Friday 22 May

Apart from the ghastly death toll (now over 36,000) several issues dominate the news agenda. The PM’s humiliating (for him) U-turn on the NHS surcharge for overseas NHS and care workers seems to have resulted more from the threat of a backbench rebellion than by any understanding of what an unjustifiable policy the surcharge was. This U-turn was described as the first of his ‘premiership’, but arguably the schools reopening debacle also constituted one, because it was only narrowly averted by ministers realising its weak position and deciding not to sanction ‘rebel’ councils. Whatever you want to call them, these manoeuvres will only serve to further undermine the government’s authority. Independent SAGE, which believes 1 June is too soon for schools reopening, has met today to discuss the issue. It’s probably unrealistic to hope that ministers will take account of its discussions but it would be interesting to know if the de facto SAGE feels threatened by the existence of an alternative body of experts.

Senior scientist Sir Paul Nurse expressed concern again on the Today Programme about the lack of accountability: ‘Who is in charge? Is it ministers, PHE, SAGE? I don’t know, do they know? It’s been like pass the parcel. We are desperate for leadership at all levels’. Besides again encapsulating the lack of psychological ‘holding’ of the public by their leaders, this relates in part to the PM’s continued absence from forums he is responsible for, for example the daily press briefings, leaving loyal lieutenant Matt Hancock to field tricky questions and to defend the indefensible. The Guardian’s parliamentary sketch writer, John Crace, excels himself today with his latest take on the Health Secretary’s plight.

https://bit.ly/2XnkqXo

Understandable exasperation has been expressed over the new quarantine policy – far too late in the day and illogical in applying to UK arrivals except those from the Republic of Ireland. It must be exhausting for ministers, trying to apply retrospective logic and planning to manifestly illogical and absurdly delayed policies and expecting the public to buy it. A BBC World At One listener tweeted: ‘Quarantining arrivals must surely have been a topic for Sage back in early March when the rest of the world was doing it. I wonder what their opinion was then. Did govt say no & if so why? Will we ever know? Transparency’. This issue is expected to dominate the Daily Press Briefing later so can we expect clarification or further obfuscation?

Still very much in the news is the test, track and trace strategy, especially given the admission that the much-trumpeted tracing app will not be ready by the 1 June, when the strategy is meant to be ‘up and running’. Last night on Question Time a hitherto unknown junior minister called Chris Philp was bullish about the strategy and said the app was not needed to make it work, a statement some may find strange given the obvious lack of experience the newly recruited tracers will have. Niall Dickson, head of the NHS Confederation (membership body for organisations which commission and provide NHS services), has written to Matt Hancock, expressing his members’ concerns about implementing a clear strategy by 1 June, saying time was running out to prevent a second wave of COVID19. Ministers don’t have that long to convince NHS workers and the public that there is a clear strategy and to provide evidence of it. Along with experts like Professor Allyson Pollock (a member of Independent SAGE) he stresses the need to understand the local context: ‘I think there is concern among those at local level because we’ve seen – not occasionally, we’ve seen often – where national stuff is done with the best of intentions, but unless the local context is understood it doesn’t really work as well as it should.” As Professor Pollock said: ‘You have to know your local community. You can’t put the fire out from the centre.” It seems the government has been very slow to grasp this, still trying to control everything nationally from the centre, along with all the bureaucracy and delay this involves. 

While it’s positive that the media have covered Mental Health Awareness Week, some of the BBC’s coverage has been disappointing, in my view. On Wednesday, Radio 4 Woman’s Hour tackled the worsening situation regarding young people’s mental ill-health and long NHS waiting lists those seeking help have to navigate, many unable to get help. No disrespect to the two interviewees (a mental health campaigner/blogger and a wellbeing practitioner) but why on earth didn’t the editors invite a qualified and experienced counsellor specialising in working with children and young people, or a CAMHS (Child and Adolescent Mental Health Service) specialist? What’s worrying about such coverage is that listeners not acquainted with this area will get a rather narrow view of the situation and remain unaware of ways to seek help independently of the NHS, if necessary. 

