Keir Harding @Keirwales Twitter profile

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Keir Harding

1 year

In 21-22 13% of the mental health workforce left the NHS. 5% and one off payment will not stop the exodus of staff. Unless we can make the conditions more tolerable people will keep leaving. I'll be talking about this here 👇👇👇

2023 Elizabeth Casson Memorial Lecture

www.rcot.co.uk

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Keir Harding

@Keirwales

1 year

I was always told to sit closest to the door when working in mental health. As a 15 stone man working with traumatised women I wonder how much unnecessary fear I inflicted over the years. I do the opposite these days.

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Keir Harding

@Keirwales

1 year

I used to discharge people who didn't engage. These days I think that suffering and being unable to use the help that's there is a priority to work on.

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Keir Harding

@Keirwales

3 years

#OTweek2020 #ChooseOT What do Occupational Therapists do?

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Keir Harding

@Keirwales

4 years

For #WorldMentalHealthDay lets try to stop telling people who have lived through neglect, abandonment and abuse that their personalities are disordered

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Keir Harding

@Keirwales

1 year

Congratulations to Occupational Therapist @MathesonMichael on becoming Scotlands Health Secretary Great to see OTs in roles where they can really adapt environments for the better. @theRCOT

Michael Matheson succeeds Humza Yousaf as Health Secretary

MICHAEL Matheson has been announced as Health Secretary in Humza Yousaf’s new-look cabinet...

www.thenational.scot

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Keir Harding

@Keirwales

3 years

The diagnosis of personality disorder is associated with so much stigma and diagnostic overshadowing that it cannot be given without violating the hypocritic oath to "first do no harm" Discuss.

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Keir Harding

@Keirwales

5 years

Draft letter to NICE which I will send on Monday. If you'd like to add your name either comment or DM me. If you think it should be radically different you can tell me that too. I'd urge as many OTs as possible to sign. Other professions and interested parties all welcome.

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Keir Harding

@Keirwales

7 years

Why are people with personality disorder so manipulative?

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Keir Harding

@Keirwales

5 years

This turned up today.

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Keir Harding

@Keirwales

3 years

For #worldmentalhealthday let's stop telling people who have lived through neglect, abandonment and abuse that their personalities are disordered.

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Keir Harding

@Keirwales

2 years

#OTweek2021 #OTsForEquity

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Keir Harding

@Keirwales

4 years

I keep going to placements & finding young girls diagnosed with BPD taking clozapine. They don’t know the side effects, they don’t know it’s against NICE guidelines and they are criticised for not being motivated (its hugely sedatating) I never see this in the community #NoOOA

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Keir Harding

@Keirwales

1 year

In case anyone missed it yesterday, @timkendall1 of @NHSEngland had to tell staff who are there to help people not to refer to patients as attention seeking and manipulative.

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Keir Harding

@Keirwales

3 years

Hard to think about #InternationalWomensDay without considering the women diagnosed 3:1 with Borderline Personality Disorder, who are often told their personalities are disordered after surving abuse, who are told they are disordered if they act as if others might hurt them...

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Keir Harding

@Keirwales

5 years

"We need to think...about how many of the girls & women on our caseloads are being told that their responses are abnormal & are caused by personality disorders, rather than... by the people who abused, oppressed, scared & harmed them" 👍 @Jessicae13Eaton

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Keir Harding

@Keirwales

2 years

For #BPDawarenessMonth let's put a different answer out there to the question: "What is BPD?" There's some other threads on this subject on twitter today, but this one is a bit different...

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Keir Harding

@Keirwales

4 years

"Psychiatry must decide whether its insistence on calling people disordered is worth the harm and alienation that results" My piece in @TheLancetPsych

Chris Jones

@clinpsychris

4 years

"We need to listen to our patients when they tell us that this terminology is harming them. They are unlikely to trust us to listen to them when we are insistent that the core of their being is disordered." @Keirwales on @rcpsych 's position statement on personality disorder.

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Keir Harding

@Keirwales

5 years

#RCOT2019 "We need a different word for social prescribing" Should that word not just be Occupational Therapy? (I ended up shouting that into the room).

