But that’s not how it works, as a bold post on the global professional network LinkedIn recently showed. Mandy Stevens, director of nursing and mental health for the UK’s National Health System, not only posted her shocking story of a mental breakdown, but a photo to go with it that quite possibly shows her in the most vulnerable position she has ever has been in in her life.
“Perhaps not the most flattering photo of me, but I’m sharing this awful picture and my story to help increase understanding of the impact of mental illness and to celebrate my recovery,” Stevens writes on the LinkedIn post.1 “I am recovering from the most terrible depression that ripped the heart and soul out of me. Very unexpectedly an NHS Acute Inpatient ward in Hackney has been my home for the past 12 weeks.”
Three months in a psychiatric hospital is a highly unusual occurrence in the United States, with most insurance companies deeming such extended stays unnecessary. In the UK, healthcare is universal – everybody is covered in the same way. The nation owns and operates the entire system.
Stevens was a high-ranking official in that system within the mental health sector. Among the nearly 2,000 comments on the post, many people wondered what “triggered” her depression. The comments raise some important questions about mental illness, the sorts of questions nobody usually ever wants to ask. In that way, Stevens has accomplished exactly what she set out to do with the post.
Crying During Meeting with Boss Was the First Red Flag
One professional who carries the title “Head of Teaching and Learning” told Stevens, “Hopefully one day there will be no stigma due to better education and understanding (about mental illness). Your story adds to this education. It would be interesting to learn what the triggers were which caused you to be admitted so quickly. I tend to think of a mental illness as being a gradual decline within a person, which creeps up on them, but your situation seemed very fast.”
As she did with so many of those 2,000 comments, Stevens personally replied, saying she has been spending a lot of time reflecting on the breakdown to see if there were warning triggers she could have noticed sooner. “The very first symptom I noted was becoming ‘wet behind the eyes’ when I was having a conversation with my boss, the Chief Exec. This NEVER happens to me and I NEVER cry at work…so that evening I came home and did the ‘Becks Depression Inventory’ which showed me as ‘moderately depressed.’ I immediately made an appointment to see a private psychiatrist that I had seen before. I saw her two days later, but the depression had really got a grip on me very quickly, and I went downhill so rapidly! It was very scary.”
What many people don’t realize is that mental illness often is brought on by great trauma, trauma completely out of the control of the people who suffer it. It could be the loss of a child, the trauma of warfare, surviving an assault…anything.
Survey of US Doctors Shows Most Don’t Seek Help for Mental Illness
Unfortunately, stigma, shame and guilt still surround mental illness, so people don’t seek help. Stevens’ bold step to go public about her breakdown is particularly surprising given what we know about the number of people living in “the mental illness closet,” so to speak, in the healthcare space. A survey of 2,000 American doctors released in September 2016 revealed some shocking statistics. Nearly half of them said they thought they met the criteria for a mental health disorder in the past but kept it quiet and did not seek treatment. Why? Worries about being stigmatized, of course, but worse, having to admit they sought treatment on their medical licensing applications.
“According to a study that appeared in 2008, about 90 percent of state medical boards have licensing forms that include questions about an applicant’s mental health,” the Washington Post reported.2 “Such questions are intended to protect the public, based on the idea that impaired or distressed physicians could endanger patients. A physician having hallucinations, for example, might not be able to focus or practice safely.”
But how many doctors are going to jeopardize their livelihood by answering such questions honestly? And if that’s the case, is anyone at all benefiting from such policies? “All of my fears were realized when I did report it,” the Washington Post story quotes one doctor as saying. “I was placed in a very strict and punitive (program) that didn’t allow me to take meds written by my doctor for anxiety and insomnia. I am now not practicing at all because of this.”
Stevens’ Story Prompts Other Healthcare Professionals to Share
Indeed, comments on Stevens’ LinkedIn post reference such measures, even in the UK. Writes one medical practitioner, “I hope your experience returning to work will be positive and supportive, focusing on your skills, not characterized by discrimination disguised as concerns about your future health, performance and safety.”
Writes another, “I am a therapist LCSW in practice. I have to take lots of care/precautions to deal with this illness. Thank you for sharing your brave story!”
As for Stevens, she is all too aware of the stigma surrounding mental illness, which is precisely why she wrote about her experience online. “If I had been in the hospital with a broken leg, or a physical problem, no doubt I would have been sharing amusing photos of my drip stand, the signed plaster cast and the hospital food, laughing with my family and extended social media community. Instead I have hidden myself away, scared of my own shadow and told very few people. Sad to say I have also been embarrassed, shy, suicidal, phobic, anxious and scared of everything.
“This selfie, taken late November, shows a Mandy that no one will recognize: tearful, distraught, matted hair, frightened, withdrawn, desolate and desperate. So, so, so far from who I normally am: A confident, competent, extrovert, professional, independent woman. This is what mental illness has the power to do.”
In a personal message to Michael’s House, Stevens said she is doing much better but is still is a bit fragile. She said she will consider giving Michael’s House a complete interview about her experience and offering more details during the next few months.
In the meantime, in the words of one marketing manager at a medical group who commented on Steven’s post: “I strongly believe that, at long last, the stigma surrounding mental health issues is finally subsiding.”
That’s certainly the hope of people like Stevens and those like her who share their stories.
1. Stevens, M. (2017, Jan. 16). From NHS Director to mental health inpatient in 10 days. LinkedIn. Retrieved Feb. 11, 2017, from https://www.linkedin.com/pulse/from-nhs-director-mental-health-inpatient-10-days-mandy-stevens
2. Morris, N. (2017, Jan. 7). Why doctors are leery about seeking mental health care for themselves. The Washington Post. Retrieved Feb. 11, 2017, from https://www.washingtonpost.com/national/health-science/why-doctors-are-leery-about-seeking-mental-health-care-for-themselves/2017/01/06/b19bc4ba-ad02-11e6-a31b-4b6397e625d0_story.html
Written by David Heitz