Rotten Bottom

In the certain knowledge that you will all be devoting this long weekend to considering how to vote in next week's election I offer links to the manifestos of the four major parties here:

Conservative

Labour

Liberal Democrat

Plaid Cymru

And for completeness on the Alternative Vote referendum...

Yes to AV

No to AV

And read Mental Health Wales' "Election Special" to get the mental health angle.

Good luck with all that. Personally I have done the studying already and voted by postal ballot. There is therefore a choice of staying in to watch the Royal Wedding or setting out on my first fishing expedition of the year.

The angling blogs indicate that mackerel were getting caught in numbers from West Wales marks last weekend but that will be the very hot weather. My main target will be pollack and perhaps wrasse. I have been taking advice in the bait shop in Neath where the consensus is to float off the rocks with the hook hanging deep below so the pollack can swim up to it (they swim around near the bottom looking upwards for prey).

But my old angling book suggests getting the hook down there two feet above a weight on the sea-bed (i.e. just high enough to stop crabs nibbling the bait). I like the sound of this as it gets the bait exactly where you want it, but it has the disadvantage of making it likely that you lose tackle in the weed, necessitating use of the amusingly-named "rotten bottom" rig - a flimsy line and worthless weight which can break off leaving your hook and line intact above. Old spark plugs make good throwaway weights but are frowned upon now for mysterious environmental reasons. Pebbles with a loop of ribbon super-glued on might work - I'll report back.

Syrups, Drugs and Holy Prayers

Just back from five days in Bristol over Easter. The weather has been stunning and seemingly every Bristolian has been sitting out on the grass or the old dock sides consuming picnics and cider.

We are outside too most of the time but take in a performance of The Comedy of Errors by the resident company in the Tobacco Factory Theatre. I've seen their productions before and this one is up to their excellent standards, giving depth and feeling to what can seem a slight and rather silly play. But in the tradition of this blog I must now artificially draw out the mental health interest...

In fact none of the characters has a significant mental health problem but (before you sigh with relief that this post won't bang on too long) there is significant interest because all four main characters (two pairs of identical twins each pair improbably sharing the same name - so two called Antipholus and their servants two Dromios) are misdiagnosed as psychotic and attempts made to restrain them and compel them to treatment. The mistaken diagnosis arises because of confusion between the identical twins, leading them to appear to act irrationally (but I won't try to explain the plot).

In a key scene one of the Antipholuses' wife brings a psychiatrist Dr Pinch plus burly attendant nurses to "section" Antipholus which he duly does, sweeping up one of the Dromios as well on a snap diagnosis. Shakespeare certainly didn't waste his time researching the equivalent of the Mental Health Act operating in Ephesus where the play is set so he is probably describing what he thinks might happen in Elizabethan England. It is not clear precisely what legal instrument the doctor uses to detain his patients but his diagnostic tool-set is rather limited:

Mistress, both man and master is possess'd;
I know it by their pale and deadly looks

And his proposed course of treatment looks cautious and unambitious:

They must be bound and laid in some dark room

Later on the other Antipholus is "voluntarily admitted" to a hospital where the Abbess (actually the Antipholuses' mum but nobody realises this until later) describes her therapeutic approach which looks a lot bolder, combining both medication and talking therapies:

Be patient; for I will not let him stir
Till I have used the approved means I have,
With wholesome syrups, drugs and holy prayers,
To make of him a formal man again

Fortunately the Abbess doesn't get around to using these treatments before the misunderstanding is cleared up. Meanwhile the other two patients overpower Doctor Pinch and set fire to his beard in revenge for his hasty and inaccurate diagnosis and less than empowering care and treatment plan. This turning of the tables certainly offers some cathartic if cruel satisfaction to anybody in the audience who has suffered unfair treatment at the hands of mental health services...


Postscript

Cycling to Bath and back, an annual ritual, is less painful than I feared but why does fat move in middle age from its useful location on your backside - providing a portable cushion ideal for bike saddles and other hard seating - to the pointless one on your stomach? Evolution (or a benevolent Creator - take your pick) seems to have slipped up on that one.

A Car, a Tank, and a Private Aeroplane

Having just happily revisited childhood in my last post I find a lot of interesting stuff to look at in the latest Assembly Government "Children and Young People's Wellbeing Monitor" (see our story with links here).

I was particularly struck by the supplementary report "Voices of Children and Young People in Wales Study" (direct link here) which presents a series of quotations from children and young people, many of them penetrating.

