You are currently viewing our classic site, if you wish to visit the new site click here

Mental Health Blog

I'll start today with the fact that this may well be one of the last presidential blogs in the current format.

Because, after investing a significant amount of money, effort, and time, the British Psychological Society will soon start to roll out a brand new website.

The new website will be much more engaging and accessible, and is particularly designed to help members of the public to access the work of the society.

It has been designed to help us better demonstrate the contributions of our members in various ways … including a new President’s blog.

We have a very good role model in the form of the Swedish Psychological Association. Their website is well known amongst the Swedish general public, who regularly use the site to find information about psychology and psychologists. They’ve shown that there is a real desire for this type of information.

We, of course, have a similarly ambitious goal to provide this service in the UK and to be the first port and call and the number one showcase for psychology. We will continually develop the Society’s internet presence across to demonstrate our commitment to this goals.

On that point, it’s worth noting the range of material already accessible - on our main site, on the Research Digest, on The Psychologist and on our rather impressive YouTube channel.

We have a great deal to offer, including sharing the sometimes unsung successes of our Boards and member networks.

And there’s more good news today in that the government has just announced has announced £816m of funding for health research over the next five years.

Of that amount £68m will be for mental health research, over £45m will go on dementia research and there will also be investment in research on cancer, obesity, health technology and many other areas of interest to psychology.

It’s a substantial investment and one that we welcome whole heartedly, but we must work to ensure that the focus on biomedical research is not at the expense of further research focused on the psychosocial aspects of mental health conditions and conditions which have a psychological impact.

Our Research Board will be leading our efforts to ensure that a substantial amount of this investment is spent on research into prevention and in finding and implementing the psychological and psychosocial interventions that really work.

And, finally, we’re looking forwards to the UK political party conference season, with a BPS presence at the three major party events.

As well as talking about opportunities from this new research investment, the subjects we shall be raising are: the psychology of political and strategic decision-making, our call for action on neurodisability in the offender population, dementia and our forthcoming report on the psychology of the condition, and psychology and the benefits system.

As we say:

"Psychology matters. The subject matter of politics - the well-being of citizens, security, economic prosperity, employment, relationships, criminal justice, education and healthcare - is fundamentally dependent on an understanding of how human beings think, feel, relate to one another, make sense of the world and make decisions about the things that matter.

"Political decisions have life and death consequences - when our economy suffers, people suffer, and when politicians lead us into conflict, the consequences are daunting. So it’s right that psychologists support and advise our politicians in the important job they do on our behalf."

Wed, 14/09/2016 - 17:15

I have to confess a personal interest. In a few days time, my son, like many thousands of others, will be going to university. Distressingly, this means beginning what may well be a lifetime of debt. The psychological consequences are potentially serious.

A new survey of young people aged 18 to 24 suggests a large proportion experience significant concerns about money. In the survey the average debt was nearly £3000, before commitments such as student loans or mortgages were added. The average student loan balance is £25,505.

It is unsurprising that many of the young people surveyed felt that their debts were a "heavy burden". It seems, from the available data, that student debt has not deterred young people from going to university, but it may well make them anxious during and after their studies.

It’s good to see young people making their way in life, and it’s very good to go to university. But the consequences of such debt are worrying.

Debts can affect our mental health in many ways. Practically, when we do not have enough money to pay for all the things that are essential, like food, rent, bills, travel etc., our lives can become very difficult. When we cannot make the minimum repayments on the debts themselves, things become more difficult still.

As the young people in this survey reported, debt can be a persistent source of anxiety. It can also be a source of shame and regret. If we are in financial difficulties, we may feel ashamed and not want to talk to others about it.

To my way of thinking, these are the ‘normal’ rather than ‘abnormal’ psychological consequences of living with financial uncertainty. If I were pressed, I’d suggest that the ‘abnormality’ lies in our present economic, social and political system, rather than in the minds of young people.

My son is fortunate. Not (despite his own beliefs) because he has inalienable personal gifts, but because I have had a steady job for 28 years, and I can act as a guarantor (and benefactor).

