Miscarriage misconceptions boost feelings of guilt and shame, study says

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causes, guilt, isolation, loss, miscarriage, misconceptions, pregnancy, shame, stigma

Miscarriage misconceptions boost feelings of guilt and shame, study says

Feelings of guilt and shame in women who experience miscarriages are exacerbated by misconceptions over the causes, a US study suggests.

An online survey of 1,084 people, which formed the basis for research published in the Obstetrics & Gynecology journal on Monday, found that almost half of those who had a miscarriage felt guilty. Two in five said they felt like they had done something wrong, and the same number reported feeling alone.

A significant number of the respondents were under misapprehensions as to what caused the loss of the pregnancy. Three-quarters believed that a stressful event could bring about a miscarriage, 64% thought that lifting a heavy object could be a cause, and a fifth that previous use of oral contraceptives could induce pregnancy loss.

Coupled with the fact that 57% of those who had suffered a miscarriage said they were not given a cause for the loss, the researchers, from the Albert Einstein College of Medicine at Yeshiva University and Montefiore Medical Center, both in New York, believe such misapprehensions could contribute to the the negative feelings experienced.

Dr Zev Williams, the director of the programme for early and recurrent pregnancy loss, said: “The results of our survey indicate widespread misconceptions about the prevalence and causes of miscarriage. Because miscarriage is very common but rarely discussed, many women and couples feel very isolated and alone after suffering a miscarriage. We need to better educate people about miscarriage, which could help reduce the shame and stigma associated with it.”

The respondents, who were self-selecting, filled in a 33-question survey, which was open for three days in 2013, to assess perceptions of miscarriage, with 10 of the questions specifically directed at men or women reporting a history of miscarriage.

Of those who took part 15% said they or their partner had suffered a miscarriage, but the majority of respondents (55%) believed that miscarriages are uncommon (defined as less than 6% of all pregnancies). The truth is that miscarriages end one in four pregnancies and are by far the most common pregnancy complication, the paper says.

A fifth of people incorrectly believed that lifestyle choices during pregnancy, such as smoking or using drugs or alcohol, were the single most common cause of miscarriage, more common than genetic or medical causes. In reality, 60% of miscarriages are caused by a genetic problem.

The importance of hearing from others who have gone through the same experience was highlighted by a significant minority of those who had suffered a loss in pregnancy. Almost half said they felt less alone when friends disclosed their own miscarriage and 28% stated that celebrities’ disclosure of miscarriage had eased their feelings of isolation.

The authors concluded: “Patients who have experienced miscarriage may benefit from further counselling by healthcare providers, identification of the cause, and revelations from friends and celebrities. Healthcare providers have an important role in assessing and educating all pregnant patients about known prenatal risk factors, diminishing concerns about unsubstantiated but prevalent myths and, among those who experience a miscarriage, acknowledging and dissuading feelings of guilt and shame.”

The majority (55%) of respondents were women and all were aged 18-49. The sociodemographic distribution across gender, age, religion and geographic location and household income was consistent with 2010 national census statistics but race and ethnicity were not.

My battle with depression and the two things it taught me

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Depression, medication, stigma

My battle with depression and the two things it taught me

It’s often said that depression isn’t about feeling sad. It’s part of it, of course, but to compare the life-sapping melancholy of depression to normal sadness is like comparing a paper cut to an amputation. Sadness is a healthy part of every life. Depression progressively eats away your whole being from the inside. It’s with you when you wake up in the morning, telling you there’s nothing or anyone to get up for. It’s with you when the phone rings and you’re too frightened to answer it.

It’s with you when you look into the eyes of those you love, and your eyes prick with tears as you try, and fail, to remember how to love them. It’s with you as you search within for those now eroded things that once made you who you were: your interests, your creativity, your inquisitiveness, your humour, your warmth. And it’s with you as you wake terrified from each nightmare and pace the house, thinking frantically of how you can escape your poisoned life; escape the embrace of the demon that is eating away your mind like a slow drip of acid.

And always, the biggest stigma comes from yourself. You blame yourself for the illness that you can only dimly see.

So why was I depressed? The simple answer is that I don’t know. There was no single factor or trigger that plunged me into it. I’ve turned over many possibilities in my mind. But the best I can conclude is that depression can happen to anyone. I thought I was strong enough to resist it, but I was wrong. That attitude probably explains why I suffered such a serious episode – I resisted seeking help until it was nearly too late.

Let me take you back to 1996. I’d just begun my final year at university and had recently visited my doctor to complain of feeling low. He immediately put me on an antidepressant, and I got down to the business of getting my degree. The pills took a few weeks to work, but the effects were remarkable. Too remarkable. About six weeks in I was leaping from my bed each morning with a vigour and enthusiasm I had never experienced, at least not since early childhood. I started churning out first-class essays and my mind began to make connections with an ease that it had never done before.

The only problem was that the drug did much more. It broke down any fragile sense I had of social appropriateness. I’d frequently say ridiculous and painful things to people I had no right to say them to. So, after a few months, I decided to stop the pills. I ended them abruptly, not realising how foolish that was – and spent a week or two experiencing brain zaps and vertigo. But it was worth it. I still felt good, my mind was still productive, and I regained my sense of social niceties and appropriate behaviour.

I had hoped that was my last brush with mental health problems, but it was not to be.

On reflection, I realise I have spent over a decade dipping in and out of minor bouts of depression – each one slightly worse than the last.

Last spring I was in the grip of depression again. I couldn’t work effectively. I couldn’t earn the income I needed. I began retreating to the safety of my bed – using sleep to escape myself and my exhausted and joyless existence.

