I was inspired to write this blog when I saw this link and pledged to talk more about mental health. Mental health awareness is very important and not promoted enough. Of course I am a mental health nurse so I would say this, but if you read my blog regularly I need to ramble on such things, this is me trying to get my thoughts on mental health issues straight in my own head and hopefully encourage you to promote mental health awareness.
Of course in my chosen profession I think mental health awareness is extremely important. I see first-hand how stigmatising mental health problems can be, and sometimes from surprising places. I find than even other medical professionals who do not work in mental health have preconceived ideas about people with mental health problems, assuming they will be disruptive or need an escort for a procedure or test. This is not always the case, to me it should be our judgement as staff who know the *patient/client/service user (*choose your preferred term, I will use patient from now on) to decide if they need such support or of there is any risk. They do not ask every person who comes from home to have a nurse escort for an x-ray or some other test, do they? And to be honest a lot of the general public are much more scary than a person with mental health problems.
People ask me what it is like to work on a mental health ward, and in all honesty it can be very busy and stressful, but the reason why I and many other people choose it as a profession is that we get to meet some really nice people. Yes, they are unwell but to see improvement in them is our reward. And regardless of mental health problems, the patients still have a personality, they are people with feelings and opinions, yes they can be a bit muddled up in the case of psychosis but such people are still likeable/admirable/intelligent/nice people even in an acute episode. In the same vein, yes there are people I don’t particularly get on with too, but I am not expected to like everyone, so long as I fulfil my duty of care and treat them all with the respect I expect, it is fine.
The thing that annoys me most about other people’s perceptions of people with mental health problems is, well there are several...
- - They are not deaf or stupid, there is no need to talk really slowly or patronise them. They may have difficulty concentrating if really unwell (as they often are when admitted to acute wards), but this means you should keep it clear and simple in such cases and not always expect a coherent answer (I mean this when patients are really unwell not when recovered). Be patient and considerate, give them some time if it is obvious they are struggling. But most of all if they are an adult, speak to them as if they are one, they or their carer will tell you if further explanation is needed. Have some respect. You don’t know their level of functioning, don’t just assume it is very poor.
- - People get better and have full lives to varying degrees. Some mental health problems mean people need to relearn skills such as caring for themselves or social interaction. Some people need support for a long time or even their whole lives, but others recover more quickly and should not be “labelled” or assumed to be “crazy” or unable to function as well as you or I. I have seen people from many professions and for the want of a better word “classes” have issues with mental health problems. It can affect anyone at any time in their lives. Yes some social groups may be more likely to suffer such illnesses due to poverty, stressors, environment, social upbringing, nutrition, alcohol or illicit substance misuse. But none of us are immune. Many people have a serious mental health problem and either recover or learn to manage the symptoms and live happy and full lives. If you hear someone has had mental health problems, don’t make assumptions.
- - Getting back to work can be a big step. If people have not worked for months or years due to a serious mental health problem, it can be daunting. Such issues are made worse by the fact that employers can harbour such negative perceptions of mental health problems. When in reality, if they were unable to function at a level to do a job most patients would not even be applying. Judgements should not be made from a mental health problem being listed on an application form, meet the person and decide for yourself, ask questions. Everyone is different. Some people will only ever have one episode of mental health problems, others may have repeated episodes, but ask about coping strategies and relapse signatures (if they are comfortable talking to you about it and it is appropriate, again don’t assume they want to talk).
- I know I work at one extreme of the spectrum of mental health problems, but I do know from my work with outpatients and personal experiences that there is a stigma which can be very damaging for more than the above reasons. Even people who are managed by their GP face such problems. Mental health is not discussed enough fairly in the media. Even this week I saw a “celebrity” on the news talking about her mental health problems and sensationalising them. This does not help. Over exaggerated or dramatic stories or statements do not give the perception of most people’s experience. Celebrities need to think about the influence they have on the general public, use research and facts. Yes, by all means tell their story (as dramatically as they like, if they must), but remember it is not how everyone will experience such problems, they should promote using GPs, psychiatrists and the treatments available, seeking help is often the hardest step. They should not fall into the trap of reinforcing the negative perceptions of mental health.
