Rape in the military: exposing the shocking truth

Tags

abuse, armed forces, blame, crime, documentary, film, Military, rape, sexual assault

Rape in the military: exposing the shocking truth

He hit me across the left side of my face … and my face hurt so bad. He screamed at me and he grabbed my arm and he raped me.” Kori Cioca’s heartbreaking account of her rape by a commanding officer while serving in the US Coast Guard is not the most shocking part of her testimony. Following the attack, Cioca was told by her superiors that if she went forward with her case she would be court-martialed for lying; her assailant, who admitted the attack but denied rape, then received just 30 days of base restriction and loss of pay and the US Department of Defense continues to refuse to pay for the surgery she needs for the nerve damage to her face.

Cioca is just one of the women interviewed in The Invisible War, a feature-length documentary that lifts the lid on the abuse of women in the US military and which got its first UK screening in the Frontline Club in London last week.

The film has raised similar concerns this side of the Atlantic that rape is a hidden scourge in the military. According to figures released to Labour MP Madeleine Moon, a rape or sexual assault is reported by a member of the armed forces every week. Over the past two and a half years, there have been 53 reported rapes and 86 reported sexual assaults in the army, the navy and the air force, but Moon believes the figure is an underestimation and could be as many as an attack a day.

Between 2001-2011, Ministry of Defence figures show 56 members of the armed forces were court-martialed for sexual offences – of these, just 16 resulted in a conviction.

UK screenings of The Invisible War are in the pipeline, as is its release on iTunes in the UK, while its makers are urging UK viewers to host their own screenings.

Lifting the lid on the extent of the abuse is vital to tackling the problem of rape in the military, says Amy Ziering, producer of the film, which was directed and written by Kirby Dick. “There is a perfect storm of conditions to keep this secret,” she says, speaking from Los Angeles. “There is no incentive to report rape, it is not treated as a priority in the military and the nature of the crime means that it is so implosively devastating that many women get the blame, or blame themselves.”

The statistics revealed in The Invisible War, which won the audience award at this year’s Sundance film festival, make shocking reading: a female soldier in combat zones is more likely to be raped by a fellow soldier than killed by enemy fire, over 20% of female veterans have been sexually assaulted while serving in the US army, of 3,192 sexual-assault reports in 2011 only 191 members of the military were convicted at courts martial.

Rape within the military has been exposed before – the Tailhook Association meetings in 1991, the Aberdeen Proving Ground in 1996 and the Air Force Academy in 2003 – but it has rarely been done with such a devastating combination of first-person testimony, watertight research and high-level interviews.

Through the testimony of victims and their families the extent of that devastation is laid bare, as well as the failings of a system that sees a rape victim’s commander decide whether to take action after a rape report.

Ariana Klay, who graduated with honours from the US Naval Academy and served in Iraq, describes her violent rape by a senior officer and her civilian boss. “He said that if I told anybody, that he was gonna have his friend Marv, from Indiana, kill me and throw me in a ditch, ’cause that’s how they took care of things in Indiana,” she tells the camera. When she reported the rape she was told to do “what a Marine officer should do, and that’s to ignore it and move on,” and she alleges the Marine Corps said she must have welcomed the assaults because she wore makeup and skirts – part of her regulation uniform.

“The thing that makes me the most angry,” says Klay, “is not even the rape itself; it’s the commanders that were complicit in covering up everything that happened.”

The film shows Andrea Werner, who reported her rape to her army superiors, only to be charged with adultery, even though it was her assailant who was married; Lieutenant Elle Helmer, whose case against her commanding officer at the Marine barracks in Washington DC, was closed owing to “lack of evidence” before a new case was opened charging Helmer with conduct unbecoming of an officer and public intoxication.

Ziering was instrumental in getting the women to open up about their horrific experiences. She readily agrees that her gender invariably played a role: “I became very emotionally involved in the victims’ stories, it was what drove me, and I wanted the film to have that heart and passion,” she says.

Ziering finds the documentary world “more welcoming and equitable” for women than Hollywood. “There is absolutely no balance in the movie world. It is so bleak there are so few women directors, it’s still very much an all boys club. It’s just horrible,” she says, though she notes the “big star” directors in documentaries still tend to be men. Dick and Ziering’s film has already had a far-reaching impact: offers of financial donations and support for victims have been made after almost every screening and when US secretary of defense Leon Panetta watched the film earlier this year he ordered military commanders to hand over all sexual-assault investigations to a higher-ranking colonel, and announce the creation of a special victims unit in each branch of the armed forces.

Ziering reveals that some commanders are using the film as a training tool, showing it to new recruits. “My real hope is that in 10 years’ time there is not another film made about this. We’re going to keep the pressure on – this can’t just be allowed to blow over.”

The growing problem of cyber-bullying

Tags

abuse, Children, Cyberbullying, parents, school, social media, suicide, Teens

The growing problem of cyber-bullying

Although it’s been around for as long as I can remember, I appreciate that for most adults cyber-bullying is quite a new phenomenon. And I don’t quite think they’ve yet grasped how to treat it. Unlike other forms of bullying, its effects often aren’t seen until it gets completely out of hand, and sometimes when it is too late.

According to the cyber bullying charity the Cybersmile Foundation, every 20 minutes a child between 10 to 19 years of age attempts to commit suicide in England and Wales. While one in three children in the UK suffers from cyber-bullying.

However, apart from the occasional scandalous news story such as the recent suicide of Canadian teenager Amanda Todd, most of it is never brought to light. So what’s really going on?