So I returned to the doctor and told her about it. It was warm, and I was wearing a cardigan. “I think we should test your thyroid,” she said. “But an antidepressant might help in the meantime.” And here I realised, for all my distaste for the stigmatisation of mental illness, that I stigmatised it in myself. I found myself hoping my thyroid was bust. Tell someone your thyroid’s not working, and they’ll understand and happily wait for you to recover. Tell them you’re depressed, and they might think you’re weak, or lazy, or making it up. I really wanted it to be my thyroid. But, of course, when the blood test came back, it wasn’t. I was depressed.

So I took the antidepressant. And it worked. To begin with. A month into the course, the poisonous cloud began to lift and I even felt my creativity and urge to write begin to return for the first time in years. Not great literature, but fun to write and enjoyed by my friends on social media. And tellingly, my wife said: “You’re becoming more like the person I first met.”

It was a turning point. The drug had given me objectivity about my illness, made me view it for what it was. This was when I realised I had been going through cycles of depression for years. It was a process of gradual erosion, almost impossible to spot while you were experiencing it. But the effects of the drug didn’t last. By September I was both deeply depressed and increasingly angry, behaving erratically and feeling endlessly paranoid.

My wife threatened to frog march me back to the doctor, so I made an appointment and was given another drug. The effects have been miraculous. Nearly two months in and I can feel the old me re-emerging. My engagement and interest is flooding back. I’m back at work and I’m producing copy my clients really love. Only eight weeks ago, the very idea that I would be sitting at home tapping out a blog post of this length on my phone would have made me grunt derisively. But that is what has happened, and I am truly grateful to all those who love and care for me for pushing me along to this stage.

And now, I need to get back to work. Depression may start for no definable reason, but it leaves a growing trail of problems in its wake. The more ill I got, the less work I could do, the more savings I spent and the larger the piles of unpaid bills became. But now I can start to tackle these things.

If you still attach stigma to people with mental illness, please remember two things. One, it could easily happen to you. And two, no one stigmatises their illness more than the people who suffer from it. Reach out to them.

You needn’t be wrong to be called delusional

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conspiracies, credibility, delusion, delusions, DSM, fixed beliefs, Martha Mitchell effect, mental health issues, paranoia, stigma

You needn’t be wrong to be called delusional

It’s not clear who forcibly sedated her in 1972. It’s not certain that she was admitted to a psychiatric ward in the following year. What’s definite though is that many people thought she was mad as she ranted about conspiracies in the White House during eccentric phone calls to the press. Questions about Martha Beall Mitchell’s sanity were encouraged by the Nixon administration, who consistently briefed against her and probably had her medicated against her will. But ultimately her claims were proven correct when the Watergate scandal broke.

Mitchell was the wife of the US attorney general and saw the planning and cover-up of the Watergate burglaries first-hand. In retrospect, her seemingly paranoid claims made sense and, in her honour, Harvard psychologist Brendan Maher named the Martha Mitchell effect after her to describe the situation where someone is incorrectly diagnosed as delusional but turns out to be right.

But, contrary to popular belief, the relationship between madness and truth is a complex one. They are made out to be strangers but often they are more like distant cousins.

This relationship has recently been acknowledged with the publication of the new version of the psychiatrists’ diagnostic manual (the DSM-5) where one of the most interesting but less noticed changes has been the redefinition of the delusion, a symptom that has long been considered the “basic characteristic of madness”.

Delusions, in the medical sense, are not simply a case of being mistaken, as the everyday use of the term suggests. They are profound and intensely held beliefs that seem barely swayed by evidence to the contrary – even to the point of believing in the bizarre. My heart has been replaced by steam. My thoughts are being stolen by satellites. The government communicates with me through birdsong.

But many delusions are not outlandishly eccentric, they are simply implausible. Consider the scenario where people believe that their neighbours are conspiring against them or that they are the subject of a film star’s secret affections. Occasionally, these beliefs turn out to be true, but this is not a reliable guide to whether someone is delusional or not. This was memorably illustrated by the psychiatrist Andrew Sims, who warned in his psychopathology textbook Symptoms in the Mind that spouses of people with delusions of infidelity may occasionally be driven to infidelity. This romantic betrayal does not suddenly cure their partner of their mental illness.

The general idea is that delusions represent a problem with how you believe – that is, a problem with forming and changing beliefs – not a problem with what you believe. In other words, simply believing something strange or unusual should not be considered a problem but having “stuck” beliefs that are completely impervious to reality suggests something is mentally awry.

On the ground, mental health professionals are often required to decide if someone’s thinking indicates a disturbance in their understanding of the world, and this is where the new DSM-5 definition of a delusion may usher in a quiet revolution in psychiatry. No longer are psychiatrists asked to decide whether the patient has “a false belief based on incorrect inference about external reality that is firmly sustained despite what almost everyone else believes and despite what constitutes incontrovertible and obvious proof or evidence to the contrary”. A wordy and unhelpful definition that has so many logical holes you could drive a herd of unicorns through it.

Instead, the new definition of delusions describes them as fixed beliefs that are unswayed by clear or reasonable contradictory evidence, which are held with great conviction and are likely to share the common themes of psychosis: paranoia, grandiosity, bodily changes and so on. The belief being false is no longer central and this step forward makes it less likely that uncomfortable claims can be dismissed as signs of madness.

And this is where the larger issue lies. As happened with Martha Mitchell, claims against authorities are often dismissed by suggesting that the person has mental health problems.

History is littered with such examples but sadly there are enough contemporary cases to illustrate the point. In a controversy currently rocking Germany, evidence of money-laundering at a big bank has become a huge scandal, not least because it was dismissed as delusional seven years ago when the accuser was diagnosed with mental illness.

Closer to home, when the NHS whistleblower Kay Sheldon reported failings in the Care Quality Commission, the first response was to suggest she had a mental health problem and to commission a psychiatric assessment.

