Why do we treat mental disability differently from physical disability?

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mental-illness-shirt

The new president of the Royal College of Psychiatrists in the UK, Sir Simon Wessely has recently said, “If we treated people with diabetes the way we treat those with depression there would be an outcry”.

The fact that different disabilities are treated differently by the medical world is illogical in itself. Mental illness is never taken as seriously as physical disabilities and disability acquired by an accident holds more privilege than one acquired at birth.

When I was in the process of applying for funding for housing modifications from the Ministry of Health, the amount of time and paperwork it took was unnecessary added stress to what I was already going through. If I however were wheelchair-bound from a car accident for example, ACC would have provided the funding immediately and there would be no limit to the amount they would give. Myself on the other hand had a capped amount that I was eligible to and each application took at least a year. By the time the year passes, I’m almost at the point of desperation.

To say that one type of disability is entitled to more privileges than another is an out-dated and unfair practice. While the kind of support one will require will differ from case to case, the type of disability one has and the way in which it was acquired should be irrelevant when it comes to accessing support.

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The mental stress is still there regardless of how or what the individual situation is and each person is entitled to live their life the way they choose to with the least hindrances as possible. Whether the disability is mental or physical, stigmatisations and inconsistencies in treatment or occupational therapy does nothing but add unnecessary stress on the person who requires it and their family.

21 COMMENTS

  1. None of us in a similar situation reading this are surprised Latifa, just another battle we either keep on fighting or give up from sheer exhaustion and suffer the consequences of not getting the treatment/assistence we need. I’m way beyond being cynical about it.

    I can point out another example of our 2-tier system. Many years ago injuries that were the result of a pre-existing medical condition (eg epileptic seizures, falling out of a wheelchair, ataxia) weren’t covered by ACC. Thankfully they eventually saw the light but it involved a lot of lying on the paperwork by patients and doctors to come up with more “acceptable” reasons for said injuries. (Remember that escaping prisoners at the time qualified for ACC if they injured themselves….)

    Fast forward, and these days while it’s possible to claim ACC for treatment for said injuries, there are bona fide injuries due to medical conditions- you’d be surprised at the damage severe muscle spasms can do- but they don’t fall under ACC’s definition of a “accident” because it involves “internal force”. So the physio treatment (which has to be private since hospital physios became unaccessable to outpatients) becomes completely unaffordable. As it is even the ACC surcharge is now unaffordable if you’re on a benefit.

    I’ve had several major injuries this way- some fall under ACC, some don’t. The latter I can’t get any treatment for and have turned into disabilities in their own right and my independence is under threat. There is absolutely no logic to this, we’d get a better deal blowing ourselves up cooking P.

    I totally agree about this ranking of disabilities. Who is society- and the state- to say that one type of illness/disability is more acceptable, more worthy, than another? Noone is immune to anything, I suppose that people who have their full health take it for granted? Stigma against mental illness is so ingrained I don’t think it will ever go away, and even among mental health professionals there’s stigma towards patients with certain diagnosies so you just can’t win. And you don’t want to be dealing with the medical system for a chronic medical illness and also have a psych label. All chances of being treated as a human being go down the tubes.

    Ok, rant over 🙂
    Thank you for your post, these things need to be bought to people’s attention periodically.

  2. The diagnosis of mental illness can be much more subjective than the diagnosis of a physical condition (as the physical condition can be objectively measured).

  3. At last someone is speaking up on this issue. Our hospitals treat every kind of illness, but some years ago closed their doors to the mentally afflicted. It is desperately important that the mentally ill have a haven from the pressures of living in stress filled society, by which I do not mean custodial care, but voluntary admission. The regional clinics with their 8 hour and 5 day weeks, are far from providing the kind of care that is needed. They rely heavily, of course, upon prescribing drugs – drugs substituting for people care. The mentally disadvantaged cry for time out from customary demands. They need protection which embraces protection from themselves. We certainly cannot pretend that there is no longer stigma connected to mental illness, and hospitals in there policy of exclusion are unfortunately contributing toward keeping that stigma alive. Meanwhile, gaols have for a large part replaced the missing hospitals for those in mental distress.

