I am researching the rights of the child and have started to read about the United Nations Convention on the Rights of the Child. The full English text of the Convention can be found here: http://www.ohchr.org/english/law/pdf/crc.pdf.

 It’s a lot to take in so, for the moment, I’m just posting the link. I’ll add to this post once I’ve had time to consider further what the Convention says and means…………..

Happy reading……..

My little 7 year old son hugs and hugs and hugs me, clinging on whenever he sees me. I call him “my little shadow”. Wherever I go, even if it’s just to the loo, or to make a cup of tea, or to empty the washing machine, he’s there by my side. Sometime’s he’s there silently and neither of us speak – we just want to be in each other’s company. Other times, he’s there because he wants to share his thoughts, his questions, his jokes, his fears, his problems at school, his observations or just simply to tell me how much he loves me.

Last weekend, he was hugging me so much, just constantly. Whenever I sat down, even when I was sopping wet from the sea and cold, he jumped onto my lap and snuggled in for all he was worth. Thumb goes in his mouth and he’s comforted and warm; if he was a cat, he’d have been purring.

During one of these cuddles, I asked him who he gets cuddles from when he’s not with me. He said “nobody”. I prompted him gently to try and remind him of all the possibilities when I’m not there.

“What about if you feel sad at school or you just feel like a big warm hug; can you ask your teacher? Or the other teacher who’s known you since Reception.? You really like her and she’s a mummy too so she’s good at hugging and she knows that boys still like a big hug…….She’s given you lots of hugs when you were in the junior school.”

“No, I don’t like “teacher hugs”.

“Well, how about from your nanny. She’s soft and warm and cuddly. I know she likes to cuddle you if you want one coz she’s told me so.”

“No, I don’t want her cuddles – they’re not the same as yours”

“Well, I’m sure Daddy will give you hugs if you ask him. He’s big and strong like a bear and “man cuddles” are often the best cuddles – they make you feel really safe..”

“No, mummy. I just want a “mummy hug” – nobody else’s hugs are like mummy hugs.”

“But then who hugs you when you need one?”

“My rabbit [his cuddly toy]. Rabbit hugs me. Those are the best hugs when you’re not here, mummy. Why can’t I live with you mummy? Nobody else hugs like you do. They don’t feel the same.”

I’m lying in bed surrounded by my children’s cuddly toys – it’s the nearest I can get to having my children with me. The teddies smell of my children – some even have slightly discoloured bits where one of the children has spilt something on their teddy as they’ve dragged it around with them. Last count, there are around 30 cuddly toys in my room – all belonging to them. They’re crazy about them. There are leopards, lions, sheep, rabbits, bears, glow bears, cats…….all sorts, shapes, sizes, colours. All of them much loved.

There here with me because the children want me to have something to cuddle when they’re away from me. Each time they come here to me, they bring different ones so that the teddys do a “rota” system: the teddies spend a few weeks here, then a few weeks at their dads…………

My son gave me his favourite rabbit to cuddle whilst he’s gone. When I objected, he said it was the only rabbit that had enough of his love in it to keep me going – he wanted his rabbit to love me whilst he’s gone. He took away another new one and said that I could have the new one once he’d loved it for a bit so that it was filled with his love and then I could cuddle up to the newly love-filled rabbit……Rather like the duracell bunny, I guess….

Only problem is, these teddies don’t cuddle back. They don’t bring tears of laughter to my eyes when we swap a silly joke or make up a story. They don’t have warm, loving hands that hold mine. They don’t tease and argue and fight and joke and laugh and cry  and sneeze and jump and muck about and giggle helplessly. They don’t look at me with love, kindness and care; I can’t even bear to look into their glassy, cold eyes and see………….nothing.

They’re empty in truth.

And that’s what I am without my children.

I want to know just who came up with the spectrum of “reason”, of “normal behaviour” of “normal thoughts”? Is it defined anywhere? And, if so, who evaluates it and to what benchmark? Does it change with society’s current “norms”?

Who says that my behaviour, thoughts and emotions are “normal” or not? And what gives any assessor of these the right/credentials to evaluate them and against what scale/spectrum? Who says that the mood swings experienced by someone with Bipolar are “abnormal”? Where’s their evidence?

I have just bought a book: “Mental Health Law policy and practice” by Peter Bartlett and Ralph Sandland, both Professors at Nottingham University. They open their book with this very subject i.e. who decides what the common language of “reason” is?:

“In the serene world of mental illness, modern man no longer communicates with the madman: on the one hand, the man of reason delegates the physician to madness, thereby authorizing a relation only through the abstract universality of disease; on the other, the man of madness communicates with society only by the intermediary of an equally abstract reason which is order, physical and moral constraint, the anonymous pressure of the group, the requirements of conformity.

As for a common language, there is no such thing; or rather, there is no such thing any longer; the constitution of madness as a mental illness, at the end of the eighteenth century, affords the evidence of a broken dialogue, posits the separation as already effected, and thrusts into oblivion all those stammered, imperfect words without fixed syntax in which the exchange between madness and reason was made.

The language of psychiatry, which is a monologue of reason about madness, has been established only on the basis of such a silence. “ Foucault, 1965: x – xi

Hear, hear Foucault. The fact that one person communicates (albeit imperfectly) their thoughts to another person (who “hears” what they are “able” to hear) who then perceives those thoughts to be markedly contrary to his/her own experience of the world, does not mean that the person communicating their thoughts has “lost their reason”.

Often people find it difficult to articulate what they are thinking, especially if they are not used to articulating their thoughts. They may describe feelings, thoughts, sensations, perceptions, observations in a clumsy, half – illuminating way such that the person receiving the information can’t decipher the exact meaning. This may then come across as lacking in reason. But are they right to then extrapolate from that incoherence the conclusion that the person has “lost their reason”, isn’t “normal”, has “lost their judgement”, isn’t perceiving the world as others perceive it.

