Damon Lambert: Time to throw a bone to Black Dog - ending the stigma against people with mental illness

Damon Lambert, Treasurer of ok2b - a charity seeking to achieve a positive shift in the public’s attitude towards people with mental health problems - and a Tax Director for a multinational Bank, describes the importance of tackling prejudices about mental illness.

Winston Churchill, the man voted the greatest ever Briton named his bipolar disorder, (sometimes referred to as "manic depression") "Black Dog". Yet despite the Information Age we live in, the Stigma around Mental Health is as pervasive as ever. Society's perception of the second most common health problem in the UK still abounds with ignorance of the illness, prejudice against its sufferers, and discrimination against them at work and in the wider society. Media attitudes, especially in parts of the deadwood press often use alarming, castigating and insulting terms when most sufferers are completely harmless and fully capable of working and parenting. Indeed there are several arenas, not least the Arts, Cricket - and scratch the surface hard because people do of course hide such illness - business, where people with mental illness are big achievers.

Stigma causes problems in many ways. Sufferers are deterred from seeking medical treatment due to social embarrassment and fears for their job. This causes deeper illness and slower recovery and in extreme cases, this can lead to what should have been preventable suicide. Stigma pervades not just the general populace but often health care providers, who consequently do not dispense effective treatments and may be unsupportive. In certain groups, e.g. ethnic minorities the problem can be especially acute. This all creates a vicious circle, sufferers may lose out on work and employment, hence impacting their housing, hence causing deeper stress, hence impeding recovery, deepening symptoms or both. There is also the economic cost of stigma. Mental illness is one of the biggest causes of absenteeism from work; both in days taken off, and also due to stigma, the barriers people with mental illness face in gaining, or returning to, employment. The loss of their contribution to the economy, both in terms of wasted talent and taxes foregone, is at least in the tens of £billions. When mental health and wellbeing is dealt with in the same form as physical disease the impact of earlier detection and treatment will include a financial benefit to the polity.

It's time us Conservatives challenged the pernicious impacts of this stigma head on. The party should encourage employers to positively welcome employees with mental illness, to enable and include them, and especially to encourage them to return to work from illness, because work aids recovery. It's long been overdue that the anachronistic ban on people with a history of mental illness serving on juries was removed; they are as much the accused's peers as anyone else. Service users should have greater choice, although in some cases having a choice at all would be an improvement. People with mental illness are best placed to choose the treatment that best works for them, in contrast to the centralised and custodial approach favoured by the current government. The Disability Discrimination Act should be revised and amended, there is little evidence of it having an impact in reducing discrimination against the mentally ill. Plus there should be an education programme to provide facts to dispel the damaging myths so sufferers, their friends and family, healthcare workers and employers can positively deal with mental illness. Currently, the prevalent prejudices too often embed disadvantages into the lives of those with mental distress.

Conservatives should recognise the above as True Blue policy. These policies seek to empower individuals by removing barriers to their wellbeing in order to enable them to contribute their most. They seek to end the damage of ignorance and instead enlighten with compassion and knowledge. People with mental illness are often subject to social, cultural, economic and healthcare discrimination at a degree thankfully now historic for others who suffered unjust bias. Its'time the Conservative Party threw a bone to Black Dog and brought the treatment and perceptions of mental illness into the twenty-first century.

Comments

[A longer memory]

All ver true - but it shouldn't be forgotten that Liam Fox, when he was Shadow Health Secretary, made mental health a priority. He organised two Mental Health Summits, gave a number of substantial speeches on the subject, and even launched his leadership campaign at a "Clubhouse" - a sort of sanctuary for those recovering from mental health problems - to highlight the need for a new political approach to this and other 'social' issues.

Conservatives have been ahead of the curve on this issue. We need to try to stay there.

[Tony Makara]

We need to set safeguards into welfare reform to ensure that those who are suffering from mental illness are not hounded when rigorous testing of Incapacity Benefit claimants comes into place under a Conservative government. It is not patronizing to say that most people are generally ignorant of what full blown depression, bi-polar and schizophrenia are. These are very real incapacitating ailments rendering the person completely unable to function in a work environment.

Some conditions such as anxiety neurosis can be managed with the right medication but each case has to be treated on an individual basis and there should be no trawler net target numbers to push the mentally ill off Incapacity Benefit and onto Jobseekers Allowance just to save the exchequer money.

Physical illness and the capacity to return to job-seeking will not be difficult to define. However mental illness is more complicated. A schizophrenic who is hassled and pressured and ends up in a degrading 'boot camp' for the unemployed may well take his or her life. Welfare reform has to make special dispensation for those with serious mental illness.

[Paul Walter]

An excellent article Damon. It is worth mentioning that the Labour government deserves credit for accepting the recommendations of Professor Layard and to recruit 3,500 new therapists specialising in CBT - Cognitive Behavioural Therapy. In many (not all, of course) cases, CBT can help avoid the worst levels of debilitating depression, without the need for heavy medication or extended periods off work.

It should be remembered that much of Churchill's creativity and energy actually derived from the very characteristics which also led to his "Black Dog" moods.

[Londoner]

Absolutely spot on article. I had not previously heard of this charity - although support other mental health charities - so will seek it out. There are hundreds of thousands of us with personal experience of this - family, friends or self - and it is heartening that the taboos are finally breaking down, including in business.

