WEBVTT 1 00:00:00.001 --> 00:00:01.000 Okay. 2 00:00:01.000 --> 00:00:08.000 Yeah, very much. It's lovely to be here. 3 00:00:08.000 --> 00:00:19.000 It's day 4, and we're well wary, and we're tired, and I can see heads are dropping even before I started ranting. 4 00:00:19.000 --> 00:00:25.000 So stick with me. I've only got 3 slides and a reference slide. 5 00:00:25.000 --> 00:00:34.000 But seriously, I'd like to thank Jeremy and Dirk for allowing this session to take place. 6 00:00:34.000 --> 00:00:42.000 There should be more sessions, or models, or, as I call it, theories of mental illness and mental health. 7 00:00:42.000 --> 00:00:50.000 I'm Bruce Cohen. I've been researching according to my reviewers, much longer than I should be. 8 00:00:50.000 --> 00:01:00.000 Actually the issue of mental illness and mental health, and I'm here to tell you that I have heard more than enough already in this. 9 00:01:00.000 --> 00:01:07.000 In this conference about deficit modelling, and I'm here to tell you we're not in a psychology conference. 10 00:01:07.000 --> 00:01:13.000 This is actually sociology. And we need to think much more critically than we have been now. 11 00:01:13.000 --> 00:01:18.000 The relationship between criminality and mental illness is a slippery beast. 12 00:01:18.000 --> 00:01:23.000 They're a slippery beast. They certainly the connections have never really been proved. 13 00:01:23.000 --> 00:01:36.000 But that doesn't stop. Lots of criminologists and lots of kind of forensic psychiatrists from attempting to do just that. 14 00:01:36.000 --> 00:01:39.000 And an imprecise way that this has been looked at. 15 00:01:39.000 --> 00:01:47.000 And it's particularly theorized now, is looking at the prison population across Western society and noting that there's much higher rates of mentor illness in prison than there is in the general population. 16 00:01:47.000 --> 00:02:06.000 But that's only the latest thing that's going to happen, and I'll talk very briefly about kind of a number of conservative theories that has continued to theorize in this manner about the connections. 17 00:02:06.000 --> 00:02:14.000 Of course, as people will know, the mentally ill are actually a lot like less likely to commit crime. 18 00:02:14.000 --> 00:02:19.000 They are actually more likely to be victims of crime, particularly victims of violent crime. 19 00:02:19.000 --> 00:02:28.000 But that hasn't actually stopped. People fearizing around the higher rates of mental illness among criminals as seen by high rates in the prison system. 20 00:02:28.000 --> 00:02:29.000 Sorry I should say this comes from chapter in this book. 21 00:02:29.000 --> 00:02:38.000 A terra handbook of Criminology. 22 00:02:38.000 --> 00:02:43.000 So? Who's our daddy's while we see right here who they are? 23 00:02:43.000 --> 00:02:48.000 So conservative theory, deficit models. Here Moran reminds us that both criminology and psychiatry have remained surprisingly attached to biological theory. 24 00:02:48.000 --> 00:03:00.000 First of all, in the contemporary settings. So criminologists continue to search for the crime. 25 00:03:00.000 --> 00:03:21.000 Gene as popular genre for films. Of course, while academic psychiatry, of course, believe that we have already proved that mental illness is a brain disease, and the bomedical model is really dominant model of mental illness today in Western society, we see some examples of this 26 00:03:21.000 --> 00:03:41.000 in the contemporary setting, 19 sixties, psychiatrists, neurosurgeons were suggesting that black urban rioters in America were basically suffering from brain dysfunctions during the civil rights movement and treatment was needed including the bottom East etc. 27 00:03:41.000 --> 00:03:46.000 More recently in the Us. There was a violence initiative which was basically profiling urban populations, urban being. 28 00:03:46.000 --> 00:03:56.000 Basically a monacar for black populations and looking for youth that were predisposed genetically predisposed to violence. 29 00:03:56.000 --> 00:04:08.000 A vaccine against criminality, then could be found using medical researchers, conduct disorder. 30 00:04:08.000 --> 00:04:12.000 People could. Actually, young people could be treated for disorders, and so forth. 31 00:04:12.000 --> 00:04:22.000 That's from breaking and Bregan's book in New Zealand. Of course we had Robbie and his incredibly racist warrior Gene. 32 00:04:22.000 --> 00:04:25.000 A theory that basically Maori were more predisposed towards violence, towards criminality. 33 00:04:25.000 --> 00:04:31.000 Low Iqs, etc. Etc. We could go on. 34 00:04:31.000 --> 00:04:39.000 I'm not going to. But except to say it remains kind of like quite dominant in the research field. 35 00:04:39.000 --> 00:04:46.000 In criminology, in sociology, following Durkheim with, had a whole plethora of social causation. 36 00:04:46.000 --> 00:04:53.000 Theories, particularly stress theory, remains incredibly kind of popular in the in the Us. 37 00:04:53.000 --> 00:04:59.000 We can also think of straight theory, follow structural functionalism from Durkheim. 38 00:04:59.000 --> 00:05:05.000 This is the idea that basically, of course, rather than biological courses, we're looking for social, environmental economic causes. 39 00:05:05.000 --> 00:05:14.000 And that's a lot of the papers that I actually see in the Mental Health field at any conference that I'm kind of attending, including this one. 40 00:05:14.000 --> 00:05:19.000 And there are serious problems with the that I will outline in a second. 41 00:05:19.000 --> 00:05:23.000 So both criminality and mental illness fearise a result of living in high socioeconomic, disadvantaged areas. 42 00:05:23.000 --> 00:05:35.000 Etc. So we can think of poverty, mental illness, criminality is basically somehow kind of related to one another. 43 00:05:35.000 --> 00:05:45.000 And a lot of research goes on that area. However, as you all know, correlation does not equal causation, although it's seems like a lot of people think it does. 44 00:05:45.000 --> 00:05:52.000 At this conference and keep basically drilling down into the mass of quant data to look for precisely what that is. 45 00:05:52.000 --> 00:06:01.000 We've spent a hundred years or more in sociology attempting to do that without any success. 46 00:06:01.000 --> 00:06:07.000 The relationship between mental illness and crime is furious, says Carol, and Renzetti. 47 00:06:07.000 --> 00:06:17.000 Seagull suggests that both mental illness and criminal behavior, and maybe actually the result of independent factors from that such as social problems living in disadvantaged neighbourhoods, negative policing practices that doesn't get talked about enough. 48 00:06:17.000 --> 00:06:33.000 I think at Sociology Conference, Eva, typically researchers found that actually, rather than causation between crime and mental disorder. 49 00:06:33.000 --> 00:06:34.000 Actually, there's a stronger, variable in vault here which actually is social class. 50 00:06:34.000 --> 00:06:38.000 Is actually working classes, the dangerous classes being labeled as basically both criminal as well as like mentally ill as well as like. 51 00:06:38.000 --> 00:06:56.000 In deficit, in poverty, and so forth. There's also, you will be aware of, maybe the transinstitutional feesis. 52 00:06:56.000 --> 00:07:01.000 This is the idea. How do we explain the higher rights of basically prisoners with mental disorder? 53 00:07:01.000 --> 00:07:04.000 That is basically psychiatric deinstitutionalization in the sixties, seventies, eighties across western society. 54 00:07:04.000 --> 00:07:15.000 Well, basically that population migrated into the prison system got caught up in the criminal justice system. 55 00:07:15.000 --> 00:07:19.000 Again. There's actually little to support this thesis. 56 00:07:19.000 --> 00:07:27.000 There was kind of research done previous leaders that suggested maybe 3% of the kind of like people who've been a psychiatry institution. 57 00:07:27.000 --> 00:07:31.000 So I kind of like have actually ended up in prisons at some point. 58 00:07:31.000 --> 00:07:39.000 Kim goes further in kind of crunching the numbers, and actually says this, this kind of this correlation cannot actually be proved. 59 00:07:39.000 --> 00:07:51.000 There is, in fact, a relationship, one of the problems, of course, is like the prison system, actually expanded, particularly in us in the eighties and nineties, as did the labels of mental disorder. 60 00:07:51.000 --> 00:08:12.000 The Dsm basically went into overdrive with a Dsm. Free and then subsequent additions. And now we have 360 or so, 370 mental illness, apparently that psychiatry have proved our actual realities. 61 00:08:12.000 --> 00:08:24.000 So these models are problematic because they assume basically a static definition of crime and of mental disorder. 62 00:08:24.000 --> 00:08:29.000 This is fundamentally the elephant in a room picture of Foucault. 63 00:08:29.000 --> 00:08:38.000 There with cat just to keep you entertained. Guess the name of the cat but you calm. The name of the cat was insanity, so elephant in the room. 64 00:08:38.000 --> 00:08:39.000 There's a lack of validity to mental illness. 65 00:08:39.000 --> 00:08:48.000 Classification, and likewise there is no evidence for the uselessness of any psychiatric intervention. 66 00:08:48.000 --> 00:08:53.000 Practice, psychological as well as therapeutic interventions. 67 00:08:53.000 --> 00:09:03.000 Let me just quote the great sociologist and medical historian, Andrew Skull. 68 00:09:03.000 --> 00:09:14.000 The frantic efforts to distinguish ever larger numbers of types and subtypes of mental disorder come to seem like an elaborately disguised game of make believe. 