The authors of the book state the following:

“If policy has developed through silencing the mad, if it is, as Foucault claims, a discourse of reason about unreason, it then tells us as much, or more, about the reasonable as the mad. For reason to articulate insanity, it must do it with reference to sanity, because this is the only way the border can be understood.

In this way, mental health law and policy can be seen as a mirror, in which we see our own values reflected.”

Therefore, the people making mental health law and policy are basing their policies and law on their own perceptions of reason and reality – how do they know that their view of “reason” is in fact acceptable and representative of “the norm”. Even if it is representative of “the norm”, is “the norm” acceptable?

On the basis of “the norm” being the reason of the majority of people, we would still have black people confined to slavery, women would not be able to vote and it would be acceptable for a husband to rape his wife (a crime which until the 1980’s was not considered to be a crime; or at least, it wasn’t recognised as a crime in any of the criminal law statutes or cases).

Sooner or later, these “norms” have to be challenged and any anomolies resolved. It is my intention to challenge the ideas that law makers and policy makers have about mental illness and I will start in relation to Family Law.

Michel Foucault  (October 15, 1926 – June 25, 1984) was a French philosopher, historian and socialogist. He held a chair at the College de France and taught at the University of California, Berkeley. 

Michel Foucault is best known for his critical studies of various social institutions, most notably psychiatry, medicine, the human sciences, and the prison system. Foucault’s work on power, and the relationships among power, knowledge, and discourse, has been widely discussed and applied.

Well, I’m feeling miserable today. Hurt actually, very hurt. My closest friend has told me that her ex-husband (who was also a very good friend of mine before they got divorced) has written to her saying that he “will not allow his son to visit my home.” He has threatened legal action against her saying that he “questions her sound judgement as carer” in allowing her son to visit me. He goes on to say that “she should have known better”. 

She and I are both appalled and she has written back and asked him for his reasons but he is refusing to give any saying that as he is someone with joint care and control he does not need to go into this in any detail. He goes on to say that his request is not unreasonable so she should respect his wishes and if she fails to do so he will seek legal recourse. He won’t specify what “legal recourse” he thinks he might pursue nor the grounds on which he might pursue it.

So what legal action can he bring? Presumably he might try and obtain a Prohibited Steps Order against me under section 8 of the Children’s Act 1989, prohibiting me from seeing his son.

So WHAT IS A PROHIBITED STEPS ORDER?

A Prohibited Steps Order is an Order from the Court preventing/prohibiting a parent doing something with their child. It is an Order made under Section 8 of the Children’s Act 1989:  “that no step which could be taken by a parent in meeting his/her parental responsibility for a child, and which is of a kind specified in the Order, shall be taken by any person without the consent of the Court.” [Section 8(1) of the Children's Act 1989].

The Order is entirely prohibitive or negative in substance, as its name suggests. The kinds of involvements with children which might be prohibited are infinitely various but, most obviously, contact between the child and an “undesirable adult” could be restrained. Either parent can make an application to the court to prevent the child associating with someone who has an adverse influence.

So am I an “undesirable adult” or someone who has an “adverse influence”? I haven’t as yet found any guidance or cases on whether someone with a mental health condition is prima facie “undesirable” but if I do, I will keep you all informed.

So what case might he run in front of the Court to obtain such an Order? What are the facts?

1. I don’t abuse children, either sexually, physically or emotionally, nor did the Court find that I had done any of these things, nor have I ever been investigated by social services for any kind of abuse.

2. I don’t drink, I don’t take any recreational drugs and I don’t even smoke.

3. I don’t have a criminal record, nor have I ever had one, nor have I ever been prosecuted for any criminal activity.

4. I have Bipolar which is medicated properly. I haven’t had a relapse since first going on treatment 3 years ago nor have I been hospitalised since first being treated.

5. My psychiatrist says that I am perfectly capable of looking after my children. If he was concerned in any way, he has a professional duty to report his concerns to social services; he informs me that he has never doubted my ability to look after my children.

6. I have shared residency of my children; the Judge would not have given me Shared Residency if she thought I was in any way a danger to my children as I am allowed to look after them on my own for 50% of the holidays and alternate weekends. There is no stipulation that I am to be supervised or that I have to have help in looking after them.

 Given all of the above factors, what is my friends ex-husband going to say to justify his “legal action” against my friend and me?

This is a man who met me around 13 years ago when I had Bipolar but none of us knew as it hadn’t been diagnosed and I was therefore untreated at the time and for the following 10 years that he has known me. During that time, we frequently met up and he never once told me or others that he thought there was anything wrong with me. When he and his wife, my friend, were divorcing, he spent hours on the phone to me whilst I counselled him through his hurt, anger, frustration, confusion and all his other feelings of breaking up with my good friend. He turned to me for that emotional and psychological support and repeatedly thanked me for my help. Clearly he felt that I had good judgement and that I was someone he could rely on to help and support him.

He subsequently became depressed and had to have a course of anti-depressants, so he himself is not immune to depression.

He and my friend broke up before I went into hospital in 2004 and was diagnosed and then treated. He hasn’t seen me since my diagnosis so has had no direct experience of me, my behaviour, my interaction with anyone else, nor does he know any of my friends; the only person he knows that could recount anything about me is my ex-husband and my friend. He hasn’t seen what I am like with my children or with his son so he has no experience of what I am like with children since having been treated for Bipolar.

And yet he considers me unsuitable in some way. My friend has asked him for reasons as to why he thinks his son shouldn’t visit me but he refuses to give reasons. 

