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OPINION: Crisis-driven intervention in mental health is threatening people’s lives

It’s no secret that mental health services in the UK are chronically underfunded. Our current government has expressed time and again it’s disdain for universal healthcare, and has funded it accordingly. As a result of this under-funding, mental health services in the UK now operate a “crisis-driven intervention” model. This is incredibly dangerous.

So what does this model look like? Simply put, it means that services will only intervene when things become to bad to ignore, when the person has reached “crisis” point. For some this can look like suicide attempt, some may be left to starve near to death from eating disorders; for me it meant no one acted until my paranoid delusions were so severe that I was a risk to myself.

Crisis-driven intervention is what happens when the system lacks the resources for early-intervention services. Early-intervention could allow for much swifter identification and treatment of mental health conditions, mitigating some of the various harms associated with such conditions. If we could stop things from reaching boiling point, then we could stop that moment where it spills over, creating a mess all over a persons life.

This is a cause for not just the activists and advocates amongst us, it is a cause for all of us. Any one of us can develop a mental health condition, it is important to know that the support is there if we do.

We must vote for governments that will give appropriate funding to our vital health services, and we must petition the current incumbents to preserve our wellbeing. I have been the person who falls through the cracks, and it is a place that I would not wish on anyone. We can all have an impact on this topic.

It’s also vital that services operate a service-user involvement model, so that treatment policy can be guided by the service-users, who by necessity become experts in their own condition and treatment. Having been involved in service-user consultancy for several years, I know first hand how vital such endeavours are.

Crisis-driven intervention models are unacceptable. They are literally costing lives. How many people are out there who received help too late? Perhaps we will never know the full figure, but what we can do is ensure that the appropriate services are there for the generations to come.

OPINION: Abstinence-based drug programmes are not fit for purpose

If you have followed my work, I think it’s likely that at some point in your life you may have experimented with recreational drugs at some point in your life. I don’t say this because I assume that my followers are drug-users, I say it because you are human, and drugs and alcohol are a staple of society. It’s fair to say that the vast majority of people have probably tried so-called “soft” drugs like cannabis in their life, and in fact many in the autistic community speak openly about self-medicating with cannabis.

This in particular is why I take such umbrage with abstinence-based approached to drug and alcohol education. These programmes teach people that drug and alcohol use is a shameful secret, to be hidden away. This in turn increases the risk of harm. Harm-reduction based approaches are vastly superior. We should be teaching people that drug and alcohol use is a normal part of society, and how to approach it in a sensible and safe manner.

Let me step back for a minute. I’m not saying we should teach people that substance use is okay. Substance use is dangerous, and associated with many negative life outcomes, but we should be honest with people about how prevalent it is our society. Kids in school should be taught the genuine effects of these drugs; physical, psychological, and socioeconomical. They should also be taught that if they DO use drugs, there are measure they can take to protect themselves from some of the more immediate harm.

Abstinence-based approaches are a symptom of a society that criminalises substance use. Substance use is a public health issue, not a criminal one. By criminalising substance use we create a black-market for them. It happened with drugs, it happened with the prohibition of alcohol. Entire criminal enterprises survive off of the illegality of the sale and posession of substances. I could write a whole piece on this topic alone, and most likely will.

Back to the point. Drug and alcohol related deaths will continue to rise until we move over to harm-reduction models. This can look like in school education on substance use. This can look like appropriate funding of mental health services. This can look like appropriate and affordable housing. It can also look like the decriminalisation of drug use. This list is non-exhaustive

Until these things are done, drug use will remain prevalent in our society. No amount of pleading and scaring will keep people away from recreational substances. We MUST embrace the fact that drugs and alcohol are here to stay, and move forward with commonsense approaches to that fact.

Support Needs vs Functioning Labels: How I talk about my strengths and struggles

It is well established in the autistic community that functioning labels are outdated and harmful in that they diminish a persons strengths (“low functioning”) and deny access to support for others (“high functioning”). For decades, functioning labels have been used to separate autistic voices from one another and invalidate many of us through the well known “not like my child” gambit.

Functioning labels, in my opinion, are problematic for two reasons. Firstly, they assume an unchanging field, treating functioning as if it were something that remains the same throughout life. My ability to function (as with all autistics) is constantly changing. Functioning can be wildly altered by environmental factors, and how many “spoons” we have left of a day. Functioning can change in the space of days, sometimes hours and minutes.

Secondly (and this is perhaps the most ableist part of functioning labels), is that at the core of them, functioning labels measure one thing, a persons economic value. Those deemed “high functioning” are more able to pass as neurotypical, there by having greater access to employment and the ability to pay taxes. Those deemed “low functioning” are typically less likely to access employment, meaning that they do not pay taxes and often require disability and welfare benefits to survive.

