in the individual as well as in society then mental healthcare must look
at it's objectives differently.
Treatment involves the old paradigm of mental health treatment combined
with changing society. In my opinion the latter is achieved by
destigmatising the symptoms of mental illness (not the cluster or the
diagnosis). It is also about building a society that understands that
most people at some point in their life wiill go through some sort of
crisis, and that modern society shouldn't be designed to work for the
average, 75% (the not 1 in 4), or 95% (the scientific measure of
confidence interval or something like that): it's for everyone.
Laws like the Disability Discrimination Act stipulate reasonable
adjustments for physical and mental disabilities. Reasonable adjustments
are provided for those who don't fit into the Industrial revolution
"factory" so provisions are provided. Some of these are also used to
advantage other groups. This is the start of the change in society that
is necessary for the mentally 'ill' and 'normal' people to be equal.
It is not enough.
Take the financial system. The personal credit system has supported the
developed nations continue to prosper over the last 40 years since the
destigmatisation of personal debt in the 1970s. It is based on the
assumption of continued employment. This is a poor assumption because a
lot of people will have a period of unplanned unemployment. The credit
system doesn't interface with the mental health system until recently
and only in debt collection. A person can take out a £10,000 loan when
manic with no checks however a system to prevent this could also
disadvantage those who suffer through life crisis.In times of
recklessness people can take all sorts of self-harming decisions. It's
not just financial risks.
The consumer market is a minefield of complex deals and offers designed
to confuse the buyer into spending more. These systems will disadvantage
people with low financial capability and may look to exploit them.
The mental ill may have poor opportunities in long term relationships
however I am unaware of the evidence to support this. My personal
experience is women prefer sane men as partners. To paraphrase Sheryl
Crow, "I'm not the kinda guy you take home." The swings of conditions
like bipolar can make a partner the light of a person's life or the bane
of their existence. Some people can handle this though.
Job opportunites are fewer and gaps in employment are a negative point
on an application. Even with the DDA many suffer discrimination and many
do not understand the power of the DDA.
Temporary cognitive impairments associated with many mental illnesses
and forms of distress affect performance. This is human however many
organisations want a perfectly uniform performance. A story about the
guy who invented the lightbox was he was the top salesperson at his
company in summer but was on the verge of getting fired in winter. Many
people do not understand this sort of cycle is common. This may also
disadvantage some people during education, for example a person going
through depression may score worse on an IQ test than someone in a state
of hypomania or in an average state of mind.
Since "The Great Confinement" the stigmatisation of madness has
increased significantly because the severely mentally ill disappeared
from view. Care in the community is starting to repair that mistake but
the root stigma of madness needs to be addressed. This will be a social
change movement that will take a century to complete. It may have
already started through the work of people like R.D. Laing.
Crisis can bring about change in a person and this is part of their
journey through life but few social systems understand this.
I have no idea if there has ever been a Prime Minister who had been
through severe mental illness.
Mental illness itself is still pathologised.
The list of areas where society could be improved to fit the full
spectrum of the human race would need a toilet roll. People with
physical disabilities have seen wheelchair ramps and lifts installed in
many buildings. I dream of a day when society will make the same effort
to include those it describes as mentally 'disabled'.
The central teachings of many religions are perhaps a place to start
looking for the solutions to mental health and mental health stigma.
Love thy neighbour. Help the leper. Don't want your neighbour's
donkey...no....not that one. Accept that without death and destruction
there can be nothing new. The soul would have no rainbow if the eyes had
no tears.
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