Category Archives: Cold & Flu

Is help finally at hand for suicide crisis on America’s farms?

In early May, Kansas farmer John Blaske is waiting for the rain to stop so he can begin planting. From the front door of his farmhouse, a green yard decorated with bird feeders slopes down to a series of fields where the corn will be planted. Beyond the fields, there’s a tree line and a small bridge with a creek running below. It’s peaceful here, and mostly quiet, except for the sound of the occasional car or tractor, or the cows calling from the paddock.

The waiting makes him restless, he tells me. And it’s not just the rain. He’s also waiting desperately for the opportunity to talk to fellow agrarians or to legislators about the stress, depression and suicidal ideation he experiences as a farmer.

We have been talking by phone for well over a year now, and last fall, when the summer heat was just beginning to lift, I visited his farm in the tiny town of Onaga.

My conversations with Blaske became part of a story, published in December in the Guardian, about the high rate of farmer suicide. According to a 2016 report, people who work in agriculture take their lives at a rate higher than any other occupation, and at twice the rate of military veterans.

The story reached the computer screens of over a million readers, even landing on the desks of legislators. But Blaske himself could not access it. Without a computer or the internet, he was unaware of theconversations, media coverage, and legislation provoked in part by his story.

I’ve done my best to keep him updated, with phone calls and print-outs of articles mailed to his home. But behind the scenes of this story is a stark digital divide, which highlights the isolation experienced by rural America and the feeling that – even in a farm bill year – farmers have been forgotten.

I’ve got good news about bad news

John Blaske at home. Blaske doesn’t have a computer or Internet access, but he’s keen to talk about mental health with other farmers.


John Blaske at home. Blaske doesn’t have a computer or internet access, but he’s keen to talk about mental health with other farmers. Photograph: Audra Mulkern for the Guardian

I’ve become fond of the phrase, “I’ve got good news about bad news,” and I’ve been saying it a lot lately.

Just weeks after the article was published, Washington state representative and fourth generation farmer JT Wilcox immediately responded by introducing a farmer suicide prevention bill into the state legislature.

It passed unanimously through both the House and Senate, and just three months after the article was published, it was signed into law by Governor Jay Inslee.

And recently, two bills aimed at addressing the farmer suicide crisis (The Stress Act and The Farmers First Act), were introduced into the US House and Senate for inclusion into the 2018 federal farm bill.

Both bills would reauthorize the Farm and Ranch Stress Assistance Network (FRSAN), a program which would provide federal grants to create crisis lines, provide counseling for farmers and train rural behavioral health professionals.

Both of these bills now have strong bipartisan support, as well as endorsements from a slew of progressive and conservative rural and farmer organizations. One key difference is that only the Farmers First Act comes with funding – a proposed $ 50m over five years.

As arduous as it is to pass federal legislation, it’s all the more so within something as politically divisive as the $ 867bn farm bill. While some farm groups voiced support for the House version of the farm bill, many farm and rural organizations loudly opposed it, arguing that while it contains some positive elements (including language from the Stress Act), the overall bill would harm family farmers by gutting conservation programs and local food initiatives, decreasing access to credit for small and mid-sized farms, and failing to provide a safety net for struggling farmers.

Indeed, the farm economy is in crisis. Net farm income has decreased by 50% since 2013, and recently, the farmer’s share of the US food dollar fell to 14.8 cents, the lowest since the USDA began tracking the statistic in 1993. Milk prices are so far below the cost of production that dairy cooperative Agri-Mark recently sent out suicide hotline numbers along with the milk checks. Add in the Trump Administration’s see-sawing statements about a trade war with China, which would impact up to 94 agricultural products, and the potential for financial losses is being felt industry-wide.

Because of the plight of farmers, there is increased scrutiny on the farm bill. On 18 May, the House voted down its final version of the farm bill, with 30 Republicans joining 183 Democrats in defeating the bill. While the House will attempt to rebuild the bill and bring it back for a vote in late June, public focus will largely shift to the Senate, which is drafting its own farm bill, projected to be released in June.

Still, there remains hope among farmers and advocates who have long worked to advance suicide prevention resources. “I am more hopeful than I have been in my 38 years of working in this arena that behavioral health supports will be funded as part of the farm bill,” wrote Dr Mike Rosmann, an Iowa farmer and psychologist, in an email.

‘Some people can’t hang on that long’

Ginnie Peters lost her husband to suicide in 2011. This is his working bench.


Ginnie Peters lost her husband to suicide in 2011. This is his working bench. Photograph: Audra Mulkren for the Guardian

When I call Blaske to update him on the legislation, he says the provision of extra federal grants for crisis lines and counselling would be a positive outcome that would provide life-saving resources to farmers. But he says struggling farmers can’t wait. “Some people can’t hang on that long,” he says. “I mean, farmers are out there busting their butts just trying to make a nickel or a dollar or a dime.”

If there has been any criticism of farmer suicide legislation, it is that it doesn’t address the root causes of the behavioral health issues sweeping across farm country, including the negative farm economy. A recent Mother Jones article was titled: “We wouldn’t need the suicide hotline if dairy farmers were getting paid what they deserve.”

