Asylum Magazine (Volume 17 No 4) Winter 2010

Readers may know that in 2008, due to the sudden death of its Editor, Asylum magazine went into crisis and stopped publication. The re-launch was last March. However, people still kept sending in material and so this issue is made up of submissions from the last few years. Readers have sent in lots of great stuff – thanks very much for that. We always welcome contributions.

We are also aware that we haven’t always been able to respond as quickly and as efficiently as we would have liked. We are now reorganised and we do our best! And yes, we know that the Asylum website has long been out of date, and are just now working on it. Already some vital information has been updated (e.g. about subscribing).

Since the re-launch, and in response to feedback, we have tried to include shorter articles (and in a more readable typeface). Some readers like each issue to be specific to one topic, but we hope this general edition appeals to everyone. Asylum 17.4 was put together by Jim Campbell and Helen Spandler.

They selected some of the best material submitted in the last few years. We take another look at service-user views and action on crisis services (Soteria and the Leeds Survivor-Led service) and also include articles about Survivor Movement history, labelling, identity and stigma, alternative perspectives on the Diagnostic and Statistical Manual, and panic attacks. We are always interested in ongoing critical work by radical mental health workers, and include a submission from the Midlands Psychology Group.

We also include a Letters page, providing interesting views on articles in Asylum since the re-launch. We hope you enjoy this edition and find food for thought and encouragement in the struggle for a more decent and reasonable mental health system. We are acutely aware that this struggle will intensify in the midst of ongoing threats to our public services and welfare system. We are always keen to share with readers new and creative ways of campaigning and protesting about mental health issues.

For the first edition we hope to feature Mad Pride who held a demonstration in Hyde Park against cuts to services and benefits on 26th October (see page 26). For next year, we are also working on a special issue on Spirituality (edited by the Spiritual Crisis Network), and one to mark 100 years of the diagnosis ‘schizophrenia’. So we’d like to encourage all our readers to make sure they send their subscriptions for 2011! Please continue to contact PCCS Books for this and for bulk-buying. And please do keep sending in ideas, material, letters, pictures and poems. Without your submissions, your help with distribution and your ongoing support, we could not survive.

The Therapeutic State extends its reach: Community Treatment Orders Just as we are about to wrap this issue for publication, the topic of CTOs is again in the news. Against much opposition, from right across the mental healthcare spectrum, CTOs were introduced in late 2008. By means of this legal device, released patients judged not to comply with prescribed treatments may be compulsorily taken back into hospital and treated. A CTO lasts for six months and can be renewed immediately: there seems to be nothing to prevent a person from being subjected to a CTO ad infinitum.

The Care Quality Commission found that during the first year of operation more than 4,000 people were subjected to a CTO. One in every five patients was recalled. This is at least ten times the number predicted by the Department of Health. Eighty-one percent of the patients in the research sample had a diagnosis of schizophrenia or another psychotic disorder and 12% were diagnosed with a mood disorder. Almost all were prescribed some form of injected antipsychotic medication.

Everybody knows these drugs are toxic and can be both psychologically and physically dangerous – for example, they are well-known often to cause distressing ‘side effects’, not to mention obesity, diabetes and TD. The fact that such compulsory treatment is becoming commonplace is very disturbing. The rationale for CTOs was that they would deal with ‘revolving-door’ patients. And yet 30% of the patients in the sample did not have a history of refusing to take their medication or of failure to cooperate with community services.

CQC thinks that a reason for the higher-than-expected numbers could be that, in the current ‘risk aversion’ and ‘blame’ climate, some psychiatrists ‘play safe’ by putting patients on a CTO as a preventative measure. This is undoubtedly an important factor, but surely another reason is simply the shortage of NHS beds and alternative crisis facilities. Bed shortages, a lack of crisis houses and inadequate support in the ‘community’ could also mean professionals feel the need to use such compulsory measures when discharging patients.

CQC is also concerned that there are disproportionately more patients on CTOs from some of the black and minority ethnic (BME) groups. Of course, there is already over-representation of BMEs in the general psychiatric population, so that figures …(See, 27th Oct 2010)

Jim Campbell, Helen Spandler and Phil Virden


Download Volume 17 No 4



  • A small act of revolution. Bill Bailey.(p4)
  • Panic attack: a window for wisdom (anonymous) (pp5-6)
  • The dead sheep in the water tank: Some thoughts on ending stigma. Terry Simpson.
  • User-led mental health services? We’ve done it for a decade. Adam James on Leeds Survivor-Led Crisis Service (pp 8-9)
  • Letters: Jane McCullough; Hilary Pegg and AE Plumb (pp 9-10)
  • Soteria: as viewed by (ex-)users and survivors of psychiatry. Peter Lehmann (pp 11-14).
  • One Step Beyond: Alternatives beyond Psychiatry: Book Review by Helen Spandler Alternatives beyond Psychiatry Edited by Peter Stastny and Peter Lehmann Reviewed by Helen Spandler (p.14)
  • Mental illness or self-interpretation by Jeremy Spandler (pp 15-16)
  • Welcome to NICEworld by Midlands Psychology Group, pp 17-20
  • State regulation: A disaster for service users as well as psychotherapists. Ian Parker, p. 21.
  • The need for a new category of schizoprenia in DSM-5 by Phil Thomas, pp 22-25.
  • Poems by Carol Batton, p. 25
  • Mad Pride demo: 26.10.2010, p.26
  • Special feature on survivors’ history:
  1. A poet’s view of the Survivors History Group by Julia Sorribes and Phil Ruthen: Survivors of the UK’s mental health system rewrite their history.
  2. Asylum to Action by Helen Spandler: A review by Mark Cresswell. Survivors’ history and the symbols of a movement. (pp 27-31).
  3. The Symbol of the Survivors History Group.