Talk given at the RCN's International Conference for Psychiatric Nursing on mental health reform. The talk describes the ethical challenge facing nurses as government policy both undermines mental health and avoids the need for meaningful reform. Can nurses work with people to bring about the necessary changes?
Slides for WAAMH on elements of a reformed mental health system. An exploration of practical innovations - self-directed support, WomenCentre and PFG's peer support system. The presentation goes on to consider the challenges of social justice and system change in mental health.
Logically personalisation and mental health are in perfect harmony - the fact that progress is so slow reflects deep imbalances of power, control and perception.
The Inter-Agency Standing Committee (IASC) is the primary mechanism for inter-agency coordination of humanitarian assistance. It is a unique forum involving the key UN and non-UN humanitarian partners.
Presentation by Hunter Institute of Mental Health Projects Coordinator Ellen Newman for Thrive 2016, weaving wellness and wellbeing conference. This presentation is about mental health literacy and strategies for supporting children’s mental health and wellbeing.
Slides for WAAMH on elements of a reformed mental health system. An exploration of practical innovations - self-directed support, WomenCentre and PFG's peer support system. The presentation goes on to consider the challenges of social justice and system change in mental health.
Logically personalisation and mental health are in perfect harmony - the fact that progress is so slow reflects deep imbalances of power, control and perception.
The Inter-Agency Standing Committee (IASC) is the primary mechanism for inter-agency coordination of humanitarian assistance. It is a unique forum involving the key UN and non-UN humanitarian partners.
Presentation by Hunter Institute of Mental Health Projects Coordinator Ellen Newman for Thrive 2016, weaving wellness and wellbeing conference. This presentation is about mental health literacy and strategies for supporting children’s mental health and wellbeing.
This workshop was presented at the Queensland Mining Industry Health and Safety Conference 2014 and presents progress on the Working Well Program and ways to support mental health in the workplace.
Speaker session 3
• Speaker 3: Professor Suzanne Moffatt, Senior Lecturer in Social Gerontology, Newcastle University
Title ‘The impact of income maximisation on health: findings from the Do-Well Study’
Health Equity for Immigrants and Refugees: Driving Policy ActionWellesley Institute
This presentation discusses health equity for immigrants and refugees.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
Presentation of current evidence for promotion of mental wellbeing and prevention of mental disorders. The presentation argues for moving from research to action, using the mental health in all policies approach.
Men and women feel differently about the trials and tribulations in their life. These feelings manifest themselves into pyschosocial disorders such as drinking and suicides for men while women tend to cope better through social interaction. So how can men find ways to avoid the stigma and seek the help and support they need to work and live productive lives?
Despite the enormous burden that mental ill-health imposes on individuals, their families, society, health systems and the economy, mental health care remains a neglected area of health policy in too many countries. Mental disorders represent a considerable disease burden, and have a significant impact on the lives of the OECD population, and account for considerable direct and indirect costs. This report argues that even in those OECD countries with a long history of deinstitutionalisation, there is still a long way to go to make community-based mental health care that achieves good outcomes for people with severe mental illness a reality. The disproportionate focus on severe mental illness has meant that mild-to-moderate mental illnesses, which makes up the largest burden of disease, have remained overwhelmingly neglected. This book addresses the high cost of mental illness, weaknesses and innovative developments in the organisation of care, changes and future directions for the mental health workforce, the need to develop better indicators for mental health care and quality, and tools for better governance of the mental health system. The high burden of mental ill health and the accompanying costs in terms of reduced quality of life, loss of productivity, and premature mortality, mean that making mental health count for all OECD countries is a priority.
Building the capacity of family day care educators to engage in mental health promotion, encouraging children to flourish. Presented by Hunter Institute of Mental Health Projects Coordinator, Ellen Newman.
Most managers hiring or supervising staff have little or no understanding of mental health and psychosocial disorders in the workplace. everyone is wired differently to learn, work, understand and comprehend, and engage in social settings. Some business activities require high levels of customer service while others are more research oriented and require less human interaction. There are many other issues related to mental health diseases and their controls prior to hiring and there are workplace stressors that can create anxiety and depression over time because of the nature of the work. How do managers and business owners deal with these situations and more importantly, how it is impacting the quality and quantity of work done. How do these issues impact the brand, reputation and image of the company? Learn more about this very important issue that most people don't want to talk about.
