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The media still attaches a stigma to mental health


2:00 pm - September 26th 2010

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contribution by Richard Shrubb

The stigma of mental illness needs to be tackled among the media itself, before the media can be effective in dealing with it among the public.

I have a story for sale on Mental Health First Aid (MHFA). It is about getting to someone experiencing distress and helping them out, in much the same way as you’d bandage their arm after the photocopier glass had cut them at work.

It has been used in major flooding events – one voluntary emergency organisation saw their shortcomings after some mass traumatic events, and got trained in MHFA.

Northumberland Fire and Rescue got trained as well. Big firemen now know how to support someone in mental distress – their training ostensibly to help their comrades, perhaps after a gruesome car crash. MHFA should prevent people getting PTSD, or certainly get them treated before it becomes too serious.

I pitched this story to 52 trade magazines earlier this year. I usually have a 60% success rate among editors with a good story that would suit their market. I sold nothing. Mental health is often deemed ‘not core’ to their readership, even though statistically 25% of the readership will suffer at some point in their lives, irrespective of what title you’re publishing.

I know a woman who has excelled in life because she says the voice she hears with her schizophrenia can also read. Thus it reads a page and she reads the other page. Two ‘readers’ reading a book and you halve the time of reading.

She’s a doctor now, but fears her patients knowing this gift that has helped her attain so much. Have you read about her? Only here… I tried to sell this to a doctor’s magazine which didn’t bite.

If mental illness uniformly affected one in four of the population, everyone in the the world would be touched by it. There is no excuse that it ‘isn’t core’, especially to an article aimed at a trade. What job doesn’t have stress? Stress may be boredom, overwork or anything between?

As another example, rural health. The mentally ill are generally the poorest and most vulnerable in society. Rural health inequalities are well documented for the poorest. Attending a conference on the subject I found little interest in it among the authorities, let alone when I tried to report this in the media.

How is someone going to be talked out of harming themselves when they live 50 miles from the psychiatric staff in the Highlands? Is it because these stories are best brushed under the carpet?

In order for the stigma of mental illness to be tackled in any way the media must start dealing with the hidden prejudice around mental health. The likes of Shift Speaker’s Bureau have got it right – the media is the right medium to attack it. But the media itself must change in order for this to happen.


Richard Shrubb is a health and social care journalist. www.richardshrubb.co.uk

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Reader comments


Need to change the headline. It’s not mental health that’s stigmatized, it’s mental illness.

“Mental health is often deemed ‘not core’ to their readership, even though statistically 25% of the readership will suffer at some point in their lives, irrespective of what title you’re publishing.”

Source?

You might want to read this first:

http://www.guardian.co.uk/commentisfree/2010/apr/24/one-in-four-mental-health-statistic

I have a story for sale on Mental Health First Aid (MHFA). … I pitched this story to 52 trade magazines earlier this year. I usually have a 60% success rate among editors with a good story that would suit their market. I sold nothing.

Would they take the story if it was free?

4. Just Visiting

> I know a woman … the voice she hears with her schizophrenia can also read. Thus it reads a page and she reads the other page. Two ‘readers’ reading a book and you halve the time of reading.
>… I tried to sell this to a doctor’s magazine which didn’t bite

Well, I guess it depends on whether you provided good sources for your story – an interview with the woman, an interview with her pyschiatrist etc. A scientist who had proven that she could read two visible pages in the same time it took her to read just 1 visible page. Sources the magazine could phone up for themselves if they wished.

Did you include them?

If you didn’t include those, and it was just a story about ‘a woman I know’….. well no wonder they didn’t take it.
It is a remarkable story. Without evidence to back it up… hard to believe it’s true really.

Writers and journalists interested in mental health should form a group so that everyone can share ideas. Other speciality writers do this. If anyone is interested in having a chat about this trying hanging out on #mhuk on Twitter or track me down on @beatricejbray.

I also think we need to stop thinking about stories which are explicitly about mental health and instead think more widely about stories which have an impact on mental health. Sports stories are a good example.

I do not think the media will change unless more journalists are open about their mental health problems. Coverage on racial issues changed because editors began to recruit journalists from ethnic minorities. I think it will be the same with mental health although that is tough call in today’s economic environment.

The Guardian are running a minority writers’ workshop at the moment. For details see:

http://www.guardian.co.uk/minority-writers-workshop

This is open to writers with mental health problems.