69 00:09:14.000 --> 00:09:28.000 After all, despite the plethora of claims that mental illness is rooted in 40 biochemistry in the brain deficiencies or surpluses of this or that neurotransmitter the product of genetics, perhaps or one day, perhaps traceable to 70 00:09:28.000 --> 00:09:39.000 biological markers, the ateology of most mental illness remains obscure, and its treatments are largely symptomatic, and generally of dubious efficacy. 71 00:09:39.000 --> 00:09:42.000 On the therapy side. By the way, Paul, Montana. 72 00:09:42.000 --> 00:10:02.000 But there are many other kind of pieces of research over there actually semates all the kind of therapies the evidence for therapy is actually useful, and says there's a lack of any good quality ever that any therapy outperforms placebo yeah so that is basically, contested ground even though, a lot of 73 00:10:02.000 --> 00:10:09.000 sociologists now seem to take that for granted. Let's not bother the definitions. Let's not bother with the evidence. 74 00:10:09.000 --> 00:10:14.000 Let's just move on to basically doing our number crunching causation and deficit modeling. 75 00:10:14.000 --> 00:10:15.000 So, taking a more critical approach, we can understand both mental illness and crime. 76 00:10:15.000 --> 00:10:31.000 In fact, of course, as labeling, furious, and social constructionists have before me, as produced for specific reasons and subject to social, cultural, and political negotiation. 77 00:10:31.000 --> 00:10:43.000 Markers of criminality or venture pathology can be theorized as labels which are applied to certain groups or to individuals designated as being socially deviant. 78 00:10:43.000 --> 00:10:44.000 Falling outside. What is the normal behaviour that is expected within society? 79 00:10:44.000 --> 00:10:53.000 Or I would say, by powerful groups that actually define the dominant norms and values within society. 80 00:10:53.000 --> 00:11:06.000 So, for instance, the dangerous classes in the nineteenth century, the Suffragettes, in the early twentieth century labeled as hysterical, banged up in prisons. 81 00:11:06.000 --> 00:11:27.000 Force, fed, etc. Etc. The colonial Liberation, Civil Rights, Women's Liberation and Gay Rights Movements in the Mid twentieth century to just name a number of knowable examples where groups protest groups basically groups that we now may be take us like actually forward in really kind of morally good things were 82 00:11:27.000 --> 00:11:38.000 actually labelled as basically being both criminal, being violent, usually being pathological, being dangerous, you know, kind of like fame. 83 00:11:38.000 --> 00:11:43.000 Famous report by Crovers, done in the 19 fifties for the British Government. 84 00:11:43.000 --> 00:11:48.000 Basically, said of Kenyan population, and the Malmo uprising. 85 00:11:48.000 --> 00:11:58.000 Basically these people are collectively pathological. They have some new roasts amongst the people because they're resisting their kind of uprising against the British. 86 00:11:58.000 --> 00:12:17.000 And it's like what could be kind of like a clear, a symptom of mental illness than rising up against colonial authorities and wanting to take back your country and many other examples I could give, and you could find them from my other works. 87 00:12:17.000 --> 00:12:20.000 Sorry. 88 00:12:20.000 --> 00:12:22.000 I told you it'd be around. I don't know. 89 00:12:22.000 --> 00:12:31.000 So to wrap up more or less, I would say here, how do we explain this? 90 00:12:31.000 --> 00:12:38.000 Actually the connection about the numbers of people labelled with mental disorders in prison, while since the 19 seventies we've seen the migration of rather than actually psychiatric patients to prisons. 91 00:12:38.000 --> 00:13:07.000 We've seen a migration of psychiatric and associated professions into other spaces, including the Castro space forms of social social deviance, has been mentioned by medicalization scholars like Conrad and Snider, are increasingly becoming medicalized over time. 92 00:13:07.000 --> 00:13:08.000 And this increasing medicalisation has a number of rationales. 93 00:13:08.000 --> 00:13:35.000 Reasons for it in the prison system one is, it attempts to humanize the prison system, claims that prisons are the largest institutions, housing people with mental health problems today suggest that such institutions should be seen seen by the public as places of health rehabilitation rather than the things that are which 94 00:13:35.000 --> 00:13:41.000 is basically places of punishment. The increased legitimacy of both the side professionals in basically the society as well as like actually, the prison system. 95 00:13:41.000 --> 00:14:04.000 This works both ways. Mcbride's recent work talks about the effect of therapeutic prison reforms over the last few decades have been shown as being wide, ranging prison staff are trained to be psychologically aware attuned to discourses of recovery and risk while increasing 96 00:14:04.000 --> 00:14:09.000 number of mental health experts are employed in prisons to assess and treat prisoners. 97 00:14:09.000 --> 00:14:15.000 It's a form of coercion, says says Bride, rather than anything to do with therapy. 98 00:14:15.000 --> 00:14:23.000 Of course, we can think about basically the use of treatments in prison, basically sedating prisoners of antipsychotics, etc. 99 00:14:23.000 --> 00:14:44.000 And labeling last point depoliticize the criminal justice system, a system that is deeply political, as hopefully we are aware of the reclassification of a large proportion of prisoners as mentally ill, says Mcbride, greatly increases the ambitious psychiatric authority 100 00:14:44.000 --> 00:15:00.000 within presence, and it's amplified. The salience of psychiatric knowledge, classification, and intervention in penal policy as such contemporary psychiatric discourses foreshadowed by a view of prisoners as inherently troubled persons with a plethora of 101 00:15:00.000 --> 00:15:07.000 psychiatric needs quite useful, actually, in terms of keeping people actually in prison and giving kind of rationale. 102 00:15:07.000 --> 00:15:19.000 For why they should stay there. Lost point from Moran to conceive of crime in medical terms is to de-politicize and remove moral judgment from the behaviour. 103 00:15:19.000 --> 00:15:20.000 Much of the label, much as the label crime allows no attention to the social environment. 104 00:15:20.000 --> 00:15:31.000 Sickness removes the Offending Act act actor, even far from a political and ethical context. 105 00:15:31.000 --> 00:15:32.000 Under this definition, estates crime becomes a question of the individuals. 106 00:15:32.000 --> 00:15:44.000 Ability to adjust, adjust to this society. If we choose to adjust to this society, if that is actually a good thing. 107 00:15:44.000 --> 00:15:45.000 Martin Luther King at a time, did not say it was a good thing to adjust to a racist society. 108 00:15:45.000 --> 00:15:56.000 I don't think it's a good thing now, either, ultimately, to adjust to the status quo. 109 00:15:56.000 --> 00:16:17.000 Thank you very much for your time. I am available for bail Mitzvahs and weddings. Of course. 110 00:16:17.000 --> 00:16:23.000 Thank you. Professor Bruce. Now we have our second presentation. 111 00:16:23.000 --> 00:16:52.000 Professor Jeremy Dickson, please. 112 00:16:52.000 --> 00:16:56.000 Okay, so my name is Jeremy Dixon. 113 00:16:56.000 --> 00:17:09.000 I'm presenting a paper on Models of Mental health problems, and the paper is by myself and Dirk Richter, who is also a member of the Rc. 114 00:17:09.000 --> 00:17:13.000 49 group. Unfortunately, it's very early morning in Germany. 115 00:17:13.000 --> 00:17:17.000 So Dirk can't be with us, so you have to do make do with me. 116 00:17:17.000 --> 00:17:23.000 I'm afraid, but I will do the best to represent what we've said together. 117 00:17:23.000 --> 00:17:35.000 So, to begin with, let's think about why, it might be important to think about ideas around mental health, illness, and concept. 118 00:17:35.000 --> 00:17:58.000 So we know that the concepts of mental health and illness have been debated for centuries, and and if we think about the twentieth century, we can see a number of developments that we'll all probably be familiar with studying this area, so we know for example, that between the 19 119 00:17:58.000 --> 00:18:10.000 forties and the 19 seventies. Psychoanalysis seemed to dominate as the main way of thinking about mental health problems. And then there's been a shift from the 19 eighties onwards. 120 00:18:10.000 --> 00:18:18.000 Where Bio medicine seems to be the dominant frame, and the 19 nineties was deemed to be the decade of the brain. 121 00:18:18.000 --> 00:18:22.000 In the Us. For example. 122 00:18:22.000 --> 00:18:27.000 So these things have been debated for a long time. But it's important for us to think about criticisms, and where they come from. 123 00:18:27.000 --> 00:18:40.000 So you'll see on the photo here, 3 prominent critics of psychiatry. 124 00:18:40.000 --> 00:18:44.000 So the first being Thomas Satsoric, the myth of mental Illness. 125 00:18:44.000 --> 00:18:54.000 Irving, Goffman, the second picture, who had done a study of asylums being total institutions, and then Foo code without cap. 126 00:18:54.000 --> 00:19:05.000 This time? Who's also and historical studies of psychiatry at the clinic. 127 00:19:05.000 --> 00:19:13.000 So we're familiar from with the concept of sociologists criticizing mental health and illness in psychiatry. 