Wednesday, 16 May 2012

Instances of stigma

Just had an email from the Time to Change campaign in response to an enquiry I made. The link to the website is here for you.

Following on from assumptions and to do my bit to encourage more dialogue I thought it time I confessed to some of the prejudice I've personally had to deal with and the associated fears it can lead to.

Prejudices from medical professionals themselves
I am all too aware that some medical professionals in the field of mental health care are not willing to engage with sufferers as if they have anything useful to impart at all. To them we are still very much guinea pigs or laboratory rats. There are others who abuse the mentally ill, precisely because they can and that no one will believe their victims. When I myself was in hospital all those years ago there I witnessed two incidents of grooming patients for sex with those nurses. Those patients reported it and both those nurses thankfully were dismissed, but that doesn't happen in all instances.

We live at a time when there is greater awareness within the profession itself, greater understanding and greater vigilance than ever before, but that does not mean that these things have been eradicated completely or that they ever will be. We can only hope that they will be and hope too that by speaking out as those fellow patients did it will help to put a stop to such things.

In the UK are fortunate because we have advocacy services which are designed to help with things things whenever they are needed from organisations such as Mind and Rethink. There are solicitors too who specialise in defending the rights of the mentally ill albeit all too few of them. So sad though it is that such things still occur, at least there are independent sources of help should you ever need them. The independent part is crucial as even within the NHS, different people in different authorities have different ways of dealing with complaints, some more helpful than others.
But, not all independent people are that independent at all...

Prejudice at work
Later after leaving hospital I reported an instance of a line manager at work bullying a colleague which resulted in my being sent to an independent psychiatrist contracted by that employer under the guise of being part of their Occupational Health team. He reported back that I had made no progress in my mental health since leaving hospital and was possibly getting if anything worse or heading for a relapse. That might have been a half acceptable report if it wasn't for the fact that he had never met me before so could not in any way comment on my condition while I was in hospital, nor did he have access to my medical notes so he was at best guessing and erring on the side of caution to protect his reputation.

Even so it still did not allow for the fact that I was not happy about the incident of bullying which is something he point blank refused to enter into a discussion with me about. What he was doing was laying the groundwork for my employer to get shot of me as quickly as possible in order to save them money. No employer like staff who complain and especially not about something as serious as bullying as it could damage their reputation. Far easier, some employers think to start to discredit the person who complains as quickly as possible. And if you turn into a whistle blower by turning to the media, then you virtually kiss goodbye to ever working again as no employer is ever likely to want to take you on.

Fortunately my own medical team were well acquainted with this particular psychiatrist and his methods to 'help' employers and geared up for a long battle with him. My impression was that it was not the first time they had had to do so.

It turned out to be unnecessary though, as my line manager was subjected to similar treatment at the hands of Human Resource and Occupational Health Teams. Fed up with being treated like that himself, he turned round, held his hands up to his unfair treatment of our colleague and apologised. It emerged that he was anxious about a close relative (a newborn child) who was intensive care and his anxiety inadvertently had found an outlet through verbal intimidation and abuse. The matter was quickly resolved, but not thanks to the employer, their Human Resource Team, Occupational Health or that psychiatrist. Subject any of them to the same thing and how would they feel and react? The workplace is tough for anyone, but need it be made harder than necessary?

Years later, I had a similar run in with a different employer. My health was deteriorating and remembering that earlier incident I risked asking my employer for help. Despite asking for a sabbatical, a reduction in duties, hours and responsibilities and a transfer they did not respond and instead merely focused on how progressively ill I was becoming and the amount of time I was taking off sue to stress. At no point though did it effect my ability to carry out my duties as efficiently as before with regard to customers though, but I was causing great concern and stress to my colleagues most of whom I have to say opted to gossip about how crazy I was. The effect was I clocked up a lot of time off due to stress, and still there was no solution as the key elements which triggered this episode were studiously avoided.

Under British employment law my employer should not have accepted my resignation but they did despite valiant efforts from my Head of Department in my defence to keep me but such can be the might of the machinery of larger organisations who's primary objective is to save the company money. And a again a mental health professional was a company employee - a former mental health professional and specialist from the Maudsley Hospital turned Occupational Health Adviser. The Maudsley has a excellent reputation in mental health care, but sadly it can not be held responsible for the actions of former staff once they leave and later decide to use their knowledge to intimidate others.

What is particularly shocking is that both these employers were Investor in People badges holders so should know that by listening to and providing support to any member of staff when they need it, they in effect, increase the chances of a greater level of commitment, determination and loyalty to them in the long term once that member of staff is better.

