Why is no one talking about what happened to Dalian Atkinson?

[Zetetic]

I was focusing on your point about family etc activism, in similar circumstances.

I don't really see the distinction between the use of force in the two situations - in both cases it's violence legitimised by the claimed state of the victim.

In the former they used a huge amount of manpower to kill Lewis, here they used Tasers as a force-multiplier.

[TrenterPercenter]

Going round in circles.  The violence of course is distinguishable but they end up in the same outcome if you want to view it at the level you are choosing too, I'm not arguing against that either so I'm not sure why you are going on about it still.  Both Seni and Dalian are similar that is why they are in comparison to Duggan and Lawerence.

[Zetetic]

Seriously what is this shite.

Nevertheless, we really should reflect on what the mantra implies about someone like Atkinson, if we want to take this seriously.

It tells us (correctly) that attempts to help such a person are relatively ineffective and therefore - from a sufficiently broad perspective - inefficient.

The implication of that, in the context of scarce resources, is that helping someone like Atkinson is a waste of time (or whatever currency you choose). Every hour or pound spent on such a person is an hour or pound that could have been spent making sure that innocents "don't transition to the kind of psychotic illnesses" that this person now manifests.

Eventually, at a time not yet specified, the mantra tell us that we'll be rid - or close enough - of people like Atkinson. But what to with them now? We could treat them decently, I suppose, but at what cost, what human cost? There are other people, more open to effectiveness and efficiency, after all.

The punchline is that treating them like shit rarely turns out to be particularly cheap anyway, so it doesn't end up freeing up the resources for Early Intervention that you'd hope - but it does show commitment at least.
 

Edit: To be clear, Trenter - of course, you don't want people like Atkinson to be treated like shit and I don't believe otherwise of you. Of course, you want both early intervention and humane treatment of the seriously unwell. I'd assume, you see the "scarce resources" point as highly politicised bullshit that could be solved given the will to do so.

[TrenterPercenter]

Nevertheless, we really should reflect on what the mantra implies about someone like Atkinson, if we want to take this seriously.

It tells us (correctly) that attempts to help such a person are relatively ineffective and therefore - from a sufficiently broad perspective - inefficient.

If you want to be taken serious with this you really need to stop using words like "mantra" - this is Brexit-tier language that does nothing more than display your prejudices and ignorance.

Let's deal with some of that ignorance right now.

First off Early Intervention EI is not the same as Early Intervention for Psychosis EIP.  EI is an approach that is used in lots of different areas of health EIP is something very specific to a condition - you can't use them interchangeably without looking like someone that doesn't know what they are talking about.

Sticking with EIP, Atkinson did not qualify for EIP due to his age, something that would have been in its real infancy when he likely had his first episode, the first EIP detection units didn't exist until in 1996....in Australia, they are not in the UK until few years later and even then as pointed out Atkinson would have been too old.  So you've just proclaimed EI? EIP? doesn't work citing a case that doesn't have anything to do with EIP.  EIP used to operate from 14-21, then 14-25 and much more recently 14-35 (and looking now even to 65 which is very new) at no point did Atkinson ever qualify for EIP services.

Even if Atkinson did qualify and receive EIP care, and was subsequently murdered by the police that of course still doesn't suggest anything of the sort that EIP doesn't work - I think as mentioned before you need to look at the actual studies for EIP which all show the economic and outcome benefits of EIP (and more emerging evidence for EI for other diagnoses).  EIP doesn't stop everyone from getting iller, it reduces the impact of the illness, most of this is done around the First Episode of Psychosis (FEP) with the evidence, that's evidence not your claims of "mantras", that the sooner an individual receives what we call onset of criteria treatment (treatment but specified i.e. you can't just have someone take one dose of antipsychotics and call it "treatment") the better longterm outcomes are and less likely and frequently subsequent episode are to occur.  This is known as the critical period.  Dalian Atkinson never received treatment in his critical period because the critical period hadn't been discovered until he was in his 30s.

The implication of that, in the context of scarce resources, is that helping someone like Atkinson is a waste of time (or whatever currency you choose). Every hour or pound spent on such a person is an hour or pound that could have been spent making sure that innocents "don't transition to the kind of psychotic illnesses" that this person now manifests.

No, there is no implication, that is something we've just shown you made up and is based on your lack of knowledge of EIP and some bizarre world where Atkinson, someone that never benefited from EIP being murdered by the police, is evidence against the actual trials and longstanding research that show EIP works. It's fantastically bizarre.  There is no currency you speak of this is also an invention of yours for a bad argument.  Improving outcomes for individuals is the primary and most important thing here it just so happens that reducing the need for the care required for serious MH conditions like psychosis also saves money also (again not a mantra but health economics research) - that is a good thing as it releases funds for other treatments.