I have only pitched two ideas on mental health, one to the Financial Times and one to the Guardian. Both were successful. The thing is I do not want to be tagged as a mental health journalist. Editors are great ones for typecasting. I will only consider myself free when I can be open about having a mental health problem and be able to write about a wide range of subjects, including mental health. That day has not come yet but maybe it will.

No offence meant but your story just doesnt sound interesting! Worthy perhaps, but from what you say (and one hopes you told the potential buyers more than us), it seems very pedestrian. Why would they buy it?

Also, even though many people do suffer from mental illness at some point (I have myself in the past), that alone doesn”t make it interesting to read about. Many people have asthma (5 million in the UK including me) but it so seldom makes the media that noone even realises that 200 people every year die from asthma! I mean, if you get hardly any coverage on something as heartstoking as a child dying from an asthma attack, what makes you think something as dull sounding as Mental Health First Aid would get more coverage!?

I don’t think your story is necessarily related to only media; there is a vast network of doctors who don’t believe in mental illnesses. A previous doctor I had actually told me to go and read “The Road Less Taken” when I was suffering significantly from Depression.

With PCT cuts I don’t see this improving. The UK really needs a shake up in all of its mental health concerns.

8. the a&e charge nurse

[7] “there is a vast network of doctors who don’t believe in mental illnesses” – I am not exactly sure how you can quantify the % of ‘non-believers’ but in any case no doctor is able to say there is a PROVEN biological basis for any of the ‘functional’ mental illnesses (schizophrenia, bi-polar affective disorder, depression, anorexia etc) although many theories exist.

Thomas Szasz published “The Myth of Mental Illness” in 1960 and the central thesis of this work remains just as relevant today as it was 50 years ago.

Szasz points out ‘the mind’ is not an organ so cannot be diseased (although it may be described as such in metaphorical rather than biological terms) and he likened psychiatry to astrology and alchemy, i.e. a pseudo-science.

There are those that believe that mental illnesses must involve some sort of organic brain abnormality that has yet to be properly understood – but that is about far as it goes half a century after Szasz’s seminal work.

1 No, it is mental health and that’s why we have The Mental Health Services, just as we have the NHS not the National Sick Service, see what I mean.
6 You are quite right, it does sound dull and it isn’t helped by the fact that stigma makes people with mental health problems hide-away. Human concern stories require that the person is identified in order that the article allows others to empathise with their plight. The fact that the subject of the story is a doctor doesn’t really help either, it only suggests that schizophrenia isn’t that disabling in the first place. It’s very much a vicious circle, but the media don’t give society a chance to accept people with a mental health diagnosis when they are often referred to as ‘schizo’ and ‘psycho’ and then they get it wrong.

@Charge Nurse

Thomas Szasz published “The Myth of Mental Illness” in 1960 and the central thesis of this work remains just as relevant today as it was 50 years ago.

I’d have to disagree. Over the past 50 years psychiatry, though still a very inexact art, has become progressively more effective, developing more and more medications and psychotherapies. Meanwhile Szasz is still repeating the same worn-out cliches.

Szasz points out ‘the mind’ is not an organ so cannot be diseased (although it may be described as such in metaphorical rather than biological terms) and he likened psychiatry to astrology and alchemy, i.e. a pseudo-science.

Not really. The mind is part of the brain (unless we believe in Descartes concept of a mind/body split, which I’m told most philosophers regard as old hat these days) and the brain is indeed an organ.

There are those that believe that mental illnesses must involve some sort of organic brain abnormality that has yet to be properly understood – but that is about far as it goes half a century after Szasz’s seminal work.

Person hears voices. Person takes an antipsychotic medication. Person stops hearing voices. Unless we’re allowing for a massive placebo effect, that sounds like evidence for an organic brain abnormality to me.

One criticism of Szasz is that he doesn’t seem to have spent much time working with patients with severe mental illnesses. It’s easy to say mental illness is just a social construct when all you’re doing is psychotherapy with stressed-out Manhattan stockbrokers. It’s quite another to say it after a bad day on the psychiatric ICU.

Various people have complained about the “dullness” and “worthiness” of mental health stories. Well it is not like that if you live the life but should you go on to write about your thoughts on the experience the temptation is to self-censor because you are fearful of audience reaction.

