Jasmine Wing points to the importance of mental health as an issue of public concern, and laments its marginalisation from the election debate.
At the start of the current general election campaign, it looked like mental health was gong to become an election issue. Since then the election campaign has come to resemble a supermarket scramble (buy one party and get one free), and mental health has, once again, failed to get the attention it deserves; hence this feature is intended to serve as a reminder of how important it really is.
The UK has one of the highest rates of self-harm in Europe, with approximately 400 instances per 100,000 people. Anxiety and depression are the most common mental disorder in the UK. Figures obtained by the BBC under the Freedom of Information Act showed that prescriptions for anti-depressants have risen more than 40 per cent over the past four years; and prescriptions for drugs such as Prozac have risen from 16 million to 23 million since 2006.
But there is a limit to how many statistics anyone can swallow. In order to understand an issue and its significance, ‘evidence’ is never enough. Accordingly, I invited two young women from East London to describe their experience of mental illness and the stigma attached (their names have been changed), before going to discuss how the whole issue should be approached.
It’s a pity that it’s not being approached properly as part of the election debate; but perhaps the incoming health minister – whoever they are after polling day – will tackle the problem in the appropriate manner.
We live in hope.
Imogen’s Story: shut out and set aside
For the last three years I have suffered with an eating disorder and body dismorphia. And if that wasn’t enough, on top of it all, I suffer with depression, for which I am on medication.
When I tell people about my mental health disorders, most people just do not know how to react. It is not easy to explain to people. Many people have distanced themselves from me after telling them. I find it hard telling people especially with my panic attacks, people just don’t understand why I have them, and ‘there is nothing to panic about’ is the response I usually get.
In the past after I have explained my eating worries to others, it has changed the way they look at me; they looked at me as disgusting.
I believe the media contribute to the negative stigma surrounding mental health. They do this in the way they portray celebrities. The language journalists use has a big effect, like the wording, ‘got nutty’ or ‘losing it’. It is filtered down and affects the lives of those suffering, like me!
More information is need for us to start changing the way people perceive mental health and start to treat it in the same way as general health.
My disorder has had a huge impact on my life. I have lost many friends. During college one of my close friends, who I told everything to, revealed to my group of friends that I had bulimia. They all turned against me and told me they did not want me to go on the girl’s holiday we had all planned together.
I would not say people feel sorry for me, I would say people would tend to distance themselves more than feel sorry on my behalf.
Since I find it hard to speak to others, there is a website which I have found useful called the BigWhiteWall – it is a place where I can express myself without being judged.
Right now there is a vast population of people of all ages with mental health issues. To tackle the stigma I believe awareness has to be increased. There has been research into the dangers of stigmatising people with mental illness, and it shows that the more knowledge and awareness there is on the part of people interacting with someone with mental illness, the less likely they are to view them as dangerous.
To tackle, challenge and change the stigma around mental health, we need to be doing more.
Emily’s Story: from stigma to solidarity
I was first seen by a psychiatrist aged just eight. I started self-harming aged 11 and attempted to take my own life at 15 years of age.
At 18 years of age I was diagnosed with borderline personality disorder. This was after 10 years of mis-diagnosis from doctors. BPD is really hard to explain or understand. It’s just so complicated. Even my best friend doesn’t understand me… I don’t even understand me at times, actually. People also mistake BPD for bipolar disorder unless I tell them what it stands for.
I find it really hard to tell people face to face, because I just know they won’t be able to understand.
After break-up from my first boyfriend, when I was 18 I was hospitalised and it was then that I was finally diagnosed. I was so relieved, finally after years of thinking ‘what the hell is wrong with me I don’t relate to anything or anyone’. I had never heard of BPD before. But I cried when I read about it, not because I was upset but because it suited me so well. ‘Why have no-one even mentioned this to me before?’
Afterwards I was put on anti-psychotics and antidepressants, neither of which helped me. The anti-psychotics had severe side effects. They seem to corrupt my daily life more than my disorder did before the medication. So at 19, I decided to take myself off all medication. I was also given Cognitive Behavioural Therapy which I didn’t find very helpful. However, things have started to improve. I have recently just been admitted to a CBT program which is specified for people with BPD and who self-harm. Despite it being a yearlong and requiring three hours a week, I feel really lucky to be on this course as where I was born it isn’t available.