But while economic conditions are absolutely part of why farmer suicide rates are so high, other contributing factors exist, including rural isolation, unpredictable weather, lack of rural health services, and a stigma surrounding mental health issues. Thus, even if the farm economy improves, people working in agriculture will benefit from a system of behavioral health resources.

“Agricultural behavioral health assistance is needed more than at any time since the 1980s, and will continue to be needed as an investment in healthy agricultural producers,” wrote Rosmann in a 4 May article in Iowa Farmer Today. He maintains that while natural resources are often considered elements such as topsoil, water, or seeds, farmers are the most critical agricultural natural resource we have. As such, he says, the health and wellbeing of farmers is essential to a functional food and agriculture system.

Matt Perdue, a fifth generation farmer from North Dakota and the government relations representative for NFU, says the farmer suicide legislation addresses an immediate need for the group’s 200,000 members. He also says the need for such support goes beyond the current farm financial crisis.

“When we look at the farm economy as a whole, we’re not taking into account specific situations,” says Perdue. “A farmer might be experiencing severe drought or getting hit with a hailstorm while the rest of the economy is strong. The industry has so much uncertainty in it, so we need to be providing mental health support to farmers and ranchers at all times.”

‘While economic conditions are part of why suicide rates are so high, other contributing factors exist.’


‘While economic conditions are part of why suicide rates are so high, other contributing factors exist.’ Photograph: Audra Mulkern for the Guardian

On 9 May, NFU’s Roger Johnson sent a letter to Secretary of Agriculture Sonny Perdue urging him to address the crisis. “We call on the United States Department of Agriculture (USDA) to serve a critical role in providing support to farmers and ranchers in crisis,” he wrote. He notes that net farm income is projected to drop by 6.7% in 2018 (to negative $ 1,316), the lowest since 2006, and the fact that 60% of rural residents live in areas with a shortage of mental health professionals.

“This is something we think requires a holistic response,” says Perdue. “Federal legislation is just one way to address the issue. We also need to be talking about this at the state level and the local level. It’s going to take as many different avenues as we can find.”

A simple idea: a big picnic

In Kansas, Blaske has been thinking about those different avenues. “I think that we need to have get-togethers – like a big picnic, where farmers let their feelings out and learn to not hold everything inside, because that’s when it all blows up,” he says.

It’s a simple but effective idea, and one that echoes the farmer gatherings through the 1980s farm crisis, when farmers took to community spaces to organize and take care of one another.

During that time, Dr Rosmann took on the role of gathering Iowa farmers and their families. Upwards of 200 hundred farmers would gather in a church or school for community prayer, candid conversation about their struggles, and various presentations: an attorney explaining the stages of bankruptcy, a banker discussing financial management, Rosmann speaking about stress and behavioral health.

When I tell Blaske about Rosmann’s gatherings from years ago, he says: “I’d go in a heartbeat. But so far, the opportunity hasn’t been presented. Nobody’s ever called and asked me to do anything like that, but that’s what I’d love to do.”

So he waits – to begin planting, for a phone call, for the mail, for something to change. “You asked me what I hoped would come from this story,” he said to me on the phone recently. “I want to be seen. I want to be heard.” Then his voice broke, and he abruptly finished our call.

‘I felt like farming killed my husband’

Ginnie Peters at home.


Ginnie Peters at home. Her husband, Matt, a farmer, died of suicide in 2011 at the age of 55. Photograph: Audra Mulkren/Audra Mulkern

Last October, I sat at a kitchen table in Iowa and listened to Ginnie Peters talk about her husband, Matt, a farmer who died of suicide in 2011 at the age of 55. As we spoke, she thumbed through the journal she has kept since Matt died. The entries are short and poem-like:

You were in my dreams again last night. We were out in the front yard in the dark.

The spruce tree has been planted where the oak tree had been.

I will love you forever, guy.

“For a long time I felt like farming killed my husband,” Ginnie said.

Outside the door of their farmhouse was a cistern where Matt would sit before coming inside for the night, and a young ash tree with branches still low enough to reach. Ginnie would tell him to touch the tree, to leave all his stress there in the leaves. They kept a crisis hotline number by the phone throughout the hard years of the 1980s, but by 2011, “when Matt really needed it, it was gone”.

Recently, Senator Joni Ernst – a sponsor of the Farmers First Act – called Ginnie to talk about the federal legislation. “I’m grateful that someone is finally paying attention,” Ginnie told me on the phone. “This could be the difference between life and death for many.”

“We were able to get through the 1980s farm crisis, but I couldn’t get through my farmer in crisis,” Ginnie told Ernst. “If the Farm and Ranch Stress Assistance Network had been funded in 2008, Matt might still be alive.”

‘Lava haze’ and ‘vog’: toxic volcanic gases prompt health fears in Hawaii

Three dozen tourists were gathered at the Wailoa Sampan Basin Harbor in Hilo, Hawaii, hoping to get a glimpse of the lava that they’d seen on the news for weeks.

But because Hawaii Volcanoes national park – often a key stop in travelers’ itineraries – was closed after Kilauea erupted, their best hope on Monday afternoon was taking a boat to the point where the lava met the sea.

Some said they’d packed breathing masks, just in case the trade winds — which usually blow in clean sea air — changed direction and began blowing a lava haze, a noxious mix of gases and particles, their way.

