Poor old Gazza
Poor old Gazza is in trouble again.
Paul Gascoigne was back in hospital last night after asking staff to give him a steak knife and then trying to drown himself in the bathtub of his hotel room. The troubled former England football star was being assessed by doctors after going "hysterical" at a top London hotel, it has been reported. Police were called to the four-star Millennium Hotel in Knightsbridge yesterday afternoon after staff became concerned about his condition.I am not a football fan but even I knew Paul Gascoigne was one of the great talents. He has not coped with the money, and the fame, and the alcohol. But what is to be done? One of the comments under the article infuriated me:
Daily Mail
Will we have to wait until he's hurt himself or someone else before the medical profession takes note? Why release him after two weeks? - he obviously needs long term care and treatment. Isn't there someone in his life who can work with him towards this? If you are suffering mentally, you just can't be relied upon to take care of yourself and this goes for everyone, not just an ex-footballer. The help for people with these problems in our civilised, developed, western country is absolutely disgusting. No one cares until a death occurs and then it's crocodile tears all round. This poor man NEEDS proper, long-term treatment. The NHS needs an overhaul and the laws need sorting out.Thanks Mavis, but precisely why is the medical profession at fault? What do you mean by asking doctors to "take note?" It's a free country, Mavis. If you want to drink yourself to death, that is your right. If Gazza was not a famous footballer, I don't think you would be interested.
- Mavis, Manchester
Do you remember "Edna the inebriate woman"? Do you "take note" when you pass a tramp with a brown paper bag in the street, or do you shed your crocodile tears? And if you do "take note", Martha, what do you do next?
Labels: Edna the inebriate woman, Hypocrisy, Paul Gascoigne, tramps, what is an alcoholic
18 Comments:
Another George Best ! What do these guy's ever do to help themselves ?
I wonder will they name an airport after him after he finally implodes .........and that shows how much the people in Belfast have in their heads.
Maybe Manchester Mavis didn't express herself with the logic and eloquence that the medical profession is trained in.
However, she did seem to have her heart in the right place.
It seems to me that the medical profession doesn't have the answer(s) to Gazza's problems. It would be silly to blame it for that, but a little humility sometimes can go a long way.
This post has been removed by the author.
Mavis is right though isn't she? Mental health facilities and services in this country are appalling, so if Gazza was looking for care on the NHS, would he get it? Doubt it?
So not sure why poor Mav enraged you, you are over sensitive and over protective towards drs, actually I think she was talking generically about the HS not necessarily abot drs and definitely not about GP's ! As such .. How do you manage pts who ask for help who have problems like poor Gazza - is there help available - excluding drugs
This post raises interesting questions and goes to the heart of psychiatric (and medical) practice.
Generally people do lots of things that are not good for them. Doctors and their governments do have a responsibility to protect people from themselves to a certain extent but if we consider people as self determining, then they must take responsibility for their own actions as much as possible.
Psychiatrists are able to keep people in hospital against their will. This is called 'sectioning' and the legal framework for it is set out in the Mental Health Act. There are quite strict conditions for limiting someone's freedom in this way and if Gazza does not meet them then he cannot be kept in hospital, however worried medical staff and his family may be. There are such things as compulsory community treatment orders, but they couldn't be used to stop someone drinking alcohol, which I should think is at the root of Gazza's problems.
The person who made the comment in the Mail clearly had Gazza's best interests at heart. However, in the same way that we cannot compel people not to smoke then we cannot compel him to engage with psychiatric services, or stop doing things that hurt them. There is a tendency in some circumstances to think 'doctor, something must be done!', there is only so much we can do, or should do as doctors.
Mavis also seems to think that Gazza is receiving no treatment - we have no reason to believe this. He may be getting the best the NHS can offer - if this isn't good enough then write to your MP and ask them to lobby the Government and ask for more money for psychiatric services (let's remember that the population have a history of voting in tax-cutting governments...). Gazza could have afforded private treatment at one point, but he pissed all his money up the wall - is he not meant to take some responsibility for this?
"in the same way that we cannot compel people not to smoke then we cannot compel him to engage with psychiatric services" - true, although it would be helpful to many if there were adequate psychiatric services to engage with.
The two dominant theme's on this site are;
* the tortuous process of getting patients to the
right doctor at the right time.
