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You and Yours聽- Transcript 大象传媒 Radio 4 |
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TX: 15.03.05 - Call You and Yours聽- Mental Health Part 2 PRESENTER: LIZ BARCLAY |
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THE ATTACHED TRANSCRIPT WAS TYPED FROM A RECORDING AND NOT COPIED FROM AN ORIGINAL SCRIPT. BECAUSE OF THE RISK OF MISHEARING AND THE DIFFICULTY IN SOME CASES OF IDENTIFYING INDIVIDUAL SPEAKERS, THE 大象传媒 CANNOT VOUCH FOR ITS COMPLETE ACCURACY. BARCLAY And today we're discussing attitudes to mental health. Do we, as a society, have an in-built prejudice against people with psychiatric problems and what can be done to change those attitudes which leave patients feeling socially excluded and stigmatised? Yesterday we heard the views of Cliff Prior, who runs the mental health charity Rethink; health minister Rosie Winterton; and first Mike Bush, who has used mental health services. BUSH Focussing on the issue of stigma and what I call mentalist attitudes that we have in society, because this is the issue which percolates and colours people's perceptions on mental health, like racism and sexism, it's institutionalised in society and it percolates through and influences people's perceptions and attitudes, particularly that of policy makers and politicians and where money goes. WINTERTON This can be an illness like any other, it doesn't mean that somebody has to be taken away elsewhere, if they can be properly treated at home, if they can stay in work. That's about changing people's attitudes, reducing that fear factor. If they know that somebody that they're working with has a mental health problem, that they are involved in actually helping to support that person, in the same way as they would if somebody had a broken leg, for example, then that how you kind of chip away at the discrimination. PRIOR We are a long way on from the position, perhaps even as recently as 10 years ago, where there was serious doubt about the effectiveness of treatments, we do now know that early help, talking treatments, informed choice of the best medication, social care and support, help to families - that package works, people can recover decent lives. The problem is that the public and political mindset has rather stayed back in the '60s and '70s where not very much could be done. Now it can be done, we need to change. BARCLAY Cliff Prior, Rosie Winterton and Mike Bush. Do you share those views? If you're a user of mental health services have you been listened to and supported or have you been told to pull yourself together, have you been the butt of jokes because of your condition? How do you think we can combat such attitudes? E-mail us through the website, that's bbc.co.uk/radio4/youandyours or call us 08700 100 444, that's 08700 100 444, those lines are open now. And Dr Trevor Turner, vice president of the Royal College of Psychiatrists is here to discuss your ideas. Straight to the phones, Susan Clelland is on the line from Glasgow, Susan what's your experience? CLELLAND Well I have found that I'm applying for jobs if I put down my specific mental health problem I just didn't get an interview. BARCLAY What was your specific mental health problem? CLELLAND If I put down manic depression I just don't get interviews. If I put down depression I'm lucky sometimes I get an interview but manic depression there's no hope. BARCLAY So has this always been the case or are things changing in any way? CLELLAND No I think that's always been the case. Schizophrenia would be another no go area I would imagine as well. BARCLAY If you were to put down bipolar disorder, would that make a difference? CLELLAND Possibly in that it might confuse them a little bit, but when they asked what that was, I have been asked at an interview what that was and after that it was a waste of time. BARCLAY So you don't think it's just down to the language that's used perhaps? CLELLAND No I think it's colourful use of the term manic depression in dramas on TV and newspaper reports just as to the - they all highlight that if somebody attacks somebody - they have manic depression etc. BARCLAY So we basically understand what manic depression means, but bipolar disorder being the same thing we don't really understand that - that title? CLELLAND No that's not recognised really. BARCLAY Are you in work now? CLELLAND No I'm not. BARCLAY So you're still facing that same situation? CLELLAND Yes. BARCLAY Susan, thank you very much for your call. Tony Bevan's on the line from Edinburgh. Tony, what's your experience? BEVAN Hi Liz. I've been suffering from depression, recurring episodes, for about 20 years and I've been on incapacity benefit for about seven years after a breakdown. During that time I've realised that there's absolutely no chance that I can get a job with an employer. I can't even get work experience or voluntary work. I was absolutely humiliated a few years ago when I tried to do that. So the only option for me is to - what I've done is try and teach myself a craft, I've taught myself book binding. BARCLAY So is that - do you do that on a self-employed