Vulpes Libris

A collective of bibliophiles talking about books. Book Fox (vulpes libris): small bibliovorous mammal of overactive imagination and uncommonly large bookshop expenses. Habitat: anywhere the rustle of pages can be heard.

Thursday Soapbox: Madness & Art

By Mark Buckland, MD of Cargo Publishing.

Several months ago, I found myself in a conversation with a journalist at a networking event. I’d had a few drinks and was in my usual passionate mode; harping on about the excitement and revolution that seems to surround publishing right now. I tried to make (what I thought were) several astute points and the journalist nodded and smiled. We seemed to be getting on fine.

I said cheerio and turned away to cross the room. Behind me, the journalist (who shall remain unnamed, because they were understandably mortified afterwards) made the index finger of his hand wobble his lips and the other hand tapped the side of his head. This was a gesture to someone at the other side of the room and not for me to see. But I did. And I recognized it.

It is, of course, the universal sign for “this guy’s mental.”

Now, this is clearly extremely insulting. But I didn’t get angry. I didn’t say anything. I didn’t even say anything as condescending as “you don’t know what I’ve been through” or “guess I’m the only one who’s passionate about books, mate.”

Because I’ve heard it all before. And I am a “nutter”, a “loony”, “schitzo.”

I am all of these things because I am someone with a “mental health disability.” I have a permanent condition featured in the broad group of psychotic affective disorders. This means that, from time to time, I have an onset of psychosis-that’s seeing and hearing things that aren’t there and being delusional among other things. The rest of the time, I have general issues regulating my mood; meaning I have bouts of depression, total elation and what a psychiatrist very gently termed “cognitive issues.” Means I don’t really understand what’s going on around me.

So what the journalist did, while unbelievably immature, was a common reaction. I am quite intense; without it, I would not be able to convince people to work for Cargo. I am quite moody; again, without it, I wouldn’t achieve the ecstatic elation that fires my creative side. And yes, I do get quite chatty, after a few drinks particularly. There’s no benefit to that element really.

Mental health discrimination doesn’t come in big, sweeping gestures. There is no spiteful, indemic word like “nigger” or “poof” to discriminate against mentally ill people. The whole series of gestures and words used to describe “crazies” are innocuous in comparison to the two I just gave and none of them carry a venomous weight of historical bile that racial, sexual or sexist jibes do.

No, discrimination in this area is far more convoluted. I often imagine it through the terms of an economist; a mentally ill person is a broken, defective unit of production. By that, I mean, someone who develops, say, schizophrenia temporarily becomes unable to produce money or wealth for the state. They don’t pay taxes. They devour hospital time, expensive drugs, outside support, outreach centres, home help, substance abuse support. And there is no end in sight. No definite conclusion of when this once productive person will return to normal capacity and stop burdening the state.

People with heart disease can be fixed. We know that there are a range of options-stents, bypass operations, pacemakers, even a full transplant. There is a timetable when this person will begin functioning and contributing again. Sure, they won’t be running marathons or fighting heavyweight title fights anytime soon, but they are back.

You probably think this is a crude and inaccurate comparison that devolves humans to automaton level. I would agree. But how else do you explain the prioritsing of resources toward the issue? In Scoltand, 1 in 5 people will suffer some form of ill mental health at some point; just 11% of NHS spending is currently devoted to it.

Put simply, it takes a long time to help someone who is mentally ill. It takes nurses, doctors, psychiatrists, psychologists and pharmacologists; all who have to be trained and then work with the patient. And the drugs are expensive. And psychiatric wards are even more expensive. And, put simply, it’s bloody difficult. I remember sitting in my first ever psychiatric appointment at 15 years old and spending most of my time coaching the trainee psychiatrist, who was too nervous to ask just about anything. Most of the staff, who do care and want to help, are overworked, underpaid and ill-informed to deal with the vast presentation of cases. Again, hearts have certain fixes; head’s don’t.

Then there’s the statistical drive. After two sessions, a smug NHS consultant stated I was “manic-depressive psychotic”. Even with no knowledge in psychiatry, I knew that was wrong. Moreover, the worry was from how quick they could begin a regime of powerful drugs and tick me off as another recorded case. After two sessions. I wondered how many grieving widows had ended up manic depressives, nervous students as paranoid schizophrenics or insomniacs as hypomanic. Can that quick turnaround really be producing healthy, stable people?

Imagine that unit again, sparking, malfunctioning. Now, to an employer, that’s okay if you know that once it’s fixed, it’s fixed.

If you know it’ll breakdown again at some point-why would you want it?

