Speaking up about mental health issues can reduce the stigma

In June, four British MPs bravely told the world about their own mental health issues in an effort to reduce the stigma. They talk about what happened next

By Juliette Jowit  /  The Guardian, LONDON

Wed, Aug 01, 2012 - Page 9

Charles Walker starts to sit down next to me, rises and pulls up another seat. “Let’s have this fourth chair here,” he says, and pulls it up between us. I think he is joking. However, he is not: Without the fourth chair it would be very hard for him to do this interview, maybe even impossible.

A week before we meet, the British Conservative MP stood up in the House of Commons and talked about living with obsessive-compulsive disorder for more than three decades.

“I am delighted to say that I have been a practicing fruitcake for 31 years,” he began. “On occasions it is manageable and on occasions it becomes quite difficult. It takes one to some quite dark places.”

One of the most obvious manifestations of his condition is his compulsion to do everything in fours: wash his hands, switch lights on and off, go in and out of a room. “My wife and children often say I resemble an extra from Riverdance as I bounce in and out, switching lights off four times.”

Walker is a compelling orator and his speech was full of poignant detail and humor. However, as we chat it becomes obvious that he is painfully serious about that fourth chair.

“You train yourself not to give in to it, but it’s agony: It’s like fingernails ...,” he trails off, the image of the chalkboard left hanging.

Walker was speaking at a debate on mental health in the House of Commons one slack Thursday afternoon, when few reporters were watching carefully. However, somewhere between fellow MP and former Labor defense minister Kevan Jones admitting for the first time in public that he had a history of serious depression and Walker explaining that he leaves crisp packets lying around because he can’t face having to wash his hands multiple times, the outside world began to listen.

Two more Tory MPs also spoke: Former GP Sarah Wollaston, who has experienced depression, postnatal depression and severe anxiety attacks, and ex-City banker Andrea Leadsom, who has also gone through postnatal depression.

The subject mentalhealthdebate soon began trending on Twitter. Many of the responses echoed my own: admiration and thanks for what the MPs had done from those with their own mental health issues — in my case clinical depression and anxiety.

The purpose of the debate, tabled and led by Conservative MP Nicky Morgan, was to raise the profile of mental health as an issue and address the stigma and isolation felt by the vast majority of patients. Morgan opened with some statistics: One in four people will experience a mental health problem at some point in their life; it is the largest cause of disability and accounts for 23 percent of the “disease burden” on the NHS, yet only 11 percent of its budget is spent treating it. Despite all that, the general topic of mental health had not been debated in the main chamber for at least four years.

“Just imagine if this were a physical health condition,” Morgan added.

During the next couple of hours MPs raised important issues: Advocates accompanying mental health patients when they discuss their treatment with professionals, Criminal Records Bureau checks, funding, cuts to social services and complaints about assessments of whether they are fit to work. Tory MP Gavin Barwell talked about his new private bill, supported by all parties, which will remove laws that institutionally discriminate against people who have had serious mental health problems — for example, barring them from being jurors.

However, if the afternoon has any lasting impact on those with mental health concerns, it will be because of the unsentimental, but unsparing personal stories of those four MPs.

I wondered how these courageous people felt afterwards: Did they wake up full of regret the next morning? How did their family, colleagues, friends and constituents react?

“Whether it affects how people view me, I do not know,” Jones said. “And frankly I do not care because if it helps other people who have depression or who have suffered from it in the past, then good.”

Once we are both seated next to the two empty chairs, Walker points out his local newspaper, the Cheshunt & Waltham Mercury. The front-page headline is: “‘Fruitcake’ MP praised for bravery.” Does he regret using the word?

“Absolutely not,” he says. “I have been involved in mental health for the best part of seven years: Part of the problem is people are terrified of it and they shouldn’t be. That’s why I thought it was important to show a lightness of touch.”

“Since it’s talking about my own condition, I can talk about it how I like. If we didn’t laugh in my own home about my own particular manic phases, life would be so much more difficult,” he adds.

