Would You Respond To Physical Illness Like This?

7 January 2014

What if we treated mental illness like we did physical illness?

Imagine an individual with severe flu and some people responded as they would do to a mental health issue:

“Why don’t you just try…not having the flu?”

“How come you are not normal like everyone else?”

“It’s just a phase, it’ll pass”

“I don’t think its right to take so much medication for your flu. Go out, socialise and exercise, that will make you better”

“Just change your frame of mind and things will change”

Sadly these common responses to mental health issues such as anxiety, depression or self harm are not the result of insensitivity but rather lack of understanding. Hospital trained-Chaplain Diane Weber Bederman condemns these kinds of reactions. She compares a man who crashes his car due to a heart attack but kills people in the process to a man who shoots people whilst suffering from an acute psychotic break. Her diagnosis, ‘In truth, neither one is to blame for their illness or the tragic unpredictable event’. Bederman ltMentalIllnessbelieves less sympathy will be held for those experiencing mental health issues who then harm others as a result of their problems ‘”Mental” illness drags behind it a heavy bag of ignorance and confusion that has led to the stigma of shame and prejudice for those with the illness as well as their families, and continues to promote fear in the public square.’ Indeed high profile cases in recent years can be seen to fuel people’s fear of the mentally ill and hinder understanding.

Nick Watts a campaigner against eating disorders who recently spoke at a school, was shocked at the responses he received when asking students opinions on self harm. A student’s response, “Self Harm, but no-one here worries about that, only stupid people do it.” This lack of empathy particularly amongst young people worryingly delays help for self harm due to the lack of education on self harm and other cases of mental illness. Watts is adamant ‘We should be working with our young people to bring up a generation that understands the complexities of these issues and can have these difficult discussions openly’.

According to a study, we generally get our impressions of mental health and what they are, for instance, depression, anxiety and stress as they are more widely known as it is universally believed everyone experiences them. Suicide and attempted suicide on the other hand, tend to be more widely known through the media and its large coverage of teenage suicide for example. Precipitators such as the media and school are therefore the common possible roots to helping those who self harm through information and facts on mental health and re-education.

It may also be important to take into account cultural context. Brandon Knettel a doctoral student in counselling psychology observed the differing attitudes to mental health in non western countries such as Tanzania. For instance, due to poverty, diseases such as malaria take priority before attention can be drawn to mental health issues. Interestingly however, those who experience severe mental health issues are more visible in Tanzania, whilst those with such diagnoses in Western countries are not as visible as they tend to reside in hospitals and treatment facilities. Knettel acknowledges this cultural divide and concludes “Oftentimes, rather than try to understand the cultural discrepancy, we’ll immediately try to solve everything as if it is a Western problem requiring a Western solution.”

We cannot tackle the issue of self harm and mental health without a clear understanding of the distinction between visible and invisible health problems. Just because we cannot see it does not mean it is not a priority, as Bedeman warned in her previous example with the contrasting diagnoses.

It is noticeable that the BBC and ITV have just recently started to encourage the general public to simply talk to someone that they suspect of mental ill health. Talk to them about their condition rather than avoid them. Just talk to them! Maybe next time someone opens up about self harming behaviour more people will respond with sensitivity and understanding rather than refusing to take it seriously until we ‘see’ the scars.

Can Drinking Be Classed As Self Harm?

6 December 2013

Self harming does not necessarily need to be physically painful, it can in fact occur without the individual knowing what they are doing to themselves. Ordinary behaviour such as over eating, smoking or working long hours can all help numb the pain an individual is going through. This can however be categorised as self destructive behaviour, one of the most fatal being drinking excessively. Although alcohol consumption is an everyday activity for some it is important to raise self harm awareness in relation to alcohol consumption.