Not all of us are so lucky. Even in a rich and developed nation – perhaps particularly in a rich and developed nation – such things as personal debt and the inequity between neighbours can be tough.

That is why, in my opinion, a commitment to social justice should go hand in hand with the application of psychological science.

Wed, 31/08/2016 - 12:14

As I’m technically on holiday, I’m cheating very slightly this week, with an edited snippet from my book.

I commute to work by car and unfortunately drive for quite long distances on motorways. So my journey to work (like, I suppose, everything else in life) depends on the operation of the laws of physics.

When it rains, we often see collisions and other accidental tragedies; the roads are slippery, it is harder to see. When people have accidents, the police investigate the probable or likely cause of the incident for legal and insurance purposes. Their analysis includes human factors, but also includes complex physics.

To work out why a tragedy has occurred, the investigators will calculate things like the velocity of the vehicles involved, coefficients of friction between rubber and tarmac, reaction times calculated using equations of acceleration and deceleration, the role of centrifugal forces, tyre pressures and ‘footprint’, the role of aquaplaning, lift, etc.

They will measure elements of the physical world; the weight of the vehicles, radius of turns, the slope of ascents or descents, whether the conditions were wet or dry, the temperature, tyre pressures, the condition of brakes and the nature of the road surface.

All these aspects of physics are important; they explain why accidents happen. But road traffic investigators don’t use a special branch of physics called ‘abnormal physics’. We don’t expect scientists to apply one special branch of physics to car crashes and differentiate this from the laws of physics that apply to ‘normal life’.

There is not an ‘abnormal coefficient of friction’ that leads to car crashes and a ‘normal coefficient of friction’ that keeps us safe. Instead, and wisely, we recognise that it is important to understand the universal laws of physics – such as friction – and then use that understanding to help design safer roads and to drive more safely as individuals.

The laws of psychology are similarly universal. Psychological principles apply to health and wellbeing and to distress and problems. There simply isn’t an ‘abnormal psychology’ that applies to distress or explains ‘illnesses’ and a different ‘normal psychology’ that applies to everything else. There is just psychology.

Everybody makes sense of their world, and does so on the basis of the experiences that they have and the learning that occurs over their lifetime. We all use the same basic processes to understand the world, even if we come to very different conclusions.

The patterns and contingencies of reinforcement – rewards and punishments – shape us all: the basic psychology of behavioural learning is universal. We all learn to repeat those things that are reinforcing, and we all withdraw from things that cause us pain.

We all construct more or less useful frameworks for understanding the world, and we all use those frameworks to predict the future and guide our actions. We’re all using the same processes of learning and understanding, and those processes have similar effects on our behaviour and emotions.

However, because no one is exactly the same as anyone else, or has exactly the same experiences, we all make sense of the world in slightly different ways, with different consequences. But that’s entirely different from suggesting that there is some kind of ‘abnormal psychology’.

Instead, because applied psychologists use their understanding of psychology to solve real problems in the world, we could talk about clinical or educational or forensic psychology - if we must. Or about the psychology of psychological wellbeing, or even ‘mental health’ or offending, or parenting… just say what we mean without insulting people.

But not, in my opinion ‘abnormal psychology’. I’m afraid I just don’t think there is such a thing as ‘abnormal psychology’.

Wed, 24/08/2016 - 10:44

Yohohama skyline

I have been travelling a lot over the past week, representing the British Psychological Society at ‘scifoo’ in California and at the International Congress of Psychology (ICP2016) in Yokohama. The lurking plausibility of a Donald Trump Presidency, perplexity over the Brexit result have been common talking points. Our place as psychologists in an international network of scientist and practitioners is hugely important, but needs some nurturing and care… especially now.

Our international colleagues see UK psychology as world leading, especially in fields that require critical or idiosyncratic (or even iconoclastic) thinking. Major worldwide trends in psychology have leading thinkers from UK universities and our admired health and social care system. We need to be continually mindful of our position in major international discussions.

