Prof. Matthias Schwannauer
Head of Clinical & Health Psychology, University of Edinburgh
One of the key problems for people with mental ill health difficulties are the often negative perceptions we all hold about mental health – and yet one on 4 of us will experience significant mental ill health in their lifetime.
The societal and perceived stigma associated with so called mental health problems is often more detrimental to the individuals wellbeing, outlook and recovery that the impact of mental ill health itself. stigma and discrimination are closely linked and affect relationships, education and work, leading to loss of income, opportunity and community.
This level of discrimination is evident on an institutional and societal as well as on a personal and interpersonal level – leading to internalised stigma, shame and entrapment. as such stigma and its consequences are more closely associated with negative outcomes of depression and suicide than the experience of symptoms associated with mental ill health. in turn social identification and community buffer well being against the consequences of discrimination.
Current societal and the historical discourse of mental health and mental health care has always been as much about its place in communities and its societal purpose as it has been about the actual provision of care – how we locate and understand all of our mental health and well being mirrors very much our individual and societal values and ethics.
Even though we moved a long way from the asylum and autocratic authoritative care – truly collaborative care and service models of mental health that are shaped by the needs of those who access them remains as true a challenge now as it has been in past centuries and decades.
There is a general paucity of evidence to improve stigma or lessen its negative consequences, increasing knowledge and awareness appear to make little difference to what people think about mental health, but the most robust catalyst for change of perceived stigma and negative attitudes and beliefs towards mental ill health is social contact and community.
So, relationships and interaction with each other is what matters most and that is especially pertinent in the context of mental health and well being. and yet, social interactions, community and relationships are not on the list of treatments and recovery journeys as mapped out by most services.
Gaetano Benedetti, a social psychiatrist instrumental in the Italian movement to close asylum based care, in his formulations of psychological therapy for individuals with major mental health difficulties maintained that social isolation became the main problem for individuals in their recovery and that the community of expression of their creative and intellectual lives one of the key mechanisms to reduce the sense of isolation and create community.
Projects like the one we witnessed tonight truly challenge the us and them of mental health and demonstrate that the interaction and shared purpose is key in breaking down perceptions and barriers.