128 00:19:13.000 --> 00:19:18.000 In particular, but the. 129 00:19:18.000 --> 00:19:34.000 These things have changed over time. So whereas in the past it's been sociologists or anti-speople deemed as antipsychotists who've tended to make the criticisms a lot of criticisms now have started to emanate from medicine as well 130 00:19:34.000 --> 00:19:40.000 so the bottom picture there shows the research domain criteria. R. Doc. 131 00:19:40.000 --> 00:20:01.000 As it was known, and this was an initiative where medics with an interest in brain science we're trying to sort of find the causes of mental disorder or illness in the brain, and it was notable because they launched criticisms of the diagnostic and statistical manual 132 00:20:01.000 --> 00:20:06.000 saying that it well, actually, these things that are being described aren't real mental health entities. 133 00:20:06.000 --> 00:20:07.000 They're just sort of put together and we don't use a term. 134 00:20:07.000 --> 00:20:15.000 Social constructions. But that's essentially what they meant. 135 00:20:15.000 --> 00:20:16.000 So it's important for us to think about how we think about mental health problems. 136 00:20:16.000 --> 00:20:28.000 And this has been done in the past. So there's been several monographs and anthologies, and even a book series. 137 00:20:28.000 --> 00:20:29.000 But these reviews have usually looked at specific concerns about mental health problems. 138 00:20:29.000 --> 00:20:46.000 So largely. They have looked at things historically, or sometimes they've looked at taxonomic characteristics by which we mean systems of classification and. 139 00:20:46.000 --> 00:20:53.000 One of these reviews have been useful, and we wanted to look at this issue more systematically. 140 00:20:53.000 --> 00:21:01.000 So there's good reasons for doing this. We argue. 141 00:21:01.000 --> 00:21:05.000 Whilst there's lots of contested definitions around. 142 00:21:05.000 --> 00:21:12.000 What a mental health problem is. These problems have real life effects for people who use services. 143 00:21:12.000 --> 00:21:38.000 The services themselves, who have to work out who they are, providing services, and for and also policymakers who have to think about law and policy, who falls into mental health services and who falls out of them, and the other thing that we were aware of was that there's been increased emphasis on 144 00:21:38.000 --> 00:21:47.000 service user and survivor perspectives. But this is often an neglected issue in this area. 145 00:21:47.000 --> 00:21:53.000 So what did we do? So we conducted what we call a quasi systematic review. 146 00:21:53.000 --> 00:21:58.000 Essentially, we've used the sort of normal methods for a systematic review. 147 00:21:58.000 --> 00:22:10.000 But systematic reviews tend to look at interventions, and are often looking at research, that because we wanted to look at theories, that's why we've used this quasi term. 148 00:22:10.000 --> 00:22:24.000 So we searched these databases that you can see here the rationale for searching these particular ones were they were the ones in which mental health and illness tend to be discussed most often, and they're the biggest ones. 149 00:22:24.000 --> 00:22:31.000 But we also looked in places like Amazon, and did citation, tracking both forwards and backwards. 150 00:22:31.000 --> 00:22:46.000 The reason we looked at it in books and other things was that we were aware that expect us by service users and often professionals are often peer reviewed, so may not come up on the database. 151 00:22:46.000 --> 00:22:48.000 Searches, so we excluded empirical papers because they didn't develop theory. 152 00:22:48.000 --> 00:23:03.000 And we also excluded primarily philosophical publications, and we used a template initially to try and record what we were doing. 153 00:23:03.000 --> 00:23:13.000 So we looked at what the focus of the article was, whether it was clinical practice, research theory or consumer issues. 154 00:23:13.000 --> 00:23:33.000 The purpose of the article, whether it was a proposal of a theory, whether it was endorsing a particular way of seeing mental health problems, whether it was critiquing them or reviewing them, and we were fairly open actually as to the kind of things, that we accepted so we looked at books, and articles, but also things 155 00:23:33.000 --> 00:23:41.000 like letters or opinion pieces or editorials as long as they looked at theories, and enough detail. 156 00:23:41.000 --> 00:23:45.000 So here's a result. 157 00:23:45.000 --> 00:23:53.000 And it's mainly on this one slide, and I'm aware that this is quite small, I'm afraid I couldn't find a different way to do it, so I'll try. 158 00:23:53.000 --> 00:24:03.000 And identify what each of these are well, I can't move the microphone around with me, unfortunately, but we've got biology. 159 00:24:03.000 --> 00:24:08.000 First here. So there's a number of things that come under this heading. 160 00:24:08.000 --> 00:24:18.000 So the kinds of things we were grouping here is things which primarily are looking at sort of brain science and thinking about. 161 00:24:18.000 --> 00:24:27.000 Can you sort of map causes? So these authors in this category talk about having brain-based taxonomies for mental health problems? 162 00:24:27.000 --> 00:24:34.000 They are argued generally that brain science is still lacking in that we don't really know the proper causes. 163 00:24:34.000 --> 00:24:42.000 So they gave a number of explanations about how we might go about looking at those things, so just to take a couple here at random. 164 00:24:42.000 --> 00:24:49.000 So some people are arguing that we ought to be looking more at microbiotica is one way of looking at these things. 165 00:24:49.000 --> 00:24:54.000 Others are saying that we need to be able to model the way the brain operates, using computers in order to get a proper understanding. 166 00:24:54.000 --> 00:25:03.000 So the second column to the left. We have psychology. 167 00:25:03.000 --> 00:25:20.000 So there's a number of different models here. Sally, to Genesis, for example, is concerned with psychological well-being in ways of mapping that we've also got psychoanalysis, which, of course, people will know what we're talking about there network psychology 168 00:25:20.000 --> 00:25:29.000 phenomenology and existentialism. So these models are primarily looking at things from a psychological perspective. 169 00:25:29.000 --> 00:25:36.000 Looking at forms of behavior, and how they can be modeled. Thirdly, we've got social models. 170 00:25:36.000 --> 00:25:43.000 So these models draw on social disability in critical realist models. 171 00:25:43.000 --> 00:26:00.000 So quite often they may draw on the work of people like Mike Oliver, for example, who says it's not a disability in itself which is disabling, but the way in which society responds to it, and then to the right of that we put consumer models recovery is down there I know 172 00:26:00.000 --> 00:26:02.000 there's a lot of debate around whether recovery still remains a consumer model. 173 00:26:02.000 --> 00:26:25.000 But that's how we've sort of placed it but we've also got mad studies and neurodiversity in which people with mental health problems who make arguments about whether it should actually be seen as a problem essentially and are identifying the positive things that come with that particular way of thinking about the 174 00:26:25.000 --> 00:26:34.000 world, and then, lastly, we have cultural models where people are identifying traditional or spiritual approaches and showing their value. 175 00:26:34.000 --> 00:26:38.000 So essentially, let's not think about any things as mental health problems. 176 00:26:38.000 --> 00:26:42.000 But let's think about them as valuable ways of understanding the world. 177 00:26:42.000 --> 00:26:49.000 We also have some things which to fall in between. 178 00:26:49.000 --> 00:26:52.000 So this, particularly in this sort of first biopsychology. 179 00:26:52.000 --> 00:27:01.000 There's there's a lot of models here where you've a quite often got people taking a psychological perspective. 180 00:27:01.000 --> 00:27:17.000 But then also looking at the things like brain science, and and and how they relate to one another so, yeah, there's a range of approaches there and then in between psychology and social approaches, we have the psychosocial approaches. 181 00:27:17.000 --> 00:27:29.000 And then social models and consumer models. There's this in between category of radical protocols and anti psychiatry, and some of the sort of models didn't quite fall within one or the other. 182 00:27:29.000 --> 00:27:38.000 So we've place some of these here. So we have ethnopsychology falling somewhere in between property clusters. 183 00:27:38.000 --> 00:27:44.000 How it's that meeting! 184 00:27:44.000 --> 00:27:48.000 7 weeks, and. 185 00:27:48.000 --> 00:27:53.000 Digital models, so I've drawing a bit on consumer models. 186 00:27:53.000 --> 00:28:00.000 Most things are concerned with. 187 00:28:00.000 --> 00:28:08.000 Holds down the bottom. So in the article which I've put up on the site, if you want to have a closer look at it, we give some explanations of each of these models. 188 00:28:08.000 --> 00:28:14.000 So I'm aware of just sort of dashed through them because of time. 189 00:28:14.000 --> 00:28:27.000 But what we tried to do was give a sort of, you know, 2 or 3 line explanation of what each of these things meant, or what the arguments are essentially. 190 00:28:27.000 --> 00:28:52.000 So what does this tell us? Well, when we were looking at these things, we found a mixture of older models which had been there for several decades together, and these continue to be discussed and indoors, so an example is psychoanalysis, so although that's quite an old model you still 191 00:28:52.000 --> 00:28:56.000 get papers or book chapters where people are saying, you know, psychoanalysis is a good thing. 