@tylerblack32 @JRBneuropsiq @ReadReadj @pash22 @DrAnnieHickox Always happy when Jesus takes the wheel!
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Robert Howard
53.6K posts
Robert Howard
@ProfRobHoward
UCL old age psychiatrist | Improving dementia and mental health treatment | Layla | Clinical academic training
London and Norfolk Katılım Kasım 2015
2.8K Takip Edilen18.4K Takipçiler
@JRBneuropsiq @ReadReadj @pash22 @DrAnnieHickox Feisty Dr. Ramirez-Bermudez is my favourite Dr. Ramirez-Bermudez :)
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Very interesting article on why surveys are not a reliable or stable form of research.
25% of respondents give different answers when posed with the same question twice.
And beware of the online survey, especially when it is served up with a dollop of hyperbole!
H/t @pash22
Ash Paul@pash22
Who's to Blame for Survey Instability: Respondents with Nonexistent Preferences or Researchers with Flawed Measures? gking.harvard.edu/publication/wh… via @kinggary et al
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Robert Howard retweetledi
@veggiebrekkie @asifamhp @ProfRobHoward @hundredfamilies True enough. And a sad part of what you said is that an AOT might be needed to see a person once a week. That was easily possible for CMHTs when I started. The decline which has been overseen by ignorant policy makers including prominent doctors is scandalous
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Robert Howard retweetledi
Quick thread: "How do SSRI's work" 🧵
I've had a few patients ask me how SSRI's work.
To be clear, my first answer is "well we know they are supposed to block serotonin reuptake, but it's not that simple and we don't really know."
But, if you want the best 2026 science...
/1
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Robert Howard retweetledi
@nuwandiss @ProfRobHoward @hundredfamilies We r sometimes/often required to be positive & to detain people ✔️ @veggiebrekkie
SMI is a thing✔️
The commissioning & resourcing of MH Crisis Services needs to be a thing✔️
That requires multi agency partnership working to be a real thing✔️
& beds & real alternatives✔️
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Robert Howard retweetledi
.@skysarahjane @SkyNews
How would banning pro-Palestine protests stop recently discharged severely mentally ill patients attacking people with knives?
Am I missing the logic here?
Or did people use these awful attacks to fit their agenda before any facts were known?
Sky News@SkyNews
.@skysarahjane has been speaking to people in Golders Green who were concerned about anti-Israel demonstrations, and asks independent reviewer of UK terror legislation, Jonathan Hall, whether it's time to ban them. trib.al/13XgqUo 📺 Sky 501 and YouTube
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@suzypuss @nuwandiss @hundredfamilies And it isn’t perhaps surprising to have to explain this to a receptionist…..
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@nuwandiss @ProfRobHoward @hundredfamilies Team essentially behaving as though they have never learned about how mental illness can affect a person’s behaviour. I used to to have to explain this to the receptionist at the hospital when she complained about my patients being late and uncommunicative.
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This is exactly what I think when I hear the emerging evidence from the staff involved. The important questions for me would be what proportion of our teams are operating at these levels of dysfunction and incompetence and what are we going to do about it?
Recovery in the Bin@RITB_
@ashac_patel Except they weren't doing everything that a COMPETENT team with staff operating at a reasonable professional standard could have done. This was not a team of reasonable quality trying everything and failing. It was an incompetent team doing less than the bare minimum and failing
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@tanya252 We need a culture in which competence is valued and assured. It isn’t complicated.
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@ProfRobHoward We need culture of reporting “near misses” and incidents without fear - like the aviation industry. E-learning scrapped!! Stop jnr staff being promoted to snr positions. Stop forgetting the WHY when fooling ourselves CIPs are good!! Eg AOT into LMHT
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Robert Howard retweetledi
@ProfRobHoward @hundredfamilies Yes, the basic standard has to improve significantly
But unless we change course & acknowledge that neighbourhood teams are never going to meet the need of patients like this, this will keep happening
We need specialist teams
Those who are too blinkered to see this need to go
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@NicklessColin @medicalmodelbri Substitution of clinical staff by less qualified workers is not the problem here. It’s something far more worrying and difficult.
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@ProfRobHoward @medicalmodelbri What levels of staff are unqualified for the roles that they perform? What amount of PAs doing the jobs previously of Drs? What level of staff are working longer than their contracted hours? What level of vacancies and why are they not being filled?
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@micmicmic1 Do you not think it is a valid and important question?
