Want to end mental health stigma? Stop medicalising distress

Millions of pounds is being spent on Time to Change, the anti-mental health stigma campaign. Some of the big national charities are involved. Even the Institute of Psychiatry is pitching in.

So has this been a great chance for a grand coalition to tackle stigma and discrimination once and for all?

Mental health stigma in our society starts with the way people are diagnosed and labeled as having “mental health problems”.

People so-judged are set apart from the rest – ‘stigmatised’ – and when labels, such as ‘schizophrenia’, and ‘personality disorder’, have negative connotations in the popular imagination, then widespread discrimination is likely.

The obvious thing to me is to stop the problem at source. Stop labeling people and diagnosing them and you’ll be a long way down the road of ending the problem.

I’m not saying stop supporting people, or treating symptoms, but leave it at that. Don’t go on and surmise some medical condition behind what you see. I think there are certainly ways that people can be helped with abusive voices, wildly-disordered thoughts, delusions and hallucinations. These seem to me to be real causes of terrible suffering and we have to help each other cope with them. Each person will need a unique kind of help according to the particular circumstances of their life and experience. The point has been made many times that we won’t be free from these kinds of bad experiences until we live in a more benign human world. Putting mental health labels on our experiences does not help.

To carry on diagnosing people and still trying to rid society of stigma is like trying to keep a water supply clean when there is a dead sheep in the storage tank. You can get better and better filters, and can spend more and more on purifying the stinking water as it comes out of the tap. With enough finance, and a sophisticated enough system, you could probably eradicate all traces of impurity. This is like trying to make concepts like “bi-polar” or any other label acceptable to the general public. But however great your filter system, it doesn’t solve the basic problem. And this is going to get worse as the corpse decays, and bits of rotting matter seep down through the pipes.

I accept Time for Change has done good things – in my city, Leeds, anyway, and I wouldn’t want to seem glib or insulting to the people (many of them mental health system survivors), who’ve put their time and energy into it. I think it’s generally better to do something than to do nothing. But I think if we want to end stigma in mental health once and for all, we need to look deeper into the whole role of the mental health system.

Terry Simpson is chair of the UK Advocacy Network, a service-user controlled federation of advocacy projects, patients’ councils, user forums and self-help and support groups working in mental health.

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