In my experience, most cases of cyber-bullying incidents aren’t, thankfully, as bad as Amanda Todd’s story. They usually comprise of arguments on Facebook that turn into popularity contests. Someone will spark off the conflict with a claim or rude post on the other person’s wall or photo and it will lead to a string of abusive and sarcastic messages. The rules of the battle are to remain nonchalant throughout and the winner is decided by whose comments received the most “likes”.

It then becomes almost a spectacle with everyone watching the fight unfold and messaging each other on who they think is faring the best. The bravest friends stick up for their comrade with their own comments and those less willing to get involved will simply join the mass of likes. This goes on until the receiver or the poster of the original message has enough sense to delete it and the fight continues in private.

Unfortunately, not all cases are so harmless and some can lead to serious emotional damage. A friend of a friend was a recent target when girls in her year created a Blackberry messenger group about her. It was comprised of over 20 people messaging each other about how they should kill the “slag”, supposedly because she was going out with an older boy. They then added her to the conversation and she wasn’t seen at school for two weeks. A close friend of mine was also a recent victim of abusive texts after false accusations arose around her having cheated with somebody’s boyfriend. “I felt so isolated and exposed,” she told me, “There was nowhere I could turn where they couldn’t get to me”.

There are also instances of malicious public statuses, embarrassing pictures being sent round and abusive questions on sites such as Formspring, a medium on which anonymous questions can be posted to specific people. Teens hiding behind their anonymous identity can post extremely hurtful things, which they would never say in real-life, but which they feel are acceptable in cyber space. Those who don’t answer are often accused of being cowardly and as a result receive even more “hate”.

Over 80 per cent of children fear that cyber-bullying is getting worse. Due to the growth of social media, every move you make on sites such as Facebook and Twitter is watched and regulated. Just a slight slip such as an “uncool status” or adding somebody as a friend, who you supposedly don’t know well enough, leaves the perfect opportunity for bullies to strike.

Victims of cyber bullying are always told they should seek help from school but they can often be just as confused as the perpetrators themselves. Although it is the wrong thing to do, many teenagers believe that their only chance of survival in the social media jungle of bullying is to fight back with equally as harsh and hurtful comments. This just leads to more tension and leaves schools and authorities with no easy way of putting an end to it without being accused of showing favouritism to a particular side.

I spoke to the founder of the Cybersmile Foundation, Scott Freeman on what he recommends when he receives distressed phone calls from victims and parents. Many parents are extremely worried about whether their child is being cyber-bullied and often are not sure how to protect their children if they don’t even know if it’s going on.

They are told to look out for certain signs such as their child acting paranoid and protective about other people looking at their computer and not wanting to go to school. A big reason why children may not want to alert their parents to the problem is the fear that their privileges, such as having a Facebook account and surfing the web may be taken away. Parents must show that they are on their child’s side and want to help them not punish them.

Children who call the helpline are suggested to talk to either to their parents or a member of staff at school about it straight away. If given permission to do so Cybersmile will contact their parents to run them through what can be done. If the child feels uncomfortable with that they should talk to a close friend, the most important thing is not to suffer alone. Cybersmile also offers counselling for anyone who is really having trouble. Most children live in fear of being cyber-bullied and this shouldn’t go on.

The charity also raises awareness of the problem, they fear is growing, by giving talks in schools and universities. They are designed to shock students into thinking about what they do online and who they may be affecting. Cyber-bullying workshops are also on offer for parents and children in order to bridge the gap between both generations and work on ways to combat the problem.

Cybersmile is working on changing the harassment law which they feel is outdated because it does not include online bullying. They believe that the internet should be viewed as a public space in which people who are acting abusive should be punished by law. A petition calling for government action has already received over 1,000 signatures, in the hopes of helping to erase cyber bullying. The foundation is producing anti-cyber-bullying wristbands which will be available from the 5th November. The money raised will be used towards supporting their 24 helpline which can be contacted on 0845 6887277.

For more information about the Cybersmile Foundation visit www.cybersmile.org

We Need to Break the Taboo Surrounding Self Harm and Start Talking About It

Tags

Children, GPs, hospitalisation, parents, self-harm, support, teachers, young people

We Need to Break the Taboo Surrounding Self Harm and Start Talking About It

One in 12 children and young people deliberately self-harm with around 40,000 cases needing hospitalisation each year because their injuries are so severe. Those statistics alone suggest that we must do more to help children and young people who are turning to self-harm and our new research shows how imperative this task is.

Research by YoungMinds and the Cello group launched today shows:
• Three out of four young people simply do not know where to turn to talk about self-harm
• A third of parents would not seek professional help if their child was self-harming
• Almost half GPs feel that they don’t understand young people who self-harm and their motivations
• Two in three teachers don’t know what to say to young people who self-harm

The research findings are worrying. Among young people, parents, teachers and GPs self-harm is considered more concerning and more serious than many high-profile youth issues such as youth gangs, drugs, binge-drinking or eating disorders. Young people themselves also rank self harm as a very high area of concern.

Myths, misconceptions and lack of understanding characterize self-harm, our research shows it can be viewed as too serious with links to suicide or too trivial to prompt action by being seen as attention seeking. With this polarisation of views it makes it really difficult for people to seek or provide support.

As a society we feel ill equipped to talk to young people about self-harm and at the same time young people are saying they don’t know where to turn. If as our research shows, parents, teachers and GPs don’t feel equipped and confident then is it any wonder that young people are stuck not knowing where to go?

