Expert report provides new insight into nature of mental illness

A week after the government announced its review of mental health legislation, an expert report published by the British Psychological Society's Division of Clinical Psychology on Friday 13 October challenges received wisdom about the nature of mental illness.

The report, Understanding Psychosis and Schizophrenia: Why people sometimes hear voices, believe things that others find strange or appear out of touch with reality, and what can help, has been written by a group of eminent clinical psychologists drawn from eight universities and six NHS trusts, together with people who have themselves experienced psychosis. It provides an accessible overview of the current state of knowledge, and its conclusions have profound implications both for the way we understand 'mental illness' and for the future of mental health services.

Many people believe that schizophrenia is a frightening brain disease that makes people unpredictable and potentially violent, and can only be controlled by medication. However this report - a revised version of one published in 2014 by the British Psychological Society's Division of Clinical Psychology - suggests that this view is false.

Instead, the report says:

* The problems we think of as 'psychosis' - hearing voices, believing things that others find strange, or appearing out of touch with reality - can be understood in the same way as other psychological problems such as anxiety or shyness.

* Thinking of them as an illness is only one way of thinking about them, and not one that is shared by everyone or by all cultures.

* They are often partly or wholly a reaction to the things that can happen in our lives - abuse, bullying, homelessness or racism.

* People who experience these problems are rarely violent. However, unhelpful stereotypes can lead to people getting a poor deal from police and mental health services. If you are black you are particularly at risk. For example, mental health services detain nearly four times as many black people as white people every year.

* No one can tell for sure what has caused a particular person's problems. The only way is to sit down with them and try and work it out.

* Accordingly, mental health workers should not insist that people see themselves as ill. Some prefer to think of their problems as, for example, an aspect of their personality which sometimes gets them into trouble but which they would not want to be without.

* We need to invest much more in prevention by attending to the way we treat each other in our society. In particular, we need to address poverty, racism and homelessness as well as childhood abuse, neglect and bullying.. Concentrating resources only on treating existing problems is like mopping the floor but ignoring the source of a leak.

The report's editor Anne Cooke from Canterbury Christ Church University said:

"We are delighted to launch the revised version of this important report. The amendments address the specific issues experienced by people from black and minority ethnic communities in relation to psychosis, and also the relationship between psychosis and social inequality more generally."

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