Alastair's Blog

Return to:  Blog | Articles | Videos RSS feed

Asda, Tesco, Amazon show we are still in the dark ages re mental illness stereotyping

Posted on 26 September 2013 | 8:09am

With apologies to Angela Merkel – I had intended to keep my praise of her as lead blog over the weekend – I feel I have to say something about the current furore raging about the ‘mental patient Halloween costumes’ being sold by Asda, Tesco and on Amazon. Thanks in large part to social media, Asda and Tesco have done the decent thing and withdrawn them. I suspect Amazon will be a tougher target – ‘we don’t give a shit about much apart from making money’ appears to drive them – but we will get there.

I have been busy on twitter and on the airwaves trying to explain why this matters, and will be talking to Jeremy Vine on Radio 2 at lunchtime. The mentally ill have enough to deal with without the brutalising stigma that still surrounds mental illness. That is why the Time to Change campaign exists, to break down the barriers and the taboo and to fight for better services and understanding. I know people who are mentally ill who say they can cope with the symptoms of their illness. What they cannot bear is the fact they feel they cannot talk to anyone, not even their family, let alone their boss, because of their fear of the reaction. That is stigma. Imagine if cancer victims or asthmatics or diabetics felt the same? Mental illness is an illness. Just because you cannot see it does not make it real. And stigmatising it takes us back to the dark ages.

Here is the piece I have done for The Fabian Review on mental illness, which was published this week, before the Asda-Tesco-Amazon storm blew up.

Mental health is still treated completely differently from physical health. To ensure mental health sits at the heart of the whole person agenda, politicians must lead the way in helping to destroy taboos, and underpin changing attitudes by law.

When I think about what the world would look like if mental health were considered of equal value to physical health,

I imagine something radically different to what we have now.

I imagine professionals using a recovery-based approach to caring for people with mental health problems, rather than just medicating them and leaving them without proper support or care.

I imagine an end to the postcode lottery of good care, and cultures of restraint replaced by cultures of respect and dignity.

I imagine a time when people are as comfortable talking about their mental health as they are about their physical health. When there is no taboo in asking for help and people are confident in knowing how to look after their own mental health.

I imagine a time when the rights and services that exist for physical health conditions also exist for mental health and we give actual meaning to the legislative reality of parity between the two.

I imagine a time when power is given back to patients, so that they are at the heart of the decision-making process about their care and professionals are responsive to their needs. While this can be a tricky issue when people are in a crisis, that doesn’t mean these issues can be avoided. All too often, rights, choice and control go out the window. It doesn’t have to be like that. It shouldn’t be like that.

I imagine a time when your definition of crisis counts. That the plans you have co-written, along with those who are helping you, determine the care you get. A time when these plans are built with you – not against you.

I imagine a time when doctors and nurses uphold their duty and care and undertake the assessment and monitoring of people’s physical health needs, along with recognising and responding to mental health needs. A time when the benefits of peer support are obvious and accepted as of equal value to those of healthcare professionals. A time where people are no more scared to admit to a mental health crisis of the past on their CV than they are a successful fight against cancer.

I imagine a time when we look after the most vulnerable people in our midst, rather than isolating them and leaving them to languish.

I imagine a time when the model of social recovery is the standard, rather than the exception – building in employment support, clinical services, social care, community relationships and carers.

I imagine a time when we are beyond talk of integrating just health and social care services. A time when siloed responses by government agencies in planning services across health, justice, social care, social security and employment are eradicated.

All of these things are at the very heart of ‘parity of esteem’ – as enshrined in legislation for the very first time in British history in the Mental Health (Discrimination) Act 2013. The legislation is a good step. But if ever we needed an example of the passing of the law being the start, not the end, of the road to progress, this is it. Because for all the progress made, the scale of the challenge – not just in terms of service but also of attitudes – cannot be overestimated

We are a significant way off from the vision I describe. Charities such as Mind and Rethink Mental Illness, and dynamic partnerships like Time To Change, have long been calling for shifts in attitudes, practice and outcomes. Yet as a society, even in the face of gross examples of care and shocking outcomes, we still put up with things that should never be tolerated – in society, in our communities, in our NHS.