Although many tourists to Hawaii island – the Big Island – choose to visit because of the active volcano, some have gotten more than they bargained for since the eruption. (Petra Wiesenbauer, who runs a popular Pahoa lodge near the park, had to hurry three guests out of the door while she and her neighbors fled the lava and toxic fumes.)

Up until lava crossed Highway 137 late Saturday night and entered the ocean, volcanic smog, called vog, which contains mostly sulfur dioxide and acid particles, along with ash, had been the biggest air quality concern.

But then the molten rock began pouring into the cool seawater and added clouds of lava haze or “laze”. Officials warned people to stay away since the plumes can travel up to 15 miles downwind, according to the Hawaii Volcano Observatory.

Toxic clouds rise up as lava from Kilauea volcano hits sea – video

The clouds form when hot lava boils seawater, creating tiny shards of volcanic glass and hydrochloric acid that then get carried in steam. The plumes can be deadly.

The USGS says on its website: “This hot, corrosive gas mixture caused two deaths immediately adjacent to the coastal entry point in 2000, when seawater washed across recent and active lava flows.” Hawaii civil defense cautioned people on Monday to “stay away from the ocean plume since it can change direction without warning”. In the case of laze and vog, store-bought respirators filter particles but not hydrochloric acid or sulfur dioxide.

Vog and laze can cause eye irritation, skin irritation and respiratory issues, according to officials. Those with conditions like asthma or cardiovascular disease are most sensitive, as are the elderly, children and pregnant women, according to an interagency group of volcano experts. Even before the recent Kilauea eruption, Hawaii already suffered air quality issues from volcanic gases. The island of Hawaii has the highest sulfur dioxide (SO2) emissions in the nation, according to EPA spokesman Dean Higuchi. And according to a 2016 report published in the scientific journal Environmental international, levels were “1,000 times greater” than the EPA’s definition of a major pollution source.

There has been a moderate increase in the number of people coming into Hilo medical center for treatment of vog-related symptoms since the eruption, according to Elena Kabatu, a hospital spokesperson. But she said that many more were likely experiencing the less serious effects of vog, such as dry eyes or a scratchy throat.

For those living in Pahoa, near the lava, conditions vary depending on whether the trade winds are blowing, residents said. Gilbert Aguinaldo, who has offered his vacant, central Pahoa lot to serve as a hub of locally organized community aid, said that volunteers were loaning out respirators and breathing masks to anyone who needs them.

Both vog and laze can cause eye irritation, skin irritation and respiratory issues.


Both vog and laze can cause eye irritation, skin irritation and respiratory issues. Photograph: Terray Sylvester/Reuters

“We are a little worried about the laze,” said Heather Lippert, 40, who was waiting to board the boat for the lava tour, “But I’m sure they’ll try to keep us safe.”

Vanessa Homyak, 36, said she and Lippert, who are from San Diego, had originally intended to stay at an Airbnb in Pahoa when they scheduled their vacation. But after the eruption began, the pair reconsidered. “We called the host and asked how things were,” she said. “They said, ‘If we were you, we would probably stay somewhere else.’”

They took the advice, staying instead on the other side of the island. But though they were out of the path of the lava, they discovered that they were directly in the path of the vog.

“We saw it when we flew into Kona, this big brown layer in the air,” Lippert said.

Erik Jacobs, who lives in Waikoloa, in the north-west part of the island and had just returned from a two-week vacation, said the vog was already irritating his eyes, making them feel dry and scratchy. He said his neighbors told him the vog was the “worst they’d ever seen” on the Big Island late last week.

Ex-footballer Terry Butcher accuses British army of failing his son

The former England football captain Terry Butcher has accused the British army of failing his son, who died after developing post-traumatic stress disorder (PTSD).

Butcher told an inquest on Monday that Christopher, 35, had turned to alcohol and drugs after being discharged from the armed forces in April 2015, due to the mental health condition.

“Christopher passed away several months ago. But, in reality, the Chris that we all knew and loved had ceased to exist years before,” Butcher told Ipswich coroner’s court.

“Diagnosed with severe post-traumatic stress disorder, his life spiralled downwards as the demons took control of his mind. In truth after intense tours of Iraq and Afghanistan he became a victim of war.

“These circumstances are all too familiar. Our country has a number of veterans suffering from the same condition, released from the armed forces too early and having to rely on an overloaded NHS that is ill-equipped and underfunded to cope.”

Butcher, who struggled to hold back tears during the hearing, said the armed forces’ duty of care towards personnel had been “discarded too easily, which has resulted in a growing number of our veterans turning to anything that might help including alcohol, drugs and suicide as a means of alleviating the flashbacks and nightmares”.

The inquest heard how Christopher, a former captain in the Royal Artillery, had been haunted by nightmares and flashbacks about the deaths of comrades and civilians in Afghanistan.

Butcher found his son’s body wedged between his bed and a wall when he went to check on him on the morning of 16 October last year at his home in Suffolk.

A postmortem failed to identify Christopher’s cause of death, but found he had an enlarged heart, which could have been caused by drug use. Toxicology tests revealed he had non-lethal levels of cocaine and heroin in his body, as well as prescription drugs he had been taking for several years. A makeshift crack pipe in a sunglasses case was also found in his room.