https://www.bbc.co.uk/programmes/m000j94h

Last night, BBC2’s Horizon (What’s the matter with Tony Slattery?) focused on the former comedian, who seemed to suddenly disappear from the airwaves in the 1990s after a sparkling and ubiquitous media presence. Having experienced longstanding mental health problems, these became worse as he descended into heavy cocaine and alcohol use. Accompanied by his very loyal and supportive long-term partner, Mark, the filmmakers undertook to further explore the charismatic Slattery’s distress, given different diagnoses over the years, including severe depression and bipolar disorder. Both men were commendably open and generous in what they shared with viewers. The problem was, in my view and those of others, is that this exploration was predicated on a longstanding and unhelpful biomedical view of mental functioning, which basically asks ‘what’s wrong with you?’ rather than ‘what’s happened to you?’ This approach is based on psychiatrists making a diagnosis, which can often change, and usually prescribing medication, open to question given the close relationship between the psychiatry discipline and the pharmaceutical industry. Besides the fact that many of these medications have undesirable side-effects and only mask the symptoms rather than addressing the underlying causes, there are no biological markers which make it possible to determine with certainty what the ‘disorder’ (another biomedical term) could be. The problems with DSM (Diagnostic and Statistical Manual of Mental Disorders produced by the American Psychiatric Association), the psychiatrists’ ‘bible’ informing diagnosis, are now well documented.

Effectively exploring the root causes of mental distress involves talking treatments and as it’s known that difficulties like this often emanate from childhood trauma, a skilled trauma therapist. Not surprisingly, it turns out that Slattery experienced sexual abuse as a child but didn’t feel able to tell anyone about it at the time, or as time passed, by the sound of it. This results in a significant and lonely burden, shame and fear of stigma, often carried for many years. It’s to be hoped that Tony Slattery can now access the help he needs.

https://bit.ly/2ZsyzoX

An issue I doubt we’ll see media coverage of but is very real nevertheless, is the lack of government attention to the effects of lockdown on those living alone, especially given the significant growth in single person households in recent years. These concerns were well articulated by someone commenting on a Guardian article about being ‘imprisoned’.

‘Very little attention has been paid during lockdown those who live alone. There’s some concern and support for the elderly, but approximately 50% of the 8.2m single-adult households in the UK are people aged under 65. We’ve been totally ignored by the government and media, though many of us have very little support and of course are not allowed to go within 2 metres of ANY other human being, with no end in sight. “Bubbles”, if they come, wouldn’t benefit many of us because couples and families, and single friends fortunate enough to have family nearby, will, understandably, choose to be in a “bubble” with them rather than friends. But our dilemma is receiving no attention at all – this weekend the Guardian and Observer again had articles on families, couples, relationships in crisis etc etc. Nothing about those of us who are now left physically and emotionally isolated, no requests to tell Guardian Community how it is for us – nothing. I’m seeing mental health issues in people who 2 months ago seemed strong and resilient but are buckling under the strain of isolation and lack of human contact.’

Finally, a good example, perhaps, of ‘first world problems’ is news that COVID19 has delayed progress in developing new emojis, so there might be no new ones in 2021. This could feel very minor, but we’re told there are important aspects to it. ‘On an emotional level, the rollout of new emojis is important people who want to represent themselves in the lingua franca of the 21st century. And on a technical level, the pictograms are an important carrot dangled by the smartphone manufacturers to get people to go through the effort of installing software updates, which are crucial to protect users from security vulnerabilities and hacking attacks’. We’re told that some 2020 ones are on the way and will ‘hit phones this autumn’. So that’s ok, then!

https://bit.ly/2WTl8MW

Published by therapistinlockdown

I'm a psychodynamic therapist in private practice, also doing some voluntary work, and I'm interested in the whole field of mental health, especially how it's faring in this unprecedented crisis we're all going through. I wanted to explore some of the psychological aspects to this crisis which, it seems to me, aren't being dealt with sufficiently by the media or policymakers, for example the mental health burden already in evidence and likely to become more severe as time goes on.

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