Stigma in crisis: mental health, fear-mongering and murder

Opposition to having a charity-run mental health crisis centre in your street is both very telling and depressingly predictable.

Reading the objections to the Planning Permission application, you would think that they were proposing a hostel for unrepentant murderers, not a charity-run mental health centre. Rethink recently submitted an application to turn a house in Sheffield suburb into a “safe haven” crisis house for people experiencing mental health problems, and the opposition they have faced is both very telling and depressingly predictable.

The plan is to provide a place where a maximum of six people can stay for no longer than a week when their mental health is deteriorating towards a crisis point. The converted semi would offer a safe environment where they could receive intensive emotional support, and would also house a 24-hour helpline.

Along with complaints about increased traffic on the street, many local residents oppose the crisis house on the basis that children live on the street and walk to school, and the theme of “danger, danger” is seen throughout. One person complains that people who are unwell “will be frightning (sic) to local residents and may cause risk to children and other people in the area”, while another says that, “I would be reluctant to allow [my young teenager] to return from school unaccompanied if I thought there was a risk of her having to deal with difficult situations arising from this”.

Another uses carefully chosen (dare I say cherry picked?) statistics to prove just how likely residents will be to be murdered if this goes ahead (clue: there will barely be a survivor in the entire city), and the overall message is that those experiencing mental distress are to be feared, avoided, and ostracised. In short, they are most definitely “other”.

Many of those who object to the building's change of use do agree in principle that such facilities are worthwhile and important, they just do not think this one should be on their own street.

Some of the objections are also bewildering in their naïveté. When one woman explains that, “This is a quiet leafy suburb and I am not overreacting when I feel concern about the fact that we cannot be sure of who is coming and going”, I do wonder if she realises that this is the case, crisis house or not. The thing is, with the numbers of people experiencing mental health problems in the general population being so high this community, like all others, already has people experiencing mental distress in its midst anyway. They may not broadcast their difficulties but perhaps this is not surprising: the strength of feeling from those who commented on the planning application is pretty representative of the attitudes towards mental ill-health in our entire society.

So, let's start with the facts. 95 per cent of murders are committed by people who do not have a diagnosed mental health issue. Given that 25 per cent of the population can experience mental health problems, sane people appear to be statistically far more dangerous to be around. And people experiencing psychosis – those that the public seem to be the most afraid of – are 14 times more likely to be the victim of violent crime than they are to commit it.

Rethink are clear that nobody would stay in the house if they were thought to be a risk. They would be in hospital.

When somebody is in crisis they can either stay at home (where they are somebody's neighbour), go into hospital, or go into a crisis house for a few days. Kate Wareham, Rethink's regional Associate Director explained to me: “the intention is that we prevent people's illness escalating to the point where they require a hospital admission. We provide a safe, secure environment for people when they are experiencing a mental health crisis”. It will be used by people who accept that they need a bit of extra support for a while, and if Nether Edge residents (who are replicated the entire country over whenever mental health facilities are proposed) think that stopping the crisis house before it starts means they will have nobody experiencing mental distress living near them, they are seriously misguided. As Kate pointed out, “These people already live in Sheffield! These are people in the community”.

Planning permission has been granted to the facility, and Rethink really want to work with the local community, aware that many service users will not want to go to a crisis house where local people fear them. When someone needs a safe haven, they do not want to come up against this stigma and opposition to the care they need.

Stigma like this does have wide-ranging effects, all of them damaging. It means that the first response, when a horrific massacre takes place in the US, is instant speculation on the killer's mental health status; it means that people with mental health problems can't get a job when they want to work; it means that people feel isolated and excluded; it means people get physically and verbally abused; it means not getting physical health problems taken seriously; and it means that some people don't seek treatment that they desperately need because they are so afraid of what people will think.

Prejudice and bigotry are never pretty, and I'm more worried about children being taught to fear those who are distressed than I am about the statistically tiny threat from somebody who is undergoing treatment and receiving help. If they grow up believing that their own, or other people's, mental health problems will mean they will commit violent disorder and exhibit frightening behaviour, the stigma will continue to grow. Instead, we need to understand that many people experience mental distress, and that some of them will need more help than others. Putting barriers in the way of those people will only exacerbate their problems and their isolation. Society must move to a position of compassion and humanity towards this significant percentage of the population who currently experience it as anything but compassionate and humane.