In all I am saying, don’t make assumptions about people with mental health problems, talk to people about mental health issues, encourage others to do the same. We need to foster a society where it is possible to be open about such issues and have open discussion.
Thanks for reading, comments, tweets or emails of your thoughts would be lovely if you don’t mind and have the time.
This is an interesting topic and one that if I'm honest I've never really given much thought to. Since I've been in teaching I have encountered kids with ADHD, autism of varying degrees, and some with various behavioural issues but I never really thought of them as 'mental health issues'. I try to treat those kids appropriately and give them the support they need, which I think doesn't necessarily mean treating them the same as everyone else - for me equality isn't about treating everyone the same but giving everyone the same opportunities.
ReplyDeleteI know a few people who have suffered from depression and my brother-in-law has schizophrenia, this blog has given pause for thought that I don't really know much about it and perhaps that is something I should change.
Thanks for being thought provoking once again Nic. Good work.
Thanks misswiz for the comment.
ReplyDeleteYou are right it isn't necessarily about treating people the same as everyone else in every respect, some people with mental health issues do need additional support and consideration, but it is to not make assumptions until you know this. In particular with people who have had a previous mental health problem but are now recovered from the severe episode, many people have preconceived ideas about the lasting effects if any.
Education about the different types of mental health problems is certainly needed, especially with younger people, to teach them about it in schools would be great. I often have to education students/doctors and the general public about Electroconvulsive Therapy, as is still surrounded by controvesy, even though it is a very good and safe treatment. I find patients can be judged if they tell people they have had it.
Thanks for the comments, and provoking my thought further.
Lots of people in my family suffer from mental health, as have I. I've never really known if it can be passed on genetically (?).
ReplyDeleteIt seems that in today's society the subject of mental health is quite the taboo. I don't mind talking about it in private with people I trust, but I wouldn't feel comfortable discussing it in a large group or online. I do, however, think it helps to talk and be informed/aware of mental health.
I'll do this again. Speaking from experience, mental illness is often mis-represented as the sufferer looks 'normal' from the outside.
ReplyDeleteAs a brother who had to talk their sister 'from the ledge' so to speak, mental illness has been a big part of my life. Changing people's attitudes towards it will aid sufferers greatly.
My respect for you has gone up exponentially as you willingly aid people. I do it mainly through sibling duty, and I find it a strain somewhat. It's good to know people have the best interests of sufferers inn their hearts, not out of a sense of responsibility.
I'm rambling now. I'll stop.
Very thought provoking indeed. I have a friend who I am now unfortunately not in touch with anymore. When I was, I went to see her a number of times while she was in hospital for a number of mental health problems. I found it quite difficult to know what to say and how to say it, I was very worried about saying the wrong thing. Awareness is so important and I should have taken the time then to find out more. This is partly why I decided to study Psychology at uni.
ReplyDeleteMental health problems seem to be very stigmatised and people just don't want to talk about it openly, the more awareness and understanding people have, the more the stereotypes can be got rid of and hopefully, people who have had/have mental health problems will be judged for who they are and not by their illness.
I work in a guidance role with teenagers, many of whom are identified with learning, social and behaviour difficulties and/or mental health issues. I get frustrated by the tendency among some 'professionals' to label them and then file them away as though the act of categorizing their difficulty is all that needs to happen. I hate it when a child gets treated as though they ARE a problem instead of a person who HAS a problem. A label is of no use at all unless you then take steps to enable that person to develop coping strategies that will help them to function and progress. I often use a solution-focused approach to help people to examine what has worked for them in the past and to apply it to new situations. Fear and lack of understanding often form the root of discrimination, so I am all for any initiative that encourages people to examine their attitudes and gain a more informed perspective.
ReplyDeleteA sobered up comment ;)
ReplyDeleteI think I've been quite lucky as a whole, not only with my dodgy mental health but with people's reactions. Returning from counselling on a wednesday morning was invariably met with a joking "how are the crazies today" from friends, or just a sympathetic look from others. But then I suppose in terms of my circumstances it was the expected thing. If you loose a parent at 15 very suddenly then it seems subjective depression and self harm aren't "weird" but "tragic" and "understandable". So on that level I suppose at least there's a reason.
