Category: Advocacy

Posted in Advocacy, Mental Health

Why Do We Pathologize Pain?

Posted on by Millie :)

We’ve come to pathologize emotional pain and human distress. That’s to say, we’ve come to medicalise it – give it labels that make it into a medical problem. And of course this serves a purpose in our society and our systems; I personally am hugely grateful for my mental health diagnoses because they help me understand myself and how I view the world. But the term ‘pathologizing’ goes beyond just medicalising emotions. It defines the problem that ensues from medicalising our emotions. 

According to the Cambridge dictionary, pathologizing means: ‘the act of unfairly or wrongly considering something or someone as the problem, especially a medical problem’. This is something we see in mental health spaces all the time, with very little awareness of it. The way we discuss mental illness is so often through an individual lens. We ignore how the modern world’s expectations affect what we see as disordered – for example a huge criteria for mental illness diagnosis is a lack of productivity. But productivity is defined by societal norms and expectations. We label someone as depressed, saying they have a chemical imbalance while ignoring the fact that they are living in poverty and perhaps if they weren’t their mental health would look very different. At best we say that these external factors are simply contributors and not an essential part of our human experience; we ignore how we define was is disordered or not entirely. 

There’s a million problems with this. It prevents us from trying to build a better world in a more informed way. It isolates sufferers and prevents them from getting the kind of care – like housing, community, less workload – that they actually need. I could go on and on about this (and I do quite often!) but today I want to answer the question – why do we do this?

Well pathologization stems in many ways from medicalisation. I think there’s benefits and issues within this itself, but it’s understandable why we do this. By giving clear criteria for diagnosis in a medical format it would seem we can more easily start a larger number of people getting treatment. Unfortunately this isn’t the case, but in theory this would seem to make that easier. It also allows us to have some kind of framework to understand ourselves and more easily find others who may have a similar experience – it has certainly helped me with this! And in theory it would help others have a doorway to understanding people with a mental illness by looking at it through a medical lens, so they would know how to start approaching the problem. Furthermore it also gives a structure for how we can syphon off funding for mental health care by making it a wholly medical service. All logical and on the surface optimistic reasons to medicalise emotional pain. 

But soon we see the problems come in such as trying to ‘fix’ people to medical standards too rather than to their own standards. We start seeing people as the medical problems rather than as people with diverse experiences. We try to fit people into one route for fixing the issue because that’s easier. Medical problems need medical solutions right? Medication and hospitalisation rather than community and economic support. We see them as scores and issues. And soon we are pathologizing them. The individuals become the problem they present with, and when the one-size-fits-all treatment doesn’t work, we assume it must be the individual’s fault. 

Maybe it’s just a natural progression from medicalisation then? But maybe it’s also a symptom of the way our western society functions as a whole. We are not exactly encouraged to see ourselves in the context of the world around us. We’re told we are individuals and isolated in many ways – so it would make sense that we see our problems as individual problems that need isolated solutions. So simply because of the way we have learned to exist in the world we don’t think to see our emotional distress as interconnected. 

Then of course, as already mentioned, we live in a society driven by productivity at ever increasing speeds. We have an intolerance for difference, for people who need different support or cannot fit themselves into the world’s expectations of them. So we need to label them as disordered rather than face the idea that the way the systems are running isn’t working. It negates society’s responsibility to change and accommodate. But the thing is as the world gets faster, the economy gets worse, pressures get bigger, more and more people are finding themselves with mental health issues. Do you really think this is a coincidence? The world is becoming more and more incompatible with human rhythms of nature, so more people are finding themselves in distress. But also if the expectations shift to demand more of us or different things from us, then whatever behaviour doesn’t fit those expectations ends up being labelled as disordered. 

And maybe it’s fear – we don’t want to face that we share emotions with someone with schizophrenia or bipolar. We don’t want to admit we relate to an autistic person, or can kind of see the sense in what that psychotic person is saying. We are scared that the difference lives in us too, maybe? And again – we have not learnt the skills to be able to conceptualise how others may live differently to us through their perceptions of the world. We have not learnt tolerance, nor we have not learnt to question the status quo – because it would threaten the status quo. 

I think we pathologize pain because it’s the easiest thing to do when everything else seems so overwhelming. But we can begin to change this simply by opening ourselves to compassion; opening ourselves to a different narrative. We are all human and we are allowed to have deeply painful, wonderful, beautiful human experiences. That means sobbing our eyes out or seeing shadows no one else can. Feeling does not make us the problem. 

Hopefully that made some kind of sense, my little brain ramblings on the internet. Sending so much love and support xxx

Posted in Advocacy, autism, Mental Health, neurodiversity, Personal Growth, sobriety, therapy

Hurt by Psychiatry

Posted on by Millie :)

Content warning: ED, psychiatric abuse, suicidal ideation, any mental health topic really

I want to write a really strong and defiant letter. I want to write some crazy, proud, creative theatre piece. I want to write something truly hopeful. And while I do have hope, and I do have gratitude – because it is essential to my survival – I also have a lot of pain. And anger. I can talk openly about so many traumas and just general shitty things that have happened in my life. But the one I’ve never been able to write about, never even been able to get through a conversation about without screaming and crying, is the pain endured under the psychiatric complex. Because they were meant to help me. Time and time and time again I have gone looking for help and time and time and time again I have been turned away with only more hurt. I know help is a brave word. I’m not afraid to say it. But I am afraid that when I say it no one will listen. This is my story of a journey through the mental health system. 

Just a disclaimer, because as a writer on mental health I feel it is my responsibility – if you are in a bad place and looking for professional help, please do not use this as your excuse not to. I do know some people have been greatly helped by the mental health system, and you could be too. This is not intended to invalidate anyone’s good experiences, but rather to say that all of us deserve to have those good experiences. This is simply my story as someone who feels they have slipped through the cracks. If you feel this may affect you negatively I implore you to take the decision not to read any further. 

I first asked for help from the mental health system when I was 12 years old. I was experiencing mood swings and distress that were really bothering me – maybe just normal teenage things, maybe not, but the point is it doesn’t matter. They were bothering me. Anyone who wants help, even just to navigate daily life, should be given it. I was assigned a counsellor from the early intervention team. I didn’t like them, so I asked to change. I was discharged from the service – I took that as a message that if I had an opinion on my care, my care would be withdrawn from me. 

My first contact with CAHMS (child and adolescent mental health services) was due to an eating disorder at 14. My life was being ruled by it – I had complete meltdowns when I couldn’t exercise, was hyper fixated on food all the time, was weak and angry and alone; I was really hurting. They weighed me. They told me I wasn’t a low enough weight. I took that to mean I wasn’t sick enough. Without any regard for how I felt, or how food was ruling my life; without anyone trying to find out anything about my experience they denied me the help I so desperately needed. Suggested possibly a meal plan – with no support to implement it or formulate it. If a teacher hadn’t sat with me at lunch every single day for a year and coached me through it because she’d been there too, I don’t know how I would’ve gotten through it. 