The most obvious way to explain what is brutally wrong with our current approach is that despite recent legislation, we treat mental health completely differently from the way we treat physical health. And now with Andy Burnham’s whole person care vision we have an opportunity to change that and achieve the 1948 World Health Organisation definition of health: “a state of complete physical, mental and social well-being”.

Currently, there are huge waiting times for talking therapies, with no right to access this kind of care, due to technical restrictions with how the National Institute for Health and Care Excellence (NICE) evaluates what it can mandate. The NHS constitution commits to putting mental health on a par with physical health but has a get out of jail free card with regard to those who are being cared for under the Mental Health Act.

There is a lack of crisis and emergency care, at a time when the demands are growing not diminishing. If you show up with a mental healthcare crisis, you are not guaranteed access to care and treatment.

Research into causes, treatment and medication for mental illness are grossly behind the times. Drugs aren’t properly evaluated and there is a stranglehold on the amount of investment in mental health research. When talking about people with mental health problems, the use of poor language continues within the press and politics.

We rarely read or hear about schizophrenia unless it is to peddle the myth that the mentally ill are likely to be violent, when in truth they are more likely to be victims of violence than perpetrators. To read some of our papers you would think a good chunk of violent crime is committed by the mentally ill. In fact, fewer than 5 per cent of crimes are committed by people with severe mental illness.

Stigma has a serious impact on the quality of services for people with mental health problems. Too few feel able to complain. Worst of all are inequalities in rates of premature death. Why do we just accept, as we seem to do, that people with severe mental illness are at risk of dying up to 20 years before the general population? This disparity is absolutely unacceptable. The brutal findings of the independent Schizophrenia Commission, established by Rethink Mental Illness, found that people with severe mental illness are woefully in need of basic levels of physical care and support, despite being at higher risk of preventable illnesses such as diabetes. This is purely in response to the use of anti-psychotics. Yet doctors repeatedly fail to undertake and monitor the most basic of physical needs, such as taking blood pressure, reviewing medication and weighing people.

The crisis care campaign from Mind showed that services are under-resourced, understaffed and overstretched. The reality of the situation is quite stark – four in 10 trusts are failing to meet Department of Health guidance on staff levels. Too often people are turned away. Their calls go unanswered. They are told they are not ill enough to qualify for help. Too few people have care plans, despite being mandated by care regulators.

Mental health has always been a Cinderella service and now it is at further risk. People are asking, what are mental health bodies for? All of this is happening a time when funding for mental health is failing. Faced with the pressure of sweeping reforms to public services, the fear is that without immediate attention things will get much worse before they get better.

The good news is that with a truly integrated, personcentred service, things can and will change, with effort and attention. We used to have an enormous taboo about speaking about cancer. This idea now seems outdated – swept away – and these days no one would ever say that treating cancer was not a priority. You would never ask why someone got cancer. You would never ask why someone has asthma or diabetes. You wouldn’t say, ‘What have you got to be cancerous about?’ ‘You shouldn’t be having trouble breathing.’ You wouldn’t leave someone with cancer or lung failure alone to fend for themselves.

Greater openness led to greater political support for tackling cancer. We need to take the same approach to mental illness. We are already seeing – amidst all of the talk of cuts and austerity – that services for people who are experiencing mental illness are being cut.

Where is the outcry that would greet a similar approach to cancer or children’s services?

If someone goes to accident and emergency with a broken leg, the hospital is obliged to treat them with courtesy, dignity and responsiveness. If you are faced with the horror of news that you have cancer, the system has to respond within a minimum period of time. But if you are going through a mental health crisis there is no guarantee whatsoever that you will be helped.

Things are improving, but far too slowly for those who are suffering, neglected, isolated and without support or care. One day we will look back and wonder – did we really believe that depression was a lifestyle choice? Did we really believe that if you have been diagnosed with schizophrenia you are likely to be violent? Did we really find it acceptable that if you have had a bout of mental illness, you must under no circumstances tell your employer?

Some day we will look back on all of this and despair that we waited so long to right such fundamental wrongs. Change only comes if people make it happen. So where do we begin?