Only one in 10 young people are comfortable seeking advice from teachers, parents and GPs. Over half would go online to get support about self-harm despite only one in five trusting online sources. Thousands of young people are getting emotional support from online communities rather than going to their parents, teachers or GPs. Everyone concerned about the emotional wellbeing of young people needs to acknowledge and accept this and look at why young people are supporting each other online.

We shouldn’t blame people for not being confident or equipped our research shows a real desire for people to be able to talk to young people about self harm. The majority of people believe that they need to be able to offer support to young people who self-harm; however, nobody feels empowered to act.

Thousands of young people are suffering in silence every day. Our research demonstrates that we need to break the conspiracy of silence around self-harm so young people feel more able to seek support and parents, teachers and GP’s feel equipped to provide it. We also need to find ways to breach the gap online that exists between adults who want to help but don’t know how to enter the online space and young people who find peer support there but may also come across the more negative and dark side of online communication.

The YoungMinds Parents’ Helpline offers free confidential online and telephone support, including information and advice, to any adult worried about the emotional problems, behaviour or mental health of a child or young person up to the age of 25.

Call us free on 0808 802 5544  Monday to Friday 9.30am-4pm or email parents@youngminds.org.uk

Grandparents who become full-time carers plead: ‘We can’t do it all for love’

Grandparents who become full-time carers plead: ‘We can’t do it all for love’

One night earlier this year Stephen Merchant, 55, was contacted by his local council’s children’s services department. Twelve hours later, he was the full-time carer for his grandson, Charlie, who will be three years old on Wednesday. “Life changes in a phone call,” says Merchant, who comes from Northampton.

He had to give up his job as a driver. “My employers offered a baby seat in the lorry,” he jokes, “but Charlie comes first.” Charlie was taken from Merchant’s son and girlfriend when it was found that the baby had fractures. “I was the only one in the family who could change lifestyles at the time,” he says. The two now live on around £250 a week, or £12,000 a year. “I’m not flush, but I can survive. The family help. I’ve got bags of clothes for Charlie that will keep him in trousers until he’s five. He’s happy at nursery. Charlie’s great. He’s part and parcel of my life now.”

Merchant’s income fell considerably when he became a full-time carer. Once he becomes a pensioner and Charlie is a teenager, the financial squeeze will become even tighter. Merchant, like most grandparents and relatives in his position, receives almost no practical or financial support.

It is estimated that 250,000 children are in kinship care and are twice as likely to live in poverty as children living with their parents. A YouGov poll published last week by the charities Grandparents Plus, the Family and Parenting Institute and Family Lives, and funded by the Big Lottery, starkly illustrates that, while the public’s attitude is hardening on benefits, there is overwhelming support for more practical and financial help for grandparents and other relatives bringing up children. More than two-thirds (67%) of adults agree or strongly agree that grandparents and other family members rearing a related child should receive practical help and a financial allowance. Even more (78%) agree with that, if the grandparents are on a low income. Strong support (60%) also exists for grandparents to have paid leave.

“Grandparents provide children with love, a sense of identity and belonging, and crucially they maintain a child’s relationships with the wider family,” says Sam Smethers, chief executive of Grandparents Plus. “But they need support.” In care, a child could cost more than £50,000 a year. If fostered – and therefore still the responsibility of the local authority – a carer could receive up to £40,000 a year. However, only 4% of grandparents foster their grandchild; the rest rely on the discretion of local authorities to provide an allowance. “I don’t want my daughter’s child to grow up thinking they are ‘in care’ under my roof,” one grandmother explained.

“The system ought to reflect the needs of the child and carer,” says Cathy Ashley, chief executive of the charity Family Rights Group. “Instead, often the only way to get help is for grandparents to push children into the care system. That can’t be right.” A study this year said 72% of carers rated support from children’s services as “poor” or “very poor”.

Rosemary and Gordon Rawlings live in Plymouth. Rosemary, 64, was a school cleaner, Gordon, 67, is a retired postman. They raised five children and for the past six years have cared for their daughter’s child, Heidi, aged 12.

“She’s a Rawlings and she’s going to stay a blooming Rawlings, no matter how hard it is,” Gordon says. The family live on just over £200 a week. “We don’t smoke, we don’t drink, we don’t go out,” Gordon says. “But it’s worth it when Heidi gives us a hug. When she first came to us, we had to feed her in small portions because her stomach was so small – she had never been fed proper meals. Now she’s doing really well at school.” He adds: “A hundred pounds a week would make all the difference. But we’re not alone in receiving nothing. It’s happening across the country.”

Kathryn Bennett, 62, is a retired teacher with acute arthritis. Her husband Roger, 65, was in the fire service, then worked part-time and retires shortly. Their income will go down to around £20,000 a year “We never claimed benefits, we saved for all the things we were going to do when we retired,” Kathryn says.

In May 2011 her daughter, who had mental health problems, died aged 35. Her three children, now 12, seven and four, with a range of challenging behaviours, came to the Bennetts, who used their life savings to extend their home. “For 18 months I cried and wept and begged for extra help,” says Kathryn. “I was close to a breakdown and we said the two boys would have to go into foster care. Why does it have to reach a crisis before something happens?”

The Family Rights Group and five other charities this month launched an inquiry into the care system, reporting in 2013. Grandparents Plus also hopes that Edward Timpson, the recently appointed education minister, whose own parents fostered more than 80 children, will become a champion of kinship care, end the postcode lottery and establish a national support system.

The Bennetts now have 24 hours of respite care and receive £720 a month. That pays for Miguel, 23, a Spanish male au pair. “It’s made such a difference,” Kathryn says. “But we were made to feel awful for asking. The social worker said, ‘Do you know how many mums I have asking for help?’ I had to say, ‘But I’m not a mum, I’m a grandmother’.”

