Thoughts from the criminology team

Home » Mental health

Category Archives: Mental health

Advertisements

The Lure of Anxiety

HT

Helen is an Associate Lecturer teaching on modules in years 1 and 3.

I wear several hats in life, but I write this blog in the role of a lecturer and a psychologist, with experience in the theory and practice of working with people with psychological disorders.

In recent years, there has been an increase in awareness of mental health problems. This is very welcome. Celebrities have talked openly about their own difficulties and high profile campaigns encourage us to bring mental health problems out of the shadows. This is hugely beneficial. When people with mental health problems suffer in silence their suffering is invariably increased, and simply talking and being listened to is often the most important part of the solution.

But with such increased awareness, there can also be well-intentioned but misguided responses which make things worse. I want to talk particularly about anxiety (which is sometimes lumped together with depression to give a diagnosis of “anxiety and depression” – they can and do often occur together but they are different emotions which require different responses). Anxiety is a normal emotion which we all experience. It is essential for survival. It keeps us safe. If children did not experience anxiety, they would wander away from their parents, put their hands in fires, fall off high surfaces or get run over by cars. Low levels of anxiety are associated with dangerous behaviour and psychopathy. High levels of anxiety can, of course, be extremely distressing and debilitating. People with anxiety disorders avoid the things they fear to the point where their lives become smaller and smaller and their experience severely restricted.

Of course we should show compassion and understanding to people who suffer from anxiety disorders and some campaigners have suggested that mental health problems should receive the same sort of response as physical health problems. However, psychological disorders, including anxiety disorders, do not behave like physical illnesses. It is not a case of diagnosing a particular “bug” and then prescribing the appropriate medication or therapy to make it go away (in reality, many physical conditions do not behave like this either). Anxiety thrives when you feed it. The temptation when you suffer high levels of anxiety is to avoid the thing that makes you anxious. But anyone who has sat through my lecture on learning theory should remember that doing something that relieves or avoids a negative consequence leads to negative reinforcement. If you avoid something that makes you highly anxious (or do something that temporarily relieves the anxiety, such as repeatedly washing your hands, or engaging in a ritual) the avoidance behaviour will be strongly reinforced. And you never experience the target of your fears, so you never learn that nothing catastrophic is actually going to happen – in other words you prevent the “extinction” that would otherwise occur. So the anxiety just gets worse and worse and worse. And your life becomes more and more restricted.

So, while we should, of course be compassionate and supportive towards people with anxiety disorders, we should be careful not to feed their fears. I remember once becoming frustrated with a member of prison staff who proudly told me how she was supporting a prisoner with obsessive-compulsive disorder by allowing him to have extra cleaning materials. No! In doing so, she was facilitating his disorder. What he needed was support to tolerate a less than spotless cell, so that he could learn through experience that a small amount of dirt does not lead to disaster. Increasingly, we find ourselves teaching students with anxiety difficulties. We need to support and encourage them, to allow them to talk about their problems, and to ensure that their university experience is positive. But we do them no favours by removing challenges or allowing them to avoid the aspects of university life that they fear (such as giving presentations or working in groups). In doing so, we make life easier in the short-term, but in the long-term we feed their disorders and make things worse. As I said earlier, we all experience anxiety and the best way to prevent it from controlling us is to stare it in the face and get on with whatever life throws at us.

 

 

Advertisements

San Francisco: A City of Contrast

Golden Gate Bridge

Haley Read is an Associate Lecturer teaching modules in the first and third years.

Often when I visit different cities around the world, I notice that huge contrasts in the standards of life experienced by others are ‘plain for the eye to see’ within such small spaces.

