Keir Harding Profile picture
Occupational Therapist Providing training, consultancy & alternatives to long term hospitalisation for those who self harm and are recurrently suicidal

Apr 25, 2023, 19 tweets

🧵A big part of trying to make the #RCOTCasson lecture bigger than ever was trying to get it outside of where it would normally be talked about.

I asked "It the Casson lecture being talked about on the BBC too ambitious?" @BBCNews @BBCWalesNews

It turns out that it was too ambitious, but with two days to go, let's have a look if there's anything that could hook the media in for a wider discussion.

Firstly lets get nationalistic - A Welshman, in Wales delivering the professions highlight lecture in honour of a Welsh doctor with record attendance on its bicentennial anniversary. @BBCNews @BBCWales

To get a bit more local, it's not just a Welshman, it's a Wrexham person and there's lots going on in Wrexham at the moment...
@WalesOnline

Then there's the content. Firstly (and I don't think this is a big hook but who knows) there's how important relationships are and things in services can damage them.

As @DrChloeBeale wrote, sometimes it seems our systems are designed to harm. We pretend that what is on offer is the best people can get though, and this hurts staff (and patients)

In the review of the mental health act @WesselyS wrote about how staff make decisions based on fear rather than the best interests of patients. That damages relationships too.

thelancet.com/journals/lanps…

News might be interested in how fear of raising concerns means staff have to tolerate seeing people being harmed. The @BBCNews wrote this a while back

My experience of raising concerns when I felt people were being harmed was getting absolutely ripped apart and silenced. That a decent personal interest story.

Also, there's loads of staff groups striking but we're only talking about pay and not conditions.

50% of jnr Drs experiencing extreme stress
Paramedics watching people die in 40 ambulance queues.
1/4 of OTs looking to quit in 5 years...

We need to think about making services people want to stay working in, not paying them a bit and hoping they tolerate it better.

13% of the NHS mental health workforce left last year.

22000 nurse left the NMC register.

We need to fix this and it isn't (just) more pay.

Staff are morally injured, frightened and frightened to talk about it.

We forget about the environment that's intolerable and focus on the individual.

The BBC told us.. @BBCNews

That's a lot of people. Of those people, those with the probable mental disorder were those living in poverty who were unsure they could eat.

Is worry about not being able to eat a mental disorder? 😕

Further, self harm in children is rising. The risk of suicide increases significantly if you self harm.

Is the younger generation in greater danger of dying by their own hand than any previously?

Is there something in our society impacting on our children or should they just work on their resilience?

Our neoliberal society emphasises individualism and a response to the increasing gap between rich and poor is to tell people they are ill. We try to help then send people back to the environment that caused their difficulties.

And this is a choice. We don't have to live like this. I'd argue that some people won't survive us living like this and the biggest casualties will be our children.

This environment has to change. DMs open. Happy to talk more.

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