Whilst Tony Makara is right about the possibility of long term disability, I would much rather emphasise the potential for recovery and continued employability (including in senior and important jobs). Many conditions, such as bipolarity and depression (not the same thing, I thought Churchill was a depressive, not bipolar, but I am prepared to be corrected), are lifetime susceptabilities but do not inevitably recur in serious form. Those of us with these susceptabilities are much better able to manage them if there is an atmosphere of openness than if they are deep, dark and shameful secrets.

I would also mention that Liam Fox was absolutely right to make this a priority. The gulf between the ability of the NHS and the private sector to get people well is shockingly wide in this field. Even though the private insurers can be tricky to deal with if you get recurrences, many of us know that our chances of having survived serious mental illness would have been hugely less if we had not had access to the private sector.

[Charlie Elphicke]

Well said Damon. This is an excellent article.

Damon says: "These policies seek to empower individuals by removing barriers to their wellbeing in order to enable them to contribute their most."

This is an essential point. I've been helping a man with adult ADHD. He told me in terms that he wants to have a job and be productive rather than wasting his life on benefits unable to hold a job down. He cannot get treatment because ADHD is only treated in children as far as Kent's health services are concerned.

NICE guidance is expected on the matter in the next month or two - in the meantime health chiefs are taking the chance to sit on their hands and "save" money. Yet are we not collectively paying a bigger price in the cost of benefits paid, taxes foregone and life potential wasted?

[Tony Makara]

It would be good to have a clear statement from the Conservative party on how learning difficulties fit into the welfare reform plans. I did some voluntary work with people who were mentally challenged, many of these people on the surface appeared to be physically fit and mentally lucid, that is until they were given basic tasks to do, then they would struggle in a way that baffled. Clearly such people, though not suffering a crushing mental illness as such, did lack the ability to function in a structured work environment. Could they end up in a 'boot camp' for being slow-witted?

We have to question why Grayling is so keen on the term 'boot camp' as it equates being unemployed with being a criminal or social degenerate?

I certainly agree that there will be instances when a mental health problem can be improved by getting the patient involved in a structured environment again. That is why it is important that each case is based on the professional advice of a doctor and not subject to the target-driven directive of a politican. It is important that politicians recogize that young people are prone to mental illness too. A young girl who suffers from depression isn't going to be helped by being hearded into a boot camp. Politicians need to show some humanity on the question of welfare reform and mental illness.

[Torymory]

It depends on the nature of the mental illness.

I have had to "deal" on a social basis with 2 people with bi-polar disorder - one severe, one mild. In both cases I started off with the best of intentions, wanting to help them, not stigmatise them etc. However in both cases I was emotionally worn down and in the end and could not take any more.

Frankly I would not want to experience in the workplace what I experienced socially.

The severe sufferer although she did not work was otherwise fully "included" into society - living in her own home, attending church, active in the village community etc. However her social inclusion led to her son's social exclusion - he worked full time and was a Councillor. He had to give up the Council and had great difficulties at work because of the erratic nature of his mum's condition. She was happy as Larry most of the time - he was severely depressed and felt trapped by her condition. It would certainly have been better for him if she lived in a more protected and less independent environment.

So yes give people with mental illness a chance - but spare a though for the people who have to cope with them on a daily basis. Sometimes they may not be stigmatised, they may just be impossible to work and live with.

Re Tony Makera's point on Adults with Learning Difficulties - many do work. The retail industry seems to be doing sterling work in this field - especially DIY stores and supermarkets. They always seem to enjoy their work and have excellent rapport with customers.

[fitaloon]

Apparnetly BBC says David Davis has resigned

[Londoner]

Re post at 12.48.

Was that a comment on mental illness?

[SJB]

As someone who has been 'black dogged' by moderate depression, attention deficit disorder and anxiety since childhood, I can't agree more with Damon's sentiments. Depression and other mental illnesses are dehabilitating and miserable lifelong conditions. I suspect part of the solution lies in changing the attitudes of the many firms and public institutions who think that it is acceptable that bullying behaviour of some employees should be tolerated in the same way that sexism and racism in the workplace was tolerated thirty years ago. As bullies tend to prey on those who are less psychologically robust, this I think leads to absenteeism due to stress. It is not the only factor but I think an important one. Attitudes outside the workplace also need to change.

From a medical point of view, I get the impression from numerous visits to doctors and psychiatrists that we are as close to successfully treating mental illnesses as we were to treating physical illnesses one hundred or two hundred years ago. We still don't fully understand how the wiring of the brain works.

I think Charlie Elphicke has hit the nail on the head when he alludes to Attention Deficit Disorder. It can baffle and frustrate many people in the workplace and elsewhere when those who appear intelligent enough are unable to function by performing seemingly simple tasks which require sustained concentration, especially those tasks that require organised thinking.

Christopher Grayling's answer of a 'boot camp' is as credible as Willie Whitelaw's 'short, sharp, shock' for habitual offenders nearly thirty years ago. It is old-style Conservative thinking that is simply designed to attract votes.

I am a floating voter but it is both surprising and encouraging that the Conservative Party seems to be engaging in a thoughtful debate about an issue which has been stigmatised for far too long.

[Sally Roberts]

Well done for this compassionate and thoughtful article!