On the one hand, many of our international colleagues are on the cusp of overtaking us in terms of both ideas and delivery. I have liaised closely with Norwegian colleagues over the past few years on conceptual psychosocial models of mental health care.

Now we see an unashamed psychosocial focus in Norway, with a recent ministerial recommendation for universal provision of medication-free services. Norway is approaching a ratio of 1 clinical psychologist for every 500 members of the public; a ratio that would equate to 120,000 clinical psychologists in the UK. While I would proudly suggest that UK psychologists are offering world-leading ideas, some of our international colleagues have leapfrogged us.

On the other hand, some of the ideas that are common currency in the UK are rather unknown elsewhere. My views on psychiatric diagnosis and the nature of ‘disorder’ and psychological distress may not be universally accepted, but these debates are vibrant and active in the UK.

We have a number of BPS documents – on psychotic experiences and on the contested nature of diagnosis – and are having active discussions, not only within the BPS, but in such bodies as the Council for Evidence-based Psychiatry, the Critical Psychiatry Network and Mental Health Europe – Sante Mentale Europe.

We’re not at risk of being leapfrogged, but international colleagues seem to be unaware of these discussions, which is just as alarming.

Scifoo is a meeting of leading scientists, largely in the physical sciences. Here, the disputed notion of biomedical psychiatric illness was very positively received, but seemed entirely new and different.

Even at the purely psychological ICP2016, the idea that we need radically different approaches appeared difficult to integrate into colleagues’ views of the core purpose of their profession and discipline. The limitations of traditional psychiatric diagnoses, and the impact of such medicalised language on people’s understanding of the fundamental nature of their problems seemed new to many colleagues.

We need to be nimble and present to maintain our position in international debate. As individual academics and practitioners, we have a responsibility to speak with colleagues across the world. After the Brexit vote, that responsibility is particularly acute.

As President of the BPS, I have a particular responsibility to ensure that our links with the international scientific and professional communities are maintained. Our international profile is good  but it is not guaranteed. The effort involved in maintaining our international links is definitely worth it.

Wed, 27/07/2016 - 11:21

I thought, last week, that the political world could not get any more turbulent. But events in the South of France, in the USA, in Turkey, and even here in the UK, proved me wrong.

A couple of weeks ago I mentioned the importance of leaders in civic society - including the British Psychological Society - stepping forwards in the confusion and, frankly, vacuum of detailed policy-making post Brexit. We’ve previously spoken out on the dangers of xenophobic and hate-filled speech and on the psychological factors associated with flawed political decision-making.

All these issues seem to grow in importance each week. Of course, psychology as a discipline and a profession overlap with others. Sociologists, anthropologists and ethnographers all study society as much as do psychologists. Historians, especially political and military historians, have perspectives that overlap with, inform and are informed by, psychology.

Psephologists and political geographers analyse the human factors associated with political decision-making and survey the views of the voting public. And, of course, since political decisions impact upon all of us in our professional activity, all professions have legitimate interests.

So it’s important to remember that the psychological perspective should accompany other, equally valid, perspectives. We are, as has been said before, stronger together. And it is important that professions and disciplines act in unity. We aren’t the only professional and academic body active in this area - but we are, as you would expect, active.

I am delighted that the BPS is central to discussions by the Academy of Social Sciences (representing, of course, the social sciences) and Science Council (representing the more physical sciences) in their discussions about UK science and professional activity post Brexit. I’m also delighted to have been a co-signatory to an open letter to the new UK prime minister, asking her to confirm the previous government’s commitment to mental health and to ‘parity of esteem’ in the provision of services.

This reshuffle has not produced the dedicated cabinet minister for mental health that we had been calling for, but the release of the NHS ‘Implementing the Five Year Forward View for Mental Health’ plan just a few days into the new cabinet suggests it is still high on the agenda.

We’ve got a whole new cast of political characters to work with and we will be working hard over the coming months to introduce our Society to them and explain the value that psychology can bring to their policies and to the way they make their decisions.