THE CARERS

Pam Purvis, 47, and her husband Tommy, 50, from Tyne and Wear, married six years ago. “Our wedding was full of other people’s kids,” says Pam with a smile. “We said, ‘Thank God, we’re too old to have any more.’ Then Connor arrived.”

Connor, now in school, was eight months old. He had been taken away from Pam’s daughter, one of Pam’s five grown-up children. A second child, Jayden, nearly 18 months, arrived more recently from a different local authority (LA).

“The first LA told me I had to give up work and they’ve given us a great package for Connor until he’s 18,” Pam says.

But then she adds: “The second has said I have to find a job when Jayden is three and its financial help stops.

“My husband is retired on a disability allowance and I obviously don’t earn anything, so I’m worried about the future. The boys are brilliant, but why does everything have to be such a battle?”

Stigma of mental ill health is ‘worse than the illness’

Tags

anxiety, barriers, Depression, discrimination, economy, employment, mental health issues, psychotherapy, recession, relationships, stigma, Therapy, treatment

Stigma of mental ill health is ‘worse than the illness’

It is the single biggest cause of disability in the Western world but many sufferers say the stigma attached to it is worse than the illness itself, according to researchers.

While celebrity sufferers who speak out about their depression are hailed as heroes, ordinary citizens are shunned, taunted and abused.

An international study of more than 1,000 sufferers in 35 countries has found that three quarters said they had been ostracised by other people leading them to avoid relationships, applying for jobs and contacting friends.

Discrimination is leading many to put off seeking treatment with a subsequent worsening of their condition.

Drugs and psychotherapy can help 60-80 per cent of people with depression but only half get treatment and only 10 per cent receive treatment that is effective – at the right dose, for long enough and with the right kind of therapy.

The international study published in The Lancet found that levels of discrimination were similar to those for schizophrenia revealed in a similar study three years ago.

Professor Graham Thornicroft, head of health service and population research at the Institute of Psychiatry said: “We have a major problem here. Non-disclosure is an extra barrier – it means people don’t seek treatment and don’t get help.”

While public confessions of depression by well known people including the tennis champion Serena Williams, the US actress Kirsten Dunst and chat-show host Stephen Fry were increasing, abuse of sufferers was also widespread.

The Norwegian Prime Minister, Kjell Bondevik, attracted worldwide approval when he relinquished power for three weeks to his deputy in 1998 while he recovered from an episode of depression. He was subsequently re-elected.

In contrast, Professor Thornicroft described the case of a woman who had dog faeces posted through her door because neighbours wanted her out and another in which police halted an interview with a man whose flat had been burgled when they learnt that he had been in psychiatric hospital.

“Our findings show discrimination is widespread and almost certainly acts as a barrier to an active social life and having a fair chance to get and keep a job,” he said.

The Government’s Time to Change campaign launched in 2008 aimed at reducing discrimination against people with mental illness had proved to have had a “modest but significant” impact, he added.

In a separate study, researchers have found that the 2008 economic crash led to a deterioration in the mental health of men – but not women.

Anxiety and depression increased markedly among men in the three years following the crash, but women escaped largely unscathed.

Rising unemployment and falling income are not to blame, the researchers say. Instead, job insecurity is thought to be the cause.

Mental ill health among men rose from 13.7 per cent in 2008 to 16.4 per cent in 2009 before falling back to 15.5 per cent in 2010, according to the study published in the journal BMJ Open.

Men derive much of their social status from their occupation and are still the main wage earners in most families. They are becoming more mentally unstable because of the fear of losing their jobs in the recession.

The authors from the Social and Public Health Sciences Unit in Glasgow, say that while women’s mental health appeared to change little in the period it may have deteriorated since due to job cuts in the public sector.

 

More children have anorexia than previously thought, study finds

Tags

anorexia, bulimia, Children, Eating Disorders, hospitalisation, treatment

2011:

More children have anorexia than previously thought, study finds

More than two and a half times as many children under 10 have anorexia nervosa as previously thought, according to the first study into eating disorders among British children.

On average, 1.5 in every 200,000 British children under 10 have anorexia, according to experts from the UCL (University College London) Institute of Child Health, who carried out the research.

Direct comparison with previous UK data is limited but a general practice registry study in the early 1990s found an incidence estimate of 0.6 per 200,000 for anorexia among children aged up to nine.

The findings have shocked experts, who called for “urgent action” to help save young lives. There are no national paediatric guidelines for the care of individuals with eating disorders.

“Recognition of eating disorders in children by GPs can be poor and, unfortunately, many eating disorder services are aimed specifically at adolescents,” said Dr Dasha Nicholls, a consultant child and adolescent psychiatrist at the UCL Institute of Child Health and the study’s lead researcher.

“Childhood eating disorders are not quick or easy to treat. For a minority of children it may be the start of a severe and enduring illness, with death rates comparable to some forms of leukaemia.

“Early-onset eating disorders – defined as those starting before 13 years of age – represent a significant clinical burden to paediatric and mental health services. Efforts to improve early detection are needed but our study also shows there is an urgent need to consider the needs of children with eating disorders separately – and not simply lower the age range of existing adolescent services,” said Nicholls.

Most of the 208 patients in Nicholls’s study were girls – 82% – but boys accounted for almost one in five cases.

More than 80% of the children in the study, to be published in the British Journal of Psychiatry, had an anorexia-like illness: 37% had diagnosable symptoms while 43% were classified as having an “unspecified eating disorder” because although they showed symptoms of anorexia they were not underweight. Only 4% had bulimia.