What seems interesting is that inequality between the rich and poor are striking within western countries that are often perceived as being quite wealthy, ‘forward thinking’ and technologically advanced. This brings me to my recent trip to San Francisco, a city partly characterised by the beautiful red Golden Gate bridge which is situated near a beach where sun kissed, athletic and healthy-looking San Francisco residents seem to spend their free time socialising, sailing on boats, walking their pedigree dogs and playing sports. Of course, the view of the isolative Alcatraz prison to the East of the bridge dampens the illusion that San Francisco is a city which has historically upheld progressive and rehabilitative ideas. Whilst today, within this very same space, and more evidently, within a few blocks walk from this location, residents experience life in a very different manner. Many individuals are homeless, have significant physical and mental problems, the occasional prostitute hangs around attracting business and drugs are taken and offered out to passers-by. And on that very same red bridge many individuals attempt to and/or take their own lives out of desperation. So, for me, San Francisco exemplifies a city that is steeped in inequality.

In fact, a recent United Nations (2017) report points to high housing prices, the lack of social, educational and healthcare services for poorer Californian populations and tough responses to issues of homelessness and petty crime as being key to the increasing and continued levels of inequality within cities such a San Francisco. Last week in seminar sessions [CRI1007] we discussed the Universal Declaration of Human Rights (1948). What appears interesting here is that despite an international agreement that every individual should have a Right to Life, domestically, San Francisco’s approach to the provision of social and medical care for individuals results in the lesser quality and length of life for poorer populations. As in San Francisco the Right to Life is limited, as the city does not seem to be obliged to protect individuals who may die due to ill mental or physical health, the lack of medical insurance or the numerous experiences of poverty.

Prior to visiting San Francisco, I was quite excited to revel in its famous music scene and its picturesque charm. Yet, despite it being a fantastic place to visit that is full of eccentricity and character, the sombre tone of the city was made blatantly clear. I did however, leave feeling incredibly grateful for non-government organisations and communities who often provide for those who are viewed as being ‘deviant’ and not worthy of help. Such as the Gubbio Project, which, with the help of volunteers and public donations, provides Church shelter and basic provisions for the homeless. However, it is clear that a greater amount of support is required for the poorer residents of San Francisco.

 

Photo by Life Of Pix on Pexels.com

An Officer’s Perspective

 

Jazz blog image

Northampton University…. In 2011, I first moved up to Northampton to study criminology and sociology. At the time I had never moved away from home before and it was a somewhat daunting experience. However, now looking back at this, it was one of the best decisions I have made.

Before I set out to go to university I had always said to my family I wanted to join the police force. I chose to study criminology as I believed this was going to help me with joining the police and also provide me with an insight as to what I was potentially going to be letting myself in for.

From studying criminology for three years I learnt about various ideas surrounding police and their interactions with communities, portrayal within the media and about the history of the police and how it has developed into the service we have today.

I remember, in particular, being interested in the way in which the media portrayed the police and the impact this had on how young people, and whether this influenced their opinions on police, so much to the point I completed a dissertation on this topic.  This interest came about from a module called YOUTH CRIME AND MEDIA. Ultimately, I found that young people, in particular those aged between 18-25, were influenced by the media and this helped them form their opinions of the police.

Whilst I was at Northampton University, I was a Special Constable for the Metropolitan Police having joined them in 2013, my third year at uni. This began to give me some experience into what the police dealt with on a day to day basis. Although I was only doing this for 16 hours per month, I would recommend this to anybody who is considering joining the police.

Since graduating from Northampton University, I joined the Metropolitan Police as a PC and I have been with the Met now for 2 years.  I can honestly say that, when people say this is a job like no other, they are all correct. I go to work not knowing what I am going to encounter from one call to the next. The one thing which has really stood out for me since joining as a PC, and having graduated from university, is how misunderstood the role of police appears to have become. When I was growing up I remember thinking that the role of police was to chase criminals and drive fast cars. However, this nowadays is a small proportion of the work we do and the role of police officers is a lot more diverse and changing daily. We have a lot of interactions with people who are suffering a mental health crisis who may need our assistance because they are feeling suicidal, investigate the disappearance of missing people and even attend calls where someone is suffering a cardiac arrest and a defibrillator is required, as police officers now carry these in their vehicles.

