Schizophrenia: Public perception

The stigma of the hidden schizophrenia epidemic

 

Henry Cockburn was diagnosed with schizophrenia in 2002. Until then, his father Patrick, The Independent’s award-winning foreign correspondent, knew next to nothing about the illness. But sharing the news with his friends made him realise how many people had had the same experience but kept it secret. Today, in the third instalment of his ground-breaking four-part series, he contrasts the prevalence of mental illness with its stigmatised public perception.

When my son, Henry, was diagnosed with schizophrenia in early 2002 I knew nothing about mental illness. After seeing him for the first time in hospital in Brighton I went online in my hotel room and was dismayed to discover that the US Surgeon-General had said that schizophrenia was to mental disorders what cancer was to physical illness.

Later, I mentioned to close friends what had happened to Henry and found that a significant number knew all too much about schizophrenia because they had a close relative who suffered from it. Looking after a schizophrenic brother or a sister, or, most commonly, a son or a daughter, turned out to be a preoccupation that dominated their lives.

But these same friends had never previously mentioned their struggles with mental illness to me, though I thought I knew them well and they must have known that I was likely to be sympathetic. Some of their stories were appalling. A sister-in-law suffering from schizophrenia poured petrol over herself during a family holiday and took weeks to die from her burns; an apparently happy son at the end of his teens suddenly killed himself; loved ones had their lives ruined by voices and delusions. Accounts were grim but also uplifting, showing again and again the courage, self-sacrifice and endurance of families helping a mentally ill relative.

Why are people so secretive about mental illness – schizophrenia in particular – in a way they are not when a serious physical illness is involved? Why did my friends only speak to me about what had happened to them after Henry was diagnosed with schizophrenia, as if they could only expect sympathy and understanding from somebody similarly touched by a serious mental disorder?

There is the obvious wish to avoid stigma: a consuming fear that a son or daughter known to be schizophrenic will be shunned as an outcast, ostracised socially and unable to get a job. It is a reasonable fear since people are wary of an individual admitting to a mental disorder, though they may express sympathy for the plight of the mentally ill in general. A NHS survey on attitudes to mental illness in 2011 showed that 77 per cent of people agreed that “mental illness is an illness like any other”. But only 25 per cent agreed with the statement that “most women who were once patients in a mental hospital can be trusted as babysitters”.

Advocates for the rights of the mentally ill seek to combat discrimination, intolerance and ignorance. They see these as being fostered by a media that irresponsibly links mental illness to crime and violence, stigmatising the great majority by dwelling on the actions of a sub-group of highly psychotic or drug-abusing individuals. A report by Mind, a lobbying group for the mentally ill, says “there is a common perception that people with mental-health problems are likely to behave in a violent way – a view that is supported repeatedly by films, novels and the media”. The insane, cunning, random killer is a staple of drama in every format and this is a tradition unlikely to change.

Mentally ill people protest that they are, in fact, more likely to be the victim of an act of violence than the perpetrator, and that the great majority of murderers are sane. Of the 5,189 homicides in Britain over nine years between 1997 and 2005, only some 510, or 10 per cent, were committed by people who had been in contact with the mental health services over the previous 12 months. Somebody with schizophrenia might appear to be four or five times more likely to carry out a violent crime than the rest of the population, but studies show that the figures are skewed by a criminalised minority and that 99.97 per cent of people suffering from schizophrenia will not be convicted of serious violence in a given year.

Such statistical evidence may be compelling, but does not in practice determine popular perceptions of risk. The chances of a mentally ill person making an unprovoked attack on a stranger are tiny, but this will not comfort a public accustomed to watching terrifying fictional stereotypes of the insane as portrayed in Psycho or Silence of the Lambs. Ignorance of mental illness, and a genuine scientific bafflement over its precise mechanics, creates a vacuum of information that is filled by melodramas on television or at the cinema.

And when real killings by people with mental disorders do occur they are heavily publicised, thereby reinforcing existing fears which are shown to be not wholly illusory. One psychiatrist says, “It is not the frequency of such murders but their unpredictability that makes them scary”. Another psychiatrist I interviewed said he hoped I could do something to reduce stigma, but he also asked that on no account should his name be published because he feared being stalked by former patients.

A businessman told me that, many years earlier at the height of his full blown psychosis, “I fully intended to go to my grandparents’ home on the south coast because I believed I should kill them to preserve their innocence”.

Campaigners blame exaggerated media coverage of the mentally ill for exacerbating stigma. They quote one journalist as saying, “There is no sexiness in mental health unless someone has committed a terrible crime”.

This is correct, but the media reflects public fears and its exaggerations are scarcely new. Dramatists have been associating murder and madness in England at least since Shakespeare portrayed Lady Macbeth urging her husband to murder before going insane.

The campaign to reduce stigma has had some success, making it more difficult to portray the mentally ill as aliens from another world. But the NHS survey of attitudes to mental illness shows that opinions are slow to change. Some 62 per cent of people agreed in 1994 with the statement that “people with mental illness are far less of a danger than most people suppose” and the figure was exactly the same in 2011. The proportion saying that residents had nothing to fear from people coming into their neighbourhood to obtain mental health services rose from 62 to just 64 per cent over the same period. Perhaps another approach to reducing stigma is needed.

There is also a danger seldom mentioned that, in seeking to emphasise the humanity and normality of a mentally ill person, the catastrophic nature of schizophrenia and other serious mental illnesses is understated.

This in turn may lead people to underestimate the needs of those suffering from psychiatric disorders and the degree to which they are necessarily dependent on others. The deep differences between mental and physical illness should not be blurred. The drive to eliminate stigma will have proved self-defeating if it creates an image of sufferers from psychosis as being less ill than they really are.