Wed, 20/07/2016 - 12:05

The British Psychological Society is actively engaged in several important policy issues, but two are particularly contentious. They are technically complex and they are personally challenging.

A recent government consultation asked how to implement the replacement of bursaries for nursing and other healthcare students with an expanded system of loans. This change raises complex issues for our discipline.

Our response stressed that “the proposed reform to healthcare education funding falls short of the long-term holistic workforce strategy necessary to achieve the government’s goal of delivering high quality integrated physical and mental health care.”

Given that clinical psychology trainees receive both fees and salaries from Health Education England, any move towards loans as opposed to bursaries would constitute a major threat to our profession. Thus we stated clearly that this support “is vital and must continue”. But this support does not cover all applied psychology, and, as we said in our response “is not sufficient to deliver the progress needed to achieve the government’s goal of significantly improving the psychological health and wellbeing of the population.”

We need to enter into substantive discussions with the Department of Health and Health Education England about the future shape of our professional training. We know that our profession is under review. There are many options – from the discussions held under the New Ways of Working programme, suggestions I have previously made and the opportunities offered by the existing Clinical Scientists route.

One thing that psychologists are good at – trained in – is grappling with difficult issues and forging coherent consensus. In this response we expressed a clear message on behalf of the whole profession that takes us forward with authority. But on a personal level, this was a difficult issue. It was challenging to balance the well-argued concerns of colleagues over the commissioning of clinical psychology training with the opportunity for other applied Divisions to boost the psychological workforce and begin to address structural inequity if they were at least able to access loans to meet their training costs.

One of the reasons I love my profession is that we didn’t just put our head in the sands. We took the bull by the horns, and developed a coherent and authoritative position, which we will develop further in the coming months. Armed with this, we are ready to sit down at the table and try to influence the course of events.

I had to confront a second personal and professional dilemma this past week as on Friday I met with colleagues in the Department for Work and Pensions. Many of my friends have aired grave concerns about DWP policies, arguing that they inappropriately ‘psychologise’ unemployment and locate the problem within the unemployed person.

The BPS and other organisations have also raised concerns that the DWP considers employment as a clinical outcome, and that the underpinning rationale for these policies was not improving health, but for ideological purposes. We are concerned that people would be coerced into therapy or face sanctions on their unemployment benefit payments if they refused consent.

We continue to scrutinise these policies and insist on the appropriate, ethical, use of psychological theory at all times. The British Psychological Society has argued that staff must not be involved in coercion and must maintain their professional independence as therapists. Claimants’ rights to autonomy and freely-given consent (to, for instance, participation in research trials or therapy) are non-negotiable.

Moreover, employment is not a universally positive outcome for everybody. There must be a clear commitment to appropriate work that includes long-term tailored support or there is a real risk of jeopardising recovery or worsening of mental health problems. Personally I’d go further and argue that employment should only be an outcome if that’s what the client wants.

I have my own opinions, which are guided by my understanding of psychological science, by my professional training and by my values, and which I know I share with my colleagues. Last year, I spoke out about the misuse of such policies but a principled stance is not necessarily the same as simple opposition.

The most important discussions are not easy. They aren't conceptually easy and they aren’t emotionally easy. But they are necessary - we have an obligation to engage and discuss such contentious and difficult issues, not avoid them.

Wed, 13/07/2016 - 13:51

The cliché is that we should fix our own oxygen masks before helping others. Working in a therapeutic profession is a privilege, but there are good, even self-serving, reasons to ensure that those professionals changed with helping others are properly protected.

Many of us have been concerned by apparent pressures on junior doctors and proposals to require young people entering nursing and other professions to take out loans to fund their training. And there are pressures on the ‘psych’ professions, too.

A short time ago, we reported on the findings from the joint British Psychological Society and New Savoy Partnership staff wellbeing survey. This revealed worrying apparent increases in staff stress since a similar survey in 2014, with 46 per cent of psychological professionals surveyed reporting depressed mood and 49 per cent reporting feeling they are a failure. Seventy per cent of the 1348 people surveyed said they were finding their job stressful. More details of the survey, and the results, can be found in a detailed paper.

