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You’d have to be mad to tell people you’re mentally ill


Last May I officially became a grumpy old man when I wrote a letter to the BBC complaining about Have I Got News For You.

I don’t normally watch it on account of the fact that it hasn’t been funny since about 1984, but it was on and I was there and Ian Hislop, a perpetually angry little man, started ranting about Alastair Campbell, the former adviser to Tony Blair.

Hislop was not “doing satire” on Campbell. He was not being witty or funny, he was not deconstructing politics or power, he was simply calling him “mental”. He ranted without a discernible punchline or point about him being mental and how this disqualified all he did and said.

Now even the most liberal interpretation of humour - that is, you can say anything as long as it is funny - failed to save this embarrassing tirade. Nobody laughed. A few did giggle - the way they might when they hear a drunk burp in a library. But I didn’t write to complain about it not being funny. I complained because Campbell had spoken and written at length about his mental ill health and was part of a national anti-stigma campaign. Ironic really that what you get as a high profile person “coming out” as mentally unwell is name calling on primetime TV.

‘The BBC doesn’t do racist gags now does it? It has drawn a line in the sand. Unfortunately however, “madness” remains on the wrong side of the line’

Anyway the reply - which took a mere four months to materialise - missed the point. “Jokes are made about all of us at some time,” it said vaguely. So will the new series turn its comic attention to wheelchair users, gay people or Pakistanis? One hopes not. The BBC doesn’t do racist gags now does it? It has drawn a line in the sand. Unfortunately however, “madness”’ remains on the wrong side of the line. We may be more accepting of difference but not if that difference involves those who are mentally ill.

I mention this now because I was listening to some mental health student nurses recently talking about how vital the issue of stigma and discrimination is for their patients and how this issue - along with so many others like counselling, recovery, risk management and relapse prevention - combine to make the work of a mental health nurse fundamentally different to that of an adult or children’s nurse. The branches are united by the principles of care but the skills, knowledge and activities are separated by their patient needs.

I remain interested in the ever lively debate around nurse education. How can we ensure we equip everyone with all they need to make them able and confident? Well maybe we should think of them less as branches and more as separate trees in the same forest? Make the courses separate from the start and thereby allow students to have education and practice that focuses on their patients’ needs all the way through the training.

Too much genericism doesn’t help students. Particularly mental health ones. Mental health nurses do a unique job in a perpetually misrepresented and misunderstood world. They need and deserve more specialist educational investment. Ultimately that is down to the Nursing and Midwifery Council. So I won’t be holding my breath.


Readers' comments (14)

  • Well said!! As someone who had a 'breakdown' due to stress I can only say that we are all so close to having mental health issues that it ought to generate much more empathy & concern than the aforesaid Mr.Hislop showed! (I watched this episode with my chin on my chest in disbelief!) I am sure that Alistair Cambell would have more empathy with Ian Hislop should the tables be turned... but then it seems that most people who are sympathetic with mental health issues are either in the caring professions, suffered from some form of mental health problem themselves or, both!
    Let Jo Brand do the jokes about mental health Mr. Hislop; she knows what she's talking about.. and you concentrate on trying to get more interest in proper funding for the NHS! Clinical Depression is a stigma which affects lives!! Alistair Cambell helped to bring this issue to the foreground and is to be thanked for it!

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  • Oh please!
    Is this what constitutes an article these days? Ian Hislops use of the word mental is the same as peoples use of the word 'wicked' or 'cool'. Clearly people who use those If i say, 'that's crazy' i mean many things such as;

    'Often the Nursing Times has so little significant material it's crazy' i don't mean

    'Often the Nursing Times ha so little siginificant material that it has a mental health issue'

    For all we know Alistair Campbells mental health might just have been caused by his:

    1. his dubious policies
    2. his often unevidenced and pretentious style of spin doctoring that clearly was at odd with yours, mine and his own morals.
    3. his knowledge that 9/11 and 7/7 were faked, Robin Cook and David Kelly's as a contractor under the name 'Tim Osman' and so on and so on.

    rather than mere stress and job pressures.
    and i think you'll find Frank Bruno did almost 1000 times more than him in bringing attention to depression and related illnesses.