* "dumbing down", in other words off-setting
increasing health costs by palming off more and
more patients to the (various) quacks.
But neither conditions apply in Gazzas case, yet he's still as mad as a box of frogs.
Booze has killed more men than bullets, but most men (even balding Geordies) would rather be full of booze than bullets.
Gazza may have "problems", but none that doctors have been able to do very much about so far.
people cannot be detained (against their will) under the mental health act - if they only have a booze diagnosis & do not have a co-morbid mental illness.
Hi A/E Charge nurse
Agreed. This is not about dumbing down and, oddly, for once it is not about lack of psychiatric services (much as there is a lack)
All doctors have a collection of patients with serious alcohol problems but sadly until such time as they genuinely want help there is precious little you can do. We all "take note" as Mavis said. What she does NOT say is what exactly she expects us to do.
Give me a plan.
JOhn
So when does "substance abuse", be it alcohol, drugs or whatever, become a mental health issue?
Working in A&E I've lost count of the number of times patients with drug/alcohol dependencey hasve presented in 'crisis'. Often with well meaning friends/family who are determined that this time he/she will 'kill the beast' and return to sobriety. I've also lost count of the number times I've walked out of the back door of the hospital and seen said 'convert' drinking, smoking or shooting up.
The main problem, in my opinion, is the medicalisation of these social/behavioural problems, I suspect it is often more about shifting blame/responsibility than it is about seeking treatment.
Whilst Mavis/Martha's sentiments about Gazza's predicament is laudable. I can't help thinking that the lachrymose Geordie needs to buck up and take some responsibility for his lifestyle and it's inevitable result.
"So when does "substance abuse", be it alcohol, drugs or whatever, become a mental health issue "
NEVER
Read the act -
Mental Health Act 1983 & amendments to become Mental Health Act 2007
see also The Mental Health (Northern Ireland) Order 1986 (No. 595 (N.I. 4))
See section 3 Mental Health Act UK & amendments etc
*** 1983 Act currently says that the definition of mental disorder shall not be construed as implying that a person may be dealt with under the 1983 Act as suffering from mental disorder "by reason only of promiscuity or other immoral conduct, sexual deviancy or dependence on alcohol or drugs. ****
source-
http://www.opsi.gov.uk/acts/acts2007/en/ukpgaen_20070012_en_1
Section 3: Changes to exclusions from operation of 1983 Act
23. Section 1(3) of the 1983 Act currently says that the definition of mental disorder shall not be construed as implying that a person may be dealt with under the 1983 Act as suffering from mental disorder "by reason only of promiscuity or other immoral conduct, sexual deviancy or dependence on alcohol or drugs." Section 3 substitutes for this a single exclusion stating that dependence on alcohol or drugs is not considered to be a disorder or disability of the mind (ie a mental disorder) for the purposes of section 1(2) of the 1983 Act (the definition of mental disorder).
24. Clinically, neither promiscuity nor "other immoral conduct" by itself is regarded as a mental disorder, so the deletion of that exclusion makes no practical difference. Similarly, sexual orientation (homo-, hetero- and bi-sexuality) alone is not regarded as a mental disorder. However, there are disorders of sexual preference which are recognised clinically as mental disorders. Some of these disorders might be considered "sexual deviance" in the terms of the current exclusion (for example paraphilias like fetishism or paedophilia.) On that basis, the amendment would bring such disorders within the scope of the 1983 Act.
25. The use of alcohol or drugs is not, by itself, regarded clinically as a disorder or disability of the mind (although the effects of such use may be). However, dependence on alcohol and drugs is regarded as a mental disorder.
26. The effect of the exclusion inserted by this section is that no action can be taken under the 1983 Act in relation to people simply because they are dependent on alcohol or drugs (including opiates, psycho-stimulants or some solvents), even though in other contexts their dependence would be considered clinically to be a mental disorder.
27. It does not mean that such people are excluded entirely from the scope of the 1983 Act. A person who is dependent on alcohol or drugs may also suffer from another disorder which warrants action under the 1983 Act (including a disorder which arises out of their dependence or use of alcohol and drugs or which is related to it). Nor does it mean that people may never be treated without consent under the 1983 Act for alcohol or drug dependence. Like treatment for any other condition which is not itself a mental disorder, treatment for dependence may be given under the 1983 Act if it forms part of treatment for a condition which is a mental disorder for the purposes of the 1983 Act (see section 7 below for the definition of medical treatment).
