We must stop looking for easy attributions of blame and accept that the mind is a complex organ, writes DAVID BELL
JEREMY CORBYN has talked frequently about the need to break down stigma around talking about mental illness and this is certainly a live issue for people living with mental illness in general and more so for people living with schizophrenia.
Although mental health is massively under-resourced in our NHS and social services today, funding is not the only problem — an equally large problem is the attitudes of our society to mental illness and Corbyn is right to draw attention to that.
But in my view the picture is an encouraging one. In fact society does now feel more at ease with discussing mental ill health than in years past.
Gone are the days when people with serious mental illness were sent away to one of the large institutional asylums and sometimes never discharged.
Although many of those asylums were compassionate places which provided true sanctuary from the pressures of life and benefited from progressive leadership, they also sadly became places where people with mental illness whose behaviour was severely disturbed could be left and conveniently forgotten about.
People with mental ill health now live mainly in the community with stays in one of the local mental health units that have replaced the asylums being limited to usually just a few months at a time.
As people with mental illness now live in the community, so society has been forced to admit the presence of this very large group of people — about one in five people will need treatment for some kind of mental ill health during their lifetime — and the issue of mental ill health has become much harder to ignore.
However there is still much more to be done. Although some areas of mental health such as depression, eating disorders and obsessive compulsive disorder are now better accepted and less stigmatised by our society, there are still types of mental illness, particularly those which cause severely disturbed behaviour such as schizophrenia, which society at large still feels very uncomfortable talking about.
This is perhaps a natural reaction — although we now have better treatments for schizophrenia which are very effective at alleviating the symptoms, we still have no cure for the condition and it is still seen by public and professionals alike as a failure of our public health system.
It is also a sad fact that the mortality rate for schizophrenia is still much too high and the fact that dangerous behaviour is usually the cause leads to questions of blame.
Dangerous behaviour in schizophrenia is a tragic fact of life and will account for more deaths in the UK this year than road accidents.
Suicide is the dominating issue here — about one in 10 of the 280,000 people living with schizophrenia in the UK will die by their own hand within 10 years of diagnosis.
There is also the much smaller but equally as tragic problem of homicide. People with schizophrenia are responsible for about 30 homicides each year in the UK.
When tragedies happen our media and public look for someone to blame. The doctors, social workers, the police, sometimes the patient themselves are put in the firing line but rarely can we understand easily that it is no one individual’s fault — the only blame actually lies with the illness itself.
Schizophrenia is a cruel condition that robs the patient of the basic faculties of freedom of thought and expression. Often they are unable to communicate what is truly going on their minds to the professionals because of their psychotic thinking.
This is not their fault. It is simply another cruel feature of the illness but one which complicates diagnosis and prevents the most effective treatments being administered.
A condition that we still have no way of curing and that is responsible for several thousand deaths each year is not one that sits easily with our national psyche.
We still expect that when we get ill our health system can cure us and we find it difficult to accept when the doctors have no ready solution.
The issue of suicide generally in society is also one that we have yet to confront. Again, issues of blame so often dominate in the vox populi — “How could he do that to his family?” “She took the coward’s way out.”
These are the sort of views that all too often appear in conversations about the tragedy which is our national epidemic of suicide.
In recent years our society has done much good work in challenging our attitudes to mental ill health.
We can be justifiably proud of this progress. However the real challenge lies ahead. Next we must confront our attitudes to those conditions that cause disturbed and often dangerous behaviours and that we are uneasy to discuss.
We must also address our attitudes to suicide — a tragedy which has grown to epidemic proportions in our society today.
This will not be easy. The challenge is one faced by public and professionals alike and in which the news media must also play its role.
We must stop looking for easy attributions of blame and accept that the mind is a complex organ with equally complex disorders that require complex and often expensive solutions.
No longer can we allow the mental health service to be the poor relation in the NHS. But above all we must somehow find greater compassion and honesty on the part of society as a whole and its individual members in the way that we treat these difficult mental disorders.
If we are to challenge schizophrenia and reduce its desperately high death toll we must be ready to discuss it in society and in our media dispassionately and honestly, dealing in only the facts and not the many myths that surround it.
David Bell is director of Living with Schizophrenia a UK-based project which aims to promote a new understanding of schizophrenia (www.livingwithschizophreniauk.org).