Wednesday, 15 January 2014

UN to question Vatican on 16-1-2014 in Geneva on the Rights of the Child

 
From SNAP (Survivors network of those abused by priests):

This Thursday, for the first time ever, the Vatican will be questioned about its record on child sexual violence by an international body. The UN Committee on the Rights of the Child in Geneva is holding the meeting in two sessions on Jan 16, each three hours long. SNAP and our attorneys from CCR will be there. Later in the evening (Geneva time) CCR and SNAP are hosting a report back via Livestream directly after the review to report about it to survivors, advocates and supporters. Two separate events and you can view them both on the internet.

Watch the UN review via livestream here!

The review will take place on Thursday, January 16, 2014 from 10am-1pm CET, (4am-7am EST) where the Vatican will be reviewed on their compliance with the Convention on Rights of the Child and then from 3pm-6pm CET (9am-12 noon EST) the Vatican will be reviewed on their compliance with the Optional Protocols on the Sale of Children, Child Prostitution and Child Pornography.
**This will be broadcast in the English language. This is broadcast by the UN.

Then two hours later at 8 pm CET (2 pm EST) we will have the “reportback” by CCR and SNAP.  Tune in here .

You can  follow the conversation on Twitter and ask questions before or during the livestream by tweeting to the hashtag #HolySeeConfess or by emailing questions to askCCR@ccrjustice.org.

SNAP and CCR submitted reports to the Committee on the Rights of the Child detailing how the Holy See has violated the core principles of the Convention on the Rights of the Child.

If you have questions please email or call the SNAP office at: 312 455 1499 or Chicagoffice@snapnetwork.org .

Don’t miss the chance to participate in this historic event!

All the best,
Barbara Blaine 


Barbara Blaine
http://www.snapnetwork.org/

Wednesday, 1 January 2014

Sham Peer Review or True Concerns? Compare and Contrast

http://charlotteleslie.com/


Recently on 10-12-2013 Parliamentary Health Select Committee's member Ms Charlotte Leslie MP (photo above) asked medical regulator, the General Medical Council:

Q10 Charlotte Leslie: To follow the points Sir David was making, do you recognise or acknowledge that sham peer review takes place?
Professor Sir Peter Rubin: What do you mean by “sham peer review”?


Medical regulator, now more than 150 years old,  has persecuted medical whistleblowers and other doctors on demand from some medical directors working in National Health Service (NHS) in the manner of sham peer review. While some doctors can tell the difference between sham peer review and genuine concerns, it would appear the regulator cannot tell the difference. Dr Lawrence Huntoon has described psychology of sham peer review HERE.

So, what is the difference between genuine complaints and those asking for sham peer review (backstabbing)? What are the characteristics of these two very different complaints? Table below attempts to compare and contrast Sham Peer Review with genuine concerns about  a doctor:



Feature


Sham Peer Review request

Genuine concerns about doctor


Investigation of the complaint(s)


Done poorly or not at all

Investigation done more carefully

Time pressure

Putting pressure on doctor to answer the complaint very quickly, without access to records and within a couple of days e.g. on weekend for complaint made on Friday. When this is complied with, refers to regulator anyway. Does not seek clarifications from doctor if not happy with a reply. Poor conflict management skills.
Pulls doctor out of the clinic while seeing patients for an urgent meeting to answer a non-urgent complaint because “busy” at other times.


Given reasonable period to respond

Hoarding of minor complaints

Complaints not disclosed to doctor on time but reserved to hit him/her with several complaints at once.
Habitual stacking of complaints and issues not dealt with.
Pathological avoidance of situations which may give rise to a difference of opinions.
Pathological fear of conflict.




Complaint(s) disclosed promptly to doctor to answer


Abuse of poor policy or process

On reading regulator’s faulty policy e.g. policy which has features of indirect discrimination against a group of doctors (like those who are contract workers or in private practise) decides to use this to get rapid access to the regulator


Not used

Language of serious concerns


Complaints written in a way to maximize the interest of the regulator in the absence of harm to patients: “I have serious concerns about Dr……”


Evidence of harm to patient or potential harm to public presented after thorough investigation and when other options are not feasible


Emotional abuse/humiliations


Statements as to the mental health of the doctor in the absence of any medical evidence or reference to the internationally accepted criteria. No referral to Occupational Health or any reference to doctor’s medical practitioner.


Refer doctor if ill to Occupational Health promptly without referral to regulator and ensures right questions are asked and answered. Patients protected by use of locum doctor to cover absence due to illness



Gain







Preservation of own reputation takes precedence over lives of others.
Sham peer review serves as a cover up of own wrongdoing




No gain from making a referral to the regulator



.