I have no idea whether these people had mental health difficulties but it should have had little bearing on how seriously their concerns were taken. The fact that their claims could be dismissed by allusions to poor mental health is part of the unfortunate stigma that still surrounds the issue. But the stigma goes both ways, and assuming people do not have mental health difficulties because they are correct is the flip side of this.

In the years after Martha Mitchell had been dismissed as delusional, it emerged, contrary to her claims, that she was under the care of her own psychiatrists, drinking heavily and, at times, suicidal. Nixon, for his part, said Watergate would never have happened if it wasn’t for Martha. Both believed that mental illness would undermine her credibility. History, however, came down on the side of truth.

Why should teachers talk about mental health with students and colleagues?

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anxiety, Bullying, career, colleagues, Depression, harassment, management, mental health issues, recovery, secret, stigma, stress, support, teachers

Why should teachers talk about mental health with students and colleagues?

Clare can now talk with calm reflection about the moment she decided to end her life. She remembers feeling as if she were living in a sort of twilight zone where nothing made sense: she was being shunned by colleagues and faced losing her job as a teacher.

Things had spiralled out of control after Clare was signed off work with stress-related depression. When invited back to school to talk about when she might return, managers tried to renegotiate her contract. Clare immediately sought legal advice. “I felt isolated, bullied and harassed.

“My managers were asking other staff members about me and I was becoming increasingly anxious by what was happening. Instead of supporting me and making reasonable adjustments to the fact that I was off with stress, the school’s response was completely punitive.”

Part of the problem is that mental illness in teaching is stigmatised, says Clare. “If you reveal that you are stressed, it is seen as a great weakness – that you are just not up to the job.”

Figures published by the Association of Teachers and Lecturers (ATL) this year showed that more than a third of school and college staff have noticed a rise in mental health issues among colleagues in the past two years. Despite this, 68% kept their problems a secret from their bosses.

In a recent Teacher Support Network survey, the majority of teachers (89%) blamed excessive workloads for their mental health problems, and 40% wouldn’t talk to anyone at work about mental illness because was seen as “a sign of weakness”.

People worry about being seen as not good enough, says Tim, a teacher who retired early due to stress and anxiety. “If you are suffering from work-related stress you are especially reluctant to seek the support of senior management for fear that your complaints could be seen as an indictment of their management.”

David Ambler, ATL district secretary in Birmingham, says mental health problems are also stigmatised because of worries about how this will make a school look. “To reduce the stigmatisation of mental illness requires more than simply a change of attitude among headteachers and senior management in school. It requires a change of attitude among the general public and parents to understand that teaching is a stressful job and sometimes teachers go under or need treatment.”

When Michael was signed off with stress-related depression, he found that some colleagues were understanding but others were not. Teachers worry about the impact of admitting to a mental health problem on their career, he says. The headteacher who employed Michael in his current post said that she was taking a huge risk and put him on a six-month trial period. “Employers are not as sure about mental illness as they would be about physical illness,” he says. “If I broke my leg, for example, and came back to work I don’t think I would be trialled in the same way.”

But this needn’t be the case if the stigma around the issue of mental illness is tackled and the right support is put in place. Rachel, who has experienced depression for years but hasn’t taken time off work, puts her ability to keep teaching without taking any extensive leave down to the support of her senior leadership team and colleagues.

“I am able to talk to all my senior management team and have good friends on the staff who also know and are supportive. My experience of mental health, if anything, has done the opposite of holding me back. But if I had not received the understanding and support I did then I would almost certainly have ended up off sick and probably left teaching.”

Nor is this just an issue of doing the right thing and supporting people experiencing mental health problems – it’s also essential to their recovery. Alison Stark, a senior teacher at a Dutch secondary school, who is off sick with work-related burnout, says there is a more open culture to mental health in the Netherlands.

“The first step is admitting that you have a problem. I talked about my problems with a friend and just being able to say out loud that I am struggling helped me accept things,” she says.

Her school has been patient and supportive – rather than worrying about what to say, colleagues have sent her cards, flowers and message of support. “It is important that schools have a supportive management who are understanding. Headteachers need to support management and create an atmosphere in which teachers can talk about it [mental illness].”

For Stark, the most supportive person has been her deputy head, who has sought solutions by asking her what she needs and what would aid her recovery. “They say, ‘do you want me to allow you home access to email or not? Should I block it and protect you?’”

An openness about mental illness could also help students by ensuring they have positive role models. Kelly, who just started in a girls’ school, is recovering from an eating disorder and used to self-harm. She says stress from teaching can cause a flare-up in food-control behaviours and she has visible scars on her arm. “I am what you could call a normal weight so it’s not obvious I struggled with bulimia, anorexia and excessive exercising,” she says.

Kelly wants to share her experiences to show her pupils that no one should let mental health problems define them, but she worries about the repercussions. “I worry that my school would not be supportive of my talking about my experiences as they would be concerned about the potential backlash from parents. If students mis-reported the story at home some parents may be concerned about my capacity to cope.”

• Most of the names in this article have been changed to protect the teachers who shared their stories.

The Tackling mental health stigma in schools series is funded by Time to Change. All content is editorially independent except for pieces labelled advertisement feature. Find out more here.

Depression doesn’t make you sad all the time

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Depression, happy, myths, sad, stigma

Depression doesn’t make you sad all the time

One of the most popular, enduring, and irritating myths about depression is that it means depressed people are sad all the time – and that by extension, people who are happy can’t be experiencing depression, even if they say they are. It is a skewed and horrible version of depression, and it’s one that further stigmatises the condition and isolates people with depression and related mental health conditions. This is because, put bluntly, depression doesn’t make you sad all the time – though the level of sadness a patient experiences can of course vary depending on the individual and the severity of depression.