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Keir Harding

@Keirwales

4 years

Everyone in work has been told so now the world can know - 6 more weeks in the NHS before devoting all my time to helping people and organisations avoid mental health placements that last years. Really hard decision to make but genuinely think I can be more effective outside.

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Keir Harding

@Keirwales

4 years

My vote has been cast. I'm urging all true Patriots to tick both Brexit Party and Conservatives so we can definitely #GetBrexitDone 🇬🇧🇬🇧🇬🇧

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Keir Harding

@Keirwales

5 years

It is #WorldSuicidePreventionDay Suicide is something that terrifies clinicians & organisations That fear means that those in our care sometimes dont get the best out of us. I wrote this a while back to help the struglling clinician I was 15 years ago

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Keir Harding

@Keirwales

7 years

New pinned tweet for suicide prevention month. (My first, and so far least popular, blog)

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Keir Harding

@Keirwales

28 days

I've got hugely mixed feelings about this. I hate the idea that because someone has a mental health diagnosis they can never make a decision like this, but to feel every option has been exhausted by 28? And have staff agree with you? Heartbreakingly sad.

Dutch woman, 28, will end her life by euthanasia next month

Zoraya ter Beek, who lives in a small village in the Netherlands , will be 'freed' early next month, she has claimed. She will be euthanized on the sofa in her home with her boyfriend by her side.

www.dailymail.co.uk

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Keir Harding

@Keirwales

4 years

So for anyone who hasn't seen NICE are now looking for an OT to join their committee on self harm Many thanks to @JuliaScottRCOT and @RCOT_JuliaR for following up on the members concerns and all of the people who put their names to the letter. Great result for #OTWeek2019

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Keir Harding

@Keirwales

6 years

Jointly written with @HoppyPelican , this is the most important thing I've written. For those who get forgotten on #WorldMentalHealthDay

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Keir Harding

@Keirwales

4 years

"We now frown upon doctors who used terms such as “moron” or “cretin” to describe those entrusted to their care. The term personality disorder will fare equally badly" My piece in @TheLancetPsych Full text via the link below 🙂

Words matter: the Royal College of Psychiatrists' position statement on personality disorder

January, 2020, saw the publication of the Royal College of Psychiatrists' position statement on personality disorder.1 In comparison with the current NICE guidelines,2 the statement sets out an...

www.thelancet.com

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Keir Harding

@Keirwales

6 years

It's that news that no one has been waiting for. I passed my dissertation and have an MSc ☺ Special thanks to @HoppyPelican @drnsgordon @robgpoole @aspin_gill @zelda_mulligan and @gladlib

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Keir Harding

@Keirwales

4 years

Well this is nice 🙂

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Keir Harding

@Keirwales

4 years

Some ways of reshaping the language often used around those given the label of 'personality disorder'. Let me know what you think.

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Keir Harding

@Keirwales

3 years

The summary of the new Mental Health White paper. It calls for more Occupational Therapists in mental health care! @JuliaScottRCOT @theRCOT @RCOT_MH

Reforming the Mental Health Act: summary

www.gov.uk

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Keir Harding

@Keirwales

8 months

Sometimes patients will be afraid about what might get written about them. You can reassure them about your work by opening the laptop at the end of the session and writing the entry together. Most will decline to do this, but the offer will tell them a lot.

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Keir Harding

@Keirwales

2 years

Just finished this from @JDaviesPhD It really gripped me and spoke to aot of thoughts I've had over the past few years about pathologising understandable distress.

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Keir Harding

@Keirwales

4 years

I'm highly recommending this podcast with @mrjamesob talking to @DrRosena The single minded precision focus on becoming a Dr against the odds is such a moving and inspiring story.

Full Disclosure With James O'Brien: Rosena Allin-Khan joins James

Labour MP Rosena Allin-Khan joined James O'Brien for this week's episode - and James described it as "one of the most uplifting episodes yet".

www.lbc.co.uk

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Keir Harding

@Keirwales

4 years

Can we do better than calling someone a paranoid schizophrenic?

