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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It's easy to see where Berlin is being rebuilt – just hit the streets

My week, from walking the streets of Berlin to class snobbery and the right kind of gentrification.

Brick by brick, block by block, the people are rebuilding the city once called Faust’s Metropolis. To see it clearly, put your boots on. One of the most bracing walks starts by the Gethsemane Church, which served as a haven for dissenters in the last days of the GDR and takes you down ­towards the Hackescher Markt.

Here, in what is still the eastern half of a divided city that wears its division more lightly, is a Berlin experience both old and new. In three decades of frequent visits, it has been fascinating to note how much this part of town has changed. Even a decade ago these streets were rundown. With crumbling buildings showing bulletholes, it wasn’t hard to imagine what the place looked like in 1945. Now there are lilacs, blues, and yellows. Cafés, bars and restaurants abound, serving the young professionals attracted to the city by cheap rents and a renewed sense of community.

 

Breaking the fourth wall

Looking north along Schliemannstraße, you’ll find a delightful vista of well-tended balconies. It’s a pleasant place to live, notwithstanding the gaggle of grotesques who gather round the corner in the square. On Kastanienallee, which forms the second leg of the walk, an old city feels young. It’s a kind of gentrification but the right kind. There’s more to eat, to drink, to buy, for all.

Berlin, where Bertolt Brecht staged his unwatchable plays, was supposed to have been transformed by a proletarian revolution. Instead, it has been restored to health by a very middle-class one. Germany has always had a well-educated middle class, and the nation’s restoration would have impossible without such people. The irony is delicious – not that irony buttered many parsnips for “dirty Bertie”.

 

The new snobbery

The British Museum’s survey of German history “Memories of a Nation” is being presented at the Martin-Gropius-Bau as “The British View”. Germans, natürlich, are curious to see how we observe them. But how do they see us?

A German friend recently in England  said that the images that struck him most forcibly were the tins of food and cheap booze people piled up in supermarkets, and the number of teenage girls pushing prams. Perhaps Neil MacGregor, the former director of the British Museum who will shortly take up a similar role here at the new Humboldt Forum, may turn his attention to a “German View” of the United Kingdom.

There’s no shortage of material. In Schlawinchen, a bar that typifies Kreuzberg’s hobohemia, a college-educated English girl was trying to explain northern England to an American she had just met. Speaking in an ugly modern Mancunian voice that can only be acquired through years of practice (sugar pronounced as “sug-oar”), she refer­red to Durham and York as “middle class, you know, posh”, because those cities had magnificent cathedrals.

When it comes to inverted snobbery, no nation can match us. To be middle class in Germany is an indication of civic value. In modern England, it can mark you as a leper.

 

Culture vultures

The Humboldt Forum, taking shape by the banks of the Spree, reconsecrates the former site of the GDR’s Palace of the Republic. When it opens in 2018 it will be a “living exhibition”, dedicated to all the cultures of the world. Alexander von Humboldt, the naturalist and explorer, was the brother of Wilhelm, the diplomat and philosopher, whose name lives on in the nearby university.

In Potsdamerplatz there are plans to build a modern art museum, crammed in between the Neue Nationalgalerie and the Philharmonie, home to the Berlin Philharmonic. Meanwhile, the overhaul of the Deutsche Staatsoper, where Daniel Barenboim is music director for life, is likely to be completed, fingers crossed, next autumn.

Culture everywhere! Or perhaps that should be Kultur, which has a slightly different meaning in Germany. They take these things more seriously, and there is no hint of bogus populism. In London, plans for a new concert hall have been shelved. Sir Peter Hall’s words remain true: “England is a philistine country that loves the arts.”

 

European neighbours

When Germans speak of freedom, wrote A J P Taylor, a historian who seems to have fallen from favour, they mean the freedom to be German. No longer. When modern Germans speak of freedom, they observe it through the filter of the European Union.

But nation states are shaped by different forces. “We are educated to be obedient,” a Berlin friend who spent a year at an English school once told me. “You are educated to be independent.” To turn around Taylor’s dictum: when the English speak of freedom,
they mean the freedom to be English.

No matter what you may have heard, the Germans have always admired our independence of spirit. We shall, however, always see “Europe” in different ways. Europe, good: we can all agree on that. The European Union, not so good. It doesn’t mean we have to fall out, and the Germans are good friends to have.

 

Hook, line and sinker

There are fine walks to be had in the west, too. In Charlottenburg, the Kensington of Berlin, the mood is gentler, yet you can still feel the city humming. Here, there are some classic places to eat and drink – the Literaturhauscafé for breakfast and, for dinner, Marjellchen, a treasure trove of east Prussian forest delights. Anything that can be shot and put in a pot!

For a real Berlin experience, though, head at nightfall for Zwiebelfisch, the great tavern on Savignyplatz, and watch the trains glide by on the other side of Kantstraße. Hartmut Volmerhaus, a most amusing host, has been the guvnor here for more than 30 years and there are no signs that his race is run. The “Fisch” at twilight: there’s nowhere better to feel the pulse of this remarkable city. 

This article first appeared in the 01 December 2016 issue of the New Statesman, Age of outrage