By Ben Mills
Throughout history, mental health and those who have mental health conditions have been constantly stigmatised in society. Luckily, things have changed massively in recent years. But just how much has our attitude towards mental health changed, and has the stigma surrounding mental health finally been eroded?
Throughout history, mental health and those who have mental health conditions have been constantly stigmatised in society. Luckily, things have changed massively in recent years. But just how much has our attitude towards mental health changed, and has the stigma surrounding mental health finally been eroded?
1407 and the first mental health asylum opens in Britain. These so - called “hospitals” opened their doors to patients suffering from mental health issues, and so began an era of serious misunderstanding surrounding mental illness. These establishments treated those people living with mental health conditions as scientific subjects rather than patients, as outsiders and “lunatics”. The horrific conditions inside these asylums, from frequent restraint of patients to long periods of isolation represent perfectly the attitudes to mental health which have plagued society from the start; “madness”, as it was so often referred to, and the “mad” were excluded from their communities as different, strange, odd.
It was not until the mid to late 19th century that things began to change for those living with mental health conditions, as laws like the 1845 Shaftesbury Acts called for “the regulation of the care and treatment of lunatics”. But even still, though care itself may have been improving, attitudes towards those with mental health in wider society certainly were not. The terminology of this Act itself, describing patients as “lunatics”, shows the exclusion those with mental health issues continued to face.
These so - called lunatics were regarded as dangerous and a threat to society. It took a long time for people to begin to see that the only people whose safety was threatened by the actions of someone with a mental health issue was themselves.
Through the 20th century, however, people became more accepting of mental health. In the UK, the founding of the NHS in 1948 and subsequent laws and improvements to treatment of mental health as well as a greater understanding of the key causes of illnesses like depression (partially down to psychology, once skeptically regarded as a pseudoscience rather than an actual medical treatment, becoming more of a respected profession) meant that overall, life was improving for those with mental illness. The focus of treatment began to shift from “curing” and experimenting on mental health patients to providing treatment in a more caring environment.
The 20th century also brought about large changes in societal attitudes to mental health. These massive shifts in how care for mental illness was carried out, as well as a greater representation of mental health in popular culture such as books, music and film allowed for greater inclusion of those with mental health illnesses in general society. Into the new millenium, attitudes continued to grow positively as understanding and awareness of mental health became more commonplace. More and more people began to realise mental illness was a “real” health problem, the impacts of which are on par with the impacts of a physical illness. Increased campaigning by charities such as Mind and the Mental Health Foundation helped raise discussion around mental illness and gradually, the stigma began to break down.
So that brings us to where we are now. 2018. A time where mental health care is better than ever, where a combination of advanced drugs and psychotherapy allows for quicker diagnosis and treatment of mental illnesses. Where society understands mental health and where discussion surrounding the topic is open. Where sufferers of mental illnesses are included in society. Where mental health is finally destigmatised. Or is it?
Yes, the statistics are positive. In 2015, a national survey reported a 6% increase in tolerance towards mental health since 2011. But look deeper, and all is not as it seems.
Because shockingly, this same survey, though reporting this positive change in attitude, also reports disgracefully low figures towards more specific aspects of tolerance towards mental health in society. Only 66% of respondents say they would be comfortable living with someone with a mental health issue. Only 80% say they would be happy living near someone with a mental health issue. Only 76% say they would be happy working with someone with a mental health issue. And so no. Sadly, our 2018 society is not as accepting towards mental health as it should and must be.
This week, the CLV Phoenix has explored many areas of mental health, and the general picture we are seeing is that we are in the middle of a very troubling mental health crisis. In our schools, in our workplaces and at home the increasing pressures of modern day life are taking the toll on the wellbeing of millions across the globe. We know the statistics and we know how bleak they look. We know that 1 in 4 people will experience a mental health problem in their lives. That 3 students in every classroom suffer from a mental health condition. That suicide is the biggest killer of males under 45. These statistics are deeply, deeply troubling. But our current attitude towards mental health is not making them any better.
