Tag: Human Rights

Fuck You, You Knew

A survivors response to the Royal College of Psychiatrists (2026) Position Statement PS04/26 – ‘Addressing the impact of non-recent child sexual abuse on the mental health of adults’

In August 2026, the Royal College of Psychiatrists published a “landmark” position statement on the impact of non-recent child sexual abuse. It seemingly acknowledges that survivors have been disbelieved, retraumatised, misdiagnosed, and harmed by mental health services. It recognises the relationship between childhood sexual abuse and experiences extending beyond traditionally defined PTSD, including substance use, dissociation, and psychosis. It acknowledges Dissociative Identity Disorder (DID) as a real and historically contested diagnosis, and that this controversy has contributed to survivors being underdiagnosed and misdiagnosed. It appears to confront the harms of psychiatric diagnosis itself: the medicalisation of distress, shame, stigma, diagnostic overshadowing, and the fragmentation of people across multiple diagnoses. Splashed across the pages, prominently displayed survivor testimony describes generations of sexually abused women pathologised as personality disordered, calling the personality disorder (PD) construct systemically harmful, demanding its abandonment. And, extraordinarily, the President of the Royal College apologises for the “avoidable” harm survivors have experienced within mental health services.

These seem like pretty bloody significant admissions. There are things in this statement that survivors, activists, and critical professionals have fought for centuries to have psychiatry acknowledge. There is something enormous about seeing them written down in an official statement from psychiatry’s own professional body. Some of what is contained in these 94 pages would have been almost unimaginable as an institutional position not very long ago.

My first response when I read it was: They can get fucked.

Perhaps I was supposed to feel vindicated. Here, finally, was psychiatry acknowledging things survivors have spent our lives trying to make it acknowledge. Instead, I felt incensed. Because acknowledgement without responsibility is an insult. These things didn’t simply happen to us. People did them. Psychiatrists did them. And now, after all this time, I was being offered a half-arsed apology from a PDF. I don’t want a half-arsed apology from a PDF. I don’t want to be told that survivors have suffered “avoidable harm” because psychiatry was sometimes insufficiently aware, insufficiently trained, or accidentally got things wrong. I want a person to look at what was done to me and my peers and name it; I want them to acknowledge that we objected while it was happening; I want them to tell us that we were right, that they were wrong, and that it should never have happened. I want someone to own what psychiatry – and psychiatrists – did to us. Instead, within a paragraph of its “apology”, the College is already looking after the psychiatrists. “This will feel like an uncomfortable and unfair criticism”, we are warned, of professionals who “dedicate their lives to helping their patients”, particularly those who “do work hard to get this right.” Harm becomes “unintentional”, caused by “what is considered best or normal practice”, lack of training or awareness, or healthcare systems and structures.

But you see, I. Don’t. Care. whether you “intended” to hurt me. Intention is not accountability. “Did you mean to harm us?” is a fundamentally different question from “Did you harm us, did you know you were harming us, and what did you do when we told you?” If it was “avoidable”, why wasn’t it avoided?

Flicking through, page by page, it’s startlingly obvious how professional innocence and need for staff safety is repeatedly preserved. Even in a document supposedly about the psychiatric harm experienced by survivors of child sexual abuse, considerable space is made for professionals’ own self-care, and potential to be harmed vicariously by hearing about our trauma. Elsewhere, clinicians faced with inadequate trauma services are described as potentially experiencing “ethical dilemmas” and “moral injury” when they can’t help but harm us. Apparently even our mistreatment requires consideration of how distressing mistreating us might be for them.

Somehow, throughout the entire document, unless they are patting themselves on the back, or comforting each other about how hard it is to harm their patients, professionals are entirely removed. Services seemingly run themselves, while patients are assessed, diagnosed, treated, detained, restrained, abused, neglected, and harmed by some nebulous, undefined power beyond the control of the profession. Psychiatrists magically appear when there is compassion, hard work, or good intention to take credit for – but when there is harm, suddenly nobody is holding the pen. Nobody in this document wants to be the person who did anything wrong.

The same instinct appears when the College approaches sexual abuse perpetrated within the mental health system itself (I say “approaches” – it generously apportions one whole sentence out of 94 pages). It tells us that it is important to acknowledge that, “even if rare”, some survivors were sexually abused within children’s mental health services. “Even if rare” is doing an extraordinary amount of work there. The harm is minimised before it has even been acknowledged. At no point does it say who is abusing the children (staff? patients?), while children confined and abused on adultpsychiatric wards disappear from the sentence entirely – their highly documented and widely shared experiences of abuse don’t even exist. Most extraordinarily, or perhaps not, nowhere is there an apology from psychiatry for the fact that children were (and still are) sexually abused within psychiatric services. Psychiatry is apparently prepared to (sort of) apologise for the harm it caused survivors of CSA, while quietly acknowledging that some of that CSA was actually perpetrated within its own institutions, by its own staff, without apologising for that. Bit too uncomfortable is it? Once again, nobody did anything. Nobody abused the children who were abused; nobody failed to protect them; nobody allowed it to happen. It just happened “within children’s mental health services”.

This is what makes the College’s repeated appeals to “lack of awareness” so difficult to stomach. Psychiatry did not discover the relationship between childhood sexual abuse and mental distress in 2026.

It has always known.

In 1857, Dr Auguste Ambroise Tardieu documented the sexual abuse of children, including abuse within families. In the nineteenth-century Salpêtrière hospital, Charcot encountered sexually abused women among those diagnosed with “hysteria”. Freud’s patients told him about childhood rape and sexual assault, and in 1896 he publicly connected childhood sexual experiences with “hysteria” and “obsessional neurosis” before taking a dramatic u-turn – subsequently (and disgustingly) relocating the origin of CSA into fantasy. Across these histories, knowledge of sexual violence repeatedly collided with theories which located pathology inside the people subjected to it; and within it all, psychiatry had the power. This was not an abstract disagreement about how best to conceptualise distress. Survivors of sexual violence were disbelieved, detained, confined, sterilised, subjected to electroshock, insulin comas, lobotomies, and other damaging and even deadly interventions. Their resistance itself often became – and still becomes – evidence of pathology. Their accounts of what had happened to them were – and still are – transformed into evidence about what was wrong with them.

The College did not officially exist when this history began, but this is part of the intellectual and institutional ground on which it was built. The College’s predecessor, the Association of Medical Officers of Asylums and Hospitals for the Insane, was founded in 1841 – right at the heart of these early academic and clinical discussions. You do not get to inherit the authority, knowledge, and professional lineage of your predecessors while becoming historically weightless when somebody asks who bears responsibility for what that profession did, hiding behind words like “normal practice”. “Normal practice” is not the fucking weather. Professions create normal practice. They teach it, publish it, defend it, reproduce it, and enforce it. If generations of survivors tell you that your “normal practice” is harming them, you cannot indefinitely call the resulting harm an unfortunate consequence of insufficient awareness. If we told you that you were hurting us and you carried on, the problem was never that you didn’t know.

