Is epistemic injustice common in NHS mental health services?

Being ignored and mistreated

As someone who was diagnosed with depression aged nine, the story of the unacceptable treatment of children under the care of the mental health services at West Lane Hospital in Middlesbrough has left me feeling sick. But not surprised.

Concerns were first raised about the hospital in 2013, but an investigation by the CareQuality Commission found staff were meeting all the standards required. Five years on and it’s a different story: 20 staff members have been suspended following a second investigation.

Talking about her treatment on the hospital’s Newberry ward, former patient Faith Wilthew said: “They kind of treated me like an animal. They would just lift and move me whatever way they wanted to. They definitely did not listen to me.”

The news about West Lane follows shortly after an inquest heard how a teenager killed herself after staff and rule changes at Lancaster Lodge in London, which the teen had referred to as becoming like a “boot camp”.

Although my contact with NHS mental health services as a child were only ever as an outpatient, I used to feel uneasy with the way I felt anything I said would be repeated back to me with a different take from the one I intended.

It felt very much like the psychiatrists I dealt with had a very specific agenda and were looking to pigeonhole my depression as being caused by certain types of events.

Unfortunately, my experiences with mental health services have not improved as I have gotten older.

What happens when you come into contact with mental health services as an adult is that you meet other service users and compare notes.

Most people I’ve spoke to have at least one horror story where their opinions and concerns were ignored and in some cases mocked. Many had been threatened at some point with being detained under the Mental Health Act for raising concerns about their care.

I believe the wrongs that occurred at West Lane Hospital and Lancaster Lodge are not isolated incidents but examples of epistemic injustice at the heart of NHS mental health services where the thoughts and opinions of patients are dismissed.

I know that, as someone with mental health issues, my thoughts on this subject could easily be dismissed (which in itself would epistemic injustice), which is why I’ve rooted out a couple of academic papers from Kurs and Grinshpoon (2017) and Crichton, Carel and Kidd (2017) that support my beliefs.

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