First, with the acceptance that mental health matters to all of us. The way we behave in wider society sets the tone – and government and politicians have a key role to play in helping to destroy taboos and break down barriers. But changing attitudes must be underpinned by law, creating equivalent rights for mental healthcare in the same way as for physical healthcare. People should feel they can be open about their problems.

We need to invest in care, or at the very least, stop cutting services which were always underfunded and straining at the seams. Mental health budgets have reduced in real terms and cuts are having a very real impact. Suicide rates are very worrisome, compulsory treatment is on the rise and the police are systematically detaining people with mental health problems – who have committed no crimes – rather than having to do this only under exceptional circumstances. The rate of prescriptions of anti-depressants and anti-psychotics continue to rise.

We have to turn the tide. We have to ensure that reforms to health, social care, welfare and public health work for mental health, instead of waiting for our current problems to get worse. Public health professionals urgently need mental health training. GPs must fulfil their basic duty of care.

The most important thing we can do is keep breaking down barriers in talking about these issues. We must continue to work to end stigma and discrimination – not just with employers, friends, and in our communities, but within the very culture of the NHS.

Politics also has a massive role to play in this. Last year in parliament, for the first time in history we heard four MPs speaking out about their own experiences. They received an overwhelmingly positive response from the public but there is so much more work the political class can do. We can wait no longer. The time to change is now.

  • Ehtch

    Just posted this poem I made this morning to and for my friend, Kris, my new bestie from US, female, who has struggled, mind and that, Ali, as some tends to do, well, some of us. I quote meeself, If you don’t mind,

    “I do suffer from the nervous yips,
    so yes. then hence my YT name.
    Eyes in behind with anxiety looks,
    body language a mess, no fame.

    Twitching and nervous scratching,
    for all about near around to see.
    That black dog feeling of dread,
    look as if search toilet for pee.

    Hard to explain to jolly ones about,
    smiling their way constant thro life.
    While me with my side of lips down,
    no time from without frown ‘n strife.

    Now you know what yippitydodah stands for now Kris – a combination of the nervous yips and being “happy(!!)” with having them, with “pity” in the middle too, hidden.”

    And yes Alastair, Asda and their straight jacket Halloween suit. But I thought it was quite funny myself. Reverse psychology always works in my book, leave it all hang out for all to see, be honest. Don’t hide it away.

    • KrisInAustinTX

      Ehtch, I’m afraid I must push back on this one. I can’t say I find the costumes funny. Mental illness hurts. If I were up to it, I’d raise hell with Amazon.

      • Ehtch

        Oh come on Kris mun, as I am always telling you each day, laugh right in the face of adversity, even if it comes from within yourself.

        You know my darling Kristine you have someone heart captured now, me, so you have that life hurdle right out of the way, so will knock a couple off of steps of life’s ladder personal. I am here now Kris, for come what may.

    • Michele

      But it’s the bloodstains and axe-type associations that remove any idea that the suits might encourage people (especially children) to not fear.anyone with a MH condition!

  • Michele

    This is completely incomprehensible, dozens of people should be sacked at the procurement level and in the companies/importers that flogged such crap.

    Merchandise at big companies does not reach PoR through one person per company. Buyers and/or merchandisers don’t have autonomy, they have to present to departmental range reviews that are overseen by directors, did some such meetings get provided with gin instead of water?

    This is from the same bucket of sick as racism (but I daren’t suggest it compares with nazism as they actually killed patients – of whatever religion).

  • maggie zwaan

    Hi

    Good for you speaking out on Channel 5 news.
    I’m 56 and been through a mental health condition many years ago and now manage it through medication to a certain degree but as you know it’s not a cure all.
    I was turned down for interview once when i was job hunting because i had to declare my heath history. That seems appalling perhaps now, but I am sure that if employers get a whiff of a mental health history you will not get a look in.

    I work full time now in housing and deal part of the time with mental health patients.The work can be very difficult but I am trying to fly the flag for those with mental health conditions because I know what it’s like as I have been through the system first hand. It’s time the country woke up and acknowledged that one in 4 people have problems and it’s as important as any other disease or condition

    Maggie Zwaan mmzwaan@yahoo.co.uk.

