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Thursday, 14 November 2013

The schizophrenia stereotype scares the sufferer too

“When you hear about schizophrenics, they’ve usually chopped someone up or shot someone.” I remember the day 44-year-old Lloyd Drew, a former market trader, told me that. He was sitting in his dad’s kitchen in Bermondsey, south London, chain smoking and perspiring while downing coffee after coffee.

He was anxious, unsure of himself and trying to make sense of what the label “paranoid schizophrenic” meant to him – a label he had found attached to himself. “It makes me worry because I don’t know my own mind,” he said.
He’d been discharged from a psychiatric ward five months earlier after hearing voices, specifically the voice of a 30-year-old woman called “Martha”. She was getting him into trouble, telling him to drive his dad’s Jaguar. Lloyd started to worry that he was damaging the ozone and so decided to rebalance his carbon footprint by stealing a wind turbine from a boat. He got caught by the police and then ended up at Ladywell psychiatric unit in nearby Lewisham.
Like several others I’d met, Lloyd bravely agreed to take part in Bedlam, a Channel 4 documentary series about mental illness. “It needs to be on the telly. People don’t understand it,” he told me.
He was right. I didn’t, he didn’t and neither did his 70-year-old father, Ray, a tough man who came from a family of south London dockers.
Lloyd’s deep-rooted anxiety about his diagnosis was, in large part, a product of years of sensational and inaccurate media reporting about the risks posed by paranoid schizophrenic patients living in the community. We’re told to be afraid, to be very afraid, and Lloyd was.
Last month the Sun splashed with the headline “1,200 killed by mental patients”. The story didn’t say how many of these crimes were committed by patients who were being treated in the community –compared with those neither in the system nor diagnosed with mental illness until after the offence had been committed. More critically it didn’t mention that the huge majority of murders – about 95 per cent – are committed by those who don’t have a mental illness, and that those who do are about 10 times more likely to be victims, rather than perpetrators, of violent crime.
Until I met Lloyd, I’d never thought about the profound effect this type of reporting can have on someone who actually has a psychotic illness.
We were filming with him around the time Drummer Lee Rigby was killed. It happened not far from where Lloyd lived and it was preying on his mind: “It’s just a matter of staying stable, especially with this thing going on in Woolwich. You hear a lot about schizophrenics on the news – it makes me feel worse, in case I could do that.”
Ray was also uncertain about things. He couldn’t suddenly erase everything he’d ever read about the risks posed by mentally ill patients who live in the outside world.
Since Lloyd’s discharge from psychiatric hospital, he had been living with Ray who was now experiencing psychosis at close quarters for the first time in his life, hearing his son talking to an imaginary woman called “Martha”.
“It doesn’t worry me now,” he said but continued: “It did at first because I thought you never know, do you? I don’t want it [the voice] to say get up and hit your dad over the head or kill your dad. I know it sounds silly but you wouldn’t have no chance would you?”
Lloyd, once a successful stand-up comic, is one of 6,000 community mental health patients registered in the London borough of Lewisham. More than a thousand have a psychotic illness.
His first psychotic episode occurred in 2007, following a series of stressful life events – the death of a close friend, the break-up of a relationship with his longterm partner and then the loss of his mother.
Dr Martin Baggaley, medical director at South London and Maudsley NHS Foundation Trust, said it was important to allow a documentary team to meet patients like Lloyd. “The access was primarily to dispel stigma and myth around mental health services and their patients,” he said. “People are often labelled as ‘schizophrenic’ and there is an unhelpful association with homicide and violence in the media. This can worsen stigma and lead to people not engaging with treatment.”
There are about 45,000 patients with mental health conditions being treated in the four boroughs covered by Dr Baggaley’s trust. Many are kept well and out of hospital by an invisible army of social workers, psychiatric nurses and psychiatrists overwhelmingly driven by a sense of compassion, but some patients are reluctant to engage because they find it hard acknowledging their illness, they don’t want to take medication or they believe they’ve got better.
Lloyd wasn’t one of those. He wanted help and to learn how to manage his illness. He regularly met with his care co-ordinator at a community mental health team in Deptford, but as filming went on, it was clear he was struggling. His psychiatrist, Dr Fidel Gallo, said Lloyd had been using alcohol as a way of coping. At one stage he’d been going through two bottles of wine a day.
He had turned into something of a hermit, too paranoid to go out, apart from the odd visit with his dad to the local pound store or for a drink at a nearby social club. He was overweight, smoking heavily and starting to look unhealthy.
To a degree, society had made Lloyd feel like this: unpredictable, scared, second-guessing himself all the time. “I don’t know what people are going to think about paranoid schizophrenics in the community,” he said. It’s going to be hard for both him and his father, but while we continue to brand Lloyd and people like him as dangerously unpredictable, his mental illness won’t be his only struggle.

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