192 00:28:56.000 --> 00:29:01.000 We ought to, you know, continue to think about this, even though we've become much more biological. 193 00:29:01.000 --> 00:29:07.000 But we also find really a lot of the models aren't. The older models aren't going away, but you have this emergence of lots of newer models. 194 00:29:07.000 --> 00:29:16.000 So network approaches particularly computational neuroscience being a examples. 195 00:29:16.000 --> 00:29:36.000 So we've got this diagram. And to me this was interesting, really, because, as sociologists, we tend to rail against you know, biological models, or the medical model, or sometimes say, how about the bio psycho social model is is meaningless. 196 00:29:36.000 --> 00:29:41.000 But actually that disguises. What's out there in some senses, because it's a lot more complicated than that. 197 00:29:41.000 --> 00:29:44.000 And there's a lot more models and lots of the models. 198 00:29:44.000 --> 00:29:48.000 I was not aware of, I suppose, until I start to do this review. 199 00:29:48.000 --> 00:30:01.000 So some limitations, several book chapters and books were included, and we sort of got those, because through book sellers and database searches. 200 00:30:01.000 --> 00:30:08.000 But we may have missed some of those, because we know that they're they're not searchable through databases. 201 00:30:08.000 --> 00:30:17.000 The next thing to say is that there's a range of different goals related to these models, and where they're proposed, endorsed or critiqued. 202 00:30:17.000 --> 00:30:39.000 And so, generally speaking, the ones on the left of the graph that I showed tend to have scientific, clinical aims, whereas the ones in the centre, right, the psychosocial models tend to propose political or legal solutions to mental health problems there's not very many models which 203 00:30:39.000 --> 00:30:45.000 encompass both of those roles, or attempt to do so. 204 00:30:45.000 --> 00:30:52.000 One of the. Exceptions to this is perhaps a power, threatening framework which tries to do that to some extent. 205 00:30:52.000 --> 00:31:01.000 I mean, there's that's arguable, I suppose, as to how far it achieves it. 206 00:31:01.000 --> 00:31:09.000 So, as I mentioned understanding of diversified and definitions are also more and more contested. 207 00:31:09.000 --> 00:31:21.000 And one thing to notice suppose is that the consensus that we all ought to support the biocycle social model seems to be refracting. 208 00:31:21.000 --> 00:31:33.000 Debates seem to be getting more bad tempered amongst academics, about which model we should follow, and. 209 00:31:33.000 --> 00:31:34.000 Yeah, there's debate about what we ought to do about this. 210 00:31:34.000 --> 00:31:40.000 So some people when they're doing reviews, for example, Zaccha and Kendler talk about that. 211 00:31:40.000 --> 00:31:46.000 We just looked at sort of critically adopt what we see as useful. 212 00:31:46.000 --> 00:31:52.000 So they argue, for example, that researchers should choose between approaches drawing on judgment and empirical data. 213 00:31:52.000 --> 00:32:05.000 But it's very difficult to see which type of model should be used in preference to another, so we can only really speculate on why models seem to be increasing. 214 00:32:05.000 --> 00:32:08.000 We've got a few ideas which we put forward in the paper. 215 00:32:08.000 --> 00:32:16.000 So one reason might be because of the tendency for professionals and academics to specialize into particular areas. 216 00:32:16.000 --> 00:32:24.000 So you get these new areas of specialism which everybody then sort of that places themselves around. 217 00:32:24.000 --> 00:32:29.000 A second reason could be dissatisfaction with conventional protesters, such as the Dsm. 218 00:32:29.000 --> 00:32:56.000 And one thing we notice here is that user perspectives are becoming more vocal, particularly from survivors or consumers. And also there's an increased amount of writing from other mental health professionals who not really had quite so much of a say, up until now such as social workers for example. 219 00:32:56.000 --> 00:33:07.000 So in summary, uncertainties about the nature of mental health, problems have become more pronounced over recent decades, and we think that leaves 2 theoretical options. 220 00:33:07.000 --> 00:33:18.000 So first of all, we could acknowledge that we can't just sort of bind all these approaches together in the way that has been suggested in the past about sort of biopsychosocial model. 221 00:33:18.000 --> 00:33:34.000 Or alternatively, we could develop a meta theory amusingly, actually, Alan Francis is one of the authors are on word, but one of the people who was in charge of a previous Dsm. 222 00:33:34.000 --> 00:33:40.000 He actually saw our article somehow, and I don't think he'd read it, but he just tweeted her. 223 00:33:40.000 --> 00:33:42.000 We should just all do the biocycleocial model. 224 00:33:42.000 --> 00:33:48.000 So, and a lot of psychiatrists then agreed with him, and so, you know, I think people are still arguing. That's the case. 225 00:33:48.000 --> 00:33:53.000 But I think it's much more complex as we can see. 226 00:33:53.000 --> 00:34:03.000 And lastly, we would argue that there needs to be more input from people with mental health problems themselves, and also a wider range of professional groups. 227 00:34:03.000 --> 00:34:20.000 So thank you for your attention. If you want to read the article itself, and it's was out this year in the Journal of Mental Health, and the reference is there, and I've also put the article itself up as a paper on the program. 228 00:34:20.000 --> 00:34:37.000 So you can have a little. Okay, thank you very much. 229 00:34:37.000 --> 00:34:43.000 So now we have an online presentation. Monica, can you? 230 00:34:43.000 --> 00:34:45.000 Here, us! 231 00:34:45.000 --> 00:34:49.000 Yes, I can show you, but I am not sure on the screen, because you are sharing. 232 00:34:49.000 --> 00:34:53.000 So please. 233 00:34:53.000 --> 00:34:58.000 Yes, I will stop. Ashley. Experience. So now she should be able to share. Go ahead. 234 00:34:58.000 --> 00:34:59.000 Okay. 235 00:34:59.000 --> 00:35:06.000 Monday. 236 00:35:06.000 --> 00:35:07.000 Yes, we can see. 237 00:35:07.000 --> 00:35:17.000 Okay, so, I'm Monica. Next to me I will start and then Delta will continue. 238 00:35:17.000 --> 00:35:31.000 So first, we thank you for the opportunity to participate in this interesting panel, and the purpose of our presentation is to analyze the phenomenon of the eating disorders. 239 00:35:31.000 --> 00:35:36.000 Monica. Sorry. Sorry. Can you put in a full screen? 240 00:35:36.000 --> 00:35:41.000 Please. It's better for us to see here. 241 00:35:41.000 --> 00:35:44.000 And do you see the full screen right now? 242 00:35:44.000 --> 00:35:46.000 Not yet. 243 00:35:46.000 --> 00:35:53.000 Okay, but I see the full screen and well, I don't know. 244 00:35:53.000 --> 00:36:04.000 How can I? Just a second and. 245 00:36:04.000 --> 00:36:12.000 I have a suggestion that we leave this this way because II don't want to always time for the technical issues. 246 00:36:12.000 --> 00:36:25.000 Hmm! I did everything I could to do the full screen, so. 247 00:36:25.000 --> 00:36:28.000 Do you have a slide shot? 248 00:36:28.000 --> 00:36:29.000 Rocket. 249 00:36:29.000 --> 00:36:35.000 Do you see the screen right now or no, I'm not. 250 00:36:35.000 --> 00:36:45.000 Okay. So when we go on with the presentation, and maybe in the meanwhile you will see the full screen, because maybe it takes some. 251 00:36:45.000 --> 00:36:48.000 Sometime. And do you see the flights changes? I will. 252 00:36:48.000 --> 00:36:53.000 And that's okay. We can. We can read here, I think. 253 00:36:53.000 --> 00:37:05.000 Okay, okay, good. So we analyze the phenomenon of eating disorders as a form of adverse health behaviors in men. 254 00:37:05.000 --> 00:37:15.000 In the context of firstly, the broader perspective of sex and general relations, and, secondly, on critical studies on men and masculinities. 255 00:37:15.000 --> 00:37:21.000 We assume that it is not so much a biological fact of being a woman or a man. 256 00:37:21.000 --> 00:37:28.000 That explains the frequency of doctor's visits or exhibiting risky health behaviors as a social fact, indicating how gender is understood and performed. 257 00:37:28.000 --> 00:37:43.000 Played out in a given society, different behaviors of women, advanced be analyzed in light of cultural specificity and individuals choices shaping their identity. 258 00:37:43.000 --> 00:38:06.000 The example of eating disorders reflects the entanglement of mental disorders, concepts, and sociocultural gender schemes, particularly the dialectic tension between the persistence of traditional gender patterns, despite the persistence of traditional gender patterns, despite a 259 00:38:06.000 --> 00:38:09.000 binary gender schemes blaring, and vice versa. 260 00:38:09.000 --> 00:38:17.000 This mechanismms manifest themselves not only in eating disorders, but in the concepts of other disorders. 261 00:38:17.000 --> 00:38:18.000 For example, depression and as well, diseases die diagnosed. 262 00:38:18.000 --> 00:38:46.000 Worldwide more frequently in women, if depression, anxiety, disorders, personality, disorders, including avoidance, dependence, histrionic and borderline a personality and eating disorders such as anorexia and bulimia, among men more common are addictions to psychoactive 263 00:38:46.000 --> 00:38:59.000 substances, and such personalities, orders as antisocial, narcissistic schedule it paranoid and obsessive symptoms of disorders is mentioned above. 