wards run their own Twitter accounts now? What’s next, Instagram?  Perhaps we can lose the Care Quality Commission and start carrying out reviews of hospitals on Trip Advisor instead.

Sussex Partnership Foundation Trust has an extensive Twitter network, with official ‘ward twitters’ and multiple ward staff running their own accounts. They call the patients ‘service leaders’ – language that denies the actual status of patients, often detained against their will, on psychiatric wards. The staff are referred to as ‘leader leaders’, trained through the ‘Leader Leader Academy’ which promises ‘quality improvement through Clarity, Competence, Control and Courage’ (is satire dead?). These ideas are taken from an American naval captain, turned public speaker, who suggests every business should adopt a ‘leader-leader’ model of management rather than a ‘leader-follower’ approach. The aim is to push responsibility as low on the organisational hierarchy as possible and for all employees to take ownership of leading the business. I somehow don’t think he was talking about patients detained under mental health legislation when he came up with that.

Am I really a ‘service leader’ while locked on a ward with little say about when I leave, whether I take medication and what belongings I have access to? If we flatten hierarchies to the point that we deny their existence, aren’t we just gaslighting those at the bottom? My own experience in a Sussex Partnership hospital was not one of a ‘service leader’. The problem with using such dishonest language is that it obscures the power and responsibility of those who can actually wield it. For example, a Sussex Partnership nurse tweeted a debrief form that had been filled in by a ‘service leader’ after they’d been restrained. What led to such poor judgement? Perhaps an unintended consequence of this language change is that staff begin to actually believe that patients have equal power, and that it’s OK to share their private, medical information on Twitter.

One of the wards using these terms is a psychiatric intensive care unit at Mill View Hospital. I was appalled to see multiple pictures of ‘service leaders’ posted on their Twitter feed, with smiley emojis superimposed on their faces. One of these pictures was posted by the ward manager, then ‘liked’ and retweeted by the CEO of Sussex Partnership, Samantha Allen. The patients would be clearly identifiable to anyone who knew them and the photos were humiliating, degrading and in clear contravention to multiple data protection laws (not least, that staff had the original, unedited pictures of patients on their phones).

Who are these Twitter accounts serving? Every kind of ‘professional’ Twitter sphere can come across as self-congratulatory, but the stakes are so high here. While I can understand the value in mental health professionals using Twitter to share best practice, it should never be at the expense of dignity and confidentiality. The tone of these ward accounts is all wrong – happy, smiley emojis covering the faces of those detained, talk of infantilised fun with the ‘service leaders’ – it paints an idealistic picture of life on the ward that is pure fantasy. I don’t go into hospital looking for ‘fun’. I hope that I receive timely care, that my human rights will be upheld, and that my dignity and confidentiality will be respected. Sadly, none of this has been the case in my own recent experience of Sussex Partnership hospitals.

The emoji pictures of patients have since been removed, after an uproar from professionals and service users alike. However, data still remains that could be used to make a jigsaw identification of a patient. The ward ‘newsletter’ includes a patient blog section where details about patient’s care and life stories are shared, and so-called ‘service leaders’ are still visible in some pictures.

It is all the more galling because the problems at Mill View Hospital have been well documented in recent years. There was a death on one of their wards as recently as December last year, that resulted in a coroner ordering an immediate investigation into safety. She described the ward involved as “mismanaged and chaotic”, and accused Mill View staff of giving the subsequent police investigation “the run around”. I am left wondering how the families of those who died there would feel about this kind of gratuitous self-promotion on social media.

Another problem on Twitter is that the ideas shared can be lost in their repurposing. One ward in Leicestershire, posted a picture of postcards with motivational quotes on, stating they were writing a personalised crisis plan on the back for each of their patients being discharged. A nurse from Sussex Partnership took this idea and recreated it, but instead of a personalised crisis plan, they listed generic crisis numbers on the back. What was a nice idea – personalised crisis plans on more than just hospital stationery – lost all it’s substance and became just another opportunity for ‘likes’ on Twitter. I left a Sussex Partnership hospital earlier this year without a proper care plan. If they had given me a motivational postcard with generic crisis numbers taped to the back, it would have felt like a punch in the face.

There are real people in vulnerable situations behind these Twitter blunders, that are having their human rights totally disregarded by Sussex Partnership staff – just for some ‘likes’ on social media. It suggests a culture where PR is valued over anything else. Until Sussex Partnership take raising their standard of care seriously, we should watch their Twitter rebrand with caution.

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