For many people the term 'mental illness' conjures up a host of images: the old bag lady sitting on a park bench complaining to the trees; the middle aged, smelly man with wild eyes and straggly beard, collecting used dog ends and talking to himself; the frightening psychopath, let loose on society by a flaw in the Community Care Act, and ready to wield an axe at his next unsuspecting victim. To accompany these various images, society has also developed a number of euphemisms and labels to attach to those who suffer from mental illness. See how many you can think of in just one minute.

Sadly, although we have now entered the 21st Century there is still a stigma attached to mental illness. What image do you have of someone who is mentally ill? Sufferers are normal people with normal lives. Mental illness does not just affect those who are socially deprived or have a low IQ. Unfortunately the stigma of mental illness can affect the sufferer who can feel they have no one to confide in because they are too ashamed to admit their problem. It can even cause problems for those who have recovered as returning to work or social situations can be awkward when colleagues and friends do not understand.

A Brief History

Demonic possession was once thought to be the cause of mental illness. The sufferer was stigmatised by society, subjected to sometimes brutal exorcisms and treated as a pariah. As scientific knowledge grew, the notion that mental illness could be caused by brain abnormalities became widely accepted. Treatment did not, however, become any less brutal. Sufferers would be locked in large, over-crowded asylums. Some would be stripped naked and chained to walls, others restrained in straitjackets. Conditions in these asylums were unsanitary and degrading. 'Therapy' would include leeches, blood letting, enemas, emetics, and even hot irons. Although treatment progressed during the 20th Century as new psychotropic drugs were experimented with, these experiments were still barbaric and the detention of patients in harsh asylums continued. Anyone who has read or seen One Flew Over The Cuckoo's Nest by Ken Kesey will have an idea of the cruelty of such institutions.

The turning point in the UK for the treatment of sufferers of mental illness was the Mental Health Act (1983). As well as the detention sections it also recognised the informal status of most patients and laid out in law policies to ensure vulnerable patients are protected. Most sufferers are now treated within the community; the type of treatment given depends on the individual person and may include medication, counselling, psychotherapy, occupational therapy, to name but a few.

Mental Health Disorders

Mental health disorders vary greatly in both the way they affect people and the ways in which they are treated. Many readers will be familiar with such well-known conditions as depression, bipolar disorder, schizophrenia and the eating disorders, but there are many other labels used by psychiatrists: delusional disorder, borderline personality, somatization disorder and so on. It is therefore useful to break mental health up into a number of areas. The following list provides links to entries on h2g2 about different forms of mental health disorder, with examples being provided in brackets.

• Mood disorders (depression, bipolar disorder)
• Anxiety disorders (phobias, panic attacks)
• Obsessive compulsive disorder
• Eating disorders (anorexia nervosa, bulimia nervosa)
• Psychotic disorders (schizophrenia)
• Personality disorders (antisocial, schizoid, narcissistic)
• Stress and bereavement reactions (post-traumatic stress disorder)
• Somatoform disorders (hypochondriacal disorder)
• Alcohol and substance misuse (drug dependence)
• Sleep disorders (insomnia, narcolepsy)
• Obstetric mental health (post-natal depression, puerperal psychosis)
• Child and adolescent mental health (ADHD, autism)

Your Mental Health

If you are a sufferer of any type of mental illness then it is important that you get the help that you need. A good place to start is at your doctor. He/she will be able to refer you to the people that can help. It is also important for you to have the support of family and/or friends. Self-help groups can be particularly useful, as the best people to provide support and advice are often those who have had similar experiences and can understand how you feel. Below is a list of contacts. If you are under a mental health team, find out who your community psychiatric nurse (CPN) and your social worker are. These people can help you with any problems you may encounter but do not feel able to deal with.

If you are the friend or relative of someone with a mental illness, you may feel like you want to help but you do not know what to do. It may help you if you find out information about their illness and below is a list of useful contacts. The most useful action you can take is to listen and be supportive. You will not be able to cure your friend or relative's illness but you can show them that someone still cares. Many sufferers feel very alone and stigmatised and this small gesture can mean a lot. Do not try to cope alone though, it can be very stressful for you too and you need to make sure that you have the support you need.

A message for all those people who have never given their mental health a second thought: it is estimated that one in three people are suffering from some form of mental illness at any one time. To quote the British National Lottery, 'it could be you'. Mental health is just as important as physical health and should be looked after as carefully. Allow yourself time to relax, try to reduce the amount of stress you have and try to develop better coping mechanisms to deal with the remaining stresses. Most importantly, maintain a good support network – when troubles start piling up make sure you have someone to confide in.

Useful Contacts

The following links provide further information and advice, and links to other international organisations

• MIND
• HyperGuide to the Mental Health Act (UK)
• The Mental Health Foundation
• National Depressive and Manic-Depressive Association
• The Samaritans (UK)
• Saneline (UK)