receive a diagnosis if they see a psychiatrist. People who suffer
psychiatric crisis without seeing a doctor are still experiencing mental
illness however they aren't in any of the research or data, they receive
none of the support and they have to learn their own ways to cope.
There's this thing about mental illness where people who are seen by the
medical profession are going through an extreme internal process or are
at an extreme of abnormality (whatever the judgement is on that). Some
people go through the experience without contact with mental healthcare
and learn to survive.
The problem is identifying the people who have been through the
experiences or live with the states of consciousness, being or behaviour
but are 'copers'. What would be the way to find these people? Many may
not consider they have a mental illness or speak of their experience in
mental health terms. (there is another problem about whether a coper is
mentally ill, i.e. if they lack the psychosocial dysfunction or poor
prognosis then are they mentally ill but I'll leave that discussion on
what is mental illness for another time).
Last year I was reading some research about the cognitive deficits
associated with schizophrenia. I wondered if the cognitive deficits were
not a factor of the 'disease' but a factor of the people who ended up
hospitalised by the experience. The people with the capability to
overcome the internal experience, hide their abnormality and cope with
the suffering may not end up being seen by psychiatric services. This
pattern would do all the way back to the people who were first put into
asylums. People had to learn to cope with mental illness before the
advent of psychiatry and psychopharmaceuticals.
There was a school of thought in psychiatry in the late 20th century for
the cognitive deficits observed in schizophrenia to become part of the
diagnosis. There is also a well-funded programme of research in America
in America to look at creating clinical measures - I can't remember if
these were neurobiological or cognitive though.
This is kind of like what Marius Romme and others have done: Learn
coping techniques from people who developed them organically to survive
the rough and tumble of mental illness. He aired a TV program in the
progressive Netherlands where a voice hearer opened up on national
television. A telephone number was given for people to contact after the
programme and he did a big piece of work to look at their coping
techniques - both copers and non-copers. The research was published in
the British Journal of Psychiatry and in a book published by Mind.
In the UK there are about 50,000-100,000 people (off the top of my head.
I haven't looked at the data for this in a while) who are in the "no
care" category and refuse NHS secondary mental health services when
they've been referred. This is a very important group for research in my
opinion. In this case they are important because there will be people in
there who have learned other coping mechanisms or strategies for life
and these may be of benefit to the large number of people using primary
and secondary mental healthcare.
It kinda makes sense in terms of the wellbeing agenda. If necessity is
the mother of invention then those with the poorest wellbeing will have
had to invent their own solutions and this could be useful for everyone
else.
No comments:
Post a Comment