    • While the government claims to have spent more on mental health diagnosis and treatment for youth, the only adult group getting some more significant attention are prisoners.

      Indeed, I have heard from reliable sources of cuts to mental health services, that do not always appear as being cuts, but that really are so, as they are the result of less health spending per capita.

      With the many statistics we get, many forget, that the population has over years increased substantially. When there may be “more” total health spending, that may not mean more is spent per person, it may actually be the opposite.

      We get the same misleading info with the BS Christmas retail sales growth, and economic growth stats. Growth may not really be actual growth on a per capita basis.

      In Auckland community mental health services only seem to cater for the most extreme and acute cases, and often the “treatment” is very short term, and ends with prescribing medication and none else.

      Mental health deserves more attention, recognition and funding!

  4. Good blog Latifa. I agree with your sentiments on this important issue. Thank you for opening up this topic for discussion. More public education is required.

    I think because mental illness in most forms cannot be seen, it is disregarded.

    Ignorance of mental disabilities is as big a problem as the affliction is itself.

    Social standards have dictated it’s shameful to admit to being mentally unwell, when it’s not. Mental illness is no less painful than that of a physical ailment. In fact it can be much worse, not helped by society’s ‘closed door’ attitude towards it.

    In the past I have suffered from agoraphobia, accompanied by mild depression, which really made me ill and affected my life and that of my family. I didn’t display any physical scars, so for all intents and purposes to other people I was fine, but considered selfish and inconsiderate in the way I ‘chose’ to live. Many times I was told to get over it, when despite all efforts on my own behalf failed to achieve a positive result. I felt quite useless as a person.

    However after a meltdown some years ago, I was professionally treated and I have never looked back. It was like a ray of sunlight coming into my life. All it took for me, was to admit something was wrong and seek appropriate help, which taught me how to recognize and manage certain trigger emotions, along with particular situations likely to cause me to feel unable to cope.

    Even though I have recovered and emerged a stronger and better person as a result, I do empathize with anyone suffering from what I consider the ‘quiet’ disability, mental illness.

    Because an affliction cannot be seen, it doesn’t mean it doesn’t exist, causing great turmoil and suffering.

  5. Yes , but you’re talking about human conditions and afflictions in an inhuman politic . The time will come when those unable to work , for the Banks , money lenders , retail Christmas pimps , will be euthanised , dried out , ground up and spread out as fertilisers for the dairy ‘ industry ‘ .
    At the end of ones working life you’ll be given a suicide kit and a cheap watch with a count down timer . The mentally and physically unwell ( un fit for work/profit generation ) are currently being assessed as burdens to Profit ( hallowed be thy name ) . paula bennett , the leering , tree stump in a frock , is already belching gasses to that effect . You think the outed Swindler and liar jonky-stien gives one small , flying , feathered fuck ? Nope .
    How then are the ‘ handicapped ‘ going to survive until the Great Back Lash ? Charity ? Begging ? Crime ?

