(For reference, please see Dr Hugh Middleton’s post, “Illnesses like any other”. The challenge of a multi-disciplinary approach to mental health.)
Hugh Middleton raises some admirable and poignant questions here, particularly in relation to the responses of young doctors regarding mental health as a strand of their medical training. I find the ‘Marmite-like properties’ of psychiatry (as a discipline to teach) to be a marvellous simile. Consequently, I am left pondering if this characteristic of mental illness is relevant also for the general population (e.g. the other readers of Hugh’s Jan., 2012 Observer edition). My own area of interest is prison mental health and the volatility alongside importance of political and public opinion is remarkably salient. Thus, I wonder if mental illness is a topic — for the public — that either commands attention, devotion, and concern or perhaps at other times a certain amount of distrust, inattention, and insensitivity; to précis (albeit oversimplified), a love versus hate relationship. Although, clearly, this rumination renders the public a unified social group with an absence of dissident opinions; whereas, this is of course not the case. To continue, as a (medical sociology) researcher, and not a clinician/psychiatrist, I find it a captivating and engaging pleasure to ‘revel in the mess’ that is the quagmire of mental health and illness policy, practice, research, and development. However, the aforementioned position of some doctors (as highlighted by Hugh) is understandable, as they are required to accept responsibility for these patients and their mental health; whereas, a researcher’s accountabilities in legal- and health-based terms are, relatively, diminutive. Thus, perhaps is it easier for academics to embrace Hugh’s notion of swimming in the ‘messy swamp’ that is psychiatry and its related endeavours. Notwithstanding this call to support yet recognise mental health research as a convoluted pursuit — remembering the ‘uncertainties of diagnosis, the absence of confirmatory laboratory findings and conflicting theoretical frameworks’ — there is perhaps (regrettably) also scope to consider how such studies align with the current age of austerity and the requirements for research to produce overt outcomes and demonstrable impacts. Nevertheless, if we accept ‘mental illness as an impending tsunami of disability’, continued research and development in the field of mental health is most certainly a requirement; moreover, neglect would, arguably, display myopic tendencies. After all (as noted by Hugh), ‘happiness, despair and confusion are everyone’s business’ and not just the concern of the portion of our population (approx. half, I’m told, but surely not?!?) who love to spread Marmite on their toast.
Nottinghamshire Healthcare NHS Trust & University of Nottingham
Institute for Mental Health