I hope the writers of the report, who should be congratulated for letting children and young people speak for themselves, will not mind me saying that their line of questions (evidently set in the strange language of "wellbeing") is comprehensively trumped by the more expansive responses they received.

The section on psychological wellbeing (page 48) is not the most interesting in terms of insight into that very issue because the answers to practical, "real" questions about family, friends, money, and so on unsurprisingly yield much more depth.

The section on ambitions for the future is the best, illustrating the decline with age from a clear and lucid goal...

I'd want a car, a tank, and a private aeroplane - 9 yr old boy

... to the reality of uncertainty and cynicism...

I know what I want to be. I know it’s not going to like work out because mostly when you leave school it never works out like you want it to. But like I want to study all the stuff and be like a lawyer and just do something like that. Why wouldn’t that work out? You could do it, but it’s not easy when you leave school. Everyone says when they’re younger "I want to be blah, blah, blah, I will be blah, blah, blah" - 13 yr old girl

She should persevere. She already sounds like my lawyer.

See Hafal's site for young people here.

Eternal Summer

I write sitting at my desk in blazing sunshine. Once in a while the weather lives up to that seemingly eternal summer of early childhood which most people happily if falsely recollect. This sensation of early youth is reinforced by wearing shorts (don't worry, no pictures) and drinking orange squash. It is serendipity that the torrent of bank holidays is also almost upon us. I hope your cup is as full as mine as I go home to oil my bike chain and extract fishing tackle from the depths of the cwtch-dan-star.

However, it would be an exaggeration to say that Wales is sweltering because of election fever. One of the drawbacks of devolution (among many benefits) is the proliferation of elections with the attendant risk that any one election may seem less important. Add to that the continuing assumption of many (to judge by turn-out) that the Assembly election is less important than the General Election - not of course wholly without reason as undevolved matters like taxation and declaring wars do matter.

But we need to show people how much hangs on the Assembly elections and it is good to see that Hafal's Service User Champion Sue Barnes has used the opportunity of her latest column in the Western Mail to flag up the relevance of the forthcoming poll for people with a serious mental illness and their families (see Sue's full article on this link).

Meanwhile Hafal's manifesto is getting a tremendous response from candidates of all parties, many of whom have responded supporting patients' and families' call for them to...

(1) Protect funding for mental health
We need candidates’ assurance that they will fully protect resources for
mental health, both NHS funding and funding provided to local authorities for
mental health social care. We are calling on all candidates and all political
parties to ensure that Health Boards and Local Authorities are held to
account for their spending on mental health services, that any efficiency
savings are re-invested back into mental health and that there is clear and
transparent financial reporting of this.

(2) Deliver on new Mental Health law and regulations
The Mental Health (Wales) Measure (the new mental health law) was passed
last year with cross-party support. We need candidates’ assurance that the
Measure will be delivered in full and that the Regulations and Code of
Practice are developed with our rights in mind, ensuring that every person
with a serious mental illness has an holistic care plan covering all areas of life.

(3) Put patients in the driving seat
Service users and carers know that positive change is only possible if we roll
up our sleeves and take charge both of our own circumstances and of wider
services. We need candidates’ assurance that they will empower us to
choose the services we personally receive and also to have a full say in
developing policy and commissioning mental health services.



Postscript:

Weaselly cynics concerning democracy like Karl Marx mock the "pointlessness" of being able occasionally to "choose your oppressors" at elections and of course it's true that democratic systems don't automatically lead to freedom and equality. But the answer to those cynics was worked out long ago. Aristotle wrote: εἴπερ γὰρ ἐλευθερία μάλιστ' ἔστιν ἐν δημοκρατίᾳ, καθάπερ ὑπολαμβάνουσί τινες, καὶ ἰσότης, οὕτως ἂν εἴη μάλιστα, κοινωνούτων ἁπάντων μάλιστα τῆς πολιτείας ὁμοίως (rough translation - It's widely recognised that democracy is the best system for achieving freedom and equality but to really work it has to mean maximising equal engagement of all citizens in the continuing business of government).

What the ancient philosophy wonk was driving at is that the elections are important but you've also got to sustain people's involvement all the time, keeping the politicians as our servants not our masters. That's what point (3) above is all about.

Chicken-of-the-woods

Admiring the bluebells in our local wood today I spot a cluster of the brightly-coloured bracket fungus known as chicken-of-the-woods (laetiporus sulphureus) on an old tree high above the path. A determined climb gets me alongside and I harvest two pounds of this gastronomic treat (it's £50 a pound in London's fancy foodie mecca Borough Market).



