Risk assessment in self harm adds nothing.

I don't normally discuss risk assessment of repeat self harm. I'm more interested in suicide, and this paper does not report such data. Instead it looks at a more common event -- recurrent self harm within six months. The authors used a series of measurements -- the ReACT tool, the Manchester rule, the SAD persons … Continue reading Risk assessment in self harm adds nothing.

In praise of the lecture

The best lecturer I had at medical school taught anatomy, was close to retirement, and did not give out lecture notes. He spent his entire lecture drawing: starting with the bones, he would add the muscles, viscera and have a discussion as to how this worked. He was impossible to take notes from unless you … Continue reading In praise of the lecture

Free speech fabulous win for Milo

Milo Yiannopolous has written a book. And the fix is in. Former Breitbart tech editor Milo Yiannopoulos is scheduled to publish his book Dangerous next Tuesday, on Independence Day. Ahead of that release Gizmodo has obtained a copy of the finished book, as well as the January draft previously leaked to Buzzfeed. Maybe “the most … Continue reading Free speech fabulous win for Milo

The betrayal of the mad.

I work, most weeks, with people who have mood disorders and psychosis. A fair number of them, from time to time, want to ehdn their lives. My job is to engender hope. To remind them that this storm will pass. And it is my duty to discourage suicide when possible: the fact that a person … Continue reading The betrayal of the mad.


I disagree with Great Ormond Street. If a family want to try alternative therapy and there is no evidence based treatment, or no cure, they should be allowed to do so. To assume that we, as medicos, have a monopoly on cure is arrogance. It is hubris. We are not God, and we are not … Continue reading Hubris.

Barriers to an effective treatment?

ECT is as effective a treatment for mood disorders than any other, and using harder outcomes, such as readmission rate, may be better than others. This paper, a comparison of the readmison rate of the 1.5% who got ECT after admission to a psychiatric ward for a mood disorder with those who did not, is … Continue reading Barriers to an effective treatment?

Suicide prevention: is it resources?

A hypotheses in JAMA psychiatry recently was that the number of beds (a proxy, albeit a poor one, for Mental Health Funding) has cecrased at the same time the suicide rate has increased. This is a correlation. But is it causative? The closure of most US public mental hospital beds and the reduction in acute … Continue reading Suicide prevention: is it resources?

May there not be Assisted Dying in New Zealand.

This is from the NZ Medical Journal, and is an example of a research article that is polemical. The question, again, is euthanasia, which now seems to have gained the name of assisted dying, because euthanasia is seen as not sufficiently euphemistic. As shown in Figure 1, 37% of doctors and 67% of nurses responding … Continue reading May there not be Assisted Dying in New Zealand.

The failure of community care?

There are two groups of people who are at very high risk if suicide: Those who have made a suicide attempt Those who have been discharged from a psychiatric ward This paper is a meta analysis of suicide rate post discharge. it includes over a hundred populations with reported post discharge suicide rates over time. … Continue reading The failure of community care?

We had liftoff Thursday.

I am a few days late with getting this update on. But NZ has now sent a rocket into space. About as far as a V2 (as Infogalactic Tech noted) but the German Rocket Scientists had the resources of a state. And a shorter range. Rocket Lab broke new ground today when its Electron rocket … Continue reading We had liftoff Thursday.