basis? BEVAN It's not really a business. I have occasionally managed to sell some books in some galleries but I simply don't have the resources to buy really the equipment that I need or the materials that I need or to make it a real business. I've been trying for seven years but it's really an impossible task. BARCLAY Do you think this is out and out discrimination or is it just a lack of understanding on the part of the employers? BEVAN I think there's - as far as employers are concerned - I think there is a lack of awareness and knowledge of what depression is, it's often seen as something to do with violence. I was asked if I would be aggressive or if there was any danger if they used me - I'm the least violent person you'll probably meet. But there's a lot of ignorance. BARCLAY Tony, thank you very much indeed. Susan is on the line from Epsom. Susan, what's your experience? SUSAN I had a nervous breakdown last year and I actually went back to work and going back to work was horrendous - sorry it still upsets me now and I'm not normally upset. They didn't treat me well at all. If I'd broken my leg I would have been treated okay but I was just treated horrendously. I stuck it out and I'm still at work, I'm one of the lucky ones after hearing the last two. I've been in my job nearly seven years ... BARCLAY And what is your job? SUSAN I work for a private health company actually and I've been - I'm an administrator and I do payroll and everything. And I was just treated horrendously. BARCLAY So you're saying you were treated horrendously by people who are themselves in the caring profession? SUSAN Yes. Very much so. So it still upsets me now because I was a very together person, something happens in my life, never had it before, and they just treated me awful when I returned to work, awful. BARCLAY So do you think that same ignorance that Tony was talking about of the conditions prevails in the caring profession? SUSAN Yes, very much so I'm afraid. I mean we've got somebody off in my company who's hurt her foot and has been off a lot longer than me and yet I was bombarded with letters, had to go on a course within a month, do a certain amount of work, wasn't allowed to use the computer when I went back to work, got taken to a meeting which I was told was informal, which wasn't, and I just don't know what I did wrong. What did I do wrong? BARCLAY Susan, I'm sorry it still upsets you but it's quite obvious why it would still upset you. Thank you very much for your call. Dr Trevor Turner what do you make of those three calls, we're talking about employers really with a lack of any kind of awareness and understanding of conditions but even people who work in the health profession seem to be in the same boat? TURNER Well they all ring many bells, they're very typical of what patients say all the time. The NHS is as bad as anyone else, I have to say, it's a tragedy but with so many people who could do - it's a very worker rich environment - so many people could do part time or appropriate jobs yet the NHS occupational health departments can be ferocious in the way they control people, monitor them, make them go through all the hoops that we heard from the caller. There's a tremendous stigma, I'm afraid, amongst senior clinicians as well, many doctors, senior surgeons, will make jokes about "you're the only sane psychiatrist I know" and think that that's funny. This goes on to such an extent that when we talk to patients about employment we generally advise them to see their GP about doing a report and advise them to use physical explanations of illness, for example, a virus or stress of some sort rather than use even words like depression, which we've heard before. It's interesting the word nervous breakdown of course was brought in to try and give it some sense of a physical illness as opposed to a mental illness anyway. BARCLAY Do you think the Disability Discrimination Act will make any difference, because mental illness can be classed as a disability under the act? TURNER One hopes it does, yes, because I think a certain portion of your staff have to be part of a disability group. I'm afraid there are many ways of getting round this though because you can refuse to, for example, start even to see people or interview people if you decide there's a hint of this in their records, you can pressure people in a range of other ways as has been pointed out. So it has to be very closely adhered to and you've got to be very brave as a patient to fight them. BARCLAY Let me go to Amanda Jones, who's on the line from the West Midlands. Amanda. JONES Hello. BARCLAY What's your view? JONES Well there's an awful lot of discrimination out there and I think it is institutionalised but I think a lot of it isn't helped by the media with their stereotypes. I mean I have manic depression and it's ruined my life really up until a few years ago when I was at long last diagnosed and then put on medication. But at one point I was having a really, really bad episode which included psychosis, and somebody who'd I'd known for a while and I thought was a friend, I found was scared of me, which is ridiculous