According to the National Suicide Research Foundation there is a direct link between self harming and excessive drinking. Reinforced by professor Arensman, director of research, self harm is a “direct effect of the depressive effect of heavy drinking”. It is reported that 38% of 12,010 self harm cases were related to alcohol consumption. They even suggest that by ending heavy drinking amongst adolescents and young people they could reduce self harm by 17% in 2-3 years. It is also interesting to point out that this behaviour peaks during holiday season where people are admitted to the emergency department from self harming after consuming alcohol, requiring increased help for self harm. Dates like New Year’s Day and bank holidays show self harming and alcohol consumption is “very strongly associated with public holidays”.

binge_drinking

It is no surprise that harmful consumptions of alcohol can count as self harm and not the traditional cutting that many would assume, since self harm is a means of relieving pain and negative emotions. As there are healthy ways to reduce stress such as exercising and relaxation there are unhealthy ways such as drinking or smoking. People who suffer from Bipolar or mood disorders for instance are more likely to abuse alcohol or drugs than those without such disorders. In order to provide self harm help it is therefore vital to inform individuals of safer methods of reducing stress and managing emotional discomfort.

Additionally, alcohol can lead to impulsive actions such as self harm or suicidal behaviour by removing inhibitions and making an individual behave in ways they would not normally behave. According to NHS Scotland for example more than half of hospital attendees who self injured claimed to drink before or during the act. 27% of men and 19% of women gave alcohol as the reason behind their self harming.

Helping those who self harm seems a daunting task due to the serious nature of self harm according to those not fully informed, but even the most common actions can be detrimental to one’s health. Over consumption of cigarettes, food, work, reckless behaviour and ultimately alcohol can provide temporary escape from negative feelings but could soon become a dangerous addiction and ultimately lead to physical harm to the body and mind. Adding to this, by self harming under the influence of alcohol an individual is less likely to be aware of their actions and less likely to stop. For many individuals it is easy to choose fast relief for pain, which is why we must push for healthier and safer means to reduce negative feelings and ultimately self harm.

Scarred On The Battlefield

11 November 2013

“I didn’t feel anything at the time. I couldn’t. I was immersed in the normality of Afghanistan…But it’s when youbattlefield come home and you’re re-immersed in the different normality of home, the cosiness of home life, that you can remember things differently. And I just remember playing my part in killing an extremely terrified, dying man.”

These are the words of Jake Wood, a 40 year old investment bank analyst who served as a reservist in Afghanistan from April to October 2007. Wood relays the feelings of alienation when a soldier returns to their regular life and must adjust to the starkly contrasting environment. After suffering from “survivors guilt” as well as “killers guilt” Wood underwent years of intensive treatment which he believes prevented possible suicide. This is one of the many cases of mental health amongst war veterans and raises questions of what we can do to help those who self harm in the army.

Recently a government decision to double the number of reservists in the army from approximately 15,000 to 30,000 soldiers threatened to create a wave of mental health problems. Reservists of the Territorial Army hold careers outside of the military and do not work full time, as such they lack the wider mental health support available for full time soldiers. This results in reservists being more vulnerable to mental health issues, most notably Post Traumatic Stress Disorder. This can further lead to self harm or suicide as reinforced by the study carried out by King’s Centre for Military Health Research and Academic Centre for Defence Mental Health. In 2012 after carrying out phone interviews with 821 participants 5.6% reported self harm and attempted suicide during their lifetime, more notably following PTSD. These worrying statistics highlight the need for self harm awareness within the military.

Other methods of self harm include alcohol abuse and severe substance addiction,  interestingly rising from negative experiences prior to joining the army. These can include a history of abuse, homelessness or unemployment or many other such experiences. Veterans have also admitted to failing to reach out for help due to the social stigma attached to self harm in the army. Army veterans, particularly men, are expected to adhere to the macho image associated with the army. As a result veterans refuse to speak to a GP or specialist out of fear or embarrassment within the establishment. This brings up the common problem for providing help for self harm where individuals refuse to come forward and admit their problems.

It would seem however that more awareness and self harm help is being distributed more recently. A new smartphone app recently released aimed to provide information and help on 11 mental health issues including depression, anxiety and Post Traumatic Stress. The app endorsed by the Ministry of Defense aims to dispel myths about mental health and self harm by providing information on where to get help. As such information and support for mental health is becoming readily available online with links to prominent organisations such as Young Minds and Samaritans. Scars received on the battlefield can be mental as well as physical and by increasing awareness of mental health issues amongst the army we can provide the proper treatment to help ease individuals get their life back.