The first thing to remark on is the amount of interest people have shown since I have been carrying this around with me. Consumers have indicated they would like to know more about it, that books like this should be available in every Psychiatric Disability Support Service, in all employment services handling placement of those with psychiatric disabilities, and for general reading. I have promised to pass it on to at least three people already.

This is probably in part due to the fact that while there has been some research done on the effects and presence of stigma and discrimination in the lives of those diagnosed with mental illnesses, there is a dearth of literature that engages consumers themselves in speaking about their experience of discrimination.

In this book, Wahl explains the research done. It used a combination of interviews and questionnaires. Apparently, most respondents identified themselves as "Caucasian" (80%) where the total percentage of the American "Caucasian" population is 75%. The only question I have here is that although the study identifies this as proportionate, I wonder about other research that has actually found that non-Caucasian populations are often over-represented in both the criminal justice system and in psychiatric hospital admissions. However, this issue is not a concern of the findings of Telling is Risky Business.

The book is divided into chapters covering: the effects of psychiatric disability, as perceived by consumers, not in clinical terms, but in terms of discrimination experienced as a result of a disclosed psychiatric diagnosis. It begins with one person’s story, which is an effective touch, as you move from the personal to the collective voices, statistics and quotes. It also covers both direct and indirect stigma as explained by respondents to the questionnaire, and finishes with some suggested ways of fighting stigma, and a resource list. The book also covers media reportage, in the ways that survivors are often maligned, and in the selection of stereotypical and unhelpful, sensational stories.

I think this read is an educative one for non-consumers. It is carefully written and understated, so in a way, the material is all the more shocking, and the technique of combining statistics with testimony works very well to push home a point.

There are some discrepancies between how the Australian consumer movement has evolved, and what has happened in the United States, so although the quotations feel very familiar, and most of the points made in the book are completely comparable with our experience in Australia, there are some dissimilarities. Framing the issue in terms of discrimination, for example, in the psychiatric disability sector here, is still in its infancy. We tend to talk a lot more about stigma than discrimination, and I have always preferred the discrimination framework which is at least supposed to be linked to related legislation, and advocacy.

Also, of course, the health systems of the two countries are very differently organised, in terms of health insurance and welfare. There are clearly enormous concerns for people who can only purchase a certain amount of care, (budgeting for your therapy) which has no parallel here in Australia except perhaps in the private hospital system.

The only other mild criticism I have is that the title of the book is slightly misleading, if you are a consumer, and you are wanting to examine in detail the whole experience of coming out as a psychiatric survivor. Initially, I was expecting accounts of people who had chosen to tell, or not to tell, and to learn what happened as a result of this choice. Rather, this is an educative tool, more to be read by those who do want to arm themselves with effective knowledge and argument when it comes to countering discrimination, whether or not you are a survivor.

Although there is some detail about the sampling, methodology and rationale for the book, it is all quite easy to read, and is written so that you could skip those sections if you wanted, and could go straight on to the content. I must admit I was on the lookout for patronising tones, or false sympathy, but I was pleasantly surprised. The writing is forceful when it needs to be, and usually lets its facts speak for themselves without too much over explaining. A welcome addition to the armoury, (especially if you know any service-providers who are seeking some guidance).

Categories: MentalHealth, ClientReviews