I am a survivor of child sexual abuse, and sexual violence as an adult. This has been the heart of most of my interactions with mental health services for the past 14 years. Like most people with my history and presentation, I was labelled with personality disorder. I was later diagnosed with DID and trauma-related psychosis, but the harm was already done, and continues to be done. This position statement isn’t abstract for me, it’s about my life. Not only that, but my name appears twice in the citations – my own survivor testimony used to create the document. Putting aside my anger, I tried to read it with some sense of objectivity, there were some good things – DID was being recognised; psychosis was too; personality disorder appeared highly criticised; and ‘false memory syndrome’ was finally put to bed. There were things I disagreed with also, such as the conclusion that formulation was the way forward, with absolutely no consideration for how many survivors experienced formulation as exposing and unsafe. Nobody appeared to have thought about the administrative usefulness of a diagnostic label in retaining a person’s confidentiality, dignity, or sense of control. I guess none of them have ever thought about what it would be like to submit a document detailing all the ways you were sexually abused to the local council to get a blue badge, or to your university to get reasonable adjustments…“What happened to you?” sounds wonderfully humane until the resulting formulation containing your most shameful and humiliating secrets is taken from you and forced to travel through bureaucratic systems, baring your soul to anyone and everyone who works at a desk. There was also an overall sense of the statement lacking teeth. DID was recognised, but there was no statement that the College would be pushing for NICE guidelines for dissociative disorders. Despite overwhelming evidence of the link between CSA and self-harm/suicidality, the words “self-harm” were only used twice, while suicide wasn’t discussed at all – there was no guidance on how this should be approached in practice. I wondered if they had perhaps published the first draft instead of the finished document. Where was the actual change it implied it was creating? It became a bit much, I had to have a break. As angry as I was upon the first reading, it was only when I came back and read the statement again after a few weeks that I realised it was actually even worse than my first impression.

On my first reading, my eyes had been drawn to the large, brightly coloured quotations scattered throughout the document. They say the things survivors have been screaming at the mental health system for decades: “Don’t attach the sticky label of borderline personality disorder”; “The personality disorder construct is systemically harming childhood sexual abuse survivors”; “We have known about this harm for many years”; “It is time to abandon the ideas behind this diagnosis”. One contributor says that while working in a personality disorder service they realised almost every patienthad been sexually abused as a child. Another says that if you disclose childhood sexual abuse and you are a woman, you are more than likely to end up diagnosed with personality disorder. It felt extraordinary reading these in an official College position statement – no wonder I thought the College had admitted something enormous.

Then I read the document again without reading the bright boxes, and nothing happened. Remove the survivor quotations from this supposedly co-produced document and the position statement remains intact. There are no holes in its argument, no missing steps, no paragraphs rendered incomprehensible because the knowledge on which they depended has disappeared. The survivors’ words sit visually front and centre, but the institutional argument does not depend upon them.

Look at what happens when those survivor voices collide with the College’s actual words.

Survivors say the personality disorder construct is overdiagnosed, systemically harming survivors, and should be abandoned. The College says “a proportion” of survivors have been treated in personality disorder services, which “have often been the only specialised psychological services to provide long-term care for patients with complex presentations”. Patients are described as “obtaining a diagnosis of EUPD” to access that treatment – as though we wandered into a hospital and picked one up at the gift shop. When the harms they don’t want to acknowledge around personality disorder are discussed, the institutional acceptance and authority disappears, and we are left with “survivors describe”, instead of “personality disorder is harming”. The college immediately reminds us that personality disorder “remains a controversial area within psychiatry”. Then the statement explicitly pivots to tell us: “This isn’t a matter of contested concepts, disputes about labelling or diagnostic models”, before criticising NICE for allowing PD to be diagnosed without structured assessment or collateral history – as if NICE guidelines themselves do the diagnosing. Later, the statement recommends (on the basis of survivor work which I contributed to) that specialist trauma services need to be separate from personality disorder services, while also, incredibly, concluding that despite this, “a significant number of survivors may not require specialist trauma services”. (Deep sigh). The personality disorder service survives. The construct survives. So does the contradiction of knowing that the people supposedly belonging there are overwhelmingly survivors. Specialist trauma services probably aren’t even that important.

The College has found an ingenious way to borrow the radicalism of survivor testimony without adopting its conclusions. Survivors are given visual prominence while the institution retains deniability. Their words make the document look brave, while in reality, nothing new is said. In the most incredible display of cowardice, the statement even tells us that these quotations are personal perspectives which “do not necessarily represent the views of the College”. That matters. Rape Crisis, responding to the statement, praised the way survivors’ “truths are rightly front and centre”. I initially read it similarly. But, in reality, their truths are front and centre on the page. They are not front and centre in the position.

This is not what co-production means. Co-production is not writing an institutionally comfortable document and decorating it with survivors’ words in pretty boxes. If survivor knowledge has no consequence for the argument, if it can be removed without changing its meaning, and if the clearest demands can be printed in enormous coloured letters while the actual position walks straight past them, then their presence is simply stolen legitimacy for conclusions they did not produce. And perhaps that is what I find most unbearable about this statement. Psychiatry cannot say that survivors have not told it. It cannot say that the critique was unavailable. It cannot even say it failed to hear the survivors involved in producing this document. You heard them closely enough to transcribe them; you heard them closely enough to type up their words; you heard them closely enough to put them in brightly coloured boxes. And then you carried on.

But this is bigger than some brightly coloured boxes. The boxes are simply a reflection of the problem that runs through this entire statement, and through the history it refuses to acknowledge. Psychiatry knew sexually abused women had been sexually abused, and diagnosed them with hysteria anyway. Psychiatry knew what had happened to survivors while it confined them, pathologised them, sterilised them, electrocuted them, lobotomised them, and subjected them to treatments that harmed and killed them. It knew when generations of survivors told psychiatrists that their disbelief, theirdiagnoses, their restraints, their detentions, and their withdrawal of care were harming us. It knows that children have, and continue to be, sexually abused inside the institutions psychiatry itself created and controls. It knows what happens to survivors funnelled into personality disorder services, because survivors have been telling it for decades. It knows because its own 94-page statement says so. And where survivors have gone further than the College is prepared to go, it knows that too, because it has printed their words in separate boxes, and added a quiet disclaimer.

This is not a problem of awareness. You knew what was happening to us. You knew what had happened to us. You knew what you were doing to us. We told you. Other survivors told you. Your own literature told you. And still, apparently, our suffering wasn’t sufficient to make you stop.

So fuck you. You knew, you still know, and nothing in this document can convince me that you have any intention of changing anything. I don’t believe that you are sorry. I don’t think you even know what the word means.

Wren Aves

Surviving Trauma – and Being Treated Like the Problem

Text on dark street: Community Protection Warning Bad citizen antisocial mental crime s43ASBCaPA2014

If you met me in everyday life, you probably wouldn’t guess much about my past.

I work. I have hobbies. I have friends. I have interests, hopes, dreams, and the usual regrets people carry through life. On the surface, I’m just another person getting on with things.

What you can’t see is what I’ve survived.

I’m a survivor of complex childhood trauma, including child sexual abuse. I’m also autistic and live with bipolar disorder and complex PTSD. These things shape my life every day, even when they aren’t visible.

Like many people with trauma histories, I’ve spent years trying to rebuild a life while navigating systems that often struggle to understand people like me. Again and again I’ve encountered the same barriers: a lack of awareness about autism in women, a lack of understanding about trauma, and mental health services that too often fail the people who rely on them most.

The hardest part is the bitter irony at the centre of all this.

The people who abused me never faced consequences.

Yet somehow I have ended up the one being labelled as the problem.

After a suicide attempt, I received a Community Protection Warning from the police.

It’s difficult to describe what that feels like. When someone reaches the point of attempting to end their life, they are already at the edge of what they can carry. In that moment, the response you hope for from public services is care, protection, and understanding.

Instead, I was treated as though my distress itself was the issue that needed controlling.

The experience left me feeling as though surviving trauma had somehow become something I could be punished for.

Conversations I’ve had since suggests the current use of Community Protection Warnings may be a replacement for earlier “demand management” initiatives such as the High Intensity Network and Serenity Integrated Mentoring (SIM) model. Those schemes were widely criticised for criminalising people in mental health crisis.

What troubled me even more was the reasoning described in the Professional Standards Department response.

The justification for the action appeared to centre on reducing police demand and resources, rather than safeguarding someone in crisis.

A clinician involved in my care later reported a phone call with the officer responsible for the warning. During that conversation, the officer was told that the measure had caused harm and increased my risk of suicide. According to the clinician’s account, the officer indicated that this outcome was considered acceptable because it reduced police demand and was part of a wider approach rather than a decision specific to me.

