Thought I would finally wade into the fray. Not sure yet if I am going to make this a comment or a post.
The following is not a professional statement nor should be taken as any kind of representative view of mental health staff in general. In fact as I am going to be writing it with no plan, off the top of my oddly shaped head I might not even agree with it all.
Irreverent Buddhist [IB] suggests that vast majority of mental health clients have suffered abuse, particularly sexual, as children. He also states, with reference, that the figures for abuse amongst the general population are unacceptably high:
The figures I found in a previous post were different.
A review of the surveys of larger, non clinical populations in 21 different countries confirms that child sex abuse is an international problem and that the estimated prevalence ranges from 7 per cent to 36 per cent for women and 3 per cent to 29 per cent for men.[40] Evidence shows that children who have been abused are at greater risk of experiencing mental and emotional distress in adulthood.
Either set of figures are too high. A quick Google search indicates abuse rates in childhood for psychiatric inpatients is about the %50 mark. I am not sure of the rate of people with a mental health diagnosis who are inpatients.
* 1 in 4 British adults experience at least one diagnosable mental health problem in any one year, and one in six experiences this at any given time.
- The Office for National Statistics Psychiatric Morbidity report (2001)
This gives us a rate of about %16.
If anyone knows the percentage of people who are psychiatric inpatients and knows statistics please feel free to make sense of the above.
Of course we have a problem. What is mental illness. It seems to be one of these things that everyone knows but no two people fully agree on.
Brittanica gives us:
Any illness with a psychological origin, manifested either in symptoms of emotional distress or in abnormal behaviour.
Well that has cleared that up then. Last time I checked there was not a terribly useful legal definition of mental illness.
People seem to mean different things by the term. It covers everything from a mild depression to a full blown barking at the moon psychotic experience. Some describe this as a ‘sane response’ to a terrible life. It matters little. Society, the medical profession, my young nephew will call it mental illness, or something worse. As a technical term it is too broad to be of much use. I am quite sure comparing someone with a mild reactive depression to a person with severe rapid cycling bipolar affective disorder is a pointless task. Yet both are covered by the term ‘mentally ill’ as if their is some point of commonality between them.
To digress. Actual formal diagnoses (schizophrenia, depression, personality disorder, anorexia etc) can be a useful shorthand. But for actual nursing care of limited usefulness as they do nothing to describe the personal experience of the people we actually work with.
I will finish up this post in a bit as my television programme has just come on.
My point, if any:
To say something like:
%50 of people with mental illness have been abused as children
is pointless. The term mental illness is too broad and woolly. Definitions of what constitutes abuse vary from survey to survey. Something like:
%50 of people with a diagnosis of [insert whatever] report being abused as children.
is something that can be measured and studied.
To turn the statements round and say; ‘sexual abuse in childhood causes mental illness‘, to me makes as much sense as saying ‘All ducks are birds, therefore all birds are penguins‘.
We can say something like:
People who are sexually abused in childhood are more likely than the general population to end up with a psychiatric diagnosis.
But, in my experience, this is something we all know.
When I can I will do a follow up post on antipsychiatry. Please consider this post my long delayed expansion to this.
Both this, and your previous post that you link to is very interesting and balanced. You have my approval
I can definitely go with the “second trigger in those already predisposed” theory.
Thank you Mr Mans Wife. I am trying to avoid sweeping generalisations. They tend to simplify and force people into black and white arguments. Modern psychiatry and psychology are young disciplines, science of the mind is poorly understood. It is easy to attack but I still think it is the best thing we have currently; nurses are in the best position to humanise psychiatry, help clients, support them and keep striving for something better.
Mental – an important observation [nurses are in the best position to humanise psychiatry].
It wasn’t that long ago that nurses were discouraged from openly conversing with ‘psychotics’ due to the erroneous belief that these exchanges might further exacerbate abnormal cognitive processes.
Of course this idea would be laughed out of the ward round these days [wouldn't it ?] but it does highlight the risk of false constructs that can arise when the underlying phenomena is only partially understood.
Good point A & E, though oddly it enough it is still something I hear quite a few people saying. Primarily younger students and people not at the ‘coal face’ of mental health.
I fully expect 50 years down the line we could well look at our ideas today and find them laughable. But I do think, as long as the system is willing to adapt and absorb new knowledge, that it is the best option. Nurses having the most face to face time with clients (apart from Carers and loved ones of course MMW) are in the best position to adapt the care for each individual.
I must be living in a parallel universe. I have never exchanged anything more than a few words with any nurse – and then only to ask them to unlock a bathroom, or to let my husband out following a visit. On one occasion I read on my discharge papers that I had a named nurse, which was news to me because he had never even spoken to me. The only therapeutic intervention I can ever remember was once, after I had just been admitted, and one of the nurses offered to make me a cup of tea. I was so surprised I nearly fainted!
Did they just offer ? Or did they actually make you one ?
Sorry.
On behalf of all Mental Health Nurses I would like to apologise to you and call the nurses who were meant to be caring for you a bunch of [insert insult here]
I asked a patient on my ward (first week new placement) if she gets much time spent 1:1. She replied “everyone is so busy” Nice understanding patient there, but a few staff are busy and the rest are good at looking busy.
I might post more about this on my days off actually.
A couple of notes about the 1 in 4 experience a diagnosable mental illness in a year statistic: Only about half of those actually seek treatment. The majority of them will have the most common mental illness, which is mild situational depression. The NICE guidelines for this are (if I recall correctly), watchful waiting.
In other words, 1 in 4 people have a mental illness each year, lots of them don’t seek treatment, and many of those who do don’t actually need any (beyond a few chats with their GP and/or practice counseller).
[...] Mental Nurse 2007» july» mental health» A follow up to Mental Illness: One. As before this post is not a thorough research based article. It is a mix of personal experience, [...]