In a previous post I have written about the decision by NICE to re-consult on depression guidelines. This late stage development followed on from a briefing from a group of experts who felt the draft guidelines were “not fit for purpose”. This group of experts were “extremely concerned about significant flaws in methodology, lack of transparency and inconsistencies in the document.”

NICE have since confirmed that a meeting took place on the 27th April 2018 with the authors of the expert briefing and that this “was not minuted or otherwise recorded.” Given the call for transparency by this expert group I considered this most disappointing.

This is the backdrop to me writing to one of the signatories of this expert briefing, Professor Sir Simon Wessely, explaining that I was interested only in the transparency of the process and not the persons involved.

I have shared Professor Sir Simon Wessely’s initial replies to me. I have not shared the last few as they did not consider the subject at hand  and the content was about my approach to transparency. Professor Sir Simon Wessely finished his final communication to me with the word “Sink”.

I have an interest in language and how it is used. It is evident that only Professor Sir Simon Wessely will know what he intended in using “Sink” as his last word to me. The dictionary definition of sink is:

I have also heard the word “sink” used as a shorthand for “heartsink patients”

My great aunt, Muriel Fife Fairlie, was an Edinburgh artist and she painted her kitchen sink in 1977. As a wee boy it was a painting that I liked very much and I was fortunate to be left it after my aunt’s death. It now hangs in our house in Bridge of Allan.

An editorial in the current journal edition of Human Givens is titled Driving emotions, and makes reference to recent wider considerations on antidepressant prescribing, including the potential for dependence and withdrawal.  The Editors of Human Givens say in reference to the approach taken by the Royal College of Psychiatrists: “a driving need to protect status may sometimes lead to serious consequences.” It should be made clear that Professor Sir Simon Wessely is a past President of the Royal College of Psychiatrists and has not knowingly been involved in recent College activity such as this. However as President of the Royal Society of Medicine, Professor Sir Simon Wessely was involved in this Podcast on antidepressant prescribing with his wife Professor Clare Gerada where the arguments presented were fully aligned with those of the Royal College of Psychiatrists.

In summary:
We must listen carefully to the collected experience of those who have been prescribed antidepressants longer than is evidence based.

We also need to put caring conversations into practice “to break down barriers than can exist between patients and healthcare professionals, encouraging open and honest conversations which achieve positive outcomes for both parties.”

3 Replies to ““Sink””

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