In partnership with The Open University, the BBC has produced two documentaries focusing on the history of asylums, the reality of being sectioned and living with mental illness. These programmes - ‘Mental: A History of the Madhouse’ and the award-winning ‘Sectioned’ - were first shown on BBC Four in May 2010.
Following the programmes, viewers were invited to take part in an online survey of their experiences and opinions of choice in using mental healthcare services. The survey, conducted by Dr Jonathan Leach and me – members of the team running mental health courses at The Open University – investigated the different perspectives, ideas and approaches to mental health and distress that exist in the UK today. We were interested in exploring people’s views and experiences – particularly about how much choice people feel they have in accessing different types of support. The survey was completed by 386 people during the period May to November 2010, and some of the main results are considered below.
With the statistic that one in six people in the UK will suffer from ‘significant’ mental illness at some point during their lives, this is a topic that will affect many of us either directly or indirectly. It was therefore no surprise that of the 386 respondents to the survey, over 70% identified themselves as either users or ex-users of mental health services. There were many respondents who also indicated more than one role or interest in relation to mental health:
- 24% of current and ex- service user respondents were working in health and social care services
- 48.8% of health and social care workers/professional respondents were current or ex- service users
- 50% of respondents with an academic interest in mental health identified themselves as current or ex- service users.
‘Sectioned’ gives a view of current practice within mental health services and follows three men as they negotiate their way towards recovery. Mental health services have changed beyond recognition within the space of a couple of decades and in-patient facilities, treatment choices and staff attitudes have all improved since the worst of the asylums were closed. But is there still room for improvement and development?
Most treatments still rely on using drugs while many of our respondents indicated that talking therapies and other creative and practical forms of support were most helpful:
- Being there / giving time
- Keeping in touch
- Sharing experience
- Providing food
- Workplace support
- Being accompanied to appointments
- Financial assistance.
Choice can be considered as an important element in any branch of health and social care. Availability of choice for service users is one of the factors used for judging the quality of a service. However, in the mental health sector, choice can be a contentious issue. There are a number of reasons for this, including disagreements about what causes mental distress and how to treat it, lack of resources and the element of compulsion in some aspects of treatment.
In response to survey questions regarding choice and treatment, where 69.7% of respondents reported that although their mental health needs had changed, only 31.5% felt that the support available is now better suited to their needs. In response to the question: If you have sought help for mental distress, did you feel you had a choice of treatment and support options?, a startling 77.4% of 336 respondents said they had limited or no choice of options when seeking help for mental distress, and although it is positive that 68.1% of the respondents felt that health and social care services supported them, this does leave the other 31.9% who did not feel this way. Similarly, the 17.9% who felt that services punished them in some way is a cause for concern.
In response to the question: Advice for people experiencing a mental health crisis?, 309 respondents posted a message with the majority being positive about the benefits of seeking professional help, although sometimes this was qualified by concerns about the abilities of services to meet the needs and expectations of service users. It is noteworthy that all but a few respondents would encourage anyone in mental health crisis to seek help and support as soon as possible. Given the high proportion of current and former service users who contributed to this survey, these comments provide a valuable resource of helpful advice from people with direct experiences of dealing with mental health crises.
Perhaps, because of the fear and stigma attached to mental health problems, many of us don’t think about how we would like to be treated in a crisis, or what support we could draw on to avoid that crisis in the first place. Unfortunately, at the time of crisis, we are probably in the least rational frame of mind to make those choices. So the more we all start talking about mental health and distress and what to do about it, rather than making it a taboo subject, the better equipped we will be to offer and make appropriate choices.
There is still a long way to go in the way that people with mental distress are treated within society as a whole, and specifically by current mental health services. We hope that the two programmes will contribute to the debate about mental health services and ways that progress can continue to be made.