Keir Harding Profile picture
Apr 25 19 tweets 8 min read Twitter logo Read on Twitter
🧵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 Image
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 Image
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 Image
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. Image
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) Image
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 Image
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. Image
We forget about the environment that's intolerable and focus on the individual.

The BBC told us.. @BBCNews Image
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? Image
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. Image
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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More from @Keirwales

Apr 19
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
Read 17 tweets
Mar 19
I don't know enough about this, but seeing that I can't spot people who know saying it, let's have a go.

Are we watching the dismantling of the NHS?

Let's have a look...👇👇👇
Lots of people are leaving the NHS and other public services. 22000 left the NMC register around 2020. 13% of the mental health workforce left the NHS around the same time. Obviously its about pay, but every profession describes conditions that can't be tolerated.
Now much of the media discussion has been about pay for individual professions, as if there was a way to raise the pay of NHS paramedics but not porters. Nurses but not administrators.

This is because the NHS uses agenda for change. Every job (almost) is banded from 1-9
Read 19 tweets
Mar 17
Had one of my
most disappointing theatre experiences ever at @LiverpoolEmpire tonight. I don't know if it was a particularly bad night but wow. The highlights included...
1 A constant sound like a walk through a forest in autumn as it sounded like every single person had brought extra crinkly sweet bags containing sweets wrapped in ultra crispo wrapping paper.
Even when trying to be quiet it sounded like they were searching for the toy in a box of cornflakes.
Read 8 tweets
Jan 27
So some thoughts on the ICD-11 and "personality disorder". Here goes...
First, this describes the changes. Its very accessible. 👇

cpe.psychopen.eu/index.php/cpe/…
Now this adds a bit more detail as to how you get a diagnosis and what difficulties/mild/moderate/severe means

frontiersin.org/articles/10.33….
Read 11 tweets
Jan 25
Right people, this is a list of some of the articles we're talking about in the training today

There's this from @HoppyPelican

journals.rcni.com/mental-health-…
And this from @ProfLAppleby (worth following)

pubmed.ncbi.nlm.nih.gov/3224249/
Read 7 tweets
Jan 25
This is my letter that The Times didn't want...
thetimes.co.uk/.../can-privat…...
Can Private Hospitals Save the NHS?
Perhaps an answer to this question can be found amongst the 2 billion spent each year on private mental health hospitals.
I work with people who recurrently self harm and feel suicidal. The NHS has effectively privatised inpatient care for this group of people with only 55 NHS beds available.
The private sector do a fantastic job of taking these patients out of NHS hospitals but after that the benefits end.
Read 7 tweets

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