Being a true equal: citizenship, mental health & the welfare stateCitizen Network
Simon Duffy explores the value of citizenship in reforming the welfare state and improving mental health. This talk was given at the Viscerv Conference 2016 in Melbourne.
This workshop was presented at the Queensland Mining Industry Health and Safety Conference 2014 and presents progress on the Working Well Program and ways to support mental health in the workplace.
Speaker session 3
• Speaker 3: Professor Suzanne Moffatt, Senior Lecturer in Social Gerontology, Newcastle University
Title ‘The impact of income maximisation on health: findings from the Do-Well Study’
Health Equity for Immigrants and Refugees: Driving Policy ActionWellesley Institute
This presentation discusses health equity for immigrants and refugees.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
Presentation of current evidence for promotion of mental wellbeing and prevention of mental disorders. The presentation argues for moving from research to action, using the mental health in all policies approach.
Men and women feel differently about the trials and tribulations in their life. These feelings manifest themselves into pyschosocial disorders such as drinking and suicides for men while women tend to cope better through social interaction. So how can men find ways to avoid the stigma and seek the help and support they need to work and live productive lives?
Despite the enormous burden that mental ill-health imposes on individuals, their families, society, health systems and the economy, mental health care remains a neglected area of health policy in too many countries. Mental disorders represent a considerable disease burden, and have a significant impact on the lives of the OECD population, and account for considerable direct and indirect costs. This report argues that even in those OECD countries with a long history of deinstitutionalisation, there is still a long way to go to make community-based mental health care that achieves good outcomes for people with severe mental illness a reality. The disproportionate focus on severe mental illness has meant that mild-to-moderate mental illnesses, which makes up the largest burden of disease, have remained overwhelmingly neglected. This book addresses the high cost of mental illness, weaknesses and innovative developments in the organisation of care, changes and future directions for the mental health workforce, the need to develop better indicators for mental health care and quality, and tools for better governance of the mental health system. The high burden of mental ill health and the accompanying costs in terms of reduced quality of life, loss of productivity, and premature mortality, mean that making mental health count for all OECD countries is a priority.
Building the capacity of family day care educators to engage in mental health promotion, encouraging children to flourish. Presented by Hunter Institute of Mental Health Projects Coordinator, Ellen Newman.
Most managers hiring or supervising staff have little or no understanding of mental health and psychosocial disorders in the workplace. everyone is wired differently to learn, work, understand and comprehend, and engage in social settings. Some business activities require high levels of customer service while others are more research oriented and require less human interaction. There are many other issues related to mental health diseases and their controls prior to hiring and there are workplace stressors that can create anxiety and depression over time because of the nature of the work. How do managers and business owners deal with these situations and more importantly, how it is impacting the quality and quantity of work done. How do these issues impact the brand, reputation and image of the company? Learn more about this very important issue that most people don't want to talk about.
Being a true equal: citizenship, mental health & the welfare stateCitizen Network
Simon Duffy explores the value of citizenship in reforming the welfare state and improving mental health. This talk was given at the Viscerv Conference 2016 in Melbourne.
The UK government's cuts to welfare - known as 'welfare reforms' - will increase levels of mental illness, increase costs, inefficiency, inequality and injustice.
Presentation by Antonella Segre, of Connect Groups - Social Prescribing: An old concept but a new way forward. Presented at the Western Australian Mental Health Conference 2019.
Review of the research, literature and expert advice on reducing discrimination and enhancing social inclusion in mental health / illness. Written by Neasa Martin, funded by Queensland Alliance, Australia 2009
Jo-Anne Welsh - Factors affecting recovery for women
Director of Brighton Oasis Project
The Road to Recovery for Women and Children - Annual conference 2013
These are complicated organisations facing very complicated tasks – but articulating what they are for in a way which is simple and powerful. What should the mission of mental health services be? Not just your organisation, which may be very generalist or very specialist – but mental health services’ overall role and purpose in society. What should we be working together to achieve?
