Mental ill health: the last taboo?


by Laurie Penny    
11:39 pm - February 11th 2009

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For days, now, I’ve been trying to put down in words what I feel about the Christine Laird case, the civil case currently about to create a legal precedent for suing one’s employees if they dare not to reveal that they have a history of mental ill health. I work in mental health, and what I’ve been hearing everywhere is – well, maybe she wasn’t doing a very good job anyway.

And I am here to say: I have absolutely no interest in what sort of job Christine Laird was doing. She’s not being sued for doing her job badly, she’s being sued for being a closeted mentalist, something that, in this culture, she had every reason to be. The simple fact is that, faced with a very real prejudice against people with past or present mental health difficulty in the workplace – faced with a situation in which only 40% of employers will even consider employing someone with a mental health difficulty, and only 24% of people with chronic mental health conditions are in work – most of us lie. Current disability laws do not protect workers like Christine Laird who choose to hide mental health conditions for fear of facing prejudice. This means that current disability laws are a steaming crock.

Do I think that being a mentalist is something to be proud of? Of itself, no; I’m no more proud to have mental health problems than I am proud to be short, or that I have straight hair, or a high IQ, or that I’m white. These are inalienable things about me, borne of nature and of nurture. In the same way, in any sane society, being gay shouldn’t have to be something to be ‘proud of’ – but the fact is that living life honestly and successfully as a person of non-heterosexual orientation in this 21st-century world is still a challenge, and one that every queer person who is honest about their sexuality should justly respect themselves for. In just the same way, people struggling with the daily challenges of mental health difficulty should be able to feel proud of themselves for doing so, rather than think of themselves as the state and their families too often characterise them – as dangerous criminals.

And I am angry. Because I am a person who struggles with mental ill health, and I am proud. I’m sorry, mum. I’m sorry, dad. I know that the way I was born has caused you a great deal of grief, and for that I’m sad and I’m sorry, but I’m not ashamed. In fact, I’m proud as anything to be sitting here today, alive and thriving and dealing both with my mental health problems and the stigma that they have won me, as I ever was when I got my degree. It’s been a long, hard road, and I’m sad and I’m sorry, but I’m not ashamed.

And if I could ever be honest in a job interview, here’s what I’d tell them. I’m the best candidate you’ll see today, not just because of my creativity or my academic record, but because the challenges I face daily have made me a stronger, better person. I learned more about the world and how to live in it over the 9 months I spent as a psychiatric inpatient than I did in the three years of university that followed. I know about waiting, and frustration, and I know what it’s like to have your dreams ripped away from you and to have to build them again and build them better. In order to make full use of my talents, you may well have to adjust your prejudices as well as your working practices. You may have to allow me time to deal with my condition; you may have to trust me to work to the best of my ability without the marker of 9-5 attendance or constant insufferable smiliness, but you’ll know that every bit of work you’ll get out of it will be my best, because I have something to prove.

I look at the amazing young people I’ve befriended over the last few years, and I see how powerful and beautiful they are, how they constantly support and buoy one another up, despite the fact that in many cases their families and employers don’t or won’t understand what their lives are really like. I look at these beautiful young people, and I worry for their futures. I know that people just like us, people with mental health problems, are today’s disenfranchised, making up 72% of the prison population and a large percentage of the homeless and unemployed. I know that we are barred from holding parliamentary office, shunned by employers and stereotyped by the media. If I have a child, the chances are that with my genetics that child will grow up facing some of the same difficulties that I face. I want my children to have the same opportunities and life chances as anyone else.

Our laws, our employment structure and our attitudes to mental ill health need to change, and they need to change now. We can no longer afford to keep the millions of citizens with mental health difficulties largely disenfranchised, disaffected, poorly treated and out of useful work adapted to their needs. We can’t afford it morally, and these days we certainly can’t afford it financially. I’m not satisfied with the welfare reform bill being quietly swept under the table; I’m not satisfied with Employment and Support Allowance, with Personal Care Budgets. I will not be satisfied until people with mental health difficulties have the same rights to live and love and work and receive care as people whose needs are different.

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About the author
Laurie Penny is a regular contributor to Liberal Conspiracy. She is a journalist, blogger and feminist activist. She is Features Assistant at the Morning Star, and blogs at Penny Red and for Red Pepper magazine.
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Reader comments


*Applauds*

Glorious. So glorious I feel a tad guilty for saying: shouldn’t it be “40% of employers won’t even consider…”?

No – unfortunately, 60% of employers won’t even consider….

Ach, sorry, I misread the sentence.

*Shuffles back into the shadows.*

time for mental health to be in the closet is up.

UK mental health numbers are worse than the US .
US mental health numbers are the 2nd worst worldwide, I believe.

Ben@3: *pets*. I heart you.

This mentalist is off to bed now. :)

UK mental health numbers are worse than the US .
US mental health numbers are the 2nd worst worldwide, I believe.

Slightly Disingenuous given that the standards and practises of psychiatry vary hugely from country to country as does access to mental health facilities. I somewhat doubt Saudi Arabia can be accurately compared to the United Kingdom in terms of mental health. Like most international comparisons outside of raw population statistics, it is probably of limited reliability.