    To give me up as an example .
    I’m quite flash . I work in a flash film industry doing flash things with a camera and my beauty and wit enable me to rub shoulders with other flash people , both foreign and local .
    Sadly , I deviated from my flashiness and using a heavy crow bar , dug many holes in very hard , dry ground to run out caution tape for a flash job I was on at the beginning of the year . At the end of about 100 holes , my left arm felt odd , I had upper back pain at about T one and I felt increasingly uncomfortable , and worried frankly .
    Then my left hand went numb , my left foot went numb and I had increasing and intense pain in my back / neck .
    So , off I went to a Dr ( Not my usual since I was out of town ) who swooned , fell back in his chair and all but called the CIA , the FBI , The NSA , The DEA , his Priest and his whore when I asked for 30 mg codeine’s . ” They’re addictive , sorry . ” He said .
    After I got disprins and a book on getting to know Jesus I left his office with one of his National Geographic’s tucked under my jersey .
    But I digress .
    As my condition worsened over the course of the project to a point where I had to wake myself up half an hour earlier to take pain killers to stand up , I decided to ask to be released from set because I couldn’t function . Because of that , I lost a significant amount of money and missed out on what was to be a legendary wrap party , complete with very flash people .
    Enter ACC .
    ACC is a swindle . The ‘ Gypsy ‘ Dr they sent me to was a swindler and a liar and had his hand in their pocket . ACC was , at the time , a judith collins project . Read swindle .
    I visited the ACC office in town and met with an ACC man . He was an adept detective with the keen mind of a man determined to steer me away from Big Judy’s Abstract Cash Cow . Which he did with by now a not unexpected expertise .
    After scans , MRI’s , tests , more tests , more letters , more phone calls , more appointments , more of my money spent I was finally told , by the Doctor that I had a ‘ disease ‘ He siphoned the words through his teeth like a Vampire introducing himself to a blood bank . The grim delight he took in dropping the news was unsettling .
    I asked , as politely as one ought . ” What the fuck are you talking about ? And how do you get such a high polish on your shoes ? ”
    He showed me pictures of my insides and fell into a deep pathos as he laboured to explain to me that I was in a sad state of decay , my bones were crumbling from over-use , my discs were bulging from their confines , poisons were leaking from them , I was to retire immediately and live on pain killers for the rest of what he was convinced , to be a short and painful life of misery and loneliness , since I was no longer able to be considered ‘ flash ‘ .
    Therefore . I had a pre – existing condition . Namely , that I had a spine . The ‘ disease ‘ diagnosis was based on nothing but normal wear and tear from 59 years of hump backed , chronic , sexual self abuse and hard work . Nothing unusual there for any of us .
    ACC side stepped their responsibilities to pay me some small compensation while arguing that I was old thus wearing out thus fell outside their responsibilities . Responsibilities I’ve paid for , for most of my working life .
    Perhaps I should have told him I was barking mad , tried to murder him with his desk set then proceeded to hang myself from his lamp shade ?

    My point is ; mentally ill , physically ill , funny colour , weird smell , hairy palms , things falling off , growths , extra limbs , webbed feet , mad bouts of faeces flinging , hanging pictures of cameron slater on your toilet wall , day old chicken taxidermy , what ever you think qualifies you for help ? Forgetaboutit . Neo liberalism is your slave master and when you’re done , you’re done . And if you were done before you did ? Isn’t that why Insurance Scum like genome / DNA profiling so much ? The day will come when you try to get Insurances and they insist on a DNA sample be taken to assess your risk to their profits ? And you fail ? No job . No house . No car . No children . No money . No help . No support . Best find a scrap heap and chuck yourself on top of it .

    Or fight back .
    Time to be bold Ladies and Gentlemen . Time to fight . Or die .

    • This comment is stuff to base a movie on! It may be a comedy or something more serious, but what a “classic”, Countryboy!

    • Countryboy – stick to the whiskey. That Soylent green is baaad juju.

      PS ACC-WINZ – two cheeks of the same bum.

  6. And who are the groups keeping this model in place? The medical establishment? The government? How about the disabled organisations themselves?

    Sad to say, the worst of the worst – is disabled themselves. Yes I said it – the disabled organisations here and overseas are the enemy of a true pan-disability focus.

    Where shall we start – Deaf Aotearoa – it is good place to start – not only a racist organisation, it is an organisation that does more to marginalise deaf with mental health issues than any other organisation and agency in relation to deaf.

    What about the DPA (Disabled Persons Assembly) – another bad joke – They do not deserve the name. They have been pitiful in a pan approach to disability – ironic that their current CEO, is the former CEO of deaf aotearoa.

    Till such time as disable organisations clean up their own house – this is an issue that is dead in the water. It does not help that the same group of people, with pernicious and antiquated ideas sit on boards and councils of disabled organisation, sit on the same boards and councils which advise government.

    Disable lack a voice, and will continue to do so – till all the traitors and sellouts are dealt with.

    • I asked, on the DPA NZ facebook page, why there was not an absolute outcry about yet more reports of abuse and neglect of disabled people at the hands of contracted providers?

      Where was the outrage?

      Where were the voices from the DPOs, screaming in the loudest voices from the highest rooftops when yet another disabled person is killed in state funded care?

      Sorry, Nathan.

      There was a pinned post from DPA NZ…along the lines of ‘this is a new era where disabled people are in partnership with the government, having conversations, and generally getting along like a house on fire.’ So to speak.

