Through the looking glass

Gillian Brightmore says treatment for mental illness needs to be modernised.

The history of mental illness is a sad one & it’s treatment even sadder.

In the twenty first century what hope is there for improved treatment and  the stigma of mental illness to be finally eradicated?

With the advent of such alternative therapies such as CBT & Mindfulness a new era in it’s treatment may be beginning when a drug regime is no longer  the only course of action for falling into a state of negativity and low self – esteem.

In her book, “Sunbathing in the Rain” the Welsh poet Gwyneth Lewis herself having undergone a severe depression, but as a result has written is, “ a cheerful book about depression”.

In this she argues that at times depression can be a turning point in a person’s life or a journey through depression to another level of self awareness. We can in fact learn from the depression that all was not well in lives and that change sometimes is necessary.

A therapy such as CBT can give a person the ‘tools’ to tackle this and in many cases overcome it helping in the journey through depression by  overcoming the ghosts of the past.

Such a process could be seen as going through an experience and where one is able to learn something about one’s own personality  & the issues that have brought  about a  state of withdrawal & hopelessness. Often such causes are social as well as psychological. It is important I think that we talk about what has happened to us & not to be ashamed of it. By bringing our experiences to light we will help fight the stigma associated with it and demand more effective forms of treatment.

We must not let the medical model of so called , ‘health professionals’ or ‘experts’ dominate us preventing empowering ourselves .Too often patients become lobotomised with drugs such as Clozapine  and together with the  negative feedback  given out by many consultants  increasing a person’s feeling of worthlessness. Added to this is  the cruel stereotyping that still exists in our society –  ‘them & us ’ syndrome.

 In my experience NHS Mental Health staff who often exploit their patient’s vulnerabilities making them victims of the system to further their own careers and who are themselves in turn brutalised by the present system . It is therefore high time that such questionable delivery of a service should be exposed for the bad practice it is in fact is.

You only have to look at the terminology used to describe people who have had the misfortune to use mental health services being   described as ‘users’ – as though we were active drug addicts. Why is it that such a terminology is only used to describe people suffering mental illness  ?

It is time that mental health sufferers were now really treated with some dignity and  respect and  not merely paid ‘ lip service ‘  by the professional staff often lacking any sense of compassion or empathy particularly in the case of nursing auxiliaries  who have  minimal training and the wage level of a Tesco employee yet are expected to ‘care’  for seriously ill patients; vulnerable people often being left in sole charge at night. When complaints are made to the NHS they are often fobbed off with the observation that it is the state of mind of the patient who has made the complaint , but not the situation itself and not in the way it was perceived .

This is a grave problem that  needs to be addressed as one in four of our population will suffer with the illness during a lifetime and many patients meanwhile are ending their lives in suicide or self harm.

Surely therapies such as CBT or Mindfulness should be made available without long waiting lists or not at all;  as the case in Wales? Why are these not available for a patient on discharge from hospital so that a further relapse could be prevented? It would be a lot cheaper in the long run and far more humane than the current medical model of enforced drug control that ignores life experience and  social conditions that often lead to mental breakdown?

Patients cannot make a journey of self- discovery as well as recovery if they are not to be continually put  on mind altering drugs merely acting as a ‘bandage’  concealing the underlying causes.

It seems to me to be partly a question of social control with many mentally ill people being women, ethnic minorities or people with a different sexual orientation suffering the most with a double stigma in place.

One would have thought a patient-centred treatment would have been made available by now in  the twenty first century.

Given psychotherapy grief could be alchemised and it is possible to step through the looking glass into a brighter future where we are in control of our own lives and  we may overcome the ghosts of past experience so that we can finally step out of the shadows and out through the Looking Glass.   

Let us hope that this will be the case.

Gillian Brightmore is a Tutor formerly with Dept. of Lifelong Learning at Cardiff University / Extra-Mural Dept Swansea University.

4 thoughts on “Through the looking glass

  1. Thank you for your comments. I think it is a missed opportunity that we aren’t able to be referred for cognitive therapies despite the research showing good results for it. In cases of stress, then surgeries can refer patients to stress management courses, which seem to be well attended, and which might help people with mild depression. But it is also important to consider medical/biological aspects of depression, such as nutrition, and factors such as alcohol intake, which might be aggravating depressive feelings.

  2. Very well said Gillian. An article with a truth and directness
    Saying what needs to be said. With continuing stresses on people there is a need for alternative solutions as an option and more places for support.

  3. Thank you for your comment Alice. However I do know how valuable and life – saving CBT to be from bitter personal experience between 2003/06.
    Sadly it was not available from NHS-W so I finally paid for the therapy myself , but only after 2/3 years of failed and invasive drug,’ treatment ‘ in the Dickensian conditions of the city’s hospital and after languishing on a 2/3 year NHS waiting – list .
    The Welsh NHS should be truly ashamed of the barbarity of what I witnessed on a 21st century Acute Ward in Wales. Some people I met during that period died, not through issues of, ” nutrition” or “alcohol” , but of neglect , but of the arrogance of many of so – called, ‘professional’ staff including consultants. Women, particularly those older , sadly suffered even more.

  4. Excellent article Gillian, and a bold one to put out there.

    With regard to the NHS prescriptive route, I think it is also a case of ‘entrenched thinking’ playing a significant part – that is, the established medical profession pretty much just going through the motions in prescribing the medicine route to a patients recovery. It is also a case I think of patients placing complete trust in the medical profession to address their needs, and just assuming that the correct course of action is being followed for them even when it may not feel right.

    I think that there is a significant bottom line here – administering a patient with a 1 hour session of counselling / psychotherapy etc. over a number of weeks is an intensive financial demand when compared to the cost of mass produced medicines. But I feel that this financial ‘hit’ in the short term is worth it, as am convinced talk therapy has longer term benefits over pharmacology. As you mention, the loss of self-esteem associated with long term medication can subdue a patient, and this in turn can translate into long term difficulties in their professional life (e.g. long term sickness) – whereas talk therapy endeavours to address the roots of any issues in a way that medicine cannot – as you say, it could be cheaper in the long run.

    When I last experienced an episode of mental ill health it was addressed through 2 routes: pharmacology and counselling (personal). The staff within the medical profession were helpful and the pharmacology approach over the immediate term (1 week) was a great assistance; but when advised to pursue this option daily for a number of months it didn’t feel right, so I declined and turned entirely to counselling. Physical difficulties associated with my illness (sleeping, anxiety etc.) were addressed within the first 3-4 sessions, and a further 3-4 sessions restored me to a point before my encounter with the illness.

    Alice makes reference to medical and biological aspects associated with illness and rehabilitation and I think this is key. Lifestyle has been central to my tackling of mental ill health in the past.

    Importantat to address this in the short term, as I feel that as a society which becomes increasingly isolated from direct human contact through technology, I suspect that incidences of mental ill health will manifest themselves more.

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