Friday, 9 April 2010

Clare Allen: A manifesto for ending mental health stigma

Clare Allen (Photograph David Levene)

Clare Allen is my new hero. And if you read this article you may know why: A manifesto for ending mental health stigma. In it she states that the next government must repeal the law that stops her from standing for parliament on the grounds that she has previously been sectioned and she lists her manifesto for investing in well-being; overhauling the benefits system and giving more to carers.

I was disgusted when I came to this country. Suddenly my very private and chronic struggle became fair game as employers required you to fill in mental health questionnaires at first interviews. In South Africa, you can't be seen to have discriminated on candidates on the basis of age, race, gender, sexual preference, creed or religion; you can't ask questions regarding chronic or mental illnesses at interviews and you're not allowed to ask female candidates about their plans for child bearing.  There are strict equal opportunities laws and a move from affirmative action to Black Economic Empowerment. It is not always applied correctly but the Labour Guide is always there to give you free advice if you feel you have been discriminated against.

I had a wonderful interview shortly after I got to the UK. I had been told I had the job and we discussed my starting date. I was given a piece of paper to fill in before I left - a mental health questionnaire. I answered truthfully, listing my chronic but mild and manageable disorder and was later told by the agent that I was not a suitable fit for the position.

I realised then that I had come from a country where the constitution is based on a charter of human rights, where the questionnaire itself would have been illegal, never mind the decision reached on the basis of it. I never, ever mentioned the disorder again and in fact, this is probably the first time I am mentioning it publicly in the 30 months since I have been here.

Clare Allen is my hero because people like her fight for the rights of the mentally ill and they give them a voice, breaking the silence.


The excellent news and related to the above is that The Equality Bill (2010) was passed through Parliament yesterday and has made pre-employment questionnaires illegal.

“A key issue in the Act is the harmonisation and extension of discrimination law to cover age, disability, sex, gender reassignment, sexual orientation, race, religion or belief and, in many but not all instances, marriage and civil partnerships. ‘Disability related' discrimination will be replaced with a prohibition on discriminating against a disabled person by treating them unfavourably where that treatment is not a proportionate means of achieving a legitimate aim.

Another new provision in the Act prohibits employers asking job applicants questions about their health and whether they have a disability, other than in specified circumstances (including whether the applicant will be able to carry out a function that is intrinsic to the work concerned). Employers will still be entitled to screen applicants about health after making a job offer” - HRMagazine.co.uk.

Finally.  Welcome to the 21st Century Great Britain.

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Sunday, 31 January 2010

Suicide of an Innocent

I wasn’t going to post this and in fact had deleted it before it was scheduled to post last week.  It is uncharacteristic for this blog as it is drawn straight from the vault of my personal experiences.  I’d like to thank Cher at Ask Cherlock for having the courage to speak out about her ssues and for inspiring me to do so too.

Seven years ago today, my friend Angela committed suicide.  To me, the lowest point about that whole time was that I was not surprised and I did not blame her.  There were so many issues at play but I very much knew that something like that was going to happen and yet I had felt powerless to stop it.


"Self Portrait 2" originally uploaded by Skaletto

During my studies in psychology, I learned a couple of very important things.  The first is that not all depressed people are suicidal.  In fact, most of the planning and organising that goes into a suicide is simply beyond the capabilities of a depressed person.  One of the most dangerous times is when a person is emerging from a state of deep depression. 

Many people think instinctively that you should never challenge a depressed person or ask them if they are thinking of suicide.  That is not true.  It won’t put the thought into their head if it wasn’t there already but a person will inevitably falter and not be able to lie convincingly if they have been thinking of it.  Ask them, “are you thinking of hurting yourself?”.  I asked Angela many times and she did not answer, several times.

I knew.

There are lists all over the web about what to say and what not to say to depressed people.  I really liked this list over at Wing of Madness: When Someone You Know Is Depressed.  I love the advice in that list and I especially love the part about “take care of yourself”  Yes, it is good for a depressed person to have positive role models.

