While experts are right to congratulate Prince Harry (Harry praised for telling of ‘chaos’ over Diana’s death, 18 April), and call for more spending on mental health, there is an elephant in the room. Mental health services are dominated by an outdated, simplistic medical model of distress that is rather at odds with the prince’s views. While he makes the obvious link between painful life events and mental health difficulties, our services are still telling distressed people that they have illnesses, like major depressive disorder, caused by chemical imbalances – an unsubstantiated drug company creation – and by inferior genes that make them more vulnerable than others to depression, anxiety, psychosis etc.
Unlike Harry’s psychosocial approach, this socially blind bio-genetic model actually increases prejudice, by using stigmatising labels and exaggerating differences. It has also led to over 62m prescriptions of antidepressants annually in England, at a cost of about £800m a day to the NHS. Our children too are being labelled and drugged at an equally alarming rate. Time for psychiatric services to move on from the failed diagnose-and-medicate approach and start asking us what happened to us, and what we actually need.
Professor John Read
University of East London
• Is bereavement a mental illness? Does grief require medical treatment? It is a profound mistake to treat such essential aspects of the human condition, and our responses to them, as purely personal “in-the-mind” medical crises, evidence of “ill-health”.
It is the overwhelming assault of our culture on our sense of personal space, time to be, not just to do; that generates much of the distress. The shame and stigma won’t be removed from this distress until we realise that it is not simply an individual, personal illness – though sometimes it becomes that – but a social, cultural malaise that will be deepened, not alleviated, by pills or sometimes misdirected talk therapies.
St Albans, Hertfordshire
• Although Prince Harry’s revelations have rightly been praised by mental health experts, it would be helpful to focus on the particular issues surrounding those of us who have been bereaved in childhood.
First, the adults around us do not know how to approach us; second, we are commonly isolated in terms of the experience within our peer group; third, we have not yet developed the means to express our feelings effectively to the adult world around us. Add to that the “scorched earth of English repression”, as Richard Beard so brilliantly described it (Family, 8 April), and the fact that you miss out on natural processes in relationships that are part of growing into adulthood, and you may well finish up with a toxic foundation of anger within you.
Those bereaved in childhood have been widely misunderstood and ignored; the prince’s remarks allow us at least to start a debate as to how we should treat this most vulnerable group.
• Suzanne Moore writes (Harry got help. Many others deserve it too, 18 April) that no one touched the two young princes during their mother’s funeral service. But why would anyone want to display public emotion, knowing that columnists were looking down on them? The family she saw that day was no different to other families who do not show their emotions at a funeral. Many people, frozen in grief, cognitive processing and exhaustion, are paralysed when it comes to being on display while they deconstruct and reconstruct what is in the coffin in front of them.
One message of the royals’ Heads Together campaign is not to judge other people, because you don’t know their circumstances.
• Prince Harry is fortunate to have had what is increasingly being called “real therapy”, meaning in-depth and enjoying a trusted relationship with the “shrink” (to use his word). This kind of private practice therapy has almost completely vanished from the NHS and the public sector because all funding is being sucked up by the Improving Access to Psychological Therapies scheme. In this manualised and medicalised state therapy system, with economic rather than psychological goals, it takes a long time and much judgmental evaluation before a few get even cognitive behavioural therapy. We can be pretty sure that CBT is not what was offered to the prince.
It is time for the Department of Health to acknowledge that the old-style psychotherapy and counselling did a lot of good, and that it is still possible to restore it.
Professor Andrew Samuels
Centre for Psychoanalytic Studies, University of Essex
• I read, with interest and admiration, Prince Harry’s comments regarding how boxing helped him (Report, 18 April). This is something we, at Empire Fighting Chance, already know. We have had massive success with our own non-contact boxing programme for people with mental health issues, often engaging those that traditional services fail.
My co-founder and I have spoken at numerous all-party parliamentary groups about how it is possible to help those most in need by offering something different. However, there seems a real reluctance to invest in and integrate credible, community-based programmes.
Yet everyone can benefit from a community intervention: treatments are not class, race or postcode dependent. Deprivation is a huge factor for poor mental health and the poorer you are the less likely you are to know about or access services. Having something based in your community, provided by a name you know and trust, works. People are not embarrassed to attend – in our case they are proud to say they are going to the boxing gym. Once in it, they train like everyone else, they are not “on display” in some sterile leisure centre, so we get better results.
Finally in a time where funding is hard to come by, budgets are stretched and the health service is under tremendous pressure, we must recognise the role within that sports-led community projects can offer and look to innovate delivery. Resourcing them adequately appears to make sense from a business and, much more importantly, human angle.
Chief executive officer, Empire Fighting Chance
• Today’s underfunded NHS is unlikely to increase access to the support needed by those processing emotional trauma. I and many others, in UK and internationally, have found help from co-counselling, a peer-support system that, after a 40-hour training course, gives access to lifelong listening support that is comfortable with emotions. Pills and professionals have their place, but, as Harry said, listening is more helpful than advice for working through emotional issues that are an inherent part of being human.
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