Suffolk’s assistant coroner, Dr Dan Sharpstone, concluded that Christopher died from an enlarged heart due to uncertain causes with a background of drug use and PTSD.

Butcher remembered his son as a man who had a “glittering career in the army ahead of him, a loving wife and dreams of having children of his own. His unnecessary death has deprived us of a wonderful son, husband, brother and grandson, friend and comrade”.

Sharpstone said: “When people serve in the armed forces, they give everything in the defence of our country and this may result in death or serious injury. However, it can also result in PTSD.”

  • In the UK the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Other international suicide helplines can be found at www.befrienders.org.

Italy’s far right uses Irish vote to boost anti-abortion campaign

Activists and far-right politicians have seized on Italy’s low birth rate and the attention on Ireland’s referendum on abortion to boost their own campaign to outlaw the practice.

As the 40th anniversary of Italy’s legalisation of abortion approaches, the renewed effort also comes as the far-right League, which contains many anti-abortion militants, stands on the brink of forming a government with the anti-establishment Five Star Movement following inconclusive general elections in March.

Ahead of the 22 May anniversary, ProVita, the Italian anti-abortion association, has published a booklet repeating debunked claims that women who have an abortion could be more prone to breast cancer and suicide or become alcoholics or drug addicts.

Quick guide

The Irish abortion referendum

The Irish abortion referendum

-

Photograph: Clodagh Kilcoyne/X03756

The move came after authorities in Rome covered up a huge poster featuring an 11-week-old foetus in the womb on a wall in the Vatican area in April. A message alongside the image said: “You are here because your mother has not aborted you.”

“The plan was to intensify the campaign ahead of the anniversary,” said Alessandro Fiore, a spokesman for ProVita. “But we increased it even more after the poster was censored; we were contacted by many people from across Italy who wanted to do something similar in their towns. The Irish referendum, by chance, also helps to strengthen our message.”

Toni Brandi, the president of ProVita, joined counterparts in Ireland on a recent visit, as the country prepares for a landmark referendum on liberalising strict abortion laws on 25 May.

Italians voted to legalise abortion in a similar plebiscite in 1978. But 70.4% of gynaecologists still refuse to terminate pregnancies for moral reasons, which means it is almost impossible for women to access a safe procedure. That number is around 90% in southern regions, while in the central Molise region only one doctor carries out terminations. Last year a woman in Padua, a city in the northern Veneto region, had to visit 23 hospitals before finding one that would end her pregnancy. Doctors in Rome who do not object to the procedure are banned from going for jobs at hospitals managed by the Vatican.

Politicians from the League and smaller far-right party Brothers of Italy are helping to galvanise the anti-abortion campaign. Massimiliano Romeo, a senator with the League, said: “Six million children have been killed in the womb [since 1978], then they say we have to import migrants to boost the population.”

If the League succeeds in entering government, the party has pledged to make it a priority to better inform women of what they say are the physical and psychological consequences of abortion.

But claims that abortion leads to depression and suicide, causes cancer and affects future fertility have long been dismissed by medical organisations.

Emma Bonino, a politician who had an illegal abortion at a young age, was at the forefront of bringing about the enactment of the so-called Law 194. Until 1978, illegal abortions were the third-biggest cause of death for women in Italy.

“The campaigning by this group is nothing new,” Bonino, a former foreign minister, said. “They have been there for the last 40 years, as a minority movement – they have the right to exist and express their opinion but we have always managed to fight them. Our duty now is to fight organised conscientious objection – which actually has nothing to do with conscientiously objecting but career.”

Many medics fear being pushed out of the system or not being hired if they perform abortions. And those that do are often shamed. In the late 1990s a doctor killed himself after being exposed for terminating pregnancies in secret.

Ministry of Health data shows that the number of abortions performed each year fell from 233,976 in 1983 to 84,926 in 2016, while the number of moral objectors has risen. Unwanted pregnancies also significantly decreased after Law 194 was introduced, as people could avail themselves of information about contraception which until then had been forbidden thanks to a ban stemming from the Benito Mussolini-era.

There is no data available on the real demand for abortion or on the numbers carried out illegally. In recent years a significant demand is said to come from migrant women who have been forced into prostitution.

Silvana Agatone, a gynaecologist in Rome who does not object, said one of the reasons the health ministry is able to register a decline is because medics who once performed abortions, and who were required to report each procedure, have retired.

“They no longer get as many report cards each month but it doesn’t mean to say women are no longer having abortions,” she said. “It means that illegal abortions are increasing.”

There are fears that access to safe abortion will become even more difficult in future, as fewer medical students are receiving training.

“The Catholic-right has conquered the hospitals – there are so many militants,” said Elisabetta Canitano, a gynaecologist and president of the feminist association Vita di Donna.

“Even if the foetus is incompatible with life – they say ‘God sent it, so God will take it when he decides’. They insist that the woman must go ahead with the pregnancy, even if the child is then sent to a hospice to die.”

Italy’s far right uses Irish vote to boost anti-abortion campaign

Activists and far-right politicians have seized on Italy’s low birth rate and the attention on Ireland’s referendum on abortion to boost their own campaign to outlaw the practice.