An additional one in five children had symptoms of disordered eating, such as food avoidance and being underweight, but did not have a preoccupation with their weight or shape.

Half were admitted to hospital, over 70% of whom had anorexia. After a year, almost two thirds were still receiving treatment. 73% had improved but 6% were worse and 10% unchanged.

Almost 44% of the children had a close family member with a history of mental illness, most commonly anxiety or depression. Another fifth had a history of early feeding problems, particularly fussy or picky eating.

Studies suggest that although the incidence of eating disorders has been fairly static over the past few decades, anorexia is being diagnosed among children in increasingly younger age groups.

Data on the rate and outcome of early-onset eating disorders is sparse. The National Inpatient Child & Adolescent Psychiatric Survey found that eating disorders were the most common diagnosis among child and adolescent psychiatric in-patients in England and Wales, 9.2% of whom were under 13.

The survey, however, did not include children on paediatric wards. “Ours are the first published data on the scale of paediatric resource used by this patient group in the British Isles,” said Nicholls.

Previous research from the NHS Information Centre has found that children aged 14 to 16 account for one in every three patients treated in hospital for an eating disorder, an 11% rise on the 2,316 cases recorded for the previous 12 months.

The centre’s data, however, found only a “small number” of 10-year-olds diagnosed with conditions including anorexia and bulimia.

A 1999 Office for National Statistics study found 0.3% of 11- to 15-year-olds had an eating disorder, with no one in the five- to 10-year-old age group.

The new study found wide variation in confidence among paediatricians over how to treat children. “This study provides the baseline figures needed to determine whether increases in hospitalisation rates are real or perceived, and can aid planning of age-appropriate services,” said Nicholls.

Because the new study gives the first estimate of the incidence of early-onset eating disorders, Nicholls said she was unable to say if there has been a rise in this group. “But we hope our research can be used as a baseline from which to monitor future trends,” she added.

The findings have galvanised concern that society’s obsession with physical appearance is making children become body-conscious at an increasingly early age. Blame has been placed on everything from poor parenting to the media and websites such as Facebook.

 Miranda

When Miranda turned eight, her parents took her to a pizza parlour to celebrate. For any other child, it would have been a common enough treat. But for Miranda, the trip was nothing short of momentous – as it signified a return to health.

Now 11, Miranda finds it hard to remember why, at seven, she developed an eating disorder so severe that she stopped eating and drinking and ended up almost 10kg underweight, with a body mass index (BMI) of 12.5. (A BMI of under 18.5 is officially underweight.)

“I remember living in a clinic with other children. None of us could eat normally,” she said. “I was there for five months. They said I had food avoidance emotional disorder. I don’t know where it came from but in my diary, I said it was like having a pixie in my tummy. The pixie was like the devil. When I wanted to eat, the pixie would fight me. At the beginning, in my diary, I said the pixie was stronger than me. But then I got stronger than him. I remember it being like he got smaller and I got bigger. The pixie’s not in my tummy any more. I hope he never comes back.”

ADHD study reveals children’s views

Tags

ADHD, aggression, Bullying, Children, control, diagnosis, medication, stigma, treatment

ADHD study reveals children’s views

 

Children with hyperactivity problems do not feel that Ritalin and other drugs they are given turn them into zombies or robots, but say they feel the medication helps them control their behaviour, according to a study that has asked for their views, in what is claimed as a first.

Dosing children with stimulants to control angry, aggressive or overly-impulsive behaviour has excited controversy for many years. Critics say medication is the wrong way to go and that ADHD (attention deficit hyperactivity disorder) is an extreme form of normal behaviour that needs understanding and psychological therapy rather than drugs.

But, said biomedical ethicist Dr Ilina Singh from Kings College London, author of the research, nobody has asked the children themselves.

Her work, published as a book and an animated film to help inform the debate around the drugs, was funded by the independent Wellcome Trust. It offers insights into the feelings and experiences of children with ADHD and reveals, worryingly, that they are often bullied at school and that doctors do not talk to them about their condition as much as they would like.

The drugs, said Singh, are not the only answer – she would like to see research into meditation and other alternatives for the children – but “the assumed harms of stimulant medication were largely not supported by this study,” she said, although she added: “This is is no way a blanket endorsement of stimulant drug treatment.”

Children said the drugs gave them a time and space to consider their reaction to things that could make them behave aggressively. “They said what a great thing it is to have a bully come up to you in the playground and not react impulsively but have a moment to think, ‘what do I do next?’,” said Singh.

The children also talked about the downsides of medication. A small group felt the person on the drugs was not their authentic self. “I didn’t feel like myself when I was taking the medication,” was one comment, and “I was too quiet; it wasn’t me.”

“One of the messages that children have is that they want more treatment options outside of medication, but they aren’t available,” said Singh. “There are long waiting lists for any kind of behavioural treatments for kids.” But drugs, she said, are “absolutely not the only treatment we should be focusing on.”

The Voices (voices on identity, childhood, ethics and stimulants) study involved detailed interviews with 151 children aged 9 to 14 and their families in the UK and the United States. They were from three groups – children diagnosed with ADHD and on medication, children with a diagnosis who were not on drugs and children with no psychiatric diagnosis.

In the US, the drugs were most likely to have been prescribed to improve children’s school performance by helping their concentration.

