Issues and controversies surrounding mental health

Jordan Evans
Blog Post 7

Having undertaken extensive research and brainstorming on the topic of mental health over the past five weeks, my group set out to map the issues and controversies that surround this complex subject of mental health. Collaborating amongst a group of four allowed for a diverse range of perspectives and focal points within such a broad topic. Up until this point, I have been interested in the lack of, and poor quality of health care services provided to those struggling with mental health issues. Other group members have been focusing on mental health amongst the male demographic and the stigmas that are associated, how technology could affect mental health and spiritual approaches to recovery of mental health illnesses.

We began by mapping out the different actors (human and non-human) that are embedded within the context of mental health and listing the corresponding associations related to each.

issue-mapping-lowres

Upon reflecting on our explorative map, it was strikingly obvious that the notion of ‘barriers’ is something that our group believes is highly involved and intertwined with mental health issues. These barriers primarily consisted of barriers to recovery – obstacles, such as a lack of access to facilities, expensive treatments or stigmas, that may stop someone from receiving the treatment they need – but also involve barriers to gaining support and comprehension from others – such as a lack of knowledge and understanding about mental health issues, and barriers that may contribute to mental health problems – such as gender stereotyping and cultural backgrounds. When dealing with issues and stakeholders, barriers are incredibly important to understand as they are inextricably interwoven in the ways that mental health is approached, understood and dealt with in our society.

Having collaboratively divulged a brainstorm of the actors involved within the context of mental health, my group strove to map out what controversies and issues we believed were poignant in this environment.

 

controversies-map2

Having previously undertaken research surrounding mental health services and facilities, particularly in regards to eating disorders, my controversies laid primarily around these areas. With the knowledge that services are underfunded, difficult to access and some have even being cut completely, I am interested in the controversies regarding those struggling with eating disorders accessing help. I believe that people with eating disorders do not feel supported or valued by the mental health care system. Their illness is not taken seriously, by both society, government, and even health care professionals, with physical health taking priority. Devastating and detrimental misunderstandings of the disease with a lack of knowledge strengthens stigmas, and causes sufferers to disengage from clinics and professionals who might have been able to provide them with much-needed support and help. Mental health services themselves have become a barrier and deterrent to recovery.

Controversies that I identified include:

  • online pro-ana communities that are incredibly easy to access and get engulfed in, that promote eating disorders and ‘help’ people suffering to be ‘better at anorexia’
    see: ‘The harm of #thinspo and pro-ana websites
    “It felt safe. which sounds weird because i was essentially killing myself but I felt safe doing it in that environment. On the websites people encouraged her eating disorder and offered up tips for losing weight and hiding it from her family and doctors.”
  • having to be under a certain weight and BMI to be admitted to hospital to receive treatment for anorexia
    see: ‘Your BMI isn’t low enough for treatment: the deadly approach Britain is taking to anorexia
    “Eating disorders don’t go away by themselves. Asking for help goes against everything an eating disorder stands for. You tell yourself you don’t need help, don’t deserve help – and when that is confirmed by a doctor or funding body saying that your BMI is too high for treatment, you weigh too much, you’re not ill enough, where else is there to go but down? After over ten years of living and struggling with anorexia, bulimia and depression, I got the treatment that I needed, but I had to fight for it and that destroyed me. I cried down a phone, begging for the very thing that I was scared of the most. Many people won’t do that and too many end up too ill to ever recover, or dead.”

    Eating disorders: Patients with ‘wrong weight’ refused care‘”To be told you’re not thin enough – it’s almost an incitement to get worse. It’s like someone going to their GP and being told – you drink one bottle of whisky a day right now? Come back when you drink two.”

  • lack of funding from the government to provide adequate facilities and services for those suffering from eating disorders
    see: ‘Eating disorder patients’ lives at risk due to long waits for NHS treatment
    “The lives of people seriously ill with eating disorders are being put at risk because they have to wait up to three years for NHS treatment. Patients forced to endure long delays are at greater risk of serious damage to their health because it deteriorates while they are waiting. They also have a smaller chance of making a full recovery.”
  • cutting of mental health services targeting eating disorders, such as the butterfly foundation hotline
    see: ‘Eating disorder patients left in the lurch as Butterfly Foundation helpline faces axe
    “It fills me with horror because at the moment, this is the only national dedicated service for people with eating disorders. If this was something like cancer affecting young people, we wouldn’t be saying, ‘well let’s take away the phone support line’ or ‘let’s withdraw services’. There would be a major community outcry.”
  • physical health care taking priority and seen as more important than mental health care

    see: ‘McGorry says mental health care becoming a field of broken dreams
    “The fact that she now had a “medical” (genuine) illness rather than a psychiatric one transformed not only her treatment but also the attitude of health professionals. She was now a “deserving” patient.”

