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Posts Tagged ‘Mind CEO’

Dear Mr Farmer,

You have just been awarded a CBE. You have just been voted most admired charity leader of the year and seen the findings of the task force you led adopted by the NHS as grounds for hugely increased investment in mental health care. Your career as a charity bureaucrat is beginning to look rather spectacularly successful.

I remember the beginning of your rise to prominence. In the early 2000s you were recruited as director of public affairs by the then National Schizophrenia Fellowship, an organization founded by one, John Pringle, in 1971 to campaign on behalf of people afflicted with schizophrenia. It had formerly been run largely by parents and volunteers. In 2001 you and Cliff Prior, your boss (also since awarded a CBE), staged a palace coup, railroading a change of name to Rethink on the grounds that the presence of the word schizophrenia in the original title attracted stigma and deterred both potential funders and people who might actually benefit from the organisation’s help. I use the expression “coup” because only 14% of the total membership voted; those who favoured change amounted to only 9%. A majority of members did not like either of your proposed alternatives, Reason and Rethink, and only 5% of total membership approved of Rethink, the name chosen by the Board of Trustees. A member of NSF staff at the time told me that “the balance of power within the organization had shifted: the professionals had gained the upper hand.”

I mention this because it does not seem to fit very comfortably with your standard rhetoric about consulting the people most concerned, carers and those they care for: the sick, now known, I notice with horror, as “experts in lived experience.” But right from the beginning you have adopted the woolly and evasive jargon of political correctness with gusto. “The ethos of optimistic realism” was the empty slogan you coined in your campaign to change the National Schizophrenia Fellowship’s name. And there were many other semi-literate horrors you perpetrated in your campaign literature, which I kept for many years but have now, unfortunately, thrown away.

You are not alone of course in your enthusiasm for the new sub-Orwellian mentalhealthspeak. Doctor the language and all that is disorderly, unsavoury, difficult, embarrassing: all that tends to suggest that anyone might belong to a category of being that might be perceived as inescapably inferior must be eliminated. Thus, illness has been abolished; we are all on “journeys of recovery,” as the CEO of our local mental health trust wrote to me à propos of my son’s schizophrenia some ten years ago now. Now we are all more well or less well, just as we are less able to stand rather than unable to stand or just older rather than old or elderly. And if you query the sense of talking about recovering from afflictions from which recovery in the normal sense is not possible, you will be told that actually recovery does not mean what you thought it meant: it means rather whatever you want it to mean. In effect, if I say I have recovered or you say I have recovered, then I have.

Suspiciously convenient, one might think: sort of useful for bureaucrats who love positive outcomes and ticking boxes. Is this perhaps what you meant by the “ethos of optimistic realism”?

The losers in all this: the people like my son who suffer from schizophrenia and other serious mental illness. You of course do not talk about mental illness any more. Your talk is all about mental health problems: how one in four people in the population will suffer from a mental health problem in the course of a year, which is a statistic that only makes sense if taken to include Monday morning blues, disappointment in love, missed job opportunities, bereavement and many of the things which through most of human history have been regarded as routine life experiences. You talk endlessly about psychological services, about making talking therapies more widely available. Very likely these things help with the kind of existential problems life throws in our paths… But, even in France, where talking therapies have been in regular use with schizophrenia, psychiatrists will tell you they rarely work in psychotic illness.

You wheel out Stephen Fry and Jonny Benjamin as examples of how people can recover from psychotic illness. I do not in any way underestimate Stephen Fry’s suffering when he is ill, but there is plenty of evidence that people with bi-polar disorder can function very well between bouts of illness. Even Jonny Benjamin – admirably courageous young man that he is – is very much the exception rather than the rule where schizophrenia is concerned.

Your achievement in changing the name of the National Schizophrenia Fellowship to Rethink has ensured that for ten years and more the staff have scarcely allowed the word schizophrenia to pass the barrier of their teeth. Terry Hammond, one of the organisation’s trustees, has himself written: “Schizophrenia is fast becoming the neglected illness and all this is happening in the name of recovery – empowerment – independence…I believe there is no comparison between the life-changing effects caused by schizophrenia and other forms of mental illness…Most people who develop schizophrenia do not go on to live ‘normal lives.’ Most are unable to work. Few get married or successfully socially integrate nor do they become prime ministers, spin doctors, comic geniuses or award-winning actors…too many policy makers and politicians have been taken in by the ideological claptrap which has been preached over the years by the mental health extremists…empowerment, independence, normalisation, recovery: all worthy aspirations, yes, but in the hands of politicians and Primary Care Trusts, they are simply excuses for delivering community care on the cheap…most of those who are campaigning at this level are individuals with depressive and anxiety disorders – not schizophrenia.”

John Pringle in the 1971 letter to The Times that led to the foundation of the National Schizophrenia Fellowship wrote that, while some people may make a partial recovery from schizophrenia, thousands “level off like my son at a low level of adaptation, physically fit and normal-looking to a casual outsider, but without application or anything that can be called will-power, and finding most inter-personal relations almost impossibly difficult… they are incapable of looking after themselves without special guidelines and supervision…”

They need help even with the daily routines of life and they are not getting it.

When are you going to acknowledge your debt? Your career has been founded in a sense on schizophrenia, but through your uncritical espousal of the fashionable discourse of the care services you have contributed in no small degree to silencing the few voices that once spoke out for schizophrenia.

 

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