But then when I was diagnosed with aspergers syndrome and had to tell my friends it meant I wasn't nervous. The general response was the same as my own personal one of, well that explains a hell of a lot then. Which was nice, it was nice to get to carry on being who I am regardless.
It's more as I've met new people that its been worrying, I try to put it forwards straight up and go look, this is who I am, I'm not all that different to other people but I have odd moments. And so far the response has been good, no-one has treated me any differently to how they did before, no-one has been scared off.
The single bad experience I've had was with an odd kind of mental lock down where I couldn't manage to speak or to explain, where the friend I was with just left me. What was weirdest was she was a friend I'd made though my various mental health problems. Unlike some of the others she was never accepting of it and almost constantly a danger to herself, and yet as she met my friends they took to her as a person, not as someone who had just come out of a secure unit, or someone who'd just spent a week in hospital on an IV. I don't really speak to her anymore, we fell out. But they do. Other friends are more accepting, so maybe to an extent its how much you accept yourself.
If you can go into a job interview and say yes I am autistic or I am bipolar or I do suffer depression but I'm okay with that I can deal with it. Then you're more likely to prove yourself as safe and suitable for a job.
I don't really know where I'm going with this, so I'll shut up now.
Stupidly long comment is stupidly long.
I am glad you wrote this post, Nic. I am a huge advocate for people being more open and realistic about Mental Health (MH) issues - It is part of why I am so blatantly open in my tweets and blog about my own.
ReplyDeleteThere is far too much stigma around MH and it is sad to see it. I have come across it many a times. From the people who assume that you can not have an MH illness if you are intelligent (WTF? have they never heard of Stephen Fry?!) - and yes, I have even met some psychs who have that opinion. To the people who treat you like a fragile flower that may break at any moment or walk on the other side of the road, or laugh at you and act as though what you are feeling inside is somehow 'abnormal' because it has no definitive 'why'.
I agree with Misha. The ability to walk into a job interview and say, frankly 'I have x' but that is fine and I deal with it via 'y' is so much better than having the fear that the person across the other side of the table will immediately put a 'No' next to your name the moment you mention that you may have something they consider a 'risk'.
MH in reality is no more a risk than someone coming in and saying they have diabetes. If controlled and managed, if looked after in the right way using coping mechanisms and any professional help that may be appropriate - It is of no real concern. There are chances things may go wrong, but they can be dealt with. There are chances the condition was very badly managed in the past, but that does not mean it can not be well managed now. None of them affect the persons ability to do a job, or be a person, or have a personality outside of that condition.
If anything, my belief is, the more that people are aware of, and open about MH issues, the more likely someone who needs help will get the help that they need - They wont shy away from stigma or the fear of being thought of as 'crazy'. Someone frightened or confused in a street could be helped by a kind passer by, instead of looked at as though they are no longer a human being.
I look forward to those days. Hopefully, they will come.
Roiben x
Found this blog really interesting and echo the thoughts of the other commentators.
ReplyDeleteI'm studying psych and Mental health side of it is what I have find most intriguing (especially the neuroscience side to it) and agree with what you wrote in your post.
(I can't think how to phrase the point I'm going to make) The stigma attached to the issues is what needs to be targeted and in some cases the over diagnosis. What I mean by that is when I was in secondary school everyone was going on about how they suffer from depression and have been and I know a few people who got sectioned or just sent to psychiatrists, and even though my friends were having a tough time, they didn't quite need the extent of help they got. (this is of course my opinion from being around them at school and stuff) And the one's who were just given hundreds of appointments with the local "shrink" never took them up because "they didn't work" which I think is another point that needs to be addressed.
In summary: I found this blog really interesting and I couldn't think what words to use.
rachx
Nice blog, it's brilliant that awareness is happening, people need to be more open-minded. I know of several people who have had mental health problems. One friend who has had mental health problems has recieved alot of trouble, and even though I'm her friend and it may sound biased, I can honestly not understand the ignorance of people sometimes when it comes to mental health problems and the background which may cause them - which in many cases is not considered.
ReplyDeleteApart from this I have nothing much to say, my strong feelings and experiences come from issues of mental illnesses and diseases, but that's a different subject so I'll shut up now.
But good blog, MH problems should be talked about and understood, and this contributes to sharing the awareness so well done Nic.