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@ProfRobHoward I am not sure the country and the public are prepared to hear this answer..
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@WhippGary Speak out, Margaret. It upsets me that there is so much public anger towards VC, who, it increasingly appears, was a sick man let down by the system that should have protected him and the Public from the effects of his schizophrenia.
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@ProfRobHoward Don't get me started!
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Robert Howard retweetledi
Robert Howard retweetledi
I am wiling to make a sizeable wager that the #NottinghamInquiry will recommend the re-establishment of Assertive Outreach Teams (AOTs) in England & Wales✔️
@nuwandiss
@hundredfamilies
The Inquiry will make many more recommendations - many familiar etc >
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Robert Howard retweetledi
Online stalking has all the hallmarks of stalking offline.
Unfortunately, it’s the victim who ends up having to change their behaviour, in order to feel safe.
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Robert Howard retweetledi
@stinkybitsstick @tylerblack32 @ProfRobHoward Exaggerating risk, using fear-based and unscientific language such as “brain injury,” and engaging in pill shaming is not informed consent.
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@Foreman1David @tylerblack32 Precisely. And we have a job to do to persuade patients that functional disorders are real and as deserving of consideration and treatment as "harder" illnesses like schizophrenia and depression.
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@tylerblack32 @ProfRobHoward Patients can present like this with functional disorders, which are often missed as sources of disability and can be serious. “Catching someone out” by showing the disturbance is of use rather than ability does not prove malingering.
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goodness.... say what you will about antidepressant use (most people CAN tolerate weeks-long withdrawal), there is no good reason to do any of those pictured treatments for withdrawal - hyperbolic tapering is super easy to do.
danielle gansky@DanielleGansky
ANTIDEPRESSANT WITHDRAWAL INJURY is a serious neurological brain injury that happens even when you stop an SSRI following “standard” doctor tapering advice. After long-term use, the brain & nervous system adapt and change but the rushed 2-4 week one-size-fits-all tapers doctors still use are dangerously fast and actively causing brain injuries on a massive scale. Right now, thousands of people are being harmed simply by doing exactly what their doctors tell them and end up with long-term neurological damage and years of disability. The system gaslights victims, denies the harm, and hides the truth. This rivals the opioid crisis. If you've been affected, you're not alone. Share your story. #antidepressantwithdrawal #pssd
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@7juXxsnL @sanilrege @DrAnnieHickox @jonathanstea @QLDCountryGP @StigmaB47868 You’d expect Scientology (for that is what CCHR is, although for some reason they feel they need to obscure their identity) to support those who look to the supernatural and extraterrestrial for guidance.
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Quoting Niall McLaren, infamous for using exorcisms ti treat psychosis and conducting second opinions in hospital cafeterias in the Logan area. #psychiatry @SanilRege @DrAnnieHickox @ProfRobHoward @jonathanstea @QLDCountryGP @StigmaB47868
CCHR Int@CCHRInt
“There is a great deal that ails psychiatry, over-diagnosis, over-treatment, misallocation of resources, consistent breaches of patients’ fundamental human rights, and so forth— and they all go back to the one problem: mainstream psychiatry lacks a scientific framework.” – Dr. Niall McLaren, Psychiatrist
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@hfp91 Workforce provision is an additional and important challenge for mental health services. If you think I have argued for provision of beds alone as the sole fix for our problems you are mistaken.
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@ProfRobHoward The psychiatric service has collapsed
The inability to retain skilled & knowledgeable staff, #psychiatrists #nurses #socialworkers been the greatest failure - having more beds without staff is a poor argument
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Shouldn’t come as a surprise to anyone. No mention here of the lack of beds, meaning that Community teams have no effective access to hospital admission in the support of their most vulnerable and unwell patients.
Recovery in the Bin@RITB_
“ Mental health patients in the UK are routinely coming to harm because of high caseloads, understaffing and overwhelming administrative work…” theguardian.com/society/2026/a…?
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Robert Howard retweetledi
You can't fix depression because it's not something to fix. Nothing is broken. It's not an illness in the illness sense. It not like the person has strep throat and you can just take a pill. We have collectively lost our minds.
Om Prakash, MD@ompsychiatrist
If 8 minutes of planks “fixed” depression, we would have cured it decades ago. Feel glad it helps him but selling that as a solution is misleading and risks trivializing a serious illness. #DepressionIsReal #MentalHealthMatters
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