See section 3 Mental Health Act UK & amendments etc
*** 1983 Act currently says that the definition of mental disorder shall not be construed as implying that a person may be dealt with under the 1983 Act as suffering from mental disorder "by reason only of promiscuity or other immoral conduct, sexual deviancy or dependence on alcohol or drugs. ****
source-
http://www.opsi.gov.uk/acts/acts2007/en/ukpgaen_20070012_en_1
Section 3: Changes to exclusions from operation of 1983 Act
23. Section 1(3) of the 1983 Act currently says that the definition of mental disorder shall not be construed as implying that a person may be dealt with under the 1983 Act as suffering from mental disorder "by reason only of promiscuity or other immoral conduct, sexual deviancy or dependence on alcohol or drugs." Section 3 substitutes for this a single exclusion stating that dependence on alcohol or drugs is not considered to be a disorder or disability of the mind (ie a mental disorder) for the purposes of section 1(2) of the 1983 Act (the definition of mental disorder).
24. Clinically, neither promiscuity nor "other immoral conduct" by itself is regarded as a mental disorder, so the deletion of that exclusion makes no practical difference. Similarly, sexual orientation (homo-, hetero- and bi-sexuality) alone is not regarded as a mental disorder. However, there are disorders of sexual preference which are recognised clinically as mental disorders. Some of these disorders might be considered "sexual deviance" in the terms of the current exclusion (for example paraphilias like fetishism or paedophilia.) On that basis, the amendment would bring such disorders within the scope of the 1983 Act.
25. The use of alcohol or drugs is not, by itself, regarded clinically as a disorder or disability of the mind (although the effects of such use may be). However, dependence on alcohol and drugs is regarded as a mental disorder.
26. The effect of the exclusion inserted by this section is that no action can be taken under the 1983 Act in relation to people simply because they are dependent on alcohol or drugs (including opiates, psycho-stimulants or some solvents), even though in other contexts their dependence would be considered clinically to be a mental disorder.
27. It does not mean that such people are excluded entirely from the scope of the 1983 Act. A person who is dependent on alcohol or drugs may also suffer from another disorder which warrants action under the 1983 Act (including a disorder which arises out of their dependence or use of alcohol and drugs or which is related to it). Nor does it mean that people may never be treated without consent under the 1983 Act for alcohol or drug dependence. Like treatment for any other condition which is not itself a mental disorder, treatment for dependence may be given under the 1983 Act if it forms part of treatment for a condition which is a mental disorder for the purposes of the 1983 Act (see section 7 below for the definition of medical treatment).
I remember Gaza playing against Scotland in Euro ‘96 when he flicked the ball sideways over a defender as he was running towards goal, collected the ball as it returned to earth and scored all in one instinctive graceful move. I am not a football fan either but it was poetry in motion and the moment has stayed with me ever since. It’s a shame how he has ended up.
http://www.youtube.com/watch?v=fafsK9XK1ms
We seem to be moving to a society where nothing is ever the fault of the person affected. I heard a good excuse on TV from an alcoholic (Jeremy Kyle, my addiction)it wasn't her fault she got drunk it was the fault of the person serving the drinks,the measures were too large.The no blame culture means we can divorced ourselves from the consequences as we're the victims too.
But it wasn't just the goal that was sublime, 'e'.
There was also Gazzas exuberant celebration.
Remember Gascoigne lying prostrate while an isotonic solution was squirted into his mouth with torrential force - the afficiandos immediately recognised this iconic moment as the Geordies bid to re-enact infamous 'dentist' incident.
Gazza, Sheringham and McMannaman had all been bollocked during Englands build up to Euro '96.
The three boozy internationals were photographed gulping copious amounts of alcohol in a dentist chair - they were celebrating Gazzas 29th birthday a time when he had the (football) world practically eating out of his hands.
Even then everybody knew Gazza was daft as a brush but he was indulged largely because of his prodigous talent.
Sure that was an isotonic solution and not a Geordies attempt at re creating Urolagnia?
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