The fallout of prejudice
My personal stance now is that it is better to walk away and find another employer than get embroiled in battles of that kind which in themselves are long winded, intensely stressful and extremely distressing which makes them a risk to our mental well being. That above all else this is why things need to change. It is why more advocacy services are needed and why speaking out enables us to reclaim our dignity and self-worth and our rightful place as equal members of society with much to contribute.

Luckily in my quest for better employers I have since been blessed with securing work with two excellent employers, neither of which were Investors in People badge holders but both of which frankly wipe the floor with the some who are. (Please note some Investors in People badge holders are extremely worthy of the accolade). So there is hope, and there are decent folk out there and on balance they outrank the ones who are not so fair and prejudiced these days. Fifty years ago that simply wasn't the case.

Following a redundancy (I was in good company as the head of the organisation made themselves redundant at the same time), I am once again unemployed and I prefer not to risk being employed by another prejudiced employer again. I will only work for the good guys from here on which is one way we can exercise our rights. If everyone took this view the bad guys would learn that it is no longer acceptable to get shot of for example, a cancer victim as soon as they can to save money when they still can and want to continue to work. Prejudiced is not just restricted to the mentally ill. This is the 21st century and there are laws against such practises in this country. Employers beware as the more employees become aware of their rights, the less bad practises will be just ignored, walked away from or glossed over.

However, I also know that from an employers point of view a place of work is not a care home or hospital (even when that is the place of work) for staff. There has to be a cut off point whereby a member of staff is better off sorting out either their health or personal issues out as their priority. Although unemployment itself can be a contributing factor and indeed be the cause of depression and episodes of mental illness we owe it to ourselves to put our health needs first above securing or retaining a job. None of us are any good to anyone if we are gibbering wrecks, what use are we to ourselves if we do not always make our health our top priority?

When we are not working, it doesn't mean we won't ever do so as I myself have proved. Not only did I secure new work despite my ordeals with unhelpful and unsupportive employers, I have gone on to become a manager responsible for recruiting and supporting staff and that was within a year of being unemployed for 3 years following that last horrendous ordeal at work. The delay was due to a further run in the the Department of Work and Pensions for a gross mismanagement of my benefits claim which resulted in my having to beg for food from neighbours and nearly losing my house due to a repossession order which benefits caused due to them not paying me what I was entitled to. It took 18 months to get that put right, but at least they did.

Maybe the records will help improve things. What I refuse to do is dwell on these things when they are over and done with. What I do is get busy making up for these disruptions to my well-being by enjoying life as much as I can when they are not happening. I literally cram in as much pleasure as I can find and spend my time looking for all the things that inspire and bring joy into my life. I simply haven't the time to dwell on part hurts. They occasionally pop back into my memory, but that's fine so long as I don't dwell on all the emotions associated with those bad times to the point that I am feeding negative thoughts and feelings. They drift in and out as sad memories only. I acknowledge them but nothing more.

Time to recognise our strength
We who have been mentally ill should all recognise that we have to develop a resilience to be able to endure it, survive it and recover from it and it's those self-same attributes that can make us extremely valuable as employees and it can equip us to stand up for ourselves when we need to so long as we are well enough to do so at the time. And therein lies the crux of the problem when it comes to the stigma. If we allow ourselves to be brow beaten we cannot defend ourselves, but for most of us we don't want to be fighting or on a human rights crusade, that's exactly the point. We shouldn't have to be and particularly not when we are ill.

One of the reasons I do not openly admit that I have been mentally ill is because I stand a better chance of being treated fairly if I don't. That's the reality. The reason I speak out at all though is partly because I don't want to deny it's happened (as I'm not ashamed of having been ill) but mostly because the taboo about talking about mental illness is so rife that it can hinder or prevent recovery and forming healthy relationships - in some instances it can make the illness far worse or trigger a new episode. As I have said in previous articles, it's not sympathy or concessions I want, it's acknowledgement for the experiences I have lived through in much the same way as a person needs to talk about a car crash that they have survived.

I used to confess to having a mental health history (which by the way is a slight misnomer, we are talking mental illness history, not actually about how mental healthy we are), but no longer do so when applying for jobs. Nor do I mention it at interview, nor when I've started work, in fact not ever if I can avoid it. When I did so, I initially I told people out of a sense of defiance because I knew I had nothing to be ashamed of and in the hope that people would be supportive if I was to become ill again, but the result was always the same, I was viewed as an oddity even in the most supportive environments.

