Channel 4 and Mental Illness

While on my trip to the UK, I took advantage of Channel 4's on demand service 4oD (which is only available in the UK).

I had been keen to see the Channel 4 production of Claire Allan's novel Poppy Shakespeare, which I reviewed in Metapsychology in 2007. The 2008 90-minute TV version was broadcast in 2008, with Naomie Harris as Poppy and an especially strong performance by Anna Maxwell Martin as N. It is true to the book, but with more fantasy scenes and playing up the absurdity of the patients' behavior. They have been institutionalized and it isn't clear if they really need help or are just milking the system. When there are cuts in services, the patients are ejected from the day ward, and they complain loudly. The mental health administrators are really only concerned with themselves and use administrative nonsense language to justify their decisions. It adds up to 1984 meeting One Flew Over the Cuckoo's Nest, with a strong dose of DaDa absurdism added. As such, it has something to offend everybody, but it makes for a robust drama. I wish it were more widely available.

I also stumbled across the Channel 4 series Psychos, which had 6 episodes, broadcast in 1999. It is set in a Glasgow psychiatric ward, and shows the daily struggles of the doctors, nurses, and patients. The lead character is Dr. Danny Nash, an unconventional but compassionate and insightful psychiatrist, who, it turns out, is also struggling with bipolar disorder. Nash is played by Douglas Henshall, whose website has a page devoted to the series. The series won some acclaim and awards, but also suffered serious criticism for its title, which was seen as stigmatizing, and also its portrayal of mental illness. Apparently there was also an offensive publicity campaign for the show at the time, with the tagline "It will blow your mind." A UK watchdog organization also condemned the trivialization of a sexual encounter between Nash and one of his patients. Despite initial plans for a second series, this criticism led to it being canceled.

The title of the series was clearly a major mistake -- what were they thinking? Yet viewing the 6 episodes makes it clear both how difficult it is to set a TV series in a psychiatric ward without succumbing to stereotypes and how much dramatic potential the idea has. There are moments here that are really interesting, with quandaries about how to help patients, working out what a doctor's responsibilities are, and when psychiatric power is being abused. In the last episode, a university mathematician patient starts quoting Thomas Szasz to the psychiatrists and questions their status in labeling him. A series such as this could serve a valuable role in educating the public on current psychiatric treatment and the experience of mentally ill people. However, the requirements of making it dramatically gripping and the worry about condemnation by advocacy groups for the mentally ill explain why it is unlikely that there will be any similar series in the UK or the USA in the near future.

Catching Up

My trip to the UK went well. The seminar at Newcastle University Policy, Ethics and Life Sciences Research Centre (PEALS) was interesting especially because a number of mental health service users came and gave helpful feedback on my presentation on the language of madness. Several supported what I was saying with their own experience: they found being called "clients" or "service users" patronizing, and they prefered language that was closer to their usage. One woman said she had a written contract with her doctor to allow him to tell her she was acting "crazy" or to use similar language when she going through an active phase of her mental illness, since she did not understand more polite neutral language at those times.

The workshop at Warwick University Medical School on Mental Disorder was well attended with about 40 people. The room was full to capacity, and we went from 10am to 6pm with a few short breaks. It was a strong collection of papers, and there were good exchanges during questions. Joan Busfield strongly expressed her dislike of the idea of relationship disorders in response to my discussion of the topic, and the sources of her disapproval became clearer in her talk -- it was a suspicion of psychiatry and a concern that psychiatric solutions tend to preclude more social solutions to people's problems. Derek Bolton pressed her on this in questions, emphasizing that there's no reason why psychiatric solutions cannot be combined with other approaches.

It was good to learn of the recent work on definining mental disorder: some people expanded on ideas they have presented elsewhere, but other papers presented work that was new (to me at least) -- I'm looking forward to learning more about Lisa Bortolotti's project on delusions. But one feature of the Warwick workshop I especially liked was the mix of philosophers with people from other departments, and I was glad to hear Liz Barry's paper on Samuel Beckett and Mental Disorder. I've been thinking about teaching my course on The Culture of Madness again soon, and it would be a very useful paper to include.

At Lancaster University Department of Philosophy, the workshop on Vices and Disorders had a good range of papers. Chris Megone expanded on his neo-Aristotelian view and his dialog with Rachel Cooper on whether it can successfully distinguish between disorders and moral failings. Havi Carel had a new project on eating disorders; she surveyed some of the literature and discussed how the line between moral judgment and medical judgment is drawn with anorexia and bulimia. It's an interesting project.

Talking with people while I was in the UK, they agreed that there are more events in philosophy of psychiatry this year than usual. It's an encourage trend, so I hope it continues.