When I’m having a depressive episode, I’m not walking around in tattered black clothes, weeping and wailing. I go out with friends. I crack jokes (especially sardonic ones). I keep working, and have friendly chats with the people I work with. I often manage to feed and clothe myself, I read books. Above all, I experience moments of happiness: a flash of delight as I’m walking on the beach with a friend and the sun is perfect and the breeze is just right; a surge somewhere deep inside when I’m surrounded by beautiful trees and it’s raining and I feel my heart swelling to encompass the whole world; a warm, friendly, affectionate sensation at the touch of a friend, a hug at the end of an evening or a hand placed over mine as we lean forward to see something better.

Yet I feel a strange conflicting pressure. On the one hand, I feel like I need to engage in a sort of relentless performative sadness to be taken seriously, for people to understand that I really am depressed and that each day – each moment of each day – is a struggle for me, that even when I am happy, I am still fighting the monster. I feel like I need to darken everything around me, to stop communicating with the world, to stop publishing anything, to just stop. Because that way I will appear suitably, certifiably sad, and thus, depressed – and then maybe people will recognise that I’m depressed and perhaps they’ll even offer support and assistance. The jokes die in my throat, the smile never reaches my lips, I don’t share that moment of happiness on the beach by turning to my friend and expressing joy.

I don’t, in other words, do the things that can help ameliorate depression, encourage people to reach out, and help depressed people with functioning, completing daily tasks of life, and finding a reason to live again. I don’t find and build a rich community of people who can offer support (and whom I can support in turn), because I have to be so wrapped up in performing my sadness at all times to prove that I’m depressed enough – even as I want to scream that this is a reinforcement of stereotypes that hurt people, that by doing this I am hurting not just myself but others.

On the other, I feel an extreme pressure to perform just the opposite, because sad depressed people are boring and no fun, as I am continually reminded every time I speak openly about depression or express feelings of sadness and frustration. I’m caught in a trap where if I don’t perform sadness, I’m not really depressed, but if I express sadness at all to any degree, I’m annoying and boring and should stop being so self-centred. Thus I’m effectively pushed into fronting, putting a face on it even when I am depressed and deeply sad – when I feel like I am choking on my own misery, I put up a cheeky Tweet. When I hate myself and I want to die, I post a link to something fun, or I write up something silly to run somewhere – even though as I write it, I am drawn deeper and deeper into my unhappiness.

Depression is an asshole, and it can become your master, but you can slip out from under it occasionally. And many depressed people in the midst of an episode don’t actually spend it fainting dramatically on the couch and talking about how miserable they are. Some are high-functioning (bolstered by the need to put a face on it), others are into morbid jokes, others try to reach out for help (isn’t that what we’re “supposed” to do?) from friends and try to make their depression less scary. Depression isn’t an all-or-nothing deal – seeing a person who identifies with depression cracking a joke or having fun or dancing with a friend isn’t evidence that the person is faking it, whether the person is experiencing a moment of genuine happiness, or fronting. Conversely, jollying up people with depression to demand that they start being more fun is equally revolting, a refusal to acknowledge that people experiencing a rough day, or a rough week, or a rough few hours aren’t going to be your trained monkeys.

Depression manifests differently in everyone and at different times. Various behaviours are not proof positive that someone is or isn’t depressed, and, as with any armchair diagnosis, insisting that someone is not actually depressed just because of a show of something other than deep, entrenched sadness is actively harmful.

Look at the woman above, joyously cycling on a beach, hair fluttering in the breeze. You can’t judge her emotional state or her larger mental health picture, nor should you.

• This article was originally published on This Ain’t Livin’, part of theGuardian Comment Network

Schizophrenia: the most misunderstood mental illness?

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diagnosis, discrimination, fear, help, media, mental health issues, paranoia, psychosis, recovery, schizophrenia, shame, silence, stereotypes, stigma

Schizophrenia: the most misunderstood mental illness?

Let’s face it, when most people think about schizophrenia, those thoughts don’t tend to be overly positive. That’s not just a hunch. When my charity, Rethink Mental Illness, Googled the phrase ‘schizophrenics should…’ when researching a potential campaign, we were so distressed by the results, we decided to drop the idea completely. I won’t go into details, but what we found confirmed our worst suspicions.

Schizophrenia affects over 220,000 people in England and is possibly the most stigmatised and misunderstood of all mental illnesses. While mental health stigma is decreasing overall, thanks in large part to the Time to Change anti stigma campaign which we run with Mind, people with schizophrenia are still feared and demonised.

Over 60 per cent of people with mental health problems say the stigma and discrimination they face is so bad, that it’s worse than the symptoms of the illness itself. Stigma ruins lives. It means people end up suffering alone, afraid to tell friends, family and colleagues about what they’re going through. This silence encourages feelings of shame and can ultimately deter people from getting help.

Someone who knows first hand how damaging this stigma can be is 33 year-old Erica Camus*, who was sacked from her job as a university lecturer, after her bosses found out about her schizophrenia diagnosis, which she’d kept hidden from them.

Erica was completely stunned. “It was an awful feeling. The dean said that if I’d been open about my illness at the start, I’d have still got the job. But I don’t believe him. To me, it was blatant discrimination.”

She says that since then, she’s become even more cautious about being open. “I’ve discussed it with lots of people who’re in a similar position, but I still don’t know what the best way is. My strategy now is to avoid telling people unless it’s comes up, although it can be very hard to keep under wraps.”

Dr Joseph Hayes, Clinical fellow in Psychiatry at UCL says negative perceptions of schizophrenia can have a direct impact on patients. “Some people definitely do internalise the shame associated with it. For someone already suffering from paranoia, to feel that people around you perceive you as strange or dangerous can compound things.

“I think part of the problem is that most people who have never experienced psychosis, find it hard to imagine what it’s like. Most of us can relate to depression and anxiety, but a lot of us struggle to empathise with people affected by schizophrenia.”