Sometimes this would result in every thought, feeling and opinion being dismissed as 'a symptom of my illness'. And no, it wasn't just the negative, quirky or critical thoughts feelings and opinions either; it was the constructive, positive and happy ones too. I was being denied the right to think or feel anything and everything in some instances. Hardly helpful but ultimately it's those people's loss and not mine as they have missed out on many things that might have been useful to them by being so dismissive of me. In observing their behaviour though, I believe I have missed out on little in that regard. One of our greatest assets can be our awareness of other people's egos.

The other thing that struck me about being open about having been mentally ill, is that it is actually a very odd thing to do with regard to health. It's like saying "hi, I'm appendicitis" as although you mean you have been mentally ill, what people generally do is assume you are and always will be mentally ill. Rubbish! Even people with long standing and permanent conditions such as Bipolar and Schizophrenia often enjoy months of better health and (what I personally find amazing), they often learn to function with the condition just as diabetics do, so much so that no one would never suspect they had any health problem at all if they don't mention it.

In October 2010 the law changed in the UK so that unless it is a reserved occupation i.e. one that is likely to involve dealing with vulnerable people or have some other reason for extra precautions e.g. armed services. It is now illegal to request medical information from jobseekers and/or employees. It is optional now. However, so far most employers still churn out the equal opportunities monitor forms out of sheer ignorance and defiance I suspect as many don't like or agree with the change. If you are applying for a job though it is wise not to take them to task on this and simply fill the form in and lie if need be. Challenge them once you've secured the job so long as you don't want to risk losing it is my recommendation!

The intent is there, but as ever with new laws it needs to work in the real world and as yet there seems little change to the way things were before aside from added paranoia from employers. As a former manager I'd welcome not having the extra paperwork involved in Equal Ops monitoring but is it right to abandon them if it leads to people not really being given a fair chance? Employers with no monitoring on Equal Ops then have license to no longer feel obliged to try to recruit from minority groups at all.

I don't think it is helpful either to our own health or in the campaign against the stigma to always talk about what it is to be mentally ill. It's why I personally no longer participate on Stephen Fry's site as I found there to be a high risk of only ever thinking and talking about illness when I wanted to concentrate on making up for lost time by cramming in all the things associated with wellness.

That said, Stephen Fry's section on Manic Depression can help you not to feel alone and people do share positive experiences about how they have coped, so I commend it for being there as I fully appreciate it helps many people. Had I not joined it I wouldn't have found some new close friends. As with all things, we must each find things that work for us and find our own way. It maybe that if I am ever unlucky enough to become severely ill again I might return there. Nothing is carved in stone, but for now I prefer the path I'm currently on as that is what works for me. My way might not be right for you at all.

The point is that I very much advocate being selective about where and when you mention mental illness and to do so constructively, simply because you owe yourself time out from the whole subject to enjoy life away from it when you can. Nothing more. I'm off to cram in some more experiences away from mental illness now but I know I will be back to not only share some of those things but also to talk more about the complexities that surround mental illness to continue to do my bit to help others still struggling to find their way through their illness.

I close this blog post though with a book recommendation which I would make compulsory reading for Human Resource, Occupational Health departments and Investor in People badge holders. It is about prejudice and has lots of simple exercises to help increase awareness. It's by an acquaintance of mine Robert Ashton who is also a business adviser so if you want a copy, contact him direct please via . Don't worry, if you don't want to start a business you don't have to! I believe there are some free copies available but they are limited and you may have to pay postage and packaging.

The book's title I think is brilliant!


  1. Just to add those two incidents of unpleasant run ins with HR and Occupational Departments indicate to me that recruitment, HR and Occupational Health training either isn't sufficiently good in training or that it isn't sufficiently monitored. Of course the employers, companies, organisations and businesses could be responsible, but actually in these particular cases I prefer to think not because of what they did for their customers and clients.

    To be perfectly blunt I would prefer never to work than be subjected to such treatment again, which would be a shame given my talents, skills, abilities, ethics and overall contributions. However as I said I have since had experience the opposite extreme of total excellence. So whenever I am unemployed my policy is to be selective to find another excellent one.

    This can only be done though, once you have as much belief and confidence in yourself as I have. Not arrogance, just sheer self-esteem.

  2. Just breezed by to add, I have since also had excellent support from the Job Centre when unemployed. So what does that tell us? That there's a need for consistency in standards is all.

    No one minds too much if mistakes are rectified quickly do they?

  3. Just been reading this blogsite...

    I'm not sure if Nikky is in the UK or not, regardless I have added additional links for anyone who is a victim of violence of any sort.

    I hope all my readers will join me in my thoughts for her and her children's safety.

