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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Brexit is teaching the UK that it needs immigrants

Finally forced to confront the economic consequences of low migration, ministers are abandoning the easy rhetoric of the past.

Why did the UK vote to leave the EU? For conservatives, Brexit was about regaining parliamentary sovereignty. For socialists it was about escaping the single market. For still more it was a chance to punish David Cameron and George Osborne. But supreme among the causes was the desire to reduce immigration.

For years, as the government repeatedly missed its target to limit net migration to "tens of thousands", the EU provided a convenient scapegoat. The free movement of people allegedly made this ambition unachievable (even as non-European migration oustripped that from the continent). When Cameron, the author of the target, was later forced to argue that the price of leaving the EU was nevertheless too great, voters were unsurprisingly unconvinced.

But though the Leave campaign vowed to gain "control" of immigration, it was careful never to set a formal target. As many of its senior figures knew, reducing net migration to "tens of thousands" a year would come at an economic price (immigrants make a net fiscal contribution of £7bn a year). An OBR study found that with zero net migration, public sector debt would rise to 145 per cent of GDP by 2062-63, while with high net migration it would fall to 73 per cent. For the UK, with its poor productivity and sub-par infrastructure, immigration has long been an economic boon. 

When Theresa May became Prime Minister, some cabinet members hoped that she would abolish the net migration target in a "Nixon goes to China" moment. But rather than retreating, the former Home Secretary doubled down. She regards the target as essential on both political and policy grounds (and has rejected pleas to exempt foreign students). But though the same goal endures, Brexit is forcing ministers to reveal a rarely spoken truth: Britain needs immigrants.

Those who boasted during the referendum of their desire to reduce the number of newcomers have been forced to qualify their remarks. On last night's Question Time, Brexit secretary David Davis conceded that immigration woud not invariably fall following Brexit. "I cannot imagine that the policy will be anything other than that which is in the national interest, which means that from time to time we’ll need more, from time to time we’ll need less migrants."

Though Davis insisted that the government would eventually meet its "tens of thousands" target (while sounding rather unconvinced), he added: "The simple truth is that we have to manage this problem. You’ve got industry dependent on migrants. You’ve got social welfare, the national health service. You have to make sure they continue to work."

As my colleague Julia Rampen has charted, Davis's colleagues have inserted similar caveats. Andrea Leadsom, the Environment Secretary, who warned during the referendum that EU immigration could “overwhelm” Britain, has told farmers that she recognises “how important seasonal labour from the EU is to the everyday running of your businesses”. Others, such as the Health Secretary, Jeremy Hunt, the Business Secretary, Greg Clark, and the Communities Secretary, Sajid Javid, have issued similar guarantees to employers. Brexit is fuelling immigration nimbyism: “Fewer migrants, please, but not in my sector.”

The UK’s vote to leave the EU – and May’s decision to pursue a "hard Brexit" – has deprived the government of a convenient alibi for high immigration. Finally forced to confront the economic consequences of low migration, ministers are abandoning the easy rhetoric of the past. Brexit may have been caused by the supposed costs of immigration but it is becoming an education in its benefits.

George Eaton is political editor of the New Statesman.