Why we need to turn the spotlight on mental health

AS head of empowerment and social inclusion at the Mental Health Foundation, David Crepaz-Keay is in a good position to talk about ‘living with schizophrenia’, the focus of this year’s World Mental Health Day next week. Perhaps what qualifies him most though, is that he himself has been “living with the diagnosis of schizophrenia” for 35 years, since his teens.

Despite being one of the most common serious mental illnesses, schizophrenia remains one of the least understood; lots of people still associate it with the very damaging – and inaccurate – notion of a “split personality”.

Schizophrenia does involve a range of difficult and distressing symptoms, though, including hallucinations, delusions and paranoia, confusion and behaviour changes. The illness tends to present in episodes – a person might withdraw from usual activities, seem unable to communicate ‘normally’ and feel emotionally ‘flat’, with varying degrees of psychosis.

Symptoms can also be ongoing and constant. However, more than 50 per cent of people diagnosed cannot access adequate treatment; something David, among many others, would like to see change.

“Society has moved a long way in attitudes towards all kinds of things over recent decades, but the way people tend to respond to schizophrenia hasn’t changed much,” he says.

“We’ve seen enormous shifts in the way bipolar disorder is perceived, with high profile people like Catherine Zeta Jones and Stephen Fry talking about their experiences of it, and attitudes have moved on significantly in a positive direction. We just haven’t seen this happen with schizophrenia.”

Understanding of depression has also improved; it’s now regularly discussed in mainstream media and, generally, more openly talked about – but the same can’t be said for schizophrenia.

“If you ask people what the characteristics of schizophrenia are, people will associate it with things like violence. If we only hear about schizophrenics [in the context of] going around with machetes, then you are going to be worried. But around one person in every 100 is diagnosed with schizophrenia, so that’s about 600,000 in the UK alone. If they were all going around committing homicides, you’d notice – it isn’t happening.

“Being more aware of the people with schizophrenia, who are leading successful or even ordinary lives – having families, holding down jobs – that sort of thing, would be very useful for increasing awareness, reducing isolation after diagnosis and helping move us away from that stigma.”

Focusing on managing, rather than “curing”, can actually be more effective. Drugs are important, but even when they’re effective, they don’t “solve” the challenges of schizophrenia, or necessarily do much to help somebody achieve a decent quality of life.

However, self-management can have a positive impact and David believes this should be the way forward. “The ideal approach to treatment is a highly individual thing,” he says. “You come up with your own goals, and then collectively, as part of the peer group, work towards achieving them.”

He believes, too, that being diagnosed with schizophrenia is not a life sentence. “Typically, people are diagnosed when they’re in their teens and twenties, and there isn’t really anything that prepares you for it. It has a devastating impact.

“Part of what we’re trying to achieve is to avoid this notion that the diagnosis of schizophrenia is a life sentence, or a death sentence, because when I was young, it was all about what you can’t do. World Mental Health Day is a really good opportunity to try and encourage people to think positively.”

For more information, visit www.mentalhealth.org.uk