Paranoia or Persecution?

A new Mind report relates a shocking catalogue of harassment, assault, victimisation and discrimination against those who suffer from mental health problems in England and Wales. This leads me to wonder about therapeutic treatment for people who are so discriminated against — when someone is factually being persecuted in their own home, where does paranoia begin?

Mind, the leading mental health charity in England and Wales, has just published a report Another Assault with shocking conclusions: Seventy-one percent of respondents with mental health problems had been the victim of a crime in the last two years, compared with 24.4 in the general population, as measured by the British Crime Survey[1] over one year. A mere 19 percent of people with mental health problems in England and Wales say that they feel safe all of the time in their own homes.

The levels of physical and sexual assault, bullying, and damage to homes were dramatically higher than for the general population, and nearly 90 percent of respondents living in local authority housing had been victimised.

Adding insult to injury, the police often respond to the victim’s characteristics rather than to the crime.¬†Sixty-four percent of victims of crime and harassment were dissatisfied with the response of the authorities to reporting the incident, and we can only imagine how many people did not report the crime at all, imagining a response from the authorities which would be at best useless and at worst traumatising. Here there are clear parallels with women reporting rape and sexual harassment or attack. Similarly to the sexual history of a woman reporting a sex crime, the mental health history is brought up in court by lawyers rather than independent psychiatrists, when it is quite irrelevant to the case.

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Whereas awareness of the treatment of women has risen and change is hopefully on the way, the same is not true for those with mental health problems — and this is not a marginal group but 1 in 4 UK citizens, as Mind estimates. The ‘disability hate crime’ sentencing provision introduced in February this year is, so far, hard to identify by police who often seem unwilling and unmotivated to consider these factors, preferring to consider the person as an unreliable witness.

Perhaps most shocking is the assertion that people with mental health problems have come to accept harassment, victimisation and bullying as a part of their condition. This leads me as a practitioner to wonder about therapeutic treatment for people who are so discriminated against — when someone is factually being persecuted in their own home, where does paranoia begin? If someone’s experience is routinely not believed, this is a very efficient way of messing up their sense of reality. Depression can be a perfectly logical response to discrimination and harassment, particularly when there is no support available, and isolation seems to be a particular risk for individuals suffering from mental health problems, who may not come together in a community (yet?) as naturally as women or people suffering from racial discrimination.

As a practitioner, this report is a sharp reminder of the circumstances some clients are dealing with, how mental distress can turn into a self perpetuating cycle, and how the solutions may lie outside the individual.

1 Home Office Statistical Bulletin: Crime in England and Wales 2006/07, 4th Edition. Edited by Sian Nicholas, Chris Kershaw and Alison Walker, July 2007

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