Thursday 18 January 2018

Stigma around mental illness is still rife

Comedian and actor Paul Merton. Photo: Getty Images
Comedian and actor Paul Merton. Photo: Getty Images

Patricia Casey

Prejudice against people on the basis of their age, gender, sexual orientation, religion or any illness that they may have (Aids, cancer, hepatitis) is supposedly frowned upon nowadays in our very politically correct country. This is a good thing, but the surface condemnation of such attitudes does not take account of what people really feel in their heart of hearts.

Those of us working in the field of mental illness know that whatever the media might say, there is still a reticence to admit to attending a psychiatrist. And psychiatrists are still the butt of silly comments at parties in the way that neurologists or vascular surgeons are not. These cringing-engendering remarks hide their fear and point to a basic deficiency in understanding mental illness.

For the past four years St Patrick's Hospital in Dublin has been monitoring attitudes to mental illness in this country, and the 2015 results have recently been published. As in other years, over 500 adults from around the country were surveyed online. The results are a mixture of the respondents' own views and what they think the wider public believe.

Only 53pc of respondents agree that people with a mental health difficulty are trustworthy and 29pc would not trust someone with a previous mental health difficulty to babysit.

Some 67pc agree that Irish people regard being treated for a mental health difficulty as a sign of personal failure, while one in four believe that Irish people would not be willing to accept someone with a mental health issue as a close friend. Some 21pc believe that Irish employers would be comfortable employing someone with a mental health problem.

On the other hand, 53pc (+4pc since 2013) of people have worked with someone who has been treated for a mental health issue and 62pc (+10pc) have a close friend who was treated with a mental health difficulty; while 43pc (+6pc) report that a member of their family was previously treated.

The high proportion who believe that people with mental illness are untrustworthy or who would not allow a person with a previous mental illness to babysit is not surprising, since there is much misinformation about mental illness.

For example, people often think of mental illness as only encompassing the severe illnesses such as schizophrenia and bipolar disorder. The image of violence associated with these conditions is also pervasive. People forget that depression, phobias and eating disorders are also mental disorders and these are very common in the general population, a fact confirmed by the large proportion of respondents who had close friends or family members requiring psychiatric interventions.

It is difficult to know how much of the negative attitudes that the respondents say others have of mental illness is accurate. But in my clinical practice I am acutely aware that my patients are reluctant to disclose to their employers that they have a mental health problem, even though this is only done to the occupational health doctor conducting the medical and not directly to the employer or the HR department unless certain accommodations are required. So the figure of only 21pc believing an employer would be happy with such a person may be accurate.

A fascinating TV series on Channel 4 in 2012 dealt with many aspects of mental illness and one particular programme in the series, The Maddest Job Interview, was particularly instructive. Three well-known British entrepreneurs and business people conducted job interviews with eight candidates. All of the interviewers at the outset expressed a great reluctance to employ any person with a history of mental health problems.

After several days of in-depth assessment of their suitability for the post, one was selected. It then emerged that she had a serious mental health problem as had the second and third choices also. Moreover, half of the candidates had attended psychiatrists and some had required hospital treatment and been suicidal.

There are many role models who have climbed the ladder to the top of their professions who have had the courage to tell their own story of mental illnesses.

The most notable include the former Norwegian prime minister, Kjell Bondevik, who now devotes himself to raising awareness of mental illness.

Paul Merton, star of news comedy Have I Got News for You, suffered with depression, as did Winston Churchill, Leonard Cohen and an endless list of other well-known figures who bring us joy and enrich our lives with their work.

The list is not confined to celebrities but includes people like you, your neighbour and your loved ones. Most of us know at least one person who has had a mental health problem at some point in their lives and who is now leading a happy and fulfilling life.

Our attitude to mental illness should be identical to our view of physical illness. The public's attitudes to those with mental illness should trouble all of us as citizens as they surely did Dean Swift when he founded St Patrick's Hospital almost three centuries ago.

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