Almost a million adults in England currently claim benefits for mental health conditions, with rates particularly high in the North. The Government is planning to increase the compulsory detention of mental health patients, but campaigners are worried this will only make matters worse. Adam Ford discovered his inner 'drapetomania' whilst talking with Amy Sanderson of the 'Kiss It' activist group.

The Great Escape

What kind of circumstances cause someone to be labelled as 'mentally ill'? Are there any patterns?
There are many circumstances in everyday life that can cause us mental distress. However, the only circumstance that gives it a label is an appointment with a psychiatrist! Some find comfort in finding a name for their distress, but more often these labels fail to give an adequate understanding of a person's mental health and just serve to stigmatise.
There are significant irregularities in the diagnosis of women, ethnic minorities and those from socially disadvantaged backgrounds. For example, Afro-Caribbeans constitute a disproportionately high amount of schizophrenia diagnoses, and women make up 75% of Borderline Personality Disorder (BPD) diagnoses.

What would be a better label, if any?
As we are all individuals, labels are not helpful. Labels are for packaging, not people. Even the description 'mentally ill' can only be used metaphorically, as 'illness' implies a biological basis - a concept that does not translate to mental distress.
The classification of 'mental illness' has shifted so much throughout time - remember, homosexuality was a psychiatric diagnosis until 1973! Before the emancipation, the diagnosis of 'drapetomania' - the compulsive desire for freedom - was given to black slaves who attempted to escape their masters. These examples reflect the medicalisation of social control over elements of society deemed 'undesirable' by those in power.

What do you think has caused increases in the number of people being diagnosed with mental health problems?
More recent increases in diagnosis rates are due to one main factor - the pharmaceutical industry. The pharmaceutical industry is only second to the US economy in turnover, and exerts a powerful grip on both medical professionals and diagnostic criteria. To keep the money coming the industry medicalises mental distress into an 'illness' to be treated, although the biological basis of this 'illness' and double blind trials of the drug are usually non-conclusive.
It is also worth noting that there are now four hundred categories of mental disorder in the DSM-VI (Diagnostic and Statistical Manual of Mental Disorders) compared to two hundred in 1980, which leads me to question how much is genuine or justified. The 'human condition' in general hasn't evolved that much, though big pharma has!

What are some of the negative effects of coercive 'treatment'/institutionalisation/use of medication?
Coercive 'treatment' is physically forced medication - usually a mixture of an anti-psychotic and a strong sedative named Acuphase. The recipient is physically restrained by psychiatric staff and this is injected into the buttock. The drug itself results in hours of semi-consciousness, total confusion and distress for the recipient, who is already in a vulnerable state. The medication may well react to others in the bloodstream, causing further distressing effects. The injection takes several days to come out of the recipient's system, during which time the confusion and sedative effects are still apparent, and the bruises from the restraint even longer. There are also forced ECT therapies given, whereby the recipient is given an anaesthetic and muscle relaxant and up to 450 volts are passed through the brain, causing a seizure. This treatment causes memory loss and can cause brain damage that can seriously affect the long term quality of life for the recipient, impairing both cognitive and motor functions. These are thoroughly degrading, traumatising and utterly avoidable. They remove any trust in care professionals and simply result in further distress.
Institutionalisation of those suffering distress is often soul-destroying. Psychiatric hospitals often provide very little in the way of meaningful activities, relying solely on drug treatments. As you can imagine, chain smoking in front of daytime TV day after day is enough to drive anyone crackers, let alone if you are too sedated to move! This can take away hope - thus motivation - and crush independence. It often simply isolates the patients from the community in which they live, making the transition back even more difficult and again, adds to stigma. It also allows for coercive treatments such as the above to happen with no accountability.

If you believe that distressed people should still be treated in some way, how should this take place?
Psychiatric medication should be a personal choice, not a medical one. They can help to alleviate distress, however they cannot work on a 'stand alone' basis, as often it simply acts as a mask. Madness comes from more than dubious claims of chemical make-up. Issues such as social, spiritual, economic or personal ones are never addressed by pills and potions. The vast majority of psychiatric drugs cause terrible side effects such as extreme weight gain, rigid limbs, excessive or no saliva, sexual dysfunction, tremors, rashes, breast excretions, blurred vision, headaches, drowsiness, dizziness, excessive appetite and even hallucinations! Over time, some side effects are irreversible. Prescription is also dependant on cost, and many of the newer drugs with less side effects are not available to all. Treating a person with just pills does not give a holistic view. For example, a nutritionist found that 60% of her clients suffering from mood-related distress - e.g. depression - were allergic to wheat. Once they removed it from their diet their symptoms diminished. There are many other lifestyle changes that can help, and coping strategies that can be used, such as physical exercise or creative expression.
An alternative to the institutions currently in use are small, community crisis houses, functioning with regular staff and little or no medication. Larger therapeutic communities are also an option, again using regular staff and little or no medication. It is not so much the institutions that are problematic per se, but the culture within them. We would also like to see a greater emphasis put on self-help networks and organisations, such as Hearing Voices and the Paranoia Network. These attempt to understand mental distress in its own terms, and place it within more of a social paradigm, rather than a medical one.

For more information visit:
www.madnotbad.co.uk
www.hearing-voices.org
www.kissit.org