  • perceptions that mental health illnesses, including eating disorders, are not real. Lack of understanding surrounding eating disorders
    see: ‘This is the reality of anorexia
    “I have been told that I am only starving myself for attention and that I am incredibly selfish for causing so much pain for my loved ones when anorexia is something that I “chose.” People tell me that I should just go eat a cheeseburger, because that will cure my eating disorder. I’ve been told to “just eat” as if I am choosing to suffer this much. I’ve had friends tell me that they wish they had the same willpower as me so that they could be skinny or run for hours on end. People have asked me what my “secret” is to having a good body, and when they realize that that “secret” is the result of years of starving and malnutrition, they suddenly romanticize anorexia, failing to realize the reality of the illness.”
  • stigmas surrounding eating disorders preventing recovery
    see: ‘The stigma around anorexia needs to stop and here’s why
    “One in every 100 with anorexia who have sought treatment die each year, and up to 20 per cent over a 20 year period will die as a result of complications of the illness and suicide. Yet this life-threatening illness is still so frequently trivialised. Anorexia is often dismissed as faddy eating gone too far or a lifestyle choice of the young and privileged. Some people believe anorexics are just attention seeking, or that they are slimming to look like celebrities. None of which accurately describes the serious and complex mental illness anorexia actually is. The most common misconception is that it is a purposeful pursuit that the person can in some way stop and control. What happens then is that person then feels very locked in without help and it becomes very difficult to treat.”

My group members explored controversies regarding medications, how mental illnesses are perceived by the public, different approaches to treatment and humanitarian and cultural issues surrounding mental health. Once we had mapped the controversies we then attached various responses and emotions that people have to these issues. We found that the reactions and reponses were all extremely similar with all of them primarily revolving around notions of anger, fear, frustration, misunderstanding and confusion. Understanding these reactions and responses will be important when we begin to design interventions and possible actions for change in the future.

This collaborative mapping experience proved incredibly valuable as we were able to identify the main issues and controversies surrounding mental health. Having previously undertaken quite broad research, bouncing between different areas of mental health, this process enabled me to distill my focus and understand what I am most passionate about and invested in. I have come to the conclusion that when identifying possibilities for action to create change I will focus on the current difficulty of access to care and recovery for those suffering with anorexia.

By conducting mapping and research methods in collaboration with group members each focusing on different areas of mental health, we were able to delve into and challenge notions and controversies that may not have been apparent to each of us if we had undertook this process individually. Having finally managed to break down my area of focus from amongst such a broad and complex topic, it has become a lot clearer on how to move to the next stages of this process. Through researching the ways in which mental health services and facilities are provided to people, and the ways in which people suffering from eating disorders in particular are beling let down by, and are feeling alienated by these care systems, I have a better chance of defining a space of intervention to respond to these issues.

 


 

References:

Jo Lauder, Stephen Stockwell, 2013. The harm of #thinspo and pro-ana websites, ABC Triple J Hack, <http://www.abc.net.au/triplej/programs/hack/the-harm-of-thinspo-and-pro-ana-websites/6965754>.

BBC News, 2015. I had to lose weight for anorexia treatment,<http://www.bbc.com/news/health-33640160>.

Ilona Burton, 2015. Your BMI isn’t low enough for treatment : the deadly approach Britain is taking to anorexia, Independent, <http://www.independent.co.uk/life-style/health-and-families/features/i-live-therefore-im-fine-the-deadly-approach-to-anorexia-and-a-bmi-that-isn-t-quite-low-enough-for-10420966.html>.

Jayne McCubbin, 2016. Eating disorders: Patients with ‘wrong weight’ refused care, BBC News, <http://www.bbc.com/news/health-36956849>.

Denis Campbell, 2015. Eating disorder patients’ lives at risk due to long waits for NHS treatment, the guardian, <https://www.theguardian.com/society/2015/jun/14/eating-disorders-long-waits-nhs-treatment-lives-risk>.

Scott, S. Armitage, A. 2016. Eating Disorder Patients Left in the Lurch as Butterfly Foundation Helpline Faces Axe, ABC News, <http://www.abc.net.au/news/2016-05-16/life-saving-helpline-for-anorexia-patients-set-to-be-axed/7412358>.

McGorry, A. 2016, McGorry says mental health care becoming a field of broken dreams, The Australian, <http://www.theaustralian.com.au/opinion/mcgorry-says-mental-health-care-becoming-a-field-of-broken-dreams/news-story/aa5b35108743d5d3ab5d09d968d4fd7b>.

Alice Doeblin, 2016. This is the reality of anorexia, WordPress, <http://thoughtcatalog.com/alice-doeblin/2016/08/this-is-the-reality-of-anorexia/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A%20ThoughtCatalog%20%28Thought%20Catalog%29>.

 

 

 

 

 

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