Thumbs up on the article though, but it is slightly short on how this is accomplished beyond a societal shift in attitudes, despite part of it being on issues which really need a policy input, such as the prison population. Is there anything specifically you’d like to see from government and public services?

Well I reckon much of the problem lies in the unintended consequences of employment regulation. If you make it very difficult to fire people (and it is VERY difficult to fire people from a council position), then it gets difficult for non-standard employees to get hired in the first place and to do so honestly. In a more flexible labour market, people could have the opportunity to prove themselves in their work, and the employer would be more prepared to take risks with new people on the basis that they weren’t putting too much more than a month’s or week’s salary at risk each month.

Of course, employers find ways round this problem – the proliferation of unpaid internships represent one way of tasting the skills a potential employee has to offer, as well as the use of temporary workers. And all these features end up harming employees outcomes and especially the prospects of those with more statistically risky attributes.

8. So Much For Subtlety

The problem here is covering so many people with the term “mentally ill”. I know why advocacy groups do it – if they can stretch the truth and claim one in four of us will have a “mental illness” then they will get more money and have more influence. But there are issues involved in employing the mentally ill.

Let’s deal with the least important first:

Anyone with a chronic illness imposes costs on their employer. If society as a whole feels it is fair and just that the chronically ill have the same employment chances as everyone else, then it ought to be for society to pay. Not for specific employers. Because they won’t and there is not a lot we can do to make them. They will find someone else and some excuse not to hire or to fire the mentally ill. So why fight the inevitable if you are going to lose? We need to subsidise the mentally ill, not bully people into employing them and not defending the mentally ill when they lie and cheat.

The assumption here is that mental illness is a form of identity like being gay is. This is highly questionable. I suppose that if the mentally ill wish to claim they have an identity similar to homosexuality there is not a lot I can do about it. But I don’t think that society ought to recognise any such identity. It would prohibit all forms of treatment for one thing. There is a chance we can cure some forms of mental illness and certainly we can treat most. The last thing we need is people who hear voices telling them to kill asserting that they not only don’t want to take their medication but that their disease is their identity and so it is genocide to make them. Which leads straight into the claim that it is genetic. We do not know the causes of most forms of mental illness and so, no, you cannot claim it is genetic. It may just be a disease like a common cold. We do not even know if it can be helped – all we do know is that at the moment we are all helpless, not that we will always be.

Some forms of inherited condition impose barriers to entry for some jobs. Alas I will never play for the NBA. Not that I want to. Nor, I suspect, will my children. It is not discrimination to say that we cannot. Nor would I make a good Bouncer, or a weight lifter or a gymnast. All for genetic reasons. It does not follow that even if mental illness was genetic it should not be a reason to prohibit people from some, not all, jobs. You have to look at the condition and decide whether or not it affects the ability of the person to do the job.

Which leads into the last observation: having been a civil servant I assure you there is no misery like working in an office with someone with a personality disorder (who would, no doubt, be called mentally ill). It DOES affect their ability to do the job. When they throw violent temper tantrums for reasons that are obscure to everyone else, when they disrupt the work of others because of personality clashes or delusions that simply do not exist, when they see conspiracies out to get them, when they take against members of the public for no readily apparent reason – these all disrupt the ability of an office to function. They ought to be sacked. I am sorry if this seems unjust but there is no choice when it is just not possible for the office to function.

That is not to say all “mentally ill” people ought to be sacked, but there are some conditions for which some jobs are just not suitable.

I have met many a mentally ill person in my time filling out DLA forms & that for people. It strikes me that they have all got problems, not one is any kind of faker. Having a mate who has depression really humbled me because I can’t begin to imagine what it’s like as his mentality is so utterly alien to mine. So I had the humility to give up trying to understand & just accept business as it it.

The actual claiming process is hell on earth. But I have developed positive views of DLA if it is awarded, because it is not means-tested & is not affected by employment or otherwise, so it’s far better than pretty much any other benefit going. This is why I am quite warm towards the idea of a CBI.

People fear losing their housing & council tax benefit. But if you are on the autistic spectrum, for example, if you get DLA (which admittedly may not happen) you can go into a job without worrying about it fucking up.

It makes me laugh that right-whingers who moan about the disabled are the same people who support businesses’ right to hire & fire at will, without realising that the disabled are least likely to be taken on by employers. Are they not capable of seeing the inconsistency?

My answer would be to encourage voluntary work, & in some cases work trials rather than the usual CV/interview case. I know a lot of people who are severely disabled & they pay their way in mainstream jobs.

For every faker, of whom I’m sure there are a few, there are genuine cases who get fucked off, & every “clampdown” hits the deserving hardest.

10. So Much For Subtlety

Asquith, let me agree that businesses will not often take on the mentally ill. They will not do so voluntarily whether it is legal or illegal.

So what are you going to do?

We can try to bully them and punish the stupid and honest. Which will not mean that the mentally ill have jobs. Or we can accept that if society wants the mentally ill in work, it ought to be society, not some employer chosen at random, that pays for it. And hence the Government ought to offer a subsidy for every employee until all the mentally ill are employed.

Nor is the problem with fakers, but with people on a spectrum who discover good reasons to claim to be ill when otherwise they would not. The more of anything you pay for, the more you have.