However. I feel the biggest thing that my criminology degree has assisted me with in relation to my job is how I analyse situations. Criminology was largely centred around different theories and analysing these perspectives. On a day to day basis I regularly find myself analysing information provided to me and trying to understand different accounts people provide me with and trying to use these accounts to decide what action needs to be taken. Overall criminology has allowed me to take a step back from somewhat stressful situations and analyse what has happened.  This has given me the confidence to present different viewpoints to people and also challenge people at times on controversial topics or viewpoints they may have.

I do think that I took the right path to becoming a police officer; criminology did equip me with various different skills that I utilise in my day-to-day role. I wouldn’t change the path I took. I enjoyed every bit of my degree, and the lecturers were always supportive.

 

 

Just Keep Swimming

Just keep swimming

This isn’t going to be the intellectual blog post I had expected myself to write. I am writing this as I am undertaking my post-grad dissertation and in all honesty, I can’t be bothered anymore. And I feel secure in the fact that I am not the only person who feels this and I most certainly will not be the last. Heck, I’ve been close to giving up altogether a handful of times throughout both my under and post-grad. I will be the first to admit that I don’t know how to leave work mode alone when I have deadlines due. And it is only through friends and family that I have to be reminded that all work and no play, doth not make for a mentally healthy Bronagh. I have always struggled separating the two and have been known to cancel or decline plans so I can do work; low and behold, I don’t write a word.

Be mindful of your mental health. You can’t work at it constantly. Between work and uni, you need to allow yourself those stress-free days off so you can produce the best work that you are capable of. I hate to harp on about the most obvious scenario. But as someone who felt bad for taking time off to have fun and as someone who is currently struggling for the motivation to complete this dissertation, just know that you are not alone. It is not uncommon to feel burnt out towards the end of your degree, be it 1 year, 3 years, or more. Just know that you have not come this far to fall at the final hurdle.

My biggest motivation was having friends going through the same situation. Meeting up to go the library so none of us bailed. Telling one another to “shut up, we need some quiet time”, putting headphones in so as not to get dragged into another one-hour chat about that dire television show we all watched the other night.  As with everything, it’s all about moderation. You are your own worst enemy, but it is you who will pull yourself out of your slump and show your self-doubt that you are both capable and worthy. This isn’t forever and you will relish those days where you have no deadlines to worry about, but trust me, you will also miss them. Do not let these tough times get the better of you and certainly do not let them put you off any possibilities of further education. The motivation will come and you will get there in the end. Carry on doing the things you enjoy and take everything in your stride.

Just keep swimming, you’ve got this.

Out early on good behaviour

prison wing

Dr Stephen O’Brien is the Dean for the Faculty of Health and Society at the University of Northampton

The other week I had the opportunity to visit one of our local prisons with academic colleagues from our Criminology team within the Faculty of Health and Society at the University of Northampton. The prison in question is a category C closed facility and it was my very first visit to such an institution. The context for my visit was to follow up and review the work completed by students, prisoners and staff in the joint delivery of an academic module which forms part of our undergraduate Criminology course. The module entitled “Beyond Justice” explores key philosophical, social and political issues associated with the concept of justice and the journeys that individuals travel within the criminal justice system in the UK. This innovative approach to collaborative education involving the delivery of the module to students of the university and prisoners was long in its gestation. The module itself had been delivered over several weeks in the Autumn term of 2017. What was very apparent from the start of this planned visit was how successful the venture had been; ground-breaking in many respects with clear impact for all involved. Indeed, it has been way more successful than anyone could have imagined when the staff embarked on the planning process. The project is an excellent example of the University’s Changemaker agenda with its emphasis upon mobilising University assets to address real life social challenges.

