Straightforward Guide To Understanding Mental Illness

Revised Edition

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• Publisher: Straightforward Publishing Digital
• Year: 2013
• Print ISBN: 9781847163219
• eBook ISBN: 9781847164476
• Topic: Medicine
• Subtopic: Diseases & Allergies

Understanding Mental Illness - Revised Edition, by Marianne Richards, is the fifth edition of this professionally acclaimed book. The complex subject of mental health is demystified in an easy-to-read style assuming no prior knowledge. The aim is to reduce fear about mental illness, providing clear information and debunking myths and outlining changing perceptions of mental illness.

Chapter 1

Drawing the Line: Sanity - Insanity

Content of this Chapter:

Intolerance and Prejudice

Moral Panics

Exclusion and Mental Illness

Language or Labelling

Feared Mental Illnesses

Exercise

Parameters for Acceptable Behaviour

Definition of States Requiring Intervention

Mental illness is hard to understand even if you have experienced it. In making the attempt it is important to take into consideration the backcloth of pre-conceived ideas present in human communities. It is also vital to understand the difficulties of diagnosing from the professionals point of view. This chapter addresses these issues.

Intolerance and Prejudice

Throughout history individuals who have not conformed to the expectations of society or tribe risked exclusion. Wearing unconventional clothing, using language or behaviour different to that commonly used in the group, or rejecting accepted politics put the perpetrator at risk from ridicule, stigmatization or death, depending on the tolerance levels of their society. These were not the only risks of living in groups.

In the sixteenth century millions of innocent men and women were charged with witchcraft and risked torture, imprisonment and burning. The Catholic Church wielded huge power and witch hunting provided a way of maintaining it. Their infamous Inquisitions wielded terrifying power in illiterate communities steeped in a common fear of evil. Anyone offending a neighbour risked being falsely accused and brought before an Inquisition. If relatives chose to comfort them as they burned they were in danger of implication. This was a time when women feared growing old lest their senile looks lead to an accusation of witchcraft.

In modern times there is little fear of witchcraft, hell and damnation however, non conforming individuals risk being excluded for much the same reasons - fear, envy, spite, anger. With our modern fear of terrorism, certain groups have been similarly stigmatized, rather than looking at the small number of individuals causing havoc in the name of some adopted cause. If things go wrong, it is too easy to blame some persecutor rather than deal with the underlying social issues.

Group behaviour was first analyzed by Sigmund Freud, Carl Jung and their descendants who uncovered many of the often unconscious reasons why humans can be cruel and irrational. We now know that the purpose of rejecting what appears abnormal behaviour, appearance or opinion serves to confirm the identity and safety of the group. On the other hand awareness can serve to warn of potential attack so recognition of non conforming behaviour has a useful angle too.

In the 21st century whilst the cruelties of exclusion still exist in a myriad of forms, those with emotional intelligence are aware of why they do what they do. Although the 21^st century brings more scope for tolerance with its more international culture, group pressure often precludes individual effort. Irrational fears of groups are referred to as moral panics.

Moral Panics

Murder often triggers moral panics particularly when linked to mental illness. In the press, a murder committed by someone with say schizophrenia was enough to trigger headlines like ‘madman’ or ‘maniac’ or ‘psycho’, usually attached to a cynical campaign (to make that newspaper look good) to ‘make our streets safer’ – i.e. by locking up anyone not drugged to the eyeballs and safely stowed in a locked ward. Thanks to work by the Royal College of Psychiatrists with the media, the days of such headlines are largely history however moral panics still thrive when societies feel threatened by attack or because resources become limited. It is now recognised that schizophrenia is not uncommon and with modern medications is often so successfully treated you would never know your neighbour was so diagnosed.

But societies are often caught unawares by their own prejudices. In the UK a retired school master was wrongly accused of murdering a young female. The man in question sported what might appear alarmingly bushy long, white hair. Accusers indulged in public tittle-tattle about his mannerisms, habits and social behaviour based on irrational fears. Such was the moral panic the man had to go into hiding. After the real murderer was caught, the man reappeared. His long hair now cut, he wore a suit and walked next to a grim-faced barrister. Same man, but viewed differently by accusers who now disappeared into the woodwork, embarrassed.

On the other hand the most prolific mass murderer nearly got away with his crimes because to society he appeared the model of a normal, caring Physician. Dr Harold Shipman, respected GP of long standing, worked for decades alongside doctors, nurses, pathologists. For years the elderly were entrusted to his care by unwitting relatives. Shipman the pillar of society made public interviews about treatment of the mentally ill in the community. One day it struck an observant undertaker there had been an extraordinary number of funerals among Shipman’s patients. Although charged for a small number of murders a subsequent public enquiry suggested the number ranged between 250 and 400, making Shipman the country’s most prolific serial killer. Shipman was not diagnosed with mental illness but was said to have had several personality disorders. It is a sobering fact that most murders are committed by so-called sane people, not those with known mental illness.