This second point is one of my personal pet peeves (to put it politely). It is an incredibly ableist measure to value economic value over the value of life itself.

Personally, I prefer to talk about myself in terms of support needs. This can change with me. I might wake up one day and feel that I have low support needs, able to plan and perform tasks on my own. On another day, or even later the same day, I may have higher support needs, requiring assistance to do things that some people would consider basic.

I like support needs because they make no assumption about my value to society. They shift and change, and can help me celebrate the positives, while asking for help with the more negative aspects of my disability. I can talk in terms of my general support needs, perhaps noting that on a normal day I require moderate support, while having the opportunity to ask for more in-depth support when I require it.

The important part of talking about support needs is to recognise that it is a moving target. No one person has the same support needs throughout their life. This is even true of neurotypicals. Does a neurotypical child have the same support needs as a neurotypical adult?

It is vital that we stop speaking about autistics in terms of fixed assumptions and economic value. Our lives have value beyond our ability to generate profit. We must cut out our own internalised ableism, and then help the rest of the world to do the same. One of the first steps for this, is to stop using the outdated model of functioning labels.

Celebrate your strengths, and never be afraid to ask for support with your struggles.

Suicide Prevention Week: A reflection

“Who cares if one more light goes out?

In a sky of a million stars

It flickers, flickers

Who cares when someone’s time runs out?

If a moment is all we are

We’re quicker, quicker

Who cares if one more light goes out?

Well I do”

One More Light, Linkin Park

This week marks suicide prevention week in the US, and September 10th will mark suicide prevention day in the UK. Suicide prevention is a topic close to my heart.

My name is David, and i’m a suicide attempt survivor.

According to the World Health Organisation, there are close to 800,000 deaths from suicide every year, equating to one death roughly every 40 seconds. Read that again; every 40 seconds, another life is lost to suicide.

That’s 800,000 people EVERY YEAR that are suffering so immensely that they can no longer continue living. I know this feeling, I have lived this feeling. My skin carries the scars from the numerous attempts I have made on my life, my liver carries permanent damage from the drugs and alcohol I ingested to cut my suffering short.

Men in particular are very vulnerable to suicide. My opinion is that as men, we are subject to toxic expectations; “boys don’t cry”, “man up”. As men we are expected to hide our pain, being emotionless walls of muscle.

Marginalised groups such as autistics face suicide prevelance 9x that of the general population. Estimates suggest that over half of trans teens have self-harmed or attempted suicide.

If we want to prevent suicide, we must dismantle the toxic expectations and standards of the world. We must combat toxic positivity. We must be brave enough to stand up and speak our truth, in the face of those who would rather ignore our plight.

We need to create a more compassionate world. One where people are not accused of attention seeking for reaching out and struggling. One where we extend to our fellow human the same love and acceptance that we extend to our friends and loved ones.

There can be no rest while innocent people give up there lives in search of an escape from suffering. We must be the change we want to see within the world.

This September, gift someone compassion, and make the world a brighter place to be.

If you are struggling to keep going at the moment, I beg of you, reach out. Do not make a permanent decision off of feelings that I promise are temporary. Life is worth holding on to, by your very existence you have changed the world. This is a world that is better with you in it. I would rather talk to you about your suffering (and do my best to help where I can) than attend your funeral.

Who cares if one more light goes out? I do.

ABA: A symbol of fear

Over the years many wonderful and brilliant advocates and activists have spoken out against Applied Behavioural Analysis (ABA) and why the compliance-based therapy is harmful to autistics, but why do such therapies exist?

Simply put, ABA is a symptom of a society that values neuronormative ideals over the beauty of human diversity. To take it a step further, it is a symptom of a society that FEARS neurodiversity. Somewhere along the line, society decided that neurotypical standards were a bar that we must all meet, shunning and oppressing anyone who dares to exist outside of those standards.

This fear is born of ableism. It is the same ableism that causes parents to kill their disabled children, it is the same ableism that makes children bully autistic kids in school.

Fear is an insidious thing, from fear rises discontent, and from that discontent comes hatred.

We can campaign against ABA and it’s related practices for as many years as we like, but until the rotten core that is ableism is dealt with, ABA and quack treatments will continue to run rampant through vulnerable communities. For the sake of all autistics, and all autistics to come, we must dismantle ableism. We must replace the hatred of difference with the beauty of diversity.

This starts at home. We must search ourselves for the ableism that so many of us have internalised and pull it out by the roots. We must teach our children not to fear those who appear different, but instead embrace the beauty of a diverse world.

The future is bright and diverse.

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