A while back, I began putting my condition as a personal note on my CV-among the fact I enjoy reading, writing, football and basketball. I put it in as what it is-a part of my life, not my life. The interviews dried up. A glowing CV, ten years of employment, managerial and ownership experience from 16 years old. Nothing. Not one employer interested anymore.

Coincidence?

It pleases me to see that the world of writing has no such discrimination. Art, as a general creative sector, doesn’t. Eccentric behavior is acknowledged, worrying signs challenged, support networks are stronger than in any other community. A recent project, the Fruit Tree Foundation, by Idlewild’s Rob Jones and Emma Pollock is a great way of using music to remind people of the kindness and the clarity of communication present in artists. Publishing is not part of that. It is a business and from my experience, business people do not appreciate such inconsistency. I am aware that by writing this right now, I am off the list of many industry types. That’s not brave on my part, just foolhardy. I will never edit for them or run anything with them. That will not be my choice.

I started Cargo because I firmly believed that there was a young, creative spirit in Scotland that was being ignored or trampled upon. I also did it because I will not be a sob story. I will not spend my life flitting in and out of psychiatric wards or zombified on drugs. Several years ago, feeling that I had seen my creative desires battered from me by medication, I stopped taking it and resolved to learn to live with my issues. I have since returned to medicine just once in five years. I have coping mechanisms, techniques and many other tricks but the only way I have been able to do this is the way that any mentally ill person can live a normal life – a network of support.

I am hugely indebted to my parents and friends for their help; I would simply not be here without them. But through Cargo, I have found a team of inspired people, passionate people powered by a shared love of books and writing and a desire to do some good. Artists, people who accept you as you are. And with this support network, we’re all able to turn to that journalist with the wobbling lip and international sign for “crazy” and just politely smile.

—–

The image is Geknielde spierman, by Vincent van Gogh (1886), painting from a plaster model. This image is from Flickr under Jankie’s photostream, and is reproduced under the Creative Commons License.

Link to Cargo Publishing’s site

And catch up with VL’s very first podcast, talking with Mark Buckland about live literature

14 comments on “Thursday Soapbox: Madness & Art

  1. annebrooke
    October 28, 2010

    Such an important article, thank you for this. It’s hugely important that mental illness should be looked on in the same way as physical illness is, though I fear there’s a long way to go before they are viewed equally and an even longer road before they’re treated equally.

    I wonder if to a small extent it might be a generational thing? Just as my grandmother used never to say “cancer” but always “the c word” in hushed and horrified tones, many of my older generation of friends now do find it hard to come to terms with the concept of mental illness and how one copes with it. Does it have the same vestiges of shame in the wider society that cancer once did? If that’s the case, let’s hope people soon begin to view it in the same way that on the whole they now view cancer.

    Mind you, I do somehow treasure the day I dared to tell an older friend that I was undergoing treatment for depressive feelings and she told me I should just snap out of it. Nothing I could say to that really!

    Come the revolution, eh …

    Though I also do wonder why it is that so many of my protagonists have significant mental problems – strange how I feel so at home with them! Anyway, sorry about the wittering. Great and very valuable article.

    Anne

  2. john
    October 28, 2010

    I suppose some great writers have had mental health issues and written about them stunningly (as well as addressing a plethora of different themes). I don’t need to list them. However, I think employers often want ‘steady individuals’ and may be seeing things through a capitalist mindset. They may enjoy reading Sylvia Plath or Woolf at home but may not want to employ a troubled individual as they see it. This kind of discrimination is obviously morally bad, but what have morality and the accumulation of capital ever had to do with each other? An employer may value a creative person with issues but if they get ‘difficult’ or have too much time off their tolerance is likely to wear thin. It is very sad indeed, but I don’t think these things are likely to change across the board.

    Drunkeness and insanity and consumption of illicit substances are not condemned in writers because writing is not a normal job.

  3. Moira
    October 28, 2010

    A really fascinating and throught-provoking piece. It reminded me of a conversation I had a few years ago with an actor, who said that in his profession you were allowed to be a drunk, but you weren’t allowed to be either physically or mentally ill. If word got out that you were either of the latter two, you were finished. Drunks were tolerated, but heaven help you if you developed rheumatoid arthritis because unless you were an ‘A’ lister (and they only represent a TINY proportion of the acting profession).