 

My particular visit was more than a simple review and celebration of good Changemaker work well done. It was to advance the working relationship with the Prison in the signing of a memorandum of understanding which outlined further work that would be developed on the back of this successful project. This will include; future classes for university/prison students, academic advancement of prison staff, the use of prison staff expertise in the university, research and consultancy. My visit was therefore a fruitful one. In the run up to the visit I had to endure all the usual jokes one would expect. Would they let me in? More importantly would they let me out? Clearly there was an absolute need to be on my best behaviour, keep my nose clean and certainly mind my Ps and Qs especially if I was to be “released”. Despite this ribbing I approached the visit with anticipation and an open mind. To be honest I was unsure what to expect. My only previous conceptual experience of this aspect of the criminal justice system was many years ago when I was working as a mental health nurse in a traditional NHS psychiatric hospital. This was in the early 1980s with its throwback to a period of mental health care based on primarily protecting the public from the mad in society. Whilst there had been some shifts in thinking there was still a strong element of the “custodial” in the treatment and care regimen adopted. Public safety was paramount and many patients had been in the hospital for tens of years with an ensuing sense of incarceration and institutionalisation. These concepts are well described in the seminal work of Barton (1976) who described the consequences of long term incarceration as a form of neurosis; a psychiatric disorder in which a person confined for a long period in a hospital, mental hospital, or prison assumes a dependent role, passively accepts the paternalist approach of those in charge, and develops symptoms and signs associated with restricted horizons, such as increasing passivity and lack of motivation. To be fair mental health services had been transitioning slowly since the 1960s with a move from the custodial to the therapeutic. The associated strategy of rehabilitation and the decant of patients from what was an old asylum to a more community based services were well underway. In many respects the speed of this change was proving problematic with community support struggling to catch up and cope with the numbers moving out of the institutions.

 

My only other personal experience was when I spent a night in the cells of my local police station following an “incident” in the town centre. This was a case of being in the wrong place at the wrong time. (I know everyone says that, but in this case it is a genuine explanation). However, this did give me a sense of what being locked up felt like albeit for a few hours one night. When being shown one of the single occupancy cells at the prison those feelings came flooding back. However, the thought of being there for several months or years would have considerably more impact. The accommodation was in fact worse than I had imagined. I reflected on this afterwards in light of what can sometimes be the prevailing narrative that prison is in some way a cushy number. The roof over your head, access to a TV and a warm bed along with three square meals a day is often dressed up as a comfortable daily life. The reality of incarceration is far from this view. A few days later I watched Trevor MacDonald report from Indiana State Prison in the USA as part of ITV’s crime and punishment season. In comparison to that you could argue the UK version is comfortable but I have no doubt either experience would be, for me, an extreme challenge.

 

There were further echoes of my mental health experiences as I was shown the rehabilitation facilities with opportunities for prisoners to experience real world work as part of their transition back into society. I was impressed with the community engagement and the foresight of some big high street companies to get involved in retraining and education. This aspect of the visit was much better than I imagined and there is evidence that this is working. It is a strict rehabilitation regime where any poor behaviour or departure from the planned activity results in failure and loss of the opportunity. This did make me reflect on our own project and its contribution to prisoner rehabilitation. In education, success and failure are norms and the process engenders much more tolerance of what we see as mistakes along the way. The great thing about this project is the achievement of all in terms of both the learning process and outcome. Those outcomes will be celebrated later this month when we return to the prison for a special celebration event. That will be the moment not only to celebrate success but to look to the future and the further work the University and the Prison can do together. On that occasion as on this I do expect to be released early for good behaviour.

 

Reference

Barton, R., (1976) Institutional Neurosis: 3rd edition, Butterworth-Heinemann, London.

A personal account of the NHS

Government responsibility

A personal tale about the NHS – I am one of the lucky ones

This blog recounts the experience of the care of my parents in the last two years, which has been exemplary and, in the context of the recent reports about the crises in the NHS, reminds me how lucky I was to experience this. It also reveals how well the NHS can perform when it is not under stress, is properly resourced and valued, even when dealing with health problems associated with old age and during the extra strains which occur during winter.

 

My father passed away at the end of August last year, after 2 years under the care of an NHS facility specialising in caring for dementia patients. The illness had not just affected his memory, but had also led to aggressive behaviour which required him being sectioned under the Mental Health Act. This was obviously a stressful time for us all, but also a time when we understood this was the only option. He soon settled into a new routine, in a home where he felt safe, cared for and where his needs could be met. It was also vital that this was located near his home in North Yorkshire, so that my mother could visit three times a week, and maintain the bond of their marriage, providing both of them with the companionship they so valued. Visiting could be difficult if he had a bad day, but most of the time he appreciated the company and was clearly happy to be in a place where he just did not have to worry about anything.

