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Stigma, discrimination, and NIMBYism in my backyard

December 7, 2009

I ran across an irritating, if less than unusual, case of NIMBYism in a local paper. I found it online on the Romford Recorder site, though I initially saw it in the most recent (3 December) free Romford and Havering Post–also an Archant publication–when I was about to peel vegetables on it.😉

Care Home Protest

I’ll quote some of the more brain-breaking bits.

RESIDENTS will have to wait even longer to find out if a residential care home housing people with learning and physical disabilities is built near their homes…

Councillors put a halt on the application for a second time because they argued that the bulk, mass and position of the home would be intrusive and un-neighbourly and because of an increase in the levels of noise and disturbance…

Resident Mr Green said: “This residential home will be located near a pub, three off licenses and a major road so for people with drink problems I do not see it as a suitable location.

“And we are concerned about the safety for our children because it is near a playing field and there are school children from at least two primary schools who walk past the site.”

The application which was also deferred at a earlier meeting would see the care home housing 12 residents with learning and physical disabilities including schizophrenia, depression, anxiety and bipolar disease.

But Cllr Robert Benham (Con, Brooklands) argued that the residents were opposed to the application because of its location, not because their patients had mental health problems.

He said: “202 local residents signed a petition against this proposal not because they are against people with mental Health problems but because this proposal is in totally the wrong location and would have a negative impact on both local residents and the care home users.”…

Before the meeting started a group of around 60 residents staged a demonstration outside of the Town Hall expressing their anger against the application

Erm, OK. A group home originally stated as for people with physical and developmental disabilities–in U.S. parlance; they’re not referring to dyslexics, as I still automatically parse the “learning disabled” bit!–is actually intended for people with mental health problems and/or developmental disabilities. I’m not sure if it was the reporter’s ignorance confusing things, or if some of the people arguing about this don’t know the difference. Possibly both.

Not that there is a difference in how people who fall into those categories should be treated, mind you.

And these anxious, depressed, bipolar (diseased?!), schizophrenic people are just waiting to go pub crawling in the neighborhood; it’s unclear whether they’re expected to attack and otherwise frighten children before, during, or after these binges. Puhleeze.

Yet the NIMBYism has nothing whatsoever to do with stigma. I know I believe that.

Especially being familiar with the mixed-use neighborhood; the proposed construction as described would hardly stand out. It’s mostly residential, but with a lot of businesses–like the pub and off-licenses mentioned–mixed in. We live close by.

I was pretty sure I’d seen at least one similar facility on that street already, and a quick look at Google turns up two: an apparently unnamed one for developmentally disabled people (specialist care for epilepsy) at 89 Mawney Road, with 6 rooms available; and Churchill House, “Mental Health, excl. Learning Disability or Dementia” (specialist care for schizophrenia) at 48/50 Mawney Road, with 12 rooms available. There is also a retirement home at 91-95 Mawney Road, next door to the first one mentioned.

My take on this? It’s far from an unusual situation, and all the more galling because of that. I’m well past sick of this kind of discrimination and general arsiness. I put this down to two main factors: ignorance and bigotry. There are already too many scarily disabled people–all 18 of them–in the neighborhood, and an appalling number of residents don’t want more. AFAICT, the group home residents already there aren’t causing any trouble whatsoever, but that doesn’t matter.

The people protesting and waving petitions don’t want to know that mentally ill people are more likely to be crime victims–gee, I wonder why, with attitudes like this? From that article:

More than one-fourth of persons with severe mental illness are victims of violent crime in the course of a year, a rate 11 times higher than that of the general population, according to a study by researchers at Northwestern University…

This is the first such study to include a large, random sample of community-living, mentally ill persons and to use the same measures of victimization used by the U.S. Bureau of Justice Statistics…

People with mental illness were eight times more likely to be robbed, 15 times more likely to be assaulted, and 23 times more likely to be raped than was the general population. Theft of property from persons, rare in the general population at 0.2 percent, happens to 21 percent of mentally ill persons, or 140 times as often…

“The direction of causality is the reverse of common belief: persons who are seriously mentally ill are far more likely to be the victims of violence than its initiators,” said Leon Eisenberg, M.D., professor emeritus of social medicine and health policy at Harvard Medical School, in an accompanying editorial. “The evidence produced by Linda Teplin et al. settles the matter beyond question.”

One Guardian article reports:

In a survey of more than 3,000 mental health service users, conducted recently by the charity Rethink, 87% reported the negative impact of stigma on their lives. The damage caused, both actual and anticipated, was wide-ranging; the areas affected include employment, family, friendships, neighbours, accessing education, reporting crime, relationships with health professionals, and feeling confident enough to visit the shops, go to the pub or take part in activities in the community…

Goffman says: “We believe the person with the stigma is not quite human. On this assumption, we exercise varieties of discrimination through which we effectively, if often unthinkingly, reduce his life chances.” An obvious example is employment. One-third of people with mental health problems report having been dismissed or forced to resign, and, according to a report published in 2004 by the Social Exclusion Unit, just 24% of people with long-term mental health problems are in employment, despite them having the highest “want to work” rate of any group. Though four out of every 10 unemployed people are reported to have mental health problems, fewer than four in 10 employers would consider employing them.