A person is considered to be mentally healthy when he or she is devoid of any form of mental illness, and this state is referred to as mental health. Any person's emotional, psychological, and social state all impact their mental health. A person's capacity to think, understand, feel, and act is influenced by their mental health. A person's capacity for managing stress and making crucial life decisions may also be impacted.
Networked Energy: Energy independence for AlderneyCitizen Network
by Chris Cook and Marcus Saul, Island Power
As Research Fellows at the Institute for Strategy, Resilience and Security, at University College, London, Marcus Saul and Chris Cook researched and developed the Pacific Natural Grid resource resilience strategy.
Here they explain how Denmark has led the way in creating sustainable networks of community-based energy production and distribution.
This has been transformative for Denmark, enabling it to become independent from the oil and gas industry’s dominance. But it is also transformative for communities, who are now creating their own energy economies.
Dr Dave Beck gave this talk for Part 5 of the ‘Grassroots Policies for Farming, Food and Wildlife’ webinar series, hosted by Citizen Network.
In his presentation Dr Beck discusses the harms caused by the monopolisation of supermarkets in the food industry. He also explores the positive possibilities of local currencies.
Dr Beck is a Lecturer at the University of Salford, Manchester.
The webinar recording is available to watch on Citizen Network's website at: www.citizen-network.org
Simon Duffy gave this presentation at the final conference of the UNIC Project, in Brussels in September 2023, providing an overview of personal budgets and the challenges ahead.
Sabrina Espeleta of War on Want outlines the enormous and growing level of world hunger. She explains how a few global corporations control the vast majority of food production and supply and markets exploit the food market, leaving communities, especially in the Global South at great disadvantage. Local peasant farmers are now organising to achieve food sovereignty, seeking to farm in ways in harmony with nature and to meet local needs. The Global North needs to respect the rights and autonomy of these people rather than to continue the pattern of exploitation.
This presentation was given on 6 July in Part 4 of a webinar series on grassroots policies for farming, food and wildlife.
Watch the recording at: https://citizen-network.org
Simon Duffy was asked by the Mayor’s Greater Manchester Charity and UBI Lab Manchester to talk at a recent roundtable event on the relevance of Universal Basic Income (UBI) to the problem of homelessness.
These are the slides from that talk. In summary Duffy argued that UBI is relevant to reducing homelessness in two slightly different ways:
1. UBI would help prevent homelessness - UBI addresses the inequalities in income and housing that create the risk of homelessness.
2. UBI would help people escape homelessness - UBI gives people a vital tool which significantly helps people change their situation in times of crisis.
Find more free resources on basic income at: www.citizen-network.org
A presentation for the One Yorkshire Committee introducing Democratic Yorkshire - a voluntary alliance consisting of a group of organisations and individuals interested in planning a better future for our County through modern democratic means secured in a written constitution.
In this presentation exploring planning law, Laird Ryan talks us through the planning process, explores what we can and can't influence and helps us consider how best to create real, organic and local alliances that make the best use of our energy.
To find out more about the Neighbourhood Democracy Movement please visit: https://neighbourhooddemocracy.org
Citizenship is our Business - The Avivo StoryCitizen Network
Avivo is one of the founding organisations in Citizen Network. they are also pioneers in self-direction and personalised support in Australia. Over the past few years they have been reorganising themselves around the principle that everyone is a citizen - and supporting everyone, including paid staff, to be citizens is their central purpose. Avivo are also leading Citizen Network's Rethinking Organisations programme and networking with other organisations on this journey.
Dr Simon Duffy spoke to Doncaster's Mental Wellbeing Alliance about the importance of thinking about what good help really means. He explored the importance of shifting power, resources and thinking upstream.
Markus Vähälä, CEO of Citizen Network, outlined the development of the cooperative as a framework to support the further development of Citizen Network as part of the 2022 Building Citizen network Together events hosted by Eberswalde University.
At BuildingCitizen Network Together in early 2022 Simon Duffy and James Lock discussed the development of Citizen Network and its current approach to membership and explored with members from all around the world next steps for its development.
These slides are from a talk Dr Simon Duffy of Citizen Network gave to Café Economique in Leeds, making the case for basic income. The argument set out is that UBI is one necessary part of a range of reforms necessary to support citizenship and strengthen community life. This talk preceded a (rather fiery) debate with Anna Coote of NEF who argued against UBI.
