It’s that time of year again: 10th October, the day the World Health Organisation perennially tries to raise awareness of mental ill health and challenge the related stigma. So, have they in any way succeeded? And what has the Madosphere been saying about today?
Well, something must be going right, because Time to Change, a cross-charity initiative run by Mind and Rethink, has received funding from the Department of Health and Comic Relief to continue running for the next four years. Time to Change sets out to combat stigmatisation and discrimination against those with mental health difficulties, and has hitherto received a lot of deservedly high-profile support.
We have achieved a lot in the last 4 years. As a society, we are becoming more open about mental health. Crucially, more people with mental health problems are now living lives free from discrimination. Find out more about our impact so far.
But there is still a long way to go to reach that tipping point where ignorance and stigma in relation to mental health are unacceptable, and where everyone with a mental health problem can be open about it without fear of stigma and discrimination.
We’ll be using our new funding to create long term change. This is more important than ever in a harsher economic climate, when attitudes to vulnerable groups to society tend to get worse.
As they note, while progress has been made, there is much work remaining to be done. However, one thing that may aid in that endeavour is the world of social media. Throughout today, the hashtag #worldmentalhealthday has been trending on Twitter, a great sign that the world is actually talking about this issue. Though that said, here in the UK National Curry Week is now trending, where #worldmentalhealthday is not. It’s quite possible that I’m curry’s biggest devotee in the entire Western hemisphere, but is there not a slight conflict of priorities there?!
But bipolar disorder comes with perks, if you can call them that. Anyone who has been in the system would contest it, because you are still treated like a mental patient. However, the perks are that you are treated as having a, “real” illness. There is sympathy there. You didn’t do anything wrong to get bipolar disorder. It’s like a nasty bug- ah, you’re unlucky. You must have caught it off your mum.
Culturally, we all know what the perks of bipolar disorder are. It has quite the glamourous image. Most people, when asked to think of someone with bipolar disorder, would call to mind Stephen Fry or some similarly artistic person sitting on a giant velvet pillow writing 10 books a day. When asked to think of somebody with BPD- if they even knew what that was- the image would be rather different. Think young, hysterical, self harming woman. (Guess which one vain, writerly I wanted to be?) Is that what they think of me, I worried? Is that what I am? Any of you reading this know the score with a personality disorder. It is the most dreaded diagnosis of them all. Your brain is not messed up- you are.
And now I have another issue! I’m a student mental health nurse. Not a, “real” nurse, as has been said to me twice so far. ”Why would you want to get pissed on by mad people?” and other such lovelies. If the professionals are stigmatised, what hope do the patients have?
Answers on a very large postcard.
Far we may have come, but as Seaneen’s last paragraphs highlight particularly well, there’s still an ingrained societal narrative out there that holds that mental health issues are the lesser cousins of physical ill health.
[W]hy do we silence ourselves so? Do we do so in consideration of cancer or diabetes or migraines? Of course not, nor should we. But why are physical maladies considered the more acceptable relatives of mental ones, when the latter are arguably just as common? And how can an unconsciously ignorant society learn, en masse, that mental health problems rarely resemble the over-blown melodrama perpetrated by biased reporting and established stereotypes…unless we speak up to contradict them?
If you are experiencing mental distress, if it’s too much to cope with, if you feel you have nowhere to turn – you do. Speak. Please, on this – World Mental Health Day – at least consider speaking up to help raise awareness of mental health problems. In a small but important way, you could well be helping millions of others that suffer in silence, and indeed yourself, when you speak.
It is Mental Health Day so of course, I have to add a little collection of words, onto the massive pile.
This year’s subject from what I hear is something like Investing in Mental Health. Since my nation does not have a national health service and as a writer I am tempted to think about my personal investment in my own mental health. What it has cost me that 40-50 years ago some fucking sicko decided to use me as his own personal whipping post with a series of holes drilled into it for phallus, gun etc.
I can’t bear to add it up [her costs for psychotherapy] but I have this math thing that just does it and we are dancing around a million bucks. Because a member of my family was a hideous violent sick pedophile and my parents didn’t care.
Uncle Norman is dead and so is my mother. Look out dad, you are getting one big bill. Because the one thing that distinguishes my mental illness from all others. It is picked up by the direct action of others. It is not genetics, it is not recreational drugs taken well too young. It is not plain bad luck.
PTSD is caught through the actions of other people. Only. Somebody owes me a million bucks. Shit.