Honesty

Prepared to lie on oath. Tries to cut a deal so to avoid giving evidence on oath if written statement is accepted


No need to make false allegations has evidence to back the complaint


Staff turnover


Higher than average staff turnover and a more frequent user of regulator’s services




Normal staff turnover

Culture of bullying

Over the period of years bullies tend to surround themselves with bullies. Authoritarian approach, dislike of dissent


Complaint politely submitted outside the culture of bullying

Manipulation and status seeking


Infiltrate medical establishment as additional means of self-protection. This may involve the regulators themselves i.e. starts to work for them.


Has no need for self-protection from within the regulator

Outcomes for patients after dismissal of doctor


Deterioration in the outcomes for the patients when excellent doctor is dismissed and not replaced

There can be an improvement in the outcomes for the patients when incompetent doctor is removed even temporarily


Chronology of referral
to the regulator


Referral follows after whistleblowing, or threat to the egos, or fear that disclosure may occur more widely outside the organization, or due to business rivalry or dispute, or after a court case taken by the doctor complained about


Referral follows from events related to poor patient care

Concerns about conduct of the doctor


More likely to be concerned about the conduct of the doctor, claims disruption. Provokes disruptive behaviour by doctor in a variety of ways such as frustration caused by passive aggressive behaviour of hospital administrator or others


Concern about patients’ welfare

Allegations

False and numerous, gossip, hearsay. Witness Statements that get withdrawn because witnesses unwilling to give the evidence once the process is in full swing and about to be heard in public


True complaints backed by Witness Statements


Person who makes false allegations

Sham peer review complainer is protected by medical regulator. Determinations by medical regulator do not give the names of, for example, medical directors who made false allegations to regulator and initiated the process of sham peer review. The names of the witnesses who gave evidence for doctor are published.


No backtracking  on Witness Statements or secret allegations or little chats with investigators at the regulator that accused doctor never hears about

Wish to do harm


Despite all the bad intentions that started the complaint process, at the disciplinary hearings before the regulator the accusers feign surprise that things got that far for the accused doctor. “I did not mean it”. Denial in contrast to the actions taken and the knowledge what the outcomes of those actions could be.


Patients are real concern

Protectionism


Protects either himself/herself and/or other colleagues he/she thinks cannot live without-feels compelled to work with them


Protects patients

Medical records

Withholds medical records and even when asked by the regulator sends only bits of the medical records at the time. Disclosure of one single medical file can take years. Regulator despite their powers to order immediate and complete disclosure is complicit with delay.


Sent promptly to regulator and doctor

Fraud


The accusers may be involved in fraud, sometimes widespread.
Prepared to send even completely different patient’s records from the case complained about to the regulator.




No evidence of financial or other gain to be made by discrediting the doctor

Mobbing


Engages a crowd of people to act as complainants in order to hide behind them. Creates impression of widespread concerns to engage the regulator.


No need to have numerous witnesses to misconduct

Concealment of evidence


Documents missing, denies existence even when one document states another one is attached to it and staple marks are present.




No need to conceal the evidence

A User of others


Prone to prejudice and could use those considered inferior to write the complaints so as to avoid personal responsibility. Hides behind others. Divide and rule.


Not present

Phoning around to get more troops


Telephones previous employers to get them to complain as well.

Not present

Pseudo consultations


Engages in pseudo consultations to get the “green” light to make the complaint to the regulator. For example, telephones National Clinical Assessment Authority for advice but actually trying to find if there are other complaints there already against the doctor. Calls other employers who also engage in pseudo consultation with Clinical Assessment Authority


No hostile dependency on other public bodies to get the support to report to the regulator.

Personality type


Snakes in suits

Unremarkable, no delight in harming others


Psychiatrists and Whistleblowing

In her excellent article Dr Jean Lennane explores how psychiatrists treat whistleblowers. It is just so true.
If they are denied access to whistleblower this does not stop them from making demands for such evaluations and allegations of dysfunctionality in whistleblowers.

Sunday, 22 December 2013

The Significance of Religious Uniforms when working with mentally ill


For decades, if not for a longer period, there have been attempts from within the church to make changes to the tradition of wearing religious uniforms by clergy. The above photograph is of Peter Owen-Jones who has some dress sense when trying to break down the barriers in communications with the faith followers. The Church of England Synod will decide in February 2014 if they are prepared to put power first or their parishioners.