      Sorry, Otto.

      ‘ The time for activism is over (although there is still room for some advocacy).’

      Instead of making a stand on behalf of those disabled people who are dependant on others for their care, demanding that the recommendations of the ” Putting People First” report are respected and those Contracted Providers who fail to meet adequate standards of care have those lucrative contracts cancelled, DPA NZ seems to be very cosy indeed the the organisation representing the interests of the Contracted Providers…the New Zealand Disability Support Network.

      The same organisation that suggested that the hideous reports of neglect, abuse, assaults and torture were a media beef up.

      The same organisation that gave awards to some of the perpetrators of those abuses.

      The same ‘voice for all disabled New Zealnders’ is more than happy to share the stage at conferences with these PLODS, at the same time assiduously ignoring two lone protesters holding up signs demanding criminal charges be laid against providers who kill.

      Well…those lone protesters actually got one on one time with the Minister for Disability Issues, the Health and Disability Commissioner and the Deputy Comissioner. We also spoke to a number of individuals equally concerned and outraged by these cases of neglect and abuse…especially those neglected to death.

      Sorry, Jason.

      Not long after my challenge to DPA NZ, I was thrown off their Facebook Page for upsetting some of the ‘community’ by talking about bowel and bladder cares….a fact of life for those living with permanent Spinal Cord Impairments. The conversation was in response to a wonderfully happy clappy Attitude programme detailing the inspirational progress made by this brave young woman rehabilitating from a spinal injury. Very good if you a lucky enough to be funded by ACC.

      Pretty shitty time it is for the spinal injured on Ministry of Health.

      Not that the Attitude people wanted to do a programme about that…
      Not that DPA NZ felt the disparity was an issue worthy of their advocacy…

      Of course, speaking up about these important issues would be seen as criticising the government.

      And who pays their salaries?

      Whoever pays the piper, calls the tune.

      Rant over …for now.

  7. Trouble with mental illnesses is there is still an attitude of you can pull yourself together and out of it, that has never fully gone away, and the collective attitude of the day will actually be going some way to retrench it into the general psyche.

    • Also people will ‘compare’ themselves and the illness where as it’s harder with a physical illness. I.e. “Well I get depressed and I just pull myself up and get on with things” – confusing the blues with depression but I don’t think anyone could get away with saying “Well I sprained my ankle once and I just rested a bit and got back to work, what are you complaining about your broken back?”.

      *on a separate note we were told by family members to solve my son’s asperger’s by sending him to scouts, lol*

  8. Latifa Why do we treat Mental Illness disability different from physical illness?

    Answer is simple,

    The medical fraternity is hiding the real cause of Mental illness as being closely related to various physical illness’s!

    Not convinced?

    I will illustrate clearly with explain my own case.

    While overseas I was chemically poisoned in the workplace along with 40 other workers!

    Because this involved a very controversial issue of “chemical toxic tort” every doctor prescribed us all as Psychologically mentally ill, and later we had to contest the workplace accident and were found to be suffering from a physical exposure to a various mixture of Volatile Organic Chemicals over several months in an inadequately ventilated workplace.

    This overturned 12 Doctors who had first rushed to blame us on simple unbalanced Psychologically unstable beliefs.

    So you now can see that the medical fraternity uses the Mental illness as a scape goat or catch all when paid to cover up chemical tort litigations.

  9. So Dr Wessely is now the President of the ‘Royal Society of Psychiatrists’. It sounds just as bizarre as Dr David Beaumont (well known by some ACC clients for some of his appalingly biased “assessments”) being the President of the Australasian Faculty of Occupational and Environmental Medicine (AFOEM).

    Dr Wessely got himself into a lot of trouble before, due to his unconvincing views and comments on ME, and also about his cooperation with certain other “experts” who tried to pervert the so-called “bio psycho social model”.