    It’s another side of the same equation. Writers are allowed to be physically ill or drunks, but mustn’t have mental health problems. It’s noticeable, of course, that mental illness is on both lists. Basically, of course, you mustn’t have anything that makes other people feel uncomfortable. I mean, heaven forfend that people should be shaken from their complacent, safe little cocoons – which is what it amounts to …

  4. Hilary
    October 28, 2010

    What an admirable article, personal, passionate and full of insight. I feel like cheering Mark’s personal response, choosing to find a way through life that harnesses his gifts and works with the grain of his mind. It’s a brave and inspiring story, though its rarity is a challenge to us all. We need to be reminded of the intolerant inconsistency that ‘allows’ certain behaviours and excludes others.

    Am I right in remembering an anecdote about a person, or a group of people, with Tourette’s choosing times of freedom not to take medication, in order to revel in the energy and creativity of the syndrome – is that from Oliver Sacks?

  5. Jackie
    October 28, 2010

    I agree that mental illness needs to be better understood and more resources allocated to treating them than is currently considered. Society in general seems in denial about how widespread the conditions & effects are.
    Having said that, I do find it troubling that so many people, especially with the more severe mental illnesses, choose not to take their medication. It is self defeating, as this makes their symptoms worse, which makes it harder for them to lead a regular life. I also find it strange that so many who don’t take their medicines boast about not doing so, as if it’s a badge of courage, rather than being irresponsible. I can understand not wanting to be a zombie, but it is usually possible to find a combination which allows the patient to be functional, as well as having their symptoms under control. A diabetic would never boast about not taking their insulin and someone with high blood pressure would know they are playing a dangerous game to skip their pills, so why is it different for those with severe mental illnesses? The patients also have a responsibility; you cannot expect people to treat mental illness the same as a physical condition, when patients themselves don’t treat it the same.

  6. john
    October 28, 2010

    Just to respond to Jackie briefly. Many people with physical illnesses eat too much, drink, smoke or don’t exercise and isn’t that a bit like someone with mental health issues not taking their pills (which may have side effects)? I say live and don’t judge. Let smokers smoke and so on and so forth. I’m a caffeine junkie myself and I’m not quitting. We don’t have an obligation to be healthy or normal (ugh), we can all just be who we want to be, have fun and try not to hurt one another.

  7. Jackie
    October 28, 2010

    Smoking hurts other people, not just the smoker, so no, I’m not in favor of just “letting smokers smoke”. And schizophrenics not taking their pills affect others, not just themselves, when their symptoms get out of hand & they are yelling, noisy & their paranoia can escalate to actual physical violence.

  8. Alex Pheby
    November 4, 2010

    Jackie – if you want to reduce the number of people who yell, are noisy and inflict physical violence on others then the best thing to do would be to shut the pubs, not insist people with mental illnesses take their medication.

    The reasons many people refuse to take the medications that doctors order them to take are varied:

    1. The medications often have side effects that are much worse than the symptoms they are supposed to prevent.

    2. The medications often don’t work.

    3. The medications have been ordered by doctors who don’t properly understand their patients (for a variety of often understandable reasons, like lack of time spent with them, for example) and prescribe them as easy ‘fixes’ to people who have complex and expensive needs which they are unable or unwilling to address.

    Unlike people with physical illnesses, the Mental Health Act allows for people who refuse to comply with treatment orders (regardless of whether they are suitable) to be locked up indefinitely (‘sectioned’) and to be liable to forcible medication (by injection) whether they agree with their treatment or not – this might be the source of the ‘badge of courage’ attitude you identify in those who refuse to take their medications: they are often showing genuine courage in resisting inappropriate and inadequate care from a health system which has neither the expertise nor the resources to treat their illnesses.

  9. Jackie
    November 4, 2010

    I’m basing my opinions on personal experience of living in an apartment building populated with schizophrenics who don’t take their meds. The 3 guys who live upstairs are awake 36-48 hours at a time, vacuuming all night, blasting their TV’s 24/7 in the bedrooms, running their alarm clocks for hours at night, and putting paranoid notes under my apartment door. Another schizophrenic neighbor got angry at his room mates & cut the Tv wires to this whole side of the building. At other times, he painted swatiskas in the garages & broke into the parked cars. Another resident, a mentally ill lady, would take screaming fits about how she was going to take a knife to all of the prostitutes(she used the ‘w’ word) living here. Needless to say, there are no prostitutes living in the building. She was eventually hospitalized last year, as she wasn’t taking any of her meds, and her physical health had deteriorated too.
    I used to have a better attitude towards those with mental illnesses, but living with them has debunked that rosy outlook.
    Why don’t you spend a few nights in my place trying to get some sleep in between the vacuuming, blasting TV’s & shouting? I bet you’d change your mind about people not taking their medications then.

  10. Alex Pheby
    November 5, 2010

    How terribly irritating for you.

