Wednesday 8 January 2014


Can't think of a picture to illustrate this post so here's a gratuitous one

There is a big news story today about improper use of antibiotics (both by doctors and the public) and the risk this poses as bugs develop immunity. We might even see the return of TB as a major scourge of poor and vulnerable people, as it used to be in the living memory of those over about 70 years old.

Earlier in the week the somewhat similar matter of the improper use of anti-depressants came up. A study indicates that these drugs are being used for problems which are not mental health-related and for minor mental health problems which should not be treated with drugs - something I have been banging on about in this Blog for years. See the story here.

At the heart of this is the debate about what constitutes a mental health problem. The important thing to bear in mind is that this is not something defined by severity. So, for example, there are life problems like bereavement or unemployment which don't necessarily cause mental health problems but may be much more difficult things to experience than a minor mental health problem. Put simply, you can be extremely unhappy but, if that is a proportionate response to the reality of your external experience, then it's not a mental health problem.

It is absolutely wrong for mental health interventions to get in the way of people resolving such life problems and it is an insidious and dangerous trend of our times that mental health busybodies are making work for themselves by redefining life's problems as mental health ones. This leads to improper use of drugs - which can inhibit people from addressing their problems - as well as all that disempowerment which goes along with the typical mental health approach.

Incidentally, it is not just drugs which can be inappropriately deployed. Psychological therapy is a distraction and a waste of resources if provided to somebody whose problems are not mental health ones - they need to get on with fixing their problems through practical steps and the support of friends, family, or appropriate non-mental health agencies.

I recollect some years ago an unusually enlightened therapist explaining to me how much can be achieved by simply changing the language we use away from mental health terminology and towards the words used by ordinary people. For example, if you substitute the over-used and misused mental health word "stressed" with the ordinary words "anxious" or "frightened" they automatically lead you towards the questions "what are you anxious about?" or "what are you frightened of?", and the answers to these questions lead you on towards the challenge of what you are going to do about the problems you identify. You can experiment similarly with the substitution of the over-used and misused word "depressed" with ordinary words like "unhappy".

It is really important I believe to make those substitutions if your problems - however severe - are not in fact mental health ones, in other words to actively steer well clear of the smothering and disempowering language of mental health. But in many cases such substitutions can be helpful even where the problems are mental health ones. It's good therapy! None of this of course is to deny that there are mental illnesses for which the term depression and other mental health diagnoses are appropriate.

Mental health organisations and professionals are much to blame for infecting society with the wrong language and wrong strategies for dealing with the challenges of life. They would do better to concentrate on improving their woeful record of poor practice in helping those whom they should be helping - people with a mental illness.