    Here is some stuff to ponder about:
    http://blacktrianglecampaign.org/2012/09/26/me-is-no-more-in-the-mind-than-ms-professor-simon-wessely-responds-to-journalist-sonia-poultons-article/

    http://www.mecfsforums.com/index.php?topic=13384.0

    http://uk-condemnation.blogspot.co.nz/2013/11/bps-model-of-disability-and-mecfs-prof.html

    It is astonishing how these people make careers. Dr Beaumont once working for the now dismissed, discredited outsourced “assessor” ATOS – for the DWP in the UK, responsible for over a thousand deaths of those wrongfully “diagnosed” as “fit for work”.

    http://www.fitforwork.co.nz/dr-david-beaumont-inducted-as-afoem-president

    http://www.racp.org.nz/page/racp-faculties/australasian-faculty-of-occupational-and-environmental-medicine/realising-the-health-benefits-of-work/may-2010-video-presentation-professor-sir-mansel-aylward/

    The latter of these “gentlement”, same as a Mansel Aylward, were the very “experts” that advised the Nat government on “welfare reforms”, and that want to get sick and disabled into work, their way.

    I can only warn people re the Dr Wessely et al, they are the ones that have a certain agenda. And what they say to Herald journalists, that is the “nice sounding” stuff, that governments and insurance companies also love, that they have the “recipe” to “help” people into work, on the competitive job market, no matter what.

    Mr Wessely got his mention in this blog as well, besides of Aylward and others:
    http://accforum.org/forums/index.php?/topic/15188-medical-and-work-capability-assessments-based-on-the-bps-model-aimed-at-disentiteling-affected-from-welfare-benefits-and-acc-compo/

    So perhaps all this good sounding stuff is really not quite what it may seem to be? What happened to the SOCIAL bit in the “bio psycho social” model being applied more widely, I ask?

  10. I’ve developed a physical disability due to mental injury, namely my body’s developed dysfunctional neural networks as a way of coping with the hyperstimulation of ptsd. This condition is conversion disorder, and, depending on how over-stimulated my mind is, I can look and sound like I’ve had a stroke.

    With conversion disorder, the more dysfunctional networks are stimulated, the stronger they become. Therefore, prognosis for rehabilitation improves the sooner combined physiotherapy and psychological treatment starts. Such an approach reduces stimulation of dysfunctional networks, to enhance redevelopment of the functional neurology.

    It was 10 months after developing the disorder that I was diagnosed. When conversion disorder was suspected, the DHB opted to leave the case to ACC for diagnostic assessment and care, allowing me minimal OT support for the initial six months they were allowed to provide. As, at that time, I had not been diagnosed, let alone offered a time frame for recovery, Disability Services would not provide assistance for mobility. I was fortunate to have a wheel chair donated to us from the local koha shed, and money was donated to our family that went toward a car (we liquidated my son’s savings fund to cover the shortfall). We ended up putting our own ramps in around the house.

    After 10 months of assessment and waiting, the specialist report confirmed conversion disorder, but relating it to the trauma that contributes to the PTSD ACC covers me for remains inconclusive. Therefore, ACC’s branch clinician has ruled to decline assistance with physical therapy. Furthermore, while psychological treatment for the trauma may have helped improve my symptoms during this time, the decision had been made by the psychologist and ACC to put the treatment plan on hold until the specialist assessment process was complete. Therefore, procedure has hindered not only my access to treatment through the year, it may well have hindered my overall recovery and increased my potential to relapse in future.

    The conversion disorder hit hard almost a year ago now. The various agencies I have been in touch over the year have been sympathetic, but it all comes down to red tape. It doesn’t really matter who meets and speaks to me face-to-face, the decisions are made by people in another city, who learn of my situation through what has been written in reports passed on to them by the ACC case manager, who then communicates the findings back to me over the phone. The case manager and the branch clinician have never met me, let alone seen me try to walk across my yard.

    So I get it – it’s easier to find support for physical disability, if that is the primary source of life challenge. But when that disability is an expression of a disease of mind influencing matter, manifesting as a result of complex neural and psychological processes, the ideology of bureaucracy becomes challenged, and the case is dropped.

    I depend on the assistance my partner provides, but while he’s included under my supported living payments, we actually receive only about $50 more than the sole-parent supported living payment. And IF IRD ever managed to pull the child-support owing from my son’s father, that’d just go to recompensing the government.