I severely relapsed with my eating behaviours twice more, and I still struggle with some thought patterns and triggers to this day (though I am in a much better place, largely due to recovery in other areas giving me the tools to transfer). But I never felt like I really recovered from it, or had the support I needed. Even 9 months ago that teacher would still notice when my old behaviours around food crept in – even before I did – and help me to recognise and head them off. I am immensely grateful for that… but it wasn’t her job. It was never her job to be the main guidance and support in eating disorder recovery. 

CAHMS did offer me six sessions of group therapy. This was to deal with my overwhelming anxiety – much of it around socialising – and deep depression. They didn’t see it as deep depression. It was. It was really, really dark. I stopped going to any lessons and lost all sense of self and hope. But yeah, six sessions would be enough apparently (obviously not). I freaked out at the thought of group therapy, it was entirely unsuitable for me. Once again I received the message in response that if I had an opinion on my care, I wouldn’t get any care. They wanted to discharge me right then, but my wonderful mum stuck up for me so they offered me three – I repeat THREE – CBT sessions. They were not useful. I was put on a years long waiting list for an autism assessment. I was offered no more support. I continued to struggle. 

My mum’s determination to get me the help I deserved was incredible, and probably the only reason I got any support at all. (My mum is probably reading this, so thanks mum). She found a charity that was amazing in supporting us through my teen years, and funded me to see a private psychiatrist – this would not have been possible without them. However I wouldn’t say that was particularly helpful either. That psychiatrist did diagnose me with autism (side note – the assessment for autism really needs to be changed), anxiety and depression. I am eternally grateful for my autism diagnosis – it truly did change my life knowing I was autistic. But it changed my life because I went away and learnt about it, as did my family. The psychiatrist did not formulate a treatment plan for any of this, or provide any further support. Some medication that didn’t work was all she offered. 

In this time I also saw a few therapists – I didn’t like them, one of them didn’t like me and kinda dumped me. All of them were privately paid for. The subpar care I received was paid for privately – can you imagine how much worse it would have been if we hadn’t been able to afford it?

I know this is all a lot of information, but stick with me here. This journey is important to understand because it is something so so many people face. I slipped through the cracks of this system – even with the privilege of being a white, cisgendered woman. I had it reasonably easy. 

In February 2020 I had what I now recognise to be my first (and most intense) mixed episode. I cannot even put this experience into words but essentially it was all the darkness of depression with all the heightened energy and irritability of mania at the same time. I felt reality slipping away from me and I have never been in such intense distress. Two teachers stayed with me at school hours after school ended to try and keep me safe. They eventually helped me calm down, but I later found out they were so concerned they were about to call an ambulance or the police, as the crisis line wasn’t helping. I went to the GP during this episode begging for help. She prescribed me valium to calm me down, but when I begged her for more support I remember her chastising me for being so emotional because she had other patients waiting. I took that as a message that I still wasn’t sick enough; still wasn’t important enough. 

In March 2020 the private psychiatrist diagnosed me with cyclothymia. We had to pay extra for an emergency appointment. She decided I was now too complicated to be under her care and needed more support so referred me back into the NHS. They did not follow up on her recommendation for more support. By the time they saw me I was a bit calmer so apparently that meant I didn’t need help. In her eyes I was too bad, in their eyes I wasn’t bad enough. So I was left with nothing. This was the trend that would continue for the next three years. 

In September 2020 I wound up in A&E. I was broken and desperate. When the CAHMS crisis person finally arrived she acted annoyed about me being there, annoyed she had to be there, uncaring. She essentially asked ‘if things are so bad then why haven’t you killed yourself yet?’ and sent me home with no support. They didn’t follow up on any support because I calmed down a bit after, so I was no longer considered in crisis when they finally did get in contact (even though they hadn’t helped me when I was in crisis) and because I was drinking at the time. Just so we are all clear – if a young person is drinking as heavily as I was, that is exactly the time they need support. I went to my first AA meeting after I left the hospital that day. And excuse my french but thank fuck I did. I have no idea if I would still be alive otherwise. And having connected with others who have been subjected to inpatient treatment, I am incredibly grateful I did not have to bear that extra trauma. This is how bad the surface level service is – it’s even worse inside. 

After I got sober in July 2021 I was still struggling. I finally got to see a psychiatrist on the NHS in October 2021 because of my mum’s insistent fighting for me. When he asked me what I wanted from the meeting, he chastised my response. He was unclear. He shouted at me, and revoked what I thought I had been diagnosed with in a letter. I was meant to see him again in 10 weeks and he cancelled. I got discharged from CAHMS without them ever asking to talk with me about how I was doing. 

The one professional who has been a saving grace is my therapist. She is autistic herself and very flexible. But again – if I wasn’t able to fund that privately I don’t know where I would be. After my charity funding stopped when I turned 18 I had to take the sessions down to every 2 weeks, even with her sliding scale, which is significantly less helpful. Luckily I’ve also found amazing peer support, especially through AA, and spent a lot of time reflecting and doing my own work, so I’ve managed to build myself a much brighter life. But it’s been hard. And sometimes I really do need some more help – no one should have to do this alone.

I Went back to the NHS this October and had my first ever good meeting with anyone, just someone in my GP clinic. Why? He was honest. He genuinely seemed to care, but there was nothing they could offer me. He explained that as far as the system saw it, I had already been helped.

In late 2022 my mental health really started to decline again. I went back to the NHS this October and had my first ever good meeting with anyone, just someone in my GP clinic. Why? He was honest. He genuinely seemed to care, but there was nothing they could offer me. He explained that as far as the system saw it, I had already been helped. So from October I was searching for a psychiatrist who would see me. 

I was turned down by over 10 private psychiatrists for being too complex, having comorbidities, or my favourite way of putting it: ‘them not being able to offer the support I need at that time’. So I was again too bad for private and not bad enough for the NHS. One of the only people who would see me charged just under £1000 a session. Others said they would consider seeing me, but were booked up until 2024.

Finally in March 2023 – 5 months later – I got to meet with a private psychiatrist. And wow, he was amazing. We had three meetings so we could cover everything. He was kind, listened to me – really listened – and didn’t patronise. He treated me like an adult, and made it clear I would have a say in my care plan and the final report that would be sent to my doctor. I would have a say? I almost thought that wasn’t allowed. I’m still sceptical, it still doesn’t feel real. 

He diagnosed me with Bipolar type 1. Just think about that for a minute – an 18 year old has been dealing with undiagnosed bipolar 1, unsupported, emerging from 12 years old. I have no idea where I would be without the angels placed in my life along the way; without the undying support of my family and friends; without the flexibility of my school. I knew something more was going on, I knew how much pain I was in, and no one in the mental health industry was listening. I was screaming into a void and not even hearing the echoes of my own screams. (A separate issue is that we shouldn’t need labels to validate that level of human distress, which is what it is at its core, but diagnosis can be so validating. Read more about that here). 