I summise that there can only be 2 reasons for his objections: the first is that I left my husband and found another man. Maybe he questions my “morality” and thinks that my “questionable morality” (in his view) would somehow rub off on his son. Given that his son knows nothing about the whys and wherefors of my marital breakdown, I find this first reason unlikely. Apparently, my friend’s ex husband knows nothing about my ex-husbands physical and emotional violence towards me nor about his drug taking or his visit to a prostitute. Yet he considers my ex-husband to be perfectly suitable to remain friends with. When we are comparing “morality” I think each persons morality needs to be brought into account, not just mine. His son is 7, the same age as mine and therefore has a limited grasp of the complications of marital breakdown.

 The second is my Bipolar. I am pretty sure that this is the reason as he said “in light of everything that came out of the custody case” . I was not on trial for finding someone else, I was on trial for my capabilities of my mothering due to my condition and my general personality. Given that he clearly found my personality acceptable to him in the past when he knew me, I doubt that it is “my personality” that is bothering him.

What “came out of the custody case” was a Shared Residency Order i.e. That being the case, what is he worried about?

I can only infer that he somehow is frightened/concerned about what having Bipolar means. Has he sought to educate himself about what Bipolar is and how it may affect someone or how it is managed through effective medication?

I am also irritated with him; if he had any courage and integrity he would have phoned or written to me directly to discuss this with me. If he wanted to know about my Bipolar, why doesn’t he find out about how it affects me from the horses mouth and not through my ex-husband who he surely realises isn’t going to be objective about all this? If he knew anything about Bipolar and that this was his concern, would he not write down some of his objections? I summise that because he knows nothing/very little about Bipolar, he cannot in fact give her any reasons for his objection other than “I object”.

My friend has stood by me and told her ex husband that she and her son will continue to see me as and when they like. We are now waiting to see whether he will follow through and bring legal action against her…………

In the meantime, Im trying not to be too hurt by it all……

Has anyone reading this had any Prohibited Steps Orders issued preventing them from seeing anyone else’s children? Please let me have any comments…………What are your thoughts on this?

New campaign to fight the growing problem of mental health discrimination

For several years Mental Health Media, Mind, Rethink and evaluation partner the Institute of Psychiatry, King’s College, London have been talking to people, developing and raising funds for this initiative, which is modelled on similar programmes in New Zealand and Scotland. In addition to tackling discrimination, the programme also aims to increase the physical activity levels of people with mental health issues. It will run over four years in England and is being supported by £18m from Big Lottery Fund and Comic Relief.This will be the largest amount of money ever invested in England to address discrimination – and will put people with direct experience of mental health issues right at the heart of bringing about change. We know from programmes elsewhere that this work can alter for the better the whole culture of mental health. Together, we now have the chance to do the same here. We won’t eliminate stigma and discrimination in just four years – but we have a fantastic opportunity to make a very significant start. The working title for the programme is Moving People and it starts within the next few weeks. The first major piece of work will be a six-month programme of events and consultation across the country starting in autumn 2007 – to get people involved and shaping what comes next. Over the next four years Moving People will tackle stigma and discrimination by raising people’s aspirations, improving public understanding and encouraging people to stand up for their rights. It will also bring people from very different backgrounds and with very different mental health experiences together to get physically active, get to know each other and improve their wellbeing. Moving People will include: A nationwide anti-stigma campaign, including TV advertising which will reach 75% of the adult population, backed by detailed information resources including a dedicated website 28 England-wide local community physical activity projects, bringing together people with and without mental health experience, from boxing and football to country walks Get Moving- mass participation events focusing on mental and physical wellbeing, building up to the 2012 Olympics Open Up – a locally delivered programme to empower people with mental health problems to challenge the discrimination we face Training and educationprogramme targeting leaders/professionals in key sectors (eg medical students/trainee teachers) to help them change current discriminatory behaviour Legal challenges, helping change discriminatory laws and policy This programme will be backed up by a comprehensive evaluation plan which measures the impact of the work on public attitudes and through the personal experiences of people with mental health problems. Each strand of activity will have opportunities for people with mental health issues to lead and shape it and the programme as a whole. An advisory body made up of service users and carers will ensure that user and carer needs are the foundation of the programme, provide specific guidance on involvement and engagement across the portfolio, and review progress against outcomes and values. The whole programme will be overseen by a management group which will include a member elected from the advisory body. We believe Moving People will offer a welcome focus for the energy, enthusiasm and commitment of the thousands of individuals, organisations and networks in the mental health community and beyond who work so tirelessly to overturn discrimination and prejudice. Our plan is for the campaign to learn from, build on and give a real boost to your existing anti-discrimination work, as well as supporting those who are just starting out. And though this programme relates to England we anticipate that it will complement and benefit anti-discrimination efforts elsewhere in the UK. We hope you’ll be as inspired as we are by this chance for us to take on discrimination together, and look forward to working alongside you. If you would like us to keep you updated over the coming weeks, please email info@movingpeople.org.uk Mental Health Media Mind Rethink Institute of Psychiatry, King’s College London

Another dated article but again worth a look at. I’m going to go ferreting around to see if I can find Louis Appleby and find out what he’s managed to achieve in the 7 years since this article was published. ………..

Friday, 14 April, 2000, 11:21 GMT 12:21 UK

Psychiatrist leads mental health reform

Mental illness is a growing problem

A top psychiatrist has been appointed to spearhead the government’s drive to modernise mental health services.Professor Louis Appleby is to become National Director of Mental Health for the NHS in England.

He is currently Professor of Psychiatry at the University of Manchester and Director of the National Confidential Inquiry into Suicides and Homicides by People with Mental Illness.