Discrimination towards mental health only deepens the difficulty of the situation being faced by a person suffering from a mental illness. Facing exclusion at home, at work, at school, in relationships and in society in general is a scary thing. It makes it more challenging for people to find the confidence to seek treatment and care for their mental wellbeing, and this ultimately is an enormous factor is the deterioration of a person’s mental health into self harm and in the most extreme cases, suicide.
We also have to understand that discrimination and exclusion in society not only comes as a consequence to mental health, but is also a key cause; low income and financial difficulties, domestic violence, traumatic events such as bereavement and cyberbullying over social media are just some of the many issues which society all too often ignores, leaving victims feeling isolated and in a state of poor mental wellbeing.
Societal attitudes towards mental health are not the only issues which are causing the recent spike in mental illness. Besides countless other causes, a fractured system of mental health treatment in the NHS mean patients struggling with their mental health are not receiving the treatment they deserve.
Raging debates around the use of drugs such as antidepressants to combat mental illnesses are ongoing amongst scientific, health and general communities. But the general consensus is that the best treatment for most mental health problems is a combination of drugs and psychiatric treatments, such as counselling. Unfortunately, GPs all to often prescribe these drugs without following them up with other courses of treatment; antidepressant prescriptions in the UK more than doubled from 31 million in 2006 to 65 million in 2016 and one in three mental health patients in the UK say they do not receive adequate treatment for their condition.
This often comes as a result of ignorance by medical professionals, leading to a failure to diagnose many cases of mental illness. People who come to doctors with concerns about their mental health must always be believed and taken seriously - if not, their condition may worsen and become a threat to their wellbeing or even their life - yet this is currently not the case. Our healthcare system should not simply neglect those in need of care.
However, it’s not the only serious flaw in the system which is causing a decline in the quality of mental health care in the UK. Target waiting times for the NHS set by the government require patients to have access to “talking” therapies 18 weeks after diagnosis. This is an utterly unacceptable timescale, and 18 weeks too long for many people seriously struggling to cope with problems such as depression, anxiety or bipolar disorder to name a few.
Other authorities are also failing those with mental health problems. Detentions of those with a mental health issue under the Mental Health Act (where police have the power to detain people if they believe they may cause harm to themselves or others) are also on the rise across England, and this comes as a direct consequence of the treatment failures of the NHS.
So with 9 in 10 sufferers of a long term mental health condition experiencing some form of discrimination against them as a result of their illness, and our healthcare system clearly not structured right to allow for effective and quality care for mental health issues, it is clearly time for a radical shift in our attitudes towards mental health.
But how do we do it? It is very clear we need to break down the barriers still making those with mental health issues feel isolated and marginalised from society. How do we break the stigma?
-Raise awareness - it’s maybe the most important thing we can do. By helping others to understand the scale of our mental health crisis, the realities faced by those struggling with their mental health and the problems we still see in society regarding our attitudes to mental health, we can change views.
-Make everyone feel included - and don’t treat somebody different just because they have a mental health issue, which makes them feel like an outsider.
-Be caring towards people and make sure they know they can turn to you if they have something worrying them
-Talk about mental health... - the best way to reassure somebody experiencing a mental health issue is by talking to them, while talking about any problems you yourself may be suffering also helps to make you feel better. It is general conversation in society about mental health, however, that will help remove the stigma around it.
- ...but watch the language you use. it’s important to use language responsibly to ensure you don’t cause offence or harm. Too often, phrases like “I’m so depressed” or “kill yourself” are thrown around carelessly without the gravity of the words and the effect they have on people being taken into consideration. Here are some guides regarding the responsible use of terminology:
Never discriminate against someone with a mental health problem
Things are looking positive when it comes to mental health in society, and we as a nation and as a global community are certainly nowhere near as prejudiced, intolerant or ignorant to mental health as we were even just a century ago. But we still have a long way to go.
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