 

What struck me most about the place was the demeanour of the staff – they were helpful, kind, accommodating, caring – all the things you would want from those in the health and social care professions. This facility brought these sectors together in a partnership to meet the many physical health needs of dementia patients, while remembering their role as carers. It was not just about administering the medication needed to keep patients calm, it was also about interacting with them, taking them for walks, days out and bringing in a variety of forms of entertainment. Patients celebrated Halloween, Christmas, Easter and engaged in activities which took them back to places and people they could remember, often through music of various genres. Dad always liked jazz, and occasionally classical, with a real fondness for Ella Fitzgerald. These times were so important, for 2 years, even though things had changed, the Dad we knew was back during some of our visits, and we could just appreciate this time until he passed away.

 

I feel sadness now at his loss, but also because I know not everyone with dementia who needs this sort of care will get it. In the lottery of health and social care, we won, and the prize was the sort of care I think everyone should have access to. What angers me about this is that it is NHS Trusts across the country, simply cannot provide this. They have to make decisions about the care of citizens based on budget spreadsheets and staff availability, rather than what is understood to be the best practice, clinically sound and will create the best outcomes for patients and relatives. The recent BBC report on the ‘10 charts that show why the NHS is in trouble’ (see http://www.bbc.co.uk/news/health-42572110) clearly illustrate why not everyone receives the care my Dad received. For example, it emphasises that we have an ageing population, meaning the NHS is dealing with increased numbers of patients with chronic conditions such as diabetes, heart disease and dementia. These are conditions which are described as ‘more about care than cure’ where patients need support, where healthcare requires as much of a focus on social care as it does on medical interventions. This has financial implications, as care for ‘average’ patients over 65 years old costs the NHS 2.5 times more, compared to the ‘average’ 30 year old, and this only increases with age.

 

Spending on the NHS has decreased from 6% of the government budget during 1997 to 2009, to 1% as part of the austerity agenda of the Conservative/Liberal Democrat coalition, with a slight increase back up to 2.5% under the current government. This also represents a lower proportion spent on healthcare compared to other EU countries such as Germany, Sweden and France – who are all above the EU average. They do this by through increased taxes, and this seems to be the crux of the matter. Would the citizens of the UK tolerate a rise in taxes to have better provisions in health and social care, for themselves and their family? According to a poll by Ipsos MORI, 40% would back a rise in income tax, with 53% supporting an increase in National Insurance payments. However, it was also revealed that the majority of participants valued the NHS and did not wish to change to an insurance based system.

 

So, a choice must be made. Personally, with what I experienced with my Dad and more recently, when my Mum had heart surgery to replace a valve, from which she is recovering very nicely, I cannot imagine not having the NHS. Perhaps we do not recognise its value until we need it, but given the strains it is under now, and that one way to alleviate this is to increase funding, then governments should surely consider tax rises to provide this. The NHS provides health and social care we will need one day, if not for us, then for loved ones, and it seems to be a model of healthcare most people in this country would prefer. With an ageing population, the current investment being below the average of 4% provided to the NHS since its inception in 1948, is having an impact. It is an impact which Jeremy Hunt and Theresa May seem to bat away as isolated problems, not trends, and as problems they are dealing with. I do not think we should be discussing our health service as being able to cope with crises and unexpected demands. We should be discussing in terms of being able to provide equality of care, even in the face of the unexpected, using a service which reflects the values of the welfare state, to ensure wellbeing, safety and healthcare from cradle to grave, for all citizens.

Susie Atherton
Senior Lecturer in Criminology

Thank f**k it’s Christmas!

Blog christmas image

Jessica is an Associate Lecturer teaching modules in the first year.