Reading that was devastating.

It suggested that the harm caused wasn’t an unintended consequence. It was something that had effectively been weighed against resource pressures — and deemed acceptable.

Living with trauma and mental illness can sometimes feel like walking through the world with invisible injuries. You learn to keep it invisible. You build a life around them as best you can.

I understand more than most the reality of the funding pressures facing police. Pressures greater than NHS & social care but with less public awareness.

But being labelled now as the problem rather than a person needing help, or not even being seen as a person at all has hurt.

No one in suicidal crisis should face the threat of being criminalised for surviving.

And no system designed to protect the public should knowingly accept the risk that its actions might push someone closer to the edge

DWP Pathways to Work Green Paper Harm: My Paranoia Has Increased Dramatically

The Labour Government’s DWP Pathways to Work Green Paper is brutally damaging people’s mental health. Below is one such testimony. If you want to share yours, in confidence, please email

recoveryinthebin@gmail.com

My paranoia has increased dramatically. (Though is it really paranoia if you know they are genuinely trying to remove support from people?) I am afraid to leave the house on days when I am well enough to go out in case a DWP person photographs me or a neighbour reports me for what they wrongly perceive to be ‘fraud’. I am trying to keep my health from worsening and going outside when I’m able, especially to walk, is literally keeping me alive, but since the green paper announcement every day I am frightened to do it.

I live with intrusive images and thoughts which have increased in frequency and severity. My brain compulsively rehearses the scenarios, forcing me to live them out. 

One of the most common scenarios now involves being in the DWP office and being interrogated about intimate and embarrassing aspects of my ill health by a complete stranger then being disbelieved when I try to explain, and having all income removed, leaving me destitute. Another common scenario my brain forces me through is me being anxious, distressed or panicked at a benefits review and being mocked for it and dismissed as a liar. (I have good reason to fear the latter, an assessor once laughed at me when I tried to explain how distressed and exhausted I was feeling, and I struggled, and I found it difficult to speak.)

My brain tells me that I am being investigated for fraud, that every time I spend money I am being tracked by the DWP, trying to find reasons to remove my support and force me to try and work. My brain shows me what will happen if I try to work, that the environments and the work itself will make me more and more unwell, that I will spend all my time and energy failing to get to work or trying to get an employer to believe me about how impossible I am finding things, until eventually I collapse or die. I speak out loud more and more to myself, forced to act out these scenarios alone in my home, which is exhausting.

These images and scenarios replay and replay and replay. I have developed some strategies to try and reduce their duration, and to help myself recover afterwards, but since the green paper announcement they are getting harder and harder to manage. I have no support managing any of this because I find it so difficult to make and keep medical appointments, and whenever I’ve tried in the past nothing has really helped, and I am made to feel like a failure. This all adds to the guilt and fear I already feel about not having enough money to live and having to rely on benefits. And it worsens all my other health conditions, mental and physical: fatigue, pain, depression, anxiety.

I wish more people who have never had prolonged contact with the DWP would understand how traumatising the green paper announcement has been for so many of us. I hold no hope that politicians will do the same but perhaps if more ordinary people listen to us they will be forced to hear our voices.

DWP Pathways to Work Green Paper Harm: Substantial Risk

The Labour Government’s DWP Pathways to Work Green Paper is brutally damaging people’s mental health. Below is one such testimony. If you want to share yours, in confidence, please email

recoveryinthebin@gmail.com

Been on disability for 25 years. Was originally in the “Substantial Risk” group. I’m Limited Capability for Work Related Activity (LCWRA) and have been for a long time I also get High rate mobility Personal Independence Payment (PIP) and Standard rate care PIP, moving onto Adult Disability Payment (ADP) this month which will remain the same until I’m re assessed by Social Security Scotland (SSS) in August.

Scotland will lose almost £500 million in social security funding if the proposals go ahead and will have to make similar cuts. But there’s no clarity on that yet. I’ve been diagnosed with several Personality Disorders (PD’s), have been blacklisted by psychiatry, cannot access NHS therapy (but have had plenty in the past). The NHS knows I’ve self harmed since I was a small child. They know I think of suicide, the NHS has no interest in either of those realities. I receive support from a local charity. I have lots of physical health issues; fibromyalgia, chronic fatigue syndrome (CFS), Functional Neurological Disorder (FND), arthritis, migraine etc plenty of the “Dustbin diagnoses”. I receive no support for those either. In some ways the DWP have been more validating than the NHS.

I’m dreading my re assessment in August although it should be easier than the DWP , I’m just so tired. I don’t know if I can face it. I’m thinking about these cuts all the time, it’s always on my mind. Have invested in a large amount of first aid gear as I anticipate an increase in my self harm, which is often life threatening. It hasn’t been a big issue for a while as being finanically secure helps my mental health immensely.
If the cuts go ahead I will lose everything, I will be on £49 a week, will be expected to look for work and will be sanctioned if I don’t.

I cannot work. The DWP has said that for 25 years. I will be made destitute, homeless and there will be no way back from it as there will be no safety net.

I will be obliged to die. I’ve already bought the rope, the pills and know what to do. I’ve been researching and practising. I will have no other option. So now I’m a life clock, a suicide deadline, out of neccesity and obligation. Death will be the only option. I’ll wait till I have to, but maybe I should do it sooner and save myself a lot of stress since it’s inevitable anyway. Either way I have no choice. You can see how my head is in a loop. There is no future. I have new serious health issues I need long term treatment for but why bother? They want me dead, seems pointless to give a shit now. Why bother improving my health. I’m not going to the GP or engaging with the NHS anymore, there’s no point, I’m already dead.

DWP Pathways to Work Green Paper Harm: Living Nightmare of DWP

The Labour Government’s DWP Pathways to Work Green Paper is brutally damaging people’s mental health. Below is one such testimony. If you want to share yours, in confidence, please email

recoveryinthebin@gmail.com

I get DWP specific nightmares and insomnia waking up at 3am.

Typically my nightmares involve the police and DWP using a battering ram to break into my home at 6am, dragging me off in handcuffs because of a malicious complaint.

Or long range cameras photographing me in my kitchen, or undercover operatives in Sainsbury’s.

My most recent nightmare involved an old GP ringing me up (his voice was spot on), with DWP, insisting I had to start a mandatory work programme, being interrogated on what I do during the day and demanding to know if I could get on a bus, and if I could it would mean I would lose all entitlement.

When I woke up it took me a couple of hours to work out that this hadn’t happened. I had to look at my phone record, check to see if I had messaged anyone. Initially I still wasn’t sure, maybe I just hadn’t rung anyone yet?

It took time to sink in, it was another nightmare.

My nightmares now match my reaction to DWP envelopes – nausea, actual vomiting, lasting panic and anxiety.

An Epistle of Cruelty: Life in the parallel shadow penal state of the DWP

A still from short film 'Curve' (2021) by Tim Egan. Showing a woman on a slanting curved massive concrete structure precariously lying on the edge of a void.
Still from short film ‘Curve’ (2021) by Tim Egan

RITB admins put out a call for testimony of what life is like living whilst receiving DWP benefits. It was painfully clear that many survivors are now afraid to speak even under pseudonym. People are silenced, and they are terrified of being noticed by the State apparatus. Therefore a Content Notice on these testimonies as they include distressing detail of bureaucratic violence, harm, and distress.

The Daily Telegraph and The Jeremy Vine Show recently put out messaging that is distressingly reminiscent of Nazi propaganda. Recalling the co-ordinated media activity of the Osborne era where scrounger rhetoric was used to make harsher and lethal policies acceptable under austerity. [Please read this letter collected by Jay Watts].

