In need of a right approach to mental health

Katie Fisher, The Independent

After more than a decade of hugely successful mental health awareness campaigning, 2020 is the time to focus our efforts on more complex problems such as schizophrenia and borderline personality disorder (BPD).

In my role as CEO of a mental healthcare charity, I work closely with patients who live with these incredibly complex mental health problems. Their experiences can be both debilitating and life changing. For many, ongoing care and rehabilitation is a necessity. But hope is also important – it’s the difference between surviving and living. That’s why we need to open up conversations around mental health, in particular a discussion of our response to patients who are struggling with these conditions.

Thanks to the success of mental health awareness campaigns – including those run by Mind and Rethink Mental Illness – we have made great leaps in dismissing unhelpful prejudices surrounding conditions such as anxiety and depression. In fact we are in a completely different place today, compared to where we were in 2007, when such campaigns began.

But I think as a society we need to understand what it’s like living with more complex conditions such as psychosis, schizophrenia and borderline personality disorder.

To find out how big the variance in stigma is, we conducted a public survey – the results of which are significant. It found that despite increased understanding of common mental health problems, complex conditions are still hugely misunderstood. For example, three in five people still believe the adage that schizophrenia means having a split personality, while one in 10 confused schizophrenia with someone who has psychopathic traits.

This misunderstanding of schizophrenia has undoubtedly led to fear and stigma. One in four people admitted they would be nervous if someone they knew was diagnosed with schizophrenia, compared to just one in 20 when asked the same question about depression. Imagine the impact that has on the person living with the illness, particularly if they’re living in the community.

One patient, who was recently in our care, couldn’t have described it better; she explained that schizophrenia is not a choice, just like someone wouldn’t choose to have cancer. She said people’s judgements often come through a lack of knowledge and understanding, rather than anything malicious.  

It’s unsurprising that we, as a society, have such views. With a lack of voices emerging about complex mental health conditions, we often rely on Hollywood films to fill the void. But depictions in films can often be unhelpful and tend to perpetuate the notion that mental deterioration leads to violence, which is quite simply misleading, especially when you consider someone living with schizophrenia is more likely to be the victim of violence, than be the perpetrator of it.

You could also argue that depression and anxiety require greater awareness because they are more prevalent in society, but the statistics suggest otherwise. According to Mind, three in every 100 people will experience depression, compared to two in 100 people for BPD or one in 100 for psychosis.

The results from our survey show we should aim to focus the conversation on severe and enduring mental health problems. Educating people and addressing these issues will make it easier for people to live the lives they want to lead in the community, without fear of being judged.

But changing public perception is not something that one charity or one campaign can tackle alone. If we all consistently, and responsibly, challenge myths around complex mental illness and have more open conversations, together we can break the stigma.

People living with schizophrenia or BPD can often feel ashamed and isolated. Add that to the impact of their clinical symptoms and life can become quite despairing.

It’s time we saw the person first, and the illness for what it is. Yes, complex conditions can be distressing, but with the right care and support many people go on to live happy and purposeful lives. Let’s open up the conversation and stop being afraid of talking about complex mental health problems.