I am not in any way saying this one experience erases all the rest. It does not. It absolutely does not. And it doesn’t not mean that psychiatry isn’t built on an oppressive, harmful foundation whose history has been hidden. It is. But it was a little hope given back to me. A relief at the very least. Before I went into that meeting I said ‘I’ll take them just not being actively mean to me’. How sad is that? What a desperately low bar. 

I’m still scared. He has instructed my GP to refer me back to secondary care teams in the NHS, which I still – like always – hope might offer some help. But the main thing offered seems to be medication, which I have some serious and valid concerns about. But I am terrified of raising these concerns or asking about alternatives for fear that a) I will be labelled as disordered and my new diagnosis weaponised against me or b) I will be labelled as non-compliant/ not wanting help enough, and sent away again. I wish I didn’t want help from them, and maybe one day I’ll be able to find a path that avoids dealing with the mental health system altogether. But I’m not there yet. Nor should I have to avoid it. It should be an inclusive, varied, accessible service. It should have community and individualised care. It should have alternative treatments and input from patients. It should see the human condition as a spectrum. But it doesn’t. And being mentally ill makes me scared that if I voice any of this, I will not be taken seriously. How can anyone ever prove that they are sane?

I deserve better. Everyone deserves better; we deserve to know that no matter what we’re going through there will be appropriate support for us. But it’s not there. And this broken system is quite literally killing people. We can’t just say fund the system either, the system needs to change. I need it to change, we all need it to change. 

I think I’m sharing this because the younger version of me wanted desperately to read it from someone else. So the core message is that you are not alone. You are not alone in the hurt psychiatry has caused you. You are allowed to be angry about it, and distrusting of it. You are allowed to choose your own care and your own path – even if others don’t understand it! (And that applies to all paths – mental illness should not be policed). Your pain is valid, completely valid, and I see you. I see you.

Sending love and support to you all today xx

Posted in Advocacy, Mental Health

The Casey Review and What it Means for Mental Health

Posted on by Millie :)

Content Warning: Police misconduct, abuse, and discrimination

This post is a short overview of how the recent Casey Review relates to the mental health system. There are many more implications for the mentally ill and all intersectional issues so I would really encourage you to do some more research into the review and the topic of police misconduct – it affects all of us, especially the most vulnerable.

What is The Casey Review?

The Casey Review is an independent investigation and review of the standards of behaviour and the internal culture of the Met Police in the UK. Baroness Casey was appointed to head up the review in October 2021 after the kidnap and murder of Sarah Everard by a police officer and several other deeply troubling incidents. The final report has just been released (March 2023) and it is a damning condemnation of the Met Police.

What Did The Review Find?

The police were found to be institutionally racist, misogynistic, and homophobic. Specifically that it has failed to protect the public from officers who abuse women; that organisational changes have put women and children at greater risk; and that female officers and staff routinely experience sexism.

Much of what is found in the report isn’t a surprise to the communities who face discrimination and targeting from the police, and also echos what was said in the MacPherson report back in 1999 after the murder of Black teenager Stephen Lawrence. This isn’t a news – it’s a continually pressing issue that cannot continue to be ignored. This isn’t news – it’s a continually pressing issue that cannot continue to be ignored.

What Does it Have to Do with Mental Health?

Mental Illness has been criminalised in this country for a long time. Police play a key role in enforcing the Mental Health Act (which is used to section people against their will). This means their attitude, organisation and behaviour can have a huge direct impact on those of us with perceived mental health difficulties.

As Mind puts it: ‘This matters to us because we know that people with mental health problems are more likely to be victims of crime, more likely to feel that impact more acutely, and less likely to get the support they need’. And yes – people with mental health problems are more likely to be the VICTIMS of a crime, despite continual stigma that we are more likely to perpetrate crime.

One key way this directly impacts mentally ill people and the mental health system is the institutional racsim. Black people are already 5x more likely to be sectioned, and to reach the mental health system through ‘negative’ routes such as police and court. And this is one of the reasons why – the institutional, systematic racism that pervades our society and police. Once within that system Black people are likely to face more trauma and forced control, a lack of appropriate care and understanding. Their distress likely compounded by the racism they face daily anyway, more trauma is created within the system and only compounded further if they also face homophobia and sexism.

The ways the findings of this report impact the mental health of individuals, and the mental health system are myriad. It is directly in opposition to justice, freedom, and healing.

Ways to Help:

  • Sign up to become a Mind campaigner
  • Look for alternatives to institutionalised care that you can support in your area
  • Contact the Met Police and put pressure on them
  • Contact your local police and MP to ask that they review their own behaviour
  • Donate food and supplies to local charities that support your community
  • Raise your voice however feels best for you – maybe you can use art, or song.
  • See this page for a list of further reading looking at the idea of police abolition and how our systems function for a deeper understanding (and a much better look at ways you can help!)
  • There’s not one way to make change, it happens together!
Posted in Advocacy, Personal Growth

Being Vulnerable

Posted on by Millie :)

Thought I’d share something a little different today. The text below is directly copied from ruminations in my diary about being vulnerable (specifically online). Half formed thoughts and unanswered questions, which is kind of the point of what I was writing about – allowing an ‘unfinished’ image of self to be seen. I’ve thought about it more and this quote in particular resonated with me: ‘Vulnerability is the least celebrated emotion in our society’ ~ Mohadesa Najumi. I’m a growing, changing person whose views will inevitably change, but I don’t think I want to live holding back because I may think differently in the future. All we’ve got is now right? So this post is a little less about mental health, and more about the process of learning to be a mental health advocate (if I can allow myself that title!). Please enjoy this copy of my wandering thoughts:

‘I think I naturally ‘overshare’ a lot, though keep some things very hidden. And it’s part defence mechanism, but also part not understanding what’s meant to be hidden. I don’t see my ‘personal life’ as any more personal or precious just because it’s mine. It doesn’t really bother me if more people know, in fact sometimes that makes it more special to me. But is that just a need for validation? Or am I broken, or missing something – because I don’t seem to understand the idea of personal life in the way the messaging of the world does??

And also, of course I’m afraid of judgement. The biggest fears being that sharing I’ve had problems with alcohol – for example – will stop me getting a job in the future. But if no one speaks openly about these things then they remain something to be feared or judged. Right? Social media is so often used to show the ‘end product’ of healing, discovery, creation etc… the polished, acceptable version. But that’s not life! I’m ok being a flawed, growing person. I have to be because I always will be. I want to show that too. 

But is there a right and wrong way to do that? Or is that just more expectations? Or is social media in fact not suitable for that? Of course it will always be just a snapshot of life – does that mean we cannot snapshot the vulnerability too? Indeed – what is vulnerability? I feel we live in a culture where we are afraid to make mistakes, especially in changemaking settings. But mistakes are a part of life. It’s all very confusing, but I don’t want to be afraid of the journey of figuring it out. I choose to move forwards with love and acceptance.’