How would you feel about having a mental health centre on your street? Photograph: Getty Images
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The most terrifying thing about Donald Trump's speech? What he didn't say

No politician uses official speeches to put across their most controversial ideas. But Donald Trump's are not hard to find. 

As Donald Trump took the podium on a cold Washington day to deliver his inauguration speech, the world held its breath. Viewers hunched over televisions or internet streaming services watched Trump mouth “thank you” to the camera, no doubt wondering how he could possibly live up to his deranged late-night Twitter persona. In newsrooms across America, reporters unsure when they might next get access to a president who seems to delight in denying them the right to ask questions got ready to parse his words for any clue as to what was to come. Some, deciding they couldn’t bear to watch, studiously busied themselves with other things.

But when the moment came, Trump’s speech was uncharacteristically professional – at least compared to his previous performances. The fractured, repetitive grammar that marks many of his off-the-cuff statements was missing, and so, too, were most of his most controversial policy ideas.

Trump told the crowd that his presidency would “determine the course of America, and the world, for many, many years to come” before expressing his gratefulness to President Barack Obama and Michelle Obama for their “gracious aid” during the transition. “They have been magnificent," Trump said, before leading applause of thanks from the crowd.

If this opening was innocent enough, however, it all changed in the next breath. The new president moved quickly to the “historic movement”, “the likes of which the world has never seen before”, that elected him President. Following the small-state rhetoric of his campaign, Trump promised to take power from the “establishment” and restore it to the American people. “This moment," he told them, “Is your moment. It belongs to you.”

A good deal of the speech was given over to re-iterating his nationalist positions while also making repeated references to the key issues – “Islamic terrorism” and families – that remain points of commonality within the fractured Republican GOP.

The loss of business to overseas producers was blamed for “destroying our jobs”. “Protection," Trump said, “Will lead to great strength." He promised to end what he called the “American carnage” caused by drugs and crime.

“From this day forward," Trump said, “It’s going to be only America first."

There was plenty in the speech, then, that should worry viewers, particularly if you read Trump’s promises to make America “unstoppable” so it can “win” again in light of his recent tweets about China

But it was the things Trump didn't mention that should worry us most. Trump, we know, doesn’t use official channels to communicate his most troubling ideas. From bizarre television interviews to his upsetting and offensive rallies and, of course, the infamous tweets, the new President is inclined to fling his thoughts into the world as and when he sees fit, not on the occasions when he’s required to address the nation (see, also, his anodyne acceptance speech).

It’s important to remember that Trump’s administration wins when it makes itself seem as innocent as possible. During the speech, I was reminded of my colleague Helen Lewis’ recent thoughts on the “gaslighter-in-chief”, reflecting on Trump’s lying claim that he never mocked a disabled reporter. “Now we can see," she wrote, “A false narrative being built in real time, tweet by tweet."

Saying things that are untrue isn’t the only way of lying – it is also possible to lie by omission.

There has been much discussion as to whether Trump will soften after he becomes president. All the things this speech did not mention were designed to keep us guessing about many of the President’s most controversial promises.

Trump did not mention his proposed ban on Muslims entering the US, nor the wall he insists he will erect between America and Mexico (which he maintains the latter will pay for). He maintained a polite coolness towards the former President and avoiding any discussion of alleged cuts to anti-domestic violence programs and abortion regulations. Why? Trump wanted to leave viewers unsure as to whether he actually intends to carry through on his election rhetoric.

To understand what Trump is capable of, therefore, it is best not to look to his speeches on a global stage, but to the promises he makes to his allies. So when the President’s personal website still insists he will build a wall, end catch-and-release, suspend immigration from “terror-prone regions” “where adequate screening cannot occur”; when, despite saying he understands only 3 per cent of Planned Parenthood services relate to abortion and that “millions” of women are helped by their cancer screening, he plans to defund Planned Parenthood; when the president says he will remove gun-free zones around schools “on his first day” - believe him.  

Stephanie Boland is digital assistant at the New Statesman. She tweets at @stephanieboland