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Why aren’t we more shocked that mentally ill people spend time in police cells because we lack beds?

Wanting to care about mental illness is not the same as caring.

A female dormitory at the Broadmoor Asylum in 1867. We haven’t moved on as far from this as we like to think. Photo: Hulton Archive/Getty Images

I supposed I should be horrified that a 16-year old girl suffering from severe mental illness was forced to spend two nights in a police cell while waiting for a hospital bed. I’ve tried to be but I’m not. The whole thing seems so fitting for a country in which the most painful aspects of mental illness remain behind closed doors. Stigma might be talked about in the vaguest of terms – we might even be familiar with the one-in-four statistic – but wanting to care about mental illness is not the same as actually caring.

The truth is, most of us don’t care about those suffering from severe mental illness, at least not when the latter are showing obvious symptoms. We want “the mentally ill” to be witty, insightful, inspired by their torment, or failing that, at least out on the other side (“I have good days and bad…”). That mental illness can be ugly, unremitting, embarrassing, hopeless, is not something for which our standard narrative allows. Is it any wonder, then, that we don’t have resources to cope with the kind of crises in which individuals require full, unconditional support? Is it at all surprising that, according to Mark Winstanley of Rethink, “each year thousands of people with severe mental illness are being held in police cells”? After all, they must be somewhere. We know they exist, if only because of the few occasions when their suffering holds our interest.

The Daily Mail reports on the “Fury as mentally ill girl, 16, is kept in police cells for two nights”. But it’s the same Daily Mail that delights in emphasising severe mental illness as a causal factor in violent crime, and which merrily lists new supposed “causes” for schizophrenia – soil, cat faeces, air pollution – without focusing on the needs of sufferers in the here and now (unless it’s in a foreign country, in which case disapproval of someone else’s brutal approach to treatment is de rigeur).

Last week Deputy Prime Minister Nick Clegg announced the formation of a new mental health taskforce. Buried in amongst the hopeful rhetoric on “turn[ing] a corner on outdated attitudes” and “the whole of society […] providing […] care and support” were some pretty clear expectations:

One in four people in the UK will experience a mental health problem and it costs the country more than £100 billion. This is too big an issue for the NHS to deal with alone.

The whole of Government needs to combine its efforts and pool its resources to help the millions of people whose mental health condition is preventing them from getting on in life.

You get the sense that people with mental illness are seen as a drain. We need to help them “get on in life”. Terrifying them with Work Capability Assessments isn’t working. How do we make them more productive? We’ll “fight stigma” (but in the meantime, let’s not allow those prison cell beds to get cold).

As a recovered anorexic who still suffers from mild depression, I have the kind of mental health background that is easy to sugar-coat. It is not without pain but I am functional. I could tell you all about My Road to Recovery or My Anorexic Hell. I still embarrass people when I mention the worst parts, but at least I now know how to edit the whole sorry tale. I know it’s not like that for everyone. The last time I was in hospital I discharged myself early because I didn’t want to be around “the really mad people”. I was both frightened and disgusted by them. I am ashamed of this – deeply ashamed – but not so much that I don’t forget about them most of the time. Other than for people who are very close to me, my concern for severely ill patients is fragile, easily destroyed by all the things I don’t understand.

Recently I’ve been reading Elaine Showalter’s The Female Malady, a study of madness and English culture between 1830 and 1980. It’s one of those books that allow the reader to look to the past and feel horror – and perhaps a little smugness – at how far we’ve come. Gone are the days of Victorian “moral management”.  Psychiatric Darwinism, with its obsessive focus on eugenics, is no more. We no longer send “difficult” relatives and recalcitrant women to waste away in institutions. It is tempting to think of ourselves as enlightened. But mental illness is still with us, and so too is prejudice and neglect.

What would someone from the future, writing about mental health care in one of the world’s wealthiest countries, say about us? Can you believe they used to lock people with severe mental illness in police cells? Can you believe they used to find a reduced life expectancy of 20 years perfectly okay? Can you believe that schizophrenia patients were characterised as violent and dangerous? Can you believe that politicians used to talk about combatting stigma while allowing anyone who couldn’t be a poster child for mental illness to waste away? If we cannot summon up the empathy to be shocked right now (not just at one news story, but at all the lives being written off every day), then I hope those who come after us will be shocked on our behalf. And I hope they are shocked not because, as ever, it’s easier to judge the past than the present. I hope they are shocked because they’re better people than we are managing to be.

Glosswitch is a feminist mother of three who works in publishing.

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Erdogan’s purge was too big and too organised to be a mere reaction to the failed coup

There is a specific word for the melancholy of Istanbul. The city is suffering a mighty bout of something like hüzün at the moment. 