If anyone wants to see the flack you can get for being open about having experience of mental health problems look no further than this Liberal Conspiracy debate on Incapacity Benefit:

http://liberalconspiracy.org/2010/09/18/incapacity-benefit-the-truth/

This is what Liberal Conspiracy Mile Killingworth said about me:

“believe me, Beatrice, I can tell when someone is acting out. Accusing people who disagree with you of being patronising is in itself frequently a indication of mental disturbance.”

Luckily Sunny Hundal stepped in to remind everyone to be civil but things did not calm down. A good opportunity to discuss the impact of Incapacity Benefit changes was missed all because a Liberal Conspiracy writer – yes a Liberal Conspriracy writer – could not resist the temptation to call me names and others pitched right in.

In the circumstances can you blame most people with mental health problems from being wary of taking part in online debates? It is simpler to play safe and be dull. Readers lose out. But in the right hands mental health stories can be extremely interesting. I would not want to see wall-to-wall coverage of this single subject but it deserves to be part of the mix.

I have seen a good presentation on Mental Health First Aid and it is anything but boring. I do assure the sceptics here that they would happily watch an item on it on the TV news. I would not say it would be enough to fill a 40-minute documentary but it deserves public exposure. However to plug that story you have to work hard to generate enthusiasm.

My message to Richard Shrub is this. Carry on. Ignore the doubters here. You may have to rejig your sale pitch but you are onto a good idea. Go for it.

12. the a&e charge nurse

[10] Hi Zaruthustra – have you forgiven OSB yet? – I do miss him (but I digress).

Let me pick you up on one point – you say, “person hears voices. Person takes an antipsychotic medication. Person stops hearing voices. Unless we’re allowing for a massive placebo effect, that sounds like evidence for an organic brain abnormality to me”.

Leaving aside the fact the voices often don’t stop but rather induce a state of apathy toward them (as with many other activities of living) it might be said.
Patient is depressed – patient receives a closed head injury by electrical means (ECT) patient feels less depressed – “that sounds like evidence for an organic brain abnormality to me”.

Can you cite even one authority who claims to have discovered the biological basis of ANY mental illness?

@ Beatrice

A good opportunity to discuss the impact of Incapacity Benefit changes was missed all because a Liberal Conspiracy writer – yes a Liberal Conspriracy writer – could not resist the temptation to call me names and others pitched right in.

It is not the case that anyone “called you names”. To say so is to …how can I say this without being accused of maligning you……it is to distort reality.

@Charge Nurse

Can you cite even one authority who claims to have discovered the biological basis of ANY mental illness?

Well, my blogging chum Neuroskeptic is much more knowledgable than me about the neuroscience of mental illness. To be honest though, I don’t really regard mental illness as necessarily an either/or between a biological model and a psychosocial model. When somebody becomes mentally ill, there’s a lot going on biologically, psychologically and socially. Obviously, this is also true of physical health issues.

One of the many problems I have with Szasz is that his thesis rests on the old Cartesian assumption that there’s a body and a mind, and the two are separate and distinct. In the face of modern-day neuroscience, this isn’t philosophically or scientifically tenable. We have embodied minds, or mindful bodies if you prefer. To say that mental illness can’t be part of the body because it’s part of the mind is simply nonsense.

When somebody becomes, say, depressed, a lot of things happen that affect the physical body. They become fatigued. Their sleep is disrupted. Their appetite drops. Their short-term memory and concentration go to pieces. Their sexual libido crashes through the floor. It’s more than just being unhappy.

Going back to your original question, Neuroskeptic has an interesting post about a Swedish study that suggest both genes and environment play a role in risk of developing schizophrenia.

@pagar

The subject raised by Richard Shrub is mental health and the media but yet again you are resorting to a personal attack on me. Why? It is because I am open about having a mental health problem and you lack the maturity to let people with such difficulties have their say.

You are insinuate that I am distorting reality. That does not sound complimentary to me and it is not even true. You want to undermine me in front of everyone else.

I am reporting you to Sunny because you are deliberately trying to intimidate people with mental health problems. You want to scare them out of a debate which affects them.

I have no problem with you having your say if you stick to the moderation rules but you have breached the rules in this case. You deserve to be reported.

“I know a woman who has excelled in life because she says the voice she hears with her schizophrenia can also read. Thus it reads a page and she reads the other page. Two ‘readers’ reading a book and you halve the time of reading.”

WOW. People wouldn’t interested in reading an article about that? Really?