This new post confirms that mental health and people with mental illness are a priority

Professor Louis Appleby, National Director of Mental Health

The National Service Framework for Mental Health, launched this month, sets seven national standards for mental health services.

The aim is to drive up quality and reduce variations in services to patients and service users.

It will include round-the-clock crisis teams for emergencies, more mental health beds and improved training for GPs.

Ministers also want to close a loophole which means dangerous psychopaths who are considered “untreatable” cannot be locked up unless they commit a crime.

The framework is backed by government funding of £700m over three years.

Professor Appleby said: “This new post confirms that mental health and people with mental illness are a priority to health and social services.

“It provides an excellent opportunity to improve the quality of services to the benefit of patients, service users and their families.

“Putting the National Service Framework into practice will ensure a modern and effective system of mental health care.”

Announcing the appointment on Friday, health minister John Hutton said Professor Appleby had a wealth of clinical and academic expertise.

“He will provide clinical leadership and galvanise expertise in the mental health field.”

Huge challenge

Cliff Prior, chief executive of the National Schizophrenia Fellowship, said Professor Appleby faced a huge challenge.

This is a tsar who needs to start a revolution

Cliff Prior, chief executive, National Schizophrenia Fellowship

He said: “He must make sure that people with severe mental illness and their carers get the help they need quickly and effectively.

“He must also make sure that mental health is at the forefront of the Government’s mind when they are allocating the extra resources promised for the NHS – this is a tsar who needs to start a revolution.”

Rabbi Julia Neuberger, chief executive of the health watchdog, The King’s Fund, said mental health was a complex issue related to problems such as poverty, unemployment and bad housing.

She said: “The mental health ‘tsar’ will have to be able to coordinate Government policies on benefits, access to work, criminal justice and housing.

“These are the issues that most affect people with mental illnesses, who suffer high levels of discrimination, isolation and poverty in Britain today.”

Around one in seven people suffer from a mental health problem, including anxiety and depression.

Four in 1,000 have a severe mental condition like schizophrenia and 11,500 people are detained in hospitals or homes under the Mental Health Act.

Around 1,000 mentally ill people in England and Wales commit suicide every year and 25 commit a murder.

Mental health has been identified as one of three top priorities by the Department of Health.

Professor Appleby’s appointment follows that of Professor Mike Richards as National Director for Cancer and Dr Roger Boyle as National Director for Coronary Heart Disease.

As you know, I am researching issues surrounding mental health discrimination, so whenever I find something interesting, I will post it onto my blog. So I googled “mental health discrimination” and this was one of the first 3 items listed: an article from the BBC. This article is out of date (7 years actually!) but still worth reading. What I am amazed about though is the fact that it is such an old article yet is one of the first 3 listed on google. Does this mean that there is no later research/reports on mental health discrimination or just that google has listed articles with no particular date/relevance order?

It doesn’t specify any particular mental health condition, such as Bipolar, but does refer to a fact that we all know: that 1 in 4 people suffer mental health problems at some point in their lives. Mmmm, I wonder how many people own up to that?

Anyhow, I’ll carry on researching and leave you guys to read…………..

Monday, 24 April, 2000, 23:30 GMT 00:30 UK

Mentally ill ’suffer discrimination’

GPS are not always sympathetic, the report says

People with mental health problems suffer discrimination from family, friends and health professionals, according to a report.The Mental Health Foundation (MHF), which publishes the Pull Yourself Together report on Tuesday, says that action must be taken to tackle the stigma in society surrounding mental illness.

The report, issued to mark Health Action Week, asked people with experience of mental health problems to reveal what kind of discrimination they had suffered or witnessed.

Seventy per cent of those who took part had experienced discrimination in response to their own mental distress, or that of a friend or relative.

GP comments to mentally ill people

Snap out of it I can only help if you’re suicidal

And 44% reported discrimination from their GPs – even though they are supposed to be the first point of call for help. Nearly a fifth of people felt that they could not tell their GPs about their mental health problems.

Some also reported that GPs had attributed physical health problems to symptoms of mental illness.

Family problems

Many people had received unhelpful or damaging advice from relatives, such as “pull yourself together”. Other sufferers said they were thought to be acting, or were considered stupid or unreliable.

Three-quarters of respondents said they would not disclose mental health problems on application forms for jobs for fear of discrimination. More than half would not tell their work colleagues.

If people are experiencing discrimination or are being told to ‘Pull yourself together’, then their chances of accessing good support are diminished

Ruth Lesirge, director, Mental Health Foundation

Ruth Lesirge, MHF director, said the report highlighted the stigma and discrimination faced by people with mental health problems, and also raised serious questions about the role of the GP.

She said: “It is the doctor who can ensure that you receive appropriate services and treatment. If people are experiencing discrimination or are being told to ‘Pull yourself together’, then their chances of accessing good support are diminished.

“With one in four of the UK population experiencing mental health problems in any one year, we have to change our attitudes and build on the good services and support that are available.”

The MHF recommends:

• All GPs should have ongoing training to develop their understanding of mental health problems
• The new Disability Rights Commission should give priority to addressing discrimination in relation to people with mental health problems
• The Government and all agencies which promote mental health should join together to deliver a comprehensive anti-discrimination campaign

Dr Hamish Meldrum, a senior member of the British Medical Association’s GP committee, said: “If GPs are saying things inappropriately I am not going to condone it, but true discrimination is extremely rare.”The more serious problem is the lack of overall resources that have been made available to fund mental health care in the community.

“GPs are under severe time pressures and do not have adequate access to back-up services.”

Pull Yourself Together is based on the responses of 556 people to a postal survey.