Even at the worst of times Istanbul is a beautiful city, and the Bosphorus is a remarkable stretch of sea. Turks get very irritated if you call it a river. They are right. The Bosphorus has a life and energy that a river could never equal. Spend five minutes watching the Bosphorus and you can understand why Orhan Pamuk, Turkey’s Nobel laureate for literature, became fixated by it as he grew up, tracking the movements of the ocean-going vessels, the warships and the freighters as they steamed between Asia and Europe.

I went to an Ottoman palace on the Asian side of the Bosphorus, waiting to interview the former prime minister Ahmet Davu­toglu. He was pushed out of office two months ago by President Recep Tayyip Erdogan when he appeared to be too wedded to the clauses in the Turkish constitution which say that the prime minister is the head of government and the president is a ceremonial head of state. Erdogan was happy with that when he was prime minister. But now he’s president, he wants to change the constitution. If Erdogan can win the vote in parliament he will, in effect, be rubber-stamping the reality he has created since he became president. In the days since the attempted coup, no one has had any doubt about who is the power in the land.

 

City of melancholy

The view from the Ottoman palace was magnificent. Beneath a luscious, pine-shaded garden an oil tanker plied its way towards the Black Sea. Small ferries dodged across the sea lanes. It was not, I hasten to add, Davutoglu’s private residence. It had just been borrowed, for the backdrop. But it reminded a Turkish friend of something she had heard once from the AKP, Erdogan’s ruling party: that they would not rest until they were living in the apartments with balconies and gardens overlooking the Bosphorus that had always been the preserve of the secular elite they wanted to replace.

Pamuk also writes about hüzün, the melancholy that afflicts the citizens of Istanbul. It comes, he says, from the city’s history and its decline, the foghorns on the Bosphorus, from tumbledown walls that have been ruins since the fall of the Byzantine empire, unemployed men in tea houses, covered women waiting for buses that never come, pelting rain and dark evenings: the city’s whole fabric and all the lives within it. “My starting point,” Pamuk wrote, “was the emotion that a child might feel while looking through a steamy window.”

Istanbul is suffering a mighty bout of something like hüzün at the moment. In Pamuk’s work the citizens of Istanbul take a perverse pride in hüzün. No one in Istanbul, or elsewhere in Turkey, can draw comfort from what is happening now. Erdogan’s opponents wonder what kind of future they can have in his Turkey. I think I sensed it, too, in the triumphalist crowds of Erdogan supporters that have been gathering day after day since the coup was defeated.

 

Down with the generals

Erdogan’s opponents are not downcast because the coup failed; a big reason why it did was that it had no public support. Turks know way too much about the authoritarian ways of military rule to want it back. The melancholy is because Erdogan is using the coup to entrench himself even more deeply in power. The purge looks too far-reaching, too organised and too big to have been a quick reaction to the attempt on his power. Instead it seems to be a plan that was waiting to be used.

Turkey is a deeply unhappy country. It is hard to imagine now, but when the Arab uprisings happened in 2011 it seemed to be a model for the Middle East. It had elections and an economy that worked and grew. When I asked Davutoglu around that time whether there would be a new Ottoman sphere of influence for the 21st century, he smiled modestly, denied any such ambition and went on to explain that the 2011 uprisings were the true succession to the Ottoman empire. A century of European, and then American, domination was ending. It had been a false start in Middle Eastern history. Now it was back on track. The people of the region were deciding their futures, and perhaps Turkey would have a role, almost like a big brother.

Turkey’s position – straddling east and west, facing Europe and Asia – is the key to its history and its future. It could be, should be, a rock of stability in a desperately un­stable part of the world. But it isn’t, and that is a problem for all of us.

 

Contagion of war

The coup did not come out of a clear sky. Turkey was in deep crisis before the attempt was made. Part of the problem has come from Erdogan’s divisive policies. He has led the AKP to successive election victories since it first won in 2002. But the policies of his governments have not been inclusive. As long as his supporters are happy, the president seems unconcerned about the resentment and opposition he is generating on the other side of politics.

Perhaps that was inevitable. His mission, as a political Islamist, was to change the country, to end the power of secular elites, including the army, which had been dominant since Mustafa Kemal Atatürk created modern Turkey after the collapse of the Ottoman empire. And there is also the influence of chaos and war in the Middle East. Turkey has borders with Iraq and Syria, and is deeply involved in their wars. The borders do not stop the contagion of violence. Hundreds of people have died in the past year in bomb attacks in Turkish cities, some carried out by the jihadists of so-called Islamic State, and some sent by Kurdish separatists working under the PKK.

It is a horrible mix. Erdogan might be able to deal with it better if he had used the attempted coup to try to unite Turkey. All the parliamentary parties condemned it. But instead, he has turned the power of the state against his opponents. More rough times lie ahead.

Jeremy Bowen is the BBC’s Middle East editor. He tweets @bowenbbc

This article first appeared in the 28 July 2016 issue of the New Statesman, Summer Double Issue