The treatment and stigmatisation of claimants is similar to the vilification of refugees. We should always act intersectionally and support each others struggles, and never fall for divide and rule messaging or pitting one groups rights against another’s. Whilst citizens do not face being drowned or rendered to Rwanda, some have had their citizenship removed and been deported, fulfilling the fascist National Front of the 1970’s policy demands. Political parties win votes competing to be crueller to both. No political party represents either group in a humane way. New Labour’s Immigration Act 1999 removed recourse to public funds for people ‘subject to immigration controls‘, the slow removal of benefits from disabled people suggests a similar policy aim, but being hampered by human rights law, disability organisations, and public opinion; the famous problem of democracy Thatcher lamented to Pinochet.

We now also have a political and media campaign against Trans people, with the country’s Human Rights organisation, the Equality and Human Rights Commission, being manipulated to now support the removal of human rights, to the alarm of the United Nations. The hostile environment while acknowledged openly by government in respect of refugees is less explicit for other demographics, but nevertheless we can feel the enmity.

The recent footage of a 6am DWP & police raid and increased whipped up hatred towards claimants has deeply distressed many people:

‘Miniscule’ benefit fraud stats ‘show minister’s hostile video was shameful and disablist’

The following testimony is collated from a wide range of individuals who responded to our callout, they offer a snapshot of the impact on health of being a claimant. Of what it is like living under the parallel shadow penal state of the DWP-

  • “I cannot talk about it here. I even have the thought they might see through my alias and work out who I am and punish me”.
  • “I know that I only deserve to live if I’m employed, that’s the message”.
  • “The two most vilified groups of people in the UK for political purposes are refugees and claimants. Those groups are despised. We are subhuman”.
  • “If the Bill is passed, job centre staff will be deciding who’s fit for work with the threat of sanctions. I’m stockpiling medication, I won’t survive”.
Work coaches with no GCSEs could decide on ‘fit for work activity’, DWP admits
  • “As a too ill for employment disabled person I have survived solely on ever decreasing and hard to get so called social security for most of my adult life, spanning decades of so called welfare reforms, cuts, austerity, and recessions. Family tax credit, Job seekers allowance, Incapacity benefit, income support, disability living allowance, ESA, PIP and soon to be UC. I have a life threatening an ever growing fear of the DWP”.
  • “Disability fraud in social security is 0.2%, the media portrays it as 98%”.
  • “An assessment centre is referred to as The Kremlin”.
  • “The impact of DWP processes and their media has had a direct impact on my mental health to the degree that I would rate it worse than my illness, worse than being sectioned and forcibly medicated, worse than being stiched with no local anaesthetic, worse than surviving a suicide attempt. It has become enmeshed into my depression, paranoia, voices I hear, the feeling of being a target for anyone’s malicious reporting, feeling constantly surveilled, under house arrest.
  • “I sometimes hear my thoughts in the voice of Ian Duncan Smith and my voices blame me for being in this position. They say outside “they’re proper people,not scum like you”.
  • “If I were offered fast painless euthanasia, I would take it, to be free of living in fear”.
  • “I hate post, all envelopes, I feel sick at the sight of them and have vomited at the sight of envelopes I suspect are from the benefit offices. Sunday is the only I can breath – no post – but it means I’m afraid to leave my home to stay with family or friends because I fear receiving a letter or form which needs immediate attention. So I feel a prisoner in my home and afraid of leaving it for longer than 24 hours”.
  • “I know that the DWP have an algorithm that targets people for benefit fraud. That they can covertly use, physically surveillance, data from airlines, supermarkets, online purchases, CCTV, audio recordings and phone conversations, monitor bank accounts and social media searching photos and locations and encouraging neighbours to don claimants in…. all to try and prove people are lying. This all has a profound detrimental effect on my mental health and I’ve done nothing wrong”.
  • “I looked up how much you get for selling a kidney or a lobe of liver thinking of if after the general election and proposed Bill removing the WCA letting job centre staff decide who’s fit for work or not, i know I wont survive it. I was disappointed to learn that organs don’t sell for that much”.
  • “I tried to end my life during a DWP assessment process a few years ago which resulted in me being detained under the MHA.  One of the reasons I haven’t walked away from the iatrogenic harm that MH services cause me is because it would be even more difficult to prove I am ill and get enough benefits to survive on if did”.
  • “I used to be an activist, I did unpaid work which was valued by universities, NHS Trusts, nursing & medical schools. I also did work with fellow SUs and groups. I ceased all voluntary work in fear of that being interpreted as being fit for full-time work which unfortunately I am not.”
  • “I was never able to sustain full-time employment, and even consistent part-time work wouldn’t be viable for because every year for my entire adult life I have typically lost about 3-4 months of the year with my mental health. There are few employers who would tolerate 4 months sick leave every year. With voluntary work, it carries a different weight and stress because I know I can step down if I need to, I can space myself and plan to do it during my best months of the year. The irony is I’m more productive doing voluntary work than I am doing paid work”.
  • “Work as a health outcome and a cure has become the neorecovery norm. It’s scary! I don’t take part in any in person direct protest activism after knowing that some disabled activists were shopped to the DWP. I stay anonymous and private on social media and anon at online and in person Mad events because of the fear of DWP spying on me”.
  • “The neoliberal Government and media strategy is to portray benefit claimants as fraudsters, cheats and scroungers this makes me feel stigmatised, stereotyped and underserving. The welfare system is deliberately hostile and cruel. The Government is trying to kill off vulnerable disabled people. They cover up the deaths caused by the system”.
  • “Just filling the form out raises the depression levels. All negative questions. Some impossible to estimate how many hours in a day do u?? Then the interview process, being asked why you haven’t managed to kill yourself yet! Which made me feel even lower, a total failure!!”
  • “I was once accused of fraud when I failed to ask DWP for permission for permitted work of a few hours and for 6 weeks. Years later I got a letter telling me to attend the job centre and I had no clue why. A scary place with security guards at the door. I freaked out so bad when there that I ended up in a crisis house. I’ve never done paid involvement work since. They can even track gift vouchers which are seen by them as earnings. Volunteering can also be seen as being fit for paid work”.
  • “They ignore medical notes and evidence. They ignore the doctors, your specialist. They are only interested in failing you”.
  • “DWP was responsible for the death of my brother”.
  • “Best thing about lockdown 1 was knowing the letters had stopped. Felt as if I could live for the 1st time in years as I wasn’t exhausted by 24/7 in fear. That dread resumed as soon as we heard the letters were starting up again”.
  • ” I’m using the PIP to find private therapy because NHS was bad. You see a lot of benefit stigma as well and that’s pretty rubbish. I feel like a failure and a burden all the time and I don’t tell people usually that I’m on any sort of benefit”.
  • “I dread being asked “what do you do?”, the judgement extends to healthcare even. I avoid speaking to anyone in the supermarket, I stay indoors and take the rubbish out at night”.
  • “I know DWP want me dead, deaths are a cost saving”.
  • “I’m autistic and was in receipt of PIP. Because of how my autism presents I feel I have to be reassessed every time the tiniest thing changes, even if it’s just a fluctuation  rather than a change.  This means I’ve subjected myself to multiple reassessments  as there’s no way of just telling them about the small fluctuation without a full reassessment. The whole process has made me sick with anxiety, not knowing how long it will take, worrying about whether I’ll have to see someone face to face that doesn’t understand my condition.  In my last reassessment they took information over the phone from an unqualified member of staff that wasn’t listed as a contact on my form that didn’t give the correct full amount of information.  Calling the DWP causes me lots of stress and anxiety as I often need the toilet whilst on the phone and get stuck waiting for over an hour.  When there is no position in the queue information it can lead to a lot of uncertainty.  Even though I’ve been 100% honest in my claim i feel worried when I see cars outside that people are watching me.”
  • “The recent DWP advert stressed me out so much I ended up cancelling my claim as I couldn’t go through another reassessment. If the DWP had an online system where you could report  minor changes without the need for a full reassessment it would help to reduce the stress the whole process causes”
  • “I’ve attempted suicide, been paranoid and psychotic and detained under the MHA. I think that there is more threat to my life from the benefits system than anything else. Yet, I’ve read all my clinical notes and I don’t see the fact that the DWP has caused many mental health crises recorded anywhere”
  • “I’m due a PIP review for severe mental health issues. Last time I had a review, I didn’t sleep. I was anxious. Just filling out the form is distressing. This time, I have no supporting evidence for anything because my CMHT have barely seen me and not listened and not helped me. I’ve misplaced my crisis team summary from last time I was under them and I’m too scared to call anyone to ask for any further evidence because I’m fobbed off all the time. The PIP review has me even more anxious this time because I’m lacking the evidence.”
  • “A recent video by DWP was shared on Twitter which featured the DWP minister in a stab vest saying “ We will track you down. We will find you. We have a very particular set of skills” and showed suspects in handcuffs, doors being smashed down and wailing sirens. Watching this video sent me into what the mental health crisis team called a “psychotic episode” and led to a police welfare check and other scary things”.
  • ” I’m using the PIP to find private therapy because NHS was bad. You see a lot of benefit stigma as well and that’s pretty rubbish. I feel like a failure and a burden all the time and I don’t tell people usually that I’m on any sort of benefit”
  • “I’m constantly paranoid my benefits will be stopped. I get very specfic delusions when real bad it becomes part of my paranoia that I’m being watched”.
The ‘Still Face’ Paradigm and the Department for Work and Pensions
  • “I think it’s the division that has been sowed by the media, the manipulation of data to present a point of view that stigmatises people”
  • “They don’t like it if you’re on alternative medication and penalise you if you’re not what they consider a high enough dose. It’s like they want you numbed and overdosed. They don’t allow for fluctuations of the conditions”.
  • “Last summer had interview for 4 hrs work which would have been a big challenge but a +ve step for me & I was likely to get the job but I pulled out due to fear of impact on benefits & being reassessed as fit for work just because of doing 4 hrs/week”.
  • “I live in constant fear of assessment & struggle to do new things worrying how they will twist it so they don’t have to give me the benefits I need to live”.
  • “I just exist, waiting for the gestapo to push me to suicide, no hope nothing”.
  • “The process is humiliating and 3.5 hr phone assessment was horrendous, nearly killed me and got to go through it all again in a few months, not even been two years yet”.
  • “If you have a pain condition you’re caught in a particularly Kafkaesque trap because doctors don’t want to prescribe opioids any more but if you’re not on them the DWP don’t believe you have chronic pain”.
  • “The benefits system, especially disability benefits system, is a special kind of hell on earth designed to make us feel subhuman, which is what most people think we are”.
  • “I literally can’t have a romantic partner because I’ll never be allowed to move in with them without losing all my benefits. My condition (ME/CFS with hEDS) is incurable so I will be alone for the rest of my life because of DWP policy”.
  • “Friends & family talk all time about ppl they know who are “fiddling” their disability benefits because “ you can see they aren’t really ill”, they always follow up with “not you, we don’t mean you” & I have to decide again whether to have another rant about invisible illnesses”.
  • “Am not on benefits anymore but I can still feel that fear. The recent video from the DWP brought it all back. The feeling of being watched, never knowing who or when. Being told by a support worker that I was worrying over nothing. Feeling like a fraud and doubting myself all the time. It was exhausting”.