264 00:38:59.000 --> 00:39:04.000 Reflect traditional gender norms, for example, more social acceptance for openly manifested emotions, such as sadness and anxiety in women than in men. 265 00:39:04.000 --> 00:39:12.000 And more social acceptance, per anger, and I think I would. 266 00:39:12.000 --> 00:39:31.000 Behavior, in man, less social acceptance, permanent sticking held because of emotional problems and being focused on body and beauty standards as a part of social, constructive femininity and ambivalent attitudes towards femal sexuality on the one hand, being focused in sexuality 267 00:39:31.000 --> 00:39:40.000 subjected to Mary's perspective, and, on the other hand, the repression of femal, unsupportinated sexuality. 268 00:39:40.000 --> 00:39:53.000 Moreover, the eating disorders more common among women, anorexia and moreover, eating disorders more common among women. Anorexia and remia reflects the appearance stereotypes, according to which women should be small delicate the appearance stereotypes according to which women should be small 269 00:39:53.000 --> 00:39:56.000 delicate, and lights corresponding with women's behaviors. 270 00:39:56.000 --> 00:40:00.000 They tend to choose such forms of physical activity or a diet to help them actually promote its aesthetic ideal. 271 00:40:00.000 --> 00:40:20.000 Men are willing to meet the male appearance stereotype, which, with an athletic, muscular figure, and engage in bodybuilding or other intensive physical exercises, especially strength, training. 272 00:40:20.000 --> 00:40:29.000 I think this orders historically been considered the most gender of our psychiatric illness. 273 00:40:29.000 --> 00:40:47.000 Presentations, the current insufficient knowledge about eating disorders in the male popular population is explained by the low morbidity rate resulting in the exclusion of men from epidemiological status. 274 00:40:47.000 --> 00:40:48.000 Despite the descriptions of cases of male anorexia. 275 00:40:48.000 --> 00:40:53.000 As early as in the sixteenth and seventeenth centuries. 276 00:40:53.000 --> 00:40:54.000 They were not included in studies until the seventeenth of the twentieth century. 277 00:40:54.000 --> 00:41:22.000 This being excluded from most of the empirical projects that ultimately led to the development for diagnostic criteria and treatment programs for eating disorders based on the data addressing exclusively women despite the seminal cases descriptions of eating these orders preferring to 278 00:41:22.000 --> 00:41:29.000 referring both female and male patients for most of the 20 century it was believed that eating disorders did not affect males or afflicted very few, and a typical mails. 279 00:41:29.000 --> 00:41:55.000 Since the heartmark symptoms like I mean Maria did not apply to my opinions current and empirical evidence suggests that this other eating behaviors are increasing at the faster rate in males versus females in community settings and the correlates of eating 280 00:41:55.000 --> 00:42:03.000 disorders. Symptoms in males are equally severe, as those reported by females. 281 00:42:03.000 --> 00:42:18.000 Exemplary anorexia's incidence among men is rising, and the ratio between women and men are has changed from 9 to one to 31 over the last 30 years. 282 00:42:18.000 --> 00:42:34.000 Differences between males and females in the prevalence of Bulimia are minor than in case of anorexia, and there are no significant differences between males and females in Binge eating incidents and muscle the smorfia. 283 00:42:34.000 --> 00:43:00.000 That a company is eating disorders is more common among men, and then I. 284 00:43:00.000 --> 00:43:24.000 The critical aspects of the functional and dimensionional data from the perspective of janitor bias and gender across path transformations and at the expense of the patient depending on the genders. 285 00:43:24.000 --> 00:43:36.000 And the last one, the consequence of diagnosis on the patient's cell perception and social relations, and concerning points, the points one and 2. 286 00:43:36.000 --> 00:43:48.000 We conducted desk research based on the integrated literature, a video procedure procedure, sorry and regarding points 3 and 4. 287 00:43:48.000 --> 00:44:03.000 We designed a mixed method research with the therapist and my patients with eating disorders, and on the in the diagram you can see the static stigmatization process. 288 00:44:03.000 --> 00:44:08.000 In a of course, simplified way, diagnostic difficulties are related to certain professional perceptions and knowledge. 289 00:44:08.000 --> 00:44:15.000 Here is where the stigmatization process starts which sets in motion patients. 290 00:44:15.000 --> 00:44:31.000 Secondary function of self stigmatization. And it's for important to underline the changes. 291 00:44:31.000 --> 00:44:32.000 Now, of course, the changes that have taken place in the classification. Dsm. 5. 292 00:44:32.000 --> 00:45:01.000 And Icd 11. Due to these changes in Dsm and Icd more man need formal criteria of eating disorders still increasing the number of men with eating disorders takes longer and in aorexia diagnosis dropping the requirement for a minor area and. 293 00:45:01.000 --> 00:45:17.000 Excuse me, Monica, are you changing these lights because you are assuming slide 2 here? 294 00:45:17.000 --> 00:45:21.000 Do? They maybe have 2 screens? 295 00:45:21.000 --> 00:45:24.000 Maybe yeah. 296 00:45:24.000 --> 00:45:28.000 Okay. 297 00:45:28.000 --> 00:45:30.000 Now we are seeing fruit scream, no scream now. 298 00:45:30.000 --> 00:45:43.000 Okay, okay, maybe that was the. So I'll. 299 00:45:43.000 --> 00:45:51.000 Okay, a diagnostic criteria of eating. 300 00:45:51.000 --> 00:46:01.000 Okay, again, it's very important to underline the changes that have taken place. 301 00:46:01.000 --> 00:46:02.000 Yes. 302 00:46:02.000 --> 00:46:04.000 Just to check slide 11. Right? Okay, okay, we are right to hear. 303 00:46:04.000 --> 00:46:11.000 In this classification, and, for example, it's okay. 304 00:46:11.000 --> 00:46:15.000 Uhhuh. Uhhuh. Diagnosis. 305 00:46:15.000 --> 00:46:38.000 It's a dropping. The requirement of Maria and extending the rights criterion to any significant underweight and expanding the cognitive criterion criterion to include developmentally and culturally relevant presentations in agreement i'm been doing a diagnosis 306 00:46:38.000 --> 00:46:59.000 decline of occurrence of danger, eating from at least twice a week to at least once a week, and the reduction of persistence of the symptoms from 6 months to 3 months, and it's in a evident restrictive put intake disorder diagnosis it's transfer 307 00:46:59.000 --> 00:47:05.000 from disorder, class feeding and eating disorders of infancy of early childhood, to feeding and eating. 308 00:47:05.000 --> 00:47:07.000 Disorder it's connected with diagnosis, regardless of patients. 309 00:47:07.000 --> 00:47:26.000 H. And the next one. And it's important in the context to refer briefly to the functional and dimensional diagnosis. 310 00:47:26.000 --> 00:47:33.000 There are many areas to consider. One xmline gender specific issue in men. 311 00:47:33.000 --> 00:47:38.000 Included among these are white history, sexual abuse, and other trauma. 312 00:47:38.000 --> 00:47:39.000 Gender orientation, depression and shame, exercise and pod, image. 313 00:47:39.000 --> 00:47:52.000 Commodore did chemical dependency, and, for example, chemical dependency, and, for example, media pressure. 314 00:47:52.000 --> 00:47:53.000 And now let's let me give you a few examples. 315 00:47:53.000 --> 00:48:06.000 For example, eating disorders are associated with a lack of satisfaction with one's body. 316 00:48:06.000 --> 00:48:16.000 In both men and women, however, due to cultural norms, men seem much more focused than women on achieving a muscular physics. 317 00:48:16.000 --> 00:48:18.000 Physics, rather than being democracy, which is righted to the attitude towards weight, loss. 318 00:48:18.000 --> 00:48:40.000 Men are also less likely to use restrictive forms of bodywork bodywork, such as like Seth stands to focus more on working on the bodies through physical activities, and among men with anorexia. 319 00:48:40.000 --> 00:48:49.000 This is more common to participate in professional or semi professional sports, especially athletics and psyching. 320 00:48:49.000 --> 00:49:01.000 Before the diagnosis, and even for a minor area, is is no longer an official criterion of anorexia. 321 00:49:01.000 --> 00:49:11.000 It is still a reference point for diagonosis and therapist, and along with a less willingness to seek professional help. 322 00:49:11.000 --> 00:49:16.000 Later Sexual Maturity. 323 00:49:16.000 --> 00:49:33.000 Later diagnoses of underwateria among men and Bulinia, like anorexia, is a later a month man and you'll see what is the age and subjective loss of control over one's behavior. 324 00:49:33.000 --> 00:50:02.000 Maybe the reason for more frequent and intense feeling of guilt, among women with Bulimia in contrast, men with Bulimia or pinge eating are more likely to experience substant substance, abuse, or dependence, and differences have been found in anger regulation in malays and 325 00:50:02.000 --> 00:50:31.000 females with bulimia. Men tend to use these behaviors to act out all the present present films imagine the eating disorder diagnosis was frequently given, not as primary, but usual, and, according to for example, Morgan a heaternal native man in 326 00:50:31.000 --> 00:50:38.000 societies that don't until accepted them are more at risk of developing a think. 327 00:50:38.000 --> 00:51:01.000 Disorder, and may suffering from eating disorders and body image issue, have an immense stigma to overcome, and as the results have been sickly neglected in both diagonosis and treatment, and the last one stereotypes of eating this old inhibit the 328 00:51:01.000 --> 00:51:07.000 availability of evidence based treatment from ace and false short of the successful management of gender. 