I’ve already been asked to give money to people ‘at risk of mental health’, for instance, when mental health is surely the goal – mental ill-health is where it becomes problematic. [This is a personal hate of mine. I would love to be at risk of mental health. Sorry, just a side note. -Pan]
Antidepressants are not the enemy. I agree that appropriate psychological support should be more widely offered, and that medications should be reviewed regularly. However the problem is not with the pills. The problem is the world we live in that makes so many of us despair enough to seek medical help to manage it. It’s with the levels of rape, domestic violence, female genital mutilation and sexual abuse that can make live unbearable for so many. World Mental Health Day should not be ‘celebrated’ by stigmatising us for coping in whatever ways we can.
Very well said.
Another feminist writer – stavvers at Another Angry Woman – has found herself in a similar situation to a number of us in the Madosphere. Yes, we’re accepted amongst those with whom we usually interact – but what happens when we move out of that comfort zone? She also notes that current treatment for mental illness is far from ideal.
I know dozens of people who are affected by a rainbow of mental health problems. Sometimes, given my social circle, I forget that in our general culture, mental illness is still massively stigmatised.
And it is. There are many who do not believe that mental illness is “real”. Being “all in the head” is somehow distinct from physical illness. This is not true: many mental health problems require treatment, mental illnesses can be disabling, and the diseases of the mind/body distinction is false anyway. Despite this, when I go through bouts of depression, I am harangued by work colleagues about when I’ll be “over it” and back. Most days, I see tabloid newspapers screaming about how people are claiming disability benefits for depression. Of course they are. It can be debilitating.
Then there’s the treatment. I waited ages before I got any treatment. One dear friend of mine was twice referred to the wrong sort of counselling–only discovering this after having waited to receive this treatment for months. Another friend asked for bereavement counselling and was curtly informed there is a nine month waiting list for that. Treatment of mental illness leaves a lot to be desired.
The BBC News Magazine examines how mental health-related terms have made their way into popular English vernacular, and asks to what extent this stigmatises those with such conditions (beware of some of the comments in this piece. God, I’m so sick of pricks who think they know everything but actually know damn all).
Using these terms metaphorically is just a joke, not to be taken seriously, argue some. Others, however, warn that this serves to further obfuscate conditions that are widely misunderstood and stigmatised.
Research suggests these are far from isolated examples. A 2007 study of the terms “schizophrenia” and “schizophrenic” in the UK national press found that 11% of references were metaphorical, with broadsheet papers more likely to deploy such phrasing than tabloids. By contrast, cancer was only used in this manner in 0.02% of cases.
…Arun Chopra, a consultant psychiatrist at Queen’s Medical Centre in Nottingham and the author of the British research, believes the tendency has a negative impact on the treatment of patients.
He argues that deploying terms in such a way contributes to public misunderstanding – for instance, reinforcing the false notion that schizophrenia is a “Jekyll and Hyde” illness related to split personalities.
Moreover, he says it can be deeply upsetting to patients and their families, and recalls seeing a woman whose son was diagnosed with the condition bursting into tears when she read a newspaper article which described the weather as “schizophrenic”.
“The use of the word as a metaphor is tremendously damaging,” Chopra adds. “It’s part of the process of creating a stigma around mental illness.
“You would never hear it used in relation to a physical condition. You wouldn’t hear someone being described as a bit diabetic.”
What are your views on this? My take has always been that actual terms do not offend me: the intent behind them does (or doesn’t, oftentimes). However, the statistic comparing the slang use of words like ‘schizophrenia’ versus the same re: ‘cancer’ got me thinking. I reckon that I would be much more likely to use the word ‘cancerous’ to describe something vile and nasty than I would be to use the word ‘schizophrenic’ to describe strange, disturbing intrusions (and I’d be even less likely to misuse the latter in the way that it’s become culturally popularised, ie. that it denotes split personalities). But then, I am mental – have my own mental illnesses subliminally influenced my tendency to use or avoid words or constructions that could be deemed offensive? A interesting query, but one to which I don’t have the answer.
Also on the Beeb’s site is 25-year-old Ross Wilson, who bravely shares his story of schizophrenia and depression.
“My approach to the spiritual path was to stare at people.
“As I got more and more into believing my Jesus-type role I actually believed I was hearing the voice of God.
“You can imagine I got a lot of strange looks and people acted upset around me.”
