You don’t need to be a psychiatrist to know that having a breakdown is not one of life’s little pleasures. At least a physical illness usually elicits sympathy – mental illness is invisible. Except, of course, in Hollywood, where the mentally ill seem to congregate to plot intricate murder and mayhem.

The truth could hardly be more different. People with severe or long term mental illness (or both) are not filthy rich criminal masterminds – adults with long term mental illness are actually one of the most socially excluded groups in society. The figures speak for themselves: Mental health problems cost the country over £77 billion per year through costs of care, economic losses and premature death. Though many want to work, only a quarter of adults with long term mental illness do. Fewer than four out of ten employers said they would recruit someone with a mental health problem. Two-thirds of men under the age of 35 with mental illness who die by suicide are unemployed. Families may struggle to cope with the financial burden of someone who cannot work, but there is also a big emotional impact – carers themselves are twice as likely to have mental health problems if they provide substantial care.

Besides the obvious financial costs, people suffering from mental illness often find themselves the victims of stigma and discrimination. They suffer socially and often try to hide their condition from their friends and family. Ironically, mental health problems are much more common that most of us believe: according to the charity Sane, mental illness will affect one in four of us during our lives. For most of us the problem will be short and transitory. Others, however, will not be so lucky. But receiving the right treatment when you need it means that a large number of people with long term mental illness will at least be able to manage their disease and return to normal or near-normal levels of functioning.

Severe mental illness used to mean almost guaranteed institutionalisation, but today most of these people are cared for in the community. This does not mean that they have seemlessly slotted back into society, however.
Even if you do recover, it can be hard to return to your old job or place of study, as everyone will know why you left in the first place. If your condition is of a relapsing nature, you might have to take frequent breaks during your working life. This can make it very hard to hold down a specific position.

Stress can exacerbate a mental illness, so you might have to rearrange your working conditions to be more flexible or relaxing. It can be hard to convince your employer to accommodate this.

After a breakdown, it can be hard to reconnect emotionally with your family. Interpersonal relationships suffer, as the strain of dealing with someone’s mental illness is often hard to cope with for spouses, children and friends. Lone parents with mental problems, particularly, have very low employment rates, may not receive family support and their children may develop emotional problems.

The government has published a report on mental health and social exclusion in a bid to help re-integrate the mentally ill back into the community, stressing the need to combat stigma and prejudice and presenting an action plan to tackle the social isolation and unemployment these people face.Critics can point out that the draft mental health bill is not really helping – allowing compulsory treatment by law on the suspicion that you might one day be dangerous does not really help break down the public’s perception that the mentally ill are a threat.

Richard Brook, chief executive of the charity Mind, said: “We are disappointed that the government has not adequately addressed the profound misgivings of both service users and medical practitioners. Mind in particular is concerned that proposals to introduce compulsory treatment in the community have been retained – when they are neither workable nor necessary. The bill is still fundamentally flawed. Compulsion must be a means of last resort.”

The unpalatable truth is that the vast majority of people who are violent are not mentally ill. When a person suffering from mental illness does become violent, he or she is most likely to harm a family member, as they are often dependent on them for care. As the American Psychiatric Association points out, a mentally ill person’s mother is the most at risk of violence. The threat to strangers is really very small.
The government’s report states “being in work and having social contacts is stongly associated with improved health and well-being”. You have to ask yourself, isn’t this true of all of us?

The puzzle of why a serious mental illness such as schizophrenia has an enduring incidence of around one per cent worldwide, may have been solved, reports New Scientist magazine.
If schizophrenia is such a detrimental condition, why hasn’t it been eradicated from the gene pool? Researchers Brad Folley and Sohee Park at Vanderbilt University in Nashville, USA investigated the brain functions of people with a condition called schizotypal personality disorder, which is like a mild version of schizophrenia. These people suffer from paranoia and jumpy speech patterns, but not outright hallucinations or delusions. They tend to perform particularly well on tests for creativity and are often related to people with schizophrenia. They used larger parts of their prefrontal cortex, the part of the brain responsible for thinking and higher cognitive functions,during the creativity tests than normal volunteers or people with schizophrenia.
“I have no doubt that the genes for schizophrenia are associated with the genes for creativity,” Shelley Carson at Harvard University says. “Someone with lowered cognitive ability who has the genes could be psychotic, while a family member with the genes may be highly creative.”