This blog has featured a lot of discussions about mental health. This is because I have served my time as one of societies psychiatric policeman- an Approved Social Worker in England, and a Mental Health Officer in Scotland.
I started out 25 years ago with a clear idea about mental illness- people who were ill did not always realise that they needed help. It was my job to try to make sure they got help. I had all sorts of different ideas about what this help should look like, and lots of frustrations with the psychiatric machine that I had to deal with, but fundamentally, the idea of mental illness itself was a stable reality within what I did.
Sure, we challenged the medical model (Illness-diagnosis-treatment (maintenance)) as this failed to take into account the social context in which some ones illness develops, but the dominant paradigm that affected work with people with ‘severe and enduring’ mental illness remained firmly medicalised. It was the only way to make sense of the psychic chaos we were faced with – hospitalise, medicate and sanitise it out of our immediate circle.
Increasingly I became a skeptic- not just of the machine, but the actual underlying concepts of ‘mental illness’.
It started many years ago when faced with young men and women who, once diagnosed with schizophrenia, were condemned to half-life at best. The medication we gave them to control their symptoms (particularly the ‘voices’) often did not work, and had such destructive side effects that everything would slowly slide downwards into a kind of suppressed humanity. Is this really the best that we could do?
Alongside this other movements were emerging. They were dangerous and threatening. One of these grew up in and around Manchester, where I was working, and was called ‘The Hearing Voices Network‘. It dared to suggest that hearing voices was a NORMAL human experience- not a symptom of ‘illness’. Rather it was a way of coping with trauma for the most part.
Rather than pushing the voices away, suppressing and chemicalising them, the HVN suggested we needed to embrace them, engage with them, understand them- even the destructive aggressive ones.
More recently we have has another movement- around the idea of ‘recovery’- living fully in the presence (or absence) of the ‘symptoms’ of mental illness.
None of these are easy concepts- they are really stories of life long journeys for people experiencing one of those ‘psychic civil wars’ that all of us go through to some extent.
What convinces me most about these revolutionary ideas in relation to mental health issues is the HOPE that they bring. The best that psychiatry can offer to many is ‘maintenance’. All the so called break-through s of the pharmacological machine that spend millions convincing doctors to use their new wonder drug have done little to change this. Suddenly however, people are saying clearly- The treatment you are offering me is NOT WORKING. I want something better for my life.
That is not to say that there are not people in the system who see it this way too. I heard this wonderful TED talk the other day. It is saturated with hope, and the raw joy of life…