Sky News

@SkyNews

4 years

Kevin Clarke: Police restraint of paranoid schizophrenic 'probably more than minimally' contributed to custody death

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Keir Harding

@Keirwales

10 months

This is someone who was recurrently suicidal after his firefighter father didn't come home on 9/11. What is the value of describing his personality as disordered?

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Keir Harding

@Keirwales

4 years

Been trying to get this published for at least 2 years. Absolutely delighted that it's made it. @CAMHSinCRISIS @NDTicentral

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Keir Harding

@Keirwales

3 years

New Blog!!! Why do those with a personality disorder diagnosis always sabotage (or do they?) I've been hearing his too much lately. Let me know what you think. Do share it around 🙂

Why those with a "Personality Disorder" diagnosis always sabotage (or do they?) — Beam Consultancy

“I can't stand it, I know you planned it” Sabotage, The Beastie Boys People with a diagnosis of

www.beamconsultancy.co.uk

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Keir Harding

@Keirwales

2 years

A better link to the BBC interview. Lets not tell traumatised people their personalities are disordered, let's make specialist hospitals genuinely specialist, and let's stop exporting people into private inpatient units.

[Video] Keir Harding on LinkedIn: #selfharm #rehabilitation #outofa...

This is me on the BBC talking about "personality disorder", the lack of specialism in "specialist" hospitals and the value of empathic, structured community… | 53 comments on LinkedIn

www.linkedin.com

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Keir Harding

@Keirwales

5 years

So I made it into The Times today to respond to a column by Matthew Paris on the weekend questioning the billions being poured into mental health. I disagreed with most of it.

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Keir Harding

@Keirwales

1 year

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Keir Harding

@Keirwales

3 years

@PeterFonagy - "saying someone has a personality disorder is inhumane" ❤❤❤ 'We need to abandon the term and use something that gives people dignity' Clearest I've heard this said from someone this influential #bigspd21

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Keir Harding

@Keirwales

4 years

Spot on @DrJessTaylor - I keep going to tribunals where people who have lived through multiple horrific experiences are defined as having a personality disorder that they were born with.

Dr. Jessica Taylor

@DrJessTaylor

4 years

Women and girls who have been raped or abused: You are not mentally ill.

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Keir Harding

@Keirwales

5 years

Very excited to talk to the BBC today about service provision for those who get a diagnosis of personality disorder. We covered stigma, trauma and the human and financial costs of not responding to people's needs.

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Keir Harding

@Keirwales

6 years

#MHTWales18 "I self harmed for 3 years without anyone knowing before you told me I was doing it for attention."

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Keir Harding

@Keirwales

4 years

Only a letter but exciting none the less

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Keir Harding

@Keirwales

6 months

It is #OTWeek23 day 2. Occupational Therapists help people do what they want and need to do. Less managing symptoms, more helping people live.

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Keir Harding

@Keirwales

4 years

"The occupational therapists never accept no" Sorry about that @MichaelRosenYes @OT_Expert @theRCOT

Michael Rosen on his Covid-19 coma: ‘It felt like a pre-death, a nothingness’

Earlier this year, the beloved children’s writer spent six weeks on a ventilator with coronavirus. He talks about the magic of the NHS, the mismanagement of the crisis and how his near-death experi...

www.theguardian.com

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Keir Harding

@Keirwales

3 years

Couple of people in the family have caught covid but our first family member died of it today at the age of 53. Get vaccinated people.

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Keir Harding

@Keirwales

1 year

@Wonderweird88 It absolutely does depend on the situation but when someone weighs twice as much as the other and there's no obvious risk we can probably lean towards whatever makes the patient feel safest. 🙂

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Keir Harding

@Keirwales

4 years

It is Occupational Therapy week!!! #OTWeek2019 #ValueofOT Best career in the world? "You find that rather than stopping people from dying, you’re helping them to live" @OT_Expert @theRCOT @BillWongOT

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Keir Harding

@Keirwales

5 years

My response to yesterday's article on complex trauma and BPD in the Guardian #BIGSPD19

Therapists too quick to assume someone has a personality disorder | Letters

Letters: Keir Harding says those who have lived through trauma deserve better, and Ash Charlton says it is a myth that one of the biggest predictors for an adult becoming an abuser is if they have...

www.theguardian.com

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Keir Harding

@Keirwales

2 years

It is out! If you need to cite something outlining worries about Clozapine and "BPD", now something exists. All the best bits we're written by @hoppypelican and @dan_warrender

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Keir Harding

@Keirwales

3 months

One of the "brilliant" things about the personality disorder diagnosis is the way that it protects itself. Once you express dissent about the way you are treated, it becomes pathology. If this angers you, there is a criteria for that too. You're only angry because you're ill.