because I'm sure that most people with this condition are more likely to hurt themselves than hurt anybody else. BARCLAY Do you put this down to the portrayal of people with mental health by the media? JONES Well I think lots of people - lots of people obviously know people with mental health problems but don't even realise. And so I reckon more often than not the only portrayal that people will get is from the television. Now there are lots of people like me, I was off work for about six years, and about two months ago I actually got a job and they've been really, really supportive, although the personnel department know what my problem is but nobody else does and said that they wouldn't even tell the managers unless they needed to know. But there must be an awful lot of people like me who have this illness and are working and managing to run their homes and it is a struggle, believe me, I know that there will be times in the future when probably I will end up back in the clinic again. But there are people who are living normal lives and I think that if you watch things like Casualty or Brookside you would think we were just real mad head cases. BARCLAY Well Amanda, thank you very much indeed for that call. But that kind of media portrayal, that lack of understanding, lack of awareness, it's something that in Scotland they've been running a campaign to try to address. AWARENESS AD I'm no different from anyone else. Sometimes I feel different, so bad inside that I starve myself but then people notice I'm getting too thin and that I cry and cry. So they slag me off, act like I don't exist and that makes me feel worse. It hurts more when they treat me like that, but it doesn't have to be that way - see me, I'm a person just like you. BARCLAY And that campaign has been running in Scotland and we've had quite a few calls already from Scotland this morning. Shaun McNeil is on the line from Motherwell near Glasgow. Shaun, do you think this campaign is working in Scotland? MCNEIL Yes I think absolutely the campaign is working. I've been fortunate to be involved in the campaign since the outset as somebody who has experienced depressive illness in the past because it has to be understood that the campaign, despite the fact that it is funded by the Scottish Executive, the campaign is actually people who have experienced stigma themselves - they're the public face of the campaign. It's an alliance of five mental health organisations up here but there is quite clear evidence that the campaign has been successful and is changing public attitudes and attitudes in the media towards mental health issues. BARCLAY What was it that sparked the campaign in the first place do you think? MCNEIL What sparked the campaign in the first place was a recognition that was a real priority issue and it was something which resources needed to be allocated to. There was actually a major mental health report, the Milan Report, which was set up to advise on new Mental Health Act in Scotland and one of the outcomes form the Milan Report was that stigma and discrimination work should be an absolute priority in this country. So that's really what was the impetus of the campaign. BARCLAY Well Shaun let's hope that it carries on working, thank you very much for your call. Helen McDermott is on the line from Norwich. Helen, that's a familiar name. MCDERMOTT Well I'm a local presenter at Anglia Television in the East of England and had a breakdown myself. BARCLAY And came out, so to speak, with your experience to the public. MCDERMOTT I did, it was a very difficult decision to make because I've had depression all my life, mental illness all my life, and managed to keep it well hidden, or hidden, perhaps not well, for many, many years but then there was - I could no longer and I was taken off - well I went off the screen for many months and did actually go to a mental hospital. And initially I didn't actually say the real reasons why I was away, it was just that I was away from the screen, many people were very kindly asking where I was. But then eventually I decided that I really wanted to talk about why I had been off screen and really my experiences. The reason I didn't want to say anything to begin with was a. I didn't feel strong enough really to cope with it and also I didn't want to make it look as if I had a flagging career that I was trying to boost up by having what seemed to be a rather fashionable illness at the time. BARCLAY I can see why that might have been an issue. Did you get support from your health professionals? MCDERMOTT Yes I did, very much so. I was extremely lucky and maybe because I am sort of reasonably well known in the region I should imagine that would have helped a bit. And I do appreciate that for a lot of people it's very difficult for them to get anyone to listen to them, like some of your former callers have just said that people are scared of mental illness, they think that people are going to come at them, I think people looked at me - gave me a bit of a wide berth or perhaps they just didn't like me on TV I don't know, that might be the real reason. BARCLAY And did the health