We have arrived at that time of the year once again: CHRISTMAS! ‘Tis’ the season to celebrate, party, give and receive gifts, catch up with friends and family, and most importantly… catch up on some much needed sleep. We have arrived at the end of the first term of the academic year, and all I can think is: Thank f**k it’s Christmas. The first term always feels the longest: whether you are first years beginning your academic journey, second and third years re-gathering yourselves after the long summer, or staff getting back into the swing of things and trying to locate and remember all the new and old names. But now is the time to kick back, relax and enjoy the festive season: ready to return to academic life fresh faced and eager come the New Year, ready to start it all over again. Well not quite…

According to Haar et al., (2014) work-life balance is something which is essential to all individuals, in order to ensure job satisfaction, life satisfaction and positive mental health. If Christmas is as needed as it feels; perhaps we are not managing a good work-life balance, and perhaps this is something we can use the Christmas break to re-consider. Work-life balance is subjective and relies on individual acceptance of the ‘balance’ between the commitments in our lives (Kossek et al., 2014). Therefore, over the Christmas break, perhaps it would be appropriate to re-address our time management skills, in order to ensure that Easter Break doesn’t feel as desperately needed as Christmas currently does.

Alongside an attempt to re-organise our time and work load, it is important that we remember to put ourselves first; whether this be through furthering our knowledge and understanding with our academic endeavours, or whether it is spending an extra 15 minutes a day with a novel in order to unwind. Work-life balance is something we are (potentially) all guilty of undermining, at the risk of our mental health (Carlson, et al., 2009). I am not suggesting that we all ignore our academic responsibilities and say ‘yes’ to every movie night, or night out that is offered our way. What I am suggesting, and the Christmas break seems like a good place to start, is that we put the effort in with ourselves to unwind, in order to ensure that we do not burn out.

Marking, reading, writing and planning all need to be done over the Christmas break; therefore it is illogical to suggest taking our feet off the pedals and leaving academia aside in order to have the well needed break we are craving. What I am suggesting, is that we put ourselves in neutral and coast through Christmas, without burning out: engaging with our assignments, marking and reading, therefore still moving forward. BUT, and it is a big but, we remember to breathe, have a lie in, go out and socialise with friends and family, and celebrate completing the first term of this academic year. And with this in mind, try to consider ways, come the new term, where you can maintain a satisfying work-life balance, so that when Easter comes, it doesn’t feel so desperately needed.

However, it is highly likely that this will still be the case: welcome to the joys and stresses of academia.
Merry Christmas everyone!

References:
Carlson, D.S., Grzywacz, J.G. and Zivnuska, S. (2009) ‘Is work family balance more than conflict and enrichment?’ Human Relations. 62(10): 1459-1486.
Haar, J.M., Russo, M., Sune, A. and Ollier- Malaterre, A. (2014) ‘Outcomes of work-life balance on job satisfaction, life satisfaction and mental health: A study across seven cultures’. Journal of Vocational Behaviour. 85: 361-373.
Kossek, E.E., Valcour, M. and Kirio, P. (2014) ‘The sustainable workforce: Organizational strategies for promoting work-life balance and well-being’. In: Cooper, C. and Chen, P. (Eds) Work and Well-being. Oxford: Wiley-Blackwell. Pp:295-318.

Bibliography:
Ashurst, A. (2014) ‘How to… Manage time and resources effectively’. Nursing and Residential Care. 16(5): 296-297.
Kuhnel, J., Zacher, H., De Bloom, J and Bledow, R. (2017) ‘Take a Break! Benefits of sleep and short breaks for daily work engagement’. European Journal of Work and Organization Psychology. 26(4): 481-491.
Logan, J., Hughes, T. and Logan, B. (2016) ‘Overworked? An Observation of the relationship Between Student Employment and Academic Performance’. Journal of College Student Retention: Research, Theory and Practice. 18(3): 250-262.
Lyness, K.S. and Judiesch, M.K. (2014) ‘Gender egalitarianism and work-life balance for managers: Multisource perspectives in 36 countries’. Applied Psychology. 63(1): 96-129.
Mona, S. (2017) ‘Work-life Balance: Slow down, move and think’. Journal of Psychological Nursing and Mental Health Services. 55(3):13-14.

 

%d bloggers like this: