Depression – ‘them and us’


Sir, – Jacky Jones’s account of misunderstandings surrounding depression is timely and apt (“Do we need to be afraid of people with mental health problems?”, Health + Family, May 12th).

It is imperative not only that misunderstandings about mental ill-health are resolved, but also that continuous improvements in healthcare, social support and political empowerment move to the centre of the political agenda. The physical health of persons with mental illness merits particular attention –men with schizophrenia die 15 years earlier, and women 12 years earlier, than the rest of the population. This is not a result of unnatural deaths – the leading causes are heart disease and cancer. To compound matters, people with mental illness are at increased risk of under-employment, homelessness and imprisonment. This leads to a vicious cycle of social exclusion, diminished wellbeing and political disempowerment, all of which amplify greatly the effects of mental illness.

The solutions lie in reforming legislation (as is currently under way), continually improving mental and physical health care, and addressing social exclusion through an all-of-government approach, in partnership with the third (voluntary) sector, people affected by mental illness and their families.

Once political will exists, change is possible. Mental health reform formed a key element of John F Kennedy’s “New Frontier”, and one of the last pieces of legislation he signed as US president in 1963 was the Community Mental Health Act.

With an election on the horizon in Ireland, it is time to focus similar political attention on mental health care. When the time comes, every candidate, on every doorstep, should be asked, what will you bring to mental health care?

One in four will be affected by a mental illness at some point in life. There is no “them”; there is only “us”. – Yours, etc,



of Adult Psychiatry,

University College Dublin.