Nell

@NellAitch

3 months

‘Do they have a history of making complaints?’ 🥲🥲🥲

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Keir Harding

@Keirwales

1 year

Lots of negativity about mental health services lately. Most people are doing their best with zero resources. My last few times on an acute ward I didn't feel safe and I'm a 16 stone man who could leave whenever he wanted. An enquiry can't come soon enough

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Keir Harding

@Keirwales

5 years

First UK celebrity I've seen talking about being diagnosed with BPD

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Keir Harding

@Keirwales

6 months

Occupations are the things we do that are important to us. Occupational Therapists ensure we can do the things that make us live, not just survive. #OTweek23

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Keir Harding

@Keirwales

4 years

To ensure I have enough rejection in my life, this week I've submitted an article to a prestigious journal and applied to do a PhD. #OTWeek2019

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Keir Harding

@Keirwales

3 years

New Blog. A way to think and talk about diagnosis. Hope its useful.

"Borderline Personality Disorder" and "Being ill" — Beam Consultancy

In my day to day work I meet a lot of people who get the diagnosis of Borderline Personality Disorder. While few of them had ever been party to an in depth discussion about what this diagnosis...

www.beamconsultancy.co.uk

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Keir Harding

@Keirwales

2 years

We first pitched this article 18 months ago. 3 rejections later we are delighted to see that some worries about this practice will be published. Me, @HoppyPelican and @dan_warrender worked our guts out on this.

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Keir Harding

@Keirwales

4 years

People might remember me sharing the blog below which critiqued an OT textbook for describing those diagnosed with ‘personality disorder’ in very stigmatising terms. Today I learned it’s being withdrawn from sale due to the potential to cause harm

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Keir Harding

@Keirwales

3 years

Its a real privilege for people to let you into their lives, however briefly. The relationship we offer might be a very small adaption to the social environment, but its very important. #otweek2020 #chooseOT

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Keir Harding

@Keirwales

5 years

New blog in response to #panorama Not just those diagnosed with Learning Difficulties. Everyone who elicits worry in those who feel responsible for them is in danger of being sent out of sight and out of mind #InSightInMind

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Keir Harding

@Keirwales

1 year

Most important #OTHacks - You are a complex individual, occupational therapy is complex. If you have difficulties that get in the way of way you want/need to do and/or if the environment gets in the way, it will probably take more than a line of advice. You deserve help...

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Keir Harding

@Keirwales

2 years

#OTWeek2021 #OTsForEquity

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Keir Harding

@Keirwales

6 months

#otweek23

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Keir Harding

@Keirwales

3 years

First time I have ever had a personal training session. I was being taught how to squat by a powerlifting champion with 30 years experience. He described me as "The worst I have ever seen". 🏆🏆🏆

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Keir Harding

@Keirwales

6 years

So important. There's no good reason for 1:1 observation to be merely watching people. So much better to do things together.

Jo Safewards GMMH

@GmmhJo

6 years

Great to hear from our OTs about their project to increase engagement in observations aiming to reduce restrictive interventions. @KirstenOT94 @EllieMayOT #gmmhpositiveandsafe

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Keir Harding

@Keirwales

4 years

Really glad @theRCOT are lobbying for OTs to be able to prescribe (after appropriate training). I'm not desperate to hand out medication like smarties, but I'm baffled as to why we were excluded from the list of potential prescribers before.

