Saturday, January 12, 2013

Mental Health and Stigma - Tiger Stripes Not Scars

Part of the Cestrian Dreams Project
GUEST Article author: Andy K Gill (BSc)

"I have scars on my arms and wrists from self-harm as a result of my mental health."

As is well advertised through popular campaigns such as “Time to Change,” the amount of individuals who have experienced some form of mental health issue is supposedly one in four (Mental Health Foundation; 2012.) Yet within the United Kingdom the prejudice and stereotypes that are attached to the aforementioned experiences are still causing unnecessary distress and disempowerment to those who fall within this category. Whilst there has been much hype regarding the promotion of those who have lived experience of such issues, or the "experts by experience", there is an identifiable inequality of opportunity or recognition for those who feel able to utilise their skills and existential knowledge to make real changes within mental health services.

In contrast, there is a need to recognise that the word “vulnerable” is not necessarily a taboo term. It is an unfortunate reality that for those living with mental distress, there are times that we can be a risk to ourselves or others. Whilst some who read this may find themselves aghast that this author is reinforcing the very stereotypes he purports to be challenging, I would suggest that without honesty and transparency regarding such issues, society will never truly find the correct balance between empowering those with mental illness and protecting the rights of everyone within society.

As a sufferer of severe mental health issues myself, I have witnessed the chaos and instability that results from binary interpretations of these often opposing ideals. I have witnessed the leaders who stand proudly with their flags, shouting from the hilltops that “We are crazy and we are proud! We know the way forward and we WILL BE HEARD!” In fact I was one of those individuals with a small yet determined (or possibly psychotic?) bee buzzing in my bonnet. After witnessing the astounding labels, the bio-medical (or Dr Frankenstein like) approaches and the looks of concern, fear or even resentment from friends and family, can you blame me? I have also experienced the relentless testing of medication and treatments. The different pills and formulas, wrapped in foil or bottled in plastic containers. They always promise so much, but often cause more harm through side effects than the mental illness they are supposedly treating.

So, after finding others with views similar to my own, I threw everything I had into helping with the creation and promotion of service user led projects. I advocated for those who needed a voice, I worked all day and throughout the night striving to achieve the changes that I believed needed to occur. I even challenged board members and criticised those in charge of the very organisations I was trying to help. But then came the head banging...

At every point during this period I was working under a set of ideals that were contradictory. I am sorry... but this again is where that word vulnerable creeps back into the discussion.

It is problematic in this author’s opinion to create and maintain services led and owned by those experiencing, or with experience of mental health issues. That is, unless such people are ready and feel in a position of recovery that enables them to be involved. There I said it! Please don’t shoot me! Now, please do not misunderstand me here, I know and believe in my very soul that those who have experienced it are the best people to tell anyone how to treat and assist those currently living it. It has been proven within the NHS and other organisations that peer led groups do indeed provide support and knowledge that other methods of intervention and treatment cannot provide (Lorig, Kate; 2009.) However, it is unrealistic to expect that those who attend peer led groups in mental health will eventually be the people who return and lead such services.

The very reason that such individuals attend services is because they are feeling unwell and vulnerable. Whilst the empowerment of such people should be a priority, expecting them to at some point take their turn at running the show is simply unrealistic. Hence the head banging. Again and again those in charge of the services I volunteered for informed me that I had failed to get other service user’s involved and was moving away from the ideal. Of course this meant that I would encourage anyone who came along to become more involved and to take lead. Consequentially, I was continually giving opportunities for others to take charge, only to be told that no-one wanted the responsibility. This eventually led to a cycle of frustration and disappointment coupled with expectations that I simply could not meet.

After enduring this for months I myself became ill, and eventually my partner forced me to my GP who referred me to secondary services. I never attended the appointment. Instead I simply moved away from my roles, held my hands up and quit. Since doing so the same situation has occurred with another service user who has now left also.

So what is the point of this discourse you may ask? Well, it is simply this. There are those with mental illness who are ready and there are those who are still too vulnerable to take up arms. It is an unfortunate but necessary truth that we all need to address. Peer led support is amazing, and I have seen it work miracles! But any peer group or service needs to be implemented with an understanding that not everyone wishes to stand up and be counted.

As for me, after leaving my roles I was offered a place at university to study for a MA in Social Work. Ecstatic, I again took up my flag and marched into a hopeful future full of sunshine and optimism. After completing one year of theory with flying colours, I have now been informed that due to my mental health history, the universities’ occupational health practitioner feels that I am not quite ready for the course, and I need to wait another six months to restart the whole thing (if I wish to.)

Very frustrating, yet I understand. For you see, I have scars on my arms and wrists from self-harm as a result of my mental health. At times these are simply scars and provide a grim artistic vision of demons that can, at any point, raise their ugly heads to try and drag me down again. At other times these scars are my tiger stripes. They show my strength, experience and that at my core, I am a survivor. What is important for all of us “one in four” is that we recognise when the time is right for us to stand up and fight the good fight. But this can never be done at our own determent. Sometimes, as much as I am sure we all hate to admit it, we can be vulnerable. But that’s okay, because so can everyone else.


Lorig, Kate. Et al (2009). Community-Based Peer-Led Diabetes Self-management: A Randomized Trial. The Diabetes Educator July/August 2009 vol. 35 no. 4 641-651.


Cestrian Dreams was founded by Alwyn Ash in December 2012, with the aim of highlighting mental illness, raising awareness, and helping to overcome the stigma associated with the disease. Originally set up with its very own website, Cestrian has now been incorporated with Alwyn's personal site.

"1 in 4 will suffer with some form of mental health issues"