Simon Duffy gave this talk for Radical Visions on home, citizenship, institutionalisation and neighbourhood democracy. He explains why institutions are wrong and what we might be do to end the drive towards institutionalisation.
A presentation for the Estia International Confernce in 2021 from Dr Simon Duffy exploring personal budgets, citizenship and community and the challenges for services aiming to work in partnership with people with disabilities in Greece.
An example of good practice in inclusion in employment from Slovenia, shared at the Day Centres Without Walls conference, hosted by JDC in Lithuania. Day Centres Without Walls is an Erasmus+ project funded by the EU.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
The Gram stain is a fundamental technique in microbiology used to classify bacteria based on their cell wall structure. It provides a quick and simple method to distinguish between Gram-positive and Gram-negative bacteria, which have different susceptibilities to antibiotics
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Basavarajeeyam - Ayurvedic heritage book of Andhra pradesh
Mental Health Reform: Personal Responsibility & Social Justice
1. Personal Responsibility & Social Justice
key elements in mental health reform
Dr Simon Duffy ■ The Centre for Welfare Reform ■ 6th September 2013 ■
International Network for Psychiatric Nursing Research, RCN, University of Warwick
2. Dr Simon Duffy
• Worked with disabled people
for 24 years, invented personal
budgets and developed self-
directed support
• Philosopher, with an interest in
ethics and social justice,
• NOT an expert in mental
health.
3. The Centre for Welfare Reform
• Welfare state is good - it is just
designed wrong.
• Move away from meritocratic
thinking, instead value human
diversity & equality
• New thinking must promote
justice, citizenship, family &
community.
• Innovate to build practical
alternatives
4. 1. Questions of mental health cannot be separated
from questions of social justice.
2. The mental health system is in need of radical
reform.
3. We must fund life, not services.
4. Current government policy is very dangerous.
5. Mental health professionals are confronted by an
enormous ethical challenge.
6. 1. Income inequality
2. Debt
3. Stigma
4. Multiple social problems
5. Real poverty
If mental illness is an illness then its an illness
that requires social justice as part of the cure;
for it is linked closely to...
9. 45% of people in debt have mental health problems compared
to 14% of people who are not in debt
Developing unmanageable debt is associated with an 8.4% risk
of developing a mental health problem compared to 6.3% for
people without financial problems (i.e. a third higher)
Relative risks for people in debt: alcoholism (2x), drug addiction
(4x), suicidal ideation (2x)
Professor Martin Knapp, 2012 Tizard Lecture
Debt is correlated with mental illness
10. Chick Collins on the ‘Scottish Effect’
Social stigma is correlated with mental illness
13. Managing a serious health condition 64%
Finding a safer place to live 27%
Living with childhood abuse 51%
Didn’t finish their education 76%
Recent experience of domestic violence 85%
Fractured family (for those with young families) 66%
Children experienced abuse (for those with children) 55%
Living with a severe level of mental illness 55%
Living with some mental illness 91%
History of drug or alcohol misuse 52%
Victim of crime 41%
Perpetrator of crimes 39%
Worried by debt or lack of money 65%
Of 44 women working with WomenCentre:
14. Service label n Urgent problem n Real need n
Victim of domestic violence 55 Debt 50 Better self-esteem 64
Mentally Ill 39 Housing 48 To overcome past trauma 54
Criminal 35 Benefits 46 To manage current trauma 51
Poor Mother 33 Health 37 To stop being bullied 50
Misuses Alcohol 24 Rent 32 Guidance 50
Uses Drugs 22 Criminal Justice Advocate 24 Relationship skills 45
Violent 19 Dentistry 8 Mothering skills 26
Chronic Health Condition 16 Others 3 Others 1
15. The multiple reinforcing erosion of personal resilience
Mental illness is linked to real poverty
17. 1. Where is the recognition of the social justice
factors that impact on mental health?
2. Can we be confident in the effectiveness of
medicine to treat mental illness?
3. Can we be confident in the helpfulness of the
mental health system?
4. Do we know how often do our crisis responses
make things worse?
Does our current response to mental illness
make sense?
