Far be it from me –

Review – Our Encounters With Madness

 ‘Our Encounters with Madness

Authors: (eds) Alec Grant, Fran Biley and Hannah Walker

Publisher: PCCS Books, Ross-On-Wye

Date: 2011

ISBN: 978-1-906254-38-4

Price: £18.00

Pages: 246


A common problem encountered by my mental health nursing students is their fear that they do not know enough about mental health and illness. This is exemplified by their expression of frustration with some of the key nursing textbooks – they often perceive that they don’t tell them enough about mental illness. To remedy this, they turn to the likes of the DSM and the ICD 10. They want to know what mental illness looks like. They want to know how to diagnose mental illness. They want to know what medication treats what group of symptoms. This fear is compounded when they encounter medics and some medically minded RMN‘s in clinical practice – they feel like they lack ‘the [medical] basics’. But there is a vast difference between knowing what mental illness is, and knowledge about mental health and illness. Knowing requires little more than a thorough reading and memorising of the aforementioned diagnostic guides. Knowledge is far trickier. Indeed, knowledge is perhaps only available through listening to – and more importantly, hearing – people and their experiences, their own narratives or life stories, their distress, their fears, hopes, aspirations, desires. ‘Knowing’ enables the formulation of such rich material into diagnosis, treatment or recovery plans, risk assessments – an undoubtedly important part of nursing practice. I would argue that it is a combination of knowing and knowledge that creates good, empathic, critical and thoughtful nurses.

This book contains a wealth of personal narratives, from a variety of perspectives, that can help create ‘knowledge’ in both student nurses and qualified practitioners.  As one of the authors writes in the introduction, textbooks “are written on behalf of ‘mental ill-health sufferers’ by either specialists in psychiatric medicine or in various forms of psychotherapeutic modality” – yet these “fail to get over what it really means, or feels like to have or to care for someone with mental health problems, or suffer in response to abuse, in the context of a life. Formal accounts deal with human distress by proxy, and then to have a narrow focus on ‘illness’ or ‘disorders’ – labels often rejected by those in receipt of them”. Grant continues, “such ‘expert’ accounts often lead to a self-fulfilling prophecy: individuals who are onlyconceptualized, described and experienced by their readers in a one dimensional way – as just their illness, or just their disorder – are often treated as if that’s all they are, all of the time” (p. 3). This book provides practitioners, students, carers and – perhaps most importantly – people who experience mental health issues themselves with a multidimensional, emotional and emotive, and above all hope inspiring anthology of experiences. In this respect alone, it is a vital read.

Sections on the experience of receiving diagnoses and on the vivid, hugely personal experience of mental health issues are set alongside people’s varying encounters with the mental health system itself, and the staff who support it. Both positive experiences of staff and services are recorded alongside those that highlight the (sometimes vast) disjuncture that still exists between individual expectation, service ideology and the lived reality of individual’s journeys through the system.  There are also a number of narratives exploring the experience of being a carer and on abuse and survival.

This is a phenomenal book that should be listed as ‘essential reading’ for students and professionals alike. Collections of individual narratives such as these are few and far between, and each story in here deserves to be told and heard, like all individuals’  testimonies and narratives.  The ‘knowledge’ contained within these pages should be accorded the same status as the ‘knowing’ attainable through textbooks and other theoretical materials.  Who knows the experience of mental health better than those who experience issues or fluctuations with their own, after all.

Charley Baker, Lecturer in Mental Health,

School of Nursing, Midwifery and Physiotherapy,

University of Nottingham,

Nottingham UK

This review was published in the Journal of Psychiatric and Mental Health Nursing

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