'It's nothing like a broken leg...'

For me, it's the bit about the state of mental health treatment that rings bells - mostly disregard from underfunding, punctuated by crises, and occasional helpful arrangements like crisis houses. It's very different from the trust you can place in efficient treatment of physical illness or injury.

I recently took part in some qualitative research about anti-stigma campaigns for depression. There is more 'awareness' than there was twenty years ago, but I'm not sure there's much less discrimination. My general impression was that stats don't help, and celebrities only help so long as there are relatable narratives. (We need more public narrative of all kinds, including from Kathy, 54 who works at Morrisons, or the 'Black man ... whose symptoms might be put down to the racist trope of aggression'.) I mentioned the case of a nanny who worked for a psychiatrist and had a one-off psychotic episode precipitated by stress and lack of sleep. The psychiatrist came out with the line about 'all organs of the body can go wrong, why should the brain be any different?' but the woman still had to find another family to work for. There's an assumption that seeing mental illness as of physical origin is destigmatising, but research shows the reverse seems to be the case.

I certainly agree we need more attention to how public policy affects mental health, and there must be recognition about how bad things get. I kind of disagree about 'normalisation'. If it's minimisation and excluding experience of things like psychosis, then yes, that's wrong. Normalisation should however be about understanding, something psychiatry in particular isn't good at. By definition psychiatric medicine is looking for abnormalities: if you have one, this is what's right for you; if you look normal to me, then go away. I'd admit I find it hard to understand and relate to hypomania, although I see most psychosis as anxiety and confusion. The nearest I can get is to imagine skating as fast as possible on thin ice to avoid going through... whether that explains why people are so unaware they're completely over the top, I don't know.

And one thing HJP omits of course is autistic-led training for staff, particularly senior staff.

Cassandro said:

I kind of disagree about 'normalisation'. If it's minimisation and excluding experience of things like psychosis, then yes, that's wrong. Normalisation should however be about understanding, something psychiatry in particular isn't good at. By definition psychiatric medicine is looking for abnormalities: if you have one, this is what's right for you; if you look normal to me, then go away.

Cassandro said:

And one thing HJP omits of course is autistic-led training for staff, particularly senior staff.

Yes.  I admit I thought that's what she meant about 'normalisation', though I was a little unclear on the point she was making.

On that point, and the other one, I've just sent her an email.  I'll be interested to see if she responds, and what she has to say.

Cassandro said:

I kind of disagree about 'normalisation'. If it's minimisation and excluding experience of things like psychosis, then yes, that's wrong. Normalisation should however be about understanding, something psychiatry in particular isn't good at. By definition psychiatric medicine is looking for abnormalities: if you have one, this is what's right for you; if you look normal to me, then go away.

Cassandro said:

And one thing HJP omits of course is autistic-led training for staff, particularly senior staff.

Yes.  I admit I thought that's what she meant about 'normalisation', though I was a little unclear on the point she was making.

On that point, and the other one, I've just sent her an email.  I'll be interested to see if she responds, and what she has to say.