Trying to raise awareness of mental health problems


Tomorrow's Day for Life, sponsored by the Catholic bishops, deals with the sensitive issue, writes Breda O'Brien

ONE IN four of us will experience some form of mental illness in our lives. Yet last year's Mental Health Awareness and Attitudes in Ireland Survey found that almost two-thirds of respondents would not want other people to know if they themselves were experiencing a mental health problem. Worse, a study by the National Disability Authority found that only two in five people agreed that people with mental health difficulties should have children if they wish.

Obviously, we have a long way to go. It is particularly appropriate, then, that the focus of tomorrow's Day for Life, sponsored by the Catholic bishops, is on mental health. The annual Day for Life is dedicated to "raising awareness about the meaning and value of human life at every stage and in every condition". The objective this year is to raise awareness of the needs of those affected by mental ill-health, their friends, their family and their carers, and the support that the parish community and professional services can bring.

Stereotypes of the mentally ill dominate, such as the dishevelled person shambling along muttering to themselves. While such people may be in this condition partly through having been failed by services, they constitute a minority of those suffering from mental illness. As the Day for Life pastoral letter states: "The person in your parish community who may be suffering today is the young mum with post-natal depression, the local businessman with stress, your own parish priest, the man who has recently lost his wife to cancer, or the young person who has lost faith in life, as well as someone with an obvious, severe and enduring mental illness."

Despite the fact that mental illness ranges from being mildly debilitating for short periods to being extremely disruptive over the long term, our attention tends to focus on the more serious forms. It is here that inaccurate representations are most likely. For example, people with serious mental illness are more likely to be victims of violence than perpetrators. Schizophrenia is one of the most stigmatised illnesses, but with early detection and appropriate help, people can and do recover, or at least return to a functional state that allows them to contribute to their communities.

Of course, the problem lies in the words "early detection and appropriate help". Despite the fact that there has been a four-fold increase in per capita spending on mental health in real terms in the past 20 years, the share of total public health expenditure has fallen from just under 14 per cent in 1984 to 7.76 per cent in 2007.

A report by the Mental Health Commission suggests that expenditure needs to rise to 10 per cent over five years, but given that mental health was underfunded when we were awash with money, what chance is there of this happening now? Yet money seems to be found for other projects, no matter how ill-advised. Thornton Hall will be an enormous prison campus situated in an area that will be very inaccessible for most prisoners' families. The site was bought by the State for €200,000 an acre despite adjoining sites being sold for one-tenth of that price.

The Central Mental Hospital is to be relocated there, despite strenuous protests from mental health organisations. Prisoners should not be despised and the site is poorly situated for their families, too. However, prisons are a place for those who have committed crime, and any mental hospital situated so close to a prison will automatically be associated in the public mind with criminal behaviour. This relocation is likely to increase stigma, not lessen it.

Mental health is one of those elusive states often only appreciated when lost. Until the 1990s, there was scarcely a language to discuss positive aspects of psychology and how people can maximise their chances of living happy and productive lives. Two researchers, Martin Seligman and Chris Peters, set out to find universal values that contribute to human flourishing. Despite the seemingly impossible nature of the task, they came up with six broad virtues: wisdom, courage, humanity, justice, temperance and transcendence (the latter being the ability to forge connections to something greater than oneself). In an interesting twist, many of the key figures in the positive psychology movement are either atheists or agnostics, but all value the contribution of religion to people's wellbeing. Jonathan Haidt, author of the Happiness Hypothesis, who describes himself as a Jewish atheist, goes so far as to suggest that people should reconnect with the religion of their youth and practise regularly.

Not that religion is a magic bullet to prevent mental illness, given that mental health problems result from a complex mix of biological, social and other factors. Prof Sheila Hollins, former president of the Royal College of Psychiatrists, contributes a podcast on the Day for Life website, (To some people, she is better known as the mother of Abigail Witchalls, who was stabbed in the neck while pregnant. The chief suspect in the attack died shortly after by suicide. Prof Hollins, Abigail and her family forgave the attacker and referred to the suicide as the greater tragedy.) In her podcast, Prof Hollins says that sometimes people feel that if they were only better Catholics, they would not suffer from mental illness or addictions, which is nonsense. The onus is more on those who claim to be practising Christians to overcome their prejudices and act as advocates for those who suffer from mental illness.

Prof Hollins also observes that it can be difficult for people when medical professionals are insensitive to the religious dimension of their lives. For some people, recovery can mean learning to live with a long-term condition, and it is here that a relationship with God can most be a support. As Prof Hollins says, "We as health professionals need to understand that there can be no full health without a person's mental and spiritual health being fully cared for, alongside their physical health."

It may be providential that the Catholic bishops have decided to highlight this issue at this time.