329 00:51:07.000 --> 00:51:25.000 Specific problems and further status. Our status of plan to start to start the in September. 330 00:51:25.000 --> 00:51:44.000 Maybe this year, at the first step of our with mental health specialist working with patients with eating disorders, including clinical case descriptions, different differing intentions, gender and ambivalent sexism scale. 331 00:51:44.000 --> 00:51:52.000 An idea with mental health, a specialist working with patients, with eating disorders, ailing a deepening. 332 00:51:52.000 --> 00:52:01.000 The issue as a covert by this survey and idea with men in fear of diagnosis, with eating disorders, aiming at reconstructing the gender. 333 00:52:01.000 --> 00:52:18.000 Experience, and the main questions are, what are the diagnosticians and the therapist working with patient with eating disorders, gender schemes? 334 00:52:18.000 --> 00:52:26.000 And how do these gender schemes related to the patient's perception, perception depending on their gender? 335 00:52:26.000 --> 00:52:39.000 And the last one. How though the eating disorders diagnoses, impact the mail patients, self perception, and they social relations enter the conclusions. 336 00:52:39.000 --> 00:52:47.000 Our conclusions are. It's believed that there are significant differences between men and women with beating disorders. 337 00:52:47.000 --> 00:53:01.000 This differences are present in the predisposing, precipitating, and perpetuating factuals for an eating disorder. 338 00:53:01.000 --> 00:53:06.000 By researching this factuals more thoroughly, better. 339 00:53:06.000 --> 00:53:31.000 Empirical data will lead to more effective and confused diagnostic criteria assessment tools and treatment interventions and promoting evidence of this issue is a crucial aspect of advancing this field as everness may promote environment where men can talk about their food and the 340 00:53:31.000 --> 00:53:38.000 issue. And currently, there are few resources for maize to use for support. 341 00:53:38.000 --> 00:53:53.000 Many men don't even recognize this issue as eating disorders have large read in view as a woman problem problems with excessive exercise are often ignored as over exercise may create a deceptive, deceptively healthy outward appearance. 342 00:53:53.000 --> 00:54:02.000 Unlike those with amorexia, bulimia, and pinj, 18 disorder. 343 00:54:02.000 --> 00:54:18.000 One. Exercise is not a compensatory behavior, and the last one, and finally encouraging a cultural allowing may. 344 00:54:18.000 --> 00:54:44.000 Vulnerability is an important goal. Men are not supposed to be emotionalally normal in our present culture, yet they encounter pressure daily to be more muscular and make the current may boarded shape ideas as they feel pressure from managed sources to meet mainstream societies 345 00:54:44.000 --> 00:55:08.000 definitions of masculinity. Thank you. 346 00:55:08.000 --> 00:55:38.000 Okay. 347 00:56:05.000 --> 00:56:07.000 Okay. Okay. My name is Yuki Kamla, and I come from Japan. 348 00:56:07.000 --> 00:56:27.000 I'd like to take this opportunity to talk, discuss some examples of how psychiatrists applied salaries, all mental health to their practice. 349 00:56:27.000 --> 00:56:48.000 And here is an outline of this presentation fast, and the purpose and method section explains that the emphasis on and dairy is observed not only between a doctor and patients, but also among psychiatrists. 350 00:56:48.000 --> 00:57:11.000 It also highlights that it is a topic that psychiatrists need to address in their practice then, and date. Analyse section arise the practice in which is high addressed, applied social approach of the reflective process to case conferences. 351 00:57:11.000 --> 00:57:22.000 Finally, in the discussion, Summary Section examined how the incorporation of the effective positive relate to the dialogue among psychiatrists. 352 00:57:22.000 --> 00:57:38.000 Let me begin speaking about this presentation with its purpose and method, in that I'd like to present the background of the topic of this presentation. 353 00:57:38.000 --> 00:57:51.000 The minute institution in question here had crossed its psychiatric world 5 years ago, and due to due to persistent deficit. 354 00:57:51.000 --> 00:58:03.000 Now it provides only outpatient care reasons, psychiatry and home visit when the psychic word of this institution was functioning, the doctor met each other every day or area of each other. 355 00:58:03.000 --> 00:58:28.000 Treatment style, and worked closely together. Such close interactions are no longer possible, and the opportunity to share information about various treatment approaches and important future of the Psyche at this workplace are now limited. 356 00:58:28.000 --> 00:58:44.000 The issue has potentially been addressed by using case conferences as a place where Brock students are practitioners can teach and share various approaches to their practice. 357 00:58:44.000 --> 00:58:58.000 Howver, some practitioners have objected to the aforementioned notion, saying that conferences have become a press of variation and assessment. 358 00:58:58.000 --> 00:59:15.000 They reported that, and they were no longer able to freely express and discuss their ideas, and as a result they had to device a new way to manage his conferences through a trial and error. The next slide. 359 00:59:15.000 --> 00:59:26.000 We elaborate on the purpose and method of this presentation. 360 00:59:26.000 --> 00:59:30.000 Function. 361 00:59:30.000 --> 00:59:49.000 Okay. And this presentation describe how the reflective process as a syapic culture activity relate to the comprehensibility of the activities of the a medical institution discussed here. 362 00:59:49.000 --> 01:00:04.000 Therapeutic culture referred to cultural aspect, and such as tourism policies, and field of fees that are inherited or shared, shared by members within a medical institution. 363 01:00:04.000 --> 01:00:10.000 I think Tara Learner's famous work over the mine didn't know. 364 01:00:10.000 --> 01:00:24.000 It's also focused on societritic culture, in particular, by describing the cache plastic of the activity taking place in this medical institution. 365 01:00:24.000 --> 01:00:41.000 The practical method that collectivity makes the clinical practice of much productive, comprehensive as a societal political culture will be identified. 366 01:00:41.000 --> 01:00:57.000 In other words, answer the following question will be explored. How can psychiatrists, with their different treatment, stance and perspectives, work together in the same medical institution? 367 01:00:57.000 --> 01:01:14.000 Adapter as a methodological attitude. This presentation describes a participants own understandings as presented in an interaction rather than the researchers interpretation or explanation of the interaction. 368 01:01:14.000 --> 01:01:27.000 Identifying method that are specific to this situation can have implication for other practices, and that may be related to a therapeutic culture. 369 01:01:27.000 --> 01:01:33.000 Before moving on the analyst. I'd like to briefly describe that before collective process. 370 01:01:33.000 --> 01:01:46.000 The method used in this medical institution is the Medical institution reporting on in this study incorporated the idea of the refractive process into its practice. 371 01:01:46.000 --> 01:01:51.000 As a way of enabling psychiatrists to work together. 372 01:01:51.000 --> 01:02:01.000 The reflecting chain is a cycleotherapic technology proposed by a Norgian psychiatrist, Tom Andresen. 373 01:02:01.000 --> 01:02:10.000 Anderson claimed that soon the reflective process, one's own perspective can reflect the aspect of others. 374 01:02:10.000 --> 01:02:19.000 In doing so, the surplus to gain the client aspects and and the client gained the 0 best one. 375 01:02:19.000 --> 01:02:28.000 It is applied in a unique way to the medical institution in which this research was conducted, not to the therapy. 376 01:02:28.000 --> 01:02:51.000 Examining each phase. This presentation describes the relationship between the application of the reflective process and the understandability of the practice in the case conference as a therapeutic culture. 377 01:02:51.000 --> 01:02:55.000 An overview of the case. Conference is given here. 378 01:02:55.000 --> 01:02:59.000 Fast interview, phase. That's the beginning of the case. 379 01:02:59.000 --> 01:03:00.000 Conference, the case reporter for Judge Session select an Interview. 380 01:03:00.000 --> 01:03:22.000 Who asked the question of the reporter Jane, the reputter himself answered the 2 question in this way, a point that the reporter is an error of war insufficient information brought out. 381 01:03:22.000 --> 01:03:47.000 This is what they call interview ways, and next ehlectic phase, 2 members of the reflecting chain silently observed the interview phase, and when the interview is over the members of the reflective team take time discussing the content of the interview while the reporter and interviewer silent to 382 01:03:47.000 --> 01:03:52.000 listen to 10. This is what they call the refractive phase. 383 01:03:52.000 --> 01:04:00.000 This this is this this is a picture of this setting. 384 01:04:00.000 --> 01:04:14.000 The interview, comprise the 2 persons enacted by Iran, and the reflective team comply the 2 people and, circled by the green. 385 01:04:14.000 --> 01:04:27.000 One of them is participating be a remote system, and this is mine, and in the forthcoming slide, hmm! 386 01:04:27.000 --> 01:04:43.000 In this way it is possible to be both the observer and observe, by alternating this, it is also possible to reflect on each other's opinions and create new cycles. 