Journal of Social Policy: In-work Universal Credit: Claimant Experiences of Conditionality Mismatches and Counterproductive Benefit Sanctions Published online by Cambridge University Press: 01 December 2020

I’ve been made to feel like a pariah for so long now it has entered my DNA

Despite being on benefits all my life, I still feel hounded by the department. There have been times in my life and I’ve been frightened to leave the house in case somebody anybody reports me for being able to breathe and walk brackets (not that the walking part is a problem anymore )

In 2014, I was I was chosen to carry the Commonwealth torch as part of the games  in Glasgow.  I was nominated for my services to the community in a voluntary capacity. After much paranoia and anxious I decided not to  participate as I was terrified that somebody might to decide to interview me, film  me and upload my details and then I will be reported to the DWP for those very same services to the community.

 I’ve done various bits of voluntary work since I moved to Scotland in 2010. I’ve never told to the DWP. Due to the fear of them thinking this means I’m fit for a 37hr week. Instead I’ve taken the risk of flying under the radar and constantly worrying something I was going to get found out prosecuted for fraud and jailed .  

My peer support worker expenses used to get paid every three months by cheque. It wasn’t a huge amount of money but I had to put it through my bank account and  worried constantly  the DWP would access my account and find me out. I could probably have told them that I was volunteering still remained in receipt of benefits but I wasn’t prepared to take that risk. I also used to lecture in a paid capacity from time to time but couldn’t risk this  and most universities don’t have an alternate way of paying somebody on benefits…

Paranoia of  the dreaded brown envelopes is always there  but especially heightened when you are waiting for a decision on  a new claim or review  . Recently I have a pip review which took 10 months from start to final decision. Every day I dreaded the post only Sunday was a respite They also started to play stupid bastardised and sometimes use white envelopes so nothing was safe! . . You can never rest  because they keep moving the goal posts so any sense of stability is lost..

I was offered , a paid role as a support worker but it was part time and I was terrified about dealing with the DWP. How pomfret would it take for them to sort out a new claim with the daily envelope waiting again.. What if I became unwell again and had to stop working? Would I be believed? What if they dithered over my clam and didn’t pay my rent? Would I become homeless again? I couldn’t cope with that.Best not to rock the already precarious boat!

I often feel wrong in accessing leisure activities as  There is always that feeling I can’t really be that sick if I can go the cinema. Sick people have to be sick all of the time or not at all. that’s how the bastards make you feel. Maybe I’d be spotted having a good time.

The mental health system is set up to make you feel less than, a burden, at it! And if you have a PD  label forget being taken seriously. I have a history of chronic addictions which are often seen as self inflicted and the DWP compounds these internalised briefs. Oh and forget being a single mother: I once had all my disability benefits stopped when I returned home after a 5 month hospital stay with my baby daughter. Apparently motherhood means cured. 

When people ask me what I do that seems like an admission of failure to say I’m “just” on benefits. My worth is apparently based  on my capacity as an earner, a financial contributor. Now I’m  wheelchair bound it’s easier because it’s obvious something is wrong but I spent decades worrying that I wasn’t that ill and that everyone knew it! Or that my obvious problems with alcohol and drugs were seen as self inflicted and a drain on the state. I still limit who gets to know that part of me.,

I’ve asked for increases in medication purely for evidence of not being recovered. I have continued to take high doses medication. I’ve  totally lost track of whether I need it or not but it looks good for the DWP. 

Dealing the with the DWP exhausting and brings up all the feelings of basically not being good enough. Less than, a burden, a non entity. I’m finding doing this for RITB extremely triggering and I know there’s no threat. But what if a binner thinks I’m a fake and have just conned everyone for the past 40years? What if I’ve conned myself? I’ve been made to feel like a pariah for so long now it has entered my DNA.

Further Reading: Deaths by Welfare Project

Deaths by Welfare Project

It was clapping for the NHS that made me realise I had trauma

dark image with light making a silhouette of a face in profile. Photo by Engin Akyurt: https://www.pexels.com/photo/silhouette-photo-of-woman-1446948/

I think it was clapping for the NHS that made me realise I had trauma.

In hindsight of course I knew that what I’d been through was traumatic but I also minimised it, the memories were blurry, and the real stonker – it saved my life therefore I wasn’t allowed to wish it hadn’t happened, that would be wishing I was dead.

