Unsuitable cases for treatment

While campaigners call for more acceptance of mental illness, the definition of what it means is being broadened. This, says service user Maureen Sellwood, is having a direct effect on provision for and perceptions of severe mental health conditions

As a long-term user of psychiatric services I have become increasingly concerned about the current trend in health and government initiatives to label everyday stress and even basic unhappiness as mental illness. The latest edition of DSM-5, the psychiatrist’s bible, has included a number of conditions previously seen as commonplace difficulties. They include such things as overeating, gambling, internet addiction and even PMS. Premenstrual stress affects some 50 per cent of women who are apparently now to be included as “suffering from mental illness”.

I have attended counselling groups in my local psychiatric day centre alongside people who are having difficulty getting on with their colleagues at work and those in unhappy relationships. These experiences may be stressful, a certain amount of stress is an inevitable, even necessary, part of human experience – it cannot be compared with severe psychiatric problems.

Charities like Rethink and Mind have campaigned tirelessly to counteract stigma and prejudice against people with mental health problems. They are having considerable success, and can rightly be proud of their achievements. However, in their zeal to depict all of us as dealing with “normal” complaints they have moved the goal posts that define mental illness. Mental illness is a very broad term and, of late, it has become broader still. At one time it would never have been suggested that someone distressed because of a job loss or bereavement was mentally ill.

Although severe stress can play a part in triggering severe mental illness in susceptible individuals, placing human unhappiness alongside conditions such as schizophrenia has resulted in the needs and experiences of people living with serious mental health problems being undervalued. Complex needs are now in danger of being treated with short courses of counselling or even pleasant walks in the countryside – such treatments may be helpful to those coping with the vicissitudes of life but are certainly not appropriate for people dealing with a terrifying life-long condition. When I have been “unwell” as they say, I have, many times in the past, felt compelled to run energitically for miles through city and open fields alike – it didn’t seem to improve my mental health one jot.

Because of those, albeit laudable, initiatives to have mental illness seen as a common and “normal” experience, those of us who are most in need of help are being sidelined, threatened with the loss of benefits and support and left to a life trying to deal unaided with the trauma of psychotic illness.

Ironically, at the same time as this redefinition of what constitutes mental illness is taking place, there is public outcry, fuelled by the tabloids, against “violent mental patients” being allowed to wander the streets. There are calls to have those of us who live with psychosis locked away for life but what we really need is proper care and support, support that is increasingly being denied us as a consequence of a now blurred and hazy definition of mental illness.