Back home most of the delicacy is dried and stored - it's a very good substitute for dried penny bun (boletus edulis - or ceps or porcini as Hugh Fearnley-Whatsisname and his fellow gastropornographers would call it) and we have the rest for dinner fried in olive oil with shallots, garlic and rosemary on a bed of wild garlic from the same wood.

The recipe is from Franco Taruschio who used to run the Walnut Tree near Abergavenny, in those days the best restaurant in Wales. Yum: it does resemble chicken in texture but the flavour is like fresh mushrooms plus a scent of sweet tobacco - very like the more famous penny bun eaten the world over.

Two years ago I found a specimen of chicken-of-the woods weighing over 60 lb - not unusual and could be profitable if you could get it to market quickly (easier said than done). Needless to say you shouldn't pick and eat fungi unless you know what you are doing. I only pick a few very recognisable types which can't be confused with the deadly ones. Even chicken-of-the-woods, though accepted as an edible species, disagrees with some people.

Catherine the Great

The revelation by her publicist of Catherine Zeta Jones’ experience of bipolar disorder has resulted in more media approaches to Hafal than any previous news. This reflects both the age-old interest in celebrity and that particular curiosity about the private lives and vulnerabilities of famous people. The contact results in a number of appearance by Hafal users and staff during the day where we try to strike the right balance between respecting Ms Jones’ privacy and explaining the implications of the diagnosis which she has decided to make public (one suspects on advice about “least worse” news management rather than a desire to share her problem – such are the dilemmas of famous people). You can see Hafal’s own story on this here.

Media coverage has mainly been sympathetic if embarrassing for the actress herself. Meanwhile it is not her responsibility to do so but she has sent out a positive message by explaining that she is much better and looking forward to new work challenges. That will help to correct those who doubt it that getting back to work is a realistic expectation for most people who experience a serious mental illness.

Our Catherine has been a good ambassador for Wales and perhaps she will now be an even better one by showing continued success notwithstanding the challenge of her illness. I think Welsh people, indeed all people, will take her to their hearts all the more.

The media are learning that it is not in fact the mood of the public to mock, ridicule, or demonise people who “come out” about their mental health problems. Those of us who wish to combat discrimination should have a care not to wag fingers patronisingly at the public or assume their hostility towards people with problems (an approach which also has the effect of reinforcing the fears of people with a mental illness – who tell me that they overwhelmingly experience kindness and care when they tell people about their difficulties). The emphasis should be on building on the public’s general good will and willingness to learn and providing advice and training to key people in the community about avoiding discrimination in practical matters such as employment.

The small number of people who do choose to mock and oppress people with a mental illness won’t listen to clever publicity but must be frozen out by active public intolerance of their behaviour and, where appropriate, by application of the law.

Bass Notes

I’m up in Colwyn Bay again for our quarterly North Wales meeting of senior staff and Trustees. Last night at Enoch’s chippy I take the agonising decision to forego the battered cod in order to try the special - local bass baked with butter and parsley. Fortunately the gamble pays off as the fish is perfectly cooked and so fresh that you can certainly taste the sea and, in my imagination, hear the gulls screech and the waves crash against the treacherous eastern spur of Môn...

Snapping out of this reverie over a creme egg and cup of tea back in the Travelodge I contemplate what I need to report at our meeting and realise that for a few weeks three major campaigning strands overlap. Let me try to summarise these:-


Measure Regulations

The local consultation events have finished and looking back we are pleased that our position, summarised in our “Sue’s View” bulletins, was very widely supported at the events. But the consultation period continues and we are encouraging written responses to the Assembly.

Follow this link to see how you can join the hundreds of users, carers, and professionals who have already supported Sue’s View!





Assembly Election

Hafal’s election campaign got off to a great start with the publication of our Manifesto fronted by Expert Trainer Dave Smith and coverage in ITV’s “Wales Decides” election special on health including interviews with Hafal’s Shaz Harris and me.

See the election Manifesto, which has now been sent to all election candidates and has already received many messages of support from them, on this link and use it to collar your candidates and check them out on their mental health credentials .





"Taking the Wheel"

We have just announced our summer campaign in partnership with the Mental Health Foundation and MDF the Bipolar Organisation. This is already in the public domain in order to encourage public participation but will start in earnest immediately following the election at our Seminar on 12 May.