Ian, a 12 year-old in a lower-middle-class suburb of a major east coast US city, has been on a variety of drugs for ADHD in the last three years. “I forget things a lot and I have trouble focusing and being mature,” he told researchers. “That means I’m not doing my work like I’m supposed to. The last time I felt good about my behaviour was when I got all Bs and Cs on like my gradecard, except for one D. That was a few weeks ago. My mom freaked out she was so happy. I want to keep doing better.”

UK children were diagnosed because of disruptive or difficult behaviour. Shaun, 11, lives in a large village on the outskirts of a small city in a lower-middle-class neighbourhood where his parents grew up and other family still live. He has been on stimulants for more than two years.

“It’s like sometimes I feel really cross with other people and I just want to go lashing, lashing out,” he said. “[Other children at school] know they can wind me up easily so they do it again and again and I can’t walk away that easy … if I get punched, I have to fight back. Teachers are not effective. They don’t help. In the future I guess I want to be less naughty.”

The research found a lot of stigma attached to ADHD. Children in the US tended not to tell people they were diagnosed. Children in the UK, among whom issues of aggression and anger made it more obvious, often reported they were bullied as a result.

“Their peers will go out of their way to wind up the child they know has difficulty managing their anger or aggression,” said Singh. US children would make jokes and tease those with ADHD, but actively attempting to make another child lose control was a particularly British thing, the research found.

Children reported little meaningful conversation with their doctors and said they did not understand their condition or why they were taking drugs. Check-ups focus on weight and side-effects and there is little discussion of how they are coping with their lives.

That needs to change, said Singh. “Given the ethical concerns that arise from ADHD and stimulant drug treatment, it is imperative that children are able to openly discuss the value of diagnosis and different treatments with a trusted professional,” she said.

NHS accused of age discrimination over lifesaving surgery

NHS accused of age discrimination over lifesaving surgery

Older people are being denied vital surgery for cancer, hernia repairs and joint replacements because the NHS imposes “cutoffs” for treatment based on age discrimination, a report has warned.

Health professionals can be too quick to decide against offering surgery because of “outdated assumptions of age and fitness”, according to the study by the Royal College of Surgeons, the charity Age UK and communications consultancy MHP Health Mandate. Doctors and surgeons should stop using chronological age to assess suitability for a procedure and instead use their “biological age”, or overall health, because growing life expectancy and the increasingly good health of senior citizens make birth date alone redundant as the deciding factor, it says.

The study found that while people’s health needs increase as they grow older, rates of planned surgery for some common conditions among older people steadily decline. “The gap between the increasing health need and access to surgery means many older people are missing out on potentially lifesaving treatment,” concludes the study, which details the variation by age group in patterns of treatment for eight types of surgery.

“It is alarming to think the treatment a patient receives may be influenced by their age,” said Professor Norman Williams, president of the Royal College of Surgeons. While there are often valid explanations why older patients decide not to have surgery or are recommended non-surgical treatment, he said: “The key is that it is a decision based on the patient rather than how old they are that matters.”

The report details “barriers” to older people receiving surgery, including that “some symptoms can be dismissed as an inevitable part of ageing rather than a potential sign of ill-health. This can mean a disease is at a more advanced stage by the time they are diagnosed, ruling out surgical treatment”. Equally, some older patients’ overall health may mean the risks of having a procedure outweigh the benefits.

The report takes doctors and surgeons to task for letting outdated attitudes influence their decision-making about older people’s eligibility for surgery. “The clinical benefit of providing treatment may be questioned when relative life expectancy is shorter,” it says.

Communication with older patients to discuss risks and benefits can be limited or ineffective. Conflation of chronological and biological age “means decisions may not always be made on the basis of a comprehensive and objective assessment but on a series of assumptions about fitness in older age”.

While the incidence of breast cancer is highest in women aged 85 and over, surgery peaks among those in their mid-60s and declines sharply from 70. Similarly, rates of surgery for prostate cancer, which kills 10,000 men a year, do not reflect the number of older men being diagnosed with the disease.

Life expectancy is 78 for men and 82 for women. Yet men and women who need a new hip or knee, usually owing to arthritis or a fall, are most likely to get one up to the age of 75 but less likely to do so after that, even though National Institute of Health and Clinical Excellence (Nice) guidelines to the NHS say age should not influence whether someone has that surgery, given its benefits.

Joint replacements appear to be increasingly restricted as the NHS rations treatments in an attempt to save £20bn by 2015. That financial pressure could mean older people are disproportionately affected by this trend in coming years, the report warns.

The gap between the number of people living with a condition or health need and the rates of surgery among older people should make surgeons and other health professionals rethink their attitudes to treatment for senior citizens, said Michelle Mitchell, charity director general at Age UK. “When it comes to people’s health their date of birth actually tells you very little. A healthy 80-year-old could literally run rings round someone many years younger who does not share the same good health.

“Yet in the past too many medical decisions we believe have been made on age alone with informal ‘cutoffs’ imposed so that people over a certain age were denied treatment.”

Such practices are now illegal. In June, the government said denying drugs or treatments on the grounds of age would be outlawed from this month, meaning older people may be able to sue the NHS to challenge decisions they feel are discriminatory because of their age.

“A new legal framework to outlaw age discrimination in the NHS cements our moral duty of care to older patients and sends a clear signal to the NHS to deliver the best care and support to every patient in line with his or her needs,” the report notes.

The Department of Health said the NHS should not deny patients treatment because of their age. “There should be absolutely no place in the NHS for assumptions about entitlement to treatment that are based on age or any other form of unjustified discrimination,” said Dan Poulter, the health minister. “All patients should be treated as individuals, with dignity and respect, and receive care that meets their healthcare needs irrespective of their age.