Though I suppose it’s telling that I’ve responded to the example at what you might call one of the extremes of mental illness. Seriously, try pitching that one elsewhere. I think you’ll have more luck with it than the mental health first aid. Tell them you have one guaranteed reader and let me know the title that accepts it!

@ Beatrice

You are insinuate that I am distorting reality. That does not sound complimentary to me and it is not even true.

But Beatrice. You said that people had been “calling you names”. I was involved in the thread and that is factually incorrect. If it is true, please cite the comment.

I have a great deal of sympathy with people who have mental health problems but you cannot use mental illness as a sword to attack others without justification then call for censorship when your falsehood is pointed out.

I think an article on MHFA sounds really interesting but I’m abnormal. If the media were interested in mental health issues than we would all know about the changes in mental health provision that happened in 2009. http://www.bucksfreepress.co.uk/news/4718894.Anger_over_changes_to_NHS_counselling/

19. the a&e charge nurse

[14] thanks for the link – I do not want to derail the thread by going too far down this road – suffice to say there are still important unanswered questions (with regard to mental illness) and I think some of these uncertainties contribute to the type of coverage that we sometimes get in the media?

Nowadays it seems any extreme behaviour falls under the purview of the psychiatrist from the likes of Raoul Moat;
http://www.guardian.co.uk/uk/2010/jul/15/raoul-moat-psychiatric-help-shootings
to the Swedish twin charged with manslaughter after this bizarre incident
http://www.dailymail.co.uk/news/article-1210953/Woman-locked-making-mad-dash-M6-stabbed-stranger-death-day-released-jail.html

Was the behaviour of these protagonists a coded means to secure ‘help’ as Szasz would have maintained or were they suffering from an organic brain problem, in effect a yet to be identified neurological disease – somehow I can’t see the likes of The Sun handling such nuances with any great sensitivity?

@pagar

I do not see that you do have sympathy for people with mental health problems when you use pejorative phraseology to undermine me in front of everybody else. Everyone else on the thread has the maturity to debate a difficult subject without casting slurs on each other’s sanity. You are the only one to do so.

You were one of the people who fouled up a potentially useful debate on Incapacity Benefit and now you are doing it again with a debate on mental health and the media.

The moderation rules are clear. This is item 4:

“Our aim is to open the discussion to the widest range of people and not restrict it to a narrow group. People who write hostile comments or hate-speech end up shutting out others who may have also wanted to join in. We want to avoid that.”

Your remark about “distorting reality” means you have fallen foul of that. And here is item 6:

Therefore: abusive, highly sarcastic and xenophobic comments will be deleted without notification. Potentially libellous comments may be edited or deleted without notification too.

You have fallen foul of that. Making out that someone is “distorting reality” is abusive. You meant it that way.

Do not try and protest to me about censorship. Moderation rules are there to be observed. You are the one who is driving people away. You are stifling debate. I do not know why you have this petty vendatta against people with mental health problems but it reflects more on you than any of us.

@Charge Nurse

Regarding Raoul Moat, as I’ve said before on LibCon, I don’t really believe him. I get very cynical about people who suddenly say they need psychiatric help just coincidentally at the same time that they happen to be in trouble with the cops. Usually they’re just trying to wriggle off the hook, or to try to swap that nasty prison cell for a cushy psychiatric ward. It rarely works. The fact that he was offered a psychiatric appointment and didn’t turn up hardly lessens my cynicism.

It’s true that Moat had a deeply troubled, abusive upbringing, and it’s quite likely that he would have fitted the criteria for antisocial personality disorder (ASPD) but ASPD is one of the more philosophically shaky psychiatric categories. A lot of psychiatrists question its usefulness, not least because while we have treatments for depression, bipolar, schizophrenia etc, we don’t have any treatment for ASPD.

As for the Swedish woman, it would be hard to say without more info on the case.

People who write hostile comments or hate-speech end up shutting out others who may have also wanted to join in. We want to avoid that.”

Your remark about “distorting reality” means you have fallen foul of that.

Beatrice.

I really do not want to prolong this but what you said above was NOT TRUE.

How am I supposed to counter your statement?

If you are saying that, because you have mental health issues you are allowed to say things that are NOT TRUE, without fear of contradiction, then I withdraw from the debate.

If I am permitted to point out that what you are saying is NOT TRUE then what language may I use to express my view?

