‘I get by with a little help from my friends’

The Beatles, it seems, were wrong. New research shows that
mental illness can put a terrible strain on friendship leading to
embarrassment, silence or worse, writes Ruth Winchester.

Think of someone you know really well. Someone with a
responsible job and a mortgage. Now imagine receiving a phone call
from a psychiatric unit informing you that your friend has been
sectioned.

New research suggests that around one in four people will have a
mental health problem this year,¹ which means you have a
high chance of either having an episode or of knowing someone who
has. The stigma attached to mental illness, particularly severe and
enduring mental illness, makes it difficult to tell your friends
about the voices you hear, or the suicidal thoughts that dominate
your waking hours.

The report from the Mental Health Foundation has, for the first
time, looked at the importance of support and friendship for people
with mental health problems, and at the reality of those
friendships from both sides. For such a common illness, the figures
make alarming reading.

Up to a third of people choose not to tell people about their
mental health problem, to the extent that 30 per cent of friends
only found out when they were hospitalised or attempted suicide.
And for those who do talk about it, the process can be a minefield.
Reactions vary from surprise, embarrassment and curiosity through
to shock, fear and rejection. Even good friendships end abruptly,
become unbearably awkward or slide into silence.

The report, Is Anybody There, reiterates the fact that
supportive, positive relationships with friends and professionals
are of immense value to people coping with mental illness. But of
those surveyed, the majority recognised the stigma attached to
their illness, felt they had to “put on an act”, or felt they would
be burdening their friends if they told them. Many said their
friends were mainly other service users or people they met through
self-help groups. For those who did tell their friends, support
varied from the most basic – simply someone to listen – to
extremely committed financial and practical help.

From the other side of the fence, friends and carers of people
with mental health problems often report feeling helpless,
overburdened and emotionally strained. While 42 per cent of people
said the knowledge of someone’s mental illness had a positive
impact on their relationship, nearly nine out of 10 said
friendships were sometimes more difficult. Being available,
supportive and caring for someone in distress was tiring and
upsetting, and all too often respondents said the pressure invaded
their wider arena of work and family commitments. The respondents
were almost unanimous in calling for a wider statutory recognition
of their role, and for greater support and information to be made
available.

More positively, many friends and carers said support was
available and 70 per cent said they had received help when they
asked for it. Thirteen per cent received support from mental health
services, 10 per cent from voluntary organisations, 8 per cent from
their GP and 5 per cent through other professionals such as social
workers.

The research suggests that there are many ways of reducing the
burden felt by friends and carers, and that the back-up on offer is
often far from adequate. Specifically, respondents described the
mental health system as a “complex and sometimes impenetrable
bureaucracy” with the friends of patients “being constantly
referred from one agency to another” or having no way of finding
out more about their friend’s illness. The result was that nearly
four in 10 friends wanted to be able to talk to a professional, a
third said more information would have helped, and a quarter wanted
to be actively informed of their friend’s care.

The government’s new strategy, Mind Out for Mental Health, is
designed to reduce the discrimination and stigma attached to the
subject by educating young people, employers and the media about
the realities of living with mental health problems. When mental
illness becomes something you can chat about over dinner with
friends, the investment will have paid off.

¹ Mental Health Foundation, Is Anybody
There, MHF, April 2001. Available from 020 7535 7441
or

www.mentalhealth.org.uk/