  • diGriz

    I have gone through my own meltdown a while ago and spent a long time going through the system. Your article really captures the issues involved in mental healthcare, in particular that politics must be the lead in such a complex social issue. The most important and often the most difficult aspect of my recovery was access to health professionals within the NHS. I cant praise the individuals enough, but the system itself and the delay times between a referral and a talking cure is just unacceptable in a modern society. This coupled with GP locums with little empathy, a DWP who’s starting point is a rejection of any claim and a complete lack of multi agency integration when dealing with vulnerable people make a farce of the Equality Act or Safeguarding guidance. Only government can change how these agencies work, but with enough high profile people pushing forward the public debate this may become something a party can fully commit to prior to the next general election. I wince every time I see Andy Burnham speak in HoC or in the recent Labour Party conference, but what he outlines for an integrated health service “sounds” something I can fully support. I just hope that the implementation lives up to the sound bytes.

  • John Villiers

    I am such a case. Since 1997 I have been maintaining and improving school gardens and outdoor areas, including teaching children through in-school and out of school gardening classes. I have created a unique and highly valued service. Despite this, some potential schools refuse to employ me, not on merit, but, on a CRB vetting issue. I am an example of how unjust laws can harm good people.

    My illnesses were in 1987 and 1992 and both episodes remained un-diagnosed at the time. However, I find that some 25 years later, I am still facing prejudice and been treated as a criminal and this is affecting my livelihood and well being, even though I have not done anything wrong.

    I am distressed that despite my fantastic work references, which you are welcome to inspect, impeccable conduct, and, several years of community work that have raised several thousand pounds for good causes, that I am still tainted by some schools with the stigma that I am an inappropriate person to work for them.

    Clearly I am not a criminal but am treated as such by the limitations of the current Vetting and Barring regulations. One of my early mentors, who is now a senior OFSTED inspector quotes thus : ” I believe that John’s past is in the past. His previous hardship should not be an obstacle but a motivation to ongoing success.”

    Please can you do whatever is in your power to reject the victimisation of my illness as a criminal mis-demeanour.

    My business is http://www.schoolgrounds.info . I believe that I am providing a tremendous community service whilst also demonstrating innovation, creativity and enterprise. Through my environmental and teaching skills, I continue to demonstrate my positive contribution to society. It is quite wrong that I should be labelled as an outcast when I am guilty of no wrong-doing.

    John A Villiers

  • Michele

    Typically nasty piece from Rod Liddle published in The Spectator this week, especially where it sinks (sneakily ‘discreetly’) to mockery of a type that’s relevant to this blog topic.

    Re the McBride memoirs he’s as usual pretending to be on a bit of moral high ground (based on assumptions rather than the published confessions re who knew what that don’t suit his purpose).

    How on earth did R4 ever get lumbered with him, let alone Gilligan? At the only funny level of it all they have both been outed for using multiple sockpuppet IDs to pretend support for themselves in online discussions (maybe even also each other?).

    Is it really possible for him to not realise how close to McBride’s practices his own lying and detereminely negative activities have been for the past ten years?

  • Joe Thomas

    Keep up the good work Mr Campbell, I believe more funding should be put towards the efforts being made to give the people of the UK a greater awareness on the issues surrounding mental health. For me it is vitally important that people are educated on mental health at a relatively young age, to help tackle the taboo and stereotypes surrounding the matter at the root.

  • Michele

    Very good points made so succinctly by AC on Newsnight re the Wail / Ralph Miliband debacle.

    I’ve made a few pops myself about certain politicos’ relations, hopefully none of them as vicious as those from Dacre’s hatchet-wielders.

    As usual their article was about opinions, not fed by real info, pap for their babyfood readership.
    Isn’t it a shame it remains one of the hightest ‘selling’ titles (does circulation really equate with ‘selling’ or are lots of freebies counted)?
    We know that print runs get cheaper per page, amortise spectacularly, the more repeats there are.