Schizophrenia: The shame of silence, the relief of disclosure

Henry Cockburn: If I say I'm schizophrenic people reply, 'So you've got a split personality'

Editorial: We are failing sufferers of mental illness

Henry Cockburn: I like to be liked – and finally I’ve found friends who really like me

Is this the 'tobacco moment' for cannabis?

Henry Cockburn: 'I can hear what other people can't'

Fashion advice from the shrink’s sofa

The demise of the asylum and the rise of care in the community

Henry Cockburn: I was trying to listen to my shoes. I thought I was going to be put in a straitjacket

Life and Style
love + sex A new study has revealed the average size - but does that leave men outside the 'normal' range being thought of as 'abnormal'?
Voices
The Palace of Westminster is falling down, according to John Bercow
voices..says Matthew Norman
Sport
Steve Bruce and Gus Poyet clash
football
Arts and Entertainment
Jake and Dinos Chapman were motivated by revenge to make 'Bring me the Head of Franco Toselli! '
arts + ents Shapero Modern Gallery to show explicit Chapman Brothers film
Life and Style
ebookNow available in paperback
ebooks
ebookPart of The Independent’s new eBook series The Great Composers
Arts and Entertainment
Kurt Cobain performing for 'MTV Unplugged' in New York, shortly before his death
music Brett Morgen's 'Cobain: Montage of Heck' debunks many of the myths surrounding the enigmatic singer
Sport
Brendan Rodgers
football The Liverpool manager will be the first option after Pep Guardiola
Life and Style
life
Sport
Christian Benteke of Aston Villa celebrates scoring the winner for Aston Villa
football
Arts and Entertainment
Myanna Buring, Julian Rhind-Tutt and Russell Tovey in 'Banished'
TV Jimmy McGovern tackles 18th-century crime and punishment
Arts and Entertainment
Paul Whitehouse as Herbert
arts + ents
News
Bill O'Reilly attends The Hollywood Reporter 35 Most Powerful People In Media Celebration at The Four Seasons Restaurant on April 16, 2014 in New York City
media It is the second time he and the channel have clarified statements
News
people
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating
    and  

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    Recruitment Genius: Lettings and Sales Negotiator - OTE £46,000

    £16000 - £46000 per annum: Recruitment Genius: This is an opportunity to join ...

    Recruitment Genius: Home Care Worker - Reading and Surrounding Areas

    £9 - £13 per hour: Recruitment Genius: This is a great opportunity to join a s...

    Recruitment Genius: Key Sales Account Manager - OTE £35,000

    £25000 - £35000 per annum: Recruitment Genius: Have you got a proven track rec...

    Recruitment Genius: Sales Executive - OTE £40,000

    £15000 - £18000 per annum: Recruitment Genius: This is a great opportunity for...

    Day In a Page

    Syrian conflict is the world's first 'climate change war', say scientists, but it won't be the last one

    Climate change key in Syrian conflict

    And it will trigger more war in future
    How I outwitted the Gestapo

    How I outwitted the Gestapo

    My life as a Jew in wartime Berlin
    The nation's favourite animal revealed

    The nation's favourite animal revealed

    Women like cuddly creatures whilst men like creepy-crawlies
    Is this the way to get young people to vote?

    Getting young people to vote

    From #VOTESELFISH to Bite the Ballot
    Poldark star Heida Reed: 'I don't think a single bodice gets ripped'

    Poldark star Heida Reed

    'I don't think a single bodice gets ripped'
    The difference between America and Israel? There isn’t one

    The difference between America and Israel? There isn’t one

    Netanyahu knows he can get away with anything in America, says Robert Fisk
    Families clubbing together to build their own affordable accommodation

    Do It Yourself approach to securing a new house

    Community land trusts marking a new trend for taking the initiative away from developers
    Head of WWF UK: We didn’t send Cameron to the Arctic to see green ideas freeze

    David Nussbaum: We didn’t send Cameron to the Arctic to see green ideas freeze

    The head of WWF UK remains sanguine despite the Government’s failure to live up to its pledges on the environment
    Author Kazuo Ishiguro on being inspired by shoot-outs and samurai

    Author Kazuo Ishiguro on being inspired by shoot-outs and samurai

    Set in a mythologised 5th-century Britain, ‘The Buried Giant’ is a strange beast
    With money, corruption and drugs, this monk fears Buddhism in Thailand is a ‘poisoned fruit’

    Money, corruption and drugs

    The monk who fears Buddhism in Thailand is a ‘poisoned fruit’
    America's first slavery museum established at Django Unchained plantation - 150 years after slavery outlawed

    150 years after it was outlawed...

    ... America's first slavery museum is established in Louisiana
    Kelly Clarkson: How I snubbed Simon Cowell and become a Grammy-winning superstar

    Kelly Clarkson: How I snubbed Simon Cowell and become a Grammy-winning superstar

    The first 'American Idol' winner on how she manages to remain her own woman – Jane Austen fascination and all
    Tony Oursler on exploring our uneasy relationship with technology with his new show

    You won't believe your eyes

    Tony Oursler's new show explores our uneasy relationship with technology. He's one of a growing number of artists with that preoccupation
    Ian Herbert: Peter Moores must go. He should never have been brought back to fail again

    Moores must go. He should never have been brought back to fail again

    The England coach leaves players to find solutions - which makes you wonder where he adds value, says Ian Herbert
    War with Isis: Fears that the looming battle for Mosul will unleash 'a million refugees'

    The battle for Mosul will unleash 'a million refugees'

    Aid agencies prepare for vast exodus following planned Iraqi offensive against the Isis-held city, reports Patrick Cockburn