Exclusion and Mental Illness

To the early 20th century individuals were incarcerated in Asylums sited well away from communities. These were not people with active mental illness but so-called social misfits whose only problem was eccentricity or minor social aberrations.

In the 1970’s the UK Care in the Community Act forced the Asylums to close and patients were sent to live in social housing. Whilst there were instances of acceptance and tolerance others became openly hostile to ‘ex mental patients’ (how they were referred to in the press of the time). In the days of the asylums, those who lived and worked in local communities were curiously understanding of their strange neighbours, because they were used to seeing the symptoms which, pre-medication days, were florid and obvious but clearly did not harm other members of the local community. Also, the patients went back to their Asylums at night and were locked in.

A major flaw in the Care in the Community Act was lack public education in understanding and tolerating those with enduring mental illness which would logically have reduced fear. A small number of people will even now present represent a danger if not constantly medicated and watched. But with no education the community were left to live within their fears and prejudices.

Language or Labelling

When a group of people are bent on excluding another the first thing that is accentuated is the difference between the group and ‘it’. One of the first phenomena is the use of negative words or language to describe the individual or group. Then come false accusations or blaming. For example, the Jews in Nazi run Germany were accused of creating the poor social conditions existing in the German nation, a fear exploited by Hitler and his thugs.

In individuals with mental illness, a language develops which stigmatizes rather than describes the individual. For example the derogatory term ‘a schizo’ rather than ‘someone diagnosed with schizophrenia’. A ‘schizo’ is assumed to have no identity outside the label. Someone ‘who is diagnosed with xxx’ does have another identity and indeed there may be many periods in their life when the mental illness is dormant. The diagnosis of schizophrenia was at one time tantamount to social suicide. Labelling is helpful only for diagnosis. Giving a name to a disorder allows a course of preventative action to be taken but does not describe a person.

This labelling extends to sad cases where individuals commit suicide, whether or not they had an active mental illness. As well as a common view of suicidal persons being somehow selfish, they have been cruelly mocked on social websites. To counter this, there is a growing understanding that the state of mind known as depression, which can lead to suicide, is an illness - not a choice.

The latest view leans away from diagnostic labels and towards identifying and treating individual symptoms as they occur. Thus it is recognized someone might experience a psychotic episode, receive treatment and return to life untainted by a permanent psychiatric label. No one remains neuro-typical their whole life but fluctuates along a median line from mental health to mental ill health. It is therefore in everyone’s interest to prevent unjust labelling.

Feared Mental Illnesses

A tiny number of people with mental illness are dangerous because the nature of their illness makes it likely they will commit criminal acts. However there are few murderous psychopaths. A psychopath is born without moral capacity and cannot be ‘blamed’ for actions in a moral sense. Nevertheless murderous psychopaths have to be locked up for the safety of the community as there is no cure for this disorder.

A small number of people with schizophrenia might fail to take medication because they believe there is nothing wrong with them. They can be dangerous if under the influence of powerful delusions. However, there are many with this diagnosis successfully living relatively normal lives thanks to modern medications.

John Nash the great mathematician (his story is told in the film A Beautiful Mind) developed schizophrenia during his teens but lived a full life, had a happy marriage and was recognized for his academic work in being awarded the Nobel Memorial Prize in Economic Sciences. In the days before medication was available he was able to overcome symptoms using his powerful logic to deny his delusions. However his gift for self treatment is unique.

In conclusion, contrary to popular belief, few people with enduring mental illness are dangerous. There are far more ‘bad’ than ‘mad’ people in this world. Among so called neuro-typicals there are eruptions of greed, revenge, envy, spite and murderous rage. Lately a spate of family men butchered wives and children before committ...

Table of contents

• Cover
• Title
• Copyright
• Contents
• Introduction
• Chapter 1. Drawing the Line: Sanity - Insanity
• Chapter 2. Mental Health and Communities
• Chapter 3. Mental Illness to 17th Century
• Chapter 4. Mental Illness 18th - 20th Century
• Chapter 5. The Mental Health Act 1983
• Chapter 6. From Detection to Diagnosis
• Chapter 7. Talking Cures
• Chapter 8. Modern Medical Treatment
• Chapter 9. Pen Portraits of Therapists
• Chapter 10. Institutional Care & Support Groups
• Chapter 11. Case Histories
• Chapter 12. Social & Complementary Approaches
• Chapter 13. Reflections
• Glossary