@ 8. the a&e charge nurse

Thomas Szasz??? No one (with the odd exception it seems) believes that crank was correct nowadays. It is like saying you believe in eugenics or moral re-armament.

Szasz was a right-wing, libertarian who believed people with serious, psychotic mental health problems should be free to walk the street without any treatment.

Nowadays as this article says:

“Today, of course, Szasz is mostly remembered, if he is remembered at all, as the great silly, a flat-earth adherent in the time of telescopes and globes. Most medical students graduate without ever hearing his name. Peers who once grappled fiercely with his ideas are now surprised to find out he is still alive. His voluminous writings largely gather dust in libraries and used book stores.”

The work into DNA and genomes has greatly helped in our understanding of the biological connections to mental illness. Only this month:

“Possible Risk Gene for Schizophrenia Uncovered” – An international team of researchers has identified a risk gene for schizophrenia, including a potentially causative mutation, using genome-wide association data-mining techniques and independent replications.

http://www.sciencedaily.com/releases/2010/09/100914102110.htm

If you believe in Szasz’s theories it means you believe no one with a mental health problem should recieve treatment because it is a violaton of their human rights and civil liberties.

Go down that road and the recent worst incidents of harm caused by people with psychiatric problems, receiving “care in the community”, would seem like a tea party.

It is right-wing, libertarian bullshit.

Oops article referred to above:

‘The Myth Of Thomas Szasz’

http://www.thenewatlantis.com/publications/the-myth-of-thomas-szasz

One other criticism of Szasz is his willingness to work with the Church of Scientology in his crusade against psychiatry.

If you’re making the argument that psychiatry is superstition disguised as therapy, and it’s all just a scam to control people and take their money….well, it’s a bit rich saying it when standing next to the Scientologists.

‘Szasz points out ‘the mind’ is not an organ so cannot be diseased (although it may be described as such in metaphorical rather than biological terms) and he likened psychiatry to astrology and alchemy, i.e. a pseudo-science.’

Sorry, but that’s bollocks. There’s no separation of mind from body except in the ‘minds’ of outdated philosophers. As someone with bipolar II I’m well aware of the relationship between the relationship between my ‘mind’ and my neurochemistry and the somatic effects this has on my body and vise versa.

And psychoanalysis is quack science but psychiatry as a whole is not, at least as it is informed by the scientific method and not inferences based on Greek mythology and steam-aged metaphors.

27. Chaise Guevara

“You have fallen foul of that. Making out that someone is “distorting reality” is abusive. You meant it that way.

Do not try and protest to me about censorship. Moderation rules are there to be observed. You are the one who is driving people away. You are stifling debate.”

Beatrice,

I had a look at the thread that sparked all this, and agree with you about the use of patently offensive words to decribe people with mental health issues. Pagar’s desire to ‘reclaim’ these words in the name of fighting political correctness is about as mature as me deciding to reclaim the word ‘nigger’ so I can shout it at black people in the street. However, saying someone is ‘distorting reality’ is not, in any way, abusive. It is valid criticism. If you express opinions, you open them to the risk of being criticised. And by encouraging the mods to censor people who disagree with you, you are stifling debate far more than Pagar and his thoughtless labels.

28. Just Visiting

Hi Nishma 7

> A previous doctor I had actually told me to go and read “The Road Less Taken” when I was suffering significantly from Depression.

That’s a great little book – worth a read for anyone, IMHO anywhere on the scale from mentally healthy today to mentally unhealthy today.

The title is actually “The Road less Travelled – by M Scott Peck.

Maybe you weren’t in a place where the book was able to help directly – but I wonder if you have returned to it since?

I only deal with the workplace and (in theory) mostly mentally healthy people – and I find the disciplines of the book often very helpful in helping to mentor and coach people.

Gratification Delayed – and Committment to the Truth etc – great themes to consider.
It’s surprising how often talented people’s achievements are held back due to lack in these areas.

29. Just Visiting

Beatrice

Glad to have you on LC – which in it’s better moments is an enviroment where people of different perspectives do actually debate, share differences/similarities and opinions are sometimes changed.

1) rather than quote the forum rules – you’d be better off talking a look at how LC runs in practise – read back through a load of other threads, to see what the norms in practise are.
You’ll see that often a surprisingly high level of ad hominen attacks are permitted by Sunny and Don.

So your own treatment so far has not really been at 1 out of 10 on the LC scale.

