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An excerpt from The Science of Near-Death Experiences. Near-death experiences are an ancient and very common phenomenon that spans from ancient philosophy, religion, and healing to the most modern clinical practice of medicine. Modern advances in medical knowledge make it possible to revive patients from increasingly severe, life-threatening injuries and illnesses, including cardiac arrest.  Upon being revived, such patients often report experiencing life-changing alternate […]

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Net promoter scoring (NPS) measures customer experience and predicts business growth. Recently it is becoming more common for health networks to adopt NPS. The word “customer” should be a red flag. In medicine, we do not have customers; we have patients. It is common practice for a patient to receive a text message after they leave […]

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Move follows concerns about ‘hidden health disaster’ of sleeplessness among young

Schoolchildren across Britain may be offered sleep lessons to help tackle the problem of insomnia among young people.

The lessons became available to teachers at the end of last year and was devised by the PSHE Association and the department for sleep medicine at Evelina London children’s hospital.

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Changes will include a mental health overhaul and advances in diabetes care

As the government prepares to unveil its 10-year-plan for the NHS on Monday, here are some of the details we already know about.

Related: Simon Stevens told to transform the NHS – and keep it out of the headlines

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This article is sponsored by Careers by KevinMD.com. Wide open spaces. Fresh, clean air. No people for miles around. The advantages of rural living are plentiful, but there are disadvantages, too, especially when it comes to health care; being way out in the country likely means the choices for doctors, clinics and hospitals are severely […]

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 25-year-old woman is evaluated during a follow-up visit for an 18-month history of ankylosing spondylitis. She has minimal lower back pain with morning stiffness lasting 20 minutes. She is able to pursue her activities of daily living without any restrictions. […]

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May 2016, Kijabe, Kenya I arrived in casualty (the emergency department) to see a minimally responsive Kenyan boy with a body wasted from malnutrition. His mother stood at the bedside cradling his head, her eyes full of fear. His parents had traveled for days over rugged mountain roads in the rains to get to the […]

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Among modern industrialized nations, only the United States endures the current public health epidemic of firearm-assisted injury and death. In 2017, nearly 40,000 people were shot to death in the U.S., while proponents of the Second Amendment continue to protect it at all costs — fighting even common sense measures such as limiting access to […]

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Late one evening, I received a text from my oldest daughter. “What in medicine, that we do now, will we think is barbaric in 50 years?” Wow. They play more provocative bar games now than they played when I was in my 20s. I promptly texted back my knee-jerk response: “chemotherapy.” As we are on […]

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The Trump administration has proposed that insurance plans providing drug coverage to Medicare beneficiaries will no longer be forced to cover six hitherto “protected” drug classes. The classes — which include drugs for psychiatric conditions, cancer and immune diseases –– are among the priciest of all drugs and account for as much as 33 percent […]

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I have done some of my best thinking on the front seat at 2am

I apologise for starting a column about the joy of small things with the doom of depression, but it was in the middle of a quagmire of ennui, nocturnal sleeping patterns and the cold winds of increasing isolation – familiar to many who experience mental health problems – that this particular delight was discovered. It’s a slim delight, but a critical one. A delight that, when I am most well, I do not experience. It is riding buses at night.

Night buses are synonymous with drunken, rowdy revellers; takeaway food in polystyrene containers; the stink of skunk; amusing group banter overheard. But night buses midweek, when the sky is the colour of plums and the only other road users are council maintenance workers – those night buses are a different prospect altogether.

Related: Can our names inspire our choices in life?

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At least one of the men among those brought back to Manus from Port Moresby ahead of Apec summit as part of ‘security preparations’

A mental health crisis among refugees and asylum seekers on Manus Island has continued over the Christmas period, with at least three men medically evacuated to Port Moresby for hospitalisation after suicide attempts or acts of self-harm.

At least one of the men was among dozens moved by Papua New Guinea authorities from Port Moresby back to Manus Island as part of “security preparations” ahead of the Apec conference in November, including those who were yet to receive or complete medical treatment.

Related: Life in limbo: the Manus babies who face a stateless future

Related: Pakistani refugee detained on Manus to fight for PNG boxing title

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Campaigners wary of pledge to expand treatment to more children and teenagers

Theresa May is to promise a major expansion of NHS mental healthcare for children and young people in an attempt to tackle the “scandal” of most under-18s not receiving treatment.