387 01:04:43.000 --> 01:04:59.000 Judy time construct a counseling. I will primarily focus on the general discussion of phase. 388 01:04:59.000 --> 01:05:09.000 I don't feel work every week about 10 h per one visit, and the case conference. 389 01:05:09.000 --> 01:05:34.000 I will discuss is a date from the early stage of and the feed work. And it's the time that allowed me to refine the idea for focusing just a synapseic culture. 390 01:05:34.000 --> 01:05:42.000 Okay, this is, information this, this right showed the information from the data. 391 01:05:42.000 --> 01:05:55.000 The case discussed that day was that Mr. P. Among diagnosed with bipolar disorder and O obsessive compressive disorder! 392 01:05:55.000 --> 01:06:02.000 Dr. A. Suspected that Mr. P. Was self-centered and had a personal D bias. 393 01:06:02.000 --> 01:06:17.000 Mr. Peace's relationship with his children were poor and cold, and in particular, his lack of understanding or caring about other people's feelings was a problem. 394 01:06:17.000 --> 01:06:21.000 Dr. B. Examined Mr. Pete, who told him about Mr. 395 01:06:21.000 --> 01:06:33.000 Pete's outrageous comment for herself and her mother. 396 01:06:33.000 --> 01:06:41.000 On this slide you can see a summon of the analysts of the interview phase and the reflective phase, fast 2 different views of the disease and the personality are expressed. Dr. 397 01:06:41.000 --> 01:06:54.000 S. Stated his belief that development, disability cannot be changed. 398 01:06:54.000 --> 01:07:02.000 However, one personality is hard to change, although it can be changed with honest effort. 399 01:07:02.000 --> 01:07:03.000 In contrast, Dr. The encounter against this in complex Dr. D. 400 01:07:03.000 --> 01:07:13.000 A state that he's believes are different from those of doctor Age. 401 01:07:13.000 --> 01:07:22.000 He states that developmental disability can change. However personality can be changed, but is difficulty. 402 01:07:22.000 --> 01:07:50.000 Second. At the end of both the first and second round it was observed that the expression indicated an orientation toward time constraint, for example, it's time to go a little bit in here for a now red moon on the dinner discussion. Since we were already adult 45 bin yet. 403 01:07:50.000 --> 01:08:04.000 Third, drawing the interview and reflection quays the interior effectively determined that topic over the discussion, and outrined how how he proceeds. 404 01:08:04.000 --> 01:08:10.000 Once the interview and reflection phase were completed, the general discussion of faith began. 405 01:08:10.000 --> 01:08:11.000 The details of the analysts have been omitted here, due to time. 406 01:08:11.000 --> 01:08:21.000 Constrained. 407 01:08:21.000 --> 01:08:28.000 These white plagents are summary of the analysis of the general discussion, phase. 408 01:08:28.000 --> 01:08:33.000 The main finding of the summary of this phase are as follows, first, a partial understanding was reached between Doctor A and Dr. 409 01:08:33.000 --> 01:09:02.000 B. Who had different views. Second, every psychiatrist used diagnostic data, diagnostic concept differently and possess different views on this sex psychiatric diagnostic concept of developmental disabilities personality and character third, the conflict imbued that is this agreement regarding 410 01:09:02.000 --> 01:09:10.000 whether developmental disabilities will or will not change, remain ambiguous in the end. 411 01:09:10.000 --> 01:09:21.000 Hence it is clear that the build of each cyclist do not lead to serious conflict and remain unreservedable, ambiguous. 412 01:09:21.000 --> 01:09:39.000 Now let us return to the question forced at the beginning of this presentation, how can psychiatrists with different treatment, distances and perspectives work together in the same medical office to create a syllabus culture? 413 01:09:39.000 --> 01:09:58.000 What can we conclude from these points? 414 01:09:58.000 --> 01:10:12.000 I'd like to conclude at the presentation by summarizing the main findings of this study as follows, fast the interview, guide the flow of the overall discussion. 415 01:10:12.000 --> 01:10:24.000 Second, the time limit deduced the opportunity for a person to continue speaking while providing legitimacy for cutting off other speech. 416 01:10:24.000 --> 01:10:31.000 Third. The speaker is unable to immediately refute other abuse and argument. 417 01:10:31.000 --> 01:10:48.000 Only after the current pace has ended with the speaker, have the opportunity to defeat the abuse of finally a assessment of these differences of opinion put on hold. 418 01:10:48.000 --> 01:10:58.000 There is no evaluation of right or wrong. 419 01:10:58.000 --> 01:11:11.000 In light of these structured futures. The reflective process can be said to work as follows, this agreement is in this setting not so much a problem to be reserved. 420 01:11:11.000 --> 01:11:30.000 They act as a resource resource for exploring, exploring their own origins, and confirming the differences between oneself and others in terms of therapeutic stance, because the entire process is a refractive one. 421 01:11:30.000 --> 01:11:36.000 It is structurally permissible not to draw a conclusion or make judgment. 422 01:11:36.000 --> 01:11:43.000 In other words, do you find abuse and opinions can be easily expressed here? 423 01:11:43.000 --> 01:11:57.000 Such a co-existence and expression of different views and opinion he named the formation of a therapeutic culture cohusion, such as a shared specific stance. 424 01:11:57.000 --> 01:12:07.000 Thank you for your attention. 425 01:12:07.000 --> 01:12:14.000 So thank you for all the presenters, or keep on time, and then we have more time to talk. 426 01:12:14.000 --> 01:12:22.000 So if anyone has a question. 427 01:12:22.000 --> 01:12:32.000 Hi, everyone! I am Jerome from the Philippines, and I'd like to applaud all of the presenters for the very interesting papers that were presented. 428 01:12:32.000 --> 01:12:53.000 I am directing my question to Jeremy. Hi! I don't know if I missed it, but maybe it could give us a number of studies that were at the end of the final of your systematic review, and also another question is, did you have was there any attempt to examine the professional backgrounds? 429 01:12:53.000 --> 01:13:11.000 Of at least the lead authors of the theoretical papers, because I believe that the way certain health professions theoryize mental health is based on the scope of practice that we have, for example, before I became a sociologist, I'm actually a registered nurse so while we 430 01:13:11.000 --> 01:13:18.000 are taught a lot about biomedical psychological models of mental health. 431 01:13:18.000 --> 01:13:29.000 There's really not much we can do about it. That's why, when we theorize about mental health, because I saw that you got from the nursing, and I like mental Allied health professions Index. 432 01:13:29.000 --> 01:13:32.000 So I was thinking the way we theorize about mental health is also not in terms of its social culture, but also it's based on our scope in the discipline. 433 01:13:32.000 --> 01:13:47.000 What we are able to do, because we cannot prescribe men's, and we cannot really do like counseling, because that's not part of our practice, but we are as generalist nurses. 434 01:13:47.000 --> 01:13:57.000 We are taught. You have to care for patients with mental health, but we can only theorize so much, because this is the only practice that we have an empty issue that's going to be the same for occupational therapists. 435 01:13:57.000 --> 01:14:05.000 Physical therapists, etc. So was there any attempt to do that I'll answer your second question first. 436 01:14:05.000 --> 01:14:08.000 So we didn't attempt to map it. We didn't do it formally, but I suppose my observation would be that it does tend to follow the disciplinary. 437 01:14:08.000 --> 01:14:21.000 Lines you would expect. So, generally speaking, the Bio people in the biological camp tend to be psychiatrists. 438 01:14:21.000 --> 01:14:22.000 Those in the sort of side psychological camp, mainly psychologists. 439 01:14:22.000 --> 01:14:42.000 Some nurses to some degree social workers tend to be more on the social, and then, I suppose, with the critical stances, you then get a mixture of people so you tend to get critical nurses or critical psychiatrists, or and so forth. 440 01:14:42.000 --> 01:14:47.000 So, yeah, I think people's professional training does tend to bias you in a particular way. 441 01:14:47.000 --> 01:14:54.000 I'm a social worker by background, and so obviously that tends to and give your advice to that particular way of thinking. 442 01:14:54.000 --> 01:15:00.000 So yeah, I agree with your point. What can you just replace the first question because I didn't quite get it? 443 01:15:00.000 --> 01:15:04.000 It's just a simple question of how many, how many studies ended at the end of your final, when you, with a different models. 444 01:15:04.000 --> 01:15:13.000 Yeah, I couldn't tell you off the top of my head. 445 01:15:13.000 --> 01:15:17.000 But yeah, if you look at the paper that they're all listed there. 446 01:15:17.000 --> 01:15:21.000 Yeah, so it's most of the ones that were on the graph. There. 447 01:15:21.000 --> 01:15:28.000 So it's it's all of those essentially. 448 01:15:28.000 --> 01:15:34.000 So what modern? Question? 449 01:15:34.000 --> 01:15:42.000 Hi! I enjoyed all the presentations. I just had a question for Yuki in terms of the conference. 