Dr Lade Smith CBE, President of the Royal College of Psychiatrists, warns that outcomes for people with severe mental illnesses (SMI)1, will only get worse unless society champions their right to acceptance and support. She said:
“People with severe mental illness are discriminated against every day. They face outdated and old-fashioned stereotypes and tropes, which are simply wrong. Discriminatory attitudes have us believe that an SMI is somehow a negative character flaw, intrinsic to who people are, that can never be changed, rather than an illness that can be treated.
“Internalising this discrimination makes it much harder for people to accept their condition and believe they can be helped. Ultimately, this contributes to them delaying seeking treatment, and increases the risk of crisis.
“The reality is that people with SMI are some of the most marginalised and vulnerable in our society. Too often they are treated as pariahs - shunned and excluded. This makes it really hard to find employment, have meaningful relationships, and secure somewhere safe and comfortable to live.
“They are also significantly more likely to die by suicide, and have a life expectancy that is 15-20 years lower than the population, because of avoidable physical health conditions.
“This is a travesty. There are highly effective treatments that can help the majority of people with SMI get well. With holistic care that provides psychological and lifestyle support, including treatment for any associated substance use issues, they are also more likely to stay well.
“We cannot sit back and expect people living with conditions like bipolar illness, schizophrenia and other types of psychosis to constantly overcome barriers that society has put in their way. A concerted effort is needed to stamp out the discrimination against people with SMI, so they can achieve their potential, and have fulfilling lives, like everybody else.”
Bipolar disorder affects around 2% of the population (1.3 million people), and schizophrenia affects around 1% of the population (669,700 people). High-quality treatment that is safe, timely and therapeutic can reduce the duration of episodes and minimise relapses.
Treating people early is key to preventing lives from being cut short. It reduces the risk of crisis, improves long term outcomes, enables people to live a full life and engage in and contribute to society.
The President of the College is speaking out as urgent change is needed to tackle this discrimination. She is calling for everyone to take a moment to reflect on their own attitudes towards severe mental illness and strive for a more compassionate point of view.
Graham Morgan, 61, works to improve the lives of people with mental illness, having been diagnosed with schizophrenia aged 28.
Sharing his story, he said:
“Schizophrenia can be a horrific illness. It's hard to explain exactly how it affects me. Over the years, I've had nurses and doctors show me that when I have stopped taking my medication, a few weeks later, I end up in hospital. This shows that my condition can be well managed by my medication.
“But in truth, I live with a daily contradiction. When I use my intellectual mind, I understand that I have schizophrenia. But it’s very hard to keep sight of and so some time later, I'll change my mind and decide that in my case, they are mistaken. I am not really ill. Because, in my heart and at my core, I fundamentally believe that I am actually a bad person, contaminated, and contributing to the destruction of the world. I believe that my family, the people around me, and society, would be better off without me here.
“That's a hard, hard feeling to live with. But it’s there, every day. It’s very distracting and can cause me and others around me distress. I would much prefer to think it was an illness, rather than the alternative feeling of being a bad person, but this is the contradiction I live with.
“When you think so terribly of yourself it’s hard to also think about how others view you too. It’s horrible to think that some people would avoid being around me because of my condition.
“I have a very idealistic vision of love, kindness and belonging. I think if people like me felt fully part of society and accepted, not, tolerated, life would be very different.”
You can listen to a full interview with Graham where he talks to us about his condition and how it has affected him over the past 35 years.
RCPsych has produced a hub of podcasts, blog posts and features to help people understand what it is like to live with a severe mental illness and learn more. All the resources are free and can be viewed at the College’s Mental Health Awareness page.
To tackle the treatment gap, RCPsych wants to see urgent investment to restore access to mental health services and the widening of health checks for people with SMI.2
Footnotes
- Severe mental illness is a subset of mental illness and the term only applies to those with a diagnosable mental, behavioural, or emotional disorder that causes severe functional impairment that substantially interferes with, or limits, one or more major life activities. Conditions that could cause or be categorised as severe mental illness are generally considered to be psychoses such as schizophrenia, schizoaffective disorder, severe psychotic depression and bipolar disorder.
- See RCPsych’s manifesto Preventing Mental Illness, pages 8-9.
For further information, please contact:
- Email: press@rcpsych.ac.uk
- Twitter: @rcpsych
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