What I about to write is so sickeningly cynical that I am reluctant to commit it to print. But it is something I simply have to articulate. I am compelled to. I just hope it’s not true. I hope it’s just a product of my own paranoia.
A couple of weeks ago I submitted a post entitled ‘A Conversation With a Friend’ in which I explored the unfavourable treatment received by those who have the misfortune to be diagnosed with any form of personality disorder. I had dealt with this issue on numerous occasions in my diary (the pen and ink variety). I came across an entry in which I described how a friend of mind had a ‘psychotic breakdown’ in her second year at university. She was hospitalised, sectioned and forcibly medicated. She tells me that, on one occasion, a senior male nurse sat on her while another nurse went to fetch the needle. The section was eventually rescinded and she returned to college. In spite of several relapses she managed to graduate. She resented the way she was treated in hospital but conceded that it may have been necessary. A few months after she graduated, as a result of her condition, she was allocated a housing association flat. Then, suddenly and inexplicably, all local authority support was withdrawn. She was told that she was no longer entitled to a community psychiatric nurse or even a twice yearly visit to a consultant psychiatrist. When she demanded and got access to her notes she found out why. She had been rediagosed. She was no longer ‘psychotic’, she now suffered from a personality disorder known as schizotypal personality disorder and, as this was untreatable, she was no longer entitled to any support. She had, overnight, become a member of a group regarded by the psychiatric profession as nothing short of untermenschen.
Since then I have come across many similar cases. These people have the same problems they have always had, the same low self esteem, the same despair, the same social exclusion but all the support that had hitherto helped them to cope with this is withdrawn. A diagnosis of ‘personality disorder’ supersedes any other diagnosis you have ever been given. At the stroke of a pen, at the click of a mouse, public expenditure on the mentally ill has been reduced. Now that’s what I call genius.
These people may well be ‘untreatable’ but I just don’t see how this makes them any less deserving of sympathy, if not empathy. If someone has a physical disorder that is considered untreatable they are not belittled, they are not scorned, they are not viewed as outcasts and, even if they do not receive ‘treatment’, they still receive ‘support’.
I have been told that ‘mental illness’ and ‘personality disorders’ are separate categories and require very different approaches. If this is so then why call them ‘disorders’ at all? Just chalk their problems up to plain old fashioned character defects but I guess if they did that then psychiatrists would have to section the entire human race, including themselves.