I have decided that I can’t be alone in fretting about whether or not the DVLA are going to renew my driving licence so I’ve been looking at what other Bipolarites have said about their experiences with the DVLA. Interestingly, there are others who think that the DVLA’s rules about Bipolarites driving around in their cars minding their own business is probably Mental Health Discrimination. I’m not saying whether it does or doesn’t amount to discrimination at this stage as I am still researching it, but in the meantime this is what some others have to say. I have quoted them and then given you the link to their blog……

{I am hoping that the authors won’t mind me quoting them, but if any of you authors object please do let me know: I really don’t mean to offend anyone……..}.

“As far as I know highly qualified UK Government Medical Officers are paid a mint to read these things and make arbitrary decisions when it might as well all be keyed into a computer system by a monkey and scored to give a standard answer.  DVLA says NO.

I believe that this is simply due to lack of research on this subject due to lack of funding, plus and unwillingness on the part of the DVLA to accept testimonies from mental health professionals such as CPNs and Occupational Therapists that are involved in aftercare and monitoring during the first 3 months.

Bipolar disorder is a very individual illness and recouperation rates can vary from person to person. An Occupational Therapist once told me that she could see no reason for this strict arbitary ruling, as in her experience some patients can be well and stable within a few weeks of leaving hospital (otherwise why would they be out?!).  Being unable to drive interfered with their integration back into the community and in some cases lost them their jobs.

Personally, I have NEVER relapsed in the first 3 months after a hospital admission. I have NEVER even relapsed in the first 3 years after a hospital admission.  Why can’t the DVLA accept a more detailed report from my consultant or another mental health professional explaining this?

I believe that this is disability discrimination in that the DVLA is making generalisations based on statistics, rather than assessing the individual case.”

Bipolar Works: http://bipolarworks.wordpress.com/2007/02/02/bipolar-disorder-and-driving-or-dealing-with-the-devil/

I found this question and answer on the Netdoctor site: http://www.netdoctor.co.uk/ate/depression/204078.html

“My psychiatrist has prescribed me Ozyprexa 10mg to help me with a psychotic disorder.The drug has very bad side effects such as shortened memory and poor co-ordination. These effects make me even more depressed and I stopped taking the pills.Unfortunately my psychiatrist also revoked my driving license and is refusing to return it unless I take the pills.I feel fine when not on medication and still argue that there is nothing wrong with me.If I was to take the pills I would feel less confident driving as I think I am more likely to have an accident due to the side effects.This seems very un-ethical to me, is there anything I can do about it?AnswerDavid writes:I’m very sorry you’ve had such a rotten time recently. However, it is vitally important not to do anything that might put your life (and the lives of other road users) at risk.The situation at the moment seems to be that you’re in dispute with your specialist about your driving licence.You could ask for a second opinion from another specialist. But the final decision rests with the DVLA at Swansea and if you feel you have been treated unfairly you can appeal to them.Christine replies:I too am very sorry you’re going through such a difficult time. Unfortunately it is often very difficult for people who need medication to understand just how important that medication is and to comply with the doctor by taking it.Having said that, there are a wide variety of anti-psychotic drugs available and I do feel that some sort of compromise should be reached where you would agree to try another drug.Ideally this should be one that is equally effective but which doesn’t knock you for six like the stuff you’ve been prescribed in the past.As David says, you can always ask to see another specialist.

My other suggestion is that you contact Mind. They are very helpful on subjects like changing specialists and also on what specific drugs are supposed to do.I do hope this information will help you and I wish you the best of luck in getting this whole business sorted out. Yours sincerelyDavid Delvin, GP and Christine Webber, psychotherapist”Here is an extract from a discussion forum about Effexor, the drug, and how it may affect your ability to get a licence:http://www.depressionforums.org/forums/index.php?showtopic=1788“Other effects from this was I had to take other medication to heal my stomach, since I was in so much pain and my GP banned me from driving.  Still waiting to hear if my licence is going to be taken away from me.  
[DVLA eventually put me on a 3 year licence and then after  another OD and seizure was given a 1 year licence.  This was after months of waiting for them to review my GP and Psychiatrist report.]”

Oh, and how about this: a piece of research on whether Canadian psychiatrists feel able to determine someone’s fitness to drive. Although the research is written about Canadian psychiatrists, it is based on research on British psychiatrists and their attitutes, knowledge and experience in determining “fitness to drive” in their patients:

Canadian Psychiatrists’ Current Attitudes, Practices,and Knowledge Regarding Fitness to Drive in Individuals With Mental Illness: A Cross-Canada Survey

http://publications.cpa-apc.org/media.php?mid=302

Oh my gosh! This is an unbelievable story that I found: a man shot himself and the inquest learned that whilst the DVLA had taken his licence away, he was still licensed to hold guns. The moral is: you can’t drive if you have a mental illness, but you’re allowed to keep a gun…………The poor bloke…..

http://www.markwalton.net/1/archives/2006_04.asp

‘Licensed to kill himself’

“THE SON of a wealthy retired businessman who died after sustaining three massive shotgun wounds said last night: “This tragedy could have been avoided.”

Company director Angus Ashton, 56, claimed that although his elderly father, Philip, who suffered from dementia, had his driving licence taken off him by the DVLA on advice from a doctor he still held a licence for THREE shotguns.

“The bottom line was that my father could not legally drive a car but he could own and shoot a gun.

“I pointed this out to a senior firearms officer and nothing was done about it,” he said. “The police deny the conversation ever took place.

“I have to accept part responsibility for what happened because I should have followed it through instead of leaving the situation to drift on.”

But last week at an inquest in Warrington, Cheshire coroner Nicholas Rheinberg said he was concerned at the lack of co-operation between the DVLA and the police firearms licensing authorities and said he would investigate further.

