Mental Health: 'You could say I am a mad psychologist'

by Rufus May

30 June 2002

You could say I am a mad psychologist. At the age of 18 I escaped a depressing reality into my own sleep-deprived fantasy world, living at the center of a maelstrom of imagined espionage and spiritual warfare. Over a 14-month period I was hospitalized three times, diagnosed with schizophrenia, put on fortnightly injections of mind-numbing drugs, and told I would have to take them for the rest of my life. Recovery was never mentioned.

To resist this prophecy was hard and lonely work. In fact my recovery was about getting away from the services and off the drugs that purported to help me. I had to rebel to prove people wrong. I was one of the lucky ones. I was always told: "You'll be back." And it is true, I have been back in the system for the past seven years, but in a different role. No longer the schizophrenic outsider, I am now a clinical psychologist practicing in the National Health Service.

I trained as a psychologist because I am passionate about transforming how we understand, and work with, confusion and distress. I am also part of a social movement campaigning for real change in mental health thinking and practice. A growing number of patients, relatives and workers are demanding that society sees people's problems as meaningful and creates real opportunities for recovery.

Those in the "out crowd" are beginning to reclaim their experiences. There are more than 100 self-help groups in the Hearing Voices Network, providing safe places for people to share experiences and make sense of voice-hearing. Many in this movement directly link their voices to experiences of trauma.

Another organization, Mad Pride, turns shame on its head by celebrating the uniqueness of those who have experienced psychiatry as patients. No longer are we silent. We are, as the slogan says, "Paranoid and Proud!" Mad Pride organizes live music events and demonstrations.

In addition, there are a handful of clinical psychologists willing to be open about our experiences of madness, and our numbers are growing. Change is afoot. Professionals are starting to listen to myself and to others who say that good treatment is about sharing power. They also say recovery is possible when it is a holistic process that involves seeing the patient as an equal rather than as a degenerate.

Thinking in the asylum has not changed for 150 years. We write people off as victims of illnesses who must be managed by professionals, rather than looking at the bigger picture, trying to understand the personal and social contexts of their lives, and helping them to grow.

Hospitals are still run like prisons; consultant psychiatrists are still the all-powerful big chiefs. For most of them, psychiatry is not here to heal people; it is here to keep the peace, separate the irrational "town criers" from the rest of society, categorize them and quiet them down. The only trouble is it doesn't work. Drug prescription and suicides are both higher than ever, and recovery rates have been stagnant for a century.

If somebody is hearing voices we don't work with them to cope with the experience and support them to get on with their lives. Instead, we isolate them and dose them up with the latest brand of sedative. The liquid straitjacket has replaced its physical predecessor. Being on such medication is like thinking through syrup. I remember wondering: "How am I expected to recover on this?" To put it crudely: as a society we try to turn distressed and confused people into passive drug-dependent victims. This is not to mention the hundreds of adverse effects on the body that these chemicals cause. The widespread, long-term use of powerful drugs in a heavy-handed way continues to disable permanently thousands who have sought help from psychiatry.

Unfortunately, while the Department of Health brings out documents such as The Road to Recovery that stress collaboration and partnership, the Mental Health Bill further undermines the civil rights of patients to have a say in their care. The void between the fantasy of policy directives and everyday pill-juggling, paper-shuffling practice has never been so vast.

So if you lose the plot and reach the attention of psychiatric services, will they make you madder? I can say that in many cases they will. Can we change that? Yes, I believe so. But then I am pathologically optimistic. For real change to happen we need to alter the core thinking of ordinary mental health workers so that they see patients as people with potential who thrive on the same the things we all do: companionship, understanding and opportunity. Enabling communities are what help people recover, not expensive drugs and professional interventions.

My recovery took off when I found good people to live with, regular activities I could look forward to such as drama classes, and a job as a night-time security guard in Highgate Cemetery. I was lucky; I managed to find places where I could express myself and contribute to society. Excellent mental health services need to have strong links with community centers, colleges and local employers. But projects that make those links struggle financially.

A voluntary project in Tower Hamlets called Beside, which helps build up people's skills and social networks, has just had its funding cut. My own initiative in east London, the Grass Roots Project, supported the setting-up of three self-help groups for people with mental health problems but it has just failed to gain further funding. Instead of giving doctors powers to force people to take drugs in the community as proposed in the Bill, the Government should spend money on helping patients to help themselves.

We who have experienced the spirit-breaking effects of compulsory treatment are demanding the right to be listened to. Our many dissident groups are looking for ways to fight together for a more democratic, recovery-oriented system of care. If our call is not answered, mental health services will remain a social exclusion zone, marshaled by legal drug barons.