“The government is committed to providing dignity in elderly care, and at the beginning of October we introduced an age discrimination ban, which means that all patients will receive a more personalised care service, based on their individual needs, not their age.”

Iraq records huge rise in birth defects

Tags

ammunition, Basra, battle, birth defects, bombardment, brain dysfunctions, Children, Fallujah, health crisis, heart defects, Iraq, lead, malformed limbs, mercury, metals, miscarriage, neuro-toxic metal contamination, pregnancy, stress, toxicology, war, white phosphorus shells, WHO

Iraq records huge rise in birth defects

It played unwilling host to one of the bloodiest battles of the Iraq war. Fallujah’s homes and businesses were left shattered; hundreds of Iraqi civilians were killed. Its residents changed the name of their “City of Mosques” to “the polluted city” after the United States launched two massive military campaigns eight years ago. Now, one month before the World Health Organisation reveals its view on the legacy of the two battles for the town, a new study reports a “staggering rise” in birth defects among Iraqi children conceived in the aftermath of the war.

High rates of miscarriage, toxic levels of lead and mercury contamination and spiralling numbers of birth defects ranging from congenital heart defects to brain dysfunctions and malformed limbs have been recorded. Even more disturbingly, they appear to be occurring at an increasing rate in children born in Fallujah, about 40 miles west of Baghdad.

There is “compelling evidence” to link the increased numbers of defects and miscarriages to military assaults, says Mozhgan Savabieasfahani, one of the lead authors of the report and an environmental toxicologist at the University of Michigan’s School of Public Health. Similar defects have been found among children born in Basra after British troops invaded, according to the new research.

US marines first bombarded Fallujah in April 2004 after four employees from the American security company Blackwater were killed, their bodies burned and dragged through the street, with two of the corpses left hanging from a bridge. Seven months later, the marines stormed the city for a second time, using some of the heaviest US air strikes deployed in Iraq. American forces later admitted that they had used white phosphorus shells, although they never admitted to using depleted uranium, which has been linked to high rates of cancer and birth defects.

The new findings, published in the Environmental Contamination and Toxicology bulletin, will bolster claims that US and Nato munitions used in the conflict led to a widespread health crisis in Iraq. They are the latest in a series of studies that have suggested a link between bombardment and a rise in birth defects. Their preliminary findings, in 2010, prompted a World Health Organisation inquiry into the prevalence of birth defects in the area. The WHO’s report, out next month, is widely expected to show an increase in birth defects after the conflict. It has looked at nine “high-risk” areas in Iraq, including Fallujah and Basra. Where high prevalence is found, the WHO is expected to call for additional studies to pinpoint precise causes.

The latest study found that in Fallujah, more than half of all babies surveyed were born with a birth defect between 2007 and 2010. Before the siege, this figure was more like one in 10. Prior to the turn of the millennium, fewer than 2 per cent of babies were born with a defect. More than 45 per cent of all pregnancies surveyed ended in miscarriage in the two years after 2004, up from only 10 per cent before the bombing. Between 2007 and 2010, one in six of all pregnancies ended in miscarriage.

The new research, which looked at the health histories of 56 families in Fallujah, also examined births in Basra, in southern Iraq, attacked by British forces in 2003. Researchers found more than 20 babies out of 1,000 were born with defects in Al Basrah Maternity Hospital in 2003, a number that is 17 times higher than recorded a decade previously. In the past seven years, the number of malformed babies born increased by more than 60 per cent; 37 out of every 1,000 are now born with defects.

The report’s authors link the rising number of babies born with birth defects in the two cities to increased exposure to metals released by bombs and bullets used over the past two decades. Scientists who studied hair samples of the population in Fallujah found that levels of lead were five times higher in the hair of children with birth defects than in other children; mercury levels were six times higher. Children with defects in Basra had three times more lead in their teeth than children living in non-impacted areas.

Dr Savabieasfahani said that for the first time, there is a “footprint of metal in the population” and that there is “compelling evidence linking the staggering increases in Iraqi birth defects to neuro-toxic metal contamination following the repeated bombardments of Iraqi cities”. She called the “epidemic” a “public health crisis”.

“In utero exposure to pollutants can drastically change the outcome of an otherwise normal pregnancy. The metal levels we see in the Fallujah children with birth defects clearly indicates that metals were involved in manifestation of birth defects in these children,” she said. “The massive and repeated bombardment of these cities is clearly implicated here. I have no knowledge of any alternative source of metal contamination in these areas.” She added that the data was likely to be an “underestimate”, as many parents who give birth to children with defects hide them from public view.

Professor Alastair Hay, a professor of environmental toxicology at Leeds University, said the figures presented in the study were “absolutely extraordinary”. He added: “People here would be worried if there was a five or 10 per cent increase [in birth defects]. If there’s a fivefold increase in Fallujah, no one could possibly ignore that; it’s crying out for an explanation as to what’s the cause. A rapid increase in exposure to lead and mercury seems reasonable if lots of ammunition is going off. I would have also thought a major factor would be the extreme stress people are under in that period; we know this can cause major physiological changes.”

A US Defense Department spokesperson said: “We are not aware of any official reports indicating an increase in birth defects in Al Basrah or Fallujah that may be related to exposure to the metals contained in munitions used by the US or coalition partners. We always take very seriously public health concerns about any population now living in a combat theatre. Unexploded ordnance, including improvised explosive devises, are a recognised hazard.”

A UK government spokesperson said there was no “reliable scientific or medical evidence to confirm a link between conventional ammunition and birth defects in Basra”, adding: “All ammunition used by UK armed forces falls within international humanitarian law and is consistent with the Geneva Convention.”