Health service managers said they hoped the move would end the persistent criticism that only a minority of young people receive help for debilitating conditions such as depression, eating disorders and psychosis.

Related: Teenagers' struggle for mental health care: 'I needed help quite badly'

Related: ‘I tried to take my own life. They told me I’d have to wait a month for help’ | Mary O’Hara

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Device use may not be issue if parents supervise other areas of children’s lives, study claims

Spending time looking at screens is not intrinsically bad for children’s health, say the UK’s leading children’s doctors, who are advising parents to focus on ensuring their children get enough sleep, exercise and family interaction rather than clamping down on phones and laptops.

The Royal College of Paediatrics and Child Health has produced the first guidance for parents on how long children should spend on their laptops and phones, which throws the ball firmly back into the parents’ court.

Related: I love my ‘dumb phone’. It’s just so slow on the uptake | Alice O’Keeffe

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As three new books show, keeping active can be great for mental health. But government has a role to play as well

When Ella Risbridger was at her lowest ebb, sitting with a psychiatrist trying to explain why she had wanted to throw herself under a bus, help came from a wholly unexpected source. Her mind was “looking for a puzzle” to occupy itself, as she put it, something to take her outside the horrible thoughts she was having. And it settled, most unexpectedly, on baking.

She came home from hospital and made a pie, and from then on cooking became a sort of comfort and salvation. For her, the rhythmic and predictable act of making meals became a self-soothing ritual, a way not so much of curing her chronic anxiety as living through it. Even the recipe that provided the title of her wholly unconventional cookbook, Midnight Chicken, came from an afternoon spent lying on the floor wondering if she would ever be able to get up.

Related: When I feel unutterably sad, there’s only one thing that helps: exercise | Bella Mackie

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Readers respond to Guardian reports on a GP survey suggesting that a shortage of mental health care is putting children at risk, and on a shortage of mental health staff in the NHS

We, as a group of child mental health professionals, academics, campaigners and politicians, agree with the sentiments expressed in your front-page article (Shortage of mental health care is putting children at risk, GPs warn, 31 December).

The slogan of requiring “a parity of esteem” between physical and mental health in society, often used by ministers and others, needs to become an urgent future reality if we are to stem the emerging epidemic of mental health problems among young people. Some of us believe it would be wise to redirect 20% of current reactive spending on this area towards focused preventive programmes such as mental health first aid and other evidence-based interventions. We think this would ameliorate the current reliance on clinic-based and psychiatric medication-based interventions and reap rich rewards and results.

'My beautiful and clever son seems a shell of who he once was and I have gone from being fearful for him to being afraid of him.'

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NHS mental health trusts in England employed just 1,524 extra personnel in past year

Ministers are on course to miss their target of increasing the number of mental health staff by 21,000 by 2020, according to NHS workforce figures obtained by Labour.

A year after the government made the pledge, NHS mental health trusts in England had employed just 1,524 extra personnel, according to statistics collected by NHS Digital.

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As GPs warn young people could suffer harm because of treatment delays, one 16-year-old talks about her experience

  • Lack of NHS mental health services puts under-18s at risk, say GPs

India knows all about the importance of getting timely help for mental health problems. “I have had issues since late primary school although I only recognised it in myself about four years ago,” said the 16-year-old from south-west London. “I had body image issues and and general anxiety about odd things like talking to strangers. I had issues of not eating and binge eating, purging, stuff like that.”

She says that when she first confided in her mother about three years ago and sought help, her mother took her straight to the GP. India was referred to NHS child and adolescent mental health services (Camhs), and she estimates that it took her a couple of weeks to be seen. She believes that if she had been forced to wait longer, it could have had dire consequences for her.

Related: Online CBT is not a therapy substitute, but a step to help manage anxiety

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Emotional disorders in young people are growing while NHS services are in crisis. Apps are not the cure but a stopgap

  • ‘Inadequate’ NHS services put under-18s with mental health issues at risk


Anxiety, one of the most common mental health problems, is a many-headed monster. Anxiety disorders include panic disorder, generalised anxiety disorder, phobias, social anxiety disorder, obsessive-compulsive disorder, separation-anxiety disorder and post-traumatic stress disorder. Anyone who experiences an anxiety disorder will tell you how acutely disabling it feels.