Angus, who lives in Sutton with wife Nicola, is still shocked by the shooting incident almost exactly a year ago, April 14, 2005, when the well-known retired quarry merchant of Swanscoe Cottage, Rainow, was found with three gunshot wounds – two through his chin and one through his chest.

He died in hospital almost two weeks later.

Father-of-two Angus sincerely believes that his father accidentally shot himself after slipping on grass on his estate while taking a “pot shot” at Canadian geese which had been bothering him – and then realising the extent of his injury turned the gun on himself.

“There were four shots,” he said. “The first was at the geese, the second was through his chest and the third and the fourth were through the mouth.

“I believe he had an accident and realising he was done for he decided to finish himself off.

“His background was in breeding Aberdeen Angus cattle and he had the attitude of a ruthless farmer or sympathetic one, whichever way you look at it. He couldn’t bear to see anything suffer.”

Astonishingly, Mr Ashton, father-of-three and grandfather-of-five, would have had to have broken the single-barrelled Penderetti and reloaded it each time he took a shot.

Police ruled out foul play after forensic found bruising on his right hand which established he had fired the shots himself.

Coroner Nicholas Rheinberg recorded an open verdict on Mr Ashton, whose death, he said, was “something of a mystery”.

But he took the view that he slipped on wet grass and that the gun had discharged accidentally causing a serious injury.

“It is possible he was in pain and decided his injury was so serious that it would be better to finish it off,” he speculated.

He pointed out that some years earlier Mr Ashton had made what was known as a “living will” – a direction that in the event of him becoming so physically or mentally ill that the quality of his life would be seriously affected, no attempt should be made to revive him.

Philip Ashton, who was chairman of builders merchants Ashton Vernon and originally lived at Swanscoe Hall, struck an imposing figure at 6ft 4in and enjoyed the outdoors and a typical hunting, fishing and shooting lifestyle.

During the later part of his life he loved to wander over his sprawling land and perch on a log or a bench to admire the countryside.

But Mr Ashton, who never got over the death of his second wife, Liz, had been suffering from dementia, resulting in short-term memory loss, diabetes and heart disease.

“He remarried in 1974 and they were supremely happy,” Angus said later. “He doted on her and it hit him hard when she died of cancer in 1988. He never really got over that.”

And he added: “He was a good father to myself and my sister Grahame and his adopted son John Davies.

“He was a hard man, but he had successfully built up a company with the help of myself and John.

“In the last part of his life he was lonely. It was difficult to communicate with him – very frustrating.”

At the inquest Philip’s housekeeper, Mrs Peta Massey, said she found him lying conscious, but unable to speak, near a pond where the geese were annoying him. He was flown to hospital by air ambulance.

While in hospital he couldn’t talk but indicated both to members of his family and to nursing staff on several occasions that his wounds were due to an accident. He shook his head when asked if he had shot himself deliberately.

He died as a result of bronchial-pneumonia and shotgun wounds, with heart disease as a contributory factor.

Consultant forensic pathologist Dr Charles Wilson said it was remarkable that Mr Ashton had survived as long as he did after sustaining the injuries. But he said he was a strong man for his age.”

Do tell me any of your own stories. I’m going to keep a look out for any more on the web but do share yours be they tragic, funny, unbelievable, outrageous or just interesting.

Thanks and happy driving to those who have still got their licences…..For those who haven’t – sod the DVLA and appeal if you can…..

I have been researching the DVLA rules regarding whether or not you can drive if you suffer from Bipolar to determine whether or not the DVLA can refuse me a licence as I suffer with Bipolar 2. Being a parent with young kids, driving is very important; if I am forced to give up my licence it will make seeing my kids even more difficult than it is already.

I’ve continued driving whilst the DVLA are undergoing their investigations as to my fitness to drive. I know that I’m absolutely fine to drive, so I should have my licence re-issued as I pass all the tests i.e.:

• I have been well for 3 years
• I am fully compliant with my medication regime
• I do not abuse substances such as alcohol or illicit recreational drugs
• I don’t fall asleep from my sedatives whilst driving
• My judgement isn’t impaired unless its a white van driver behind me driving 2mm from my rear bumper – then there’s a slight wish to slam on the brakes and shout at him/her that I’m a crazy woman who he/she shouldn’t mess with…………………..only kidding…….

I think the following aspects of my driving should also be taken into account………………

• I don’t think that going 150 mph in a 30mph zone is ok……….
• I do think that anyone who goes 20 mph in a 30mph should be shot……well, ok shooting them’s a bit extreme…………maybe I could just through eggs at their back windscreen so that they’re forced to pull over and I can then get on my merry way………
• I do think that blasting up my favourite Killers song (Mr Brightside, for those of you who are interested) is a fantastic accompliment to my driving happiness levels. (As is Fat Boy Slim, Faithless, Primal Scream, Prodigy and loads of others as I am a musicaholic…..)
• I limit my caffeine intake whilst driving to 3 cups per hour ………………………………………………….!!!!!!!!!!!!!!!!! Is this an “illicit substance” for the purposes of the DVLA’s investigation???? Causes anxiety and mania???Affects concentration as your hands are too busy shaking so you can’t clutch the wheel properly…….
• I don’t think that I’m Jeremy Clarkson or any other celebrity who thinks that they are beyond the speed limits……………………………………………………..(PS I really like Jeremy Clarkson and would dearly love to go the speeds that he goes as I am an adrenaline junkie, but I reckon it would give the Judge too much to go on.)
• I don’t think that putting on my mascara, doing my nails or otherwise tending to my personal appearance is worth being pulled over for by the police
• I don’t yell down the phone at my ex-husband whilst not on a hands free device (although it has to be said that this affects my concentration momentarily as I imagine all the ways I’d like to throttle him……………..JOKE! I am NOT dangerous…..)
• Eating chocolate, crisps and sweeties is OK whilst driving as it increases my endorphin levels so that I am a happy bunny which means I can tolerate other people’s bad driving more easily……
• I have stopped talking to my lawyer whilst driving as this substantially increases my ability to concentrate and my anxiety levels due to the thoughts that the conversation I’m having is costing my £100 every half an hour I spend on the phone to him…………Bloody lawyers………

So, I will stick to my normal driving habits and hope that I’ll be given my new licence……….Watch this space.

