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Calls to end stigma of schizophrenia ‘label’

Calls to end stigma of schizophrenia ‘label’ 8:59pm Saturday 3rd November 2007 – It is a label that feels like a life sentence, dooming sufferers to a life of verbal abuse and second-class-citizen status.

Ron Coleman, diagnosed with schizophrenia in 1982 and treated with electro-shock therapy and drugs, has cited his own nightmare experience in the psychiatric system to call for the term to be dropped altogether.

The 49-year-old from Fife said: “I lived the schizophrenia label instead of living as a person. People treat you as if you’re a piece of crap, talk to you like a non-person. I got people battering on the door, shouting psycho’ and throwing things at the window. I spent 10 years in a drug-induced, zombied haze..”

“I still hear voices, but I’ve found a way of living with them. It was only when I turned away from psychiatric medication that my life totally turned around. Since then I’ve got married, had kids, got a house and love going to work every day.”

A growing number of mental health experts in Scotland agree that cases like Coleman’s demonstrate the need to scrap the term schizophrenia, since it has, they believe, become a stigmatised and scientifically redundant category.

“It’s a loaded, dated label and it can be difficult to see beyond,” said Eddie McCann, senior lecturer in mental health at Napier University. “It gives the impression that it is a perpetual state, but people do get better and lead fulfilling lives.

“The label is connected to approaches dating back almost 100 years ago. We have to think about new categories based on different types of distress. Drugs have a place, but there are huge possibilities for therapeutic work.”

Traditionally, advocates of the schizophrenia diagnosis argue that the illness is a deteriorating condition arising from increased activity in the brain of the neurotransmitter dopamine. Yet the success of behavioural therapies and counselling at the Scottish Hearing Voices Network in Dundee suggests that it may be traumatic experiences and other social factors that lead to the development of psychoses.

“The idea that you’ve got a brain disease from which you’ll never recover is just not true,” said Paul Hammersley, a cognitive-behavioural therapist leading the Campaign for Abolition of the Schizophrenia Label (CASL). “The claim that there is a medical condition called schizophrenia doesn’t stand up to scrutiny. It’s an appallingly stigmatising diagnosis. It can ruin lives.”

Coleman added: “It’s clear to me that hearing voices was created by my experience of abuse, not biology, not this thing we call schizophrenia, which itself disables people.”

In Japan, the term schizophrenia has been replaced with the term “integration disorder”, although some believe stigma would soon become attached to any new label. Instead, there is growing support for splitting the symptoms into new sub-categories including sensitivity, anxiety, trauma-related and drug-induced psychosis, since these may point toward more nuanced methods of recovery.

Andrew Moskowitz, senior lecturer at Aberdeen University’s department of mental health, said: “When it was first proposed almost 100 years ago, it was called the group of schizophrenias. There’s a long-standing belief in sub-groups. The challenge is in re-classifying an individual’s symptoms so you can actually help them.”

Yet Marjorie Wallace, chief executive of the mental health charity Sane, believes the word is still necessary to raise awareness and attract funding. “While we recognise that the term can act as a stigmatising label,” she said, “without identifying this condition as a serious illness, how can there be any hope of researching it and providing better treatments?”

But Paul Hammersley is adamant that such reluctance is unhelpful. “If schizophrenia is a flawed concept, then we have to question what we’re raising awareness and money for,” he said.

Dr Andrew Gumley, senior lecturer in clinical psychology at Glasgow University and a consultant at Gartnavel Hospital, said the term schizophrenia told doctors and carers very little about the best modes of recovery. “Scotland has been really strong about new approaches, and there’s a growing recognition that there needs to be an individualised understanding of recovery,” he said.

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