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Thursday, November 4, 1999 Published at 10:00 GMT


Health

Social exclusion: Behind the headlines

Mentally ill people need broad-ranging support, not just drugs

Growing tolerance towards the mentally ill since the Second World War went into reverse in the 1990s, according to research.

Part of the reason is the media's emphasis on so-called community care killings and 'nimby' attitudes, says a major report on social exclusion by the charity Mind.

Mental Health
It cites a 1996 study which found that two thirds of news and current affairs coverage made a link between mental illness and violence.

The Mind report is the culmination of a two-year inquiry into social exclusion and mental health.

It says mentally ill people are more likely to be victims of violence than perpetrators.

Witnessses also spoke of the way heinous crimes were portrayed by the media which they felt fostered social exclusion.

Instead of blaming an individual for "bad" behaviour, reports tended to seek to show them as being "mad".

"There is a danger that morality is being 'clinicalised'. The drive to label all people who commit crimes as 'ill' has a highly stigmatising effect on those diagnosed as 'ill' who do not commit any crime," says the report.

Witnesses said government policy on people with severe personality disorder added to the problem by seeking to treat those who had committed crimes in the same way as those who had not.

Insurance

The Mind report also covers the difficulty people with a mental health problem face in accessing financial and other services.


[ image:  ]
Many have been turned down for credit cards, holiday insurance and even mortgages, it says.

One report found that 25% of users had been turned down by a finance or insurance company.

Some said they had also been turned away by GPs for fear they would be problem patients.

And many said physical illnesses had been dismissed by doctors as being related to their mental health problem.

One woman said: "Every genuine physical illness I have had over the last 20 years has first been dismissed as anxiety, depression or stress."

The report says social exclusion in other areas, such as through racism and poverty, can help trigger mental health problems and shows that the nature of exclusion is "holistic".

Institutional racism also permeated mental health services, according to both health workers and patients.

One study found that Afro-Caribbean men were more likely to be sectioned and less likely to be offered alternatives to drug treatment and electro-convulsive therapy than whites.

The Race Equality Unit said older black people were less likely than whites to get home care services.

The report also pointed out that labelling of mental illness by psychiatric services could make mental illness worse, particularly the stigma attached to it.

Jobs

One of the major areas covered was employment. Only 13% of the seriously mentally ill had a job.


[ image:  ]
"The justified fear of experiencing discrimination at work prevents many users of mental health services from applying for work, and from disclosing their mental health problems once at work," said the report.

However, it says some companies are trying to address the problem and have developed stress policies.

For example, hi-fi retailer Richer Sounds has a stress helpline for staff, discourages employees from working more than five days a week and ensures they take their full holiday allocation.

It also provides free holiday homes for staff and access to the chairman's own private GP which it pays for.

The report says mentally ill people may need extra support to get back to work and wants a national agency to be set up to promote this.

Other strategies it suggests for defeating stigma include monitoring and challenging media stereotypes of the mentally ill, promoting inclusion of mentally ill children in mainstream schools, creating coalitions of agencies to challenge nimbyism and using the arts to foster positive images of mental health.



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Department of Health

Social exclusion unit


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