Naive Nick’s Mental Health Pledge

nick clegg mental health

Are those with mental health conditions meant to be jumping for joy at Nick Clegg’s announcement today that a target would be set that all sufferers will have access to talking therapies within eighteen weeks should the current coalition find themselves still in power after the next election?  This will, apparently, mean that around £120m of extra funding (more about the “extra” later) will be spent over the next two years – this will, I guess, go towards restoring some of the funding that has been cut over the last four years since the coalition  has been in power.

For me, the whole thing smacks of empty rhetoric, grave naivety and a cynical touting for votes.  No-one is going to moan that waiting times are going to be cut or that more spending on mental health will take place, but the ridiculous simplicity with which mental health is being treated is rather insulting to those who are suffering from these conditions.  It’s thought that up to 10% of sufferers die as a direct or indirect result of their condition.  Suicide is the biggest killer of men under 50 in the UK.  If those stats were related to a form of cancer, there would be a considerable outcry if a waiting time for treatment was reduced to eighteen weeks.  Reduced.  God knows how long the wait must be now if you’re not one of the lucky few who lives in the right postcode.

The lack of understanding of mental illness by those spouting these latest wonders is only too evident with the announcement that suicidal patients will get the same priority as those with a suspected heart attack.  That’s all very nice, but people with a suspected heart attack ring 999 – people who are suicidal do not.  Suffering from a mental health condition for up to eighteen weeks without access to certain treatment might be enough to turn someone suicidal in the first place. And there’s also this strange notion that people are either suicidal or they’re not – something which fails to take into account that people might be fine one day and not the next.  That MPs are simplifying conditions in this way is insulting – the least they could do is try to understand the issue in the first place.   But to do so, and to acknowledge the complexities doesn’t make for such rousing speech-writing.

And how about reviewing the benefits process for those with mental health conditions.  The Personal Independence Payment form might give an indication of how serious a physical disability is, but it’s a joke when it comes to mental health, with half of the questions not even applying to people with depression, schizophrenia, bipolar, and the like.  Can we use the loo?  Well, yes, thank you very much – but why aren’t you asking us about issues of concentration that prevent us doing things, or panic attacks that might stop us going to a supermarket.  And, wait for this one folks, if you can’t use public transport due to your condition you might be awarded a free bus pass.  I kid you not.

Charities have welcomed today’s news – they have little choice: more funding is better than funding cuts, no matter how modest the targets that have been set.  Just six weeks ago, The Independent ran a story stating that mental health services are “dangerously close to collapse,” and that there were 3000 less nurses working in the sector than two years earlier.  57 mental health trusts had lost £253m in funding.  And yet we should be saying “well done” and “how wonderful” to the coalition for promising to put half of that money back.   That’s hardly “extra funding.”

I confess that I have been lucky during the twenty years I have had my own condition.  When I first fell ill, I got to see a doctor within hours (this was 1995 when you could do that) and, since then, I have always been treated by my succession of GPs with respect, concern and (thankfully) good humour.  The last in that list might seem like an odd addition, but actually it highlights the importance of striking up a rapport with your GP, especially with regards to mental health conditions where, more than ever, everyone is different.  I have a great relationship with my GP, not least because she knows I’m more than willing to find the humour within the issues that I have.   It’s the way I get through.  Another doctor wouldn’t get or understand that.

The problem is that seeing your own GP (including my own) is not that easy anymore.  Often the waiting time to see your regular doctor these days is two weeks, not two hours.  If I had a severe turn for the worse with my illness, would I even contemplate seeing a doctor I didn’t know?  Probably not – and with good reason: notes on a screen are not the same as talking to someone who has seen how your condition has changed (or not) over a number of years.  Mental health conditions aren’t a series of test results, facts and figures, where X+Y = medication A.  It’s far more complicated than that – which is why some of the rhetoric used by Nick Clegg today comes across as so naive.

Any increase in mental health budgets is to be welcomed, but it shouldn’t have got this bad in the first place – and the amount of money involved doesn’t get close to making up for the cuts from the budgets over the last few years.  And, while Clegg has said he wants to work to stamp out the stigma associated with such conditions, that promise seems very empty too.  There are few, if any, signs of how he plans to do that.  Does he mean well?  Possibly.  But, as with most things he does and says, his ineptness and lack of deep understanding of the problem is laughable or offensive, depending on your mood (swing).

Axe-murderers and psycho-killers: Mental Health Conditions and the Horror Film

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I sat at home the other night watching Roger Corman’s 1961 film version of the Poe story The Pit and the Pendulum. I confess that it is my favourite of the Corman Poe films and one that I return to more than the others. When I finished the film, came upstairs and started browsing the internet, I was reminded that this week was Mental Health Awareness Week, and it got me thinking.