Walker and Jones both spoke of guilt driving them to speak out and of feeling like frauds if they did not.

“Actually, I felt better for it,” says Jones when we meet later.

However, once the emotional high of the debate had subsided, did they regret what they had done?

“Yes,” admits Jones, “but the response afterwards shows it was the right thing to do.”

Walker says he had “little twinges” when he saw the Mercury, but says that strikingly his health was good in the days afterwards: If he had made a big mistake, the stress would have manifested itself in stronger symptoms.

“This is my driving passion and I hope it’s given me more credibility to talk about it, and more of a platform,” he adds.

A week after the debate, the four MPs between them have had more than 1,000 e-mails, letters and phone calls. Many colleagues have thanked them: Among 650 MPs, there must be more than four who have personal experiences of mental health — especially given that politics attracts driven people who have to live under the stress of constant scrutiny and frequent criticism. Most of the responses, though, are from ordinary people: MPs see many who are struggling with mental health problems at their weekly surgeries. The debate seems to have encouraged them to open up or simply thank the MPs for “helping make it OK.”

Jones tells me about a woman he met in his North Durham constituency.

“In her late 50s to early 60s, a middle-class lady came up to me and said she’d had depression for 10 years, and was an alcoholic for seven. She said: ‘What you have said has given me strength.’ If I’d passed her, I’d never have guessed. If you walk down the street, you can’t tell who has mental health issues,” Jones says.

The hidden nature of most mental illness is a large part of the problem: It is ubiquitous, yet those who admit to their condition feel that they are treated differently, isolated or even ostracized. Or fear they will be.

Research by Time to Change, a charity tackling the stigma surrounding mental illnesses, suggests four out of five people with mental health problems experience stigma and discrimination, half of those said it happened every day, every week or every month. This stops a great many from socializing, looking for or returning to work or having a relationship. Perhaps the most powerful testimony was from the 35 percent of respondents who said stigma had “made them give up on their ambitions, hopes and dreams for their life,” and one in four who said it had “made them want to give up on life.”

Even before she spoke out in parliament, Wollaston had been more open than most with patients and constituents about her experiences of postnatal depression and panic attacks, perhaps because of her background as a GP. By contrast, Walker had only told one person in politics about his illness since being elected MP for Broxbourne in 2005 and Jones, an MP since 2001, had not even told most of his family.

“I come from a very traditional background: my father was a miner and I was a full-time trade union official, so we don’t talk about these things,” he says.

There are other more common pressures though.

“You don’t want to be defined as a ‘mental health person,’” Jones continues. “Also you have this fear about what is perceived as a weakness: Will it affect people’s views of you, but also make you vulnerable? Actually my depression has made me stronger.”

In her speech, Wollaston spoke about how “at the happiest time of my life” after the birth of one of her three children, she was sometimes left feeling “your family would be better off without you.”

“I am absolutely sure that my own experiences of depression and recovery — recovery is very important — caused me to become a much more sympathetic doctor, and I hope that it made me a more sympathetic and understanding MP, able to recognise the issues in others and respond to them appropriately,” she said.

By speaking out, the MPs all hope to help others by showing the world that most — not all, they stress, but many — people with mental health experiences can lead interesting and fulfilling lives when they have had help. As well as having had early careers, getting elected and campaigning for mental health charities among other causes, all four MPs have made their mark on politics. Jones was a minister of defense for one of the world’s military superpowers; Walker last year won the Spectator’s speech of the year award for his intervention in the debate about a referendum on the EU: “If not now, when?” Wollaston became the first Conservative prospective MP selected, not by the usual route of a panel of local party loyalists, but through an “open primary” in which every registered voter in the Totnes constituency could vote for who they wanted as their Tory candidate, and she more than doubled the party’s majority in 2010; while Leadsom is one of the party’s most active thinkers, already strongly tipped to be promoted into government.

“A lot of people will be saying: ‘If MPs can talk about it, maybe I can start being a bit more open,’” Walker says.