11. Alisdair Cameron

Err, So Much For Subtlety, the trouble is that “We can try to bully them and punish the stupid and honest” is the Govt’s current policy against those with MH problems: basically we/they are being told you must find a job, or there will be no benefits. Furthermore, treatment is being focussed overtly on return to work, as opposed to recovery. This is short-termism of the worst kind, putting a sticking-plaster on gaping wounds, and pretending things’ll be okay: getting someone vulnerable into shitty, low-paid, low-security work may not do wonders for their mental health in the longer term, but the back-up support isn’t there- 6 short sessions of CBT ain’t going do much for anyone but the scarcely afflicted, who’ll get better in time anyhow.
It also ignores the fact that you cannot attempt to penalise folk for not being able to find jobs, if employers won’t take them on.

12. So Much For Subtlety

AC – “basically we/they are being told you must find a job, or there will be no benefits.”

What is wrong with that? There is no shortage of jobs, if they don’t have one it is because they don’t want one at the prevailing wages. I don’t approve of their approach, but it will work.

AC – “Furthermore, treatment is being focussed overtly on return to work, as opposed to recovery. This is short-termism of the worst kind, putting a sticking-plaster on gaping wounds, and pretending things’ll be okay: getting someone vulnerable into shitty, low-paid, low-security work may not do wonders for their mental health in the longer term, but the back-up support isn’t there”

I disagree totally. It has been repeatedly shown that offering the mentally ill a Golden Bridge to a bad outcome makes them worse. This is why they never ever take soldiers with PSTD out of Theatre these days. You tell the mentally ill that it is fine for them to be so sick they do not need to work, they will become so sick they cannot work. A shitty, low-paid, low-security job is likely to be the best therapy we have for the vast majority of mentally ill people.

However you miss my point – the bullying referred to bullying employers.

“It also ignores the fact that you cannot attempt to penalise folk for not being able to find jobs, if employers won’t take them on.”

At some wage level an employer will be tempted. The best solution is to top up the wages until they are employed. My point is about penalising employers. You cannot make them employ someone if that employees imposes a cost on them. Which the mentally ill all too often do.

I agree with So Much For Subtlety @8 in disliking the tendancy to cover such a vast spectrum of people with the unhelpful term ‘mentally ill’. It’s a loaded phrase which I think obfuscates the problem in so much as it suggests that a catch-all policy should be applied to a panoply of very different problems; nobody would suggest that an all encompassing stance be taken on all ‘health’ issues from colds to HIV alike.

One of the first stages of progress in ending employment discrimination would be to build awareness not of ‘mental illness’ as a single, scary entitiy lurking unknown inside some employees’ heads, but of the fact that there are non-physical health problems that do not necessarily affect a person’s ability to work.

Christine Laird’s decision not to declare her depression as a disability is one that I believe is just – depression, although sometimes debilitating, is not a disability in the same sense that blindness or MS are. Her employer’s reaction to her problem is symptomatic of a lack of openness, understanding or willingness to accommodate a problem which, as Laurie describes of her mental health difficulties, is one that rather than preventing a person from functioning, may in fact make them stronger for overcoming or controlling it.

Before any further progress can be made, levels of awareness and understanding need to be raised. People with non-physical health problems should not all be bunched under the same umbrella, do not all require the same ‘special treatment’, and, in the majority of cases, most definitely do have something to offer potential employers. The widespread (perhaps willful) ignorance of invisible health problems needs to be addressed before honest, constructive dialogue in employment for the ‘mentally ill’ can even begin to take place.

1) A “mentalist” is a stage performer/magician, like Derren Brown or David Blaine, that is, someone who entertains with mind illusions. The word has sometimes being used as a playground taunt by the ignorant to mean “nutter” but really – it isn’t the same.

2) people with mental health problems are NOT barred from parlimentary office. The rule is “if sectioned for 6 months” which still may be a problem but is only a fraction of all those with mental health problems.

This is a serious topic, so please, let’s have some accuracy from the “journalist” here.

People with non-physical health problems should not all be bunched under the same umbrella, do not all require the same ’special treatment’, and, in the majority of cases, most definitely do have something to offer potential employers. The widespread (perhaps willful) ignorance of invisible health problems needs to be addressed before honest, constructive dialogue in employment for the ‘mentally ill’ can even begin to take place.

Yes, exactly.

16. Mike Killingworth

Well done, Laurie. A very brave honest article – blogging at its best.

I agree with those posters who question whether it is useful to lump all mentally ill people together. We don’t, after all, suppose that the needs of the deaf are the same as those of the blind.

The basic problem is that mental illness scares people in a way that physical disability doesn’t. At one extreme, there are people with severe psychoses who do represent a danger to the rest of us: at the other, it’s actually normal for anyone to wonder occasionally if their mental health is a bit flaky – most of the time it’s just stress of some kind, and not actually a medical problem – not that the boundary is clear-cut – but that is probably at the root of the fear and the negative attitudes.

As far as the Cheltenham case is concerned, if they did a thorough medical evaluation and if their former Chief Executive did conceal that she had a history of mental illness, then yes, I’m afraid that they are right to want some at least of their money back.