Posted in Advocacy, Managing Mental Health, Mental Health

Reframing Healing

Posted on by Millie :)

We receive a lot of messages, consciously and subconsciously, about what healing is. I have my own opinions, some of which will be evident in this post, but I think one of the most important things to keep in mind is what does healing mean to you? There may be limitations to our ideas of a dream life, because we don’t live in a vacuum, but only you get to decide what your healing actually means and looks like. Unfortunately it’s something that is quite overlooked in a lot of mental health spaces, and we’re not often encouraged to really define it for ourselves. But that doesn’t mean we can’t. 

Personally, an important part in redefining healing for myself has been understanding what I’ve been taught about healing. A lot of what I’ve learnt is to see ‘getting better’ as this hyper-individualistic thing. We’re told that ‘getting better’ is about becoming a productive member of society again, going back to work full time, having more output, and living up to the expectations placed on us. A lot of therapy is often about this idea – it’s about mitigating the factors that get in the way of productivity rather than fostering genuine happiness. The idea of compliance and non-compliance in the mental health system is a huge part of reinforcing this and getting in the way of anyone who needs to stop and question whether this striving for efficiency under societal norms is actually what they need. 

We don’t live in a vacuum, so I think it’s only logical to suggest that we don’t heal in a vacuum either. And yes it is possible to have personal peace without those around you experiencing the same, but that’s not to say our healing is entirely individual. We are connected; we are even a part of nature. When bears hibernate or trees shed their leaves we don’t look at them and say they should be doing more, they should be doing better; we understand that they are in a season of their life. Yet we so often fail to extend this same understanding and grace to ourselves. We are a part of nature too, and so we are connected to those around us and every part of the world around us. It is only logical to think we should lean into this connection and these seasons to find peace. So I would say healing is community. Healing is working together. Not in order to fix or mend one broken individual, but to recognise what in our living, breathing system of life contributed to their pain in the first place, and to heal all of us. I’ve found that when I am held by a community, only then am I able to find my own inner peace. 

We also seem to see healing as this end destination – we arrive at ‘healed’ and then we continue there as before… until maybe we need to be healed again. But I don’t see it like this. Healing is an ongoing, every day process for me. Just like I see myself as a continually ‘recovering’ alcoholic, I also see myself as a continually ‘healing’ person. Partly because there are new challenges to life every day; partly because I have chronic mental illness; and partly because I see healing in a larger sense too, one of societal healing. That can be hard to conceive sometimes, or to not get wrapped up in. But I see it as a source of hope rather than a drain of hope. A source of power. That healing, as an ongoing, everyday practice, also means trying to help others and be connected with their struggles. Trying to learn how we can all work together to do better, to build better infrastructure, to break the chains and patterns of the past, to move forwards.

So what does healing mean to you? Does healing mean connection? Does healing mean going back to the life you had before? Or is that just the easiest life to imagine? Does healing mean productivity, or does it mean inner happiness and peace? What do you need to see that realised? Is healing individual, or collective, or aided by the collective? Is healing a destination or a journey? 

I’m not saying there’s one right way to redefine healing. It is personal in how it manifests in our lives, but the very fact that so many out there are healing and recovering shows that while it is personal, it is not individual. And I think the mental health system needs to recognise that too. 

Sending all of my love and support to you today xxx

Posted in Advocacy, Mental Health

Psychiatry and LGBTQ+ Rights

Posted on by Millie :)

Psychiatry has throughout its history and still is very much linked with control and upholding societal standards. The view many people have is that at its core, even though it may be failing, the mental health system exists to help us be happier. And while it’s true there may be individuals in the system who wish this, the very structure is built around an idea of societal norm,  and returning people to acceptable states of being and productivity. Part of that history of western psychiatry has been its link to LGBTQ+ rights – or more specifically the denial of such rights and the pathologisation of the community as mentally ill. So here is a very brief overview of some of that history today. 

But first, why is this important? Well, the history and injustice of psychiatry is really important to understand because the way the system operates now is directly built on this, so we’re still seeing discrimination of all kinds. We can’t just fund a harmful system, we have to review it, build alternatives etc etc. If we do not understand this history we cannot engage in meaningfully informed conversations about what the future of mental health care might look like, because we risk making the same mistakes by perpetuating the system. 

So here’s some fast facts about psychiatry and gay rights:

  1. The World Health Organisation (WHO) didn’t declassify being gay as a mental illness until 1992. 
  2. They didn’t declassify being transgender as a mental illness until 2019.
  3. Between 1935 – 74 chemical and electrical experiments were done on gay men in psychiatric hospitals to try to change their sexuality in a process known as ‘aversion therapy’. Some men were made to do this to avoid going to jail for engaging in homosexual activity. Conversion therapy is still a practice in many places today, an ongoing demonstration of this abuse and trauma inflicted upon LGBTQ people.
  4. Being gay was also criminalised, as well as being classed as a mental illness, until 1973. This is a clear example of the direct link between psychiatry and criminalization. Under these laws over 100,000 men were convicted in the 20th century. One such example is Alan Turing who was forced to endure hormone ‘therapy’ to ‘cure’ him, or go to jail. He chose the former and was chemically castrated – as were many other men. It was not until 2017 that the UK offered pardons to the thousands of gay men convicted of abolished sexual offences, simply because of their sexuality. 
  5. Gender dysphoria and incongruence (for example) are still used to pathologise being trans – meaning they are terms that label being trans as some kind of individual mental defect, and means transgender people have to jump through hoops before they can access gender affirming care 
  6. 1 in 7 LGBT people avoid treatment for fear of discrimination nowadays 

The joint stigma surrounding mentally ill people and LGBTQ+ people means that they are seen as people to be feared, shunned, or fixed by many. And much of that stems from this history listed above. It is true that LGBTQ+ people are more likely to experience mental illness:

  • 52% experienced depression in the last year 
  • One in eight LGBT people aged 18-24  said they’ve attempted to take their own life in the last year
  • One in six LGBT people  said they drank alcohol almost every day over the last year.
  • Almost half of trans people said they have thought about taking their own life 

These statistics are unsurprising when we consider the intersectional nature of mental illness. It’s not something that exists in a vacuum, and although it may be experienced by an individual it is not an individual flaw. Economic insecurity, discrimination, exclusion, lack of support, homelessness, addiction – these all compound mental distress, understandably, and LGBTQ+ people are likely to suffer more with all of the above. But treatment often focuses only on the individual symptoms, and fails to address the bigger picture, which leaves LGBTQ+ people at even more of a disadvantage. And that’s without even considering the discrimination, homophobia and transphobia within mental health care, which puts an unreasonable expectation on LGBTQ+ people to trust the providers of their care when they haven’t been proven to be safe:

  • One in eight LGBT people (13 per cent) have experienced some form of unequal treatment from healthcare staff because they’re LGBT.
  • Almost one in four LGBT people (23 per cent) have witnessed discriminatory or negative remarks against LGBT people by healthcare staff. In the last year alone, six per cent of LGBT people – including 20 percent of trans people – have witnessed these remarks.
  • One in twenty LGBT people (five per cent) have been pressured to question or change their sexual orientation when accessing healthcare services.
  • One in five LGBT people (19 per cent) aren’t out to any healthcare professional about their sexual orientation when seeking general medical care. This number rises to 40 per cent of bi men and 29 percent of bi women

I think at the very least, LGBTQ+ people should be able to choose mental health care with professionals that reflect their lived experience, but this is so often not an option and as a result they are unable to engage with their care, and may even be blamed for it. But the history of LGBTQ rights is full of stories of community care and community love, and for a community that has good reason to be distrustful of authority figures, perhaps the key lies in modelling peer support and community care on the rich love of LGBT history. I don’t know all the answers; I have opinions, but I do not feel confident enough to say I definitely know what’s right. I do however know it’s time to move forwards and forge a new future. We’re going to get things wrong still, it’s inevitable, but maybe if we’re a bit more aware and intentional about mitigating harm, we can see a brighter tomorrow for mental health care, and the LGBTQ+ community. 

Sources:

  1. https://amp.theguardian.com/books/2015/jun/03/curing-queers-mental-nurses-patients-tommy-dickinson-review
  2. https://www.stonewall.org.uk/lgbt-britain-health
  3. https://www.talkspace.com/blog/mental-health-history-lgbtq-community/
  4. https://www.petertatchellfoundation.org/alan-turing-the-medical-abuse-of-gay-men/
  5. https://www.britannica.com/biography/Alan-Turing/Computer-designer
  6. https://www.gov.uk/government/news/thousands-officially-pardoned-under-turings-law#:~:text=Thousands%20of%20gay%20and%20bisexual,have%20today%20been%20posthumously%20pardoned.&text=The%20historic%20moment%20comes%20after,of%20consensual%20same%2Dsex%20relationships.
Posted in Advocacy, Mental Health

Write to MP About Mental Health System

Posted on by Millie :)

Writing letters to our MPs about important issues can feel like hitting our heads against a brick wall. I get it. Our government is failing us in about every way possible at the moment while continuing to introduce increasingly more constricting and draconian laws that limit our freedoms and right to democracy. Nonetheless, I still maintain that there may be hope to be found in raising our voices. The more people that stand up against issues the harder it becomes to ignore – and it could even be argued that it’s up to us to believe in hope even when they aren’t giving us much reason to. One of the easiest ways to raise your voice is by writing to your MP. They may not be able to do anything directly or immediately, but they are our representatives and can bring our concerns to the table. Imagine if every person in your district wrote in about the same issue – it would be pretty hard to ignore. Anyone of any age can write to their MP, and you can even email them. 

Our mental health system is in crisis; it’s built on harm and it is perpetuating that harm. And it cannot be fixed just by increasing its funding – you can’t fund a broken system and expect it to fix itself. So we need to raise the alarm and raise our voices. Below I have written a very short template for writing to your MP about the mental health system. To use simply:

  1. Use this website to find out who your MP is and what their email address is: https://www.writetothem.com/
  2. Copy and paste the template below into an email 
  3. Replace the generic details in italics with your MP’s name and your own information 
  4. Add in your own message or questions 
  5. Hit send 

It’s that simple. And it may seem small, but you never know if the small individual actions we take will add together as a collective. It’s worth a try if nothing else. And remember, if they don’t reply or give a satisfactory reply, you can keep writing to them! Don’t let this be an issue that goes unheard. So here’s the template (just a general content warning for topics relating to mental health here such as suicide):

Dear [insert MP’s name],

I am writing to you today because I am incredibly concerned about the state of our mental health system. It is clear to me that the mental health system continues to fail all of us, especially the most vulnerable in our society. As I’m sure you’ll understand this is an incredibly serious issue, with people’s lives at risk. 

The suicide rate in England and Wales was 6.9% higher in 2021 than in 2020, a trend that has been continuing over many years despite supposed attempts by the government to address mental health issues. For example – the rollout and continued expansion of IAPT that is meant to provide early and easy access to psychological therapies but has since been found to be skewing their own data by several studies. The University of Chester found their actual recovery rate to be just 23% by their own measures (which can include clinically insignificant improvements) as opposed to their claimed 46%. However a large meta-analysis found that 23% of patients with depression spontaneously overcome their symptoms in three months anyway which would render IAPT irrelevant. Despite this it continues to be heralded as a success with no one speaking up about the failures and the people it leaves to the wayside. 

That is the most basic level of treatment and doesn’t even begin to reveal the long waiting times, criminalization of mental illness and failures of the Mental health act, abuse within inpatient treatment, how risk of suicide actually increases after inpatient treatment, lack of appropriate and individualised care, lack of any support for young people, or obsession with productivity instead of personal happiness in recovery. Even within the last six months we have heard about the cases of more young people who have died while in inpatient care –  Christie Harnett, Nadia Sharif, Emily Moore, Charlie Millers, Beth Matthews, and Lauren Bridges. People are falling through the cracks, and being actively harmed by the system. People are dying. It is unacceptable and it cannot be allowed to go on. 

[Insert any personal experience or thoughts here]

Therefore I implore you to research more into the truth of the mental health system and the harm it has caused to so many. And I ask you – what will you do, as representative of this community, to raise the voice of our concern about the mental health system? What will you do to push for change? What will you do to support the mental health of young people in this community? What will you do mitigate the compounding and intersectional issues with mental health (ie. racism, food insecurity, transphobia, poverty)? 

Thank you for taking the time to read this letter and I look forward to hearing your response, 

Kind Regards, 

[Insert your name, address, and contact information here – remember, without an address you will not receive a response!]

Glowing fluorescent blue triangles in a pattern
Posted in Advocacy, Mental Health, therapy

Issues with IAPT

Posted on by Millie :)

Disclaimer: Before I dive into the issues with IAPT I just want to clarify that this blog is in no way intended to discredit anyone’s positive experience with IAPT or discourage anyone from using the service. IAPT could still be a piece in the puzzle of helping you find the right support. I am purely highlighting issues that some people face because everyone deserves to have a positive experience of mental health care – if the mental health system can’t adapt to different needs, then it needs to change. This post is about raising awareness of the gaps within that system, and the plaster solution that IAPT has become. Because we all deserve better – it could be you or any of your loved ones needing a more comprehensive, long term and personal care plan. And I would hope that the door was always wide open for you to receive the support you need.

