Manston, “invasion”, turning back boats, Rwanda. Complex issues like migration, involving vulnerable people, are rarely solved by getting tough, let alone talking tough.
Example from #mentalhealth. 10yrs ago prison policy was made more severe (remember the ban on books?). 1/6
This was meant to appeal to a section of the electorate who, misled by the media, saw prisons as too soft.
“Privileges” were curtailed.
What happened next may not have been cause & effect. Other factors may have played a part. But the timing was exact. 2/6
The number of suicides by prisoners doubled from 2012-16. Just 4 years. 135 “extra” deaths, which by the previous trend would not have occurred.
Self-harm too. A fall in self-harm by female prisoners over several years was reversed. 3/6
Finally the harsher policy was abandoned. Lives were lost, time was wasted, nothing was achieved.
Did anyone take responsibility, except in the current abstract sense? Did anyone, in that all-purpose cliché, learn the lessons?
Did those who cheered the policy stop to think? 4/6
Obviously the migration issue is different in several ways.
But the demonising, the press distortions, the resentment over supposed privileges, the political opportunism, the rhetoric - these are not so different. 5/6
The migration problem will not be solved by over-simplifying, by abandoning compassion, by degrading our own humanity.
It might be improved by what could have worked in prisons (still could): by recognising the complexity, by putting human lives first, by moral leadership. 6/6
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Plenty of justified outrage following #BBCPanorama’s film of staff abusing patients in a secure mental health unit.
It made headline news. Investigations are under way. Staff have been suspended.
But outrage alone will not prevent a repeat.
Short 🧵 & TW.
Many felt weary over a too-familiar story.
That was my reaction. 5y ago I wrote about how my mother was assaulted in a care home - the perpetrator was erased from their professional register thanks to evidence from other staff.
No action was taken against the care home itself.
Individual responsibility is important here. No-one should excuse the member of staff who treats a patient cruelly.
But abuse takes place in a wider system that can be complacent & culpable. And that is where prevention lies.
Discussion on Twitter this week of suicide rate in doctors, after widely-reposted tweet claiming rate in this country to be several times higher than in general population.
This is untrue in England (UK data not available).
It’s worth looking at the figures.
Short 🧵 & TW.
First, a reminder that suicide statistics are real people, lives cut short, preventable deaths not prevented.
No figure, high or low, is acceptable.
Key source of data is @ONS. 5yrs ago they reported on suicide in occupations.
Jobs at high risk tended to be low pay, low skill.
Risk in medics was not high. In male doctors, it was low (SMR 63). In females, average for general population (SMR 101).
Latest suicide figures for England are just published, giving us rates for the final 3 months of 2021, based on deaths registered post-inquest. Headline message: no change from previous years. But there’s something troubling there too.
First thing to say, always, is that these figures are not dry data. They are real lives tragically lost, preventable deaths, devastated families. We should never forget this.
Most important thing about figs for final quarter of 2021 is they complete the data for the whole year. They show 2021 suicide rate (10.5 per 100,000 people) was similar to pre-Covid years but higher than 2020 when the inquest system was disrupted. ons.gov.uk/peoplepopulati…
Often asked for advice on managing a suicide cluster.
Clusters - where there is a link between deaths - are not unusual.
They cause understandable anxiety in those handling them who may be taking urgent actions on limited information.
Short🧵 & TW.
Links between deaths vary. They may be direct & causal, when one tragedy triggers another. Or indirect via shared circumstances or method.
Clusters occur more in young people & settings like schools & universities but also mental health units. The connections may also be online.
Faced with a series of deaths, it’s easy to waste time checking whether they meet the cluster definition. My rule is that by the time you’re asking, it’s a cluster.
In fact, part of handling a cluster is prevention, recognising that the first death has the potential to spread.