News, August 2007

Mental Health Bill success – the end of the beginning

A NEW Mental Health Bill has finally passed through all its parliamentary stages and at the time of writing awaits only the formality of Royal Assent before becoming law.
The British Psychological Society has worked hard over the years to ensure that the new legislation reflects its concerns. These concerns have mostly been met, and the Society is pleased that this a much better piece of legislation than the bill originally introduced by the Department of Health. The BPS Parliamentary Officer, Dr Ana Padilla, told us the British Psychological Society was extremely happy to see the bill get through following 'serious, constructive compromises' made by the government.
Conditions for the imposition of community treatment orders (CTOs) are more restricted than in previous draft bills. The changes come after representations from several groups including the Society. CTOs will now only be applied to prevent risk of harm to the patient's health or safety, or to protect other people. The intention
of any CTO must also be to alleviate, or prevent further deterioration of, a person's mental condition. The original bill had instead placed the emphasis on behaviour management and movement restrictions, which carried the danger of some CTOs being used principally to control antisocial behaviour.
People detained for compulsory treatment under the existing legislation are placed under the care of a 'Responsible Medical Officer' (RMO), invariably a psychiatrist. The forthcoming Act replaces the RMO with 'Responsible Clinician', using a competency-based approach, drawn from the ranks of 'Approved Clinicians'. This person could be a psychologist or other mental health professional.
The new legislation also includes powers by which people with a mental illness can be detained in hospital against their will, even if they have not committed a crime. The Society, through the new Mental Health Coalition (see News, June 2007), had argued for an 'impaired decision making' clause, whereby such detention could only be imposed on those who lacked a genuine ability to make decisions in their best interest. Unfortunately the government did not accept the Coalition's arguments on this aspect.
But overall there are many welcome provisions in the legislation. These include a guarantee that within two years, patients under the age of 18 will be treated on age-appropriate wards; age limits for electroconvulsive therapy; new independent advocacy services for patients detained under the Act; and new rights for the victims of convicted mentally disordered patients to know when offenders will be released, and to make representations about their discharge.
Chartered psychologist Professor Peter Kinderman (University of Liverpool), speaking on behalf of the Mental Health Coalition, said:
'I am delighted that the Department of Health has listened and responded positively to the concerns of the Coalition. Most mental health professionals are committed to developing genuine multidisciplinary care. We feel that the new Act will much better reflect the way that ethical, high-quality, person-centred care should be delivered.'
Work will now begin on implementation, developing a code of practice, forming links with other professional groups, and the training and accreditation of Approved
Clinicians and Responsible Clinicians. The Society says it intends to play a major role in these processes.    PDH/CJ 

Partnership award

A PROGRAMME of intensive psychological treatment for mentally ill offenders was nominated for June's Medical Futures Innovation Awards, for mental health and neuroscience innovation.
Psychologist Katie Bailey (Head of Psychology, North West Region, Partnerships in Care) was nominated for Life Minus Violence, a joint initiative care programme with the NHS. It is an intensive groupwork programme aimed at male patients for whom aggression is often the major barrier to their progress through mental health services, and hence inclusion back into society.
The programme is now available within secure psychiatric care, and interest has been shown by HM Prison Service, the Probation Service, National Offender Management Service, other independent and NHS hospitals, learning disability services and women's mental health services.
Katie Bailey said: 'We are very pleased with the programme. The interest from so many organisations, as well as forensic services in other countries such as Japan and Canada, shows that the programme is something truly worth sharing to help benefit patient care.'
Professor Jane Ireland, Violence Treatment Lead at Ashworth Hospital, Merseycare NHS Trust, saw clear benefits in including and working with the private sector on this important initiative. She said: 'When I was first tasked by the NHS to lead the development of aggression treatment with Ashworth High Secure Hospital, I was keen to include the private sectors as partners in this, to recognise the importance of treatment being streamlined across services.'
Although it was unsuccessful in the main category, the programme was awarded the Medical Futures Best Public–Private Partnership.    JS

GCSE CRITERIA
THE Qualifications and Curriculum Authority have published their draft GCSE subject criteria for psychology. Consultation is open until 14 September.
However, although psychology will become a science A-level from next year, the situation at GCSE level is far from clear.
To download the consultation and respond via questionnaire, see www.qca.org.uk/609_18640.html.

