New Liberty Protection Safeguards will prioritise timely care of the vulnerable - Simon Wessely

Just came across this worrying article by Simon Wessely where he uses his familiar rhetorical style to minimise issues surrounding the UK government's rather wide powers to intervene in the lives of those considered to have diminished responsibility (which includes PwMEs under some circumstances).

https://www.mentalhealthtoday.co.uk/blog/crisis-care/a-dols-house-a-tale-of-two-acts

 

I started reading this but gave up 60% of the way through...he has a writing style that is just too verbose and indulgent...like he just jotted his random thoughts down on a page and forgot to edit them? He really is lacking in a lot of skill for someone with such a high opinion of himself.

I can’t make head nor tail of what he is trying to say it’s so full of superfluous guff.

 

I wonder if medical and care staff will be able to tie brain damaged and demented people to the chairs they sit in when they get in their (the staff's) way or annoy them even when that person and the chair they are sitting in is already in a locked ward. This happened to someone I knew. He walked, constantly, for hour upon hour, and annoyed the staff. So they tied him to a chair. This was in the early 2000s. The NHS had (apparently legally) taken over all care of his welfare away from his family and appeared to have carte blanche to do whatever the hell they wanted.

 

Seconded.

 

I suspect he does that on purpose, so that afterwards he can claim to have said / not to have said anything / everything.

 

If this is indicative of the analytical thought process in psychiatry, god help us .

 

Reading the article, i was reminded of Bob.

 

Yes, in my experience, using as many words as possible to say absolutely nothing is very much the standard approach for successful bureaucrats in particular.

 

A key 'deprivation of liberty', in a medical context, is patients being manipulated with misleading claims of treatment efficacy. I wonder how concerned Wessely is about that.

 

This sounds concerning: do we really want people like Wessely, and others no doubt even less "qualified", making this decision? The potential for abuse, as well as simply bad decisions, seems immense. Short-staffed? Limit liberty to ease the pressure. Think that patient is a trouble-maker? Limit their liberty. And so on.

 

Given the problems children have, this is very ominous indeed

 

timely considering iapt you will take our treatments because we say its in your best interest the states removal of human rights always begins with knowing the peoples best interest so the path to tyranny is sowed through innocuous sounding documents like this .

 

In the case of the person I was talking about, his family were told that he was tied to a chair to stop him walking for hours on end. When the staff were asked why this mattered, since he wasn't hurting anyone, they said he might fall over and then you might sue us.

 

Shame they can't be sued for tying him to a chair.

I find the thought of being leaned over by Simon Wessely for a bit of gentle persuasion deeply unsettling.

 

tl;dr Simon has come up with a plan to save money. Sure, it's monstrous.It contains conflicts of interest. There is a high probability of harming powerless people. It breaks human rights laws. But, it saves money and that will make powerful people happy.

The comment to the piece explains the problem quite well.

The article wants to expand the ability to kidnap somebody. The people authorizing the kidnapping to be bureaucrats, instead of a judge. Bureaucrats with a possible financial, personal, reputational or ideological interest in the outcome. This is not mentioned, and the editor has had to insert this important fact into the piece. Maybe Simon just forgot to mention it, or views it as trivial.

This should happen, because depriving people of their liberty is considered too expensive. The answer is not to provide more resources. The answer is to remove safeguards, minimal and ineffective as they are. These people do not deserve basic human rights. They don't deserve to be humans any more, because that costs money. They are not like us. The only concern about them is monetary.

People get very upset about a lot of things, it doesn't mean we have to do what they want because they are upset. Maybe they are wrong?

We are also taught that being held against your will is the same as somebody making sure you do not fall out of bed when in a hospice. A sleight of hand accomplished by the insertion of a personal family anecdote. The anecdote did not have to be personal, so why is it there? For sympathy, and to distract from the argument?

Maybe he can go on to advocate that people charged by the police should also be judged and sentenced by them. It would save money. They are not very popular with the general public. Being charged is not the same as being guilty, but the whole process is expensive, and why would the police be wrong?

Gosh, I'm glad you mentioned there might be some drawbacks. I'm sure Lady Hale, being a mere President of the Supreme Court would have just sped ahead without considering this important fact. Women can be just so emotional and impulsive can't they Simon?

Carceral neo-liberalism through and through.

 

Yes, I took it as a very general piece of "nothing to see here" rhetoric, in which he is minimising real ethical issues surrounding the deprivation of people's rights.

Given what I know about the UK government's general powers to incarcerate, treat and restrain people "for their own good", I found this piece quite terrifying.

The "nothing to see here" narrative seems to weave itself throughout Wessely's pieces. Whether its discussions of government power to intervene, COIs within the psychiatry profession, or issues concerning outcome switching on the PACE trial, this is the common theme.

 

I'm against it, but that probably just shows how out of touch with reality I am and proves my need for this type on "treatment".

I must admit to being a little confused tho. I understood that supplying care to even normally ill people in a hospital was seriously expensive, I seem to remember it costing £300 a day just to keep someone in a bed, without any actual treatment, although I've never understood how. When you compare that with how much it apparently costs to keep someone in a home specialising in dementia, a "comparable" setup, few doctors, few nurses, most staff on minimum wage if they are lucky, which, again I believe, is in the region of £850 a week minimum, the results are puzzling.

How exactly is this cheaper than, say, keeping someone in their own home and paying them benefits.

It just doesn't make sense from a national financial standpoint, let alone as a reasonable use of, we are told, scarce resources.

So maybe it's something else, if you rule out it being for the benefit of the patient, as being forceibly strapped to things is rarely considered healthy, or in someone's best interests, maybe it's a combination of a power kick and personal financial gain?

 

I too have seen this happen in the UK, it was in the 1990s in a general elderly ward. The lady had multi infarct dementia. The restraint was directed by a consultant but not clearly recorded in the medical notes. The family took this opportunity to have her dog put down and her home put on the market, without informing her, even though up to the stroke that took her into hospital she had been relatively successful at living independently and it was unclear at the time how well she would respond to rehabilitation in the short to medium term, though obviously long term the prognosis was poor.

My concern was that she was not being involved in planning for her future, even though she was capable of this despite her moderate aphasia and some confusion. I believed the main reason for her distress and restlessness was sudden loss of control over her life, not helped by lack of family support and being physically restrained. It was not clear how much of her confusion was reversible due to an acute neurological episode and the disorienting effect of hospitalisation, but the medical and family response could only serve to exacerbate this and mitigate against any recovery.

[added - also it was very unclear what the legality of the situation was, with no formal decision process having been taken. As a visiting speech and language therapist not part of the hospital management structure, I raised concerns through my own line manager who was very unwilling to rock the boat. Though I recorded everything I observed in my notes, in the hospital notes a descrete veil had been drawn over the restraint. Although my management refused to countenance involving the Police, I remain unsure if what I witnessed legally constituted assault and kidnap.]