    Had anyone even looked for obits of Mr Miliband Snr they’d have found this c/o The Independent ………
    “Apart from a brief spell in the Labour Party, he belonged to no organisation.
    His fierce independence excluded the Communist Party.
    His dislike of posturing and sterile dogma kept him away from the far left sects.
    This turned out to be a strength.
    He was unencumbered by any party line, which made his speeches refreshing.”

    Had they even referred to him as a boy in their headline (given that the quotes were from his writings at age 17 and not long after arriving here) they’d have been allowing for someone still gathering their ideas.

    Sad day indeed.

    • Ehtch

      Daily Snail playing to the Tory gallery, as usual, Michele.

  • Matthew Richardson

    I.A.P.T. Just seems like a cheap way to treat mental health. Eight years ago when I had a severe bout of depression, I got nine forty five minute counselling sessions over six months which completely changed my life and I was well for years. There was time and space to think. But this year when I got ill again, immediately I was told that I was always going to feel bad with depression and would have to live with it. The whole tone was impatient, delivered with a lack of “intelligence de coeur”, and it seemed like once they’d got me on tablets I was a problem solved. I have eventually got counselling to do with alcohol, for sheer lack of other help, (I don’t have the money to go private), the support has been welcome but as it only focuses on one aspect of my situation, has not been ideal.

  • Michele

    Can’t believe that the Tories are still, 3yrs on, peddling the line that Liam Byrne’s note re ‘no money left’ was cynical and uncaring flippancy about the economy in 2010.

    Yet another malevolent character assassination about someone who explained it early on — the phrase had been part of the customary non-partisan ‘welcome note’ to the incoming minister, an ironic josh re what he would have to get used to hearing from ‘his’ Civil Servants …. a la ‘Yes Minister’.

    I’m not sure why I use ‘can’t believe it’ when all one needs to understand is the breakdown of the word ‘conservative’ – cling on to old lying tactics no matter how gross and spiteful.

    Harry’s version’s not quite along the same lines as LB’s 🙂
    http://www.youtube.com/watch?v=_ENMnPdma1E

    In all this uproar about hacks exploiting family members for their ad hominem attacks we mustn’t forget another Paul, the one whose splashing staines (sic) have never been limited when it comes to exploiting family members in order to hurt an.other.

    Yep, I know I dissed some relative’s rip-off ‘design’ and another’s (a Wail writer’s) hopeless research, I really should stop emulating my betters 🙂

    • reaguns

      Re the note by Liam Byrne, I quite agree with you.

      It is also true that there was indeed “no money left” in a real sense, which wouldn’t have been the case on the handover in 1997 for example, but people should debate that on its own merits rather than refer to this note which is just tradition and banter

      • Michele

        Please don’t throw a single stat at me as if it’s the be all and end all (aka an insult).

        EVERY stat being expressed in only one way is being done for dishonest reasons. ALL ‘stats’ can be expressed in many, it’s as simple as 1 ……. or one.

        Is 1 10% of 10 or 100% of 1 or 1% of 100 and does our Press stick to one mode or skip around for fun and advantage depending on each hack’s (or their employer’s) politics?

        Purlease do not yadder back about GB selling the gold to settle the debt he inheritied in ’97 ……. its price had been tumbing for some time when Labour got in so (to some) he was right to sell and work from a reliable base.
        You are entitled to carry on pretending you really think he should have waited for it to fall more or gambled on it rising in the near future.
        Is it really too volatile a commodity for all nations to base their currencies on anyway?
        http://www.nma.org/pdf/gold/his_gold_prices.pdf

        As for ignoring the cynical SPIN constantly put on LB’s note don’t pretend you don’t understand how easily manipulable are the readers of the rags that continue exploiting it (and how demeaning of their voters the repetitive exploitation of it – 3yrs on – by tory MPs is).
        They KNOW how easily-confused some of their followers are and actually insult them by exploiting instead of explaining < oh, am so stupid to expect factual honesty?

        I think that's the difference between 1997-2010 and 2010-now. Under Labour we were treated as adults and the truth was explained, we were expected to (at least try to) understand, under (puke) the tories we are constantly manipulated (to the point of revulsion).