NORTH EAST THERAPISTS NETWORK LAUNCHED
CHARTERED psychologist Dr Dorothy Rowe delivered a public lecture in June to mark the launch of a new network of psychological therapists and counsellors in the north east of England. The University of Sunderland psychology department has launched the scheme to help improve mental health in the area. Practitioners from a wide variety of agencies including Relate, Action on Addictions, and the NHS are participating.

The lure of neuroscience

THESE days, it can feel as though a psychological finding is inadequate unless it draws on the tangible wetness of neuroscience: the chemicals and brain areas. To discover, say, that a given activity is enjoyable is not enough. To reveal that it activates our reward pathways – now that's science. To paraphrase the scepticism of philosopher Jerry Fodor: We always knew there was a difference between verbs and nouns, but once somebody showed they were associated with activity in different brain areas, well then we knew they were different 'scientifically'.
Now Deena Weisberg and colleagues at Yale have formally tested the effect that adding neuroscience jargon has on people's satisfaction with explanations of psychological findings. Naive participants, neuroscience students and neuroscience experts were presented with descriptions of psychological phenomena, such as mutual exclusivity and the attentional blink, together with both good and poor (i.e. circular) explanations of these phenomena.
Everyone, including the naive participants, found the bad explanations less satisfying than the good explanations. Crucially, however, among the naive participants and neuroscience students, those who read bad explanations containing gratuitous neuroscience references, reported being more satisfied with these bad explanations, than did the others who read bad explanations containing no neuroscience. By contrast, the presence or not of neuroscience content had no effect on the neuroscience experts' satisfaction with the bad explanations, but irrelevant neuroscience did reduce their satisfaction with the good explanations.
The researchers surmised there could be several reasons why references to neuroscience make a bad explanation more satisfying for non-experts. For example, physiological analysis, though irrelevant, could give the impression that the explanation is connected with a wider, more insightful, explanatory system. Or, as brain-imaging expert Rik Henson has noted, perhaps people's judgement is distracted by the seductive visual imagery – such as pictures of blobs on brains – with which neuroscience is associated.
The researchers said their findings could have serious implications for the application of neuroscience to social issues, such as when presented as evidence in court. 'Even if expert practitioners can easily distinguish good neuroscience explanations from bad, they must not assume that those outside the discipline will be as discriminating,' they wrote. The findings are in press at the Journal of Cognitive Neuroscience.     CJ

NATURE CALLS
The journal Nature is calling on experienced researchers to help young scientists become better peer reviewers. Its 14 June editorial outlines the key elements of good peer review: an attitude of constructive objectivity; a summary of the paper's strengths and significance; constructively and collegially expressed critical comment; and, in response to experimental weakness or alternative explanations, suggestions for further experiments that might strengthen the case or resolve ambiguities should be given. 'This may all seem obvious to the experienced reviewer,' the journal says. 'But it is only by careful oversight of a young scientist's attempts at reviewing real papers that the benefits of this experience can be passed on.' (See http://blogs.nature.com/peer-to-peer for more.)

Dual brain imaging

BRAIN-imaging technology has taken a leap forward with the publication of the first scans captured simultaneously via positron emission tomography (PET) and magnetic resonance (MR) technologies. The images were presented in June at the 54th annual meeting of the Society for Nuclear Medicine in Washington, DC. 'The PET/MR system allows simultaneous measurement of anatomy, functionality and biochemistry of the body's tissues and cells, enabling researchers to correlate MR and PET data in a way not previously possible before,' said Bernd J. Pichler, associate professor and head of the Laboratory for Preclinical Imaging and Imaging Technology in the Department of Radiology at the University of Tuebingen in Germany. It's hoped the hybrid technology will help further our understanding of the pathologies and progression of disorders like Alzheimer's, Parkinson's, epilepsy, depression and schizophrenia.     CJ

Psychologists and abusive interrogation

THE nature of psychologists' involvement in American national security interrogation practices has come under renewed scrutiny. The cause is a newly declassified August 2006 report by the Office of the Inspector General (OIG): 'Review of DoD-Directed Investigations of Detainee Abuse'. In an open letter to APA president Sharon Brehm, more than 40 psychologists claim the report demonstrates indisputably that psychologists helped develop abusive interrogation techniques for use in Guantánamo, Afghanistan, and Iraq (tinyurl.com/2qpmv8).
If the signatories' claim is true, this would appear to undermine the APA's stated position that psychologists ought to remain involved in interrogation practices, so as to ensure they remain safe, legal and ethical (see News, October 2006). Another claim made by the letter is that the OIG report shows three psychologists who were directly involved in developing abusive interrogation techniques, then went on to become members of the APA's own task force set up to investigate the ethics of psychologists' participation in interrogation.      CJ
 