As the 40th anniversary of Italy’s legalisation of abortion approaches, the renewed effort also comes as the far-right League, which contains many anti-abortion militants, stands on the brink of forming a government with the anti-establishment Five Star Movement following inconclusive general elections in March.

Ahead of the 22 May anniversary, ProVita, the Italian anti-abortion association, has published a booklet repeating debunked claims that women who have an abortion could be more prone to breast cancer and suicide or become alcoholics or drug addicts.

Quick guide

The Irish abortion referendum

The Irish abortion referendum

-

Photograph: Clodagh Kilcoyne/X03756

The move came after authorities in Rome covered up a huge poster featuring an 11-week-old foetus in the womb on a wall in the Vatican area in April. A message alongside the image said: “You are here because your mother has not aborted you.”

“The plan was to intensify the campaign ahead of the anniversary,” said Alessandro Fiore, a spokesman for ProVita. “But we increased it even more after the poster was censored; we were contacted by many people from across Italy who wanted to do something similar in their towns. The Irish referendum, by chance, also helps to strengthen our message.”

Toni Brandi, the president of ProVita, joined counterparts in Ireland on a recent visit, as the country prepares for a landmark referendum on liberalising strict abortion laws on 25 May.

Italians voted to legalise abortion in a similar plebiscite in 1978. But 70.4% of gynaecologists still refuse to terminate pregnancies for moral reasons, which means it is almost impossible for women to access a safe procedure. That number is around 90% in southern regions, while in the central Molise region only one doctor carries out terminations. Last year a woman in Padua, a city in the northern Veneto region, had to visit 23 hospitals before finding one that would end her pregnancy. Doctors in Rome who do not object to the procedure are banned from going for jobs at hospitals managed by the Vatican.

Politicians from the League and smaller far-right party Brothers of Italy are helping to galvanise the anti-abortion campaign. Massimiliano Romeo, a senator with the League, said: “Six million children have been killed in the womb [since 1978], then they say we have to import migrants to boost the population.”

If the League succeeds in entering government, the party has pledged to make it a priority to better inform women of what they say are the physical and psychological consequences of abortion.

But claims that abortion leads to depression and suicide, causes cancer and affects future fertility have long been dismissed by medical organisations.

Emma Bonino, a politician who had an illegal abortion at a young age, was at the forefront of bringing about the enactment of the so-called Law 194. Until 1978, illegal abortions were the third-biggest cause of death for women in Italy.

“The campaigning by this group is nothing new,” Bonino, a former foreign minister, said. “They have been there for the last 40 years, as a minority movement – they have the right to exist and express their opinion but we have always managed to fight them. Our duty now is to fight organised conscientious objection – which actually has nothing to do with conscientiously objecting but career.”

Many medics fear being pushed out of the system or not being hired if they perform abortions. And those that do are often shamed. In the late 1990s a doctor killed himself after being exposed for terminating pregnancies in secret.

Ministry of Health data shows that the number of abortions performed each year fell from 233,976 in 1983 to 84,926 in 2016, while the number of moral objectors has risen. Unwanted pregnancies also significantly decreased after Law 194 was introduced, as people could avail themselves of information about contraception which until then had been forbidden thanks to a ban stemming from the Benito Mussolini-era.

There is no data available on the real demand for abortion or on the numbers carried out illegally. In recent years a significant demand is said to come from migrant women who have been forced into prostitution.

Silvana Agatone, a gynaecologist in Rome who does not object, said one of the reasons the health ministry is able to register a decline is because medics who once performed abortions, and who were required to report each procedure, have retired.

“They no longer get as many report cards each month but it doesn’t mean to say women are no longer having abortions,” she said. “It means that illegal abortions are increasing.”

There are fears that access to safe abortion will become even more difficult in future, as fewer medical students are receiving training.

“The Catholic-right has conquered the hospitals – there are so many militants,” said Elisabetta Canitano, a gynaecologist and president of the feminist association Vita di Donna.

“Even if the foetus is incompatible with life – they say ‘God sent it, so God will take it when he decides’. They insist that the woman must go ahead with the pregnancy, even if the child is then sent to a hospice to die.”

Italy’s far right use Irish vote to boost anti-abortion campaign

Activists and far-right politicians have seized on Italy’s low birth rate and the attention on Ireland’s referendum on abortion to boost their pro-life campaign.

As the 40th anniversary of Italy’s legalisation of abortion approaches, the renewed effort also comes as the far-right League, which contains many anti-abortion militants, stands on the brink of forming a government with the anti-establishment Five Star Movement following inconclusive general elections in March.

Ahead of the 22 May anniversary, ProVita, the Italian pro-life association, has published a booklet repeating debunked claims that women who have an abortion could be more prone to breast cancer and suicide or become alcoholics or drug addicts.

Quick guide

The Irish abortion referendum

The Irish abortion referendum

-

Photograph: Clodagh Kilcoyne/X03756

The move came after authorities in Rome covered up a huge poster featuring an 11-week-old foetus in the womb on a wall in the Vatican area in April. A message alongside the image said: “You are here because your mother has not aborted you.”

“The plan was to intensify the campaign ahead of the anniversary,” said Alessandro Fiore, a spokesman for ProVita. “But we increased it even more after the poster was censored; we were contacted by many people from across Italy who wanted to do something similar in their towns. The Irish referendum, by chance, also helps to strengthen our message.”

