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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The rise of the green mayor – Sadiq Khan and the politics of clean energy

At an event at Tate Modern, Sadiq Khan pledged to clean up London's act.

On Thursday night, deep in the bowls of Tate Modern’s turbine hall, London Mayor Sadiq Khan renewed his promise to make the capital a world leader in clean energy and air. Yet his focus was as much on people as power plants – in particular, the need for local authorities to lead where central governments will not.

Khan was there to introduce the screening of a new documentary, From the Ashes, about the demise of the American coal industry. As he noted, Britain continues to battle against the legacy of fossil fuels: “In London today we burn very little coal but we are facing new air pollution challenges brought about for different reasons." 

At a time when the world's leaders are struggling to keep international agreements on climate change afloat, what can mayors do? Khan has pledged to buy only hybrid and zero-emissions buses from next year, and is working towards London becoming a zero carbon city.

Khan has, of course, also gained heroic status for being a bête noire of climate-change-denier-in-chief Donald Trump. On the US president's withdrawal from the Paris Agreement, Khan quipped: “If only he had withdrawn from Twitter.” He had more favourable things to say about the former mayor of New York and climate change activist Michael Bloomberg, who Khan said hailed from “the second greatest city in the world.”

Yet behind his humour was a serious point. Local authorities are having to pick up where both countries' central governments are leaving a void – in improving our air and supporting renewable technology and jobs. Most concerning of all, perhaps, is the way that interest groups representing business are slashing away at the regulations which protect public health, and claiming it as a virtue.

In the UK, documents leaked to Greenpeace’s energy desk show that a government-backed initiative considered proposals for reducing EU rules on fire-safety on the very day of the Grenfell Tower fire. The director of this Red Tape Initiative, Nick Tyrone, told the Guardian that these proposals were rejected. Yet government attempts to water down other EU regulations, such as the energy efficiency directive, still stand.

In America, this blame-game is even more highly charged. Republicans have sworn to replace what they describe as Obama’s “war on coal” with a war on regulation. “I am taking historic steps to lift the restrictions on American energy, to reverse government intrusion, and to cancel job-killing regulations,” Trump announced in March. While he has vowed “to promote clean air and clear water,” he has almost simultaneously signed an order to unravel the Clean Water Rule.

This rhetoric is hurting the very people it claims to protect: miners. From the Ashes shows the many ways that the industry harms wider public health, from water contamination, to air pollution. It also makes a strong case that the American coal industry is in terminal decline, regardless of possibile interventions from government or carbon capture.

Charities like Bloomberg can only do so much to pick up the pieces. The foundation, which helped fund the film, now not only helps support job training programs in coal communities after the Trump administration pulled their funding, but in recent weeks it also promised $15m to UN efforts to tackle climate change – again to help cover Trump's withdrawal from Paris Agreement. “I'm a bit worried about how many cards we're going to have to keep adding to the end of the film”, joked Antha Williams, a Bloomberg representative at the screening, with gallows humour.

Hope also lies with local governments and mayors. The publication of the mayor’s own environment strategy is coming “soon”. Speaking in panel discussion after the film, his deputy mayor for environment and energy, Shirley Rodrigues, described the move to a cleaner future as "an inevitable transition".

Confronting the troubled legacies of our fossil fuel past will not be easy. "We have our own experiences here of our coal mining communities being devastated by the closure of their mines," said Khan. But clean air begins with clean politics; maintaining old ways at the price of health is not one any government must pay. 

'From The Ashes' will premiere on National Geograhpic in the United Kingdom at 9pm on Tuesday, June 27th.

India Bourke is an environment writer and editorial assistant at the New Statesman.

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