With that said, let me give you an introduction to what IAPT is. IAPT stands for Improving Access to Psychological Therapies. If you are an adult and go to the doctor with a mental health concern, you are likely to be referred to this service as one of the first ports of call. It was rolled out in 2006 and there are now around 220 IAPT services in the UK. It offers patients a limited number (usually 6, up to 12) of sessions with a counsellor using CBT – Cognitive Behaviour Therapy. And it’s true that rolling out this service greatly reduced the 8-12 month waiting time for psychological therapy in 2005, which is great, but that doesn’t mean it provides a greater level of care. 

So let’s look at the information I’ve just noted. CBT focuses on changing thought patterns and behaviours of individuals – which by definition is not suitable for anyone who’s mental health is being impacted by the situation they are in. It’s true that CBT skills can be incredibly useful in helping us cope with day to day life, giving us the tools to reframe our experience so it becomes bearable and our thoughts less consuming. But that doesn’t mean it’s perfect by any means, nor suitable for everyone. For example many autistic people have likened the approach of CBT to gaslighting; it just isn’t suitable for application with neurodiverse thought patterns in many. For many others too it simply doesn’t provide the all round support they need – the therapy sessions are not designed to hold space for the person, explore route causes that will continue to be present, or brainstorm ways to change the situation they are in. It can provide people with a quick fix to a singular problem, but lacks a long term approach. 

However, it’s the only framework offered with IAPT, already excluding many from the help they need. Especially because if someone goes through with IAPT treatment they may be seen as already having support and having to face longer waiting times; likewise if they refuse to continue this raises the issue of non-compliance. Non-compliance is a complicated label used in the mental health system sometimes that essentially labels patients as unwilling to try and help themselves and makes it harder for them to access support, simply because the support they refused was not suitable or accessible to them. This is a systematic issue of not providing individualised care, but instead it is labelled as a personal fault and the burden is borne by the individual. 

Even for the people CBT framework does suit, the IAPT programme offers such limited sessions that it’s arguable how much long term support and healing they actually offer. 6 sessions is simply not enough in my eyes. What about the people with more complex issues? The people that learn slower? The people that need time to build a secure relationship with a therapist before they feel confident to start working with them? They are all being left behind by the existing IAPT service. 

None of this is surprising when we look at the roots of how the IAPT service came to be. In 2005 Lord Layard – an economist by trade addressing the economic costs incurred due to mental health crisis – and David Clark – a professor of psychology championing CBT – pitched their idea for IAPT to a board room full of government officials. They pitched it through the economic benefits that providing a cheap service that got people back to work could reap, easing the £12 billion cost of depression each year. Though I understand why so often proposals have to be pitched through an economic lens rather than a moral or social one, I do think it’s very sad. And I think in many ways shows why this system isn’t working. We’re approaching the issue of the mental health crisis wrong if we’re approaching it from a perspective of getting people back to work. Mental health doesn’t exist in a vacuum and is deeply intertwined with all aspects of society which we cannot simply ignore addressing when looking to help mental health. Furthermore, healing is not actually about productivity – this is considering healing through the eyes of someone else looking in on a life trying to define quantifiable proof of them getting better in a way that is palatable to society. Healing is internal and personal; our current mental health system does not recognise or allow space for this in our society. 

Nonetheless IAPT was heralded as an astounding success in the mental health sector worldwide for its quick rollout and wide reach. But in 2010 Dr Micheal Scott – a clinical psychologist at the University of Manchester – began to question the success of IAPT when assessing its patients. He was hearing many stories of patients with bad experiences of the programme who found it useless, dropped out, or pretended to be better to make it end quicker. He decided he needed to look further at how the effectiveness of IAPT therapy was being assessed in order to discover if it was really as great as it was claimed to be. 

The first thing of interest he discovered was that IAPT was responsible for collecting all the data on its own performance – there were no external reviews or assessments taking place. I think many of us will know that this is a bad scientific practice for collecting and understanding data – there should always be peer reviews. So he conducted an assessment to discover the true recovery rates. 

He began by reviewing the cases of 65 people. I’ll admit that’s not a lot, but stick with me here. Scott used various procedures for a robust review including in-depth interviews, diagnostic assessments, and evaluating medical records. His results showed that no matter the condition, only 16% could be considered as recovering. This is woefully below the 46% reported by IAPT themselves – and with good reason. IAPT’s method of assessing recovery rates only included those that completed treatment with them and neglected to count the half of patients who dropped out of treatment. The fact that half of patients drop out of treatment at all is a huge indicator that the programme is failing anyway, but the correct way to conduct research would be to include them in the data. By omitting them IAPT are artificially increasing their recovery rate. I would also add here that even their self-proclaimed 46% could be much higher with proper individualised, socio-culturally aware treatment plans. 

Scott’s admittedly small study isn’t the only one either. The University of Chester’s larger study found a 23% recovery rate, still much lower than IAPT’s claim. And that’s before even considering what IAPT deems recovery to mean. I’ve already explained that IAPT was built around the idea of getting people back to work, and so it’s unsurprising that the programme focuses on getting people back to what are viewed as functioning members of society rather than personally happy with their healing journey. 

This is seen reflected in how IAPT reviews patients progress. At the start of the therapy questionnaires are conducted that rate how depressed or anxious you are, and then again at the end of the therapy. If at the end of the therapy you score lower you are considered to have improved. If you scored just above the clinical threshold for depression at the start of the therapy (let’s say the threshold is 10 and you scored 11) and by the end of the therapy you score just below (let’s say 9) then you are considered recovered by IAPT. But in reality you’ve only dropped 2 points and are likely still experiencing emotional complications in your life! They’re now just not considered inconvenient enough to others to be clinically notable, but that doesn’t mean they aren’t hugely significant to you. You might not feel ‘recovered’ at all. And the scale is really sensitive anyway – you can move around 5-7 points simply by sleeping and concentrating a little better. 

Furthermore , IAPT doesn’t even conduct a control group meaning there’s no way to know if the 23% ‘recovering’ would have improved slightly without IAPT at all. In fact a recent meta-analysis (meaning examination of lots of data from different individual studies) showed that a total 23% of people suffering with depression spontaneously overcame their symptoms within three months without receiving any treatment. Which aligns with the 23% recovering from IAPT exactly, suggesting that the service is totally irrelevant. Yet it is often the only service offered to those struggling, many of whom will continue to struggle unsupported. Real lives are in the balance, and the system is trying to stick a plaster over the issue that doesn’t even work. 

This doesn’t even begin to touch on the deep issues for workers within the IAPT services, who are struggling hugely themselves and being crushed under a culture of form filling and goal hitting heralded above actually providing support. An ex-IAPT lead said, in an interview with James Davies: “To hit the waiting list targets we’d offer people some minor intervention but it was not what they really needed – it was what we could offer to get higher results”. And there lies the problem in a nutshell – people are not being offered the help they so desperately need. And how could they in a system that values goals, productivity and economy above people’s lives? How could they in a system that is built on societal expectations, harm, and conformity? How could they in a system that isn’t working to face the deep intersectional issues of the day? How could they in a system that is underfunded and in desperate need of reform? 