It would be nice to think that simply paying a benefit like DLA would deal with the problem that the costs should fall on society, not on employers. But the nature of the cost isn’t as simple as that. Suppose I told a prospective employer that I am a recovering alcoholic – which I am – and they had a culture in which all their team-building was done down the pub. I think it would be reasonable of them not to hire me – and I almost certainly wouldn’t want to work in such an environment anyway.

I don’t know what’s wrong with SMFS. S/he started off by making some fairly valid points and then degenerated into ranting a shitty, low-paid, low-security job is likely to be the best therapy we have for the vast majority of mentally ill people. I wonder if SMFS has actually advised – or would recommend – that course of action to someone s/he cares about who has a mental health problem? This is of course to leave aside SMFS’s claim that there are “plenty of jobs” which will come as news to politicians of all parties, let alone anyone else.

Anyway, to wrap this up, once again – I’m proud of you Laurie. I hope you have the tools and support to deal with whatever it is you were diagnosed as having, and all the best.

Mike

Suppose I told a prospective employer that I am a recovering alcoholic – which I am – and they had a culture in which all their team-building was done down the pub. I think it would be reasonable of them not to hire me

I woudn’t, and I’d see them in a tribunal faster than you could say “You’ve got to be freakin’ well kidding me”

It doesn’t take much effort on the employer’s side to move the team-building meetings to a more appropriate venue ffs; why on earth should you accept such petty discrimination?

Good post Laurie, although like think I do take issue with the use of the term mentalist.

18. Alisdair Cameron

@ SMFS, you misinterpret me entirely, then make plain wrong assertions. I was making the point that actually, there isn’t any bullying of employers, and the bullying is solely of the service user. It’s demonstrably proven that just shoving someone with complex MH needs into ajob, as if work were of itself a cure is counter-productive and an utterly false economy, as relapse rates rocket without support, support which employers are loth to give and which the Govt is singularly shy of funding.

Some more related thoughts:

[note of interest: I have used MH services, work in 'em and have put on a big exhibition, still running in a major museum about MH, its history, user experiences and stigma]. You can reduce stigma by saying that MH problems are normal and affect everyone, conflating mental wellbeing with mental illness (for want of a better term for the purpose of this point), but that may mean that those with severe and enduring MH problems are more marginalised, as the worried well witter on about how ‘depressed’ (non-clinically) they are, as if that gives them insight into lasting and enduring conditions. Or, you can enlighten the public about the major differences in experiences and suffering that go with severe and enduring problems, but that risks the public switching off and seeing users as ‘the other’ and not paret of mainstream society. Tough call.
For donkey’s years now, it has been generally accepted in Mental Health circles that plain sadness, unhappiness and bereavement, while unpleasant emotions, do not require treatment (nor medication) as they are psychologically healthy responses. Only if one’s ability to function on a daily basis is impaired significantly is intervention truly warranted.
One of the greatest errors made by the current Govt has been to conflate mental health (and already-strapped MH services) with happiness and satisfaction: see Layard etc. A cynic might suggest that the diversion of resources away from severe and enduring MH problems (e.g. bi-polar, Schizophrenia, full clinical depression) has two aims: by ‘treating’ cases that never really warranted treatment, you can ‘achieve’ a remarkable success rate, and ‘cure’ shedloads. Also, putting money into having a CBT-lite practitioner on every street corner to ensure folk keep happy (despite the shitty reality of their existence…) means less social dissent, and more contented (brainwashed?) low-pay worker drones. CBT is okay, but NOT a panacea for all mental distress. CBT in essence does NOT cure people, merely equips them better to manage their condition, and those it ‘cures’ are those in much less need of intervention. Furthermore, CBT is promoted above other talking treatments (e.g. solution-focus therapy) because it is cheaper and can be delivered at a basic level by someone after just a couple of weeks training.It corresponds to the Government’s fatal love of grand schemes (a CBT ‘practitioner’ on every street corner) without addressing the more intractable cases of mental distress, which only respond to a tailored approach, not a one-size-fits-all CBT session. An underqualified and less capable/intelligent practitioner is little more use than a general chat with someone.This though is what will transpire: cheap,tokenistic nods towards mental health, which diverts resources to those in the least need.
There appear to be two separate definitions or interpretations of the term mental health in operation, which muddies the waters for any debate. One is the realm regarding recognised/diagnosed/labelled mental health problems (clinical depression/bi-polar/schizophrenia etc), where needs are greatest as it includes all those with severe and enduring MH problems, regardless of where they receive services. The other is the area of mental well-being, and the management of adverse responses to commonplace life events (e.g. stress, divorce, bereavement, redundancy). With one you have a more identifiable user-base, whereas the other potentially encompasses everybody in society at large. The former is where the finite mental health specific resources should be directed, whereas the latter is in less need of MH-badged services and resources, and should be handled in general primary care/public health initiatives, if indeed by public services at all. If this is not observed then the risk is run that scarce resources are effectively diverted to those with easier to resolve issues, which may just as well be dealt with by a sympathetic GP, or indeed by non-health services.
More people should attempt to take on board that one can be psychologically healthy, while at the same time feeling sad or unhappy: they are normal aspects of the human condition. Only when they take on extraordinary aspects or really impair functioning should measures be taken. When resources are finite, as they are in health and social care, they should go to those in the most need, rather than those simply upset, but with loud voices.

