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Open Letter about BBC Coverage of Mental Health
We are writing together, as mental health professionals and people who have experienced mental health problems, to complain about the coverage of mental health in the recent BBC In the Mind series. We believe that, despite your obvious good intentions, your coverage may have done more harm than good.
There are ongoing debates among mental health professionals and others, about whether it is meaningful or useful to think of mental health problems as illnesses. There are also debates about whether their origins are necessarily always in the brain, as opposed to being responses to life events and circumstances. But your coverage – for example The Not So Secret Life of the Manic Depressive: 10 Years On, My Baby, Psychosis and Me, together with your news item about research on miniature brains – completely ignored all of these debates. Instead of laying out the controversy in the unbiased fashion for which the BBC is known, they took for granted the view that mental health problems are necessarily a manifestation of biological illness.
The idea that bipolar affective disorder (manic depression) and schizophrenia are separate, identifiable illnesses with their origins in the brain is highly contested and unsupported by evidence. Even those in favour of the idea acknowledge that there are no blood or other independent tests for either condition, or indeed for any of the other so-called ‘functional’ psychiatric disorders. Despite 50 years of well-funded and increasingly technologically sophisticated brain research, no ‘biomarkers’ (identifiable biological signs) have been found. This has led an increasing number of professionals and researchers (including many psychiatrists) to question the simple biomedical theories promoted by your programmes.
Your programmes also appear to suggest that psychiatric medication should be the main, if not the only, treatment for mental health problems. But many believe that this simplistic illness/medication message is harmful, because it potentially leads to hopelessness, despairand (ironically, given that your broadcasts aimed to reduce stigma), prejudice and discrimination. Many are also concerned about the long-term efficacy and safety of these drugs. It is of course crucial that people receive care that meets their individual needs. Given the diversity of these needs, this care might include peer support, information, psychological therapy, or (where the person finds it helpful) medication. So to simply promote medication without also presenting other approaches (such as psychological therapy, as recommended by NICE) is biased and irresponsible.
Whilst some people who experience mental health problems think of their problems as an illness and find medication useful, many others do not. For example, many members of the Hearing Voices Network have been given diagnoses of bipolar disorder or schizophrenia but have now found other ways of understanding and living with their experiences. Some of them choose to take medication but others choose to live without it. Their stories could provide inspiration and hope to those who feel overwhelmed by their difficulties, but neither documentary included people who had found non-medical roads to recovery. Your programmes did not present any balance between those are resigned to living with what they see as an ongoing illness, and those who have found other ways of living with difficult experiences (or, indeed, no longer have them).
We are equally concerned about the BBC’s failure to acknowledge that the origins of problems, and the things that keep them going, are often not simply in the brain but in the events and circumstances of people’s lives – including poverty, urban living, migration, childhood abuse, bullying and other forms of victimisation. This has been confirmed by a vast volume of research, and the evidence is in fact stronger than for the involvement of biological factors. Educating the public about this would not only increase understanding: research suggests that this kind of approach reduces stigma and, in many cases, is more helpful for those affected. So it would have been more appropriate for your programmes to adopt the kind of approach taken in the recent British Psychological Society public information documents ‘Understanding Bipolar Disorder’ and ‘Understanding Psychosis’: namely, to lay out both sides of the debate and allow people to make up their own minds. Indeed, the just published Mental Health Taskforce Report also recommends this more balanced approach to mental health care.
As a matter of urgency, then, we ask you to commission a similarly high-profile programme featuring professionals and service users who adopt the approach outlined here. We would be very happy to help, and can put you in contact with many suitable individuals.
Peter Kinderman, Professor of Clinical Psychology, University of Liverpool & President-Elect, British Psychological Society
Jill Anderson, Co-ordinator, Mental Health In Higher Education Project, University of Lancaster
Richard Bentall, Professor of Clinical Psychology, University of Liverpool
Anne Cooke, Consultant Clinical Psychologist & Clinical Director, Doctoral Programme in Clinical Psychology, Canterbury Christ Church University
John Cromby, Reader in Psychology, University of Leicester
Angela Gilchrist, Clinical & Academic Tutor, Doctoral Programme in Clinical Psychology, Canterbury Christ Church University
Nicky Hayward, Mental Health Campaigner, Survivor, Blogger and Activist
Sue Holttum, Senior Lecturer, Doctoral Programme in Clinical Psychology, Canterbury Christ Church University
Steven Jones, Professor of Clinical Psychology, University of Lancaster
Lucy Johnstone, Consultant Clinical Psychologist
Laura Lea, Coordinator of Service User and Carer Involvement, Doctoral Programme in Clinical Psychology, Canterbury Christ Church University
John McGowan, Academic Director, Doctoral Programme in Clinical Psychology, Canterbury Christ Church University
Joanna Moncrieff, Senior Lecturer in Psychiatry, University College London
David Pilgrim, Professor of Health and Social Policy, University of Liverpool
Mark Radcliffe, Lecturer in Mental Health Nursing, Kings College London
Rai Waddingham, Hearing Voices Network and International Society for Psychological and Social Approaches to Psychosis
Jay Watts, Clinical Psychologist and Psychotherapist, Queen Mary, University of London
Paul Wilson, Head of Mental Health Services for Sirona