“Mental illness may not be your fault. But it is your responsibility.” Medical student Jennifer Pewsey considers if anger is still a mental health taboo?
In 2007, the world made fun of Britney when she shaved her head in the middle of a breakdown. When I was at school, any rumour that someone was self-harming or struggling with an eating disorder would lead to that person being ostracised. Over the past decade, organisations and celebrities have worked to educate people about mental illness and de-stigmatise the diagnoses, leading to a big shift in public attitude. Many people, myself included, are much more open about their personal experience with mental illness. But stigma is far from gone, and in some ways I think it has done a 180; it’s taboo to say anything bad about someone who’s mentally unwell.
About five years ago, I started volunteering with See Me. They have given me the platform to work on mental health policy with NHS trusts, emergency services, and the Scottish Government. I’ve also been able to work with the media and VIPs to try to challenge stigma in a wider audience. I stand by everything I’ve said over the years, but ultimately journalists want the positive, uplifting stories of success.
As I hope you all know by now, contrary to historic belief, people with a psychiatric diagnosis are more likely to be victims of violent crime than perpetrators, something anti-stigma campaigns have fought hard to communicate. But I think it’s disingenuous to claim that mental illness can’t make you act with hostility and aggression towards others.
At my most unwell, I’ve fought police as though my life depended on it (or, more accurately, as though my death depended on it). When I’m struggling to sleep, my brain loves to remind me of the time I forgot to take ID to the post office: it was the final straw that day and I broke down crying and shouting over and over that I needed my parcel. I’ve been that patient who “causes a disturbance” in the emergency department. The post-crisis guilt only increases as I progress through the course, as now those people are often friends, co-workers, and tutors.
When I’ve been suicidal and sought help, people will often pick up on the fact I’m a medical student and say something along the lines of “But you have so much to offer; think how many people you could help if you stay alive”.
I understand why this is a common persuasion tactic, but it makes me wonder if I’m shown more leniency due to my education and career choice. What if I didn’t have anything to offer the universe? I requested a copy of my notes at the start of the year out of curiosity, and they start with the standard “26yo medical student, known to mental health services”. Before they’ve even met me, their mental image of me is very different to “43yo gentleman, NKA”.
These experiences have helped me to empathise with patients who show hostility towards staff, whether that be due to poor mental health, intoxication, or dementia (although I’m not immune from the frustration felt when your help is met with a string of insults). If you feel threatened, of course you’re going to fight back. If you’re suicidal and someone’s stopping you from dying, you’re going to be angry and frustrated. It’s important to remember, however, that just because someone’s hostile behaviour is understandable, it doesn’t make it acceptable.
Something a therapist one said to me has stuck with me ever since; “Your illness isn’t your fault, but it is your responsibility”.