Another problem is that when schizophrenia is mentioned in the media or portrayed on screen, it’s almost always linked to violence. We see press headlines about ‘schizo’ murderers and fictional characters in film or on TV are often no better. Too often, characters with mental illness are the sinister baddies waiting in the shadows, they’re the ones you’re supposed to be frightened of, not empathise with. This is particularly worrying in light of research by Time to Change, which found that people develop their understanding of mental illness from films, more than any other type of media.

These skewed representations of mental illness have created a false association between schizophrenia and violence in the public imagination. In reality, violence is not a symptom of the illness and those affected are much more likely to be the victim of a crime than the perpetrator.

We never hear from the silent majority, who are quietly getting on with their lives and pose no threat to anyone. We also never hear about people who are able to manage their symptoms and live normal and happy lives.

That’s why working on the Finding Mike campaign, in which mental health campaigner Jonny Benjamin set up a nationwide search to find the stranger who talked him out of taking his own life on Waterloo bridge, was such an incredible experience. Jonny, who has schizophrenia, wanted to thank the man who had saved him and tell him how much his life had changed for the better since that day.

The search captured the public imagination in a way we never could have predicted. Soon #Findmike was trending all over the world and Jonny was making headlines. For me, the best thing about it was seeing a media story about someone with schizophrenia that wasn’t linked to violence and contained a message of hope and recovery. Jonny is living proof that things can get better, no matter how bleak they may seem. This is all too rare.

As the campaign grew bigger by the day, I accompanied Jonny on an endless trail of media interviews. What I found most fascinating about this process was how so many of the journalists and presenters we met, were visibly shocked that this young, handsome, articulate and all-round lovely man in front of them, could possibly have schizophrenia.

Several told Jonny that he ‘didn’t look like a schizophrenic’. One admitted that his mental image of someone with schizophrenia was ‘a man running about with an axe’. It was especially worrying to hear this from journalists, the very people who help shape public understanding of mental illness.

Many of the journalists also suggested that through the campaign, Jonny has become a kind of ‘poster boy’ for schizophrenia and in a way, I think he has.

Jonny has mixed feelings about the label. “I hope that by going public with my story, I’ve got the message out there that it is possible to live with schizophrenia and manage it. It’s not easy, it’s an ongoing battle, but it is possible. But I’m aware that I’m one of the lucky ones. I’ve been given access to the tools I need like CBT, but that’s not most people’s experience. Because of our underfunded mental health system, most people don’t get that kind of support. I can’t possibly represent everyone affected, but I hope I’ve challenged some stereotypes.”

As Jonny rightly says, one person cannot possibly represent such a diverse group of people. Schizophrenia is a very broad diagnosis and each individual experience of the illness is unique. Some people will have one or two episodes and go on make a full recovery, while others will live with the illness for the rest of their lives. Some people are able to work and be independent and others will need a lot of support. Some people reject the diagnosis altogether.

What we really need is a much more varied and nuanced depiction of mental illness in the media that reflects the true diversity of people’s experiences.

What I hope Jonny has managed to do is start a new conversation about schizophrenia. I hope he has made people think twice about their preconceptions of ‘schizophrenics’. And most importantly, I hope he has helped pave the way for many more ‘poster boys’ and girls to have their voices heard too.

For more information, visit Rethink Mental Illness

*Name has been changed

 

Facing up to rape: Victim speaks out about the ‘faceless’ crime

Tags

anxiety, attention-seeking, awareness, educate, embarrassment, fear, humiliation, powerlessness, rape, report, sexual assault, sexual harassment, Sexual Violence, shame, stigma, violated

Facing up to rape: Victim speaks out about the ‘faceless’ crime

Up until two weeks ago, Francesca Ebel had never told anyone in her family – or indeed most of her friends – that she had been raped. Yet she has now gone public, and the response has been overwhelming.

There were no dark alleys or threats of knives. There were no dodgy areas of town or even strangers involved. And that’s the whole point, explains the 20-year-old student, who is in her first year of studying Russian and French at Cambridge University.

“It happened three years ago. I was 17 and at a party. I got drunk and so friends helped me up the stairs and into bed. It was there that I was awoken by a crashing noise and burst of white light. I realised that someone was wrenching back the duvet and clambering on top of me, frantically pressing his lips to mine. Then my legs were pulled apart and I felt a sudden, tearing pain.”

Even in her drunken stupor, Francesca knew instinctively that something was very wrong and tried to shove him off. She even said “No”. More than once. “But he ignored me, breathing heavily in my ear.”

When it was over, Francesca stumbled outside, to find him smoking and laughing with his friends, and in the days afterwards, he boasted and joked about their sexual encounter.

Suspecting that she would be branded, at least by some, as an attention-seeker and a liar, she did not accuse him of rape. In fact, even when she confided in a close friend, it didn’t occur to her to use the word rape. “How could I claim to have been raped when ‘rape’ conjures up such violent images? How could my experience possibly parallel brutalities such as gang-rapes in India? It was unthinkable. Mine was not a violent rape; my rapist’s motives were not hateful or destructive. Furthermore, I felt embarrassed, ashamed and humiliated. So I put it behind me and got on with my life.”

And to a large extent, she succeeded. “Thankfully, my enjoyment of sex has not been affected and I’ve flourished in functional relationships. So how could I even begin to claim to identify with other victims’ experiences?” she says.

But about a year ago, when Francesca was in a relationship with a lawyer, she told him what had happened. “He stared at me and said: ‘You do realise that that is legally rape. You said no and that you didn’t want it to happen’. It was the first time I saw things clearly.”

Shortly afterwards, Francesca started university and was struck by how many other women, including a close friend, talked about similar experiences – something that certainly doesn’t surprise Rape Crisis, the charity, which claims that an estimated 90 per cent of those who experience sexual violence know the perpetrator in some way.