    Either way, 'mental' as a term in no way relates to common depression, rather it refers to 'lunacy', itself termed from 'lunar'. This is most likely to come from the old fashioned linkage of the moons phases to madness or 'cyclic mood disorders'.

    This could have been a relevant post but it comes from such a spurious and flippant point that it eats itself in the crux of whether it has any reasonable genesis, which i'm afraid it does not.
    It was hardly a slur against mental illness, just the adaptations of an old word to descibe the actionsof a man, who in all truth is part and parcel of our declining faith in politics and knee deep in political crapulence, secrecy and untrustworthy corruption.

    Keep up the good work IAN!

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  • I trained in the era when a State Registered Nurse also did a stint of Mental Health and Children's Nursing as well as Obstetrics whilst a student.

    That background knowledge, albeit a long time ago, underpins my present Practice and is a foundation for updating. Working in General Practice I deal with the whole family from babies to the elderly. This includes patients with complex mental health problems. I may not be seeing them for their mental health problems as such but an understanding certainly helps whilst dealing with Chronic Disease Management and everyday health problems.

    Similarly the Mental Health Nurse needs to understand why a change in psychiatric medication has caused the patient's Diabetes to go out of control and be able to act and advise accordingly.

    We shouldn't see patients in isolation and nor should the training be disconnected from the whole patient. A common foundation programme, though imperfect at least gives an insight into the complex inter relationship between physical and mental health problems.

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  • I agree with Jacqueline. I don't believe the constant divisions in nursing is beneficial to the profession or patients.

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  • I attended some training recently, run by social workers, who asked for words that teenagers commonly used. My colleague said 'gay' - teenagers use this word to mean 'a bit naff'. Despite asking for words that teenagers use, the trainers refused to write the word on the board as they said it was offensive to gay people. Firstly, they asked the question, they got a response and should have gone with it, secondly on questioning my teenage sons they say that they use the word with no thought to it meaning homosexual. And if we go back to my childhood, it actually meant 'happy' anyway.

    Mentally ill people are discriminated against as are physically disabled, fat people (and didn't Mark recently argue for plain taking use of the word fat), and people with red hair get more than their share of stick. Words meant to hurt should not be used. Words evolve, as has the word 'gay' so in some respects they may be offensive, or not, in their cultural or historical perspective. I don't think for one second Ian Hislop intended to insult all mentally ill people, as jjez says above (and I don't agree with all his/her comments) - that would be crazy.

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  • Re Ian Hislop. I agree with you. He sneers. He could be pitied for using his brain in this way. What a handicap for him. Thank you for taking the time to write this great article.

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  • I really enjoyed reading this article and felt a sigh of relief that what could and is regularly passed off as humour actually has an insidious agenda underpinning it. So I disagree with the responses that think/feel it was throw away or lighthearted humour. Nor do I for a minute consider that he is as naive as a teenager might be in usage of such words. The definition of those words can be argued til the cows come home, however the intention behind the words and agenda driving it can, and usually is very different to a dictionary definition.
    There is also a difference between laughing with someone and laughing at them when the cost of the laugh is not yours in making the 'joke'
    I really hope that mental health and emotional health is more talked about one day without feeling the need to gird your loins to do it or worrying about the consequences of doing so, eg. ridicule or feeling dismissed.
    Thanks for writing this Mark.

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  • From someone who has suffered mental illhealth in the past herself - twaddle. His comments were not offensive and this article is a load of tosh.

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  • @jjjez, thankyou for de-stigmatizing the use of the word "mental," i now feel empowrered to use it indescriminately and at whim. do you please have a similar etymological excuse for use of the words "paki" or "bitch?"

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