It is a very serious matter. Dress can have disastrous consequences. Sadly, for example, there is evidence that there were increased suicide rates in an area where a Catholic nun, social worker wearing her habit was appointed for about four years. 

   SIGNIFICANCE OF RELIGIOUS UNIFORM WORN BY MENTAL HEALTH   PROFESSIONALS
   

To whom is religious uniform
significant


In what way is religious uniform significant

Mentally ill person

Barrier to communication

It has already been established by scientific research that no uniforms should be worn in mental health setting.

 Thus one finds that doctors, nurses, social workers and administrators in England have not worn any uniforms for at least thirty years.

Uniforms are a barrier to communications as in “us and them”. With impaired communication there is a much decreased chance of effective diagnosis and treatment. The consequences of wearing uniform defeat the purpose of employment.

Reminder of trauma

Men raped by clergy as children experience flashbacks, panic attacks when reminders of trauma are presented to them.
Diagnostic and Statistical Manual of Mental Disorders TR IV lists diagnostic criteria for mental illnesses. Under Post-traumatic disorder one is able to find that avoidance is one of the groups of symptoms. Avoidance means avoiding situations and people that act as reminders of the trauma. Talking about trauma is also a reminder. Even thinking about appointments with professionals when such traumatic events may be discussed can lead to anticipatory anxiety in patients with Post-traumatic Stress Disorder. Some patients have sleepless night(s) and even start vomiting when so anxious.
There is no point in multiplying the barriers to communications with mentally ill people and wearing of religious uniforms does just that for many.
Reminders of abuse by clergy include religious uniforms. The result can be severe panic attacks experienced by patients. Panic attacks are associated with higher mortality from myocardial infarction too. Therefore, religious uniforms represent health and safety risk in mental health setting that is preventable.






Uniform symbolic of uniformity of values for the group wearing the same uniform

It is would be recognized by most mentally ill people that uniform poses obligations on the wearer of uniform to conduct themselves consistent with the values of the institution it represents. This involves the sacrifice of individuality of the wearer.

The issues of trust arise out of this situation. Person, who has given up their individuality and made considerable efforts at it, is unlikely to uphold another person’s right to his/her deviancy from norm (as in mental health issues) and especially so where the degree of deviance from the norm can be considerable (healthy or unhealthy).

Health issues and stereotyping

There may be health issues that patients would not disclose because of the fears of what religious person may think about them, for example, sexual issues, family planning, abortions, blood transfusions, epilepsy, mental
Illness causing behavioural transgressions, hearing voices, feeling controlled by outside forces (as in some cases of schizophrenia) and so on.

Reprisals

Disclosing history of abuse by clergy to members of clergy has been very risky for victims. Now it is known that canon law requirement has been to keep the history of abuse secret from other people (including police) or risk excommunication.

In communities where clergy have influenced even access to jobs fear of reprisals has been very real and not evidence of paranoia. Unemployment creates depression, and exacerbates mental illness. It can also lead to increased suicide risk.

Threats of reprisals against the victims of abuse by clergy are some of the factors that prevented access to state justice system. Mental health is damaged by chronic injustice and this applies to victims, their families, and friends.

It has been argued by some lawyers that aiding and abetting the crimes of child abuse happened at the top of religious hierarchy through the cannon law defects as well as lack of effective child protection measures following the disclosures of abuse. The offenders were allowed to work not just within the same religious organization but with children too while the risk of reoffending remained the same. As crimes were not reported to police there would be no Criminal Records Bureau check that would reveal anything.

Authority and power v right to individuality

Healthy attitude is to accept that each person is an individual. Religious uniforms represent authority and power in mental health setting as determined by state that permits it. Religious uniforms are misplaced in mental health setting as it actually ignores patients’ need to be considered as an individual who may actually hold very different beliefs and whose need at the time is his own health foremost and not to be preoccupied with what the needs of the religious person wearing religious uniform are. It is impossible to be faced with a person wearing religious uniforms and not notice it unless one is blind or has other rare perceptual disorders. This means that mentally ill person is expected to adjust themselves to the expectations of the religious mental health worker wearing the uniform irrespective of their desire, need or ability to do so.

Equality issues through role modeling

Mental health workers are like teachers in that they represent role models. It is unhealthy to act as a role model for values that are against equality for women, those of different ethnic groups, sexual orientation, different beliefs and so on. Religious uniforms stand for patriarchal values and outdated values which are not in keeping with the laws on equality.

Anxiety

Anxiety is common in many mentally ill people and introducing more anxiety by wearing of religious uniforms causes worry to patients and needless suffering which could be prevented.

