Ranting Madwoman: Perceptions and Assumptions in the NHS

Someone I know is mentally ill. You could say the same, whether you’re aware of it or not: someone you know is mentally ill. But this rant isn’t about mental illness. It’s about the tendency to label everything about the person with their illness.

When someone is mentally ill, it’s so easy to attribute every problem they have to mental illness. We label people so glibly, and then just read off the labels instead of listening to the individuals we’ve stuck them to. #loony follows them everywhere, and when people see it, they assume it prefaces and influences everything else.

My friend – let’s call him K, because there are Kafkaesque and Kavanish echoes here – has suffered from depression for many years. He manages it with the help of his excellent GP, without medication. He holds down a regular job and has a completely normal life. He’s just someone with a common chronic illness. There’s a lot of it about.

K also suffers from physical problems which keep him in constant pain. Whether you’re mentally ill or not, constant physical pain will get you down. Yet NHS professionals who should know better want to treat K’s pain as a by-product of his depression.

K prefers to keep regular medication to an absolute minimum, so when his GP suggested mindfulness therapy he decided to follow it up. His GP made a referral to the local mental health team, the only gateway to access such therapies in K’s NHS trust. A therapist K had never met phoned and refused to discuss mindfulness therapy. Instead, he wants K to go into group therapy for his depression.

K is already managing his depression. The problem he can’t manage is his constant physical pain. This no doubt contributes to the depression, but is otherwise completely unrelated to it. If the depression goes, the pain will still be there. If the pain goes, the chances are the depression will be reduced.

I repeat: we label people so easily, and then just read off the labels instead of listening to the individuals we’ve stuck them to. A girlfriend had the same kind of problem with a totally different set of doctors a few years back. They kept telling her the symptoms she was reporting were purely because she was overweight. They told her to lose weight and the symptoms would probably go away. She found a doctor who believed in listening to the patient rather than making assumptions, and was diagnosed with multiple sclerosis.

I wish the NHS was more willing to listen now, but it’s still staffed and run in the same old top-down, we’re-the-greatest, doctor-knows-best fashion. It’s not a resourcing issue. All the money in the world can’t fix arrogance.

People with mental illness, or weight issues, or any other problem, walk around in the same kind of body as anyone else. They have the same degeneration, the same vulnerability to accident and disease. When someone says “I’m in constant pain” the proper response isn’t to decide they’re depressed and sign them up for whatever therapy you think appropriate; it’s to listen and believe them when they tell you where the pain is, then treat that.

4 thoughts on “Ranting Madwoman: Perceptions and Assumptions in the NHS

  1. Pingback: 09/27/12 Theme: Health & Illness « life lived now

  2. Pingback: Robert JR Graham » Depression and the Mind

  3. Absolutely bang on. The trouble is that the NHS is in disarray and services are overwhelmed and the therapist being burnt out by demand. Go to the BABCP website and look for an accredited CBT private practitioner. Of course that rather rests on being able to afford to pay for sessions. Email me if you want to discuss ideas.

  4. Pingback: Depression and the Mind - Robert JR Graham

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