“So Much For Subtlety”, just when it’s the hardest time in generations to find a job,you appear to support measures to beat up on those who can’t find employment/ indentured labour in return for meagre benefits, labour for the multinationals who then reward the politcos with directorships and consultancies for securing them cheap labour? Look at the welfare bill, its bullying attitude and the way in which it’s alreafy being implemented: it’s easier to pick on the less powerful, the weak, the disabled than vested interests or the criminal (not the same as those on benefits).

The problem is that “mental health” is such a broad (and arguably meaningless) description encompassing everything from a one off depressive episode to full blown, life long, florid scitzophrenia. Its like putting everything from a cold to cancer under the umbrella “physical health”. Even the most distressed person, with the right support, could probably do some sort of job, but apart from menial work, the most seriously ill probably could not. For example, having a depressive behind the counter in a bank would probably be ok (in fact at the moment it’s probably guaranteed) but who would want a schitzophrenic flying a passenger jet ?

Don’t you guys wonder why the UK seems to be the Mental Illness capital of the world?

I wouldn’t necessarily have a problem with having a schizophrenic flying a passenger jet. Look it up, it doesn’t mean what most people think it means, is treatable and like most mental illnesses covers a spectrum of different manifests expressed at a range of different levels.

6.

the figures I refer to are about depression.

if yu refer to bad faith on my part – by which I take it what you mean, then you are wrong.

re Saudi. it is wellknown fact that those of a religious disposition have less mental problems. yu may ofcourse say that women (relative to men) suffer more in saudi and ye, I would agree with that,

mental health issues are about self control. which in turn comes from an unbalanced view of (the individual’s) life. I think.

The last TABOO.

what about paedophilia?

suppose yu could say that as the consequences of this are mental health issues…

24. Alisdair Cameron

ash, you really aren’t terribly well informed about mental health are you?

mental health issues are about self control. which in turn comes from an unbalanced view of (the individual’s) life. I think.

Yeah totally, coz, liek, I heard that people with that Alzheimers just need to chill out and get some perspective on their lives, then they’d be normal.

Roob.

26. Mike Killingworth

[17] Cath, I wouldn’t have the beginning of a case. Our anti-discrimination legislation is built around the principle that discrimination as such is perfectly OK, even necessary: it then applies specific exceptions to this general rule (e.g. age, race/religion, gender, sexual orientation etc).

The difficulty in making the argument that mental health should be treated in the same ways has been highlighted by other contributions to this thread – the term covers too many different conditions. AC [18] makes some very pertinent points.

27. Alisdair Cameron

Mike @ 26 is sadly right. Despite the rhetoric from some Panglossian Govt folk, it’s very hard in practice for MH service users to get very far using say the DDA (Disability Discrimination Act), save perhaps when they are in receipt of DLA on severe and enduring MH grounds, and even then it’s damn tricky (plus more and more folk are being turfed off DLA, without having got any better, and it’s abloody lottery when it’s allocated)

24. let’s look at the facts.

please provide points of difference. thankyou.

25.

alzeimers I do not regard as a mental health issue.

think it is all about terminology.

but is a good point yu make.

there are chemicals in our body that affect us.
and then there is our outlook on life.

if the chemical are so not right then we cannot work on changing the outlook on life. so yes, we need a psychological platform (baseed on chemicals) before we start working on the psychological aspects.

when I talk about mental heath I was referring to the psychological aspects and not pharmocological.

Ash, Alzheimers is a ‘mental health’ issue – although, as I’ve said above I’m not overly fond of that term.

You don’t seem to appreciate the difference between being a bit down (i.e., your outlook on life’) and being affected by what you call pharmocological problems related to the brain. Conditions such as anxiety disorder, schizophrenia, bi-polar and major depression are all caused or aggrevated by ‘chemicals in our body’. They are not problems that people can overcome by just cheering up or changing their outlook. The happiest people you know are just as likely to suffer from non-physical health problems as people who have a negative outlook.

Psychological problems often have a physiological or biological basis, and can’t just be thought away, which is what this debate is all about; people being penalised for problems that are beyond their control, difficult to quantify and widely misunderstood.

Cath, think – thanks for picking up on the ‘mentalist’ terminology. I’m trying to reclaim it as a less-loaded word than ‘mad person’ or ‘nutter’, because it’s a way I’ve often heard mentally ill people jokingly describe themselves and others, and because its how I describe myself.
Also, it’s just a hassle to type out ‘person with mental health difficulties’ every single time.

And if I could ever be honest in a job interview, here’s what I’d tell them. I’m the best candidate you’ll see today, not just because of my creativity or my academic record, but because the challenges I face daily have made me a stronger, better person. I learned more about the world and how to live in it over the 9 months I spent as a psychiatric inpatient than I did in the three years of university that followed. I know about waiting, and frustration, and I know what it’s like to have your dreams ripped away from you and to have to build them again and build them better. In order to make full use of my talents, you may well have to adjust your prejudices as well as your working practices. You may have to allow me time to deal with my condition; you may have to trust me to work to the best of my ability without the marker of 9-5 attendance or constant insufferable smiliness, but you’ll know that every bit of work you’ll get out of it will be my best, because I have something to prove.