2) you’re probably aware, there is a general prinmciple in debating, that if a statement is made, it is legitimate for others to question it – ask for supporting evidence or reasoning.

So you have the right to say you were name-called – but if someone questions you on that, it is normal to expect you to supply a deeper level of explanation.

That is particularly easy, when you are making your claim about what happened within LC.

You only need to look in 1 place to get your evidence – the LC thread you refered to.

If a critic is indeed wrong, then you can quickly show their statement to be unfounded – which will quickly silence the usual troll.
If they are made of sterner stuff, you may even get an apology.

So over to you Beatrice – I do hope you stay and enjoy LC.

30. the a&e charge nurse

[23] let’s start again, since my point was not such to promote Szaz per se but to highlight that in the 50 years since he wrote “The Myth of Mental Illness” psychiatry as a medical discipline is problematic both in terms of the kind of treatment it sometimes provides (forced injections, ECT, restriction of liberty, compulsory medication, etc) but more fundamentally because of the absence of a biological model pinpointing neurological pathology in virtually all of the mental illnesses.

Psychiatry has a long tradition of vilifying anybody who raises their eye brows at much of what mainstream psychiatry has to offer, while the suffering of patients has been used to justify all manner of quackery from dialysis (to purge bad blood), insulin coma therapy (a form of re-birthing) to crude neurological procedures involving disrupting frontal lobes of depressed patients.
Today unruly children are being medicated without due consideration to constraints that adults impose on them (can’t play in the street, long hours in various institutional settings, etc) which is all part of the tendency to medicalise problems in living.

Personally I doubt that if any disease entity will ever be proved for conditions like alcoholism, anorexia or obsessive compulsive disorder – the jury is still out on schizophrenia, bi-polar affective disorder and certain forms of depression which in my opinion are far more likely to have a biological basis.

Captain Swing says “If you believe in Szasz’s theories it means you believe no one with a mental health problem should recieve treatment because it is a violaton of their human rights and civil liberties”.
This is an unfair accusation although I must say the times I have spent rolling round on the floor in A&E while someone is trying to jab a syringe full of haloperidol into some poor bastards arse is possibly the low point of my career?

@ 30 the a&e charge nurse

“Captain Swing says “If you believe in Szasz’s theories it means you believe no one with a mental health problem should recieve treatment because it is a violaton of their human rights and civil liberties”.
This is an unfair accusation although I must say the times I have spent rolling round on the floor in A&E while someone is trying to jab a syringe full of haloperidol into some poor bastards arse is possibly the low point of my career?

It is NOT an unfair accusation it is what Szasz believed and stated.

You wrote: “Thomas Szasz published “The Myth of Mental Illness” in 1960 and the central thesis of this work remains just as relevant today as it was 50 years ago – ignoring the fact that it is totally irrelvant today, the logical conclusion is that you do not treat vlolently psychotic people because it is an infringement of their rights.

I know plenty about psychiatric wards too, having been on one and received both ECT cand chlorpromazine & modecate. They are miserable, desperate, distressing places. Some psychiatric treatments have been terrible and are now discredited. But to argue that people with serious mental health problems should receive no treatment of any kind because their “illness does not exist” is rather like saying all welfare benefits should be abolished because poverty does not really exist and it’s all their own fault anyway.

i

To be honest, I don’t think Szasz (or his contemporaries Laing, Cooper, Foucault, Goffman etc in the whole “antipsychiatry” movement) are particularly relevant today.

For all their talk of liberation, they were still other people (psychiatrists like Szasz and Laing, academics like Foucault and Goffman) talking on behalf of people with mental health problems. If antipsychiatry is no longer relevant, its’ because they’ve been eclipsed by user-led advocacy voices in which people with mental health problems are speaking for themselves.

Mind are the most famous example of this, but they’re by no means the only one. Just recently, mental health bloggers like Mentally Interesting and Confessions of a Serial Insomniac have started making use of the blogowebs to make their voices heard.

Mostly they tend to want better mental health services – more effective meds with fewer side-effects, more availability of talking therapies, more stimulating environments on mental health wards, shorter waiting lists to access CMHTs – rather than some sort of revolution against Teh Eevil Psychiatreez.

33. the a&e charge nurse

[31] well let’s try and refine some of the concerns identified by Szasz?
Part of the problem lays in trying to untangle the assumed relationship between different forms of human suffering and bona fide disease, a problem complicated by the tendency to apply societal “norms” to the way behaviour is interpreted.

