Keir Harding Profile picture
Apr 19, 2023 17 tweets 6 min read Read on X
I don't think that @theRCOT does this for every #RCOTCasson lecture but it's lovely to see a report that perfectly links with my lecture

Or it would be if it wasn't so bleak. I assure you these issues affect every profession. Look at the picket lines if unconvinved...🧵👇
Demand has increased, complexity is higher, staff have to watch needs not being met, people cannot provide the service they want 60% of staff experiencing extreem stress Image
"Being told not to work to gold standard due to capacity issues provides a huge amount of stress" and this is partly due to having to hide it from those we work with. We rarely say "if you'd been here 5 years ago you'd be getting much better treatment". We have to pretend... Image
The pain of going through this is described brilliantly by @DrChloeBeale Image
I'll focus on the first key recommendation... Image
Why? Because if we want to keep an NHS (and despite working privately, I know I do) We need to create an environment people want to work in.

Imagine this being your day in work 👇👇👇 Image
If they don't like it they can leave!

They are. In multitudes.

13%of the NHS mental health workforce left in 21-22
22000 nurses left the NMC register in 2020
2/5 jnr Dr's can't wait to leave

And an extra 5% won't change this Image
So everyone in this system is stressed. Staff are encouraged to develop resilience while trying to put out an inferno with a watering can. People aren't nice to each other in these circumstances (they were not nice to me) Image
So what does this mean for thefuture? Nothing inspiring. 1/4 OTs want to leave too. For every person who leaves, it gets harder for those who stay. Image
We live in a market economy where
the value of labour is determined
by supply and demand
Alas healthcare doesn't really
respond to the market. If you can
afford private healthcare, you may
well not notice the NHS withering.
For ages we've relied on the
vocation and altruism of NHS staff,
but a market economy sees these
virtues as a form of stupidity to be
exploited.
We ask them the put up with the
stressful conditions described
above, and offer them some
banged pans for reward.
And while it's not all about money
conditions won't improve until
retention improves. Retention
won't improve until people want to
stay in work. People wont want to
stay in work until the environment
is less toxic.
Mining the healthcare providers of
less affluent countries who will
tolerate awful awful conditions is
an option, but its neither ethical
nor sustainable.
So let's not just talk about pay
There isn't a figure that let's people
feel OK with this👇👇👇 Image
We need to make the environment better. If the staff aren't there it's the patients who suffer Image
And I will be talking about all of this (and more) at the #RCOTCasson lecture, next week Thurs April 27th. Free to everyone. Do come along. 🙂

rcot.co.uk/2023-elizabeth…

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More from @Keirwales

Oct 4
It was great to see this article in @OTnews this month. Why? Because the @BIG_SPD conference was resplendent with Occupational Therapist people not only attending, but heavily contributing.

Is this new? 🧵 Image
Not new maybe, but this was from the conference in 2015 - 1 OT present and a poor example of one at that! Image
This year we got OT Student @ZM_LXP describing her research on the impact of a personality disorder label. “Accused of being ill, commanded to be well” was an ace title Image
Read 15 tweets
Jul 7
So what do I want from a new government in the world of mental health?

Well, 8500 new people working in mental health. Why is that?

news.sky.com/story/sir-keir…
That's important because the community mental health teams I worked in 10 years ago were drowning in the demand THEN. With the workforce dropping, those who remained have done less with less. Image
The focus on child mental health is important too and it's good to hear them talking about the appalling waiting lists for desperate children and families
google.com/amp/s/amp.theg…
Read 12 tweets
Oct 10, 2023
It is #WorldMentalHealthDay with a focus on Mental Health being a universal human right.

If you're struggling, remember to ask for help. Image
When you ask for help, you'll be joining a fifth of all 16 year old girls in the country:

"16-year-old girls are most likely to be in contact with NHS mental health services - with 22.8% of the population (69,580) having been in contact with these services during 2021-22" Image
You'll also find a notional emergency going on with 1 in 5 mental health nurses vacancies unfilled in the NHS

theguardian.com/society/2023/o…
Read 7 tweets
Sep 23, 2023
Thanks to @BPDFFS @Girl_Interrupt_ and @HoppyPelican for pointing me at this. I don't understand it very well, but I'm going to spell out what I don't understand and what I'm wondering about...
The diagnosis of personality disorder has changed. There are no 'types' any more, just personality disorder mild/moderate/severe. This paper looked at whether you could use honos scores to measure that severity.
This is what a honos section on self harm looks like.. Image
Read 17 tweets
Jul 23, 2023
Here's a thread no one has asked for looking at this from the recent #RCPsychIC conference. Is it BPD or CPTSD?

Let's have a look 👇👇👇
The slide is citing this paper so we shall dive in and see what they say...

ncbi.nlm.nih.gov/pmc/articles/P…
The paper says BPD and CPTSD/PTSD are different. There is a lot of overlap though

29% of people with cptsd met criteria for BPD.
25-58% of those dxed with BPD met criteria for ptsd
Read 20 tweets
Jun 23, 2023
And so we come to the end of the day marking 20 years since No Longer A Diagnosis of Exclusion

Some great people there 🙂

Some reflections on the day...

@HoppyPelican @MEAMcoalition @KKaurWilson @AlexStirzaker @DrSRanote @skalidindi1 @KKaurWilson @NationalKufHub
We looked at some great beacon services. We agreed there was much that could help. We acknowledged the prejudice and discrimination.

This is the same as 20 years ago.
We didn't explore why the stigma and discrimination was still there. Why the recommendations of NLADOE couldn't be followed.

(and if we hadn't had the 'thorn in the flesh' incident, I'm not sure we'd have been here today).
Read 15 tweets

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