    And I lack sufficient faith in the system not to be cynical – if a review finds my trauma significantly predisposed me to developing conversion disorder years later, my claim for independence support will likely increase significantly, and ACC will be liable for costs far exceeding the 10 psychology sessions they’re willing to cover at this time.

    I do have spirit and I know belief in myself is a major factor in my recovery. However, since having my claim for physiotherapy declined last month, I’ve been at a loss as to where to go, who to talk to, what my rights are. Friends and family tell me to fight, but it’s stress that’s put me here in the first place.

    I’d greatly appreciate any advice or knowledge that’d help my situation, if anyone has any to share.

  11. So my comment from yesterday was “not good enough”, or of the wrong type, hence got not published, I suppose. Here we seem to have the blind leading the blind, trusting in “experts” that are only serving ulterior motives, to help the government use some BS “treatment” (mostly standard type CGT that only “helps” some) to get an excuse to throw people with mental health issues onto the highly competitive job market.

    Wessely, Aylward, Beaumont, Bratt and co, all busy doing this.

    And so many disabled still have faith in the supposed disabled lobby groups, who have all fallen hook line and sinker for the manipulations, and raise no voices against it.

    Good luck with this idiotic blind faith and blinkered view of it all.

    • Mark…I beleive you are wrong when you say that “so many disabled still have faith in the supposed disabled lobby groups, “.

      Many, many people have expressed disappointment and often dismay at the lack of even token advocacy from these groups….never mind the activism that is needed.

      We come on these sites and vent our spleens….but what else can we do?

      New Zealand has a Disability Strategy, and we signed up to the UNCORPD…it bothers me that THAT umbrella organisation is now charged with ‘working with the government to ensure that the rights of disabled people are upheld.’.

      Bugger rights, I say.

      How about we try, as a community, to engage with the system with the full and complete expectation that needs will be met in a timely fashion…as all their happy clappy documents say they will be. We now expect things to take forever…those who the system works for best are those with an absolute sense of entitlement.

      In the case of those dealing with ACC…more pressure needs to be put on them to by reminding them that failure to meet these care and treatment needs NOW will lead to greater claims on ACC in the future.

      Battle on, Mike.

      • Quote: In the case of those dealing with ACC…more pressure needs to be put on them to by reminding them that failure to meet these care and treatment needs NOW will lead to greater claims on ACC in the future.”

        ACC has deep pockets, a parade of indifferent staff, all the time they need to wear you down and send you to the living hell and humiliation that is WINZ.

        Reading the comments BTL – there’s a grey area covered by neither ACC nor WINZ – where people need immediate treatment to protect against long term harm – yet, it’s not an ’emergency’ as in life-threatening. Merely destructive of independence and quality of life.

        By the time someone has struggled through the typical ‘insurance mind-set’ at ACC they’ve entered the danger zone where recovery is becoming less and less likely.

        Or they do indeed have a pre-existing condition that keeps creating new manifestations and there’s no quick route to treatment that will either hold the health gains made before the event, or reverse the need harms.

        ACC, with its insurance/legal background is probably NOT the agency. WINZ has neither sense nor authority to deal with this – and DHBs are so stiff with bureaucracy and tight budgets they dare not.

        And, with cynicism born of long experience – anything put in place to deal with this grey gap would have to be set up so our free-loading citizens don’t wreck the system for those who genuinely need it. (Why ACC is so leery nowadays…)

  12. There is a simple reason why physical and mental disabilities are treated differently. Physical disabilities can nearly always be seen whilst mental disabilities often cannot (how can you see if someone has depression?). Too many humans still subscribe to the prehistoric instinct that if you can’t see it, it isn’t there.

  13. YES !! GREAT TOPIC INDEED!

    IF you look at the statistics of numbers of people today on anti-depressant drugs (=”mental illness”) = ALARMING. (last time I looked, couple of yrs ago, 400,000 !!!!)

    The conclusion of this can only be-

    1) More and more people are unable to cope
    WHY???

    IS IT -Something wrong with PEOPLE COLLECTIVELY?

    OR…
    2)
    Something VERY wrong with today’s Govt. SYSTEM? (which makes up all the laws & regulations..tons & tons of them)

    YOU DECIDE.

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