I have a big problem with this, not because I don’t think you’d be a good candidate (depends on the job), but because *you* will never be in a position to know that you’re “the best candidate you’ll see today”. That’s got nothing to do with your health. As an interviewer, I’d put an instant black mark against anyone who said “I’m the best candidate you’ll see today”. Just say you’re a good candidate, and say why. I wouldn’t want to give a job to someone who thought they were better than everyone else, let alone to someone who thought they were better than other job applicants they knew absolutely nothing about.

33. Mike Killingworth

[32] If I was on the other side of the desk, I’d think as you do, Mark. But would Alan Sugar?

Perhaps not – but I’m assuming it goes without saying that you wouldn’t want to work for the kind of person who wanted to employ twats.

35. Alisdair Cameron

@ ash, your woolly and at times plain incorrect use of terminology does point to an unfamiliarity with MH, MH issues, models of MH (the bio-chemical, the psycho-social, the social, the disability model etc etc) mental health services, treatments, therapies etc.
Some MH problems have more roots in socail experiences, some have more genetic bases, others have chemical causes. Oh, and Alzheimer’s is an MH problem, as is dementia. Just because something has an organic cause doesn’t mean it isn’t an MH problem: for example a wide variety of central nervous system diseases, from both external toxins, and from internal physiologic illness, can produce symptoms of psychosis.
Jamie Sport in post 30 has it about right.

“It doesn’t take much effort on the employer’s side to move the team-building meetings to a more appropriate venue ffs; why on earth should you accept such petty discrimination?”

That is not a matter of petty discrimination – it is a question of changing the way an entire company strategy is constituted for the sake of one new employee. Why should they do that? If you force it through government legislation, you will just generate resentment of people with mental health difficulties, and create incentives to try and select out potentially costly employees at an earlier point in the hiring process. Better would be the most flexible system possible, combined (if you must) with transparent benefits for those disadvantaged. Given the ability to experiment, plenty of companies will work out their own ways of including people with mental illnesses in their workforce. There are too many mentally ill people out there for them not to!

30.

outlook on life can be a cause of a period of major depression. and I speak from personal experience.

outlook on life is nothing to do with cheering up.

It is about a number of things including one’s value system.

35.

thanks . we do not differ.

‘re Saudi. it is wellknown fact that those of a religious disposition have less mental problems. yu may ofcourse say that women (relative to men) suffer more in saudi and ye, I would agree with that,’

Actually, I’m researching an article on religion and mental health at the moment, and this is a load of bollocks. Studies have consistently shown that it is not one’s religion that affects one’s mental health, but vice versa.

To illustrate this: a Christian person who enjoyed good mental health might well cherish an ontology wherein a loving and forgiving saviour will one day spirit them away to heaven; a Christian person with anxiety issues and low self-esteem would be more likely to fear a wrathful god who they needed to strive constantly and vainly to appease; a Christian person with paranoid delusions might become convinced they could hear angels talking to them and instructing them to behave in certain ways. Just as, for example, some atheists are incredibly happy with their position on the natural spectrum of life and death, and some live in constant mortal terror of ultimate death without hope of afterlife.

In fact, the only exception is when a person is brought up in an extremely fundamentalist religious culture/family/environment, which has been shown to be far more damaging to mental health than simply growing up in a culture in which religion plays a part.

Mike (16): if you know of any employer which refuses to employ those who do not drink alcohol then I’m surprised they have not been prosecuted for racial discrimination as this would effectively bar Muslims (among others) from employment. Its not an accurate analogy.

I made the mistake of telling a line manager about my mental illness a few years ago and the result was that every arguement I had with him was dismissed as a result of my condition: eventually I had to transfer to another office. Shortly afterwards he was transfered out himself for racially abusing another member of staff: her complaints were taken seriously because racial abuse is more easily demonstrated.

If you are mentally ill your complaints are taken as a symptom of your illness.

Shatterface

if you know of any employer which refuses to employ those who do not drink alcohol then I’m surprised they have not been prosecuted for racial discrimination as this would effectively bar Muslims (among others) from employment.

Excellent point. Holding team meetings in the pub and making pub going a requirement of the job would constitute what’s known as indirect discrimination, for exactly the reason you give. I understand the Govt is looking at changing the law on disability discrimination to include indirect discrimination, as under existing law sex and race are the only protected groups that are covered by it.

Nick

That is not a matter of petty discrimination – it is a question of changing the way an entire company strategy is constituted for the sake of one new employee. Why should they do that? If you force it through government legislation, you will just generate resentment of people with mental health difficulties, and create incentives to try and select out potentially costly employees at an earlier point in the hiring process. Better would be the most flexible system possible, combined (if you must) with transparent benefits for those disadvantaged. Given the ability to experiment, plenty of companies will work out their own ways of including people with mental illnesses in their workforce.

It’s not just about one new employee, it’s also about potential employees who could being put off applying because they know these practices are in place, and about existing employees uncomfortable with their working culture but who are too scared to speak up for fear of losing their jobs.