  4. I was amazed to find this paragraph in this context:

    Even people with long standing and permanent conditions such as Bipolar and Schizophrenia often enjoy months of better health and (what I personally find amazing), they often learn to function with the condition just as diabetics do, so much so that no one would ever suspect they had any health problem at all if they don't mention it.

    I can't believe how prejudiced it sounds. What is so amazing?

  5. Hi Anonymous, and thank you!

    It's precisely because I realised that I had been prejudiced myself that I included it even though I have been ill myself. It wasn't until I became ill and met such people that I began to twig how determined and 'normal' the mentally ill really are.

    We all want to be acknowledged for what we can do and not dismissed, ignored and shunned because of our any illness we happen to have.

    I hope that helps explain... Method in my 'madness'. I do and will write in a way to try to provoke logical and sensible thoughts and dialogue on the subject of mental illness.

    Even among the mentally ill, sadly false assumptions are sometimes made.

    Thrilled you commented as I own I am not perfect, don't have all the answers and am only too willing to learn. We learn best through dialogue, and never through evading sensitive issues.

    1. Just need to tweak 'ever' to 'never in that paragraph now! So thank you for that too.

  6. All cool, and I completely agree about learning through dialogue and mistakes. I don't want to meet the perfect person unless of course I was looking for a cure for insomnia.

    I am openly bipolar and there are times when my condition might be obvious to some. However loads of people have been amazed when I have told them and say they would have never known. It is fascinating how people react once they know, it is normally positive but there will always be people that downgrade your intellect as a result.

  7. Hmmm, Anonymous's comment really has got me thinking... mainly that not only are all things dependent on what we encounter but that we often regard people as 'amazing' when we think we couldn't cope in their situation. I certainly feel that a lot. Compared to some, I have had a rotten time of it, compared to others I am conscious I have been extremely lucky.

    All things are relative. To loose my sight or the use of my limbs in some ways would be harder than to loose my mind again through mental illness. The worst moments for me came when I realised I was ill, not when I didn't. And that highlights just how bad the stigma is, as many end up feeling they can not engage with the world again if they have been mentally ill. Not true. You just end up becoming selective about which bits of it you choose to engage with. At least, that's what I've done.

  8. And yes, the down grade in the perception of your intellect is sadly all too common, but it's not exclusively in the realms of mental illness. I've met deaf people, wheelchair users, blind people and people who are just the opposite gender, a different age, a even people from a different ethnicity can and often are subjected to the same. And that's why I've chosen 'I Know Someone Like That' as my personal recommendation for the Time to Change campaign.

  9. The downgrade in intellect does happen but it's more of a reflection on the "stigmatiser" than the stigmatised.

    I have to say that I have had more positive experiences than bad ones. I think positive outcomes when talking about mental illness are only really likely when you are not internally stigmatised. All too often when people talk about mental illness it is apologetic even if they don't realise or acknowledge it themselves. That can actually fuel stigma rather than the desired effect of combating it.

    I came across an interesting study recently done in Istanbul that seems to point to the fact that people with narcissistic personalities are most likely to stigmatise those with mental illness.

    Many would say that I would be justified in applying this label negatively to those who have stigmatised me. We've all felt the pain of stigma and what would be wrong with an eye for an eye and a tooth for a tooth approach? Many would say nothing and part of me agrees but how can I expect people to understand something as complex as bipolar to the uninitiated when I can't take the time to understand what drives them?

  10. I think there is certainly a controlling 'gaslighting' element (see my previous article) to those who are prejudiced in any way. Mostly I believe it comes from a desire from those individuals to feel superior - why is that desire present though? I think too stigmatisation and prejudice stem from a fear of the unknown, things which are outside people's comfort zone.

    Just as we use dark humour to cope with death, so people find dark humour and insults useful when dealing with the mentally ill, all other disabilities, different religions and ethnicities, genders and anything outside what each individual is familiar with. It's become socially acceptable to do so too, but that doesn't make it right. Sometimes people do this to preserve their own health as when any of us are swamped with troubles it can simply be too much to be considerate of others.

    There's a huge difference though between the odd word or comment used as a release value to stress and tension and a deep rooted belief that others are not worthy of respect or consideration at all.

    What often saddens me most, here at the beginning of the 21st century is that the world charges ahead at such a rate it seems that sorting out ethical behaviour can end up as an afterthought instead of being at the forefront of everything we say and do. Resolve that first and we stand a chance of global peace and harmony. Dialogue is paramount, vital and crucial in all things.

  11. Phew, Nikky is still with us... just checked her blogsite and there is the most beautiful poem on there at the moment.


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