19. We spend people’s money for
them on things they wouldn’t
really buy for themselves
20. Rather than reducing inequalities itself, the initiatives aimed at
tackling health or social problems are nearly always attempts
to break the links between socio-economic disadvantage and
the problems it produces. The unstated hope is that people -
particularly the poor - can carry on in the same circumstances,
but will somehow no longer succumb to mental illness,
teenage pregnancy, educational failure or drugs.
Wilkinson & Pickett, The Spirit Level
We ignore the social and economic dimension
21. Many treatments lack supporting clinical evidence
http://clinicalevidence.bmj.com
24. Annually, there are 10,000 people placed out of area for mental health
reasons and approximately 11,000 people with learning disabilities are
also placed out of area per year. Nationally, the National Mental Health
Development Unit (NMHDU) estimated that out of area placements for
mental health cost £690 million per annum, therefore the combined cost
of out of are placements is likely to be more than twice that amount, that
is over £1.5 billion (NMHDU, 2011). Of the total number of residential and
nursing care placements for mental health each year, 22% are out of
area.
Alakeson and Duffy, Health Efficiencies
We move people and money out of communities
25.
26. These findings [better long-term outcomes for schizophrenia in
developing countries] still generate some professional contention and
disbelief, as they challenge outdated assumptions that generally people
do not recover from schizophrenia and that outcomes for western
treatments and rehabilitation must be superior. However, these results
have proven to be remarkably robust, on the basis of international
replications and 15-25 year follow-up studies. Explanations for this
phenomenon are still at the hypothesis level, but include:
1. greater inclusion or retained social integration in the community in
developing countries, so that the person retains a role or status in the
society 2. involvement in traditional healing rituals, reaffirming
community inclusion and solidarity 3. availability of a valued work role
that can be adapted to a lower level of functioning 4. availability of an
extended kinship or communal network, so that family tension and
burden are diffused, and there is often less negatively 'expressed
emotion' in the family.
Dr Alan Rosen from Destigmatising day-to-day practices: What Can Developed Countries learn
from Developing Countries? World Psychiatry 2006, 5: 21-24
27.
28. We don’t pay attention to the source of people’s real wealth
30. 1. Peer support
2. Personalised support
3. Relationship work
4. Entitlements and control
5. A focus on supporting citizenship
We can see some of the main elements of a
reformed mental health system
33. Peer support is critical and will guide us to better solutions
34. “Don't forget to tell them that we had our first PFG camping trip
last Sunday - it was amazing......we are planning Mad Fest which
will be our mental health festival for next July. Music group
started and we have our own band...........we also now have a
community garden. And we have started a partnership with the
church to have the church hall to do other crazy things in - we are
doing pull up a pew - taking a church seat with us to have a
cuppa and a chat about how people are feeling. Just
incorporating into a proper company and Our Jude is now the
Chair of Doncaster CCG's Mental Health Alliance (A woman who
didn't leave the house for five years)”
41. 1. Start with the whole woman - gendered and holistic
2. Offer a positive and comprehensive model of
support - every woman is a one-stop-shop
3. Build a bond of trust - create the means for woman
to do real work together
4. Be a new kind of community - women, working
together, to improve lives and communities.
42.
43.
44.
45. I used to work in the fashion design industry as a product developer
until I became ill. This was a hard time in my life. I was diagnosed
with paranoid schizophrenia...
...as I am now on the road to recovery my budget has reduced. I
have updated my plan myself and this has given me the opportunity
to talk about what I want for the future. The opportunity to be
creative is very important to me and is something that keeps me
well. I now receive a little support and a one off payment which I
use to help me to buy equipment to make jewellery. I hope that I
will eventually be able to teach other people how to make jewellery
to give something back. My goal is to start up my own jewellery
business and be financially self-supporting, and the recovery team is
helping me with this.
Without the support that I have I would still be wondering where my
life is going, but now I have hopes for the future. I would definitely
recommend considering a personal budget. You can really make it
work for you in a way that I didn’t know was possible. I feel lucky
that I have been able to get back some of the life I have lost.
From Health Efficiency by Alakeson & Duffy
46.
