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Gold, incentives and meh

There is a long way to go to destigmatise mental illness

Dr David Turner

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‘Much improved, but could still do better.’ If our attitude to mental illness was on a school report, that would be the end-of-term comment.

It’s true that we have moved forward dramatically in our understanding and acceptance of mental illness over the last 20 years. A couple of decades ago, ‘depression’, ‘OCD’, ‘PTSD’ and ‘bipolar affective disorder’ would have largely been jargon within the medical profession, whereas they’re now used in common parlance.

As a population, we are more aware than ever of the enormous numbers of people who suffer mental illness at some point in their life. Rich; poor; educated; uneducated; young; old - mental illness can affect literally anyone.

Then why is it still a stigma?

Most people would not be afraid to share their experiences of being on a coronary care or surgical ward at a dinner party, but I suspect far fewer would be happy to talk about their time in a psychiatric hospital with the same group of friends. And I guess that is part of the problem - medicine, surgery, obstetrics and paediatrics are generally lumped together in one hospital, and yet we still treat people with mental illness in a separate building. Is this not giving the message to patients with mental health problems that they have a ‘different’ sort of illness to everyone else?

Physical health is lumped together in one hospital, yet we still treat people with mental illness in a separate building

I genuinely admire well known individuals like Stephen Fry and Alastair Campbell who publically talk about their own struggle with poor mental health. This, undoubtedly, is one of the reasons mental illness is becoming less stigmatised. However, famous people in a way have ‘nothing to lose’ by publicly discussing the fact they suffer from a mental illness. In many ways, it may enhance their standing, as they’re seen to be doing something to better society.

What, though, would happen to a senior member of the medical profession if they made it known to the wider public they suffered from depression or anxiety? Suspension? Closely followed by a fitness-to-practice investigation by the GMC, I suspect.

This is the crux of the problem. Many people are still afraid to openly discuss that they have or did suffer from a mental illness, for fear of how it may affect their future prospects.

We’ve come a long way in promoting equality when it comes to race, religion, gender and ethnicity in our society, so how about our next challenge being to make it illegal to discriminate on the basis of mental health?

Dr David Turner is a GP in North West London

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Readers' comments (9)

  • Alternative view
    People like Fry and Campbell are supreme narcissists. They would pontificate about moss on their window ledge if it meant more time in the limelight.
    Much of modern "mental health issues" is pure medicalization of normality. But for celebrities it comes with the secondary gain of an untouchable public relations boost (" Oh, poor Prince Harry, he felt a 'mental health issue' when his mother died, isn't he just great for that")
    Look further into how 'mental health' becomes a get out of jail card for every defence lawyer now, and the stigma of this article is more than counterbalanced by a secondary gain concept.
    Alternative view, as I aver

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  • Stagmatisation begins within the medical profession of psychiatrists being failed medics or wierd and even between psychiatry and psychology ( drug pushers vs caring and nurturing).
    The RCPsych have not helped at all by becoming very biologically focussed in the 1980’s/90’s leaving the psychological to the psychologists.
    Stigmatisation will only be eliminated when the mind and body are seen as one and equivalent and GPs as first line diagnoses and treatment are properly trained.
    As a psychiatrist, I often see patients who have unhelpful views whiich have been perpetuated by the GP.

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  • Agreed Batman, unhappiness and dissatisfaction with lot are over-medicalised. Demand for a unifying diagnosis for life’s perturbations only stoked by the vocal and social media. We live in an uncaring society governed by global capitalism, no concern for the individual’s wellbeing. Truthfully our society (as opposed to individuals) needs to be the patient, we need to dial in personal value and self worth, to garner personal resilience.

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  • Read “cracked” - a great book about psychiatry. I think that harm is being done to some sufferers by the expansion of mental illness diagnoses to include normal life experience

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  • The cavalry isn't coming 9:38
    'I often see patients who have unhelpful views'

    how annoying for you :)

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  • Thank you for this article David. So here goes, I am a senior member of the profession. I am an assistant medical director with an ambulance trust, a clinical advisor with NHS England, GP lead for primary care streaming with an acute trust and an occasional Specialist Advisor with the CQC. Oh, and by the way, I suffer from depression and complex persist bereavement syndrome after the accidental death of my son, a trainee anaesthetist, from an opioid overdose. I am under the care of a both a psychiatrist and a psychologist at the Practitioner Health Programme. I have regular contact with the GMC regarding their handling of my son's substance use problem. They know I suffer from depression having announced it publicly at a conference in London last October on doctor well being, or more accurately, lack thereof. We need to challenge the stigma towards doctors' mental unwellness. But if mental illness in doctors is stigmatised, then you ain't seen nothing yet if you haven't seen our colleagues' attitudes towards substance use disorder in colleagues. No hope for the latter.

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  • Im sorry for your loss Robin.
    I take it your experience of the GMC left a lot to be desired?
    Best wishes

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  • Thank you Robin. So sorry for your loss.
    GPs with mental health issues--of which there are many--can not easily access mental health services. If they do, then they put themselves at great risk of unwanted scrutiny (GMC, CQC, colleagues, Appraisers, NHS England etc etc). The risks are therefore high. The temptation is to try and carry on with no support,seek support secretly or self medicate.

    What a disaster. I have two rules for my children. No motorbikes and not allowed to go to medical school.

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  • Thank you Curious/Merlin. The GMC listens and engages with us, but is slow to respond and change.

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