Refreshing as it may be to see mental health on the telly every five minutes, are viewers seeing a rather sanitised version of ‘Mad’?
For anyone growing up in Croydon during the 70s and 80s, Cane Hill Hospital was a local landmark of notoriety, intrigue and all manner of imagined horrors. Many a family car journey would be coloured by a quick peek at the gothic asylum as it rose up between the trees from the A23 London to Brighton Road. We wondered aloud at what darkness and derangement went on in that spookiest of buildings, and parents warned their offspring how they too could end up at Cane Hill if they didn’t eat their veg.
The closure of the Cane Hills and the advent of so-called community care should have meant a fundamental change in how mental illness was perceived by Mr and Mrs Normal on Normal Street. But it never really happened like that. If you wanted to see mental illness on TV, well you didn’t. Yes there was Hitchcock and The Shining on the big screen, but all Jack Nicholson and Psycho did was suggest mentally ill people ran around old hotels waving axes around or got all dressed up in the clothes of their decomposing parents stabbing the odd blonde. Combating stigma took a while to get going.
But fast forward a few years and switch on the telly. Mental health is ubiquitous. Not quite as ubiquitous as Midsomer Murders, but not too far behind.
Last Summer’s 4 Goes Mad season on Channel 4 was a bit of a mixed bag, and like everything else on television suffered from an over-reliance on celebrities. But among the comedians unpacking their pasts was more than one thought-provoking, stigma-challenging contribution to poke at the myths and stereotypes around mental health.
BBC3 is just coming to the end of it’s Mad World season which has focussed on the mental health of young people. Last week Channel 4’s Notes from the Inside featured classical pianist and former in-patient James Rhodes meeting and playing music for several long-stay residents of a large psychiatric hospital. And just to make sure we’re not solely talking about documentaries and flies on the wall, the much anticipated second series of My Big Fat Mad Diary made big waves and should be starting to film around about now-ish.
And for further chipping away at the stigma of mental illness, who better than top sportspeople such as Andrew ‘Freddie’ Flintoff to demonstrate how Depression (capital ‘D’) can chip away and even destroy even the tough, well honed psyche of the champion athlete?
All of this is of course brilliant and wonderful. But there is a ‘but’.
Earlier this week BBC3 broadcast the slightly ill-titled Failed by the NHS. Several young people with histories of mental health problems described their experiences of being let down by mental health services, although perhaps it’s fair to say in most cases they had actually been let down by shoddy individual practitioners and a chronic withdrawal of resources, but that’s another story.
Like most of the documentary output from the ‘New Mad’ franchise, the contributors were not psychiatrists nor psychologists nor any other species of mental health professional. They were ordinary people who have themselves experienced mental health problems at first hand. We should celebrate this. But I took to Twitter to wonder aloud who was missing from this show and most of those that have come before. Are all users of mental health services articulate, intelligent, middle-class and white?
Where are the voices of those whose lives have been punctured by constant admissions and readmissions, often compelled by the Mental Health Act? Those whose psychosis has them on first name terms with every local copper and paramedic within a twenty mile radius? Or the patients of our Psychiatric Intensive Care Units (PICUs) who, to quote Will Self’s recent (and highly controversial) Guardian polemic ‘present a terrifying spectacle of seriously disturbed patients shouting, yelping, gurning and shaking – I know, I’ve seen them.’ Yes, Will. So have I. Up close and personal, but never on my flatscreen.
As a long in the tooth trainer running frequent Mental Health Awareness courses I can see how much has changed over the last fifteen years. Mental health is, if not quite mainstream, much, much better understood than it ever was before. We no longer have to spend a whole session explaining how Schizophrenia doesn’t mean ‘split personality’ or that ‘psychotic’ isn’t a by-word for serial killer. People seem to be ‘getting it’.
But there does remain a deep-rooted curiosity about the effects of mental illness at it’s severe, debilitating worst. The short-term effects of terrifying delusions. Thought disorder that renders conversation all but impossible. Voices of people known and not known in real life, some friendly, some nasty, some commanding their victims to do quite appalling things. The sort of bizarre, incomprehensible public behaviour that has people phoning 999 and crossing the road in a hurry.
And then there are the long term effects of severe and enduring mental illness. The appalling mortality rates and physical ill-health. The homelessness, petty crime, substance use and social withdrawal. Whether we call Severe and Enduring Mental Illness Schizophrenia, Bipolar Disorder, Depression or whatever is increasingly open to conjecture. Whether some of the worst effects of SEMI are as much to do with harmful medication regimes as the illness itself is another debate. But what is not in dispute is that this is a significant population who aren’t sat talking to camera crews in coffee shops drinking skinny lattes. This is a population about whom we see or hear very, very little.
Let’s celebrate the fact that mental illness is probably far less mysterious, stereotyped and misunderstood than it was. But at the same time maybe it’s time to take more than just a quick peek at mental disorder and really throw the doors wide open. Let’s see the otherwise unseen. The real, visceral and yes, frankly bloody horrible side of severe mental illness that is yet to see the light of day and stays ever more mysterious and frightening as a result.
Lead Trainer, JCK Training
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* Many thanks to @McLikey for the Twitter chat that inspired this blog. Sometimes 140 characters just isn’t enough!