Putting patient in a situation where he/she has to deal with making of formal objections to wearing of religious uniforms also presents the task for mentally ill that they may not be able to do. It is unreasonable to expect mentally ill, vulnerable people to assert their rights and fight the system when even healthy professionals are scapegoated and destroyed (see example of Dr Helen Bright) when they attempt to do it.

Provocation and Violence

It can be said that religious uniforms can represent provocation to some patients who already may have problems with impulse control for various reasons such as high stress levels. Some patients can be paranoid and grandiose too which in itself can lead to poor impulse control and aggression towards those who are considered irritants (like those wearing uniforms).

There are various cases of murders of nuns and priests by mentally ill who had a mixture of paranoid and religious delusions. The case of Mark Bechard is a well-known case and there are many others. He killed at least two nuns in the same day and wounded seriously more.

Mental handicap/Learning Disability

It is recognised that there are people who have severe cognitive handicaps, are very vulnerable and it can be accepted that they may be totally unable to object themselves to the wearing of religious uniforms or to even instruct anyone else to object on their behalf to the wearing of religious uniforms by mental health workers. There are sometimes large numbers of children with learning disabilities who suffered abuse in the some religious institutions. Reminders of trauma may not be verbalised but manifest themselves in behavioural deterioration which would be difficult for professionals to manage or even understand in patients with communications problems.

Suicides

a) Suicides can result from untreated mental illness. When barriers to communications exist as they do in human society and medical institutions for various reasons one finds increased suicide rates. Men have higher suicide rates and there is social expectation that men cannot be emotional, or sad. Gender inequality is reinforced by most major religions and for both sexes in a different manner. Sense of hopelessness may arise in patients when they see that mental health institution they want and need to trust upholds values detrimental to their health. Some religious people do not recognise manifestations of mental illness but see it as possession by evil spirits which is offensive in itself to mentally ill. We do know that medical regulator employs staff who have such beliefs.

b)  In Dr Bright’s case, she had no suicides amongst her patients when working in a hospital where nun wearing her religious uniform was employed as a social worker. However, there appeared to be an increase in suicides following appointment of a nun wearing religious uniform and after Dr Bright’s dismissal for raising the issue  in the public domain.

Inefficient use of Taxes

It is now known that even as much as 50% of UK population would at some point in their life experience mental distress. In most case it would not come to the attention of psychiatrists. The majority of those people would be working most of their lives and paying taxes with which they would support the system that is not supporting them at all times. When wearing of religious uniforms in mental health is detrimental to patients it follows that using tax payers’ money for salaries of people wearing them is inappropriate and against the interest of the tax-payer too.

Doctors

Diagnosis and treatment

a) When there is no communication or decreased or impaired communication between patient and doctor wrong diagnosis and wrong treatment may result. Wearing of religious uniforms impairs patient’ s communications with professional wearing it, and even with those not wearing the religious uniform that become associated with it in their minds. ”They are all the same” is what some say referring to all the staff after a disappointment. This occurs in depressed patients and is known as catastrophizing. The point here is that implications are wider than one might think at first.

b) It is already established that not wearing uniforms is associated with better compliance with treatment, less absconding from wards, less self-harm, less violence from patients. See paper by Roger C. Rinn.

Power

a) Some doctors can be unfair and stigmatise mentally ill patients. This means that government policy of leaving mentally ill at the mercy of local NHS Trust policy making is misconceived when it comes to the wearing of religious uniforms by mental health professionals. There is already discrimination against mentally ill people and it is unlikely that all NHS Trust administrators would care about mentally ill or that the majority of doctors would care about mentally ill as much as about other patients assumed to be sane.

b) Medical profession is self-regulated profession which means that it is possible to get rid of dissident voices over a period of time through sham peer review process using medical regulator such as the General Medical Council that has always been religiously biased.

Raising the issue of religious uniforms has been a dissident voice which puts patients first and not doctors or other mental health professionals wearing religious uniforms.

British Medical Association is conformist and it would support strike for doctors’ pensions for their members but unlikely to take actions on human rights for patients and especially not mentally ill.

Medical ethics is that patients come first, but it does not happen in reality when religious uniforms are worn by mental healthcare workers. However, it looks very nice in print that patients come first.