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Keir Harding

@Keirwales

4 years

Sabotaging Splitting For attention Dont want to get better PD Just pd Typical pd Manipulative Playing staff off Better not to tell them their discharge date You're going to a 'specialist unit' Just behavioural Did it for no reason

🚀Hattie Taylor RN DN QN🌈

@hattierocket

4 years

I’d really like to work on encouraging uptake of more respectful language at clinical meetings. We need to bin some of the old phrases used historically and change the words we use to be more inclusive and person centred. Please could you help me by providing examples in replies

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Keir Harding

@Keirwales

3 years

#OTweek2020 #ChooseOT

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Keir Harding

@Keirwales

5 years

Sometimes I can feel a bit self conscious sat by myself in public places. I can't even guess by what factor that discomfort would be multiplied if a moomin came and sat next to me.

Fee McBee

@feemcbee

5 years

At the Moomin Cafe in Tokyo, if you go by yourself, they sit a Moomin with you so you won't be lonely 😢

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Keir Harding

@Keirwales

5 years

Not particularly exciting because I expected it all along, but my wife just won school librarian of the year 🙂

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Keir Harding

@Keirwales

3 years

If the most deprived households in England followed the NHS Healthy eating guide they would spend 75% of their income on food! #OTweek2021 #OTsForEquity This isn't an environment that promotes everyone functioning!

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Keir Harding

@Keirwales

5 years

New blog based on going to see the Joker last night. I was really impressed with how the film portrayed mental illness, especially in relation to violence. #JokerMovie #JokerFilm

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Keir Harding

@Keirwales

1 year

@HoppyPelican I make sure I work with consultant lived experience practitioners who can tell me when I'm being a knob. As you'll recall, this information was very hard to hear. 👍

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Keir Harding

@Keirwales

3 years

Always preface crisis team calls with "I'm calling from a warm bath".

Aura🌻

@Auras_Journey

3 years

So I called the crisis team this evening because I'm struggling with bad self harm thoughts. What was their advice? You guessed it.... HAVE A NICE WARM BATH 🤦🏻‍♀️ You can't make this shit up!

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Keir Harding

@Keirwales

4 years

We have a new member of the family....

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Keir Harding

@Keirwales

5 years

With 300 names in 15 hours I'm going to stop now Thanks to the OTs that added their names Special thanks to the other professionals who couldn't stand to see us excluded, particularly @Mental_Elf & @ShepherdPharm The SUs who added their names - Thank you. We do this for you 🙂

Keir Harding

@Keirwales

5 years

Draft letter to NICE which I will send on Monday. If you'd like to add your name either comment or DM me. If you think it should be radically different you can tell me that too. I'd urge as many OTs as possible to sign. Other professions and interested parties all welcome.

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Keir Harding

@Keirwales

3 years

Found my happy place.

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Keir Harding

@Keirwales

5 years

Some bleak thoughts about #MentalHealthMatters for #WorldMentalHealthDay2019 My letter in tomorrows Guardian

How can every mind matter in a broken mental health system? | Letters

Letters: Readers respond to the launch of the NHS Every Mind Matters campaign and share their thoughts on other mental health issues

www.theguardian.com

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Keir Harding

@Keirwales

4 years

Published today in the @BJOTeditor No one predicted this 20 years ago... Citations from @DrCConnell @MaryBirken @OliverDale10 @BPDFFS @normanlamb @MindCharity 🙂

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Keir Harding

@Keirwales

2 years

Can you spot the decoration that isn't supposed to be there?

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Keir Harding

@Keirwales

5 years

Matt Damon plays an Occupational Therapist in the movie Downsizing Matt Damon is Jason Bourne I am an Occupational Therapist Keir = OT Matt Damon = OT Matt Damon = Jason Bourne Jason Bourne = OT Keir = Jason Bourne I have scientifically proven I am Jason Bourne! #OTWeek2018

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Keir Harding

@Keirwales

10 months

Told my Dad I'd sent off a chapter for book He asked if it would trouble the best seller list I said it would probably be popular in the world of Occupational therapy He laughed and said "but that's a very small world isn't it." If I ever come across as desperate for attention..

