A few days ago there was a report in the paper of a study conducted by the Health and Social Care Information Centre, as part of the Health Survey for England. More than 25% of the 5,000 respondents said that they had been given a diagnosis of mental illness at some point. 33% of the females and 19% of the males reported this, and the highest rate was found amongst the 55-64 age group, where the figures rose to 41% and 25% respectively. The most common diagnosis was for depression, at 19% overall – 24% for women and 13% for men. At the extreme, one in 14 women has attempted suicide, and one in 25 men, yet the male suicide rate is more than three times higher than for females. These are scary statistics! There has been a great deal of research showing that men are much less likely to recognise that they may need help for a mental health problem and to seek assistance for it. But it appears that we are much more successful at killing ourselves! This is apparently because men choose more lethal suicide methods, and because we are more impulsive and likely to act on a suicidal impulse, particularly when alcohol is involved.
A separate report has also found that the number of unexplained or sudden deaths (i.e. not from suicides) of mental health patients in England has risen by more than 20% in the past three years, a total of 1,713 in 2014-5 up from 1,412 in 2012-3. Unsurprisingly, there are many now jumping on the bandwagon of blaming the Government and the NHS for underfunding mental health services to the point where there are insufficient resources to cope. They may well have a point: I know from my own time spent working for an NHS Trust providing mental health services just how much of a Cinderella service it was and still is, and how the large general hospitals took up a huge part of the funding.
But whilst that is clearly a major issue it is not my point today. I’ve quoted numbers which may or may not mean much to you. Does 1,713 deaths in a population of around 50 million seem all that many? Is this something we should expect and somehow accept as the norm? Should we heck as like! Every single one of those who make up those statistics is an individual tragedy. Every single one of them had family and friends who cared about them and who are affected by their loss. And I wouldn’t mind betting that most of them had at some stage been stigmatised by their diagnosis of mental illness – assuming that they had sought help, as not all of them will have done. I mentioned earlier that men are slower to seek help, if they ever do. I know this to be true, as I did it myself and subsequently found that I was far from alone in doing so. Looking back on the time when I was diagnosed with depression (described in the Story of my Illness – see the menu above) it is very easy to trace a long, slow decline in my health until I reached the point at which I recognised my need for help. I eventually saw my doctor in October 2011 but can recall events from April that year which were clearly related to this, and no doubt there were others before then: I had been off work for three months some five years earlier with what was termed ‘stress’, so it was lurking in my make up. Although I worked for an organisation which provided treatment for these kinds of illness I didn’t want to accept that maybe this is what was happening to me. Part of that may be the stereotypical male lack of insight, but there is more to it than that. A major factor is that mental illness is stigmatised. From the simple, everyday “pull yourself together” type of comments, which betray a lack of understanding and empathy, to the much more malicious type which can often be found in real life bullying and in social media, people with a mental illness are somehow made to feel ashamed of their problem, that they should in some way get over it as they aren’t really ill, are they: others can’t see anything wrong with them in the same way that they could if they were on crutches, for example. If I can’t see it, you don’t have it!
This is compounded in all sorts of ways. Often these are quite innocently done, such as the everyday use of phrases like “it all went mental” or “he’s a nutter.” But if I look back to when I was a child, a common playground insult was to call someone a “spastic” if they did something clumsy. We have learned how offensive this really is and it is no longer used, to my knowledge. Political correctness may be guilty of many stupidities but one of the successes of the past forty years or so since it became a force is a better understanding of some of the derogatory language we use and how we can improve on it. But has it had any real impact in the world of mental illness?
Sadly, I think not. Although we still have much to do, e.g. in the likes of public buildings and public transport, we have come quite a way in recognising both the needs of physically disabled people and the way we talk about their illnesses. I may be biased in my outlook but I don’t see the same progress having been made in respect of mental illness. Whilst part of the answer is to provide more funding for treatment, there is a much wider issue: we need to educate ourselves better about mental illnesses and how we respond to them and deal with them in others. Unless we do, those statistics I quoted are likely to get worse before they can start getting better. To me, this is very much the time when we should worry about this and ask ourselves if we are doing enough about it, not just as a society but as individuals within it, in our own approach to people with mental illness and how we deal with them. We should have been doing this already, and we shouldn’t hold back from doing it now.