For example, it wasn’t that long ago that psychiatrists classified homosexuality as a form of mental illness, even offering nasty forms of aversion therapy, etc, before this ‘condition’ was finally removed from DSM II (in 1973).
http://ajp.psychiatryonline.org/cgi/content/abstract/138/2/210/

It is also reported that many people hear voices but do NOT regard this as a signifier of any organic disease (although it might).
http://www.intervoiceonline.org/2007/5/3/hearing-voices-doesn-t-mean-you-re-mentally-ill-icwales-may-2-2007

As I say I would align myself with Szasz when it to comes to eating disorders, post traumatic stress disorder, addictions, and most neurotic conditions, none of which are likely to be driven by disease in the say way that the psychiatric syndrome associated tertiary syphilis is.

Even so I do not see how you can make the leap to claiming that such suffering does not merit help because we disagree about underlying cause, which in my view is more likely to be driven by early life experiences and environmental factors rather than brain abnormality (for the conditions cited) – I have already said that the situation regarding schizophrenia, bi-polar affective disorder and some forms of depression are rightly in the process of still being investigated (and have been for the last 100 years).

[32] Meanwhile Zarathustra says “I don’t think Szasz (or his contemporaries Laing, Cooper, Foucault, Goffman etc in the whole “antipsychiatry” movement) are particularly relevant today” – I find this astonishing given that the user-led advocacy groups he refers to were galvanised into action by the likes of Laing, who was amongst the first generation of psychiatrists brave enough to politicise the dysfunctional power relationships that enabled some psychiatrists to label homosexuality as a disease.

34. Luis Enrique

I know a woman who has excelled in life because she says the voice she hears with her schizophrenia can also read. Thus it reads a page and she reads the other page. Two ‘readers’ reading a book and you halve the time of reading.

can she actually read twice as fast and still retain all the information etc.? If so, that’s not a mental health problem, that’s a superpower.

@29 – You forgot to add the rule about never, ever under any circumstances make any comment that could be construed even minutely as being disagreement with the original poster.

Meanwhile Zarathustra says “I don’t think Szasz (or his contemporaries Laing, Cooper, Foucault, Goffman etc in the whole “antipsychiatry” movement) are particularly relevant today” – I find this astonishing given that the user-led advocacy groups he refers to were galvanised into action by the likes of Laing, who was amongst the first generation of psychiatrists brave enough to politicise the dysfunctional power relationships that enabled some psychiatrists to label homosexuality as a disease.

Szasz and Laing have their place in the history of ideas, but both of them have dated badly, and their ideas are no longer as closely studied as they once were. I used to be a big fan of Laing back in my younger years as a trendy humanities student, but for all he talked about liberation from abusive families, he was a misogynistic drunk who treated his own family appallingly.

And yes, the declassification of homosexuality as a mental illness is a big milestone both in gay rights and psychiatry, but again, it’s a dated argument, since it was done in 1973. I’m in my mid-thirties and I wasn’t born when it was declared that being gay doesn’t mean you’re mentally ill.

I recently met up in a London park with a bunch of mental health bloggers. They were an intelligent, articulate bunch of people who’ve experienced the best and worst of NHS mental health services. They were certainly pretty clear about how they wanted things to change.

They wanted more access to services – particularly in terms of getting hold of people during out-of-hours emergencies.

They wanted more input into their own care planning.

They wanted therapies to be more suited to their individual needs rather necessarily being shoehorned into a narrow one-size-fits-all model of therapy because that’s the only one available.

They wanted length of therapy to be determined by the length of time it was needed rather than by resources. More than one of them described therapy being stopped just as they felt they were making progress, because the funding had run out.

In terms of what had helped them. Some felt they were helped by meds, others by therapy. Quite a few had found both meds AND therapy to be of benefit. This doesn’t mean that either meds or therapy are “better” than one or the other. It just means that different individuals have different needs.

These are the issues I think mental health services should be concerned about, not the dogmatic rants of a pair of 1960s ideologues.

37. the a&e charge nurse

[36] “the declassification of homosexuality as a mental illness is a big milestone both in gay rights and psychiatry, but again, it’s a dated argument” – if you think it is “a dated argument” then you have not really understood where I am coming from?