47. Transportation 13% Crafts 2%
Computers and accessories 12% Licenses/ certification 2%
Dental services 11% Entertainment 2%
Medication management services 8% Vision services 2%
Psychotropic medications 8% Furniture 1%
Mental health counselling 8% Non-mental health medical 1%
Housing 7% Camera and supplies 1%
Massage, weight control, smoking cessation 5% Education, training, materials 1%
Utilities 3% Haircut, manicure etc. 1%
Travel 3% Pet ownership 1%
Equipment 3% Supplies and storage <1%
Clothing 2% Other <1%
Food 2% Total 100%
48.
49.
50.
51. 1. Purpose - a life of meaning
2. Freedom - directing my own life
3. Money - having enough on which to build
4. Home - being where I belong
5. Help - that fits me
6. Life - getting stuck in
7. Love - getting it and giving it
Citizenship is
the key
52. There are eight degrees of charity, one higher than the
other. The highest degree, exceeded by none, is that of
the person who assists a poor Jew by providing him
with a gift or loan or by accepting him into a business
partnership or by helping him find employment - in a
word, by putting him where he can dispense with
other people's aid. With reference to such aid, it is said,
“You shall strengthen him, be he a stranger or a settler,
he shall live with you” (Lev. 25:35), which means
strengthen him in such manner that his falling into
want is prevented.
Maimonides
54. Mental health will deteriorate as
1. Inequality increases
2. Stigmatisation increases
3. Real poverty increases
4. Debt increases
5. Local power and control decreases
56. The financial crisis was not
caused by welfare spending.
It was caused by over-lending to
individuals to support excessive
house price growth.
It is a bubble politicians cannot
afford to burst.
57.
58. Child Benefit freeze
Abolition of Sure Start Maternity for second
and subsequent children
Change to CPI indexation of benefits Reductions in support for carers
Replacing DLA with PIP
Child Benefit clawback from higher rate
taxpayers
Time-limiting of contributory ESA Transfer of Social Fund to local government
Council Tax Benefit – 10% reduction and
localisation
Extension of JSA lone parents with a
youngest child aged 5-6
Housing Benefit cuts Household Benefit cap
Abolition of the Independent Living Fund Continued use of ATOS or others
Universal Credit Reductions in ‘Access to Work’ funding
Closure of Remploy services Abolition of the Child Trust Fund
Tax credit changes Abolition of the Health in Pregnancy Grant
Abolition of the Child Trust Fund Abolition of the ESA youth rules
73. Possible explanations include:
Existing patterns of prejudice and stigma
Fragmentation of advocacy groups
Dependency of charity sector on government
Complexity of welfare system
Ignorance about our rights
Pandering to key electoral groups
Corruption or lobbying by profit-making groups
74.
75. Then did all the grants and the subsidies, the benefits and the
bargain offers pass over these poverty-stricken peasants when
Ingolfur Angerson's ideals came to fruition? What is one to say? It
so happens that it signifies little though a penniless crofter be
offered a grant from the Treasury towards the cost of tractors and
modern ploughs...
The fact is that it is utterly pointless to make anyone a generous
offer unless he is a rich man; rich men are the only people who can
accept a generous offer. To be poor is simply the peculiar human
condition of not being able to take advantage of a generous offer.
The essence of being a poor peasant is the inability to avail oneself
of the gifts which politicians offer or promise and to be left at the
mercy of ideals which only make the rich richer and the poor
poorer.
Halldor Laxness
77. How should mental health
professionals respond when
government is dangerously
wrong?
78. How do we respond
1. The need for humility
2. The danger of complicity
3. The imperative to facilitate and connect
4. The possibility of campaigning
83. And we ALL need peer support
It is easy to talk about cooperation, but in
reality we are in our current mess because
it is hard to connect, develop shared
interests and overcome jealousies and
conflicts.
But, if we are not building, we are
destroying
84.
85. 1. Human Rights - Better fundamental legislation
2. Clear Entitlements - Its ‘my budget’
3. Avoid Crisis - Family support, lower thresholds
4. Full Access - No ‘special’ funding for services
5. Choice & Control - Freedom, capacity
6. Fair Incomes - Enough for citizenship
7. Fair Taxes - No ‘special taxes’, no charges
8. Sustainability - Rethink health/social care split
86. The power of choosing
between good and evil is
within the reach of all
Origen