There are various websites giving information about the DVLA’s rules with regards to drivers with mental health problems, including:

•  Rethink is an organisation for people suffering with a mental health illness – www.rethink.org http://www.rethink.org/living_with_mental_illness/everyday_living/driving/index.html (gives the rules but also tells you how to appeal if the DVLA refuse you a licence or revoke it.
• Open Up:Mental Health Media’s anti-discrimination toolkit project. 
  http://www.openuptoolkit.net/know_your_rights/driving.php
• MIND: The mental health charity: http://www.mind.org.uk/Information/Legal/driving.htm
• DVLA: The guidelines, “Guide to the current Medical Standards of Fitness to Drive” can be found on the DVLA website at http://www.dvla.gov.uk/ . They have produced a Form M1 which you can view and download here http://www.houlston.freeserve.co.uk/mentalhealthdvla.pdf
• DirectGov: the Government’s website giving information about Government departments: http://www.direct.gov.uk/en/Motoring/DriverLicensing/MedicalRulesForDrivers/DG_4022415

The law can be found in the Road Traffic Act 1988 and Part VI of the Motor Vehicles (Driving Licences) Regulations 1999 together with other regulations and guidelines for medical practitioners.

 Here is what the Bipolar Organisation ~( www.mdf.org.uk) says:

Driving – DVLA

Below is the current information from the DVLA on Psychiatric Disorders and what action needs to be taken.
If you have any queries about these you should contact the DVLA directly.

If you have a medical condition which has become worse since your licence was issued or you develop a new medical condition, you must inform the Drivers Medical Group of your condition, as it may affect your fitness to drive. Failure to do so is a criminal offence and is punishable by a fine of up to £1000.

Psychiatric Disorders

GROUP 1 ENTITLEMENT
ODL CAR, M/CYCLE

GROUP 2 ENTITLEMENT
VOC LGV/PCV

ANXIETY OR DEPRESSION

(without significant memory or concentration problems, agitation, behavioural disturbance or suicidal thoughts).
DVLA need not be notified and driving may continue. (See note about medication in appendix at end of this Chapter).
Very minor short-lived illnesses need not be notified to DVLA. . (See note about medication in appendix at end of this Chapter).

MORE SEVERE ANXIETY STATES OR DEPRESSIVE ILLNESSES

(with significant memory or concentration problems, agitation, behavioural disturbance or suicidal thoughts)

NB: For cases which also involve persistent misuse of or dependency on alcohol/drugs, please refer to the appropriate section of Chapter 5. Where psychiatric illness has been associated with substance misuse, continuing misuse is not acceptable for licensing.

Driving should cease pending the outcome of medical enquiry. A period of stability depending upon the circumstances will be required before driving can be resumed. Particularly dangerous are those who may attempt suicide at the wheel.

Driving may be permitted when the person is well and stable for a period of 6 months. Medication must not cause side effects, which would interfere with alertness or concentration. Driving is usually permitted if the anxiety or depression is long-standing, but maintained symptom-free on doses of psychotropic medication, which do not impair. DVLA may require psychiatric reports.

NB. It is the illness rather than the medication, which is of prime importance, but see notes on medication.

ACUTE PSYCHOTIC DISORDERS OF ANY TYPE

NB: For cases which also involve persistent misuse of or dependency on alcohol/drugs, please refer to the appropriate section of Chapter 5. Where psychiatric illness has been associated with substance misuse, continuing misuse is not acceptable for licensing.

Driving must cease during the acute illness. Re-licensing can be considered when all of the following conditions can be satisfied:

• (a) Has remained well and stable for at least 3 months
• (b) Is compliant with treatment
• (c) Is free from adverse effects of medication which would impair driving
• (d) Subject to a favourable specialist report

Drivers who have a history of instability and/or poor compliance will require a longer period off driving.

Driving must cease pending the outcome of medical enquiry. It is normally a requirement that the person should be well and stable for 3 years (i.e. to have experienced a good level of functional recovery with insight into their illness and to be fully adherent to the agreed treatment plan, including engagement with the medical services) before driving can be resumed. In line with good practice, attempts should be made to achieve the minimum effective anti-psychotic dose; tolerability should be optimal and not associated with any deficits (e.g. in alertness, concentration and motor performance) that might impair driving ability. Where in patients with established illness the history suggests a likelihood of relapse, the risk should be appraised as low (either in the treated or untreated state). DVLA will normally require a consultant report that specifically addresses the relevant issues above before the licence can be considered.

HYPOMANIA/MANIA

NB: For cases which also involve persistent misuse of or dependency on alcohol/drugs, please refer to the appropriate section of Chapter 5. Where psychiatric illness has been associated with substance misuse, continuing misuse is not acceptable for licensing.
Driving must cease during the acute illness. Following an isolated episode, re-licensing can be reconsidered when all the following conditions can be satisfied:

• (a) Has remained well and stable for at least 3 months
• (b) Is compliant with treatment
• (c) Has regained insight
• (d) Is free from adverse effects of medication which would impair driving
• (e) Subject to a favourable specialist report

REPEATED CHANGES OF MOOD: Hypomania or mania are particularly dangerous to driving when there are repeated changes of mood. Therefore, when there have been 4 or more episodes of mood swing within the previous 12 months, at least 6 months stability will be required under condition (a), in addition to satisfying conditions (b) to (e).