See details of the summer campaign aimed at promoting real empowerment of people with as serious mental illness on this link and please contact us if you want to join in on one of the 25 events this summer!





Busy times but a sense that we are achieving great progress in spite of the lean economic environment.


Postscript:

In view of my previous disapproval of gambling (see this post) I hesitate to own up to a further flutter but must report that I entered and won the Hafal Head Office Grand National Sweep, my £1 stake earning a useful £44 - good odds and no tax to pay (is this illegal?). In order to quell any Libya-style rebellion which might be triggered by this suspicious result (though I had no hand in organising the book) I feel compelled to pitch the cash reluctantly into the Christmas party fund.

Campanology

I am startled yesterday morning to read in the Daily Torygraph that a Professor Roberto De Mattei has asserted that the Roman Empire collapsed because of a "contagion of homosexuality and effeminacy". The article is wryly illustrated with pictures of Frankie Howerd as Lurcio in Up Pompeii and Laurence Olivier being bathed by Tony Curtis in Spartacus - plus, by way of "contrast", rugged Maximus in Gladiator (though I thought Russ Crowe looked quite gay in that too).

A few hours later this all rings a bell as I bop in the O2 (what used to be the notorious Millennium Dome of vile memory) as one of 20,000 attending Kylie Minogue's Aphrodite Les Folies concert. This is the biggest, campest extravaganza I have ever seen and based on classical themes - Kylie in a diaphanous white peplos emerging from a sea-shell like Aphrodite, Kylie being dragged in a chariot by oiled-up slaves in S&M leather harnesses, Kylie in a helmet surrounded by mini-skirted graeco-roman (male) dancers etc., each tableau of the tiny Welsh-Antipodean diva more eye-popping than the last until she finishes with big hair and the trademark hot-pants to send us on our way. Check out this sample from last night (not taken by me) to see what I mean. The audience is an odd mixture of three groups: young gay men, women d'un certain âge like Mrs Blog who have followed Kylie from her girl-next-door days as Charlene, and young girls who think K is absurd but can spot a good ironical night out when they see one.

The music is, well, Kylie but the acoustics are rubbish not I suspect for technical reasons but because it is the modern way just to pump up the bass and to hell with the detail. The last concert which I attended in a huge venue was Bob Dylan (before he became a prat) at Earls Court in 1978. The music was loud but completely clear - I remember his saxophonist got a big cheer at the end for his bravura contribution which couldn't have been discerned without clean sound. But then Kylie isn't Dylan.

And what of Professor De Mattei's thesis? It turns out he has form in interpreting history to justify conservative viewpoints in the Catholic Church so nobody takes him seriously. In fact the whole Roman thing was pretty gay from the start - at the risk of stereotyping from the early Republic onwards there were the simultaneously militaristic and louche hard men, the larger-than-life matriarchs scheming for their boys, the bath-house politics, etc. I'm not exactly saying that Rome fell because it stopped being sufficiently gay but Gibbon probably got it righter than the pious professor by blaming Christianity for the fall of Rome - though the boring explanation of mass movement by vast Germanic tribes has to be acknowledged too.

Hell in a Handcart

News that prescription of anti-depressant drugs has increased by 40% in the last four years (see the story here) should be treated as a national catastrophe, not because it indicates a 40% increase in depressive illnesses (which it surely does not) but because it signifies the "normalisation" of drug-use to address personal problems.

The figure coincides with a big increase during that period in talking therapies in England so the only conclusion must be that people are much more likely to resort to (primary) mental health services when they encounter personal problems.

Is that a good thing? Many in the mental health establishment (and including the "progressive" third sector) think so but these statistics should make them think again.

Of course it is a good thing if people with significant mental health problems seek assistance early but if the consequences of seeking that assistance is that they are routinely prescribed anti-depressants (and increasingly people expect them to be prescribed) then they are being very badly served. And if troubled people without mental health problems are being prescribed these drugs (which they surely are) then we are on the way to hell in a handcart.

And talking therapies also aren't the answer for most people encountering even serious personal problems (though at least such therapies will not blunt the resolve of people to address their problems as the drugs inevitably do). Their best point of help is friends, family, and practical advice from the likes of the CAB and other action-orientated support.

Talking therapies should be available for people who have significant mental health problems, meaning at a minimum that (i) their anxieties, sadness and troubled thoughts are out of proportion to their actual situation and (ii) the natural processes of resolution which work for most of us most of the time are stuck so the person cannot move on.

