I’ve written a whole bunch of posts related to mental health over the last few weeks in preparation for Mental Health Awareness Month. This morning, I scheduled the introductory post for Monday 1st October.
As I was arranging it, I realised that one post missing from the lot was one themed around stigma, arguably the most important part of all of this. And so, I’m composing this post to usurp all others and it shall be the first one to greet everyone’s eyes post-introduction.
If you read the intro post then you’ll know I’m studying for a Level 2 qualification in Mental Health Awareness. I’m fresh into it, but my eyes have already been opened to a lot of things. The first section focussed a lot on what mental health is and the different ways in which mental illnesses can affect a person. What it also talked about was mental health history, which naturally brought up the subject of stigma and how general attitudes towards mental health have changed down the years.
At this juncture, I’d like to go into brief, bullet-pointed detail about the key changes:
- Pre 19th century–There was little to no recognition of types of mental illness. Most all mentally unwell folk were branded ‘lunatics’. Most ‘lunatics’ would find themselves incarcerated in gaols or workhouses where they could be supervised. The odd few may have found themselves in a place such as Bedlam, which was more or less a predecessor to the asylum;
- 19th century–The 1808 Asylums Act saw the creation of the asylum as we might better think of it today: a large hospital for the mentally ill. Nine were constructed across England between 1808 and 1823 mainly in rural areas. This was to keep the patients segregated from society and reduce the danger posed by them on society. Treatments mainly included sedative drugs and baths to calm agitated patients. Here’s an interesting fact: women could be committed for having children out of wedlock;
- Post 1900–Electroconvulsive Treatment (ECT) came along in 1938 and became a common method of therapy for patients at asylums. ECT triggers seizures that can provide relief in mentally unwell people;
- 1950s–A push towards community care began and the Mental Health Act 1959 was created, which gave the mentally unwell more rights, abolished the distinction between psychiatric and other hospitals, and encouraged the development of community-based care. The large, Victorian asylums began to close;
- 1960s–Psychiatrists began to question traditional methods of therapy, such as ECT, and pushed for the use of medicinal drugs instead so that patients could be treated outside institutions. Civil rights movements and the introduction of mental health charities began to change public attitudes;
- 1970s–The effectiveness of large psychiatric hospitals was widely discredited and a movement towards integrating psychiatric and general services increased. Psychiatric services became available at new district general hospitals;
- 1980s–The Mental Health Act 1983 replaced the existing act, giving those admitted to mental hospitals the right to appeal against committal. Concerns were being expressed about community care following a series of killings by mentally unwell people. A government enquiry into community care, led by Sir Roy Griffiths, generated the report, Community Care: Agenda for Action (The Griffiths Report) 1988.
- 1990s to today–The aforementioned report led to the introduction of The National Health Service and Community Care Act 1990 to ensure that individuals in the community were not at risk, nor a risk to others. Local authorities have a duty to assess people for social care and support. Patients have their needs and circumstances assessed and the results determine whether or not care or social services will be provided. Community care ensures people in need of long-term care are now able to live either in their own home with adequate support, or in a residential home setting.
All of that is in my own words and not heavily referenced from my course material, honest! Nevertheless, I think that shows how much attitudes towards mental health have changed in a reasonably short length of time.
That’s great. It really is. Gone are the days where those who suffer from mental health problems feel ostracised. They can comfortably slot into society, get about their daily lives, and become a success with no barriers preventing them from achieving anything.
I wish that above statement was true. I really do!
Unfortunately, the archaic stigma surrounding mental illnesses still exists today. It still exists in a big way. As good as it is that the government have stepped up their game since 1959, societal opinions and behaviours aren’t something that can be changed as quickly as a piece of legislation can. The unfortunate reality is that there are a large number of people in society who still stigmatise mental health. They stereotype the mentally unwell and hold a certain irrational fear towards them.
Worse still, because the stigma is still at large, those with mental health problems are stigmatising themselves and their conditions. They’ll deny they have a problem because they don’t want to be seen as making a victim of themselves. They don’t want the label of being mentally ill. They don’t want to be judged. A fear exists that people will brand them with their condition and refer to them as ‘Joe Bloggs, the guy with (enter mental health condition here)’ rather than just ‘Joe Bloggs’.
In many ways, mentally unwell people are responsible for keeping the stigma alive, but that is only because the stigma is still at large in society in general. Even in this day and age, when information on mental health is available in abundance at the click of a button or tap of a smartphone screen, there are a worrying number of humans amongst us who still think ‘mental illness’ means ‘dangerous’, ‘unpredictable’, ‘outsider’, etc. The archaic belief that all mentally unwell people are ‘lunatics’ is still alive.
Part of the reason for that is the tabloid media. Most people are aware that redtop newspapers are about as good at communicating the truth as a carrier pigeon would be at delivering you a new washing machine. Their sole purpose is to sell papers and nothing sells papers better than shock and sensationalism, even if the story is littered with, at best, half-truths. Despite this knowledge, people are still guilty of lapping up what they say and spreading the stories like wildfire. Unfortunately, redtops have seized upon negative stories involving mentally ill people in the past and the message has spread that they’re unstable and a threat to ‘normal’ people (can you guess which UK paper is guilty of it the most? It rhymes with ‘the nun’…)
The movie business has its part to play in the continuing stigma too. There are various movies from the past that depict mentally unwell people as dangerous. Halloween’s antagonist, Michael Myers, is an escaped asylum patient, for example. Norman Bates in Psycho. Jigsaw in Saw. While these movies might be fictional, they create an unconscious bias that people with mental illnesses are unpredictable and can’t be trusted.
Would it shock you to learn that mentally ill people are more often the recipients of violence than the ones giving it out? It actually didn’t surprise me at all to learn that because picking on those less able is something many people get a kick out of. Bullying isn’t something that gets left behind in school sadly.
The likelihood is that mental health stigma will never go away fully, much in the same way we’ll never see an end to homophobia, racism, and general bigotry. While hate exists there’ll always be prejudice, and hate will always exist. All we can do is keep reducing stigma and make those applying the shame more and more of a minority. The less of them there are the less the hatred will get listened to and believed. The more people that are brave enough to stand up and say “I have a problem and I want to get it sorted” as regards their mental health the more people will begin to see that having a mental illness is absolutely nothing to be ashamed of.
If you’re interested in learning more about mental health history, I found this link rather useful and interesting.