It's not all like "A Beautiful Mind": you can’t make schizophrenia nice

We’re brilliant at defending the mentally ill in principle, but we can be terrible at hiding our revulsion at some of the sick people we’ve encountered in the flesh.

 

The worst thing about psychiatric hospitals isn’t the treatment, it’s the patients. Or rather I guess it depends. Personally, I’ve had good treatment and bad, brilliant treatment and terrible. The one constant has been frustration with the other patients. Whatever else is going on, both inside and outside your own head, they’re always there with you and dealing with that can be hard.  

My brother suffers from schizophrenia while I’ve suffered from depression and anorexia. I’m fighting the urge to write “therefore it’s a laugh a minute round our way” but actually, sometimes it is. Not always – for my brother, the impact of increasingly large doses of medication has been devastating – but the dark humour offers some degree of comfort. If we feel traumatised, it’s often more by treatment than illness itself. We’ve occasionally spent time in the same institutions and end up reminiscing on some of the same people. It’s rare that we’re complimentary about any of them. We remember all the bad things. In a reversal of the way prejudice often operates, we’re brilliant at defending the mentally ill in principle, terrible at hiding revulsion at some of the sick people we’ve encountered in the flesh. I have no desire to defend this – I can’t – but it is, I think, a problem with chronic mental illness.

Familiarity breeds a special kind of contempt. Perhaps more so if you have suffered yourself, you become unwilling to separate the personality of the sufferer from the manifestations of his or her illness. To do so would seem patronising, maybe even a denial of his or her personhood. It’s difficult to think “they’re someone else, but for the illness”, equally difficult to think “the illness doesn’t inconvenience or frighten or anger me, because it’s not really them”. I’m not able to do this with my brother, but then I’m not sure I want to. How much of him do I want to discount, and how much of him would then remain? At what point has so much been amputated that there’s no person left? I don’t want to start chipping away at the person but if I fail to do this, to what extent am I seeing only the illness? People are not their diagnosis but the symptoms of mental illness can colour everything.

There is a need to combat the deep-rooted and irrational fear of mental illness that many people carry with them. Schizophrenia sufferers are not likely to be violent towards others. Those of us with depression don’t fall apart at the slightest touch. Mental illness can be incredibly lonely, with the psychological isolation of the disorder compounded by a real lack of contact with others, because these others are afraid. Charities such as Mind and Rethink have fought hard to challenge perceptions, in the face of constant scaremongering and casual bigotry throughout the national press. This element of their work – only a small part of all they offer sufferers and carers – is incredibly important. All the same, there are times when I wonder whether the message that filters through to the mainstream ends up being the one people want to hear rather than a true reflection of the instability and ugliness of some types of mental illness. When I see advertising campaigns such as this one and this, emphasising the “normality” of people who are mentally ill, I don’t feel as though they have much to do with those closest to me. If anything, I worry that my brother is letting the side down by conforming too closely to the stereotypes that are being questioned. That doesn’t mean the bigots understand him, but it might mean different tactics are needed to make them see the human being.

I remember my own family’s mistrust when the National Schizophrenia Fellowship became Rethink in 2002. I can see reasons for the decision being made – it is more positive and more inclusive – but to them it felt like New Labour-esque rebranding. “They don’t want people to hear the word ‘schizophrenia’,” was my father’s view. “They’re pandering to the stigma.” This may be unfair but there are reasons for such a degree of defensiveness. Rethink sounds nicer than any phrase that contains the word “schizophrenia”. But you can’t make schizophrenia nice.

Just as sufferers of physical illness are often expected to make up for their “flawed” status by being brave little Pollyannas, mentally ill people need to exhibit compensatory features in order to earn the right not to be discriminated against. Well-meaning people tell me “well, your brother must be really good with numbers” and obviously I’m tempted to say “yes, he’s just like that bloke in A Beautiful Mind” (a film I haven’t actually seen) rather than admit he failed GCSE maths three times in a row. After all, I’d only disappoint and embarrass these people following their plucky attempt to look on the bright side. Nonetheless, once it’s clear you don’t actually measure up to the compensatory factors, this can be used against you. I remember hospital staff telling me that as far as anorexics went, I wasn’t “one of those Best Little Girl in the World types but a selfish attention-seeker”. Well, yes. I never promised to be anything other than that. The point is, even if the symptoms of your illness make you a selfish attention-seeker – and even if these symptoms are so enmeshed in who you are it’s impossible to tease out the strands – all people who are mentally ill deserve human contact and support, not just the “good” ones.