Toni Brandi, the president of ProVita, joined counterparts in Ireland on a recent visit, as the country prepares for a landmark referendum on liberalising strict abortion laws on 25 May.

Italians voted to legalise abortion in a similar plebiscite in 1978. But 70.4% of gynaecologists still refuse to terminate pregnancies for moral reasons, which means it is almost impossible for women to access a safe procedure. That number is around 90% in southern regions, while in the central Molise region only one doctor carries out terminations. Last year a woman in Padua, a city in the northern Veneto region, had to visit 23 hospitals before finding one that would end her pregnancy. Doctors in Rome who do not object to the procedure are banned from going for jobs at hospitals managed by the Vatican.

Politicians from the League and smaller far-right party Brothers of Italy are helping to galvanise the pro-life campaign. Massimiliano Romeo, a senator with the League, said: “Six million children have been killed in the womb [since 1978], then they say we have to import migrants to boost the population.”

If the League succeeds in entering government, the party has pledged to make it a priority to better inform women of what they say are the physical and psychological consequences of abortion.

But claims that abortion leads to depression and suicide, causes cancer and affects future fertility have long been dismissed by medical organisations.

Emma Bonino, a politician who had an illegal abortion at a young age, was at the forefront of bringing about the enactment of the so-called Law 94. Until 1978, illegal abortions were the third-biggest cause of death for women in Italy.

“The campaigning by this group is nothing new,” Bonino, a former foreign minister, said. “They have been there for the last 40 years, as a minority movement – they have the right to exist and express their opinion but we have always managed to fight them. Our duty now is to fight organised conscientious objection – which actually has nothing to do with conscientiously objecting but career.”

Many medics fear being pushed out of the system or not being hired if they perform abortions. And those that do are often shamed. In the late 1990s a doctor killed himself after being exposed for terminating pregnancies in secret.

Ministry of Health data shows that the number of abortions performed each year fell from 233,976 in 1983 to 84,926 in 2016, while the number of moral objectors has risen. Unwanted pregnancies also significantly decreased after Law 94 was introduced, as people could avail themselves of information about contraception which until then had been forbidden thanks to a ban stemming from the Benito Mussolini-era.

There is no data available on the real demand for abortion or on the numbers carried out illegally. In recent years a significant demand is said to come from migrant women who have been forced into prostitution.

Silvana Agatone, a gynaecologist in Rome who does not object, said one of the reasons the health ministry is able to register a decline is because medics who once performed abortions, and who were required to report each procedure, have retired.

“They no longer get as many report cards each month but it doesn’t mean to say women are no longer having abortions,” she said. “It means that illegal abortions are increasing.”

There are fears that access to safe abortion will become even more difficult in future, as fewer medical students are receiving training.

“The Catholic-right has conquered the hospitals – there are so many militants,” said Elisabetta Canitano, a gynaecologist and president of the feminist association Vita di Donna.

“Even if the foetus is incompatible with life – they say ‘God sent it, so God will take it when he decides’. They insist that the woman must go ahead with the pregnancy, even if the child is then sent to a hospice to die.”

Ed Sheeran denounces use of song in anti-abortion campaign in Ireland

Ed Sheeran has denounced anti-abortion campaigners after reports they used one of his songs less than a week before Ireland’s referendum on abortion.

The British pop star’s song Small Bump was reportedly being played by anti-abortion activists campaigning in Dublin’s city centre. Sheeran distanced himself from those using his song, saying in a post on Instagram that “it does not reflect what the song is about”.

Instagram story by Ed Sheeran @teddysphotos


Sheeran’s Instagram post. Photograph: Ed Sheeran

Small Bump, released in 2011, is from Sheeran’s debut album +, and his objection comes as Ireland prepares to vote on Friday 25 May in a referendum to repeal the eighth amendment to its constitution, which bans abortion in almost all circumstances.

The song’s lyrics include: “You’re just a small bump unknown, you’ll grow into your skin/With a smile like hers and a dimple beneath your chin/Finger nails the size of a half grain of rice, and eyelids closed to be soon opened wide/ A small bump, in four months you’ll open your eyes.”

In his Instagram post, Sheeran, who is currently playing a series of concerts in Ireland, said: “I’ve been informed that my song Small Bump is being used to promote the pro-life campaign, and I feel it’s important to let you know I have not given approval for this use, and it does not reflect what the song is about.”

Ireland’s referendum has attracted interest from groups from around the world seeking to influence the vote. A significant proportion of Facebook posts aimed at influencing voters were shown to have come from pages managed partly or entirely outside Ireland. Even some groups registered with Ireland’s ethics watchdog, the Standards In Public Office Commission, had Facebook pages managed from abroad.

Facebook said it was blocking all foreign spending on advertising around Ireland’s referendum on abortion in an effort to adhere to the “principles” of the country’s election spending laws.

Poorest and brightest girls more likely to be depressed – UK study

Brighter girls and girls from poorer families are more likely to be depressed by the time they enter adolescence, according to a study triggering fresh concern about soaring rates of teenage mental illness.