That’s the thing about mental health services and sections, they operate crudely, bluntly, they come in too late and too harshly but, by the skin of their teeth, they sometimes just about manage to do the job to the bare minimum standard and because of that remain just out of reach for the full force of a survivor’s anger. 

Or that’s how it is for me.

I care deeply about the provision of free-at-point-of-use healthcare, I would never want my critiques out of context to detract from that and I most certainly don’t see the rise in private day patient programmes as the solution.

Two of the leading of these private services are lead by the two psychiatrists I’m talking about.

I was in and out of hospital for a few years age 16-21 but it’s the final, adult admission that was so much worse than any other. The hospital had a reputation, I knew before I went in that it would be better to be literally anywhere else, but illness and geography meant I didn’t have a choice. 

As soon as I was admitted I begged to be transferred but patient choice was long ago thrown out the window for a sectioned psychiatric patient. It wasn’t until I read my notes years later that I really understood CCG’s and the funding backdrop.

Anosognosia is a key symptom of anorexia. You can see your weight going down, your intake going down, your behaviours damaging your relationships, life falling apart before your eyes and your mood plummeting, any rationality blurring and fragmenting and yet somehow believe that it’s not that big a deal, other people are making it a big deal, you will change, you can sort it out, if only you can find the right brand of yoghurt, if only it can be fixed by having an additional chocolate bar and slice of toast.

“I don’t need to be inpatient, just give me another change, I increased my meal plan by 100 kcal, I am better off at home” she says, weighing something ridiculous (I’m not going to say my weight, but if someone reading this is going to trigger themselves I’m sure they already know what a sectionable weight means). 

So yes I was a risk to myself, had no insight or understanding of the risks of starvation and wasn’t going to consent to medical monitoring or take the action required to stabilise my risk. In the face of that, psychiatry, as well as my mother, contend that “for your own good” you need to be in hospital.

To this day I have no idea how to feel about this? Would I have died? Would I have found my own way through? Who would I be today if what happened next hadn’t had to happen? What would it mean to me if what happened didn’t have to happen, I guess I tell myself it had to be this way because of how painful it is to imagine a world that’s not so cruel. 

Where hospitals places of care and restoration, nurturance and healing and not lunatic asylums by any other name, an extension of a carceral system, a place to lock away the undesirables, to delineate madness from sanity, to punish those who don’t conform and who scare the rest of them.

Anyway, I remember how scared I was when I realised the ward was locked. That I, specifically, was locked on the ward. That legally I was not allowed to leave. Legally I had no agency anymore. I was clinically determined unable to make decisions about my care, I was a risk to myself and couldn’t be trusted.

Other patients, voluntary admissions, could in theory leave, but in practice we were now all locked into this corridor of 20 beds, a meeting room, two dining rooms, two bathrooms, a kitchen and a central sofa and tv, seemingly sitting in the middle of the corridor but theoretically a communal space where we had to eat evening snack infront of a cooking show in the vortex of what happens when all the anorexias form a force field around which we orbited, getting closer and closer to that food-obsessed centrifuge.

The days were bleak. Usually waiting on tenderhooks to argue with a psychiatrist or dietician about how terrifying treatment was, how uninvolved in care planning we were, having to make desperate pleas and pitches to ward round to have leave requests or meal plans discussed and, when they did show up which they seemed to schedule with casual contempt for “I’ll see you tomorrow” agreements, hours or days later to be told you had less leave than you’d asked for, no meal plan change allowed, sorry we know best, sorry you can’t cope I guess you’ll just have to keep not coping whilst also not being allowed any freedom or social contact that might give you the means and strength to carry on, oh you’re jogging in your room now? Why would you do that? You must be causing trouble, not complying, do you want to be here forever? If you keep doing that you won’t get any leave at all.

You see, despite being sectioned on the basis of having no capacity to understand your own risk and behaviour, you are now going to be scolded, castigated, bullied, punished and have it held over you that you engage in behaviours that aren’t “helpful” or conducive to the goals we’ve set for you (“recovery”) or the goals you’ve set yourself (getting the fuck out of here asap).

Most of the trauma was in that contempt: 

Being held down to be nasogastrically fed and whilst a nurse sneered “what did you think would happen”. 

The transgression: I didn’t butter my toast and believed the feed would just constitute the calories of the butter, not the whole meal.

Being laughed at when I insisted not eating animals was a moral tenet and not a restrictive one – the implication, barely concealed, that an “anorexic” having ethics was risible. 

I was broken by the stripping away of any identity, any interests, anything I had found my self worth in being dismissed as “illness”, any assertiveness about who I was and what mattered was obviously “the illness talking” and “now is not really the time to care about that, you don’t have those choices”.

The euphemisms in my notes state “had to be constantly reminded to sit down, which she refused to do until further staff intervention” – my memory tells me this involves being pushed into a chair, held down, sat on.

The most visceral memory: kicking and screaming and being held down by 4 nurses whilst a 5th passed an NG tube. Pleading to be allowed to just drink the fucking supplement, that it should be offered to me for drinking and being restrained instead.

In a sickening, disorientating disappointment, when I got the stack of notes from the 9 months I spent in this hospital, this incident wasn’t mentioned. 

I was sure restraints would be documented by my guess is that a bit of  “manhandling” – pushing young emaciated women around – wasn’t classed as restraint.

Then there was the vicarious trauma of hearing everyone else’s cries, the woman who fought back and got taken to the general psychiatric ward “until you’ve calmed down”, the women who were in and out of that ward every few months, the woman who had been there for a few years, the woman who died on leave and being told that it wasn’t really our business to be furious with the psychiatrists for not protecting her, or maybe contributing to making her life unliveable.

I was given therapy whilst on the ward, 14 sessions documented in great detail in my notes by a therapist whose stance confounds me. She found me, “defiant… confrontational…challenging…hostile…resentful…attacking… aggressive…. defensive…aloof…contemptuous”. 

It didn’t seem to occur to her that the walls I put up protected me from the contempt of the staff, the disempowerment of the ward, the endless torture of having to face your greatest fear 6 times a day, deal with your mental illness and intrustive thoughts in every gap, be scolded for being ill in the place that is supposed to be knowledgeable about your illness, that you might, I don’t know, maybe be a bit cross about it all? 

When I expressed distress about being on the ward, anger towards staff or other patients she encouraged me to get to know them or to take part in groups. She couldn’t hold space for me to process what was happening to or around me. And when I picked this up and didn’t bring it up again, she noted our relationship was improving. 

The final therapy session before I discharged myself I cried “like a very small child” about being granted less leave than I had requested, I felt “insulted and humiliated”. I cried the tears of a trapped, lost, desperate, dehumanised, humiliated, lonely young adult, and she asked me if I was not crying as I cried as a child when my mother left me to go to work.

It made me laugh that that was the last interaction we had. As if she hadn’t heard of Ockhams razor. Or the cigar that was in fact a cigar. I was crying because the hospital was a hellhole and I knew I was not getting or going to get better. Because I knew I was leaving more “’damaged” than I entered.

My belief is that in a state of malnutrition, a physiological famine trauma, whatever the cause, our nervous systems and limbic brain is picking up information in a primitive way. We absorb relational trauma in a similar way to childhood trauma because we are regressed to our basic survival functions as we were then. When we are met with harshness we don’t need to have had a neglectful caregiver to begin to demonstrate signs of neglect and abuse. 

I have had to spend so long arguing that I don’t have causative trauma preceding my anorexia. I have trauma caused BY the anorexia, and more so its treatment that happened to save my life and caused the refeeding syndrome it was meant to protect me from, that managed to end the revolving door and be my final admission.

By making the experience so awful that I discharged myself from inpatients and then outpatients and then when I relapsed never sought help and put my family through so much having to cope with me on their own as we muddled through it until I galvanised myself to address this independently. 