Nothing has been quite as rewarding as opening up to friend and family, and sharing my struggles with others who are struggling with mental health. Growing up, I felt so alone. I felt like a ‘freak’. I didn’t have anyone to speak to about how I was thinking or feeling this just made me hide away and everything seem to get worse. I now run a mental health support group on Facebook with almost 2,000 members, and offer advice to people on my blog (and have done for over a year now). I have met some great friends through this, but also, I have found out how cruel people can be.
At my lowest point at the age of just 15 I thought the best thing to do was to take my own life. I had no support and I don’t want any young person to feel the way I did. I now try to help others to be open about their problems and try to give them someone to talk to, who they can relate to and ask for advice from someone who is older.
The stigma around mental health has a huge impact on my life; it is hard enough suffering with the disorder but ignorance from other people did not make my life any easier. I’ve been bullied and made fun of all my life – in school I was even told to kill myself.
I worry if too much awareness in school could cause school kids to pick up on it and maybe ‘pretend’ to have in order to gain special attention. Because some people, especially at that age, are desperate for attention.
I think it’s a good idea to have regular surveys in schools, given out once a week or once a month in tutorials or something, and the students are asked to sit down quietly, separate from each other to fill in the questions, like the ones you get when you’re referred to mental health services.
I wish people were able to be more open about their sufferings. I worry that they are starting off by tackling the ‘not so scary’ parts of mental health such as depression. Now it is slowly becoming more accepted but I wish that could be the same for the more scary and harder to tackle illnesses and disorders.
I feel people instantly have a negative outlook towards people with a personality disorder, or other more complicated disorders, because they don’t know enough about us.
It is upsetting but I don’t think it will be changing any time soon!
Comment: how (not) to talk about mental illness
I’m sure you’ll agree these are moving personal testimonies from young women who have been directly affected by mental illness. But not everyone has been affected directly, which means that, as a society, we can’t all be expected to talk about mental illness in the same way they do – and we shouldn’t even try. However, if we don’t out some thought into how society does talk about mental illness, the danger is that, once again, the world will go silent on this important issue. In short, we need to talk about how we talk about mental illness.
You will have heard the ‘1 in 4’ saying? It is a slogan for the nation Time To Change anti-stigma campaign, and its was picked up by the deputy prime minister, Liberal Democrat leader Nick Clegg, when he seemed to be taking mental illness seriously. As a catchphrase that seeks to capture how many of us will affected by some form of mental illness, it’s now almost on par with eating your ‘five a day’. However, prompted by Martin Seager, a guest psychologist on BBC Radio 4’s All in the Mind, I think we should consider whether this kind of terminology may do more harm than good.
Although the 1:4 statistic may make mental illness sound less strange and more familiar, the problem is that it also suggests that the whole question of mental health is present only in the lives of some people, and only some of the time; as if mental health can be present one day and absent the next. But this is like saying that health itself is an issue which comes and goes, whereas we now know (and if you don’t, where have you been?) that the health issue remains with us from cradle to grave.
Just as no one goes through life without suffering some form of physical illness, so we will all encounter experiences (losing the family member you were closest to, losing the best job you’ve ever had) which could easily be the trigger for the onset of mental illness if we don’t respond to them appropriately. Coping strategies for those experiences are as important to our health as going to bed and drinking lots of fluid if you’re experiencing flu-like symptoms.
‘One in four people have a mental health problem means that three out of four, don’t have a mental health problem,’ said psychologist Martin Seager. ‘But I would say it’s probably more like four in four have mental health issues which are very serious.’ Seager conceded that this last point may be ‘the intention of the campaign’, but it doesn’t come across when you use those figures.
We are often confronted with an array of public health information on a broad variety of health conditions, Think of breast cancer and diabetes. When it comes to physical disease, the information in the public domain is detailed and precise. But when it comes to issues of mental health, there is a sudden loss of detail, and the ensuing messages are vague and imprecise. Why treat mental health differently?
Most importantly, current awareness campaigns are promoting separation, not equivalence. The effect is to detach mental health from general health and, despite the best intentions, to stigmatise it all over again.
But such separation is spurious, as Seager went on to explain: ‘our immune system really hits the floor if our mental state is bad, so really our minds and our bodies are intertwined, so I would say mental health is an aspect of all health.’
I can only echo Seager’s sentiments: health is mental and physical simultameously, and the way we approach mental health should be as an aspect of health overall – not as a world of its own, which can only be seen as dangerous and especially daunting once it has been falsely walled off from the world we all live in, all the time.
Jasmine Wing is Rising East‘s Health and Wellbeing Editor