"Them and Us" no longer: mental health concerns us all

Three days ago, a new campaign to increase funding for mental health services was announced, and received the backing of several public figures, including politicians, comedians, actors, and sportspeople who have experienced mental health issues in one form or another. The campaign, equality4mentalhealth, was launched by MPs Norman Lamb, Alastair Campbell, and Andrew Mitchell.

The thought conveyed by the signatories in an open letter calling for additional funding for mental health care is that people who need help from services do not receive treatment in a timely manner, and that the resources to help young people when crisis strikes are especially stretched.  It is a “historic injustice” that people with mental health issues are not being supported to the same extent as people with physical health issues.

I would add that stigma may be on its way out, but there is still a pervasive “them and us” attitude dividing people who experience mental health issues from people who do not. Fortunately, this attitude is being increasingly challenged in the media when stories by family members dispel myths about people with complex conditions such as schizophrenia and the absurdity of dressing as a “mental patient” for Halloween is humourously exposed.

It is the “them and us” attitude that needs to change within society at large for individuals, communities, and institutions to recognise that being unwell should never count as a reason for being ignored, neglected, discriminated, marginalised, or laughed at. As my collaborator Michael Larkin provocatively asks: Haven’t we all felt anxious or stressed at times? We all need to take good care of our mental health.

At the University of Birmingham we want to be part of the process that leads to breaking the divisive nature of discussions about mental health. As philosophers and psychologists, we do so by studying the strengths and limitations of the human mind and focus on situations in which people’s thoughts are not shaped by how things happen to be. We run a blog where research on these themes is explained in a clear and accessible way, and comments and questions from a wide audience are encouraged.

In the project I am currently leading, PERFECT (Pragmatic and Epistemic Role of Factually Erroneous Cognitions and Thoughts), funded by the European Research Council, we investigate those reports that are often regarded as marks of irrationality and symptoms of a mental disorder: implausible delusional beliefs, distorted autobiographical memories, attempted explanations of behaviour that do not fit the facts. Although such reports can emerge in the context of schizophrenia, dementia, depression, eating disorders, and amnesia, they are not confined to the large slice of the population who experience mental health issues at some point in their lives.

We all have strange thoughts and make inaccurate reports. Research suggests that we ignore evidence when it does not lend support to our heavily-inflated view of ourselves; we reinterpret memories of failure to feel better about our future chances of success; we see the past as coloured by our current beliefs and values; and we ‘make up’ stories to fill the many gaps in our knowledge of ourselves. The list goes on.

Many symptoms of mental disorders do not differ in kind from such common behaviours and the underlying mechanisms may be very similar. Obviously, beliefs, memories, and explanations are likely to be less constrained by reality if the person also experiences cognitive and perceptual anomalies, memory impairments, and emotional disturbances. The effects of this loss of contact with reality is made worse by the social isolation people experience when they lack the opportunity to get feedback from others, due to the fear of being stigmatised and misunderstood in the home, among friends, and in the workplace.

What the mentally well and the mentally unwell have in common needs to be observed, remarked upon, and studied systematically. This will help us reject the “them and us” attitude, change our individual and social perceptions of mental health, and develop strategies to prevent our widespread irrationality from compromising our wellbeing.

Lisa Bortolotti, Professor of Philosophy