You can’t always tell by looking whether a person is mentally ill. Nevertheless there are times when you can make a pretty good guess. Sometimes the mentally ill person is the man shouting on the street corner, rather than that nice man who was off work but is back in the office having “good days and bad days”. Sometimes mental illness is so debilitating that a person never experiences paid employment. That doesn’t mean they’re not a part of our society. It doesn’t mean we’re not responsible for them and it doesn’t mean we’re allowed to stick to what for them may be impossibly high standards for social interaction. Suffering from a mental illness and/or engaging with a sufferer can be messy, embarrassing and deeply distressing. You might never reach a point at which it isn’t. That doesn’t mean understanding is impossible or that attempts at contact and inclusion are worthless. For many people, they’re worth far more than can ever be expressed. 

Russell Crowe in "A Beautiful Mind". Unfortunately, not all schizophrenics are good at maths.

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

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I was wrong about Help to Buy - but I'm still glad it's gone

As a mortgage journalist in 2013, I was deeply sceptical of the guarantee scheme. 

If you just read the headlines about Help to Buy, you could be under the impression that Theresa May has just axed an important scheme for first-time buyers. If you're on the left, you might conclude that she is on a mission to make life worse for ordinary working people. If you just enjoy blue-on-blue action, it's a swipe at the Chancellor she sacked, George Osborne.

Except it's none of those things. Help to Buy mortgage guarantee scheme is a policy that actually worked pretty well - despite the concerns of financial journalists including me - and has served its purpose.

When Osborne first announced Help to Buy in 2013, it was controversial. Mortgage journalists, such as I was at the time, were still mopping up news from the financial crisis. We were still writing up reports about the toxic loan books that had brought the banks crashing down. The idea of the Government promising to bail out mortgage borrowers seemed the height of recklessness.

But the Government always intended Help to Buy mortgage guarantee to act as a stimulus, not a long-term solution. From the beginning, it had an end date - 31 December 2016. The idea was to encourage big banks to start lending again.

So far, the record of Help to Buy has been pretty good. A first-time buyer in 2013 with a 5 per cent deposit had 56 mortgage products to choose from - not much when you consider some of those products would have been ridiculously expensive or would come with many strings attached. By 2016, according to Moneyfacts, first-time buyers had 271 products to choose from, nearly a five-fold increase

Over the same period, financial regulators have introduced much tougher mortgage affordability rules. First-time buyers can be expected to be interrogated about their income, their little luxuries and how they would cope if interest rates rose (contrary to our expectations in 2013, the Bank of England base rate has actually fallen). 

A criticism that still rings true, however, is that the mortgage guarantee scheme only helps boost demand for properties, while doing nothing about the lack of housing supply. Unlike its sister scheme, the Help to Buy equity loan scheme, there is no incentive for property companies to build more homes. According to FullFact, there were just 112,000 homes being built in England and Wales in 2010. By 2015, that had increased, but only to a mere 149,000.

This lack of supply helps to prop up house prices - one of the factors making it so difficult to get on the housing ladder in the first place. In July, the average house price in England was £233,000. This means a first-time buyer with a 5 per cent deposit of £11,650 would still need to be earning nearly £50,000 to meet most mortgage affordability criteria. In other words, the Help to Buy mortgage guarantee is targeted squarely at the middle class.

The Government plans to maintain the Help to Buy equity loan scheme, which is restricted to new builds, and the Help to Buy ISA, which rewards savers at a time of low interest rates. As for Help to Buy mortgage guarantee, the scheme may be dead, but so long as high street banks are offering 95 per cent mortgages, its effects are still with us.