The government-funded research identified the two groups as being most at risk of displaying high symptoms of depression at the age of 14. In contrast, more intelligent boys and boys from the most deprived backgrounds appear not to suffer from the mental troubles that affect their female peers, the academics discovered.

The findings are based on detailed questionnaires filled in by 9,553 boys and girls aged 14 across the UK as part of the Millennium Cohort Study (MCS), which is tracking the progress of people born in 2000 into adulthood.

They add to growing evidence that teenage girls are particularly vulnerable to mental health difficulties. NHS figures show there were sharp increases between 2005/06 and 2015/16 in the number of girls under 18 admitted to hospital in England because they had self-harmed by cutting (up 285%), poisoning (42%) or hanging themselves (331%).

The researchers, led by Dr Praveetha Patalay, also found that being overweight, a history of being bullied and not getting on with peers were the three most common causes of depression in boys and girls aged 14. Their previous finding, that 24% of 14-year-old girls and 9% of boys that age were depressed, stirred widespread debate last year.

Dr Nihara Krause, a consultant clinical psychologist, said the findings about brighter and poorer girls were worrying, given the known links between depression and self-harm, and self-harm and risk of suicide.

“Some children who are depressed will self-harm. Some people say that physical pain is easier to tolerate than emotional pain,” she said. “What’s very concerning, in those who are depressed, is the link with suicide, because more and more studies show that self-harm is a predictor of suicide. Someone who self-harms is more likely to try to take their own life, especially if they are depressed. So these new findings are a concern from that point of view.”

Patalay said girls from families in the bottom two quintiles of household income were 7.5% more likely to be depressed at 14 than girls from the highest income families, but the same pattern was not found in boys.

Cleverer girls also had a significantly higher risk of having high depressive symptoms at 14, she said, and she was doing further research to calculate that risk more precisely among those with “higher childhood cognitive scores”.

Krause said: “Part of it could be that [brighter girls] have a ‘hyper brain’, a more active brain, which often means they have a much higher emotional reaction to things and they are constantly overthinking things.

“For example, if there’s a friendship situation that might be a concern to them, children of higher intelligence might think about all sorts of reasons why this situation has developed and get stressed about it.”

She pinpointed pressure on children to succeed at school – from their parents, schools and themselves – and competition for university places and jobs as a key cause of anxiety and depression in teenagers. In addition, some bright pupils are pushed too much, and those children can develop academically but be less adept at forming friendships, she suggested.

Children of either sex who have been bullied are 5.5% more likely to be depressed at 14, and boys or girls who do not get on well with their peers are 1.5% more likely to exhibit depressive symptoms.

The researchers also found that overweight boys and girls were 5% more likely to be depressed. This has prompted speculation as to whether the huge recent increase in childhood obesity is helping to drive what experts say is a growing mental health crisis in young people.

“We found a substantial link between being overweight and being depressed. Rates of overweight and mental ill-health are increasing in childhood, and they both have enormous consequences through our lives. Tackling these two health issues should be a public health priority,” Patalay said.

Emla Fitzsimons, a co-author of the findings and director of the MCS, said: “The study highlights a sharp increase in mental health problems among girls between ages 11 and 14. We certainly need to be looking at how the use of social media and cyberbullying may affect girls and boys differently.”

Dr Nick Waggett, chief executive of the Association of Child Psychotherapists, said it was unhelpful to highlight bright or poor girls as being at particular risk “when we already now there is a significant burden of mental illness in children and young people, including adolescent girls, and that there is a substantial shortfall in specialist services for them.”

Claire Murdoch, NHS England’s national mental health director, said: “After decades in the shadows, children’s mental health is finally in the spotlight, with more young people seeking help and years of unmet need being addressed. The NHS has responded, with 70,000 more young people set to get help, £1.4bn of extra funding and eating disorder and perinatal mental health services covering the whole country.

“But if the NHS is to meet fully the scale of the challenge then government, schools and councils need to work with us and our patients over the long-term.”

Trump administration to revive Reagan-era abortion ‘gag’ rule

Donald Trump’s administration will reinstate a decades-old policy that will strip federal funds from family planning clinics providing abortion or related services, marking its latest salvo to curtail women’s reproductive rights.

The Department of Health and Human Services will announce the proposal on Friday, an administration official confirmed to the Guardian. The move would revive a policy first implemented by Ronald Reagan in 1988, which effectively barred reproductive health organizations that received federal grants from providing or even discussing abortion with patients.

The policy has been derided as a “gag rule” by abortion rights supporters and medical groups, and it is likely to trigger lawsuits that could keep it from taking effect.

“This is an attempt to take away women’s basic rights, period,” Dawn Laguens, the executive vice-president of Planned Parenthood Federation of America, said in a statement.

She added: “Everyone has the right to access information about their health care – including information about safe, legal abortion – and every woman deserves the best medical care and information, no matter how much money she makes or where she lives. No matter what. They won’t get it under this rule.”

The Reagan-era rule never went into effect as written, although the US supreme court ruled that it was an appropriate use of executive power. The policy was rescinded under Bill Clinton, and a new rule went into effect that required “nondirective” counseling to include a range of options for women.

Federal funds are already barred from being used for abortion services under current US law.

The move will galvanize activists on both sides of the abortion debate ahead of the congressional midterm elections.