Your argument about creating resentment by imposing change, and leaving it instead for companies to work out for themselves, is exactly the same argument that was used when the sex and race discrimination laws were first introduced. Companies have had years to come round to the idea of employing people with mental health difficulties, they’re not a new group that’s suddenly sprung up out of nowhere, and as Laurie rightly says, they’re still one of the most discriminated against groups when it comes to recruitment and employment. Unfortunately legislation is sometimes the only way to prompt employers into making the necessary changes.

42. Mike Killingworth

[40] [41] The points you both make are valid in the way you frame them, and the way I set up my straw man would lead you in that direction. There is of course all the difference in the world between someone who does not drink for religious reasons (which includes other people than Muslims, btw) and someone who is allergic to alcohol.

For example, on the railways the First Group consider recovering alcoholics a health and safety hazard (i.e. they might relapse) and refuses to hire us, while London Underground provide support facilities for those of us in their employment. The former approach is better business practice, the latter is socially responsible.

Meeting the particular needs of their employees imposes costs on firms, just as waste disposal does, and “efficiency” (in the strict economic sense) requires firms to minimise or evade such costs.

This is before we come to the issue that Shatterface raises, of managers who simply aren’t doing their job. The boss s/he describes no doubt had a boss himself, who was doubtless well aware that S’s immediate boss was the way he was but swept the matter under the carpet. I very much doubt they were criticised when the brown stuff eventually hit the fan.

There already are laws to protect the rights of people with disabilities in the work place but they have some reasonable exceptions: you wouldn’t employ blind taxi drivers for instance and a workplace within a listed building would not be expected to build wheelchair ramps if the place of business is not open to the public.

However there are no reasons to discriminate against people where reasonable adjustments can be made and in the case of people with mental conditions these adjustments are slight. There are a lot of extremely talented people out there whose conditions can be managed but apart from within the arts world we rarely hear about them.

“it is not one’s religion that affects one’s mental health,”

yu have stats to show that (under contro studies) that this is the case.

religion (which really is any devotional shared activity) gives a sense of belonging. would yu not agree that isolated ppl have more menal health problems?

perhaps my narrative has been mistinterpreted.

what I am saying is that ppl with mental health and others have a shared underlying psychological challenge in life – and that partially include how to fulfil our deepest needs and aspirations. and also how to deal with our inner conflicts.

Often (mostly) the psychological side of life is the cause of our mental health problems.

Once this gets into the popular domain,

will be the time that the claim that ppl with mental health and others are no different
willbe widely accepted.

‘ppl with mental health and others are no different’

Well no, they wouldn’t be because, um, everyone ‘has’ mental health.

Your narrative hasn’t been misinterpreted. You’d need a narrative to begin with for that to happen.

47. So Much For Subtlety

18. Alisdair Cameron – “SMFS, you misinterpret me entirely, then make plain wrong assertions.”

Objecting to your misinterpretation is not a misinterpretation.

“I was making the point that actually, there isn’t any bullying of employers, and the bullying is solely of the service user.”

Actually there is. There is a constant threat that if they make decisions that suit them in the best interests of their business they will be dragged through the mud, fined, sued, and even put out of business.

“It’s demonstrably proven that just shoving someone with complex MH needs into ajob, as if work were of itself a cure is counter-productive and an utterly false economy, as relapse rates rocket without support”

I would differ with you on that. Again it is a question of which subset of the mentally ill you are looking at. Work is a cure in itself in many cases. The problem is institutionalisation. If the mentally ill know there is an easier option that is not shameful, they will take it.

“Furthermore, CBT is promoted above other talking treatments (e.g. solution-focus therapy) because it is cheaper and can be delivered at a basic level by someone after just a couple of weeks training.”

And of course because it can be shown to work. Which most if not all talking treatments cannot.

“just when it’s the hardest time in generations to find a job,you appear to support measures to beat up on those who can’t find employment/ indentured labour in return for meagre benefits, labour for the multinationals who then reward the politcos with directorships and consultancies for securing them cheap labour?”

Actually I would respond to that if your terms were not so laughably biased. No I do not support beating up on the mentally ill and the rest simply has nothing to do with what I said. It is better to work for a real wage than sit at home on benefits. Whether or not someone works for a multinational is irrelevant to their mental well being. Is it too much to ask you stick to what I said and not invent whatever strawmen you like?

48. So Much For Subtlety

16. Mike Killingworth

“I wonder if SMFS has actually advised – or would recommend – that course of action to someone s/he cares about who has a mental health problem?”

Yes I would. When the alternative is sitting at home in front of the TV smoking weed, anyone who loved anyone else would insist on them getting a job. This is precisely why Social, which does not give a f**k if you and I live or die, will give up benefits forever, but if we turn to our family and sponge off our brothers for a while, after a few months they will say get off your arse and get a job. Because they actually do care.

It may not work for people with all mental health issues, but it will work for many of them.

“This is of course to leave aside SMFS’s claim that there are “plenty of jobs” which will come as news to politicians of all parties, let alone anyone else.”