Dr Savabieasfahani said she plans to analyse the children’s samples for the presence of depleted uranium once funds have been raised. She added: “We need extensive environmental sampling, of food, water and air to find out where this is coming from. Then we can clean it up. Now we are seeing 50 per cent of children being born with malformations; in a few years it could be everyone.”

Metal hazards

Lead

Throughout pregnancy, lead can pass from a woman’s bones to her child; the levels of lead in maternal and foetal blood are almost identical. Children and particularly the unborn are more susceptible to lead than adults. At high levels of exposure, lead attacks the brain and central nervous system, causing comas, convulsions and even death, according to the WHO. Children who survive acute lead poisoning are typically left with mental defects and behavioural problems.

Mercury

Exposure to metallic, inorganic or organic mercury can permanently damage the brain, kidneys and developing foetus. Mercury can enter the air, water and soil. Its harmful effects can be passed from mother to the unborn child, leading to brain damage, mental defects, blindness, seizures, muteness and lack of co-ordination.

Depleted uranium

A toxic heavy metal, depleted uranium is what is left over after natural uranium has been enriched, either for use in weapons or for reactor fuel. While the US and UK acknowledge that the dust can be dangerous if inhaled, the jury is still out when it comes to long-term damage to people and their children. Scientists have suggested that its molecules can travel to the sperm and eggs, increasing the probability of cancer and damage to genes.

Lesson one: We’re students, not slags

Tags

culture, sexual assault, sexual harassment, sexual objectification

Lesson one: We’re students, not slags

“Rappers and Slappers”, “Slag and Drag”, and “CEOs and Corporate Hoes”. They may sound like adult films, but these are the names of some of the university-affiliated freshers’ week parties that undergraduates have been invited to attend on campuses and nightclubs across Britain.

When I chronicled the highly-sexualised freshers’ week experiences that female students have reported to the Everyday Sexism Project in an article for Independent Voices last week, I expected a trickle of responses.

But I received a deluge of similar stories from hundreds of students – male and female – who are appalled by the macho culture that seems to set the tone of social life at UK universities.

Parties at which female students are pressured to dress in revealing or sexualised outfits appear increasingly common. To pick just one example, a woman described a freshers’ week initiation for male rugby players: “All the rugby freshers had their trousers around their ankles and were standing in their boxers. They were encouraged to pick one of us to “grind” with them (gyrate against them). One guy grabbed me and pulled me on to the dance floor and then told me I had to grind on him or else he’d have to do a forfeit. When I refused he told me I was frigid and grabbed a different fresher.”

Another reader, Sorrel Kinton said: “I attended one of these events and was turned away at the door for wearing normal clothing … I was told I could come in if I flashed.”

The idea that students must choose to participate or risk being labelled “uptight” is a recurring theme. Nesrin Samli, who graduated from Liverpool University this summer, told The Independent, “it’s very different for people who feel more shy or uncomfortable, because you don’t have a choice – there were strict initiations and you had to do what everyone else did or you were just missed out.”

Of course, students can choose to avoid such events altogether, and many universities offer a wider range of activities, from chill-out nights to afternoon teas. But there remains a strong sense of pressure to participate in the main events, as students experience the nerve-wracking process of finding their feet for the first time away from home. Samli says: “Even if you don’t want to dress like that, it’s a matter of whether you want to be part of the group and have friends.”

Emma Carragher, vice president of the Cardiff University Women’s Association, agrees: “There’s a danger that new students feel pressured into taking part because ‘everyone else is doing it’ – if they want to take a stand against objectification they’ll be seen as weird which is obviously not the first impression they want to make.

“More than that, these events … send the message to freshers that this is normal … The first year of university is where your political and ideological views are challenged and reformed, so universities should be striving to promote the idea that women are not objects rather than encouraging it.”

A 2010 National Union of Students study revealed that 1 in 7 of the female students surveyed had been the victim of sexual assault or violence.

Yet several of the reports we have received reference “rape-victim themed” fancy dress parties and “banter” about sexual assault. One woman said that when she was at university two years ago, 15 members of a male-only drinking society were suspended when a “hit list” they had compiled of female students as sexual targets became public. Another wrote: “I the only girl in politics tutorial on feminism. No real discussion. Just jokes on women and kitchen. Including from the tutor.” Another student showed us a copy of a poster she said was used to advertise unisex football trials at her university. The top half consisted entirely of a picture of a woman’s breasts in a bra. Beneath, the text began: “Now I have your attention lads…”

Many would dismiss some of these incidents as harmless, or claim that themed events like “Pimps and Hoes” have little real impact on student welfare. But these reports suggest a disturbing culture of female students facing sexual objectification and demeaning labels, and the use of such names for official university and student union events sends a powerful message by implying the institutions’ acceptance or approval of this culture.

The idea of complicity is of great importance here. From the number of reports we have recently seen emerging in the national press on the theme of sexual harassment in the workplace over the past 30 years – most notably the Jimmy Savile scandal – it has become clear how easily victims can feel oppressed by a culture of normalised acceptance within a large institution. Likewise, young students at a vulnerable life stage might be affected by the suggestion that certain attitudes towards women are condoned by their educational institutions. It should be the responsibility of all universities to behave proactively to eradicate any implication that they might support the sort of damaging, victim-blaming ideas associated with labels such as “slag”, “hoe” and “slapper”.

Also: Cambridge University Graduate Blogs On Horrifying Misogyny In Catalogue Of A Barmaid