After primary qualifications in medicine and psychiatry I undertook higher specialist training in psychotherapy – the talking treatments. I would usually arrive early for my supervision sessions at the Royal Free Hospital and wait in the out-patient clinic. One day my supervisor remarked that I must be quite sane because I did not mind sitting among her patients.
Our prejudice against some people is because we feel different in colour, gender, age, lifestyle or culture, but we stigmatize people with mental disorders partly because we are terrified of crossing that line ourselves. When we lose a person or something that really matters to us we get down in our spirits, we react with profound anxiety to frightening life events, and during sleep our mind experiences psychotic-like fantasies and nightmares.
These disturbances of thinking and feeling are appropriate, transient reactions to real experiences and normal processes of consciousness. But if you could not wake up from your worst nightmare, or the terrifying thoughts and feelings kept recurring with no apparent cause, life would be intolerable. The person who is mentally ill is not just unhappy in miserable circumstances, but trapped in a disturbed experience of meaning and reality.
Fear of and prejudice against those who are mentally ill has resulted not only in stigma but in historically poor levels of service. This is why it is so important that the 2012 Health and Social Care Act has created equal status for mental and physical health and the new mandate to the NHS Commissioning Board tasks it with delivering on this goal. One of the eight objectives of the mandate is “putting mental health on an equal footing with physical health – this means everyone who needs mental health services having timely access to the best available treatment” and ministers have made clear the NHS will be expected to demonstrate progress by March 2015.
More attention is also being paid to the psychological needs of people with mental illness and the Coalition Government has added £400m to the programme for Improving Access to Psychological Therapies (IAPT) started by the previous government.
Legislating that mental health should no longer be the poor relation of physical health and increasing the resources for psychological therapies are positive steps towards addressing the discrimination within healthcare against the mentally ill, but psychological therapies can address stigma more directly. A behavioural therapist once told me that when he started cognitive therapy he began to understand and empathize with his patients in a wholly new way.
Psychological therapies can humanize the experience not just of people with neurotic and personality disturbances but also those suffering from psychosis and organic disorders, and they can also enable wider society to appreciate that disturbances of meaning and reality are part of the human experience that we can be understood, contained and treated psychologically so we do not have to distance and stigmatize those who suffer from them to protect ourselves.
Published and promoted by Tim Gordon on behalf of the Liberal Democrats, both at LDHQ, 8-10 Great George Street, London, SW1P 3AE.