I feel that there were no positive role models in Angela’s life but I felt utterly powerless to help her. One of the reasons was that I was actually friends with Angela through her husband and it was him and her family that were the problem.

Her mother had berated and belittled her for Angela’s whole life.  Many people suggested that she got married at such the young age of 21 just to get out of home.  I wouldn’t be surprised.  Angela’s father seemed to think that marriage was all she was good for anyway, despite the fact that she had gone to college and was qualified in her profession.

We all knew how depressed she was and that she was not responding to medication.  Then over Christmas, the staunchly religious and suicidally depressed Angela was left at home alone while her husband was called away on business.  Her story didn’t end there but the seeds of hopelessness and despair germinated. 

The excellent site Metanoia has a wonderful resource to visit if you are feeling depressed called Suicide and it is stated there that "Suicide is not chosen; it happens when pain exceeds resources for coping with pain."

I believe that at Christmas time, Angela’s pain hit new depths and I don’t think she ever recovered from it.

Angela’s friends all tried to invite her over and keep her company over the festive season but to no avail.  In mid-January rumours reached Angela that her husband was having an affair.  This was something he denied vehemently at the time but he is now married to the woman in question so I will let you make up your own minds.

Many South Africans carry guns and the law is that you must safely stow your gun away in a gun safe at the end of the day.  Angela’s husband did not.  They fought about the rumour and she quietly went into the other room, picked up her husband’s gun and shot herself in the head. 

It has occurred to me many times in writing this that he might read it.  I have changed the names and kept private an identifying factors but the story is still recognisable.  I cannot deny that I feel Angela’s death could have been avoided and that many people failed her.  At the end of the day though, no one pulled that trigger but Angela.  The lessons to be learned are clear:

  1. Do not think that you can endlessly berate, belittle or take a depressed person for a fool.  All people have breaking points.
  2. Do not take lightly a person’s depression and know that certain times of the year are worse for depressed people than others.  No depressed person should be left alone at Christmas or other major holidays.  This goes for anniversaries and birthdays too.
  3. Do not keep guns in the house of a depressed person.  If you have to, make sure it is stowed securely the minute you get home and make sure they do not know how to access the safe.
  4. Depressed people are more likely to be paranoid and confused.  Deal with any conflict reasonably and quickly.  Call in a neighbour or family friend if necessary.
  5. Modern medicine works more often than it doesn’t.  I know we don’t like to believe it but anti-depressants work for more people than they don’t work for.  If a person is not responding positively within 6 to 12 weeks, try something else.
  6. Challenge a depressed person and arrange that they are never left alone whilst in a suicidal mood or whilst they cannot deny that they intend to harm themselves*.

Another consideration while writing this was Why?  Why am I writing this and sharing this with the world?  There are a couple of reasons:

  1. People do not understand the nature of mental disorders.  A very controversial example has been the bipolar man that was put to death in China recently.  My own mother, who has seen schizophrenia and bipolar disorder with her own eyes and who studied undergraduate psychology said that if he was well enough to travel, he was well enough to stand accountable for his actions.  I disagreed and not in a very respectful way either.  I will write more on this at a later stage.
  2. In South Africa, there are laws to prevent discrimination against people.  Full stop.  In the UK, it is just dandy, in fact the order of the day, to prevent the  mentally ill from getting jobs, fostering or adopting children or taking jury duty.  I have been shocked and appalled by how the English get away with discrimination here.
  3. That is not okay and I hope to finally have the courage to discuss all of these issues this year.  Mental health issues will therefore feature regularly on this blog in the future.

Do take the time to read the Samaritans’ Myths About Suicide.  There is so much we don’t understand about suicide and yet are we always that surprised when it happens?  Not always…

* Yes, I know, it is not always that easy and suicidal people are often incredibly resourceful and manipulative. Plus, there is the whole issue of whether it is ethical to force anything on a mentally ill person. If possible, speak to the person once the episode is over though and they may tell you that they do not in fact want to die. It is possible then to agree on a plan of action for future episodes.

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