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Keir Harding

@Keirwales

4 years

One of the most important things for me this week has been getting more people talking about the long term detention of those who self harm and feel suicidal. Delighted to see this in the Sunday Express today. #NoOOA

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Keir Harding

@Keirwales

3 years

Frequently wondering should we stop debating is it BPD, ASPD, CPTSD, PTSD, ASD and just try and understand what's going on for people. Diagnosis in this area is a mess. The replacement of one dustbin diagnosis with another seems a lot of effort for little reward. ☹

OT_Expert

@OT_Expert

3 years

I was actually going to raise this question with you @Keirwales ... I've often wondered if many people who have been given the diagnosis of having a Borderline Personality Disorder are in fact misdiagnosed, and actually are #autistic ... Just very misunderstood

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Keir Harding

@Keirwales

3 years

@abbielouise_OT

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Keir Harding

@Keirwales

1 year

Our first goal when working with someone is to form a trusting and validating relationship. Our second goal, doesn't really matter unless the first one is there.

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Keir Harding

@Keirwales

4 years

"We work in a system that demands accurate risk assessment – a task that no one has been able to manage so far” New blog. Don’t read it if it’s not the right time.

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Keir Harding

@Keirwales

5 years

Brilliant that value of activity is recognised, but it's not as simple as just doing something What stopped them just doing it by themselves? What gets in the way of them participating? How can it be adapted so they can benefit the most? @theRCOT @JuliaScottRCOT #ValueOfOT

Royal College of Psychiatrists

@rcpsych

5 years

The number of workers trained to prescribe social activities, like exercise groups and art classes, to patients is set to rise, under NHS England plans. Dr Daniel Maughan says social prescribing is a really important development in healthcare, alongside medical interventions

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Keir Harding

@Keirwales

4 years

Without sounding like a communist, could we think about nationalising the care of some of our most vulnerable people? We know private sector locked rehab stays are x2 those of NHS one. It's cheaper. It would be like a national health service

Priory mental healthcare chain set to be sold for £1bn

US owner Acadia confirms it has received several initial bids for UK group

www.ft.com

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Keir Harding

@Keirwales

1 year

We wondered if there was much of an appetite for OTs to think about #TheDarkSideofOccupation it would seem so. 😮

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Keir Harding

@Keirwales

3 months

I've said before that under resourced CMHTs used to firefight. Now they chose which fires to attend and which to leave burn. With lower resources and increasing demand there is a huge pressure to find reasons to decline to help people. These are the fruits of that policy.

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Keir Harding

@Keirwales

5 years

New blog to get people thinking about the Lived Experience Practitioner Conference in London on Friday. Hope people follow the day on #LXPLeaders19

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Keir Harding

@Keirwales

4 years

A more sinister reading of this statistic is that if you've lived through trauma, you're 13 times more likely to be told that your personality is disordered.

Keir Harding

@Keirwales

4 years

People diagnosed with BPD are 13x more likely to have lived through trauma.

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Keir Harding

@Keirwales

2 years

The absence of reflection and arrogance of this clinical note is staggering.

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Keir Harding

@Keirwales

9 months

Here's a thread no one has asked for looking at this from the recent #RCPsychIC conference. Is it BPD or CPTSD? Let's have a look 👇👇👇

Royal College of Psychiatrists

@rcpsych

10 months

Borderline personality disorder vs complex post traumatic stress disorder #RCPsychIC

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Keir Harding

@Keirwales

3 years

This is quite interesting. If you are not heterosexual your chance of being told your personality is disordered doubles. If the clinician focuses on whether 'symptoms' cause distress the bias disappears. Almost as if this dx is a judgement of difference

Diagnosis bias of borderline personality disorder high among LGB community

Some health care professionals allow their bias toward lesbian, gay and bisexual persons to show when diagnosing borderline personality disorder, says a University of Michigan researcher. This bias...

news.umich.edu

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Keir Harding

@Keirwales

12 days

I'm working with someone who has 20+ professionals involved. If you swapped 2 for a benefits adviser and a housing officer you could halve the people required It's absurd that MH professionals are needed for the distress caused directly by a broken benefit and housing system.

Keir Harding

@Keirwales

13 days

"Sunak also warned about the “the risk of over-medicalising the everyday challenges and worries of life” But perhaps the challenges of everyday life have ramped up. Perhaps the absence of housing, financial security and comfort exacerbate worries.

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