“There was a major survey that came out last month, which found that more than one in 13 women at Cambridge University had been sexually assaulted and that the vast majority – 88 per cent – did not report it,” Francesca says. “The study got people talking about their own experiences.”

According to the survey, women at the university are routinely groped, molested and raped. Like Francesca, one of the rape victims explained that she did not report her attacker because she thought that nothing would come of it. “I have no reason to believe that my report will be taken seriously, be investigated or result in a conviction. On the contrary, I have every reason to believe that he would be acquitted,” the woman stated. A couple of weeks later, an article appeared in the Cambridge Tab – of which Francesca is news editor – on what to do if you are raped. “We had run a few anonymous stories of sexual assault in our publication, but this one, which was written by the brother of a rape victim, really got to me, because it listed all of the things that I wish I’d done at the beginning. Suddenly, I just felt sick of this feeling of frustration, powerlessness and stigma about what had happened to me and so many others, and I felt a need to speak out. So I did.

“By storing the incident up inside me, I had let it gnaw away at me – the questions, anxieties and fury had built up to a level which was almost intolerable,” she explains. “And perhaps most critically of all, I wanted to turn a negative experience into something constructive.”

Francesca’s article appeared in the next issue, on 17 May, titled “There are people behind recent rape statistics and you must take their stories seriously”. What followed the headline was a candid, honest and brave account of her own experience, together with a plea for readers to recognise that behind stories of rape and sexual harassment, there are people who have to carry on with their lives and come to terms with what has happened, no matter how violent or “ordinary” their experience.

“Rape can happen to anyone at any time and I hoped that my story would demonstrate that,” she explains. “I also wanted to shed some light on why it is so hard to report an incident, and finally, I want to educate and initiate. Rape is not just confined to shady, impoverished corners of the globe; and it has to stop.”

It would have been far easier to write it anonymously, she admits. “Speaking out about rape has its consequences, not just for the person themselves, but for their family and friends. But there are too many faceless victims. I wanted to put a face to a story that has happened to so many people. I’m not disparaging anonymity in any way, but it does depersonalise the issue and I think that, as a result, people often don’t realise that rape is so common.”

Almost instantly, the article went viral, having had more than 28,000 views so far. Francesca has also been inundated with private letters and comments online, mostly from women who tell similar stories.

“It has been chilling to see the same story told again and again, and they all say the same thing – that they were full of self-doubt and fear of being labelled as an attention-seeker or that they wouldn’t be believed. Many, like me, don’t see themselves as a victim or the incident as defining them, but it has nonetheless affected them hugely.”

The responses also revealed just how frightened people are of reporting it. “Many of the women explained how they couldn’t face the trauma of the very system that is meant to protect us.”

Others wondered if it would even get to court – and with just 6 per cent of cases reported to police ultimately ending in a conviction, according to Rape Crisis, who can blame them?

“For reasons I can’t express even to myself, I have no current plans to report my case,” Francesca says. “But actually for me, what has been most empowering is to have gone public, to have helped raise awareness of both how ‘normal’ this is and how harmful it is.”

On reflection, Francesca’s original fear of attention-seeking has a certain irony: “I am certainly seeking attention now. That night, I was forced to share a level of intimacy which I usually reserve for the people I trust and care for. I was violated against my will, by a friend who unfortunately remains on the periphery of my life.

“Rape is incredibly complex and can have devastating consequences, whatever the situation. Right now, there is a critical and pressing need for us to broaden our understanding of the issues and educate future generations on the nature of consent.”

Lack of support for parents who live in fear of their teenagers, study shows

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domestic violence, parenting, parents, shame, stigma, support, teenage violence, Teens, violence

Lack of support for parents who live in fear of their teenagers, study shows

Parents living in fear of their abusive and violent teenagers are being left without support because of a lack of understanding of adolescent violence directed at parents, according to the first academic study into the issue.

Data from the Metropolitan police revealed that there were 1,892 reported cases of 13- to 19-year-olds committing violence against their own parents in Greater London alone over a 12-month period from 2009-10.

Dr Rachel Condry, lead researcher at the University of Oxford, which carried out the study, said there was little support for parents in such circumstances from police, youth justice teams or other agencies.

“The problem has, until now, gone largely unrecognised, which can mean that parents can find it very difficult to get help,” she said.

“The parents we spoke to said they were stigmatised and felt ashamed – they were experiencing patterns of controlling behaviour that were similar to domestic violence. One woman told us she would get up in the middle of the night to make her teenager dinner because she feared the consequences if she didn’t; others talked about walking on eggshells.”

Britain’s incoming director of public prosecutions, Alison Saunders, warned last month that teenage violence in the home was a hidden aspect of domestic violence: “There is a lack of respect and a lack of regard for authority. When I was growing up the thought of striking a parent was beyond the pale. Is that peers? Is that TV? Is that the general environment in the house? You are not born to commit domestic violence.”

Nicola, a mother in West Yorkshire who did not want to be named, said her daughter first started to behave violently towards her when she was 13. “She’d push me, punch me, lose her temper and smash the house up – it got to the stage where I was scared stiff,” she said.

“I thought it was me, my mothering skills. People were asking me why I couldn’t control her, but what was I supposed to do? Beat her up?”

Nicola was sent on a parenting course, but felt there was no one to help her. “I’ve got three other kids and none of them were like this – it wasn’t like I didn’t know what I was doing,” she said.

The study, co-authored by Caroline Miles, found that 87% of suspects in the London study were male and 77% of victims were women, although fathers could feel more reluctant to report the issue, said Condry.

The study found that, in the reported cases analysed, 60% of victims were classified as white European, while 24.3% were African-Caribbean. It says: “Families reporting adolescent-to-parent violence are likely to be at the lower end of the socioeconomic scale”.

