A shocking story about the Metropolitan police last week: a woman who was groomed by a predatory officer has at last received an apology after the force spread false information about her mental health rather than investigate him.
Lorraine – not her real name – had first complained about PC Phil Hunter after he made a welfare visit to her home. Over a period of two years, he sent her inappropriate messages and tried to isolate her from friends and family as part of a “predatory” plan to have a sexual relationship with her.
There followed seven years of failings, in which further complaints were ignored, the Met told external agencies she was making up her claims, and a senior officer attempted to contact her GP, informing social services that he thought she had mental health problems. A letter from the directorate of professional standards now concedes decisions may have been influenced by these beliefs, which had “no basis in fact”.
“Surely predators are more drawn to vulnerable people with mental health issues,” Lorraine told the BBC. “Surely they would investigate that more, not less, had it been true?”
Criticism has rightly focused on the Met and the way they deal with victims of rogue officers. But there is also a wider pattern here. Although mental health stigma is broadly declining, there are pockets in which it still runs rampant. This is perhaps no better illustrated by the way diagnoses are weaponised against victims of abuse.
That can happen at scale. It recently emerged that hundreds of female members of the armed forces who accused their colleagues of rape were misdiagnosed with personality disorders – a difficult-to-treat pattern of maladaptive behaviour – that meant they would be no longer able to serve. When seeking help for sexual assault from heath professionals within the military, they had been in effect “written off”: slapped with a stigmatised label and then medically discharged.
According to the charity Salute Her UK, which supports veterans struggling to adjust to civilian life, some 133 of the 393 female referrals they received in a year had been diagnosed with a personality disorder. This echoes an earlier US scandal, reported in 2012, whereby rape victims in the Marine Corps and other branches of the armed forces said they were being discharged with these diagnoses. As they are pre-existing conditions, the military is not obliged to pay disability benefits.
Then, too, there is a long history of the courts using the mental health records and counselling notes of crime victims to attack their credibility – although recent legislation has made this harder.
This lingering pattern has severe consequences. Framing a victim as mentally ill shifts the focus away from the abuse, placing the onus on their disordered mind rather than the perpetrator of the crimes, who can more easily convince others that the victim is delusional.
Agencies and the justice system may disbelieve or ignore their testimony; meanwhile, their trauma is never validated, causing further distress. There may be unnecessary medication, and their medical history is for ever altered, which might mean changes to insurance, and barriers to employment.
This is compounded by the fact that people with severe mental health problems are particularly vulnerable to abuse in the first place: they are five times more likely to be a victim of assault, three times more likely to be a victim of household crime, and four times as likely to be preyed upon by relatives or acquaintances than the general population. Trauma can also trigger and exacerbate mental health conditions. Aware of the stigma, those suffering from these disorders are less likely to report crimes.
Where to start with addressing the issue? Part of it must involve a reassessment of the use of personality disorder diagnoses when treating victims of trauma. Psychiatrists are divided on whether these definitions help or harm. Borderline personality disorder is seen by some clinicians as a sexist and stigmatising label that can get in the way of treatment for post-traumatic stress disorder, which some believe is often the true cause of symptoms.
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But there is a broader issue here. Despite a plethora of mental health campaigns that seek to reduce stigma, and raise awareness, discrimination is still very hard to shift in places.
Mental health campaigns have for the past two decades often focused on normalising conditions such as anxiety and depression – encouraging people to talk about their feelings and get help if they need it. They often do so by making these problems relatable: after all, everyone has experienced feeling anxious or low.
This has been a great success: the taboo over seeking help has significantly decreased. The Time to Change campaign that ran from 2007 to 2021 was shown to have reached its aims of decreasing stigma. In the largest recent survey, three quarters of Britons say we need to adopt a more tolerant attitude to mental health, and 68% say seeing a mental health professional is a sign of strength.
Yet amid all this, vulnerable people are being squeezed out of the picture. As more are “made aware” of possible mental health issues at the milder end of the scale, resources are diverted away from the smaller number who really need them. There is evidence that stigma against severe conditions like schizophrenia is not shifting, even as sufferers from depression become more widely accepted. Media coverage of psychosis still tends to associate it with violence.
Is it time for a more targeted approach to mental health stigma? The public are more aware of loneliness, anxiety, depression and body image issues, and Britain is kinder for it. But we also need to root out discrimination in workplaces, in the justice system, the armed forces and the police, and against those with more severe conditions. Now for the hard part.
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