Sometimes when I see eating disorder campaigns calling for better access to services it makes me so sad and angry, I don’t want more people to go through what I did. We need life saving interventions and anyone who needs their life saved, at whatever weight or stage these illnesses have made their lives unbearable.

But until services are not premised on a punitive ethos, to negatively condition anorexia sufferers out of the illness, I want to urge people to be careful what you wish for. Despite the layers of denial and the cognitive impairments to insight, we do know the illness no longer protects us from pain and instead causes it, we don’t need a hospitalisation driven by the desire to tell us “look where your silly little thin-fixation leads you, let this be a lesson not to lose too much weight”.

No amount of awareness raising seems to have changed the underlying assumption that madness = badness.

I feel like I should be caveating what I write with an endless stream of self-awareness. I know that I was distressed, anosognosic, rude, loud, difficult, non-compliant, disruptive, violent, symptomatic and in danger. I know that these interventions were in response to that and yet I still found them traumatising. I am not writing to present a solution – I don’t know what could or should have been done instead within the constraints on the system and the situation – my visioning for a future ideal would be a completely different system from the ground up.

The prevailing paradigm in mental health is punishment – giving the excuse as “institutionalisation”, the aim of eating disorder wards is to be so awful you keep yourself well enough to stay out. Despite many people requiring repeated admissions, the paradigm remains the same and staff admonish you get “get out and stay out”. 

This is somewhat effective, I had three admissions, my third being the most horrific and that experience did motivate me to “stay out” although it meant I was left unwell and without support, too afraid and hurt to engage with services but unable to take care of myself.

It’s not overwork or bad apples that make staff cruel – of course most staff are exhausted and underpaid and some get into the job because they like power over vulnerable people, but that focus distracts from the fact that institutions are set up to dehumanise mad people, a strange mix of infantilisation (you don’t know what’s good for you, I have the power) and chastisement (why are you doing that?). You are non-compliant, resistant, you need to be trained to not get attention for your bad behaviour.

Something has to overcome the cognitive dissonance of a person sectioned, and therefore deemed not to have decision making capacity due to illness, who is then castigated for behaviours (symptoms) and treated as attention seeking, troublesome, wilfully sick, who thinks she’s special, who should take responsibility

It seems that some of this comes from not understanding mental illness, even well meaning staff ask “why are you doing this to yourself”, “why don’t you want to comply and get out” as if they don’t understand the reason people are on the ward.

Alongside punishment, or a sub-category of it, is coercion and threat, most admissions are forced or coerced, wards are locked (I don’t know why I was surprised but realising the ward was locked was a horrible shock to me) and compliance is gained with threat of worse treatment. On an eating disorders ward the ultimate threat for distress was transfer to the general psychiatric ward which occasionally patients would disappear to for 24 hours to be sedated.

Units are protected by invisibility, although OTs, dieticians, social workers and psychotherapy came onto the ward, the team was permanent and complicit. No external professionals were coming in or asking questions. Psychotherapy was particularly complicit – criticisms of the ward were psychoanalysed away from their material reality – I was told I should “get to know” other patients, “find things in common” and “get involved in activities” when I told of bullying, abuse, screams of distress, competition and loneliness. An episode of extreme distress at not being granted leave or given reasons was related to “not getting what you want” and she asked “is this like when your mum left you to go to work”.

Dehumanising patients also involved mocking us – for me my veganism was mocked (although veganism presents a conundrum in eating disorder services, and should be examined and possibly challenged, laughing at someone telling you they care about animals as if it’s not possible to have both ethics and anorexia, as if every belief is a symptom is mocking and cruel) as well as compulsive exercise (yes watching someone jog on the spot and then try to avoid detection is humourously pathetic, I know it’s a bleakly funny sight, but laughing outright at a persons distressed compulsions is also cruel).

Diet culture is endemic in ED services and a lot of comments showing anti-fat bias get made – whether about gaining “too much too fast”, determining a maintenance plan at a conservative BMI, telling patients they “won’t get fat” and so on. 

I’m going round in circles here but to reiterate – dehumanising patients looked like, being mocked, being threatened (with transfer, section, tube feeding, restraint, losing leave), being endlessly reminded I was on a section and my consent was not required for tube feeding, being excluded from care planning and having unreliable, irregular meetings with the psychiatrist, being manhandled (although I remember being restrained, this remains completely undocumented in my notes. I can only conclude that it didn’t need to be written down as it wasn’t a formal restraint, just the pushing around and holding down an underweight young women who didn’t require much force to be overpowered), being shown a lack of compassion or any acknowledgement that my behaviours were a symptom and not a conscious choice or measure of my character.

A word to finish on nursing observations, 1:1 observations, on the toilet, in the shower – where your showers are timed for being too long, your bowel habits are commented on and, with new policy, nurses will wear body cams – is humiliating. It is predicated on humiliation because if you do exercise or purge whilst being observed you will either just be told “don’t do that” or restrained but mainly the threat is that if you do behaviours you won’t come off observations so the primary threat is the continuation of the humiliation and the admission and lack of leave, independence or autonomy. At no point is recovery or wellbeing mentioned.

It’s incredibly painful to speak about what happens on these locked wards. I was ill and vulnerable and left the hospital more ill and more vulnerable, at a higher weight but traumatised.

Because of this “access to services” is not what I want Beat to be asking for; services need to be transformed. I also don’t want “Accommodations for autistic patients” or any other small accommodations that make treatment less worse, not least because these won’t be applied because no one wants to make the experience less traumatising in case patients “like it” and “feel safe and cared for” and become “institutionalised”. I think this is more or less a straw man, most people want their liberty, most people who prefer hospital to independence is because of how bad life is outside not how great hospital is inside. Of course both repeated/long term admissions and proper supported living would make you a “drain on the state”, hence the system we have now. Until the idea that treatment must be horrible to prevent relapse, rather than effective is shaken then I cannot bring myself to ask for crumbs.

I believe many suicides attributed to the illness are a response to the “treatment”. Facing your worst fear 6 times a day every day under threat and coercion with little support or compassion, possibly brutally with restraint and tubes – not wanting to live whilst experiencing that every day? Yeah, I felt like that too.

It’s not much use saving someone’s life if they leave with so much trauma they don’t want to live it 

I can’t remember where I found this quote but it was written: “The treatment of AN, the violence, the behaviour modification, EDUs, who services decide to let die or forced to live”.

A section and enforced inpatient stay including force-feeding with a naso-gastric tube did in fact save my life. I am ambivalent about that. I am not uncomplicatedly grateful. I will criticise the clinicians, the institution and the system. I am still here.

I am actually now a therapist and that just makes me more critical, I can understand why decisions are made and things are said because I know the prevailing beliefs both psychoanalytically and psychiatrically and institutionally in the NHS. None of this makes it OK.

I don’t actually want to see a world where no one has anorexia, it’s an illness that is like 80% genetic in cause and has been around and documented for many hundreds of years and possibly has always been within human genetic diversity. Arguing for eliminating it would be eugenicist. I want us to be held, supported, fed and allowed to explore a meaningful life without being subjected to violence and correction.

I don’t want to see my experiences “formulated” – the diagnosis of anorexia nervosa is very accurate for me, it describes most of the compulsions, fears and delusions I experience accurately, when I experience them very intensely I say “I don’t feel well” because I see them as symptoms of a chronic illness, I do not agree that “madness is a sane response to an insane world” in my life – I have a brain that was predisposed to, and then developed, an incredibly strong fear or food. 

It’s kind of just bad luck, but it’s also who I am so I don’t see it firmly as good/bad although it certainly makes my life quite difficult, now I live with it and manage the trauma I endured in its “treatment”.

