How can Tristano‘s story influence policy-making for mental health?

People’s resilience is so often a moving characteristic of these life stories. Rather than simply criticizing the system, many people find strength in adversity and build constructive lives for themselves. Tristano’s story is a powerful example. Clearly he has suffered experiences – both psychological and imposed by his environment – that most of us cannot comprehend. Nevertheless, he is determined to help others to learn from them.

Tristano’s experiences catalogue some of the challenges and fault lines in mental health care. Research shows that many mental health staff think and act in ways that are as stigmatizing and discriminatory as those of the general population. Prisons and forensic hospitals can be very institutionalized places, exhibiting all the characteristics described in Goffman’s book, “Asylums“ (Goffman E. Asylums: Essays on the Social Situation of Mental Patients and Other Inmates, London, Penguin, 1991)

Another challenge is the interface between crime and people with mental health problems, and how to deal with responsibility and treatment. The lack of confidentiality experienced by Tristano is worrying, since doctors and nurses working in prisons should be responsible for medical care, not security. All these points and many others in this inspiring piece are worthy of further debate on WHO/Europe’s web site, and I look forward to reading the views of people with similar experiences, and the opinions of others. 

Dr Matt Muijen, Regional Adviser, WHO/Europe