450 01:15:42.000 --> 01:15:57.000 What was the in terms of like experience, or I guess different people who had different levels of I think of the words today power, or, I guess experience in the room. 451 01:15:57.000 --> 01:16:12.000 How did that influence the conversations that were had? And I guess how people received that feedback or information you can talk to that. 452 01:16:12.000 --> 01:16:27.000 Thank you for your question. If your question is how the experience of doctors. 453 01:16:27.000 --> 01:16:34.000 His conference. 454 01:16:34.000 --> 01:16:51.000 And in this, in in that case, in that case, the reflecting G is more adapt and. 455 01:16:51.000 --> 01:17:00.000 And a interaching oriented to more biomedical stance and experience. 456 01:17:00.000 --> 01:17:09.000 Big differences is a mixed and. 457 01:17:09.000 --> 01:17:19.000 For example, in the interview Chamber is the most experienced as a doctor, and Doctor B. 458 01:17:19.000 --> 01:17:23.000 Is. 459 01:17:23.000 --> 01:17:41.000 And usually the case conference is the teach, teach aspects, but in this conference they can talk equality. 460 01:17:41.000 --> 01:17:52.000 The these differences is, should be. 461 01:17:52.000 --> 01:18:02.000 In a the experience, experience should be. 462 01:18:02.000 --> 01:18:21.000 Point point out by looking their interactions. I think, okay. 463 01:18:21.000 --> 01:18:24.000 Anybody else, more questions. 464 01:18:24.000 --> 01:18:37.000 Feel a bit excluded. Have you forgot to return to session, display? 465 01:18:37.000 --> 01:18:58.000 The. 466 01:18:58.000 --> 01:19:08.000 II start with a question. I have a question for Bruce, and the question is, I hope I can bring it together, and unfortunately I missed the first part of your presentation. 467 01:19:08.000 --> 01:19:21.000 So, maybe. 468 01:19:21.000 --> 01:19:22.000 Yeah. No. Okay. 469 01:19:22.000 --> 01:19:43.000 My question is, how how can you transfer those theories from Fuku and government, and labeling the approaches to the current times, where we observe that, starting from, mainly based in the user development that more and more efforts are going into get rid of violence and coercive treatment and as 470 01:19:43.000 --> 01:19:49.000 an effect. There's an increase in the forensic psychiatry. 471 01:19:49.000 --> 01:19:57.000 On the one hand, and, on the other hand, the get rid of corruption from the relatives. 472 01:19:57.000 --> 01:20:07.000 Point of view is sometimes of a new form of mental health services who are not caring anymore for the family members. 473 01:20:07.000 --> 01:20:14.000 So you know what I mean from a very practical perspective. 474 01:20:14.000 --> 01:20:33.000 So how can you transform those power critics which were developed with Foucorn and so on to the current situation and to the current practice of psychiatry? 475 01:20:33.000 --> 01:20:34.000 So I think this is the key issue, isn't it? 476 01:20:34.000 --> 01:20:52.000 Here, if okay, I'm going to submit that question again, if I can, Sylvia, and you tell me if I'm wrong, you're basically saying, Well, if it's all social construction, what do we actually do with people who are actually have behaviours? 477 01:20:52.000 --> 01:20:59.000 That considered like, you know, just in a family environment or an institution, are basically problematic. 478 01:20:59.000 --> 01:21:02.000 We can't deal with them. What are people going to do? 479 01:21:02.000 --> 01:21:10.000 Yeah, so you're basically saying, what is the solution to this? 480 01:21:10.000 --> 01:21:17.000 Well, one thing is like, basically read the conclusion of my book on psychiatric hegemony. 481 01:21:17.000 --> 01:21:22.000 Thank you very much, and that's all from me. Folks. 482 01:21:22.000 --> 01:21:27.000 But there's also. 483 01:21:27.000 --> 01:21:43.000 I think there's there's a real problem with with confusing sociological analysis, with basically that the argument of Well, what are you going to do about these people? 484 01:21:43.000 --> 01:22:02.000 I think actually, it's a question to think about. But it's another question as opposed to the questions from the for instance, the talks here today, which is again have been about, we can see the contestations in the knowledge base but we're still going to go back in the next talk. 485 01:22:02.000 --> 01:22:12.000 To basically talking about. Oh, you know, there's kind of like we have kind of trans people who are really in a state of depression, etc. 486 01:22:12.000 --> 01:22:18.000 So we need psychiatric services, or therapeutic services to intervene on their behalf. 487 01:22:18.000 --> 01:22:29.000 And that's no solution at all. That is actually, according to the evidence, more harm than good to actually so actually have these services expanded. 488 01:22:29.000 --> 01:22:46.000 There is, there's Johann Parry's book talks about real antidepressants, which is about basically collective action of actually political action, social solidarity. 489 01:22:46.000 --> 01:22:51.000 And I think that's kind of something that's obviously happening we've mad studies as well. 490 01:22:51.000 --> 01:22:58.000 Yeah, but you know, I think that's a big, big, big discussion. 491 01:22:58.000 --> 01:23:19.000 I think our issue is socialologists is to basically keep highlighting that there's actually serious contestations of problem problematic issues with actually the evidence rather than we go down the stuff which is obviously seriously problematic. 492 01:23:19.000 --> 01:23:22.000 Thank you. 493 01:23:22.000 --> 01:23:38.000 Thank you. So we have a question here from the virtual world. And then I would want to know, okay, okay, go ahead. 494 01:23:38.000 --> 01:23:39.000 Yeah, we can hear you. 495 01:23:39.000 --> 01:23:41.000 Is this me? Okay, yeah, thank you. It's a question for Germany. 496 01:23:41.000 --> 01:23:54.000 Actually, when you made this review, it's seems to be a very ambitious job to do it. 497 01:23:54.000 --> 01:24:08.000 So my question is, do you only focus on contributions that addressed theories of mental illness? 498 01:24:08.000 --> 01:24:26.000 So mental health in general? Or did you also take articles and books addressing specific articles and books addressing specific theoretical model models for understanding? 499 01:24:26.000 --> 01:24:30.000 For example, schizophrenia. So. 500 01:24:30.000 --> 01:24:32.000 Both really. So we looked at things which proposed endorse or critiqued models of mental health. 501 01:24:32.000 --> 01:24:37.000 But we also due to things which focus on a specific type of mental health problem. 502 01:24:37.000 --> 01:24:47.000 Or disorder, depending on how people were categorizing it. 503 01:24:47.000 --> 01:25:00.000 So, for example, there's quite a lot on neurodiversity or autism which came within those scope of studies. 504 01:25:00.000 --> 01:25:03.000 So, yeah, a combination. 505 01:25:03.000 --> 01:25:06.000 Yeah. 506 01:25:06.000 --> 01:25:15.000 Any more questions, good questions, you might heard this special voice. Do you? Terribly sorry? 507 01:25:15.000 --> 01:25:20.000 Yeah, so my question on on your lovely paper that you and Dirk did. 508 01:25:20.000 --> 01:25:24.000 Jeremy is. Well, where's my books for stars? 509 01:25:24.000 --> 01:25:31.000 They're kind of like. Ok, the psychiatry hedge me book. 510 01:25:31.000 --> 01:25:37.000 So that's got a Marxist theory. Also by route book. 511 01:25:37.000 --> 01:25:46.000 I appreciate. It was a quasi, something in a method so fine. 512 01:25:46.000 --> 01:25:47.000 There was a roundage book. I cut out, and that has, like a bunch more theories in it. 513 01:25:47.000 --> 01:25:50.000 So I kind of like in some total. I was wondering where's someone who might be here, Mate? 514 01:25:50.000 --> 01:26:00.000 So I'm not blaming you. Marxist theory. 515 01:26:00.000 --> 01:26:06.000 Social Constructionism, critical race, theory, Feminist theory, queer theory. 516 01:26:06.000 --> 01:26:17.000 Foucodeian were the only ones that came into my head at this time, but just wondered where they were. In this. 517 01:26:17.000 --> 01:26:22.000 Yeah, so we looked, I suppose, what we did. We? As I mentioned, we looked at things where people had sort of proposed endorsed all or critique particular theories of mental health problems. 518 01:26:22.000 --> 01:26:46.000 So as we mentioned, I suppose because we would we drew from databases first of all, so essentially, we brought up things which were they're in peer-reviewed journals, you know, so they would would have been there one of the things that I think you pointed out as a 519 01:26:46.000 --> 01:26:55.000 reviewer I know is that we didn't use the social sciences, databases, so that may have explained why a number of those series didn't come up. 520 01:26:55.000 --> 01:27:01.000 We did take them from sort of books I mean, sometimes when people talk about I mean my observation. 521 01:27:01.000 --> 01:27:13.000 I suppose it's quite often when people are using some of those they don't necessarily come up with cogent theory of mental health problems, or they don't necessarily critique one. 522 01:27:13.000 --> 01:27:21.000 So it doesn't tend to come up in the modeling, because it's you know, the talking more generally about those ideas of that makes sense. 523 01:27:21.000 --> 01:27:29.000 And so, yeah, I'm sure there are things missing, and you could probably do a separate review looking at it from social sciences, databases, and thereabouts. 524 01:27:29.000 --> 01:27:38.000 But yeah, I mean, what can I say? You'll have to get Amazon to put your books further up. 525 01:27:38.000 --> 01:27:44.000 Okay, no more questions. I have to say something. I am a psychologist. 526 01:27:44.000 --> 01:27:53.000 So that that was a wonderful afternoon for me, because I learned a lot with all of your experience and in your another way, point of view. 527 01:27:53.000 --> 01:28:03.000 So thank you a lot, and I think hope you see, you always soon.