News, October 2015

Many people applying to work or volunteer with children or in health care face background checks from the Disclosure and Barring Service (DBS – previously CRB). A review last year raised concerns that irrelevant information about people being detained under the Mental Health Act was being released and having a negative impact on the employment prospects of such people. Now new guidelines call for a number of factors must be taken into account before an individual's mental health crisis is revealed.

The guidelines point out that detention by the police under the Mental Health Act 'does not constitute a criminal investigation and should therefore be treated with great caution when considering relevance for disclosure'. They point out that if a person showed a risk of harming others during their detention this may be disclosed if it is relevant, and how long ago an incident happened should also be taken into account before including such information on criminal record certificates.

If a mental health crisis is disclosed during a DBS check the Home Office guidelines recommend the certificate should give enough information as to why this may be relevant to the employer or voluntary organisation.  

Paul Farmer, Chief Executive of Mind, said having a mental health problem or having been detained under the Mental Health Act should not necessarily be a red flag in the case of DBS checks. However, he added, there was still room to go further: 'For example, people should automatically be allowed to make representations about the current state of their mental health if concerns are raised. At the moment it is left to the discretion of the chief police officer to give someone that opportunity. In a society where stigma about mental ill health is still rife, we need all the checks and balances possible to negate any fears and preconceived ideas about the one in four of us who experience mental health problems every year.' 
Ella Rhodes

'We can make changes – we just need to be brave'

A group of psychologists successfully walked 100 miles between Leicester and London to highlight the impact of austerity on mental health. Their journey caught the attention of both local and national media as well as many members of the general public.

Dr Ste Weatherhead, who organised Walk the Talk, and his group visited food banks and homeless shelters along the route and collected the stories of those who had been hit hard by austerity measures and welfare reform. The group's aim was to highlight three areas in particular: the benefits system, homelessness and food poverty, and at each of the food banks and shelters they visited they took video or audio recordings of people's stories and how their mental health has been affected by such cuts.

Along their route, Weatherhead said, he was struck by how their cause had caught the imagination of the general public as well as professionals, the media and politicians. He added: 'We had lots of people stop us in the streets to say hi and make points of support for what we were doing. One lady met us at one of our scheduled stops and brought us cakes. A guy came and said he wanted to join in but due to mobility problems he couldn't walk far. However he did take our bags in his car for 10 miles of the journey, this made such a huge difference to our energy and our walking speed.

The group were interviewed by The Guardian, the Mirror, BBC Radio Leicester, BBC Northampton, and the BBC World Service, as well as RT TV. Weatherhead said he was overwhelmed to be joined by dozens of supporters on the London section of their walk.

He added: 'As psychologists, our job is in part to show we are listening to what people are saying. Hitting the streets in this way, really did that. It took active listening to a new level, and made us very visible in showing our connection with important issues, our desire to be with people in calling for change, our belief in the possibility of change, and our willingness to actively make that change happen.'

The stark reality of life for people using food banks and struggling with their mental health, Weatherhead said, had affected him. He added: 'In the food banks and shelters we visited, people were losing hope. They said they didn't think the systems were going to change. They got some hope from what we did.'

He told the story of one woman he met whose partner of 11 years had passed away: 'Her mental health really suffered and she ended up on the streets and needed benefits, but I've heard so many times that there are simply too many hoops for people to jump through and they lose hope.

Speaking of the future, Weatherhead added: 'This isn't about one person and one mission. Now we need other people, professional bodies and organisations to take new approaches, be brave and step outside their comfort zone in order to show they want to make a positive impact. We can make changes, we just need to be brave.'

To see the media coverage garnered by the walk and to find out more about their cause see their website walkthetalk2015.org. er

Seeking closure on 'closure'

A list of 50 words and phrases to be avoided when writing about psychology was recently published, leading to much debate among academics and science journalists. The article, in Frontiers in Psychology, includes misleading terms, misused or ambiguous terms, oxymorons and pleonasms – where more words than necessary are used to convey meaning.

The authors, who include Scott Lilienfeld, (Emory University), state the terms included should be avoided or used sparingly. They suggested that, as the field of psychology is often full of ambiguous terms and concepts, the use of language should be all the more rigorous and clear to limit potential misunderstanding.

In the inaccurate or misleading terms section of the article, the authors warn against calling drugs such as SSRIs or tricyclics 'antidepressant medication'. They write that there is no evidence to suggest these drugs are any more useful in the treatment of depression than for other conditions, including anxiety disorders or bulimia nervosa.

Among the five 'frequently misused terms' listed is fetish. The authors suggest this should only be used, as initially intended, to describe sexual arousal from inanimate objects or non-genital body parts and should not be used simply to describe general preferences for objects, ideas or people. Secondly, closure, they write, should be used in its original gestalt context as a way to describe a tendency to see incomplete figures as wholes rather than a feeling of resolution following trauma.

The use of medical model is listed in the article's 'ambiguous terms' section, as many authors who use it think it always means the same thing, although it has a huge number of possible meanings. For example, the authors write, it has been used to describe an emphasis on an underlying disease rather than presenting signs or symptoms, the assumption that psychological issues are better treated with medication than psychotherapy and the belief that mentally ill people who act irresponsibly are not fully at fault for such behaviour.

Although it may be argued that the changing usage of these words is part of the natural evolution of language, the authors do claim some terms are just plain wrong: for example, the term hierarchical stepwise regression when hierarchical and stepwise regression are entirely separate processes. They also suggest the use of the term biological and environmental influences is unnecessarily wordy when environmental influences alone encompasses all the effects on a living being from the moment it is conceived.

Vaughan Bell, writing on his Mindhacks blog, said: 'Some of the recommendations are essentially based on the premise that you "shouldn't use the term except for how it was first defined or defined where we think is the authoritative source". This is just daft advice. Terms evolve over time. Definitions shift and change. The article recommends against using "fetish" except for in its DSM-5 definition, despite the fact this is different to how it's used commonly and how it's widely used in other academic literature.'

In reply to Bell's article, Lilienfeld said the list was not intended as a 'ban list' of terms, but as a guide to use them with more clarity. He wrote: 'We are lobbying for considerably greater clarity in the use of certain terms, especially those that are often used loosely or sloppily in the psychological and psychiatric literatures. When we suggest "avoiding the use of a term," we typically mean avoiding the use of that term in certain ways and in certain contexts.' er

The Frontiers article is at tinyurl.com/opyyb3x; Mindhacks and Lilienfeld response (in comments) tinyurl.com/pxqnzkh