Are you the one in four?

‘Is Anybody There?’, a new survey by the UK Mental Health Foundation (MHF), has found that one in four people only found out that their friend was experiencing mental health problems when that person was admitted to hospital (1).

At first reading, this peculiarly convoluted ‘one in four’ seems to imply that we all have a friend with a mental illness, and that one quarter of us fail to see it. It actually means, of course, that of that relatively small group of people with mentally ill friends, one quarter of them fails to detect the problem. And is this quite so alarming as it might first appear?

The MHF claims that this ‘one in four’ finding indicates how mental illness is ‘kept secret’, because the ‘stigma’ of mental illness prevents people from getting the support they need from their friends (2). Consequently, it argues, what is needed is a broader change in attitude towards the mentally ill: more awareness-raising in schools, more positive media images of the mentally ill, and government-run anti-discrimination initiatives (3).

But this is only one interpretation of the report’s findings. Another, more commonsensical, interpretation is that mental illness is a personal and difficult problem, and it requires a high degree of trust to ask for a friend’s support.

One of the comments in the report explains the difficulties involved in supporting a friend through mental illness: ‘erratic behaviour, subsequent rows and excessive demands (emotional and physical) together with continual apprehension as to what other scenes and rows, could and would occur.’ (4) Seventy-eight percent of people supporting a mentally ill friend said they sometimes found it difficult; 43 percent felt that the emotional strain was sometimes too much (5).

It is not easy to ask for a friend to go through this emotional stress to support you. In this sense it is understandable why four out of 10 people with mental health problems were reluctant to ask friends for help, for fear of being seen as a burden; or that 48 percent of respondents were only able to tell ‘certain friends’ (6).

‘Friends’ is a broad category. Most people make a distinction between close friends, with whom they would share a difficult personal problem, and less close friends, with whom they would not. Perhaps people with mental health problems decide that they can only rely on close friends for support; and the other one in four are left in the dark.

Instead, the MHF’s interpretation of this ‘one in four’, by emphasising the stigma attached to mental illness, presents the difficulties surrounding mental illness largely as a question of unnecessary prejudice or shame, that can be solved through awareness-raising or a change in attitude. This defies the evidence presented in its own report, and by downplaying just how different and difficult mental illness is, it is unlikely to help sufferers of mental illness – or their friends.

Read on:

Mental illness: all in our minds?, by Fenno Outen

Is mental illness just ‘different’?, by Fenno Outen

(1) BBC News Online, 17 April, 2001

(2) BBC News Online, 17 April, 2001

(3) ‘Is Anybody There?’: A Survey of Friendship and Mental Health (summary)

(4) ‘Is Anybody There?’: A Survey of Friendship and Mental Health (summary)

(5) ‘Is Anybody There?’: A Survey of Friendship and Mental Health (summary)

(6) ‘Is Anybody There?’: A Survey of Friendship and Mental Health (summary)