professionals support your decision to talk about this in public? MCDERMOTT I didn't really - when you say health professionals who do you mean? BARCLAY Your psychiatrist for instance or GP. MCDERMOTT I didn't - in actual fact I didn't really consult them I have to say. In fact initially one of the psychiatrists I saw, one of the very first ones actually, would have been dead against that because when I was first off sick he said - What do you want me to put on your sick note? And I said - Well what do you mean what do you want to put on it, I said depression. He said - Well it'll follow you around for the rest of your life. Which of course is absolutely true. And I said - Well if we don't come out and don't talk about it it's never going to change, so yes, put down the truth. BARCLAY Helen, thank you very much indeed for that call. Dr Turner what do you think of the role of campaigns like - as Shaun was talking about in Scotland - and the role perhaps of celebrity, like Helen McDermott, in bringing - raising awareness in the public? TURNER Well I think there's good evidence that celebrities in other illnesses have been very effective, for example things like asthma or children's disease, like Gary Lineker. Stuart Goddard, from Adam and the Ants, has come out very bravely about his illness. And the campaign in Scotland certainly seems to be producing results. We think we're getting some results also from Our Every Family in the Land campaign, which is the Royal College of Psychiatrists and a group of others trying to put forward the notion that this is very common - mental illness - that it affects many people, that it's perfectly treatable and we shouldn't exclude and seclude. But we certainly could use more celebrities prepared to come out, it's a brave decision to make. BARCLAY We've also been having, as well as our phone calls, a lot of e-mails, they've been coming in all morning. Winifred, you've been running an eye over a few of them, what are people saying? ROBINSON Well just a brief taste. One listener from the West Midlands e-mailed us to say: I'm appalled at the headlines in the newspapers relating in any way to mental health problems. The terms used are always derogatory and negative. I am open about the fact that I had depression and that I take antidepressants, that I have had counselling. I readily admit this to other people because I hope it will open a dialogue and encourage other people to seek help if they need it. Pauline Masters e-mailed to say: I think the media, including the 大象传媒, could help reduce the stigma of mental illness by not referring to people as schizophrenic or manic depressive. These are serious mental health conditions and not personality types. Francesca Smith says that most coverage focuses on people of working age and ignores the mental health needs of older people. The government - she writes - sets the direction by responding to perceived risks from young men with mental health problems and this means that most of the money flows towards people who are under 65, to the neglect of older people. I speak as a daughter of someone with Alzheimer's Disease and as a former NHS manager. And finally Kathy Wields who is a doctor has e-mailed us to say: I have experienced severe depression and I have been successfully treated myself. But I witness stigma continuing, even in medical practice. Patients are often worried about admitting to the symptoms of mental illness. What I try to tell them is that the brain has as much right to go wrong as any other organ of the body. BARCLAY And again the fact that lack of awareness is widespread in mental practice. Jim Yates is on the line from East Mosely, Jim. YATES Hello there, hiya. BARCLAY What's your opinion, what's your experience? YATES Well can I say first of all I agreed very much with what - they were talking about celebrities saying things. And my own experience: I've had anorexia and I've had extremely good help with it. I had - from a nursing development unit and from a self-help organisation. But I kind of think the attitude that they gave me kind of percolate outwards. I had help from Annex in Tooting, which is a nursing development unit, where you always see a nurse and they always treated you with respect and they never talked down to you, if something was difficult they allowed you to adjust. And in the same way the Eating Disorders Association, they always treated with a great deal of respect what was wrong. And then that kind of gave you confidence when you were talking with other people. And I think that their attitudes kind of percolate outwards from them. And the other thing - I wanted to say also that I think where people admit to having an illness it helps and particularly if they're well known, that it means that it's more common, it's more normal and the example I thought of were to do with Alzheimer's where Burt Reynolds and Ronald Reagan admitted and then it becomes not as distant. BARCLAY And you feel - and you feel that if other people can do something positive then perhaps you can too. Jim thank you very much. Jennifer Rankin is on the phone from London. Jennifer, I think you're