I doubt it. If you think about it for a moment it will become apparent that there is no shortage of jobs. I could do with three maids and a butler. Any company would like to take on more people. Ask any farmer if there are things that could be done. The problem is the cost, not the work. What we have is a shortage of jobs at the prevailing level of wages. It is one reason why most immigrants do not take British jobs – they do the work, that obviously exists, that British people will not do at wages they will not accept.

49. Mike Killingworth

[47]

There is a constant threat that if they (employers) make decisions that suit them in the best interests of their business they will be dragged through the mud, fined, sued, and even put out of business

You could say the same thing about paying corporation tax or business rates. Perhaps you think PAYE administration is an unreasonable burden on employers, too?

[48] You clearly have a tenuous grasp of the concept of “tough love”. I don’t know why you think that people with mental illness smoke weed (well, perhaps all the ones you know do, in which case you should get out more) but in that case “tough love” would involve an intervention to deal with the addiction first, and find suitable (not “shitty low paid insecure”) employment second.

I am coming around to the view, SMFS, that you don’t like other people very much. Perhaps I should’ve twigged that from your nom de blog

50. Alisdair Cameron

@ SMFS

“Actually there is. There is a constant threat that if they make decisions that suit them in the best interests of their business they will be dragged through the mud, fined, sued, and even put out of business”

Not with mental health there isn’t. You’re plain wrong. Point to me any weight of cases where any employer has been taken to task under the DDA or other legislation for unjustly discrminating against those with MH problems.
Your line is a straw man, an an imaginary threat.

It is better to work for a real wage than sit at home on benefits

Yes, but support is needed. It isn’t there. You cannot demand of folk with severe and enduring MH problems that they take a job, any job, without appropriate support.
Your nalysis if CBT is risible. It is ‘proven’ to work mainly for mild to moderate cases (where I would argue that time alone may well produce decnt outcomes). Furthermore the type of CBT envisaged under IAPT is CBT-lite, as it were, dumbed down, delivered by the under-qualified, and for too brief a course-., and it’s by no means the best course of treatment. There is more evidence for CBT solely because the Govt has funded more research to justify its selection of the cheapest option.The government’s proposals mean that a therapy will be prescribed before anyone has done an assessment of the individual’s needs.Andrew Samuels, a psychotherapist and professor at the University of Essex, said: “What you’re witnessing is a coup, a power play by a community[CBT-ers] that has suddenly found itself on the brink of corralling an enormous amount of money. Everyone has been seduced by CBT’s apparent cheapness.”
Don’t get me wrong, it can. help, but the way it’s been rolled out means a one size fits all approach:like Henry Ford – “You can have any colour you like, as long as it’s black”.
If you’d bothered to read what I’d actually written upthread, you may have realised that I’m arguing the case most strongly for those with severe and enduring MH needs (eg those on the SMI): note the complex in my statement “It’s demonstrably proven that just shoving someone with complex MH needs into a job, as if work were of itself a cure is counter-productive…” . I make clear distinctions (based on need) among those under the umbrella term of having MH issues-had you noticed?
Try working in MH with those with severe and enduring needs, see and hear the ways in which they are being bullied by the DWP and Govt pronouncements into positions without the support that is needed, something that harms both user and employer, and costs more in the long run (one night in-patient stay costs the system approx £450+). The indentured labour threat may have been phrased provocatively too, but is something Purnell has had in mind: read the Welfare Reform Bill and its proposal to impel long-term benefits claimants to work for large companies, which will be sub-contracted at public expense, while these new workers are paid under half the minimum wage, the difference being pocketed by those companies. No mention of those contacted employers having to provide appropriate support in return for their subsidy and cheap labour. It’s all stick and no carrot for the severe and enduringly mentally ill.

‘ppl with mental health and others are no different’

Well no, they wouldn’t be because, um, everyone ‘has’ mental health.

“ppl with mental health problems…”

no need to be so pedantic.
I am sure everyone else gets the drift. “no what i mean”

Ash I’m not being pedantic. I think your incorrect use of terminology highlights how little you understand the issue, and illustrates some commonly held misconceptions, i.e., once ‘mental health problems’ begin being discussed, there’s this silly ‘them and us’ divide that springs up.

It isn’t about people ‘with mental health problems’ and ‘others’; anyone can suffer from mental health problems, at any point, and they can come and go, or simply be a temporary problem, or long term, or whatever. The sufferers aren’t different, they are normal people – just as people who might experience physical health problems are not distinct from ‘others’.

52.

i accept what yu say. (given that we are on the same side).

my point is more forceful as not everyone will have a mental health problem in their life. But everyone do have psychological challenges.

and that is the commonality between us all.

As much as we want change in the attitude toward mental health illness in different aspects of the society, we can only expect much. Given the many problems every world leaders is facing now, the issue will get as much as a glimpse. And no, second glimpse… The health insurance alone have pushed the issue far aside.


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  1. Liberal Conspiracy

    New blog post: Mental ill health: the last taboo? http://tinyurl.com/cmlq9q

  2. Liberal Conspiracy

    New blog post: Mental ill health: the last taboo? http://tinyurl.com/cmlq9q

  3. Jamie Sport

    Great article by @pennyred on invisible illnesses here, with some good discussion too http://tinyurl.com/cmlq9q





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