    When I lived in London the man next door to me used to play ragga night and day at top volume and the people above shrieked across the flat to each other and pounded up and down on their stripped pine floorboards with their shoes on at two in the morning. On the way to work I had to walk past fascist graffiti and piles of litter, vomit and dog turds. If only the people responsible had been diagnosed with a mental illness I could have had them sectioned, given ineffective anti-psychotic drugs, forcibly sedated and indefinitely confined to hospital, making my life much less noisy and unpleasant. However, they hadn’t been diagnosed with mental illnesses, they were just inconsiderate, unpleasant and anti-social like a lot of people are, so they got to go about their lives as they saw fit, making decisions about what they should do without falling foul of the Mental Health Act.

    If you live in a city, learn to put up with people doing things you don’t like. Anti-social behaviour is not a mental illness, it’s a function of living in large groups and blaming it on people with schizophrenia is prejudice and scapegoat-ing of the worst kind.

  11. Lisa
    November 5, 2010

    Firstly, I just wanted to say that I thought this was an excellent and very brave article. There is unfortunately social stigma attached to mental illness for many reasons, and I thought this Soapbox piece was really rather ground-breaking.

    Just reading through the comments above, I can see the points of both Jackie and Alex. Having had experience of schizophrenia within my family (as many people will have, I should think, given schizophrenia’s relatively frequent occurrence) I am now much more used to mental illness. It is a strange thing to admit, but as a child when I was first confronted with someone in the midst of a delusional episode I was absolutely terrified. Frozen with terror, even. I think a lot of people ARE frightened of those exhibiting signs of mental illness, especially when those people are noisy and acting erratically. The first time I heard a schizophrenic relative threatening to burn us in our beds, I took that threat seriously. It is only with time and understanding that I now realise that those threats are empty, because I know the person involved and I realise the threats are not real. But to outsiders, I can imagine that such behaviour is hugely unsettling.

    I also wanted to say that I think isolation can be the worst possible thing for those with serious mental illness. Losing social skills, and even the ability to converse at all can come of that, which is a devastating effect, as the person seems to slip further and further away until they disconnect from all the people around them. It can take a long time to come back from that.

    It is very complicated, and I know I haven’t touched on the subject of medication. All I really have to say on that subject is that it seems to take a long time to get medication and dosage right, and from my own experience, my relatives seem much happier with the drugs offered today, as opposed to those they were offered in the early Nineties, which seemed to dull them into a stupor. But as I say, that is only my personal experience and I don’t know enough about medications to say more really.

    Anyhow, thank you Mark for this excellent article.

  12. Moira
    November 5, 2010

    For reasons I can’t go into, I know quite a lot about mental illness, and schizophrenia in particular. Living in an apartment block with people suffering from schizophrenia who are not taking any kind of medication would be a lot more than merely “terribly irritating” – a slightly unfortunate choice of words, I think.

    Nearly all schizophrenia sufferers pose much more of a danger to themselves than they do to anyone else, but the situation Jackie describes would be distressing for most and positively frightening for many; and that’s not taking into account the effects of broken nights and general stress. In treating mental illness we must respect the rights of the sufferer, and in a perfect world schizophrenia, manic-depression and the like could all be controlled, suppressed or eradicated without the need for a chemical cosh. Unfortunately, it’s an imperfect one, which means that we have to find a balance – which almost inevitably means a compromise between the rights of the sufferer and the rights of everyone else.

    I can see and understand both sides of this argument very clearly – clearly enough unfortunately to know that there are no simple solutions and that adopting absolute positions helps nothing. Tolerance and mutual respect generally achieve a lot more.

  13. Alex Pheby
    November 5, 2010

    If you can point out where I’m taking an absolute position, then please do. I was arguing that those anti-social behaviours Jackie complains about are not limited to those with schizophrenia but are common in any high density shared environment, and so should not be used to characterise sufferers of mental illnesses or justify the inequalities in the way the medico-legal system treats them. This is not an absolute argument – like, for example, “all sufferers of schizophrenia must take their medication” – but a relative one.

  14. Moira
    November 5, 2010

    I didn’t say that YOU were taking an absolute position Alex. If I’d meant you, or anyone else specifically, I’d have directed the comment at you by name.

    Having said that I could all too plainly see both sides of the coin, it was a merely a plea for a little civility.

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This entry was posted on October 28, 2010 by in Thursday Soapbox and tagged , .

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  • (The header image is from Aesop's Fables, illustrated by Francis Barlow (1666), and appears courtesy of the Digital and Multimedia Center at the Michigan State University Libraries.)
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