I’m delighted that the BPS, in collaboration with the New Savoy Partnership and with the support of Public Health England, launched a Charter for Psychological Staff Wellbeing and Resilience. But we also have a responsibility to act.

So, on 21 June, at the BPS London Offices, we’ll see the next stage in this process, when Jamie Hacker Hughes (Vice-President of the BPS) and Jeremy Clarke (Chair of the New Savoy Conference) will launch a Collaborative Learning Network to share best practice on practical measures to improve staff wellbeing.

We have an obligation to our colleagues and to those who use our services to ensure that our workplaces are compassionate and safe. We need to use our skills to facilitate accountable autonomy, reflective practice, participation in decision-making, staff engagement and creation of a non-discriminatory ethos, where difference and diversity are meaningfully sought alongside work-life balance. These are valuable for us as employees, but they are also vital if we are to have compassionate and empathic services.

Find out more about my plans for next week.

Wed, 25/05/2016 - 11:13

The conference programme and a delegate's badge

Last Friday I was with the DCP Prequalification Group (assistant psychologists, research assistants and clinical psychologists in training) for their one-day conference in Birmingham entitled 'Thinking more, Saying more, Doing more'.

Our very own clinical psychologist MP, Dr Lisa Cameron MP, opened the day followed by me, clinical psychologist blogger Dr Masuma Rahim, Nina Browne and Kat Alcock on psychologists and policy and Dr Ste Weatherhead and the Walk the Talk team.

In the afternoon were Playback Theatre, Peter Kinderman, Anne Cooke and Glenn Williams on competences in clinical psychologists, and Psychologists against Austerity.

Exciting things are happening in psychology and it's great to be a part of it.

Tue, 15/03/2016 - 15:17

Following the recent New Savoy Conference there has rightly been a lot of press coverage of stress experienced by those working on the front line of psychological health services.

A notable example of this was an article for the Guardian website by Anne Cooke and Jay Watts, both Chartered members of the Society.

In an article that has attracted many comments and considerable attention on social media they write:

"When psychologists and therapists meet nowadays, the talk is often less about work and more about who’s just resigned, the latest edict about time limits and targets, and the pernicious market culture that is eroding what we do …

"The current focus is on producing figures that can win and keep contracts. Staff are often asked to see huge numbers of clients, for ever shorter time periods. What everyone wants from a therapist is someone who listens. But increasingly, listening has to compete with a demand to get to the next person on the list, to fill in outcome measures and assign diagnoses for accounting purposes or to enter in flowcharts that determine the help people get."

What is being done about this?

In addition to the Charter for Staff Wellbeing launched at the conference, the BPS is now leading on a collaborative network to work on promoting staff well-being through maximising self-care, reducing stigma and the barriers to disclosure and care seeking in staff, and working with employers to build psychologically healthy workplaces.

Fri, 19/02/2016 - 12:25

It was really good to be with the West Midlands Branch and their guests  in the Wig and Pen on 9 February in a very full upper room  for your monthly 'Psychology in the Pub' events. These events are such a good way of engaging a public and this evening was no exception. 

Of course, the rather edgy and controversial subject matter this time was a book debunking or, at the very least questioning, the pop star status that mindfulness has achieved recently, a particularly risky venture in the home city of the Oxford University Centre for Mindfulness, founded  by clinical psychology professors Mark Williams and Bill Kuyken.

Anyway, Coventry university psychologist researcher Miguel Farias and former research assistant, now child clinical psychologist, Catherine Wikholm rose to the challenge by talking to the  packed room, and fielding some pretty lively questions - about their amazingly successful recent book, 'The Buddha Pill', already now being translated into four other languages. You can see them holding their book and CD in the photograph.

Does mindfulness work! How does it work? What is it? Could it be harmful? For these and many other questions you'll just have to read the book, turn up to the next event, or both.

Thanks for having me and keep up the good work!

Thu, 11/02/2016 - 15:34