Of those who recorded a profession, 46.7% were unemployed, 11.6% described themselves as housewives, while 3.4% were teachers and 2.9% were nurses.

Condry said it was a problem that could hit families in any demographic. “It is not the fact of being a single parent that is causing this issue, but parenting an adolescent is difficult and perhaps if a parent is on their own there is more potential for things to go awry.” The study found that a range of issues, including exposure to domestic violence, peer influence, mental health issues and drug problems had played a role, but there was no one reason for adolescent violence against parents.

“There may be issues around what we think of as poor parenting but many families we spoke to did not have those type of histories – that is uncomfortable for society, but we have to get a handle on the complexity of this issue,” she said.

When asked what she thought had provoked her daughter’s behaviour, Nicola said: “She has always seen me dominated, but I’m having counselling now and I’m starting to stand up for myself.”

Eventually she got support from the Rosalie Ryrie Foundation, a charity that deals with family violence. “They were fantastic; they showed me different techniques and it’s much better – she still loses her temper but she’s not as violent,” she said.

“It’s hard to ask for help. Other people should remember that it’s easy to say stand up to them, but it’s much more difficult when you are in that position.”

Condry said: “We want our victims to be entirely blameless. We think parents should be in control of their own children – but this is not an issue that can simplistically be blamed on bad parenting.”

Domestic violence: ‘As a man, it’s very difficult to say I’ve been beaten up’

Tags

abuse, domestic violence, embarrassment, men, partner abuse, stigma, taboo, violence

Domestic violence: ‘As a man, it’s very difficult to say I’ve been beaten up’

An inch under six foot tall, Dave, a gardener with a deep, gravelly voice is not most people’s idea of a domestic violence victim. But he suffered two years of abuse at the hands of his girlfriend and was too embarrassed and loyal to report her to the police. He slept in his car for weeks before speaking to his local council, who found him a place at a men’s refuge.

He struggles to keep it together when he recalls the day his girlfriend smashed a bottle of Jack Daniels across his head, leaving him bleeding on the pavement: a deep scar is still clearly visible on his forehead. But when the 45-year-old from Essex describes the relief of being believed by the authorities, he breaks down, his broad shoulders heaving beneath his rugby shirt.

“When help finally comes it’s an emotional thing,” he says, sitting on the sofa at a safe house in Berkshire where he is being helped to rebuild his life. “As a man, it’s very difficult to say you’ve been beaten up. It seems like you’re the big brute and she’s the daffodil, but sometimes it’s not like that.”

He is one of the lucky few to get help. His refuge has two new requests every day to take in men from across the country who are fleeing violence. The home, which can accommodate three men and their children, is already full.

One in three victims of domestic abuse in Britain is male but refuge beds for men are critically scarce. There are 78 spaces which can be used by men in refuges around Britain, of which only 33 are dedicated rooms for males: the rest can be taken by victims of either gender. This compares with around 4,000 spaces for women. In Northern Ireland and Scotland there are no male refuges at all.

Alan Gibson, an independent domestic violence adviser for Women’s Aid which runs the men’s refuge in Berkshire that is helping Dave, said: “Four organisations phoned us today looking for places for four different men. They’ve been attacked and abused, but there is only one room available in the country and someone will have to decide which of those four men is most in need.”

More married men (2.3 per cent) suffered from partner abuse last year than married women, according to the latest British Crime Survey. Yet help is still much harder to find for men.

Mark Brooks, chairman of the men’s domestic abuse charity, the Mankind Initiative, said: “Support services for male victims remain decades behind those for women. This is not helped by the Government and others having a violence against women and girls strategy without having an equivalent for men. Everybody sees domestic violence victims as being female rather than male. This is one of Britain’s last great taboos.”

The Mankind Initiative helpline receives 1,200 calls a year from men or friends and family calling on behalf of men. Stigma and fear of being disbelieved, among other factors, make men much less likely than women to report abuse to the police. The British Crime Survey found that only 10 per cent of male victims of domestic violence had told the police, compared with 29 per cent of women. More than a quarter of male victims tell no one what has happened to them, compared with 13 per cent of women.

The human cost of ignoring the problem is stark: 21 men were murdered by a partner or former partner in 2010/11.

Kieron Bell very nearly became one of those grim statistics. He is also one of a handful of men who has successfully prosecuted a partner for violence. The 37-year-old bouncer from Great Yarmouth, Norfolk, had to have emergency heart surgery after he was stabbed in the chest by his wife, Sarah, in 2009. She had been violent since the start of their marriage in 2006 but he did not want to turn to the police at first, initially because he still loved her and later because he thought they would never believe that a 5ft 2in woman would be subjecting a bulky 5ft 10in bouncer to a reign of terror.

After the stabbing, his wife tried to claim that Mr Bell fell on a knife but, while recovering in hospital, he decided to report her to the police. In 2010 she was charged with grievous bodily harm and was released from prison only in May last year. “I was scared to call the police. I’m a big bloke and I thought I’d get laughed at,” he said. “I think there needs to be more information out there for blokes. If I’d known what the signs to look out for were before, I could’ve done something sooner. But I loved her and because of my child I stayed with her.”

Nicola Graham-Kevan, an expert in partner violence at Central Lancashire University, said: “Society is blind to women’s aggression. The biggest disparity is women’s ability to seek help which makes men very vulnerable to false allegations. People often won’t believe that men are victims. Men have to be seen as passive, obvious victims with clear injuries, whereas, if a woman makes allegations, they are believed much more easily.”

Dr Graham-Kevan believes the system needs to adjust to make it safer for male victims and their children, who can end up with an abusive mother. “The biggest thing for me as a parent is that children are being placed in significant positions of harm. It sounds anti-feminist, but I think we’re allowing women too many rights in the family court, because courts assume that the women are the best parent as a starting position, rather than looking at it equally.”