We all get anxious from time to time, particularly when we are about to do something we see as threatening or frightening. In the short term, anxiety is functional, making us feel alert while improving our performance. However, acute or chronic anxiety is unhelpful. It negatively affects our thinking, behaviour and emotional reactions, and can have a significant physical impact, leading to disorder. In addition, more than half of individuals with an anxiety disorder will have a coexisting diagnosis of depression.

Related: Autistic people listen to their hearts to test anti-anxiety therapy

Our connection with nature is reduced...

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Survey shows young people struggle to access treatment and face long delays

  • Online CBT is not a therapy substitute but a step to help manage anxiety

Nearly all GPs worry that young people with mental health problems will come to harm because of difficulties in accessing treatment on the NHS, according to a survey.

The poll of UK family doctors found that 99% said they feared that under-18s would come to harm as a direct result of facing long delays to see a specialist and vital care being rationed.

Related: Case study: timely help for teenagers with mental health issues is vital

78% of GPs are worried that too few of their young patients can get treatment for mental ill-health.

86% have seen a rise in the last two years in the number of 11- to 18-year-olds with anxiety.

88% say it is impossible or very difficult for young people to get help with anxiety.

68% are seeing more under-18s who have self-harmed.

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Sky-high rents, career fears, social anxieties… It’s no wonder so many young people can’t face the future

Last week I found my 15-year-old self’s diary. In its angst-riddled pages alongside gripping stories of unrequited love, fake IDs and Lambrini-fuelled exploits, I discovered a list of things I wanted to achieve by the age of 25. These included: own a house in Notting Hill; be a successful TV presenter; be engaged; own a pink Audi TT. “Fuck,” I thought, not for the first time that day. I am 25 and a half; single, unable to pay my rent and the closest thing I own to a car is a broken skateboard. My head began to spin, a familiar tightness seized my chest and the sweat glands in my palms went into overdrive, signalling the beginning of a panic attack that would last the best part of the day.

I’ve suffered from anxiety attacks since my first year at university when, with the trusty help of WebMD, I diagnosed myself with late-onset asthma and, on occasion, cardiac arrest. A doctor prescribed beta blockers during my third-year dissertation, which I was too scared to take. But, as life settled into a more stable rhythm and I stopped consuming Chekov vodka at the rate of a thirsty...

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The writer and comedian on being a problem child, how depression led her to become a champion of mental health, and what she learned from Donald Trump

Ruby Wax was born in Evanston, Illinois, and for more than 25 years has been a comedian, TV writer and performer. She holds a master’s degree in mindfulness-based cognitive therapy from Oxford University and was awarded an OBE for her services to mental health. She is the author of the bestsellers Sane New World and A Mindfulness Guide for the Frazzled and has toured with the accompanying one-woman shows. Her latest book, How to Be Human, is out now in paperback.

How to Be Human: The Manual sets out to answer life’s big questions… So in a nutshell – how can we be human?
Part of it is to understand the mechanics of what we are, because if we don’t look in to how the brain works, how we got to be like this, we just assume, oh well, I am the way I am and we never change. Understanding neuroplasticity and epigenetics we realise that we can change. And if you can understand that it’s not our fault, our condition is the human condition, then we can be nicer to ourselves because part of the problem is that everybody has these critical...

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In family medicine, there’s a minor obsession with the word “pipeline.” The term makes me want to scream. Just think about a pipeline. The “line” part is superfluous. A pipeline is actually just a pipe. Our goal is to stuff prospective mission-driven family physicians into a big pipe, confine them there and apply large amounts […]

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It must have been about a decade ago.  It was another snowy day like today.  I awoke at the break of dawn, and rushed out the door to the hospital that was several miles away.  Leaving so early in the morning, the expressways hadn’t even been plowed yet.  I did this often.  Jumped into the […]

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When I was in medical school, I didn’t realize the potential data would have in health care. Back then I learned from 1000+ page hardcover textbooks and handwrote notes in paper medical records. Fast forward twenty years — data and analytics are at the forefront of health care. Other doctors and I now have electronic […]