      • Michele

        Perhaps we might agree on one stat ……. re today’s news re highest-ever number of people in work, is it also highest-ever number of hours worked (or working hours just being spread more thinly)?

        News as opposed to actual and real info?

  • Michele

    AC going on Newsnight to ‘debate Damian McBride’ (you turned American?) would have created yet more of the very kind of atmosphere he’d deplored with the timing of the publication.

    It’s funny that it’s always the right that go on about ‘spin’ …. never, ever acknowledging what the very timing of their own deeds is if not that very word (eg: lies about a boy – not yet a MAN as described) and out of the blue the ugly blue 😉 AT the start of Labour’s Conference.

    It was as far-out and spinny-eyed as what an out-of-sight beyond the horizon rightist screeched on radio today about energy pricing and Labour’s ‘socialist empire’ (describing ambitions to control private profiteering).

  • Michele

    Hi both 🙂 yes I’m afraid that my maternal grandparents (and my Mam
    too) were Tory. G&G’s papers were the Wail, NoW and People, they used
    to sit and giggle at me being boggle-eyed reading about all the rapes and corruption in the world and wondering if I wanted to grow up!
    For them being Tory was part of being self-employed.

    • Ehtch

      Your mam had a red in one of her beds, Michele? Oh dear, but never mind. Vid for you Michele, mee old mate Ali Goldfrapp on Beeb telly last Friday night. Met her in Middlesex Poly in 1989, and yes, my eyes did certainly pop out when she started to turn up on pop telly ten years later – DAMN, I thought…

      http://www.youtube.com/watch?v=634fXhdex7k

      But saying that, the track we would have led would have been different, so very different. Don’t think Ali would have wanted to be an RAF wife, I think. Song on her first album she did of me,

      http://www.youtube.com/watch?v=ydNbuB6PLiU

      She still thinks of me – I do have that affect…

      She popped up aside me, in 1989, all five foot two of her, she knew…

      Hold her close in my arms,
      tell her don’t worry my Ali.
      Keep her warm and safe,
      will keep devils from your door.

      Fave Ali clip, of her,

      http://www.youtube.com/watch?v=7pCyqGJ26dY

      See what I mean?

      • Ehtch

        There is talk Ali Gee will do the next James Bond theme toon, on rumour control, about…

        • Ehtch

          Lie by aside,
          eventually.
          Years past.
          I know.

          Undid work
          life called.
          I know,
          entered love.

          But I say,
          happens.
          In our times,
          can’t have it all.

          Missed chances,
          it was my fault.
          Radar off line,
          when I saw you.

          More Ali Gee here, ce la fuckin’ vie,

          http://www.youtube.com/watch?v=D6im5lhOUX0

      • Ehtch

        I have many lovers in World,
        obviously just simple platonically.
        Also wish not, obviously, but yes,
        we can’t have it all.

        Entered all that we want think do,
        dark passages of same mind.
        Yes would have loved, that explore,
        not really to me, in life rationally.

        Hidden, under that skirt of yours,
        underweared wear what have seen.
        Gormless arguments have seen,
        kinickered cover have between.

        Sretching for crayons, over young,
        saw you when very young.
        Same age just younger from me,
        you Ali red knickered, when four.

  • KrisInAustinTX

    I imagine a time when friends and family do not say:

    “You’d feel better if you’d …
    … just make up your mind to be happy.”
    … count your blessings.”
    … do volunteer work.”
    … get a different job.”
    … get out more.”
    … have some fun.”
    … exercise.”
    … stop isolating.”
    … stop feeling sorry for yourself.”
    … stop being so pessimistic.”
    … stop being so self-centered.”
    … think of others who are suffering.”
    … go to church.”

    • Ehtch

      Tidy post Kristine – just feel lucky your wonderful dad was on your side. My two parents were…. don’t feel I want to discuss it the present moment. Another time maybe?

  • Michele

    I wonder if I’ve missed something in all this …. perhaps I have.

    Surely someone MUST have suggested somewhere that if the post-war MAN Miliband really hated Britain he had a way out.

    Subsidised emigration to and long-term financial support in Israel would have been so easy.