Ideas@TheCentre
Bad or sad is not mad
If I were accused of misappropriating other people’s money and my career was in jeopardy, I reckon I would be down in the dumps too.
But this hardly justifies the actions of certain ministers in the Gillard government who have argued that because Craig Thomson might be in danger of becoming mentally ill the opposition should back off pursing him in Parliament, lest the pressure leads to tragedy.
This is another example of the mental illness card being played to curry sympathy and deflect scrutiny from public figures whose behaviour attracts unwanted attention.
Ironically, this trend is a tribute of sorts to the mental health organisations that have campaigned to de-stigmatise mental illness and promote understanding.
People used to be ashamed to admit to suffering from mental illness because madness was equated with badness. It now seems that the reversal of the stigma has gone too far. The bad are increasingly using mental illness as a legal ploy to excuse or mitigate their badness.
Another related and much commented upon trend is the medicalisation of normal emotions.
If this were just another middle-class fad (like the New York elite’s obsession with psychotherapy), it could pass without comment.
But when the standard self-administered tests for risk of mental illness encourage over self-diagnosis, important public policy considerations arise.
Overestimation of the prevalence of mental illness in the community encourages governments to spend money on early intervention initiatives. As with all preventative health measures, such efforts can prove cost ineffective and misallocate scarce public resources.
Take the Howard government’s decision to extend the Medical Benefits Scheme to cover psychologist consultations. When government programs allow the well off, worried well to access taxpayer-funded services, money is squandered on unnecessary ‘prevention.’ Resources that could be better utilised elsewhere are squandered on those who are never genuinely at risk of experiencing major psychiatric problems.
When the asylums were closed in the 1980s, advocates of de-institutionalisation convinced policymakers that ‘care in the community’ would not only be the better but also the cheaper treatment option.
Thirty years later, sufferers of serious mental illness and their families continue to struggle to get access to appropriate clinical and other support services.
Community-based care is patchy and often unresponsive. Overloaded public hospital psychiatry departments are crumbling under the strain. And the dilapidated inner-city boarding houses in which many mentally ill people live are a disgrace to civilisation.
When it comes to understanding mental illness, our empathy and public health dollars would be better directed towards those who need the greatest help.
Dr Jeremy Sammut is a Research Fellow at The Centre for Independent Studies.