Short of this kind of situation we are much better off keeping well clear of mental health services which have a baleful record of misunderstanding the human condition and consequently mistreating (I mean literally in the sense of providing the wrong treatment) and disempowering people.

Some public health enthusiasts do not seem to understand the risk of inviting the public to see life as some kind of exercise in "maintaining mental health", a concept which is either completely meaningless (because saying no more than that we should try to stay happy) or sinisterly undermining of our good instincts to look after ourselves in our own way without resort to the unnatural, mechanistic, and disempowering language of mental health services. Incidentally this unhealthy message is being reinforced by New Age "therapists" who offer an alternative but equally illusory path to "mental wellbeing", usually for good money exacted from vulnerable customers.

Until recently there was a healthy distrust of involving mental health services in assisting children which might have served as a useful model for getting such services out of the faces of most adults too. Sadly, no I should say scandalously, this principle is also being lost as mental health services resort routinely to drugging children who are troubled (or, I suspect, just troublesome). We should certainly think twice before allowing mental health service insiders to induct children into their way of thinking about wellbeing.

That takes us back to the issue of the anti-depressants. I firmly believe that such drugs should be treated as a very last resort, to avert risk and extreme distress, because they operate on the principle not of helping people resolve problems but rather of taking their minds off those problems.

Anti-depressants are the wrong treatment for the great majority of real mental health problems. They are always the wrong treatment for people who do not have mental health problems but are sad, anxious, concerned about their job, etc, in a proportionate way - because those people may well need help but they don't need mental health services or treatment.

But in practice the use of these drugs is exponentially out of control and mental health services (with the connivance of thoughtless and facile media obsessing about drugs and therapy alike) are rapidly losing sight of what it is to be a human being and interfering with apparent alacrity in our natural hopes and fears, inviting us to replace our freedom and good instincts with their drugs and therapies.

And what of serious mental illness? The same principles apply. Drugs, in particular anti-psychotics, are commonly used to treat serious illness and we should not condemn that but certainly we should challenge the assumption that drugs are always required or that they are the single, central plank of treatment. I suspect that anti-depressants are also over-used with high-needs patients, though their use in reducing risk and helping people manage extreme distress should be acknowledged.

The greatest scandal in mental health services is the lack of talking therapies for people with a serious mental illness. This is partly a matter of resources but the fundamental problem is the failure of services to acknowledge the humanity of patients who still commonly report not just a lack of formal talking therapies but negligible or non-existent warm personal contact of any sort even (or especially) in extremely expensive services such as acute inpatient units.

There have been some improvements but only recently patients have told me that the only friendly words in hospital came from fellow-patients and the cleaners, the latter presumably because they didn't see themselves as providing mental health services. Work it out.



There is no psychology; there is only biography and autobiography - Thomas Szasz

Inspirational

Today I attend the launch of Hafal's newly qualified team of Expert Patient Trainers (EPTs) at our National Resource Centre, St Fagans: some of them are in the pic above.

Hafal’s EPTs, supported by funding from Comic Relief, are people with experience of serious mental illness including schizophrenia and bipolar disorder who have made strides in their recovery and have now decided to become mental health trainers in order to share their expertise in managing illness and mental health recovery, planning and delivery of mental health services and a range of related issues so that others (patients, professionals and the general public) can learn from them.

Hafal's Dave Smith, himself an EPT who has led the training, says: “I have seen how others, like myself, who have experienced an enduring and serious mental illness, have developed their training skills and grown in confidence and I have seen the great benefits to those receiving training. After a recent session I was told by one mental health professional: ‘This is how training should be done, I have learnt so much more by being trained by Expert Patient Trainers'."

Hafal has pioneered training by patients, many of them qualified, over recent years but the time is right to build up a substantial, fully qualified team working to national standards in all parts of Wales. To become an EPT our trainers undertook Agored and City and Guilds 7300 training which enables them to deliver a dynamic curriculum covering a range of issues from the broad to the technical and which can assist mental health professionals and wider groups alike.

We really must overcome not just the habit of keeping patients right out of training but also that tokenism (almost worse than having no patient involvement) which sees patients wheeled out in training sessions to describe their life story without context and then leaving the "serious training" content to the "experts".

It is long overdue for mental health policy and services to be guided by people with personal experience. Hafal’s EPT initiative could help put Wales in the vanguard of progressive practice in patient leadership but we will have to overcome the many (mainly unconscious or unintentional) prejudices among practitioners, managers, and senior policy-makers (and, yes, including the third sector) which stand in the way.