Driving must cease pending the outcome of medical enquiry. It is normally a requirement that the person should be well and stable for 3 years (i.e. to have experienced a good level of functional recovery with insight into their illness and to be fully adherent to the agreed treatment plan, including engagement with the medical services) before driving can be resumed. In line with good practice, attempts should be made to achieve the minimum effective dose of psychotropic medication; tolerability should be optimal and not associated with any deficits (e.g. in alertness, concentration and motor performance) that might impair driving ability. Where in patients with established illness the history suggests a likelihood of relapse, the risk should be appraised as low (either in the treated or untreated state). DVLA will normally require a consultant report that specifically addresses the relevant issues above before the licence can be considered.

Appendix

PSYCHIATRIC NOTES

• The 2nd EC Directive requires member states to set minimum medical standards of fitness to drive and sets out the requirements for mental health in broad terms
• The Directive makes a clear distinction between the standards needed for Group 1 (cars and motorcycles) and Group 2 (lorries and buses) licences, the standards for the latter being more stringent due to the size of vehicle and the greater time spent at the wheel during the course of the occupation
• Severe mental disorder is a prescribed disability for the purposes of Section 92 of the Road Traffic Act 1988. Regulations define “severe mental disorder” as including mental illness, arrested or incomplete development of the mind, psychopathic disorder or severe impairment of intelligence or social functioning. The standards must reflect, not only the need for an improvement in the mental state, but also a period of stability, such that the risk of relapse can be assessed should the patient fail to recognise any deterioration
• Misuse of or dependency on alcohol or drugs will require the standards in this chapter to be considered in conjunction with those of Chapter 5 of this publication.

MEDICATION

• Section 4 of the Road Traffic Act 1988 does not differentiate between illicit or prescribed drugs. Therefore, any person who is driving or attempting to drive on the public highway, or other public place whilst unfit due to any drug, is liable to prosecution
• All drugs acting on the central nervous system can impair alertness, concentration and driving performance. This is particularly so at initiation of treatment, or soon after and when dosage is being increased. Driving must cease if adversely affected
• The older tricyclic antidepressants can have pronounced anticholinergic and antihistaminic effects, which may impair driving. The more modern antidepressants may have fewer adverse effects. These considerations need to be taken into account when planning the treatment of a patient who is a professional driver
• Anti-psychotic drugs, including the depot preparations, can cause motor or extrapyramidal effects as well as sedation or poor concentration, which may, either alone or in combination, be sufficient to impair driving. Careful clinical assessment is required
• The epileptogenic potential of psychotropic medication should be considered particularly when patients are professional drivers
• Benzodiazepines are the most likely psychotropic medication to impair driving performance, particularly the long acting compounds. Alcohol will potentiate the effects
• Doctors have a duty of care to advise their patients of the potential dangers of adverse effects from medication and interactions with other substances, especially alcohol
• Drivers with psychiatric illnesses are often safer when well and on regular psychotropic medication than when they are ill. Inadequate treatment or irregular compliance may render a driver impaired by both the illness and medication.

CONFIDENTIALITY

When a patient has a condition which makes driving unsafe and the patient is either unable to appreciate this, or refuses to cease driving, GMC guidelines advise breaking confidentiality and informing DVLA. [GMC Confidentiality Handbook] PATIENTS UNDER SECTION 17 OF THE MENTAL HEALTH ACT

Before resuming driving, drivers must be able to satisfy the standards of fitness for their respective conditions and be free from any effects of medication, which will affect driving adversely.

Here is some advice from the following link on the Flesh and bones website: http://www.fleshandbones.com/readingroom/viewchapter.cfm?ID=994
 Do I have to inform the DVLA that I am taking antidepressants?
Straightforward anxiety and depression does not need to be notified to the DVLA. If there are problems relating to memory, agitation or suicidal thinking, then this needs to be notified. If the condition may make the driver dangerous, this must be notified, and the DVLA may then make  enquiries to decide whether the licence should be withdrawn. There is no obligation to notify the DVLA if you are taking antidepressants, providing you are aware that all medication can impair alertness, concentration and driving performance especially within the first month of starting medication  or increasing the dose. If you experience any problems then you should not drive. Sedative antidepressants are more likely to cause drowsiness, and antidepressants can interact with other drugs and tranquillizers as well as alcohol. In general, drivers with depression are safer when well and on regular antidepressant medication than when ill. If in doubt about your fitness to drive you should not drive and should notify the DVLA. It is the illness and the general condition that you suffer from that is the most important thing rather than the medication that you are taking.

I also found an article that said that the DVLA was setting up an independent review to look into the way medical conditions are assessed and their effects on an individual’s ability to drive.

In 2000 the Department for Transport set up a research programme into “Medical Fitness to Drive” with a number of important studies, including the attitudes of healthcare professionals towards giving advice. Areas of concern include the effects or side effects of medication. This was due to be completed in November 2005. I will look further into the results of this and post them on a separate post…………..

Well, there you go. Are there any readers who have had any experiences regarding their ability to drive and their encounters with the DVLA? Please do comment so that we can all see what the issues are and then how we may be able to address them.

 Thanks.

P.S. Any other music recommendations for driving to? No “air guitar” suggestions please as I try hard to keep my hands on the wheel at all times, even when gesticulating madly to my lawyer who can’t see what I’m gesticulating…………………