Stigma is hardly gone in the U.S., but I was appalled after I moved to Greater London with a bipolar diagnosis. My first GP found me scary, jumped to book a psych consultation I didn’t want nor need, and gave me piss-poor medical care. When I tried to donate blood, I was on medications, but they were not the problem per se; I was informed that the National Blood Service had to assume that anyone diagnosed with a mental illness was incapable of consenting to give blood–and the nurse telling me this acted as though I might flip out and attack her. Seriously. (I was told that this was supposed to change soon–in 2004–but I just haven’t wanted to risk getting humiliated while try to give them my O neg again! ) I’ve seen other people with apparent mental health problems get treated as if they had the plague.

I will be glad to get out from under the specter of England and Wales’ really freaking scary Mental Health Act, which if anything got worse under the 2007 revision:

Introduction of Supervised Community Treatment. This new power replaces supervised discharge with a power to return the patient to hospital if the medication regime is not being complied with in the community…

There were concerns amongst mental health professionals that the legislation was based more upon tabloid stories on the danger presented by mentally ill people (especially the Michael Stone case), than on the practical shortcomings of the current Act. Critics of the Bill asserted that it would mean mental health professionals being “suborned as agents of social control” (Mullen, 2005). Supporters of more restrictive legislation insisted that dangerous people must be detained in hospital by doctors in their own interests and for public protection, regardless of whether they can be treated (Maden, 2005).

I just read today about another frightening provision, Swine flu prompts changes to Mental Health Act:

The temporary changes to the Mental Health Act, as laid out in an unusually short consultation lasting just one month, would mean it would only take one doctor, rather than two, to have a person sectioned and put on medication without their consent.

The measures could have a serious effect on the thousands of patients with psychiatric issues who currently live outside state care, meaning many could be detained against their will on the word of just one health professional.

You already did not have to be a danger to yourself or others, just deemed sick (or weird-acting) enough to need “treatment”. I am not seeing anything more about this since the initial report in September.

What about autistics in the UK? Remember, this is considered a developmental disability, and an awful lot of us have also developed secondary mental health problems–at least partly from other people perceiving us very similarly to how they perceive schizophrenics and bipolars (to the point of a lot of misdiagnosis). According to the NAS’s Don’t Write Me Off campaign:

We followed a group of people with autism as they applied for Employment and Support Allowance (the new benefit for people who may find it harder to get a job because of their disability), and asked about their experiences of work and applying for benefits. The stark reality for people with autism is apparent:
* just 15% have a full-time job
* one-third are currently without a job or access to benefits
* 79% of those on Incapacity Benefit want to work.

This apparently includes all manner of perceived “functioning levels”. Elsewhere, the NAS says “Only 6% of adults with autism spectrum disorders are in full-time paid employment”; I have also seen a 10% figure somewhere, but can’t find it right now. It’s not a good situation, in any case.

Personally, I fall into the “currently without a job or access to benefits” category. My perceived “functioning level”? I’d be placed in the “high functioning” category since I do communicate verbally–if not easily, nor always very well–but my perceived oddness (and PTSD/depression from poor treatment) got me into the psychiatric system at 13. I was considered seriously disabled by mental illness, and received SSI from 1995 until I moved to the UK in 2004. I have had one (low-) paid job since then, for a few months. Starting my own animal care business and/or trying to make a living from writing look like my best options to get away from “economic inactivity”. Working for an employer has not gone well for me so far, in part because I strike a lot of other people as acting weird.

Hmm, looks like there’s some support for my perceptions of a pretty bad stigma problem overall.

Note: I ran across the initial info on the swine-flu excused revisions to the Mental Health Act at Black Mental Health UK, which I wish I’d found when writing the Schizophrenia, epidemiologists, and race? Not a good mix. post! In the article mentioning proposed changes, we find this less-than-amazing information:

This new data shows that less than half of those surveyed, (45%) feel safe a hospital ward at all times. 39% said that they felt some of the time and 16% saying that they did not feel safe at all….

Findings for the latest Mental Health Bulletin published by The Information Centre has revealed that detention rates for black women proportionally, far outstrip that of any other group. This have raised the alarm among equalities group, concerned that many vulnerable women from African Caribbean communities are being locked up on where they may actually be being traumatised.

Currently detention rates under the Mental Health Act is more than 44% higher for black people than that of their white counterparts, with black women suffering the greatest numbers of detentions under mental health law

‘You can almost know which group will feel unsafe on the wards. Our service is aware of black women who have been sexually abused on the wards and these are not isolated cases.’

That article is well worth reading. “The largest ever national survey of acute mental health inpatient experiences shows people are routinely being let down in important aspects of their care” is putting it very mildly indeed.

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