We’re (not) coming out… Not today, anyway
Salomons Service User and Carer Coordinator, Laura Lea considers why admitting to mental health problems may be such a taboo for mental health professionals.
‘We’re comin’ out… out on the streets’ sang the late Lou Reed. That was in 1972 and now feels part of a story where people having the courage to be honest led to a sea change in attitudes to sexuality. In 2013 it still rarely feels safe to tell people I’ve had mental health problems. Even before that notorious Sun front page. I’m not sure what I think will happen if I declare myself. Perhaps it’s a belief that people will wonder whether it’s me or the mental illness talking. Too much emotion might be taken as a sign that I am not entirely in charge of myself. Too calm and my responses could seem blunted. Either way I don’t want people to think that my brain is out of order. After all there’s plenty of evidence to suggest admissions of mental health problems provoke pejorative associations and might not be the best thing for my future employment prospects.
In my current career though (someone whose current job actually requires experience of being a mental health service user) I’m more out than I’ve ever been. While it’s not always easy, I hope I’m at least a small part of a bigger change, and that coming out can be as powerful an act in mental health as it has been in sexual identity. I often wonder though how much more difficult is it to declare you have a mental health condition if you actually work in the business? Certainly a recent study of psychiatrists suggests this is the case. What if you go from being someone who is known as sane, even a ‘sanity consultant’, to someone touched by madness? The study suggests that maintaining your secret is the only answer. Doctors need to hide their status as patients.
The question for me is whether something important gets lost when mental health professionals simply hide their own vulnerabilities: an opportunity to connect with service users and signal, in the most immediate way possible, that they are not alone. That the carer and the cared for, share a profound area of common experience. It’s a tough one though, and clearly professionals mostly want to keep it under wraps.
Some of my Salomons colleagues and I thought it was time to find out more about the issue. We recently ran some focus groups exploring how difficult it can be for mental health professionals (in this case clinical psychology trainees) to speak about their own experiences of difference. Difference in this case might be experience of mental ill-health but also gender, sexuality and disability. The resulting paper Finding the Personal in the Clinical Psychology Swamp (the title an attempt to acknowledge the messiness inherent in these situations) has now been published. Through our discussions we found that people were hesitant and anxious about voicing all kinds of difference. Experiences of class, parenthood and mental health were all hard to integrate into a clinical identity. When we held a related seminar open to all our staff and trainees, people came forward to speak about a number of experiences. These included being a parent, a carer or having a physical disability. However, we were unable to find someone to speak about being identified with mental health issues. If people are silent we can only guess at their experiences and motives, but it seems to me that talking about this subject is just too complicated for a lot of people.
In one way, we’ve simply confirmed what we already know. It makes me at least think that perhaps ‘them and us’ thinking persists, not only out there in Sun journalists, but also among mental health professionals. Perhaps that’s an unfair conclusion but I find it difficult to avoid. However, hopefully by raising the issue we are giving people the opportunity to think about the reasons that they are reluctant to speak up. The next steps for us are to investigate further into the reasons for this reluctance and, in the longer run, to think about ways to change things.
Are you a professional with an opinion on why a user history is difficult to confess to? Or a user of health services who would like to know more about those who treat you? Comments are open and we’re interested in your views.