Psychiatrists and Social Workers Acting With Impunity

A client of mine LC, see news item link , lost access to her 3 children for 5 months because a psychiatrist declared she had an emotional unstable personality disorder. I protested to the Court that this was wholly unfounded, having treated LC succesfully myself with CBT for depression. The appointed Expert Witness agreed with me that LC did not have an emotionally unstable personality disorder. The social workers refused to distribute my report to the agencies involved and were insistent that she attend a non-evidenced based treatment targetted at personality disorder. LC was mandated to attend regular meetings with social workers and other agencies. After legal action against Cumbria County Council they have apologised simply on the basis that there were no grounds for insisting that access had to be supervised.  The link to the News item is below:

http://www.newsandstar.co.uk/news/Cumbria-County-Council-sorry-after-mums-five-month-hell-0b215a18-055c-43e3-8b03-69ff77b5a05e-ds

But there is absolutely nothing to prevent this psychiatrist or any other, from making a diagnosis without careful reference to diagnostic criteria, routinely psychiatrists use criteria in a cavalier manner. There is no systematic enquiry about each of the symptoms that constitute a diagnostic set and no use of published thresholds to determine whether a symptom is present at a clinically significant level. This is no academic matter, the abject misery caused to my client LC for those 5 months was absolutely horrendous. To my knowledge there have been no sanctions against the social workers, they simply took a view of LC, taking their lead from the psychiatrist and refused to consider information that might contradict their conclusions. They showed no understanding of the concept of a personality disorder nor of what constituted evidence-based treatment. These professionals have been left to carry on and wreak havoc wherever, doubtless in good faith.

These matters should be a serious concern for the Royal College of Psychiatrists and the British Association of Social Workers but I have no confidence that these matters will be addressed because they are endemic within those professions.

Legal proceedings are still continuing for human Rights Violations by Cumbria County Council in respect of 2 of the children.

 

Dr Mike Scott

Fatal Consequences of Missed Disorder

On Tuesday last BBC News at Ten reported a Serious case review of the murder of 2 year old Ayeeshia-Jayne Smith at the hands of her mother, which concluded that social workers failure to identify significant psychological disorder played a pivotal role in the child’s death. Would CBT practitioners have been any better at identifying such disorder? It is not an academic question, the mother or her then partner could have come a CBT practitioners way as a referral from Social Services because of ‘issues with anger’.

The social workers had focussed largely on the supposedly supportive relationship between the mother and child, but there were concerns, a Risk Assessment meeting was held the day before the murder! But had they screened the parents for say borderline personality disorder and if positive done a more detailed examination, using reliable diagnostic criteria, their approach would have arguably been more balanced, resulting in earlier action. The diffiiculty is that for social workers and CBT practitioners staying in their comfort/ ideological zone of relationships is easier.

Existing risk assessment procedures, represent an expert consensus and to my knowledge there is no empirical evidence that they predict outcome. Agencies promote them but it is more a matter of them covering their back.

The 7 Minute Interview contains the following Screen for BPD and its’ psychometric prpoerties were discussed in an earlier post.

11. Yes No Don’t know
Do you have a lot of sudden changes of mood, usually lasting for no more than a few hours?
Do you often have temper outbursts or get so angry you lose control?
Is this something with which you would like help?