After lunch we have a really valuable discussion about the decision which about half those present have taken to go public on their experience in order to promote change. The experience of each is different but there is a common factor in that reactions from acquaintances and the wider public were universally positive and the trainers concerned had evidently themselves experienced catharsis and a sense of "moving on by coming out".

I speculate that there might be a critical mass in realistic sight where it becomes normal to be "out" and not such a big deal to discuss mental illness openly. People seem to think this is possible.

Meanwhile it is moving and inspirational to work with this growing number of pioneers who have a dream and courageously mean to achieve it. But it is hard work and needs to be done well.



As Dr King said "All labor that uplifts humanity has dignity and importance and should be undertaken with painstaking excellence".

Ramson Note

A lazy weekend mainly flopping around the house but I finally get out on Sunday afternoon for an hour's walk. The sunshine has been so consistent that I have no waterproof and so I am caught out by a cloudburst and have to shelter in the wood until the rain passes. This leads me to explore a hollow, dead tree which I have noticed before. It won't stand another year I estimate so I get pictures including an inside view (click on the pics to see the detail).




Also in the woods the wild garlic (or ramsons) is now at its best. Easily found by smell (even from your car: just wind down the window and drive slowly through wooded areas) it makes great salad leaves, pesto, or flavouring for other sauces. Don't mistake it for lily of the valley - they do look similar but the smell is the definitive proof. Mrs Blog is even making a fiver a bag selling it to a local restaurant.

Meanwhile the bluebells aren't really out yet except at the margins - sheltered spots in the sun at the edge of the woods like this example snapped before the downpour...

Press Button B

Our election campaign (link here as promised) has got off to a great start with one of Hafal's growing number of Expert Patient Trainers Sharon Harris from Merthyr setting out the consumer perspective for ITV's election special on health (Wales Decides, ITV, Tuesday 10.30 pm).

Their health correspondent Mariclare Carey-Jones also interviews me leaning nonchalantly against the campaign microbus, giving the impression that I'm on my way to harangue the public through a tannoy to "Vote for Mental Health!".



All credit to ITV for making some serious programmes about the election and let's hope we get a better turn-out than the recent referendum on Assembly powers (though that was better than many feared).

A reminder of what patients are seeking from candidates...

1. Protect funding for mental health

We need candidates’ assurance that they will fully protect resources for mental health, both NHS funding and funding provided to local authorities for mental health social care. We are calling on all candidates and all political parties to ensure that Health Boards and Local Authorities are held to account for their spending on mental health services, that any efficiency savings are re-invested back into mental health and that there is clear and transparent financial reporting of this.

2. Deliver on new mental health law and regulations

The Mental Health (Wales) Measure (the new mental health law) was passed last year with cross-party support. We need candidates’ assurance that the Measure will be delivered in full and that the Regulations and Code of Practice are developed with our rights in mind, ensuring that every person with a serious mental illness has an holistic care plan covering all areas of life.


3. Put patients in the driving seat

Service users and carers know that positive change is only possible if we roll up our sleeves and take charge both of our own circumstances and of wider services. We need candidates’ assurance that they will empower us to choose the services we personally receive and also to have a full say in developing policy and commissioning mental health services.



Meanwhile it remains to be seen whether the simultaneous AV referendum on 5 May upsets the electorate in any way. I suppose the fact that people are voting for AMs in Wales using the "additional member" system at the same moment as deciding whether to adopt the very different "alternative vote" system for Westminster could either confuse or possibly irritate people.

Postscript:

My personal confusion is with the postal voting package which falls on my door-mat. You'd expect to get just a ballot form and an envelope to send it back in but, no such luck, there's a flurry of different bits of paper marked A and B plus impenetrable instructions about folding it in unfamiliar and counter-intuitive ways. You may scoff at my problem but this is surely discrimination against those short on spatial aptitude and origami skills.

My theory is that the ballot papers were designed by the same person who invented those phones with buttons A and B which nobody could make work even with the operator supervising your call. The operator checked if you had put the money in by listening out for a little bell which the coins struck as you put them in. In about 1976 I had an argument with an operator in Cork (the Irish Republic had these phones until much later) who I'm sure miscounted the tiny chimes as my florins were fed in so I didn't have enough. I then lost the precious coins because she vengefully prevented me using Button B to retrieve them, I suspect owing to a long-lasting grievance about the Black and Tans or similar rather than our minor contretemps. After 35 years and in the spirit of reconciliation and the Irish Peace Process I hereby forgive her.