Ross moved to Louisiana with an acquaintance but his behaviour resulted in him being thrown out of the apartment after a week.
It was then that he put himself completely in the hands of his faith.
“I figured I would live by God and let the universe provide for me.
“I went walking for miles and found a bridge.”
Ross lived under the bridge beside a homeless man for three days, relying on a dirty pillow and duvet, found behind a shop, for warmth.
But eventually he phoned his parents and told them he wanted to come home.
Despite telling them they would never see him again if they attempted to section him he eventually sought help himself.
He walked into an A&E department of a hospital and told them he was “mad”.
Nowadays, Ross plays in a band called Wilson and gives talks to “promote awareness and to tackle the stigma surrounding mental health issues”.
He will perform a charity gig at The West Wing Arts Centre in Slough on 15 October.
He believes the secret to dealing with mental health problems is to tackle them early on.
He added: “There is help out there and you just need to take those first steps to go to your doctor and not be afraid of it.
“It was a horrible time for everyone. I rely on the fact that the people around me are a lot more clued up on recognising my early warning signals.”
Fast forward to early 2009, when I had finally been referred to a psychiatrist due to my increasingly bizarre behaviour, mood swings and thought patterns. I saw that psychiatrist, who told me there was nothing wrong with me and that even my ‘depression’ was in remission. I walked out of his office and back to my house where a few hours later I went quite catastrophically mental. An episode of self-harm, a large overdose and an overnight stay in the local hospital (while they tried to figure out if I was going to die) later, and I was sent home. With a leaflet, with the local crisis team’s number on it.
She [a new psychiatrist] said there and then that it was one of the most honest accounts of living with Emotionally Unstable Personality Disorder that she had ever read. She asked if she could keep it to give to other mental health professionals who didn’t fully understand the illness, in fact. She listened to what I had to say and she gave me a name for my experiences. She took me off the antidepressant I had been on which dulled my emotions to the point of perpetual blankness, and put me on a new one – which didn’t end up working for me in the long run, but was a welcome change.
She did, however, start me on the antipsychotic that was the foundation for the rebuilding of my mental health. Gone were the periods of destructive mania, of flying into rages and destroying household objects, of snapping at my poor, innocent son for perceived indiscretions. Olanzapine gave me back my life, despite my initial misgivings about it based on what I had read on the internet.
So that’s where I am right now. Nearly ten years in the mental health system, some of it good, some of it bad. The emotionally unstable personality disorder and bipolar disorder still affect me, of course – sometimes quite intensely – but with my medication and the things I learned in therapy they are mostly contained. While I am nowhere near being cured of EDNOS, I am well on the way to being in recovery.
Finally for today, blogging for The Huffington Post, Richard Grey finds himself sceptical of CBT and anti-medication biases (if it is considered acceptable to propose to people you’ve never met whilst writing under a pseudonym then Professor Grey – will you marry me?).
Looking at mental health practice right now it feels sadly devoid of the revolutionary, imaginative and creative thinking that we take for granted in so many other areas of our lives. In a very real sense the outcomes for patients with long term mental illnesses like schizophrenia are getting worse, not better.
This is a tragedy; mental illness is painful and distressing. It is hard to imagine the torment that someone with schizophrenia experiences when they hear voices telling them that they are evil and deserve to die. To understand the pain of these symptoms we have to recognise that this is their reality and it is absolutely terrifying. These are symptoms of an illness, an illness where there is dysfunction in the patient’s brain.
Researchers have demonstrated that when delivered by a skilled therapist, CBT is as effective as antidepressant medication in the treatment of depression. Against schizophrenia and bipolar disorder, CBT also seems to be effective for example in helping patients cope with voices. But, and it is an important but, CBT only works (in schizophrenia and bipolar disorder), if patients are already on medication.
Mental health practice is littered with countless examples of effective but complex interventions that work in theory but not in practice. The reason that they don’t work is that they are too complex. Perhaps rather than focusing on ever more complex intervention we should consider simple intervention that can be reliably provided to all patients with mental illness. In a time of austerity making sure that everything we do really counts makes a lot of sense.
I want to argue for a simple revolution; we stop doing the complex badly and focus of doing simple things exceptionally well. But my real plea on world mental health day is to stop listening quite so much and start imagining.
I’m aware that this article is heavily biased towards UK readers so, non-UK-ians, please leave your favourite World Mental Health Day links in the comments! If we get enough, I’ll add a selection of them to the post.