Eventually, at a time not yet specified, the mantra tell us that we'll be rid - or close enough - of people like Atkinson. But what to with them now? We could treat them decently, I suppose, but at what cost, what human cost? There are other people, more open to effectiveness and efficiency, after all.

There is that word again, and no, no it doesn't, reducing episodes leads to better longterm outcomes, there is no cure that isn't how MH works! Roughly a third of people will have one episode and make "full" recoveries (obviously like any serious illness there are other aspects here), about a third will be episodic requiring some form of support and a third sadly will become very ill and spend a lot of time in psychotic states requiring significant care, inpatient stays and medication. EIP improves all of these percentages but if you are using words like "mantra" and "we'll be rid" I'm afraid you really are being quite jilted in your appraisal of all of this.

EIP is composed of detection and treatment.  A lot of EIP is done with families to train and support them to help what is usually their children, it works with young people to help them recognise their own signs and symptoms of an episode so they can apply the relevant self-care and seek support that reduce the impact of subsequent episodes.  I've no idea what you think this has to do with Atkinson or why you think this is a bad thing.

The punchline is that treating them like shit rarely turns out to be particularly cheap anyway, so it doesn't end up freeing up the resources for Early Intervention that you'd hope - but it does show commitment at least.

Edit: To be clear, Trenter - of course, you don't want people like Atkinson to be treated like shit and I don't believe otherwise of you. Of course, you want both early intervention and humane treatment of the seriously unwell. I'd assume, you see the "scarce resources" point as highly politicised bullshit that could be solved given the will to do so.

Don't worry, I like you, but I've done enough work in this area to know myself I'm not someone that wants anyone that suffers with MH to be treated like shit (kindof a big deal for me for a lot of reasons), I've been part of lots of things that can attest to that thanks.  In fact part of the reason I'm so passionate about EIP is that it is a very positive approach to MH. Still the mental health team working with Akinson at that stage of his life was not an EIP team (most likely CMHT or AOT but even then it has nothing to do with them really either) and the police are not EIP or EI either so I don't see the relevance of you shoe horning this in here. 

As before I fundamentally disagree with your conflation of EI (or as we have established EIP) here with under-resourcing of treatment of the seriously unwell (EIP is treatment based for one) or with the police murdering someone with MH conditions.  Sorry it's just ignorance as far as I can see.

[Zetetic]

I've no idea why you think I'm arguing that EIP doesn't work.

[Zetetic]

I spent an awful lot of time in the early 2010s helping a couple of EISs capture and analyse a broad set of outcomes data, for what it's worth. (Edit: Amongst other basic information on service delivery, so it's not like I don't know what "EIP" consisted of.) Nothing I'm saying is even slightly predicated on the idea that EIP is bad.

No, there is no implication, that is something we've just shown you made up

It's literally the logical combination of "Helping people earlier is more efficient and effective" (of which we are in agreement, right?), "There are scarce resources" (a prevailing political axiom, at a minimum) and "This person wasn't helped early in life" (for various reasons, including the course history that you outline, but ... true).

[Zetetic]

And I think the issue goes beyond the fairly immediate practical problem of half-arsedly draining resources from one side of the service to another, leaving both as grossly inadequate - part of the point is that people like Atkinson's are effectively framed as write-offs.

That's, maybe, better than being framed as a mad dog, but it's still not ideal when it comes to not being murdered by the police.

[TrenterPercenter]

I spent an awful lot of time in the early 2010s helping a couple of EISs capture and analyse a broad set of outcomes data, for what it's worth. (Edit: Amongst other basic information on service delivery, so it's not like I don't know what "EIP" consisted of.) Nothing I'm saying is even slightly predicated on the idea that EIP is bad.

So what has EI got to do with Dalian Atkinson? Then the early intervention he would have received is EIP, he didn't even receive that so.....???

It's literally the logical combination of "Helping people earlier is more efficient and effective" (of which we are in agreement, right?), "There are scarce resources" (a prevailing political axiom, at a minimum) and "This person wasn't helped early in life" (for various reasons, including the course history that you outline, but ... true).

Sorry.  Try writing for the individual you are talking to.  I've no idea what these 3 statements mean.  I understand what they say individually I don't understand their relation because you are not being clear.  Let alone what it has to do with Atkinson being murdered by the police.

Put your argument in a sentence, a clear sentence that is unambiguous.  We are well into the realms of your opinion, I'm not opposed to you having it but you seem reluctant to be clear on what it is.  When we've got that licked we can perhaps talk about whether I agree with it or not.

[TrenterPercenter]

And I think the issue goes beyond the fairly immediate practical problem of half-arsedly draining resources from one side of the service to another, leaving both as grossly inadequate - part of the point is that people like Atkinson's are effectively framed as write-offs.

