Cautiously pessimistic UCL old age psychiatrist | Improving dementia + mental health treatment | Real critical psychiatry | Layla | Clinical academic training
London and Norfolk
Joined November 2015
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Robert Howard retweeted
Approximately 12,000 Palestinian Arabs volunteered to serve in the British military during WWII, fighting in mixed or separate units alongside Jewish volunteers from Mandate Palestine across Europe, North Africa, Greece, and France.
Robert Howard retweeted
Just crossed over 4 million reads on my blog. Many thanks to the readers over all of these years. Just a reminder that it is free, does not require a subscription or disclosure, has no sponsors, and it not-for-profit.
real-psychiatry.blogspot.com…
Robert Howard retweeted
mental health: “Parity of esteem with physical healthcare remains a distant prospect.”
theguardian.com/commentisfre…
Robert Howard retweeted
NHS England mental health services review: what has it found and what does it recommend?
A good summary of the core recommendations. The need for more research to fill key knowledge gaps will I hope be one of the key recommendations of this review.
theguardian.com/society/2026…
Robert Howard retweeted
Exclusive: “The instant I saw the picture my mouth fell open and my pulse began to race.” So wrote James Watson in The Double Helix: A Personal Account of the Discovery of the Structure of DNA, his controversial account of how he and Francis Crick deciphered the structure of DNA in 1953.
The image, now known as photograph 51, showed an elegant, symmetrical pattern of spots formed by x-rays diffracted from strands of DNA—the fingerprint of the molecule's helical structure.
Rosalind Franklin, an x-ray crystallographer, had produced the image in the spring of 1952. But Watson's 1968 book, amid other slights and sexist language directed at Franklin, implied the flash of insight was his alone.
Popular accounts still routinely suggest Franklin missed the significance of the photo. She never had a chance to challenge Watson's dismissive narrative; she died of cancer in 1958, a decade before his memoir was released and became a bestseller.
But a new analysis of her notes on another x-ray image, which she made just days earlier using the same DNA sample, offers a firm rebuttal.
Learn more: scim.ag/4hNj7KB @NewsfromScience
ALT How did Rosalind Franklin miss the helix in her iconic DNA image? She didn’t New analysis refutes James Watson’s claim he was first to recognize significance of famed photograph 51
Robert Howard retweeted
US spy-tech company Palantir hired former Labour deputy leader @tom_watson to defend its £330m NHS contract.
Last week, as patients and health workers protested in 40+ places across England, he went on X to attack them. 🧵...
bmj.com/content/395/bmj-2026…
Robert Howard retweeted
It’s good that she said this
But incredibly sad for our country that she needed to
Kemi Badenoch draws a dividing line with Reform UK - and in particular Suella Braverman - giving a passionate defence of being a black Briton.
“I don’t want to explain to my son when we’re watching our brilliant England team play football, that some people don’t think our black players are English.
I remember back in the day when Ian Wright and John Barnes were playing. Nobody was questioning whether they were English. We certainly didn’t have sitting MPs questioning whether they were English.
“We must not let these people take us backwards. That is not the country we are. Reform MPs are openly questioning people’s identity. They are not like us. We are not like them. We are different. We are the Conservative Party.
"Back in the day, we were the ones who put out a poster saying ‘Labour says he’s black, we say he’s British’. We are still that same party. I don’t know whether you’ve noticed, but I am black. I am British. I am proud of my country. I’m proud of our history, all that we have done, and all that we will do in the world."
Robert Howard retweeted
If the many many decent Israelis are wondering why their country is sinking in global popularity, it’s because of people like this… 👇
Robert Howard retweeted
The pseudoscientific side of #antipsychiatry: promoting the narrative that antidepressants cause homicides. Peter Gøtzsche spearheads this fraud, and Mad in America obligingly follows suit.
On the Mad in America #podcast we are joined by forensic scientist Selma Eikelenboom. Her work is in examining the possible association between DNA variants, psychoactive medication, and acts of violence. #SSRI #antidepressants
buff.ly/JgQZR3W
Robert Howard retweeted
Inside the Lyme Disease industrial complex...where flawed tests sold by private companies lead to questionable diagnoses and harmful treatments
My latest for @unherd with @mgtmccartney
Robert Howard retweeted
Quick primer on Optogenetics. The Nobel Prize in Physiology or Medicine 2026 is awarded for optogenetics:
Peter Hegemann and Georg Nagel discovered a remarkable protein, channelrhodopsin, in a single-celled alga.
Karl Deisseroth transformed the protein into a light-controlled switch for nerve cells.
Robert Howard retweeted
The Trauma Informed approach can really strip moral dignity from individuals. Every decision they make and every way they behave is anchored in a story of a trauma response (which can become absolutely absurd). We need a nuanced view of a complex individual.
Robert Howard retweeted
So what happens to under 65s?
Andy Burnham’s announcement of free personal care as part of a new National Care Service will only apply to those over 65, and not to working-age disabled people, No 10 has confirmed, sparking shock and concern among disabled people’s organisations.
disabilitynewsservice.com/fr…
Robert Howard retweeted
I can’t believe the American Psychological Association published this article: apa.org/monitor/2026/10/harm…
Medical gaslighting has nothing to do with actual gaslighting. It is clear from this article and the general discussions on it that medical gaslighting is said to occur when a healthcare professional disagrees with the etiology of the patient’s symptoms. This is very different from believing the patient is not actually experiencing symptoms, which is uncommon.