Last year Thorpe Park was under attack for its “asylum” Halloween attraction, and yet we seem to have no problem with mental health issues being used for entertainment purposes in horror films. From the “mad doctor films” of the 1920s and 1930s through to the “psycho killers” of today’s horror films, mental health issues have been used in order to instil fear into audiences, and one has to wonder whether this has had an impact on society’s view of those suffering from mental health conditions.

While most of us are not going to view the “mad doctor” films of Boris Karloff, Vincent Price and others as somehow a form of education on “madness,” can the same be said for other representations on film? I would argue that the “mad doctor” films (or any films referring to “madness”) are somehow less “real” because the specific health condition of the protagonist is not spelled out but simply given the general term “madness” – a term that is not really in use these days.

It is when the exact nature of the mental health condition is spelled out in more detail and given a name that things become more complicated. After all, if the word “schizophrenic” or “schizophrenia” is searched for within the Internet Movie Database, the list of films that is provided is quite telling: The Mad Ghoul, Bug, Cutting Class, The Boston Strangler and the “wonderfully” titled Schizopheniac: The Whore Mangler (I must hunt that one down). I don’t pretend to have watched all of the films on the list, but what is clear is that, even when the mentally ill character turns out not to be the murderer, the association between mental illness and violence and murder has been made and reinforced.

This isn’t just the case for schizophrenia, of course. The same is true for any number of mental health conditions. For example, a new indie (and low budget) horror film is due out in 2014 entitled Bipolar, which IMDB tells us has the following plot: “When Harry Poole tries out a new medication for Bipolar Disorder, he is reborn as “Edward Grey”, a seductive but dangerous alter ego who dramatically takes over his life, changing the young man and those around him forever.” Similarly the otherwise-splendid drama series Rookie Blue last year had a narrative arc that involved a bipolar policewoman acting irrationally, obsessively and dangerously – leading to other members of her force being shot and wounded (and possibly killed).

There have been relatively few studies on these issues, although Peter Byrne writes in The Psychiatric Bulletin that it has been discovered that these films are “sources of misinformation about mental illness, causing distress of relatives of the mentally ill. The images reinforce the spurious association between all mental illness and violence.”[1] In other words, many of the prejudices about mental illness and those that suffer from mental health conditions may well originate from how film and other forms of fiction have “educated” us over the years.

The big question, of course, is what to do about it. After all, even as a bipolar sufferer, I am not going to give up my regular dose of watching Karloff, Lugosi or Price descending into madness and bumping a few people off. However, it seems to me that, at some point, filmmakers have to become somewhat more responsible. Attitudes change. Nobody is suggesting the films that have been with us for decades should suddenly be banned, but is it responsible to make a film like Bipolar in 2014? Is it about time that killers in films had another reason to kill other than the fact that they are mentally ill? If the “asylum” Halloween attraction at a theme park is now viewed with disdain, then perhaps it is finally time for filmmakers to look again at their representations of mental illness and start taking into account the damage they might be doing in helping to reinforce the prejudices and misconceptions of the past.

[1] Peter Byrne, “Fall and rise of the movie ‘psycho-killer’,” The Psychiatric Bulletin, 1998, 22:176.

Bipolar and Work

Someone said something interesting to me online a week or two ago.  They said they thought that it was strange (I think that was a polite way of saying “stupid”) that I had mentioned in my blog and on my twitter feed that I have bipolar at a time when I was also looking for a job.  It’s not something that had really crossed my mind until that point and, as you can see, the comment obviously hasn’t put me off talking about it again.  What it did reiterate, however, was the public’s perception of mental health issues.  I’ve already discussed this before in relation to depictions of mental health problems in film and TV – and, since that post, I have since seen the fourth series of Canadian cop show Rookie Blue, which really should be ashamed of itself in its depiction of someone with bipolar as an obsessive stalker who puts people’s lives at risks through her actions.  We appear to take two steps forward but then one step back.  (That said, I still have a soft spot for Rookie Blue).

Now, all of that isn’t to say that bipolar makes a career or a job an easy thing, and I’m the first to admit that choosing a profession carefully so that you can somehow accommodate your highs and lows is a priority.  However, we don’t live in a time where people can pick and choose where they work or what they do.  Six years after the banking crisis, a job is a job and many need to grab whatever they can find.  Despite that, allowances need to be made and realism has to play a part because bipolar or depression or any other mental health condition is likely to cause issues at some point.

Let’s take, for an example, a job in an office in which the employee is expected sit at their desk and process 100 forms per day.   The chances of me, with bipolar, being able to perform at the same level constantly day after day, week after week, is highly unlikely.  By the very definition of the condition, one day might result in 200 forms being processed, and yet on another I might struggle to get 30 done.  A daily deadline of this kind is therefore not really feasible; during a depressive phase everything I do is almost in slow motion. However, a weekly or monthly target is certainly possible.  So, if instead of 100 forms a day, I was told I needed to 500 per week or 2000 per month, that would be fine, as I could make the most of the times when I was feeling OK and therefore give myself breathing space for when the inevitable down periods came along.