I recognise that criticising the mental health system is a complicated thing to do, because it’s where we hope to find help. But the reality is that it falls short. I do have hope it can improve; I have hope in our communities and our efforts to see better care. And I do know that despite a failing system people can recover – by their own standards – and live bright lives. But I know too it shouldn’t be so hard to get support, for anyone. 

So here are some calls to action! What you can do to help: 

  1. Most of the information in this post comes from James Davies’ book ‘Sedated: How Modern Capitalism Created Our Mental Health Crisis’. I would recommend that everyone read this book to educate themselves further 
  2. Sign up to Mind’s newsletter to find out about their campaigns for better mental health care 
  3. Write to your MP about the failing mental health system and demand care that is individually tailored, socio-culturally aware, and focuses on personal healing not productivity 
  4. Share this post and have conversations with people in your life about the mental health system – all change starts with a conversation 

Thank you so much for reading! Please let me know any thoughts or questions you have in the comments below. Sending so much love and support to you all today 🙂 

Sources:

https://www.nice.org.uk/about/what-we-do/our-programmes/nice-advice/iapt#:~:text=What%20is%20IAPT%3F,with%20anxiety%20disorders%20and%20depression.

‘Sedated: How Modern Capitalism Created Our Mental Health Crisis’ by James Davies 

https://www.madinamerica.com/2022/06/uk-iapt-abject-failure/#:~:text=We%20identified%20a%20series%20of,of%20misdiagnosis%20and%20inappropriate%20treatment.

Layard, Richard (2005), ‘Mental Health: britain’s biggest social problem?’, paper presented at No. 10 strategy unit seminar on mental health, 20 January 2005 

https://www.mind.org.uk/information-support/drugs-and-treatments/talking-therapy-and-counselling/cognitive-behavioural-therapy-cbt/

Griffith, Steve, Steen and Scott (2013), ‘Improving access to psychological therapies (IAPT) programme: setting key performance indicators in a more robust context: A new perspective’ 

Whitford, H et al, (2012), ‘Estimating remission from untreated major depression: a systematic review and meta-analysis’

Posted in Advocacy, autism, Mental Health, neurodiversity

Misogyny and The Psychiatric Complex

Posted on by Millie :)

I think nowadays more and more people are aware that sexism connects with and is compounded by other factors such as racism, economic insecurity, homophobia etc. However few people are aware of the links between misogyny and the psychiatric complex. I’d go a step further and say a majority of people are reluctant to examine or criticise the psychiatric complex at all. However this ignorance is harming the most vulnerable among us at their lowest points, and threatens to affect all of us should we experience a mental health issue (as an estimated 1 in 4 people will every year). So let’s have a brief look at the relationship between misogyny and the psychiatric complex:

Throughout history psychiatry has been used majorly to uphold societal values. As such the history of psychiatry is entrenched with sexism. The most obvious example of this was the epidemic treatment of ‘hysteria’ in women. Hysteria has been described from the second millennium BC, but it was not until Freud – a man – that it was officially considered an exclusively female disease, though it’s important to note women were disproportionately institutionalised for hysteria for hundreds of years before this. It may surprise you to know that it was not until the DSM-3 (the DSM is the leading book used for the classification and diagnosis of mental disorders) that ‘hysterical neurosis’ was deleted. 

The treatment of hysteria can be very generally described as using natural remedies to calm the nervous system until the renaissance period, notably the end of the 16th century. This is also notably where it became considered much more of a ‘female’ disease’. Around this time hysterical women would be treated by a physician interesting their fingers into genital organs to try and produce an orgasm and semen production (which raises serious questions about consent and abuse in the history of psychiatry which still pervade to this day. Some people considered suffering women to be witches or possessed with demons around this time also. For doctors at the time the uterus was their explanation for hysteria in women – claiming it caused them to be psychologically and physiologically inferior.

During the 16th century physicians and philosophers such as Thomas Sydenham, Rene Decartes, and Ambroise Pare started to recognise that hysteria was connected to the brain and other organs also, not just the uterus, but the idea of a uterine, female disease continued. For example, Joseph Raulin in the 1700s suggested hysteria was due to the fumes of big cities, so in theory it could affect both sexes but women were just weaker. 

Perhaps the most famous outbreak of hysteria is the Salem witch trials in 1692. Marion Starkey related it to more contemporary events after WW2 with the theory that classic hysteria was actually a reaction to social conflict and restriction, such as the puritanism in Salem. Note she’s the first woman mentioned. Much evidence would support that mental illness and the classification of it is intrinsically tied to the pressures of the world we live in, notably under hyper capitalist values nowadays, so I would not think it too much of a stretch to think that women during these times under such enormous pressure to conform would present symptoms of hysteria. But they were labelled as mad – their individual character was named as the problem, not as a symptom of a societal issue. And they were labelled mad by men. 

This general hypothesis of hysteria, especially during this period, seems to make sense in the majority of cases when you consider that women could be committed to mental institutions – which were comparable to jails at the time and arguably still are – by their male relatives simply for not conforming to the standards expected of them. The inhumane conditions in many of these asylums are well documented, and I personally think some treatments could be considered comparable to torture. As Angela Davis so eloquently put it: ‘Studies indicating that women have been even more likely to end up in mental facilities than men suggest that while jails and prisons have been dominant institutions for the control of men, mental institutions have served a similar purpose for women. That is, deviant men have been constructed as criminal, while deviant women have been constructed as insane.’

While psychiatry may have changed – yes, in some ways for the better and in some ways just more palatable to a modern society – its roots cannot be ignored as they are the foundation upon which modern psychiatry is directly built and this harm still exists. Let’s have a look at the current day now, through the lens of BPD diagnosis, aka Borderline Personality Disorder. 

Women are disproportionately diagnosed with BPD. There’s a 3:1 female to male ratio in the diagnosis of BPD which is quite pronounced for a mental disorder, and has led to speculation about its cause by professionals. However critics of the diagnosis have gone as far to say it is the modern day version of hysteria – a label extremely loaded with stigma that judges the emotional reactions of women. Think even of the title ‘personality disorder’ – the name itself suggests it is solely an individual issue, a defect of their character, not linked to anything in the outside world.

I write on mental health from a place of personal experience, and I will admit that because of this I am biased in how I view mental illness. There appears to be some research that genetics plays a factor in BPD for example, which would be an individual trait. However I believe it is essential that we also look at how the world as it is is unsuitable for people with that genetic component. Can we answer the question of whether that genetic and neurobiological component would present in the way it does if that individual was not subjected to trauma and systemic pressure? Perhaps not in full. But there is ample evidence that sociocultural factors affect mental illness, and that seems to be so often ignored. 