What really stuck out to me in this article was the discussions on how clinicians should say “I don’t know” and communicate their uncertainty rather than acknowledging the psychosocial and psychiatric factors that are contributing to the patient’s symptoms and disability. And if you do attribute part of their presentation to psychosocial factors, you should keep looking for a biological cause. They literally recommend this in the article!! Sure, if a clinician really has no idea, of course communicate that. But often that is not the case and the clinician has very good reason to conceptualize the patient’s presentation using a biopsychosocial model.
In my experience, mental health professionals commonly reinforce unhelpful beliefs and behaviors in patients and stigmatize mental health when it comes to functional disorders. I’ve lost count of the number of times a neurologist and I have had to explain to a psychotherapist that the patient does not have a neurologic disease and to stop suggesting to the patient that they do. This article is a good example of how clinicians can end up “colluding” with patients and reinforcing their defenses. A lot of this feels like coddling and needing to walk on eggshells to avoid upsetting patients who have stigmatizing views towards mental health, which only reinforces the stigma.
We've sadly experienced medical gaslighting with my daughter's care over and over again during the past 13 years. All I can say is it's heartbreaking and brutal. I've cried more tears late at night thinking about how she was dismissed than I care to remember.
And surprisingly, even in my current leadership role at CODA with my scientific expertise, I still face doctors looking at me sideways as I explain her multisystem illness. I've learned to handle far their response far better than early on but their approach still hurts, still angers and still deflates.
We shouldn't have to work this hard, when she's working so hard already.
"New Daily Persistent Headache, Migraine, hEDS, gut dysfunction, pelvic pain, orthostatic intolerance, MCAS." She says those words and we watch them start to type, ask her about trauma and stress, which are part of the equation, but also isn't her history of gut dysmotility since age 6 even more so? The concussion she suffered. The propensity to faint when she didn't even know why. Her severe menses. Her illnesses that had her in bed far longer than her siblings.
Put all of that in one young woman who got sick seemingly out of nowhere at age 16, and suddenly the story sounds like its too much. Too many symptoms. Too many systems. Too many diagnoses.
And, I have access to tools and relationships others may not - it literally breaks my heart to think of the thousands and thousands of patients, so sick, looking for help and being turned away.
We cannot continue to rely on a handful of expert doctors who understand how to recognize and treat chronic multisystem illness.
Millions of patients bring different biology, histories, triggers and combinations of symptoms. Individual clinical expertise alone will never meet that scale or complexity.
People diagnosed with cancer, diabetes, stroke, heart attack, appendicitis, and other recognized illnesses aren't disbelieved. They are treated.
Patients with chronic multisystem illness deserve that same scientific credibility and access to quality care.
Because when medicine can measure what has gone wrong, understand it and treat it, it becomes much harder to turn away from the person sitting in front of you.
It’s time.
apa.org/monitor/2026/10/harm…
Robert Howard retweeted
It’s a central nervous system depressant primarily for anxiety. Benzodiazepines seem to help a lot of people with ME/CFS. This is most likely due to decreasing anxiety and suppressing the body’s stress system. There is a large amount of research showing ME/CFS is associated with physical and mental stress. Some people experience a disconnect from the mental feeling of anxiety and the physical manifestations of anxiety and stress. So it’s not uncommon for people to say they are not anxious but then have physical symptoms of anxiety which are relieved by anti-anxiety medications.
Robert Howard retweeted
Just in case it's not clear, this is an obviously correct statement, only people qualified as doctors should be on doctors rotas. In the same way I'm never going to be a nurse, midwife, physio or anything else. The MDT can contribute but not substitute.
Robert Howard retweeted
People really hate the idea that there are people who don’t actually want to recover. Most of the time this is likely unconscious - the person does not consciously think “wow I love being ill and I want to stay like this” but being ill can serve a purpose.
When I was diagnosed with POTS almost 10 years ago, I joined online POTS groups and quickly found them to be terrible for recovery. Many people are more concerned with being right and proving to everyone that they are ill, rather than learning to manage symptoms and move on with life. These maladaptive behaviors definitely make POTS symptoms worse and disability persistent.
Robert Howard retweeted
When you hear people say “let them drown”, this is what those words mean.
Un homme, mort, gisant dans l’eau après avoir tenté de traverser la Manche pour trouver refuge au Royaume-Uni.
Cette image a été prise par le photojournaliste Sameer Al-Doumi sur la plage d’Hardelot, en France, il y a deux jours.
Dans l’indifférence.
instagram.com/p/DdqjKYZDVHh/…
Robert Howard retweeted
Two caveats
- People are deprived of their liberty when they are placed in care homes all the time. The “unlawful” here is about a process of authorisation to be complied with
- No outsider knows the truth of whether or not the attorney is making decisions in RF’s best interests
Robert Howard retweeted
Incredibly sad that people are losing their lives to suicide because they wrongly believe their bodies are broken. This is a direct result of the Covid fear-mongering, online echo chambers that share poor research, and mental health stigma.
Many people in these online illness communities struggle to accept two things can be true at once. You can be ill and also “extremely neurotic”. A husband just lost his wife and people are upset because he acknowledges she became neurotic and obsessed with her illness. Everyone online is acting like they knew her better than her husband 🤦🏻♂️
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