#StopSIM Coalition Consenseus Statement

StopSIM Coalition Consensus Statement relating to The High Intensity Network (HIN) and Serenity Integrating Mentoring (SIM), 21/04/21

We are a coalition of mental health service users and allies who have grave concerns about the rapid, widespread rollout of the High Intensity Network’s ‘Serenity Integrated Mentoring’ (SIM) intervention across NHS England. The intervention is designed for people who have not committed a crime, but are in contact with mental health services, are frequently at high risk of suicide and self harm and are deemed “high intensity users” of emergency services.  Key intervention components include a co-ordinated withholding of potentially life saving treatment by multiple agencies (A&E, mental health, ambulance and police services) and, using SIM’s own words, the “coercive” approach of a police officer as an interventionist.  

We call on NHS England to:

  1. Halt the rollout and delivery of SIM with immediate effect, as well as interventions operating under a different name, which are associated with the High Intensity Network (HIN).
  2. Conduct an independent review and evaluation of SIM in regards to its evidence base, safety, legality, ethics, governance and acceptability to service users.
  3. Respond to this statement within 7 days to communicate the actions taken by NHS England. Communications should be directed to contact@stopsim.co.uk. 

Our concerns about SIM relate to its evidence, legality (including GDPR, Human Rights and Safeguarding), aims, governance and ethics. Interventions or service models operating using SIM principles may be known by alternative names, however, for brevity, this statement equally applies to those services, interventions and models.

This is a preliminary consensus statement. We have been researching SIM and the HIN for a number of weeks in preparation for the release of a detailed and referenced statement.  However, we are releasing this brief statement since becoming aware that, due to the hard and concerted effort of service users, survivors and allies over many weeks – and in some instances, years – that high level conversations have been prompted.  We felt it was critical to make our position public as soon as possible. A longer version of this statement, with citations, is shortly forthcoming.

We expect to be involved in any high level conversations concerning the High Intensity Network and SIM as a coalition of service users and allies.  We can be contacted by email at contact@stopsim.co.uk or via Twitter DM: @StopSIMMH. We will be publishing further updates on our Twitter account.  

In solidarity with survivors, service users and allies who have worked tirelessly to shine a light on injustice,

The #StopSim Coalition

Copied to:
Sir Simon Stevens, CEO – NHS England Lord David Prior, Chair – NHS England, Claire Murdoch, National Mental Health Director – NHS England, Martin Hewitt, Chair – National Police Chiefs’ Council, Sir Tom Winsor, Her Majesty’s Inspectorate of Constabulary and Fire and Rescue Service.

I am now unable to talk freely about my mental health as I fear arrest

This account of my experience is purposely anonymised because I am not ready for those in my life to know the pain that mental health services and police have put me through. This began during a difficult period of my life in which I was the victim of physical, sexual, emotional and financial abuse in a relationship that I truly believed was impossible to leave safely. I had been under mental health services for most of my life not by choice and had made a lot of progress. Without being too graphic, the abuse started almost instantaneously and I was kept in line with the threat of harm to himself and me. He controlled me and he ran my life for nearly six months during which I attempted suicide a number of times. The police had a lot of involvement in my life at this point, every time I survived, I became more determined that I was the plague on this earth and that ending my existence would solve all the problems we see throughout society. I had graphic nightmares in which I survived and had to watch those around me be tortured and murdered and struggled immensely with trauma symptoms. 

My suicide attempts have been labelled as ‘a cry for help’ when in reality, every time I was saved, I thought I could feel someone else die as a result of my ‘failure’. At the time I wasn’t told about this but my local team and police force made a ‘crisis plan’ detailing how to ‘deal’ with me in a crisis and avoid ‘reinforcing’ what they believe to be attention seeking behaviours. This plan was in place for four months before I was made aware it existed and I was not shown a copy of this plan I had supposedly agreed to until two months after this. Six months in total.

The plan states that if I am found in public in a crisis situation, I am to be taken to hospital for a capacity assessment. If I am deemed to have capacity the officers involved must arrest me for any offence that they feel appropriate. 

When I was told about this plan the explicit instructions I was given were “to not commit suicide in a public environment”. I was also told that I could “do what I wanted in my personal space” AKA I can take my own life as long as it does not inconvenience any other people.

This plan has destroyed my faith in mental health and police services and has meant I am now unable to talk freely about my mental health as I fear arrest if I am honest with how I feel. I also know that I can’t risk surviving future crises and I am sure that if I was to get into such a desperate situation again, I would not walk it off. 

Mental health services are designed to treat a very specific range of presentations. As soon as you fall either side of their ‘worthy of treatment’ parameters you become a disposable commodity like I and so many others have. Knowing that those who should care have no desire to work with you is the total opposite of help. I was in a vulnerable situation and those meant to help me turned their backs leaving me in dangerous and damaging situations because of how they perceive my suffering. 

I am not a criminal. 

I am a survivor and I will not stay quiet any longer.

The Crime of wanting to die, my story from Scotland

For the past two years I had hid my shame and embarrassment. I felt like I was to blame, even though I was the victim. I was told I was to criticize, and it was my choice; my choice to be arrested and my choice to die.

My crime? I tried to kill myself, believe it or not, dying is hard, so I was slow, and I was able to be saved for better or for worst.

In 2018-19 I found myself miserable and just wanted to die, I was expiring the consequences of another person actions against me, I was expensing the symptoms of PTSD or C-PTSD. I did not see a way forward, life felt so painful, and I felt that my death was the only way forward.

I had just been discharged from my first hospital stays in a psychiatric unit. I was just kicked to the curb I had not been told what would be happening, I was told to go home in to the community with no preparation or help. Just after an admission is a time that the NHS have admitted increases rise of death though suicide. I felt so loss and hopeless, I stupidly publicity tried to kill myself, I regret it now, the police took me to the ED, and I was told “I had capacity” after the nurse talked to the police who voiced their concerns and the mental health team told them I was not feeling real depression and the trauma in my life was fictitious. How does one have capacity when I had actively tried so hard to be dead.

The police were left without much of a choice and arrested me. What choice did the police have when I was dead set on killing myself.

Believe it or not, being arrested when you did nothing wrong was traumatizing. Every day I carry the burden of my arrests and I feel my skin crawl with every mild flash back. I went through the normal booking routine, and I was informed that they did it to try and force the hand of mental health services into helping me and that I would most likely be out the next day. I complied with the whole booking proceed, and I was dumped in a concrete cold cell in a paper dress. My mug shot was taken and fingerprints. The police admitted I was mentally unwell and added several comments about how poor the local mental health hospital is, lack of bed and constantly having missing patients (over 200 patients reported missing in just 2 years). I was let go after 14 hours with not even a mark against my name.

This arrest just catapulted my problem and I spun out of control. I felt like I was marked with another label, the label of a criminal. I keep repeating in my head that I should have competed the suicide. That marked my second attempt to end my life and acted as catalyst for my year of hell.

Imagen being abandoned by the NHS at the start of your mental health journey, forced to live though the forced unparalleled consequences of actions that everyone saw as mental illness. A custody cell and under trained police officers is not equal to mental health support. Custody cells should not be used as an extension of the mental heathy system, they are not a resort to be use in times of mental health crisis. Police can not deal with people like me, I, by their own admission had committed no crime. The crime that they did arrest me with was a ‘breach of the peace’, an arrestable offence in Scotland

I find myself here today. Nothing has really changed; police are still being used as an extension of the mental health services without any of the training that come with it. Why should a health emergency be treated the same why as a criminal matter? Why is this acceptable?

How is locking someone up in a custody cell a punishment for trying to end one’s life? Why does someone need to be ‘punished’ for a mental health emergency.

If the NHS trust continues to view the police as a first responder for a mental health crisis, they should be open and honest about their use with the NHS mental health system.

Why did the NHS allow an 18-year girl to be locked up because of a lack of mental health services?