A sociocultural factor could explain why more women are diagnosed with BPD, as they often experience more pressures in the world to conform, and are more likely to be the victims of violence and assault that contributes to trauma in BPD. However the stigma surrounding BPD stemming from its symptoms may explain this too. Hypersexuality for example is a trait of BPD; being sexual as a woman is still less acceptable than being sexual as a man, so for example a woman’s behaviour may be labelled as hypersexual while for a man it’s just seen as a strong expression of his sexuality, or perhaps not even noticed at all. Likewise anger is also a symptom of BPD, and we are much faster to label women as problematic for expressing anger than we are men. So the social misogyny impacts when we start to consider a person’s behaviour as more than just odd, more than just problematic, but actually disordered. 

It would be unjust to write this article without drawing attention to the disparity in mental health care between races. Like aforementioned, psychiatry and misogyny are intrinsically linked with other social justice issues. If we ignore this intersectionality we are ignoring the full picture. For example, Black women are more likely to struggle with mental health issues, less likely to get treatment, more likely to be misdiagnosed, and more likely to be sectioned (an example of the criminalisation of mental illness, but that’s a story for another day). In fact detention rates under the Mental Health act during 2017/2018 were four times higher for people in the ‘Black’ or ‘Black British’ groups than those in the ‘White’ group, and 29% of Black/ Black British women experienced a common mental disorder in the past week, higher than for White British women or Other White women. Clearly we can see the link between the pressures and pain of racism to the experience of mental illness in Black women, and their subsequent further incarceration and abuse in the mental health industry. Likewise we can see a mirror image effect in the LGBTQ+ population – almost half of trans people (46 per cent) have thought about taking their own life in the last year, 31 per cent of LGB people who aren’t trans said the same. This is not a stand alone issue.

Another example of misogyny in the psychiatric complex is the recognition of neurodiversity in women and trans people. Early autism research was based on white boys from middle class backgrounds. Outdated tests, and a lack of understanding of how autism presents in other races and genders in the general population still result in late diagnosis or misdiagnosis of women and trans people everywhere. And here seems to be a good time to put all of this information into context – the misogyny in the psychiatric complex damages and ends lives. Whether from the trauma of institutionalisation from stigmatised diagnoses, or the pain of leading a life without understanding or accommodations, individuals and communities suffer every day. As a late diagnosed autistic myself I can attest to how painful it is to grow up being bullied, misunderstood, and confused without any path forward. I can’t imagine how different my life might have been if I had known I was autistic and had the resources to help me and my family as I navigated a world not built for me. And I had it easy! 

Yet if we take a look at neurodiversity through the lens of knowledge that gender is a construct, we can see clearly how much the pressures of the world to conform to gender norms affect people. I was taught to be a girl, while autistic. So the way my autistic brain processed that (for lack of a better phrase) was to make me mask so heavily I couldn’t see myself through it all. This is common in those who identify in genders other than male. The world taught me to be a woman and because I learnt to do it, in a system that ignores neurodiverse women, I had no idea how my brain worked. I had no idea who I was, and I was in pain. And to add a little history again, a major leader in the foundation of autism research was Hans Asperger – a man with well associated ties to the eugenics programme of the nazis. Asperger’s and autism aren’t different, but Asperger’s was used to basically say they were more intelligent, and therefore more worthy to society. These messed up roots run deep in all directions. 

However, diagnoses aren’t all great. In fact they can be downright damaging in themselves. As mentioned, a BPD diagnosis is highly stigmatised, and disproportionate in women. Having a diagnosis of any mental health issue or neurodiversity can lead to people’s experience being invalidated. If you’re labelled as mad, how can you ever convince someone you are sane? For one it can be very hard to get out of hospital and escape that system if you are committed, and extremely hard to report any abuses taking place there as they often do because concerns can simply be brushed aside as delusional, symptomatic. Any legitimate problems in interpersonal relationships can be labelled as a symptom. Any very real feeling is simply boiled down to a mental illness. Women – already more likely to experience violence – see their diagnosis weaponised against them when they try to report violence; and people with a mental illness are significantly more likely than the general population to experience violence!

The sexism in society and psychiatry doesn’t just adversely affect women and trans people though. It also affects men who are significantly less likely to come forward if experiencing a mental health issue. In 2021 men were three times more likely to commit suicide than women. And much of this can be traced to the stigma of men expressing emotions in fear of being seen as weak (translate: as fear of being seen as expressing a feminine trait). Everyone, including men, are being harmed by the systems men built. 

And yes, the modern psychiatric complex was built by men. Built on the foundations of male researchers at a time when women were denied an education, and continuing to be led by men. I’ll end on a story about how the DSM – that book used to diagnose mental illness – was created. The DSM-III was the version of the DSM that formulated how we see and diagnose disorders nowadays. It included innovations such as explicit diagnostic criteria and multidimensional diagnostic systems. But the formulation of it was hardly clear or scientific. Robert Spitzer was appointed editor of the DSM 3 and by his own admission the editorial meetings over six years between 1974-1980 were chaotic. New Yorker’s journalist Alex Spiegel reported that the psychiatrists invited would yell over each other, and the loudest voice tended to win out, while no one took minutes. People would yell out names of new diagnoses and possible checklists for symptoms, and if the cacophony in the room seemed to agree it would be typed out, set in stone. The diagnoses in that book still have very real implications for very real people nowadays, and diagnoses are removed and added in each edition following. It’s not an exact science; it doesn’t centre the lived experience of people.

If you take nothing else from reading this article I hope you remember this – sexism is systematic; it affects all of us in all aspects of our lives. But our distress, our joy, our love and our pain? That’s not just symptomatic of a system, that’s symptomatic of being human. 

Sources:

Posted in Advocacy, Happy Notes, Mental Health, Personal Growth

OHN Hopes for 2023 (and beyond!)

Posted on by Millie :)

I struggle with the idea of New Year’s resolutions. After all, New Year’s Day is simply just another day. The sun will continue to rise and there will always be new tomorrows; new opportunities for change and growth – in fact it happens every day. However I do realise that years are markers of points in our lives and our developments, so I wanted to share some hopes and aims for this space in the coming year and beyond! In the interest of transparency, I don’t have a clear plan on how to achieve everything on this list. But I’m working on it. Just like I’m working on learning more and listening to more voices on mental health and its intersections every day. My hopes will change, my perspectives will change. And I am so glad to have all of you along for the ride. 

Thank you all so much for your support of this space and mental health advocacy in 2022. 

If you would like to be more directly involved with Our Happy Notes – whether on the blog, instagram, or something else! – please do reach out. I would love to hear from you! You can fill out the contact form on this website or email ourhappynotes@gmail.com 

So without further ado, here are the hopes for Our Happy Notes in 2023:

1. More tangible actions 

2. More pressures on governments and organisations 

3. Consistent blog posting

4. Regularly get back to how it started – distributing happy notes!

5. Create connections