working in this field, are you, through the Institute of Public Policy Research? RANKIN Yes that's right. I'm coming to this from a different perspective in that we're doing some work on mental health of the future and we're trying to think about how society should be responding to mental health problems in 20 years time. So how can we move away from these stigmatising attitudes that create so many problems now? BARCLAY And that is really the question we would like an answer to - have you found an answer? RANKIN Well I think part of it is bringing society to a better understanding of mental health and as a number of callers have touched on this already - such as the See Me campaign in Scotland. But there's another side of the coin as well which is about bringing people with mental health problems into society and helping them become a bigger part of society. A big issue at the moment is that if you have a mental health problem you can lose out on many ordinary opportunities - you can lose out on the opportunity to find work, you can lose out on the opportunity to meet people and mix in your local community. So, for example, today out of people with a long term mental health problem less than one in four actually have a job and finding work and keeping work is extremely difficult. So we need to move towards a society where people - everyone who can work is able to work. BARCLAY How do you think changing those perceptions of mental illness affect healthcare provision? RANKIN Well I think it will also affect the way we - the way we structure our healthcare provision at the moment. I mean currently we operate on the system where we presume the doctor knows best and that the patient should take what the doctor suggests and whether that's medication or something else, and it usually often is medication. But I think in future we need to move towards a system of healthcare provision which is more built around people's individual choices. For example, today if you have depression and you go and see your doctor there's a high chance that you'll end up leaving with a prescription for antidepressants. But that treatment isn't going to work for everybody in the same way, so people need to have a different range of options for treatment, like different access to talking therapies and counselling as well. BARCLAY Jennifer thank you very much indeed for that. Dr Turner, do you agree with Jennifer's picture of the future? TURNER Certainly it's worrying that mental health remains a Cinderella pressure. For example, in London recently Great Ormond Street's funding problems were heavily publicised but all the mental health trusts have got similar funding problems and no one mentions those. If you look at the future, in terms of the way they think they're going to be able to help people, there's a return, I'm afraid, to re-institutionalisation, by putting people back in homes and getting rid of them and secluding them, rather than trying to engage them as has been positively mentioned in terms of recovery, work and horrible word but nice, normalisation. BARCLAY Let me just try and fit in another couple of calls. Edward Duke is on the line from Droitwich. Edward. DUKE Hello. I'm just going to suggest that the general public have moved away from the word mental as a comfortable word. Such as - Oh he's mental - or - She went mental - or something like - Sounds like a mental case to me. BARCLAY And presumably it's not just the word mental, manic depression for instance? DUKE No I'm just referring to that one word mental and wondering whether we might not be able to find another word that we can use instead, simply because mental may have outlasted its usefulness. BARCLAY Is that something that you have thought about, have you another word that you think could be used? DUKE Well I'm not here to solve the problem but I can put forward the idea that the word mind is already very well used, emotion and feelings are certainly improving in credence and possibly the word personality is very well received. BARCLAY Okay Edward thank you very much indeed for that. Dr Andrew Hodgekins is on the line from London. Dr Hodgekins, very quickly, what's your view? HODGEKINS The question posed by the programme has been how can we reduce stigma to improve funding for mental health services and make them a vote winner? I think we have to get to the point where people realise it's us and ours, not them and theirs, who are prone to mental health problems. I work in a general hospital with patients with cancer and heart disease and mental healthcare is a central part of their care. The separation between mental and physical health problems is arbitrary really and just reflects the history of service provision, rather than the reality I meet. BARCLAY Dr Hodgekins, thank you very much indeed for joining us. I'm sorry that that's all we've got time for if you were trying to get through. Thank you for calling, thank you for all your calls and Dr Turner thank you very much for joining us. Back to the You and Yours homepage The 大象传媒 is not responsible for external websites |
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