Want to end mental health stigma? Stop medicalising distress

August 29, 2011

Labeling people with psychiatric diagnoses lies at the heart of negative attitudes towards people with mental health problems, argues Terry Simpson

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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.

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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.

See also:
Big issues - Service users or Service provision
More Comment

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Time For Change cash better spent on research

From: Judith Haire, author, UK
Date: August 29, 2011

Hear hear. I am totally in agreement with Terry Simpson's views. The mental health system is antiquated and serves to foster stigma, increase isolation, segregation and increases the fear of mental illness.

I have a negative view of it because I felt warehoused when hospitalised and no one seemed very interested in me. Labels like schizophrenia are in my view totally useless. Why have any label at all? Mental illness is plain distress and often from childhood trauma; labels are unhelpful and I feel the millions spent on Time to Change's campaign would be better spent on mental health research as only 6.5% of UK funds go on mental health currently.

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No interest in psychiatric labels

From: Dr. Kev Harding, Clinical Psychologist, Moss CMHT,
Merseyside, England, UK
Date: September 7, 2011

I am in full agreement with Terry Simpson's views. I have no interest in a person's psychiatric label. Here's a link to a paper I recently wrote which describes how a psychologist can work whilst eschewing meaningless psychiatric labels: http://www.psychiatry.freeuk.com/Harding.pdf

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Label helped me to cope with bipolar

From: Anne Brocklesby, writer for Chipmunka Publishing, London
Date: September 7, 2011

Distress is a really terrible thing to live through, either at the time of events, or later.

Mental health stigma towards people who have a 'labelled' mental illness, like bipolar or schizophrenia, or personality disorder, cannot be eliminated just by stopping use of the labels.

However, labels remain with people for far too long.

When I was first labelled with'bipolar' I was relieved, because then I could read something about it. It helped me cope. Also I have many friends who also have labels.

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Psychiatric diagnosis can be self-fulfilling prophecy

From: Jean Davison, author, West Yorkshire, UK
Date: September 7, 2011

Well said, Terry Simpson. It's time the whole concept of diagnostic labels was challenged. The campaign against stigma should perhaps be first aimed at those who dish out these stigmatising labels.

I suppose I was lucky in that I didn't even know I'd been given a 'chronic schizophrenia' diagnosis until many years after I'd turned my life around.

Had I known at the time, it might have become a self-fulfilling prophecy due to its negative connotations affecting my self-concept.

I was harmed enough by the heavy treatment dictated by this diagnosis. But at least I wasn't held back even further by internalising this label which could have led me to put unnecessary limits on what, as it turned out, I could realistically achieve

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Name it and treat it

From: Anne Smith, patient, London
Date: September 26, 2011

There is either mental illness or not. If there is fine - name it and treat it. If not stop all the treatment including medicine, hospitilisation and benefits.

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Less human rights when mentally ill

From: Mary Maddock, board member of MindFreedom International, Cork, Ireland
Date: October 14, 2011

I agree with Terry Simpson. It is time we stopped medicalising human distress especially as there is no scientific evidence human distress is 'mental illness'.

There is no biological marker to determine any so-called 'mental illness' is in fact a reality.

Symptoms can have many different causes and for medical science to be authentic it needs to be able to establish the cause. Biologicl psychiatry is a pseudoscience because it fails to establish this.

Another reason for discrimination is because people are considered to be subhuman when they receive these labels and it is almost impossible to have human rights once you are labeled 'mentally ill'. 'Labels are for jars not for people'.

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