Saturday 27 July 2013

Mental Health - society's problem.

As the credit crunch started to affect European economies, many lost their jobs and so, their livelihoods and their sense of self worth. For those with mental illness, this effect was sadly even worse. Before the downturn, 12.7% of those with mental health issues were unemployed. After the downturn, this figure had sadly, if predictably, grown by 50% to 18.2%.

Predictable because the attitude of our society to mental illness has always been poor. Since the advent of the first lunatic asylums in the late eighteenth century, we have always sought to put the mentally ill somewhere else where they won't encroach overly on our own existence. Out of sight, out of mind one might say.

People do not as a rule like being ill. This applies all the more to mental illness. The stigma attached to mental illness is every bit as bad now as it was when "care in the community" sought to change all that. The idea was that integrating the mentally ill into local communities would lead to them being accepted and included. Ironically, this is exactly what used to happen in the eighteenth and nineteenth centuries. In those days, the mentally ill were broadly divided in to two groups - idiots and lunatics. While the words would be deemed offensive and unacceptable today, everybody knew what they meant and they informed the way in which the person in question would be treated.

The idiots were people who obviously had some form of learning disability but who could still serve a useful purpose within their local community. This is probably the source of the expression "village idiot". Rather than being locked away out of sight, such people were looked after by the local community and carried out the roles of which they were capable. They were not viewed as a problem and certainly weren't deemed to need asylum.

The lunatics were those people who we would now deem to have an acute mental illness beyond the capabilities of the local community. Schizophrenia, depression, mania and the mental illnesses which we now recognise and treat accordingly were deemed in need of asylum. These were people whose illness needed urgent help and it was principally with them in mind that the asylums were built in the nineteenth century.

It was felt that the asylums had come to symbolise the worst aspects of care for the mentally ill with reports of ill treatment and neglect. The latter are now known to have been inflicted within our general hospitals so it is sometimes difficult to gauge how far we have come since those early days.

The figures on employment in the mentally ill only go to confirm what I uncovered in a research study three years ago. Stigma is alive and kicking and despite the best efforts of a few "celebrities" to highlight their own problems, it seems that modern society is more intolerant than ever. It is said that all health starts with mental health so the chances of anybody reading this without having been affected themselves are slim. Of course, the people who have experienced mental illness will be better served to relate to others in the same position. Rather than them being an obstacle, such people (and that includes most of us) should be viewed by employers and society alike as an asset.

"Care in the community" is in danger of becoming one of the biggest misnomers of all time. "Care which happens to be delivered within a community which is not interested" would seem a more apt title. One thing is certain. The longer we continue to ignore mental illness, the bigger the problem will become - it is not just going to go away because unlike the rubbish we throw out once a fortnight, these are real people.

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