I’ve been studying for the best part of eight years, through my BA, MA and then PhD, but I did work full time for nine years before I started studying.  I hope things have changed in the workplace since then, and there is more understanding of conditions such as bipolar and depression.  I remember having a particularly bad spell back in 1998 and having some time off work because of it.  Most colleagues tried to be understanding, although the truth is that they didn’t understand because people were less educated about these conditions back then.  On my return to work, I was constantly asked if I was “OK”, and my line manager at the time told me my work needed to be checked thoroughly by her because of my “mental instability”.  The truth was that my work was fine, it was just me who wasn’t.  However, I got to the stage where I realised pretending I was fine was the way forward.  So I started going to work each day, assuming a bright and breezy cheerful persona for eight hours in order to stop all the questions, and then arrived home knackered each night because I had been putting in an eight hour acting performance of which Laurence Olivier would have been proud.

As it happens, the coping mechanisms that many of us have in place after having these conditions for so long probably make us more reliable workers than many others.  I knew I had to work around the bipolar while I was studying, and so would get coursework done a week or two in advance of the deadline in order to give myself a breathing space in case a bad patch came along.  I did the same with my PhD, finishing it within the three year period and writing a 70,000 word novel alongside it.  That’s not intended  to be a boast, but a sign to potential employers reading this that we are as reliable as anyone else, and to those with the condition it’s a message that it can be worked around if we put out mind to it.

There are shit periods, though, and last week was one of them for me – probably the worst I have been for a couple of years.  Luckily it was short-lived and I seem to be back to “normal” now.  But, even then, the marking of essays still got done on time, and the seminar still got prepared and delivered in the same fashion as any other week.  And no, I didn’t sit at the front of the seminar group rocking back and forth crying and screaming.  At least, if I did, no-one mentioned it afterwards (I jest).

What I’m trying to say here is that the prejudices towards (and misinformation about) those with bipolar and other mental health issues still continue.  Slowly but surely we are hearing of people who have turned their lives around and who are not only living a “normal” life but achieving more than many without the condition.  Determination is a wonderful thing.  Yes, allowances will have to be made at some point – not just by employers, but by friends and family too.  Bipolar isn’t just a pain for the person who has it, but it can be a bastard for the people who have to live with it as well.

And attitudes are changing, especially among the young.  The support amongst the younger generation on social media of campaigns to stamp out mental health stigma is staggering…and beautiful (and the same is true of campaigns to stamp out homophobia and bullying, too).   And a difference is slowly but surely being made.

But there is a long way to go.  If sufferers are going to do their best to live a normal life with their condition, then there needs to be more understanding (or, more accurately, flexibility) amongst employers as well.  Just because mental health issues aren’t always visible doesn’t mean they don’t exist or that there shouldn’t be a certain degree of allowances made within the workplace to accommodate the various ups and downs that come with these conditions.   We’re trying our best, and all that we ask for is that we are met halfway.

Breaking Point and Breaking Down

 

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The sudden spate of publicity about “Breaking Point” over the last week or so has made me revisit the idea of a follow-up book.  The following is a personal piece about the writing of the novel and the motivations behind it.  It was useful to write to put my own thoughts in order but, also, I thought it might be useful to read for those who might be encouraged to read the book in the coming weeks thanks to the recent publicity on Twitter.  If this little essay comes over as a vanity project, it’s not the intention.  It’s more like a private journal entry being made public, a stream-of-consciousness in which I attempt to put some thoughts and ideas in order. 

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Life has a strange way of surprising us when we least expect it.  I published Breaking Point as an e-book back in 2011, and sold around six copies over the space of eighteen months.  This wasn’t devastating, but instead totally expected.  After all, Breaking Point is a novel that centres on the subject of homophobic bullying in schools.  It’s hardly bestseller material.  What’s more, it sits in a kind of no-man’s–land between a young adult book and an adult book.  Sure,  for the most part it revolves around a group of sixteen year olds, but they act and speak in a way us adults try to forget they are capable of.

In order to have a bit of a break from writing my PhD thesis, I revised Breaking Point in late 2012 and reissued it in February 2013.  I found that the world was very different in 2013 than in 2011.  Twitter had suddenly become a great marketing tool, a way to reach out and tell people about the book.  In the space of eleven months, seven thousand copies of Breaking Point have now been downloaded.  I’ll admit, many of these were during free promotions etc, but nobody writes a first novel for it to make money, but in the hope that it will be read.  By someone.