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Not including residency, I have been caring for patients for five years. But was I really caring about them? We all took the oath to do no harm. We all began our journey into medicine with intentions to make a difference in patient’s lives. But sometimes our intentions erode. We become jaded. We listen to […]

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In response to the increasing burdens of administrative work and cumbersome charting levied upon healthcare providers in recent years, medical scribes have been touted as a potential solution for streamlining the documentation process.  Interest in the use of scribes has certainly been increasing, with the American College of Medical Scribe Specialists estimating that the number […]

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The intestinal microbiota, also commonly known as the ‘‘gut microbiome’’ is integral to human physiology and has wide-ranging effects on the development and function of the immune system, energy metabolism and even nervous system activity. There is a lot of excitement around the potential of targeting the microbiome therapeutically to promote health and to prevent […]

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NYPD visited Davidson after writing ‘I don’t want to be on this earth anymore’ to make sure he was all right

New York City police were sufficiently concerned about the comedian Pete Davidson on Saturday after he wrote a disturbing social media post that they visited the Saturday Night Live TV star to perform a “wellness check” before the show.

Davidson, 25, wrote “I don’t want to be on this earth anymore” on Instagram. Officers visited Davidson, who has spoken openly about his mental health problems in the past, to make sure he was all right.

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Studies have found that mental health-related ER visits decrease around Christmas, despite an array of stresses

Night falls before you’ve left work, your very best winter coat doesn’t really keep you warm enough and the only thing you have to look forward to is sitting on your parent’s couch and realizing that you haven’t really changed since you were 14. The holidays are hard.

But are they harder than the rest of the year? It’s a question I was asked by one of you and the data I found came as a surprise to me. In 2011, a study titled The Christmas Effect on Psychopathology reviewed the available research on this question (psychopathology is the study of mental health). The authors found that ER visits for mental health issues actually fell during the week of Christmas.

Related: My data sketch: George HW Bush's inaction on Aids | Mona Chalabi

Perhaps it is because there are additional coping resources available at that time that are not available to the same extent at other times.

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Trial seeks further proof that tuning into our internal organs’ activity can reduce anxiety

A pioneering therapy aimed at lowering anxiety by tuning into your own heartbeat is being put to the test in the first clinical trial of its kind.

The treatment, known as interoception-directed therapy, is being tested on 120 autistic people, for whom anxiety is a common problem.

Related: 'All my life suddenly made sense': how it feels to be diagnosed with autism late in life

Related: Autism in the workplace – an opportunity not a drawback

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My friend tried to kill himself when we were in the same psychiatric unit. Now I support others in similar situations

I was awoken by the sound of gasps and bangs coming from the bedroom next door. It was 4am on a medium-secure psychiatric unit where it’s always noisy, but I instinctively knew this wasn’t good. I ran into my neighbour’s room and found him in the process of killing himself. I screamed for help.

The man trying to end his own life was a friend. We had both attended the same pupil referral unit I was sent to after being excluded from school and for different reasons we ended up on the same psychiatric ward years later. After the nursing team had managed the incident, I asked him why he had taken such a step. He said he’d had enough of life and believed that things would never get better for “people like us”, and that our destiny was “death or to be in places like this forever”. He was discharged shortly after, but within weeks I was told that he had died of an overdose. He had only just turned 30.

Related: 'I deserve more than to be thought of as crazy': a journey through mental illness

Related: People can live with mental illness. I am living proof of this

In the...

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Feelings of being different believed to lead to self-harm and other mental health issues

Young lesbian, gay and bisexual people start becoming depressed and self-harming from the age of 10 because they feel different from their heterosexual peers, research has found.

LGB 16- to 21-year-olds are four times more likely to have felt depressed, harmed themselves and thought about killing themselves, according to a study based on interviews with 4,800 young people from in and around Bristol.

Related: Schools pulled into row over helping transgender children

Related: Supporting LGBTI pupils: 'It's important a school is ready for anyone'

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Government announces $110.7m in funding to provide treatment packages for up to 30,000 patients a year

Tens of thousands of Australians with severe eating disorders will soon be able to access treatment under Medicare for the first time.