Values and beliefs

Religious uniform may represent the values that mental health professional holds important and prefer to hold in isolation from other thoughts giving rise to cognitive dissonance such as thoughts how bad it is for the patients and staff as well as the community (public interest). Cognitive dissonance plays a role in many value judgments, decisions and evaluations. Becoming aware of how conflicting beliefs impact the decision-making process is a great way to improve ability to make faster and more accurate choices. This ideal awareness is not something that is likely to happen in medical institutions dominated by men (General Medical Council in over 150 years never had a woman President or Chief Executive) or where women are chosen for their adherence to the same values and biases as men already there have. All major religions are patriarchal and dear to some medical men for that very reason. But not all medical men are the same.




Politicians

Votes

If it is accepted that religious people vote and that getting those votes could make one believe that by having religious bias at the expense of the mentally ill would lead one to have more power if elected. The assumption here is that religious people would prefer the rights of religious uniform to that of mentally ill persons. There is no evidence that in the setting of having the knowledge that uniforms (religious and non-religious) are harmful in mental health setting the majority of religious people would be unreasonable and demand special privileges to be given to those who wish to wear them. In fact, the latest statistics show that the majority of UK citizens have secular views.

Power

Most religions are patriarchal and that appeals to some politicians who may identify with such values. But many would not if representative of the population and if asked.

Wilful Blindness

Some politicians may have been well informed and knew that religious uniforms were, really, not such a good idea in mental health setting but avoided dealing with the issues by creating a good work wear policy because of cognitive dissonance and desire to eliminate it by extolling the virtues of religion because of all the previous personal investments made in religion.

Religious Institutions


Free Marketing


When religious uniforms are seen in the setting where some good is done (health and social care) religious institutions get free marketing because religious uniforms are symbolic of religious institutions and their values. Doing the job of mental health professional while wearing the religious uniform is perceived by observer as the work of religious institution.





Power

Having the “right” to use religious uniforms when other mental health professionals are not allowed to do so places religious institutions in the positions of power and special privilege. In fact, there is no such right in law.

It becomes impossible not to consider the needs of the religious person in all interactions between professionals and patients when religious uniforms are worn. Both professionals and patients have at all time to consider what to say and what not to say in fear of offending the religious and the institutions behind them. Like in dysfunctional families one is walking on egg shells.

It is so very easy to offend the religious.



Financial benefit

Religious uniforms are also provocative and divisive.

Firstly, scientifically minded professional is provoked to react to it. Similarly, person with sense of justice could do the same.

Secondly, it is possible to eliminate competition from scientifically orientated professionals by claiming religious rights, establishing those rights as dominant rights and thereafter benefiting financially when scientific competition is firstly discredited and subsequently destroyed and eliminated from the workforce.

In the case of Dr Bright, she was dismissed and erased from medical register while the nun was promoted and remains registered with Social Care Council. The rights of mentally ill have not been considered by anyone and how many died. This is breach of Article 9 of European Convention on Human Rights because religious rights are not absolute rights as well as breach of  Article 2.


General Public

Right to expression of religious belief

While public recognize the right to religious beliefs public expects politicians to put their health first as well as the health of mentally ill. This would be in keeping with European Convention on Human Rights Article 9, having the proper balance of different rights.

Mental Health Institution

Image and values

In UK so far the social and cultural background of institutional administrators determined preference for the religious uniforms while disregarding the needs of the mentally ill. No policies were created that eliminated the wearing of religious uniforms anywhere in UK while it has been acknowledged that no uniforms are worn in mental health setting normally.

Power

Where there is power there is potential for abuse of that power. Low social status of mentally ill people and low power of mentally ill enabled religious bias to dominate with fatal consequences. Religious uniforms may be symbolic of values to which some administrators aspire.


Justice system

High prevalence of abused males

In a number of studies in penal settings in Europe and elsewhere it has been established that there is high prevalence of men who have suffered abuse as children including sexual. The incidence is about 70%.

Considering the link of traumatic experiences to that of offending one would have to consider the impact of religious uniforms when visiting prisoners some of whom may have suffered abuse by clergy.

There are men in UK prisons who have killed clergy members following experiences of abuse by them.

Military

Murders by religious psychiatrist wearing religious clothes

2009 USA Army base incident (Fort Hood mass shooting by Dr Nidal Malik Hassan who killed 13 people and wounded 29) is a good example of failures to assess the risk to army personnel.

Here psychiatrist was seeing army personnel some of whom would have post-traumatic stress disorder as the result of the war in the country where predominant religion was Islam, the same as that of the psychiatrist who dressed in ethnic clothes identifying him as a Muslim. Patients with Post-traumatic stress disorder can be very irritable and provocative and religious uniform is provocative itself. The combination was fatal for many.

This incident happened 10 years after Dr Bright warned about the wearing of religious uniforms in mental health setting in UK which was published worldwide.