How can Wilma’s story influence policy-making for mental health?

Wilma describes very impressively how the manifestations of a psychosis can dominate the entire personality, how a psychosis can alienate the person from herself. How far does society’s widespread desire to distance itself from people with psychotic symptoms reflect this inner alienation in the individuals themselves.

The alienation caused by Wilma’s experience of psychosis seems to be projected onto the outside world, in particular onto psychiatry as an institution and onto psychiatrists as those responsible for helping her find the way back to herself. In Wilma’s case, psychiatrists obviously failed for a long time to bring back her connection to the outside world. Probably acting with the best intentions, they failed because they stopped her from returning down the painful road to the roots of her psychoses, which are therefore also the roots of the person she became. Wilma describes with understandable bitterness how her “disorder“ was never cured. But therapy and psychiatric treatment helped her build an existence, develop a relationship and hold a job, while simultaneously covering up the source of her illness, having been the victim of abuse as a child.

This story once again shows the high risk of a patient with a mental health problem being reduced to the diagnosis, rather than being an individual with a life history. It shows that treating a person without listening to their story may in the best case bring stability and a framework for a normal life, but in the worst case it preserves what Wilma calls her “dark side“, the earlier violation and the resulting loss of a person’s integrity, and a potential cause of relapse.

Wilma’s story demonstrates impressively that empowering a “patient“ is not something doctors, policy-makers or society should be scared of; it merely means having the courage to offer a hand to someone who has lost her or his way. What she experienced, like many other individuals who experience severe mental health problems, shows how much our interpretation of reality relies on others’ explanations, in particular when we are children. Wilma’s story illustrates how fragile is the fine connection between our inner world and the outer world.

And above all it shows that blaming the victim for the crime is the most hideous distortion of reality.

Dr Anja Esther Baumann, Technical Officer, Mental Health Promotion and Disorder Prevention, WHO/Europe