The government says that from 1 November next year, patients will be able to access a Medicare subsidy to receive up to 40 psychological services and 20 with a dietician each year.

Related: The cost of getting well in Australia is keeping us sick | Fiona Wright

Related: The lie pictures tell: an ex-model on the truth behind her perfect photos

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Some Americans searching for alternative paths to healing have turned to psychedelics. But how does one forge a career as a guide when the substances are illegal?

Steve has cops in his family, so he doesn’t tell many people about his work as an underground psychedelic guide. The work takes up a significant amount of his time – around once a week, he’ll meet a client in their home or in a rented home, dose them with MDMA or hallucinogenic psilocybin mushrooms, and sit with them while they trip for up to 10 hours – but he doesn’t tell his siblings, parents or roommates about it, nor his fellow psychology PhD students.

They would probably never guess, either: Steve doesn’t display any signs of involvement with a stigmatized counterculture that many Americans still associate with its flamboyant 1960s figureheads. He’s a bespectacled, soft-spoken former business school student who plays in a brass band and works part-time as an over-the-phone mental health counselor. After one glass of wine, he says: “Whoa, I’m feeling a little drunk.”

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Effort to tackle severe staff shortages criticised as a ‘drop in the ocean’

The NHS will offer mature students a £5,000 bonus to become mental health or learning disability nurses as part of its forthcoming long term plan, the Guardian can reveal.

The payments are designed to tackle severe nursing shortages in two areas that NHS bosses and ministers have agreed are key priorities in which care needs to be significantly improved.

Related: Quarter of UK student nurses drop out before graduation, study finds

Related: Life as an NHS nurse in the 2010s: ‘People tell me I’m mad starting now’

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When I was a young child, like most children, I loved Disney. However, my fascination with Disney did not involve the exhilarating theme parks, characters or delicious foods. As a young boy, I was captivated by the Disney culture, the multifaceted business model and the life and legacy of Walt Disney. During the past two […]

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Health care safety efforts have long focused on improving the behavior of providers and improving the systems of care. A proven model of safety is in the airline industry. There are undoubtedly many parallels between airline safety and health care working toward common goals. This work should continue in both industries to ensure the safety […]

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I was recently seeing a rather complicated medical patient in the hospital. We were treating both a heart and kidney condition, and things were not going so well. To spare anyone non-medical who is reading this the scientific details of the bodily processes involved, we were essentially balancing hydrating, with the need to get rid […]

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Does anyone in medicine, particularly emergency medicine, understand why we lose money? Why we have to push those metrics so hard to capture every dime? I mean, we’re constantly reminded that satisfaction scores, and time-stamps and time to door, time to needle, time to discharge, reduced “left without being seen” scores are connected to the […]

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The oncologist had prescribed Xgeva hoping it would strengthen her bones while also delaying the progression of Angela Kahn’s breast cancer. But Kahn (a pseudonym) couldn’t get over the price of the drug. Before the oncologist had a chance to ask how she was feeling, she blurted out that the medication cost “$15,000 a shot.” […]

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The NHS is at last recognising that men have postnatal issues too, and that the health of family members is intertwined

The news that partners of those new and expectant mothers who suffer from depression or anxiety will be offered mental health checks by the NHS is extremely welcome. It is good for men, but also a breakthrough for women. That’s because the NHS is at last recognising not only that men have postnatal issues too, but that the wellbeing of new mothers is deeply dependent on supporting the skills and capacities of their children’s fathers.

This change will help to avoid the potentially tragic cases we hear about at the Fatherhood Institute, a UK charity. With support from the NHS, new fathers will be better able to deal with mental health issues they may have, and to help their partners through psychosis, anxiety and depression after they give birth.

Related: NHS to introduce mental health checks for new fathers

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New data from Médecins Sans Frontières shows extremely high rates of suicidal ideation and suicide attempts on the island

The island nation of Nauru is in the grips of a mental health crisis, according to new data from Médecins Sans Frontières, revealing that its Nauruan and refugee patients showed similar levels of mental illness far worse than other MSF projects around the world.

It found stigma and a lack of understanding of mental illness was leading to poor healthcare for both cohorts, but that Nauruan patients were improving under MSF treatment while refugees and asylum seekers did not.