Psychometric tests for learner drivers

LEARNER drivers should be given psychometric tests to assess their attitudes to risk. That's according to Robert Gifford, Executive Director of the Parliamentary Advisory Council for Transport Safety (PACTS). He told BBC Radio Five Live that testing learners' knowledge of the highway code wasn't enough, and that questions about their proclivity for jumping red lights and other risk taking would help pick up on their underlying values.
In fact, psychometric assessments of this nature already exist. Chartered psychologist Dr Lisa Dorn has developed a Driver Risk Index for novice bus drivers at Arriva Bus UK. She told us the purpose of the index was not to act as a test, but rather to help learners reflect on how their attitudes will affect the decisions they make during their driving career. 'If people stopped to think about the risks they run when they're speeding to a meeting, or getting angry with other road users and tailgating – perhaps we would see fewer people being killed and injured on the roads,' she said.
The Driver Risk Index incorporates scales to detect socially desirable responding, but Dorn pointed out that attempts to answer the assessment dishonestly would be pointless when its aim is to make learners safe rather than to catch them out. Indeed, crash rates among Arriva's bus drivers have reduced significantly following the introduction of the index, and Dorn and colleagues are now evaluating the approach with learner car drivers. The news comes as the Driving Standards Agency is undergoing a full review of the driving test process.     CJ

Frith festschrift

EARLIER this year, a Festschrift was held at the Royal Society in London to celebrate the outstanding contributions that Professor Uta Frith has made to psychology over the past 40 years. A series of talks were given by many of Professor Frith's collaborators – themselves prominent in developmental psychology and cognitive neuroscience. 
The Festschrift showcased new data that provided refined insights into Frith's three main research areas – dyslexia, autism and conduct disorder. The Festschrift was broad in scope, touching on the nature and relevance of the phonological deficit in dyslexia, refinements to extant theories of autism cast against typical development, and new perspectives on the conceptualisation of conduct disorder and psychopathy.
Professor Maggie Snowling (University of York), Professor Dorothy Bishop and Dr Sarah-Jayne Blakemore organised the conference. Professor Snowling said it was 'a fitting celebration of Uta's lasting influence. The Festschrift made clear the exciting and tangible possibilities for future research, which will impact upon our understanding of the origins and trajectories of developmental disorders.'    JS
- To read a full account by Lisa Henderson and Fiona Duff, go to www.thepsychologist.org.uk and click on this month's issue for an online-only article.

Schizophrenia in developing countries

TWENTY-five million people with schizophrenia live in low- and middle-income countries, where they receive little or no formal treatment. What can be done to help when these countries have so few mental health professionals?
The answer, according to Dr Vikram Patel of the London School of Hygiene and Tropical Medicine, lies with community-based mental health workers. Writing in PLoS Medicine (tinyurl.com/yv6jhw), he argues they should be tasked with raising awareness about the disorder and should identify probable cases of schizophrenia to be referred to the local health practitioner for formal diagnosis and drug treatment.
Pointing to the positive work of the UK-based organisation Basic Needs, Dr Patel says: 'The model I have outlined is not a pipe dream. It is an affordable prescription for a commitment to ensure that people with schizophrenia receive the basic minimum package of evidence based care…that meets their human rights.'
Writing in the same article, Professor Saeed Farooq of the Lady Reading Hospital, Peshawar, Pakistan, advocates introducing 'directly observed therapy' for people with schizophrenia. This approach, which has been used to treat TB in low-income countries, would involve health workers or family members observing
and recording schizophrenia sufferers swallowing freely-distributed drug treatments.
Dr R. Thara, director of the Schizophrenia Research Foundation in India agrees that it is only by ensuring people with schizophrenia receive effective treatments that stigma towards the illness will be reduced in low-income countries. 'When patients' conditions improve,' she wrote, 'especially in the restoration of their social functioning, the community's explanatory model of schizophrenia often shifts from a magico-religious to a medico-social viewpoint.'    CJ