I know this is a slightly different tone of post than my readers might be used to. It’s not a personal update (although it’s certainly personal as well) but more of a political one.
The mental health system is a subset of broader social life, and as such prejudices like classism operate in a similar way but can be made worse by the additional ableism and stigma attached to mental health problems.
There is an assumption that people with mental health problems are less intellectually capable. This is part of the stereotype of the mentally ill person and has no basis in fact.
People who have less formal education will face greater challenges in navigating the mental health system and endure greater discrimination. The system is full of obstacles such as form filling and being expected to advocate for yourself with people using medical language instead of speaking in terms you would use to describe your own day to day experiences.
In a similar way that men experience negative effects from sexism, people with educational privilege experience negative effects from the ableist assumption that a person cannot be both educated and mentally ill. (This in no way negates the fact that it is privilege in action here.)
If you have the fortune to be educated you may be refused the help you need because you don’t conform to stereotypical assumptions about how a mentally ill person appears. I find myself holding back and becoming fearful of advocating for myself because there is no understanding that you can be very capable or experienced in some areas while experiencing severe problems and inability to cope in other parts of your day to day life.
It is vital that work to improve mental health services continues to emphasise the diversity of experience and presentation of people with mental health difficulties and to make the system work for the user, rather than being a series of hurdles to access help.
Thank you for reading. Please share and I’d love to hear your comments below.
As I commented to a fellow blogger recently, I was left feeling angry and anxious after watching last week’s episode of ‘Bedlam’. Bedlam is a four part Channel 4 series currently broadcasting about the South London and Maudsley trust’s mental health services (including Bethlem hospital). The first episode was about anxiety and OCD, while this second episode focused on the subject of ‘crisis’ and was all about a short-stay assessment unit. The unit staff decide if you go into a longer term inpatient ward or if you can go home after a short stay.
I think some things about the programme were good – that they showed some of how prison-like an inpatient ward can be, and having to deal with other people in difficulty when you are feeling so low yourself. They also, perhaps inadvertently, showed breaches of human rights that actually happen in hospitals: like voluntary patients being told they have to see a doctor before they can leave and being threatened with sectioning.
I found this really upsetting to watch because not only did I have that familiar feeling of claustrophobia and fear of being readmitted ever; it is also the case that I didn’t learn until recently how much ‘voluntary’ patients are lied to and not protected. As a so-called voluntary patient I should not have been told I had to see a doctor before I could leave. I should not have felt the threat of sectioning hanging over my head, stopping me from trying to leave despite what they said. I was not advised by anyone else involved in my care of my rights under the human rights act.
Because the way the system supposedly works is not how it actually works. If you sign in voluntarily you should be free to leave with no threat of sectioning and at any time of your choosing. This is a million miles from the reality. The nurses act like bullies and also all tell you you must see a doctor before you’re allowed to leave, won’t let you off the ward unless it is agreed by a doctor (even though legally they must let you through that locked door) and the doctor makes it clear that if you try to leave before they advise you you can, you will be sectioned.
The programme portrayed some things that I felt were misleading: it is a specialist unit that is not widely available in other parts of the country and the facilities look a lot newer and cleaner than places I’ve been. I also felt that it is told more from the staff’s perspective than the service user. The staff were on many occasions deliberately cruel (I witnessed them swearing at patients) when I’ve been an inpatient and in this they are all on best behaviour, it is not true to life. I also noticed that they dodged using the term BPD and only touched on personality disorders very briefly, which I thought was typical. Like Dominic, I was also originally given the diagnosis of bipolar disorder and this was changed when I did not respond to medication.