Related: Group of Manus Island refugees move to Nauru amid worsening health crisis

Related: Many families remain separated amid ongoing Nauru medical transfers

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Health service in England to offer help for men whose partners experience health problems

New fathers and fathers-to-be will be offered mental health checks if their partner is suffering anxiety, psychosis or postnatal depression, NHS England has announced.

While it is well recognised that pregnant women and and new mothers can experience mental health problems, little attention has been paid to their partners.

Related: NHS hospitals treat soaring number of older people for drug misuse

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Screenwriter hopes new BBC production, called Care, will spark debate on growing social problem

The screenwriter Jimmy McGovern has called for a national conversation on attitudes towards care of the elderly and infirm, saying politicians needed to stop “dodging” the issue and that more television dramas should tackle such social problems.

McGovern, the writer behind award-winning programmes such as Cracker, Hillsborough and last year’s drama Broken, has made Care, a 90-minute production for the BBC. It tells the story of a single mother who has to care for her elderly mother after she has a stroke and develops dementia, and how the local health authorities refuse to take responsibility.

Related: Complaints over social care in England nearly trebled since 2010

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The three leading regulatory bodies for the counselling and psychotherapy profession have created a new competence framework as a response to the mental health crisis

Suzanne Moore is right (We can talk about self-care, but this mental health crisis is political, 26 November) that counselling and psychotherapy is about talking and that “it is better to talk about things rather than not”. Addressing the mental health crisis is one of the most challenging tasks faced by us all and counselling and psychotherapy have an important role to play in providing a solution. As the three leading regulatory bodies for the counselling and psychotherapy profession, representing over 50,000 counsellors and psychotherapists, we take this role very seriously. We have registers accredited by the Professional Standards Authority, accountable to parliament, and have in place robust professional training and conduct procedures.

To ensure that we continue to offer consistent training requirements and practice standards across the three professional bodies, we are mapping and defining common professional competencies for our professions. The Scope of Practice and Education for the counselling and...

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Prize recognises contribution to the understanding of mental health problems

  • Hannah’s award-winning article: It’s Nothing Like a Broken Leg

The Guardian writer Hannah Jane Parkinson has been named journalist of the year at the Mind media awards 2018.

The prize, which recognises an outstanding contribution to the understanding of mental health problems, was awarded to Parkinson for her article It’s Nothing Like a Broken Leg, published in June.

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Legal practitioners and charities help parents find solutions, but are hampered by the current system, write a range of professionals in the field

The government’s consultation process on how to reform the divorce system ends on 10 December. It is imperative that the best interests of children are kept at the heart of any decision. A new YouGov poll commissioned by Resolution shows 79% of the population believe conflict from divorce or separation can negatively affect children’s mental health, with this number rising to 87% among those who experienced their own parents’ or step-parents’ divorce during childhood. At an emotionally traumatic time such as divorce or separation, parents want and need support in order to put the best interests of their children first. Legal practitioners and charities help parents find solutions, but are hampered by the current fault-based divorce system. Apportioning blame can cause unnecessary acrimony – it is this conflict which can often have a significant negative impact on children.

Seventy-one per cent of the population side with professionals and politicians, agreeing that no fault divorce is urgently needed to protect the long-term interests...

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Overstretched officers are having to act as a last line of defence Is it time to say enough is enough?

Her Majesty’s Inspectorate of Constabulary and Fire & Rescue Services (HMICFRS) tells us that “overstretched police forces are having to ‘pick up the pieces of a broken mental health system’ on top of tackling crime”.

As an experienced police officer, for me the standout words in that sentence are “having to”. The police are never closed, can’t knock off early and are always the last line of defence. We can never say “no”. This seems a far cry from the partnership working ethos of the noughties, when there was so much overlap between services that people were far better supported. In these austere times, services continue to “shrink apart”, and vulnerable people are falling through the gaps.

Related: Police 'picking up pieces of mental health system', says watchdog

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About this site

Mental health is a level of psychological well-being, or an absence of a mental disorder; it is the "psychological state of someone who is functioning at a satisfactory level of emotional and behavioral adjustment".

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#1 Mental Health Blog – Talkspace

18 January 2019