I am disappointed to read such a scathing review of Bella Jackson’s book Fragile Minds (A furious assault on NHS psychiatry, 30 June). It is a difficult read, and yet I thought that Jackson wrote about her experiences with compassion for both patients and staff unwittingly caught up in erratic and overstretched services.
I am a doctor, with experience as a psychiatric patient and as a senior “staff grade” doctor on an acute psychiatric ward. My memoir, Unshackled Mind: A Doctor’s Story of Trauma, Liberation and Healing, confirms Jackson’s claims that abuses do happen in these places. More subtly, there is a continued reliance on the disease-centred model of biomedical psychiatry without sufficient attention paid to the circumstances and adversities suffered by patients before they ever came in contact with psychiatry. As a result, my own early trauma was unaddressed for more than 20 years, while I was subjected to increasingly damaging interventions, including electroconvulsive therapy and even a cingulotomy. It is only since leaving psychiatry that I have been able to recover.
Jackson’s book is a reminder that despite the best intentions, many patients are failing to get the help they need in a fundamentally flawed psychiatric system.
Dr Cathy Wield
Abingdon, Oxfordshire
I am writing to congratulate Dr Rachel Clarke for her excellent rebuttal of Bella Jackson’s assault on the failings of modern psychiatry. I have worked as the head of mental health law for a large NHS trust for 35 years, and as a frequent visitor to mental health wards, entirely agree that Jackson’s views are at odds with my experience. I was last on a secure, forensic mental health ward just a few days ago – with incredibly challenging patients.
All the staff I encountered were not only humane, but kind, compassionate and caring. I’ve also worked in roles where I visited many hospitals and have almost without exception experienced the same. Our mental health nurses and psychiatrists, as well as so many others, go out of their way to display the same values.
I am far from naive, and recognise that there is a tiny minority of individuals who fail to live up to the same core values. Over decades I have witnessed interactions where psychiatrists, nurses and others are challenged to a degree that might seem almost impossible to cope with, but they rise to the challenge with great skill, kindness and compassion, in line with their respective professional codes of conduct.
Kevin Towers
Head of mental health law and data protection officer, West London NHS Trust
I’m writing in response to the review by Rachel Clarke, especially the suggestion that the memoir is “scaremongering”. I am a consultant clinical psychologist with more than 20 years’ experience in the NHS across several London-based trusts. I train people, including ward staff and crisis services, in working effectively with people with personality disorder. Similar stories to those that Bella Jackson relates are reported to me and colleagues regularly. I don’t doubt the veracity of Jackson’s complaint, nor that NHS mental health is in a dire state; it is interesting that Clarke does, given her admission of relatively scant mental health experience.
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