A few weeks back, I was able to self-publish Breaking Point in paperback.  I knew then that very few copies would shift – most people who wanted to read it had already done so through the e-book.  But at least the paperback allows the book to reach school libraries, for example – and I hope that is what happens.   Around the same time, things took an unexpected turn when I was contacted by Amanda Taylor from the University of Central Lancashire who wanted to talk to me about the book in relation to the Social Work Book Club – this, too, has resulted in publicity of the book through Twitter and elsewhere.

The comments about the book, and the reviews on Amazon, have often been touching and moving.  I have received private messages on Twitter from people who have read the book, and received emails too.   I’m still partly in shock about this, despite the fact that the book is only doing what it set out to do in the first place.

What is that, exactly?

Well, I guess the aims were twofold.  Firstly I wanted to write a gay-themed work that didn’t resort to long passages of sex to try and get the reader to part with their cash or their time.  As a gay man, I find it really quite offensive that filmmakers and many authors think we only want to read gay-themed stories if they contain an abundance of nudity and sex – that these directors and writers are mostly gay men themselves only compounds the problem, making it appear that the LGBTs of this world are interested in one thing only.  I don’t believe that’s true.   I have been into Waterstone’s book shop and asked where the LGBT fiction can be found, and been told “it’s under ‘erotica’”.   What the bloody hell is it doing under “erotica?”  Well, part of the reason, I guess, is that most of the gay fiction out there today does have a substantial erotic element.   Fifty Shades of Grey wouldn’t raise eyebrows amongst LGBTs, such subject matter is par for the course for gay fiction.  Even today, the act of sex seems to define who and what a gay man (or woman) is.  I find that scary and sad in equal measure.

I think most of us would be just as happy finding mirrors of ourselves on the silver screen.  And I don’t mean mirrors of who society thinks we are, but mirrors of who we really are.  There is no place for a stereotype in 2013.  We are, after all, individuals.  For all the talk of the “LGBT community”, we are still not clones of each other, or definitely going to like and admire each other just because we are sexually attracted to a particular gender.  It’s lunacy.  We wouldn’t expect all heterosexuals to be the same and like the same things and people just because they are all attracted to the opposite sex.

So, I wanted to write a book that didn’t rely on cheap thrills to get an audience. And I wanted to write a book where the gay characters didn’t live in a separate world to straight characters – again, this seems to be something that only happens in the world of gay-themed independent (American) filmmaking.   But the second major thing I wanted to do was to give a certain group of people a voice.

I wrote earlier about how we perceive fifteen and sixteen year olds, and how they really act and talk.  The bullying in Breaking Point centre on a type that is not talked about in the press or on TV, and concentrates very much on embarrassment and humiliation.  The reason we don’t hear about this as much is because the victims don’t want to talk about it.  While the incidents within the book didn’t happen to me, they are nearly all inspired by personal stories people have written on the web or from the very few newspaper articles that mention this type of behaviour.  The victims don’t want to talk about it – and understandably so, and so Breaking Point was intended to give those victims a voice, and to bring these issues out into the open.  I never intended to provide answers or resolutions to the problems.  That’s not my job, and neither am I qualified to do such a thing.  I don’t think there are solutions, certainly not blanket ones that work in every case.  If there were, we wouldn’t still be having this problem.

The reason for me writing this blog post is because I am trying to get my thoughts in order as to where to go next.  For me, the answer is an obvious one.  In order to finish what I have started, the rest of the story has to be told.  Bullying doesn’t end with the last day of school – either for the victims or the bullies.  The repercussions are there for a long time, in some cases throughout the person’s life.   The victim doesn’t walk out of the school gates on that last day, start smiling, and float through the next few years unaffected by what has happened.  I was diagnosed with depression two years after leaving school, and with bipolar ten years after that – which I still have, albeit nicely under control.  These kind of after effects are what I want to use as the backbone for “Breaking Down”, the tentative title of the follow-up to Breaking Point. 

I wrote a blogpost earlier in the year about cinematic depictions of mental health issues, and I face the same quandary as the films I discuss there:  how do you make the depiction of depression realistic and sympathetic, but also make it entertaining?  A novel has to be entertaining, after all.  Well, unless it’s written by Henry James, but let’s not go there.  And this is where I am falling down at the moment.  I know how the plot needs to unfold, I know how I want to depict the issues it raises, but I still need to find a way to do that in an entertaining way that makes people want to read the next page.   And that’s not going to be easy.

Will Breaking Down ever get finished?  I hope so, not least because I like the few chapters that have already been written.  But for it to be successful in any way, it has to concentrate on the individual experience, and not resort to the stereotypes that have plagued gay and lesbian film and books, and depictions of mental illness, for so many years.

For those that have read Breaking Point, or helped to spread the word, I shout out a huge “thank you” – the idea of seven thousand people owning  a copy of my book would have been laughable just a year ago.  So, thank you for making 2013 a memorable and very special year.