Doctors’ groups and abortion rights supporters say a ban on counseling women trespasses on the doctor-patient relationship. They also believe such rules would prevent patients from being able to obtain birth control or other preventive care from reproductive health care providers, and undermine access to safe, legal abortion, particularly among low-income women.

Abortion opponents have long argued that a taxpayer-funded family planning program should have no connection whatsoever to abortion.

“The notion that you would withhold information from a patient does not uphold or preserve their dignity,” said Jessica Marcella of the National Family Planning & Reproductive Health Association, which represents family planning clinics. “I cannot imagine a scenario in which public health groups would allow this effort to go unchallenged.”

She said requiring family planning clinics to be physically separate from facilities in which abortion is provided would disrupt services for women across the country.

Kristan Hawkins of Students for Life of America also backed the move. She said: “Abortion is not healthcare or birth control and many women want natural healthcare choices, rather than hormone-induced changes.”

Abortion opponents claim the federal family planning program in effect cross-subsidizes abortion services provided by Planned Parenthood, whose clinics are also major recipients of grants for family planning and basic preventive care. Hawkins’s group is circulating a petition to urge lawmakers in Congress to support the Trump administration’s proposal.

Known as title X, the nation’s family-planning program serves about 4 million women a year through clinics, at a cost to taxpayers of about $ 260m. Planned Parenthood clinics also qualify for Title X grants, but they must keep the family-planning money separate from funds used to pay for abortions.

The Republican-led Congress has unsuccessfully tried to deny federal funds to Planned Parenthood, and the Trump administration has vowed to religious and social conservatives that it would keep up the effort.

In one of his first acts as president, Trump reinstated a “global gag rule” policy that restricted the US government from providing funds to international family-planning organizations offering abortion-related services or information about the procedure.

Global health advocates have since bemoaned the closure of abortion facilities overseas, with developing areas the most acutely impacted. Trump later expanded upon the action, affecting nearly $ 9bn in funding to combat global health issues such as HIV/Aids, Zika and malaria.

The Associated Press contributed to this report

Cancer patient waited 541 days for NHS treatment, report says

The longest waits for cancer treatment in England have soared since 2010, with one patient waiting 541 days, analysis suggests.

Two-thirds of NHS trusts reported having at least one cancer patient waiting more than six months last year, while almost seven in 10 (69%) trusts said they had a worse longest wait than in 2010. This was reflected in the average longest wait rising to 213 days – 16 days longer than in the year the Conservatives entered government.

The official target requires at least 85% of cancer patients to have their first treatment within 62 days of referral by their GP, but this has not been met for 27 months in a row.

More than 100,000 people have waited more than two months for treatment to start since the target was first missed in January 2014.

The longest waiting times data was obtained by Labour through freedom of information requests to England’s 172 acute and community health trusts, to which 95 responded.

Jonathan Ashworth, the shadow health secretary, said: “The number of people needing cancer treatment has risen sharply in the past 10 years and the government has simply failed to increase availability of services at the rate required.

“The truth is that the brilliant efforts of NHS staff around the country to deliver the best for their patients are being hampered by tight NHS budgets. Years of underfunding and abject failure to invest in the frontline doctors and nurses we need, means Theresa May is letting down cancer patients.

“Now we know the astonishing truth that some patients are waiting a year or more just to get treatment. It’s simply not good enough.”

The number of patients waiting more than 62 days last year was double that in 2010 (26,693 compared with 13,354), including 10,000 who waited for more than three months, NHS statistics show.

Every trust bar two who replied to Labour’s survey said that at least one patient had waited more than 62 days for treatment.

The figures also showed a deterioration in longest waits for two other key cancer targets since 2010.

After receiving a diagnosis of cancer, patients should receive their first definitive treatment within a month (31 days) and after an urgent referral for suspected cancer they should see a consultant within two weeks.

In both cases, as with the 62 days target, two-thirds of trusts had lengthier longest waits last year than in 2010. The average longest wait to start definitive treatment rose to 90 days – three higher than in 2010 – with one patient waiting 254 days. The average longest wait for a consultant appointment increased to 66 days – eight time higher than seven years ago – with the worst example being a patient who waited 377 days.

In an ideal world, people would start treatment within a month of being diagnosed, according to Cancer Research UK.

Sara Bainbridge, a policy manager at the charity, said: “Part of the reason why hospitals are struggling to meet the target is because NHS diagnostic services are short-staffed. The government must make sure there are more staff to deliver the tests and treatment that people need on time. The long-term plan for the NHS, which is being developed now, is a good opportunity to be more ambitious about cancer survival and increase staff numbers.”

Andrew Kaye, the head of policy at Macmillan Cancer Support, said: “These findings show that despite the tireless work of doctors and nurses, it appears that some cancer patients are still enduring shockingly long waits to start treatment.

“Long delays can put people under incredible stress at an already difficult time and could also mean that someone’s health could take a turn for the worse.”

A spokesman for the Department of Health and Social Care said: “Cancer care has improved significantly in recent years, with around 7,000 people alive today who would not have been if mortality rates stayed the same as in 2010.

“Nobody should wait longer than necessary for treatment and, despite a 115% increase in referrals since 2010, the vast majority of people start treatment within 62 days – backed by our £600m investment to improve cancer services.”