My point was not about homosexuality per se, but the fact psychiatric models are still riven with arbitrary value judgements.
It was certainly the case in 1973 and still is today – only now attention has turned to pathologising children, instead of gay men (I’m not sure if many gay women came under the perview of the psychiatrist in those dark days).

According to this study, “Psychotropic medication use by children in the USA has increased. We used the IMS MIDAS Prescribing Insights to examine prescribing trends in nine countries between the years 2000 and 2002. Trends in seven countries rose significantly from year 2000 to 2002; the UK had the highest increase (68%)”.
http://eprints.pharmacy.ac.uk/1466/1/Wongpsychotropic.pdf

I’m am glad to hear that you are heavily involved with user groups and it is good to know you share their aspirations – but do you think such movements developed in a political vacuum? – no, their antecedents can be traced back to thinkers like Szasz and Laing who were amongst the first to point out (to a much wider audience) that there was far more to the treatment of mental health problems than a large hypodermic overflowing with modecate, or Victorian asylum out in the sticks.

In my opinion the most important legacy left by the early radicals was the brushing away, or at least challenge of long standing assumptions about the unhealthy power relationships within psychiatry, as well as the veracity of psychiatric theories driving clinical activity.

You describe Szasz as an ‘ideologue’ yet for a 100 years researches have looked in vain for a biological cause of schizophrenia – are these not ideologues to?
http://ajp.psychiatryonline.org/cgi/content/abstract/151/10/1409

38. the a&e charge nurse

BTW some are now saying schizophrenia is caused by the influenza virus – or to put it in it’s proper scientific context are people being “infected with insanity”.
http://www.scientificamerican.com/article.cfm?id=infected-with-insanity

I’m sure Laing must be turning in his grave?

I recently attended the inquest into my father’s suicide, and the only story the local journalists were interested in was the misgivings my aunt had towards the mental health team whose care he was under. In actual fact her views were entirely moderate and presumably didn’t provide the requisite level of controversy to warrant further interest.

I know for sure that my father was isolated by the stigma in society, and as someone who has suffered from long term depression and anxiety myself, I know from personal experience too. I can empathise with the author’s frustration, unfortunately a sensationalist media seem to have attached such associations onto mental illness stories so that they’re only newsworthy if they take on the ‘unhinged mental patient who should never have been released kills randomly’ or ‘celebrity breaks down for all to see’ variety. So mental illness seems to be reduced to voyeurism when it involves someone who is of public interest and to evocations of regressive fearful attitudes in relation to isolated cases of severely disturbed individuals, who also happen to be a danger to others. For sure, there is a paucity of media attention to serious mental health issues, and it is a genuine cause for concern.

This article is the first I’ve heard of Mental Health First Aid, and having looked into it a little more it sounds like it could be an excellent resource. I hope that you do persevere Richard despite the disheartening response so far and manage to get your article published.

40. the a&e charge nurse

Reactions: Twitter, blogs
  1. Liberal Conspiracy

    The media still attaches a stigma to mental health http://bit.ly/bIZvqU

  2. Mind

    RT @libcon The media still attaches a stigma to mental health http://bit.ly/bIZvqU #mhuk

  3. Max

    RT @libcon: The media still attaches a stigma to mental health http://bit.ly/bIZvqU

  4. Mark Brown

    RT @MindInFlux RT @libcon The media still attaches stigma to mental health http://bit.ly/bIZvqU #mhuk < Argument I've made a few times!

  5. Linda Jones

    Interesting piece re pitching features on mental health/illness: http://bit.ly/bIZvqU (via @MarkOneinFour)

  6. Melissa Nicole Harry

    RT @libcon: The media still attaches a stigma to mental health http://bit.ly/bIZvqU

  7. Lily Eastwood

    RT @libcon: The media still attaches a stigma to mental health http://bit.ly/bIZvqU

  8. Beatrice Bray

    RT @MindInFlux: RT @libcon The media still attaches a stigma to mental health http://bit.ly/bIZvqU #mhuk

  9. Beatrice Bray

    RT @libcon: The media still attaches a stigma to mental health http://bit.ly/bIZvqU

  10. Communist Party UK

    The media still attaches a stigma to mental health http://bit.ly/bAtz3G

  11. Mel

    Hey @libcon, might want to follow your own guidance http://t.co/sF9ocIAP before making tweets like this https://t.co/9bbdBtEH





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