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Keir Harding Profile picture
Keir Harding
@Keirwales
Occupational Therapist Providing training, consultancy & alternatives to long term hospitalisation for those who self harm and are recurrently suicidal
Dec 20 • 9 tweets • 3 min read
2 billion on private placements…but is every patient being treated equally here?

I’d suggest not. The NHS inpatient provision for those I work with is a handful of beds. Those displaying recurrent self harm and suicide (all female trauma survivors)… …are near exclusively given inpatient treatment in the private sector.

How much does it cost? It’s hard to get a clear answer but no one seems to disagree with £300,000 a year per person.
Nov 23 • 19 tweets • 3 min read
Normally it's @PsychToday with the most stigmatising articles on BPD but here's @verywellmind with an expose on "Why people with BPD tend to lie.

You might think this clickbait title then refutes that bpd lying/manipulative trope. It does not...

.verywellmind.com/link-between-b… Some studies of those told they have BPD put experiences of abuse at over 80%. Zanarini did a study of over 300 inpatients told they had BPD and found over 90% reported childhood abuse. So to reframe the article lets explore

"Why do survivors of childhood abuse tend to lie?
Oct 4 • 15 tweets • 4 min read
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
Jul 7 • 12 tweets • 3 min read
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
Oct 10, 2023 • 7 tweets • 2 min read
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
Sep 23, 2023 • 17 tweets • 3 min read
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.
Jul 23, 2023 • 20 tweets • 4 min read
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…
Jun 23, 2023 • 15 tweets • 3 min read
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.
Jun 23, 2023 • 10 tweets • 3 min read
Second session kicks off with @BIG_SPD presidents @OliverDale10 and Julia Blazdell talking about where there were when No Longer a Diagnosis of Exclusion came out

"Rampant discrimination and prejudice" These were the recommendations from 2003 👇👇👇
Jun 23, 2023 • 33 tweets • 7 min read
The marking of 20 years since No Longer A Diagnosis of Exclusion

@DrAdrianJames kicks off by recognising the problems with the label and the harms that can result. Now @normanlamb recognises we know what works but don't do it.

"We spend too much money locking people up and beachingtheir human rights."
Jun 17, 2023 • 13 tweets • 5 min read
Just come across this article and I'm just going to point out a few things that are missing. I'd love to do a more formal response so @katlay @ShaunLintern @eleanorhayward do let me know.

Firstly, @Sydneylimaa found her diagnosis really useful and I'm genuinely glad.... But the article didn't describe how associated 'BPD' is with childhood trauma. 80% is a frequently cited statistic but my personal experience is higher

manchester.ac.uk/discover/news/…
Jun 15, 2023 • 12 tweets • 5 min read
On my way back from #bigspd23 and mulling over the things that have stuck with me... Image I liked that Giles Newton How's, president of @ISSPD1 was there. He talked to the idea of "bpd" being problematic as something special in the UK. Hope some of what @BIG_SPD does well stays with him. (Also really liked how wandered all over the room)
Jun 15, 2023 • 4 tweets • 2 min read
Im listening to Danny Taggart talking about CSA and looking for some stats. These are horrific. 👇 #BIGSPD23 Image I'm really thinking about the scale of CSA. That as a society and community there is so much hurt yet we act as if its a shockingly infrequent occurrence. #BIGSPD23
Jun 14, 2023 • 7 tweets • 4 min read
Really interested in this from @GaryWinship

While services are so frightened I don't think they can conceive of sharing power and decisionmaking with patients (members?) #BIGSPD23 Image Therapeutic communities have been around for a while... #BIGSPD23 Image
Apr 25, 2023 • 19 tweets • 8 min read
🧵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.
Apr 19, 2023 • 17 tweets • 6 min read
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
Mar 19, 2023 • 19 tweets • 5 min read
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.
Mar 17, 2023 • 8 tweets • 2 min read
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.
Jan 27, 2023 • 11 tweets • 3 min read
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/…
Jan 25, 2023 • 7 tweets • 2 min read
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/
Jan 25, 2023 • 7 tweets • 2 min read
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.