Ok that is clearer.  This isn't true, time is linear EI has to take place at an early stage.  No one is written off just they just no longer qualify for EI because EI for them doesn't exist anymore.  That does not take resources away from later treatment as explained, and again I'll just say you need to look at the health economics around this, it increases the funds available for non-EI treatments.

[Zetetic]

It really doesn't improve resourcing in practice.

(You got close to one obvious reason in a previous post, even as you deny it now - there's a complete lack of fungibility because of the workforce crises and the way that the NHSs broadly resemble shortage economies these days.)

No one is written off

I do not think that you would say that given more than a moment's reflection on the UK at the end of 2021.

[TrenterPercenter]

Sorry but the evidence suggests otherwise; that evidence doesn't change regardless how many times you make snippy comments to the contrary.

Sure the NHS and MH is fucked you can't lay that at EI ffs.

I feel you are wasting a lot my time Zetetic, it's quite interesting how you can make such errors in your mixing up of EI and EIP, conflating unrelated EI with police murder, disregard repeated evidence put to you around the economics of EIP, your poor understanding psychosis, saying things like "mantra" and "getting rid" and not take a breath even for a minute to consider you might be getting something wrong. 

It feels like debate guy shite and you are talking to someone who actually has quite a lot of specialist knowledge in this area; I'm not convinced by your arguments sorry and I'm frankly bored of your antagonistic and leading approach to it all so as before lets just agree to disagree, I've no idea what your chip is about this, I was genuinely interested at one point but I'm not going through pages and pages of this crap when you just seem to be continually dressing up "EI is bad because money could be spent elsewhere" that has been addressed with evidence many times over.  So we agree to disagree. 

Better funding for all aspects of MH and working efficiently (and efficiently as in relation to better care for individuals) with the means we have at the moment, I'm sure there are people out there that want dementia care cut because it doesn't provide EI outcomes but I'm not interested in that argument either.  Seems like a race to the bottom approach if you ask me. So we'll leave it there. Cheers.

[Zetetic]

None of this has really anything to do with the mechanics of psychosis - however convinced you are of my ignorance of psychosis, EIP and so on is irrelevant. (I also think that stuff that I've written on here over the last decade suggests that actually in exactly the same place in our view of the evidence here, if if I can't claim to be as immersed in it as you.)

The claims about early intervention are of a type. Yes, the specific claims about EIP (and what this actually involves) and the disease course of psychosis are relevant to justifying those claims in that case. No, this doesn't matter because I'm not contending that EIP, or any other particular example, isn't more efficient and effective.

[Mobbd]

List of unarmed African Americans killed by law enforcement officers in the United States:
https://en.wikipedia.org/wiki/List_of_unarmed_African_Americans_killed_by_law_enforcement_officers_in_the_United_States

Topics in BLM:
https://en.wikipedia.org/wiki/Template:Black_Lives_Matter

[Zetetic]

"EI is bad because money could be spent elsewhere"

I've spent a lot of time making it clear that I'm not arguing against the evidence for different instances of early intervention, and this post was specifically concerned with the point that money often can't be spent elsewhere!

(As an aside, I was literally in a couple of meetings in December where service managers were desperate trying to find some way to spend money, in-year, on improving physical health care access for a particular group and could not do so, either within the health service or otherwise. As I say - shortage economy, even if this is also feels weird given the 'soft budget constraints' elsewhere in the service/organisational units of the service.)

[TrenterPercenter]

round and round again you've got an argument but you'll be damned to explain it clearly.

You think EI works and you accept the evidence for it great - we can stop there then.  Perhaps recognise shoe horning EI into this particular case isn't appropriate and is highly suggestive, as is posting memes about housing or CBT, as is claiming EI takes money away from treatment in any meaningful way (it works, the evidence you agree with shows this and that it saves money).

Some advice for you Z, you are undoubtably a very smart person, much smarter than me in lots of ways but being 'ever so smart' isn't about being right all the time.

The fact you live in a country that treats people with MH conditions so badly is because we consent to it in our politics by voting people in that decide budgets and priorities, and not because EI exists, the way you can influence that is by raising fucking awareness of MH and creating public and political pressure around better resources.

[TrenterPercenter]

List of unarmed African Americans killed by law enforcement officers in the United States:
https://en.wikipedia.org/wiki/List_of_unarmed_African_Americans_killed_by_law_enforcement_officers_in_the_United_States

Topics in BLM:
https://en.wikipedia.org/wiki/Template:Black_Lives_Matter

Yes I mean US doesn't have any EI services but they still kill lots of black people with MH conditions.

[confettiinmyhair]

I think the after care for retired professional sportsmen and women is shoddy. Particularly for those whose careers end prematurely or abruptly. Atkinson was part of a generation of players who didn't quite make the money of the Premier League Boom of the 2000s. Do clubs have an obligation to keep an eye on players who were part of their legacy or history? Or should the PFA be a point of contact for those who leave the game?