A Home Office spokeswoman said: “We recognise that men are victims of domestic violence, too, and they deserve protection. In December 2011, the Home Office set up the Male Victims Fund to support front- line organisations working with male victims of sexual and domestic violence. We also fund the Male Advice (and Inquiry) Line.”

Names have been changed to protect identities

‘My wife attacked me 11 times. I didn’t think the police would believe me’

Tim, 59, has severe learning difficulties and is now living in a men’s refuge in Berkshire after his wife assaulted him repeatedly during their short marriage

“My wife attacked me 11 times through our marriage. We were married for 18 months, but, being a bloke, you don’t know where to go to get help.

“She tried to strangle me and she used to bite me. She also stabbed me in the hand with a fork. I’d been on my own for 14 years and she seemed like the right woman for me when we got together.

“The violence started in the first three months of the marriage. She would go for my throat if I wouldn’t do certain things.

“She wouldn’t let me see anyone. My family were trying to help me cope with my disabilities, but she wouldn’t let them come round. On New Year’s Day, she threatened me with a knife and I was frightened. Then the other day she tried to strangle me again.

“My sister said I should call the police, so I did.

“I didn’t think the police would believe me because she always seemed to twist things, but they want me to press charges and make a statement now.”

Mental health of Iraq and Afghanistan reservists causes alarm

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army, army reservists, civilian life, discharge, isolation, mental health issues, military personnel, needs, PTSD, risk, stigma, suicide, support, support networks, veterans, welfare

Mental health of Iraq and Afghanistan reservists causes alarm

Ministers must find more money to support thousands of army reservists as evidence grows that part-timers who served in Iraq and Afghanistan are more likely to suffer from serious mental health illnesses than regular soldiers who served alongside them, two leading military charities are warning.

Amid concerns there will be a sharp increase in the overall number of veterans needing expert help over the next five years, the Royal British Legion and Combat Stress say the government must focus on the so-called “weekend warriors” who have become a mainstay of British military operations and will be used to cover deep cuts to the full-time army.

The charities say reserves who fought abroad in recent years are twice as likely to develop serious mental health issues, such at post-traumatic stress disorder (PTSD), but they return to civilian life without proper support for themselves or their families.

The warning comes as some charities have reported a marked rise in the number of veterans coming to them needing help. At the start of a major series in the Guardian on the Iraq war, one former major general said he feared a “bow wave” of new cases would emerge over the next decade.

With the Ministry of Defence wanting to double the number of reservists to 30,000 over the next five years, Chris Simpkins, the director general of the Royal British Legion, and Commodore Andrew Cameron, chief executive of Combat Stress, said: “There is now a pressing need to seriously address the support requirements of reservists and their families.”

In an article for Comment is free, Simpkins and Cameron said: “We must work with the reservist community to raise awareness of mental health conditions and reduce the stigma associated with admitting to mental health issues … we are very clear that now is the time to develop resources, and we suggest that communities and health services that have increased numbers of reservists must receive more funds.”

Drawing on studies by the King’s Centre for Military Health Research, the charities say there is strong evidence to suggest reservists are more prone to mental health problems.

A five-year study of more than 500 reservists who served in Iraq showed they were twice as likely to get PTSD compared with regular soldiers. The report said reservists had “significantly elevated rates of common mental disorders” and warned that “rates of mental illness may continue to rise in the months and years after reservists have returned home”.

The charities say: “The reasons behind this increased risk aren’t fully known but … the differences between support networks for regulars and reservists may provide an answer.

“Unlike their colleagues in the regular forces, reservists do not have an extended period of time surrounded by their peers when they return home from duty, and often swiftly return to their civilian role, without the opportunity to share experiences with others who have served alongside them.

“These support networks are hugely important and the Royal British Legion and Combat Stress, alongside other armed forces charities, are working to minimise social isolation and improve integration between civilian and military life in the reservist community.”

Although UK forces pulled out of Iraq three years ago, and will have left Afghanistan by the end of next year, concern about the welfare of veterans is increasing, with some charities noting a sharp rise in referrals.

The most serious mental health problems, such at PTSD, often do not present themselves for a decade. Cameron said Combat Stress was still getting referrals from men who had served in Northern Ireland.

The charity registered a 29% increase in the number of Iraq war veterans it helped last year, bringing the total to 1,231. It is treating almost 500 Afghan war veterans – there was a 71% increase in the number of new referrals last year.

Major General Tim Cross, who served in Iraq, told the Guardian the problems faced by ex-servicemen would increase as the decade wore on. “I think we are building up. I’ve said for quite a while we [have] got a bow wave coming. PTSD on average takes about 11 years to really show,” he said. “A lot of the Falklands veterans have gone through really difficult times and they now say, I think it’s probably true, more Falklands guys have committed suicide than died during the campaign.”

A similar delayed reaction would happen with Iraq and Afghanistan, he said.

The MoD has set aside £7.2m to improve services for veterans and the government has appointed Lord Ashcroft to conduct a review focusing on the needs of military personnel as they undergo the transition to civilian life.

According to MoD statistics, 964 service personnel were medically discharged in the past five years suffering from mental and behavioural disorders – the second most common cause for discharge.

Of these, only 195 were suffering with PTSD. Though officials say the prevalence of this condition within the armed forces is roughly the same as the general population, there is suspicion among charities, and veterans that this does not reflect the true extent of a problem that might take years to develop.

Professor Marilyn Flynn, an expert on mental health issues in the military, said there was little incentive for serving personnel to admit they may have a problem: “If you say you are not fine, you go into limbo. There is no incentive to admit you might have a problem. You are neither one thing or another. There is a tremendous incentive to say that you are fine.”

Cameron said: “Do we need to do more for veterans? Yes. Can we do more? Probably. Can the charities do it themselves? No. A broken arm is obvious and easy to treat. A broken mind is not.”