‘Grief is work,’ said one of the parents of the teenagers killed by Anders Breivik on the island of Utoya in Norway. ‘To deal with grief — that’s work from the moment you wake up till the moment you fall asleep. And even then many people struggle with their grief when they sleep.’ His frank, no-nonsense approach was striking given that he had experienced probably the worst thing that could happen: to lose a child and in such a terrible way. He was talking to Claudia Hammond for her new World Service series, The Truth about Mental Health (Fridays).
The six programmes take us on a global tour of the ways in which communities and government agencies deal with illnesses such as depression, dementia, bipolar, epilepsy, autism and schizophrenia, and the traumas of natural disaster and random violence. Treatments are often radically different — that difference being especially marked between the westernised countries (where many of life’s emotional and spiritual problems are being reclassified as ‘illness’ and treated accordingly with drugs) and the developing world (where almost half of those suffering from psychosis live in chains or locked in solitary confinement). With one in four people estimated to suffer from some kind of mental illness at some point in their lives, finding more effective and less costly treatments is crucial. What can we learn from each other?
In Norway, for instance, the government and voluntary organisations all met together the very next day after the traumatising events in Oslo and Utoya to decide what their co-operative response should be. How could they help the bereaved to move through their grief and come to terms with what had happened to them in such a random, nightmarish way? What could they do to prevent survivors staying trapped in their memories of what they had witnessed?
It sounds so obvious, to work together, and to decide quickly how to develop a coherent plan, using the combined expertise of all the agencies involved, with up to 60 professionals working together, and ‘all pulling in the same direction’. But the speed and originality of the plan of action devised in Norway was unusual. It was arranged, for example, that the bereaved and the survivors should visit Utoya within a few weeks of the incident to see the very places where the teenagers were shot dead. This was to allow them to take back control; to make what had happened more real for them (not, as you might think, less). The bereaved and survivors also were not taken together. That, too, seems obvious: giving each group the space and dignity to experience their specific emotions and memories of 22 July 2011 by going back on different days. Yet it’s only now that such careful forethought is being given to the strategic planning of mental-health care.
In the first programme on Friday Hammond focused on that fine line between madness and sadness, a line that is perhaps not so well understood in the westernised world. We heard from Micol Ascoli, a ‘cultural psychiatrist’ at Newham’s Centre for Mental Health, who treats people with mental illness in one of London’s most multicultural boroughs. She talks about the ‘art’ of psychiatry, or of learning how to accommodate cultural differences in our response to mental illness. Angela suffers from bipolar affective disorder and in her ‘manic’ phase hears voices, which she likes to think of as ‘a gift from God’. She does not want to take psychotropic drugs; on the contrary, she thinks hearing voices is important to her as a person. It might seem defeatist or needlessly expensive to accept that Angela will need regular spells in hospital (when her voices become too overwhelming). But the money spent on hospital care can be saved in drugs, while she feels both supported and affirmed.
You might think that ventriloquism could never, ever work on radio but Educating Archie, starring Archie Andrews, was an instant hit in the 1950s and ran for eight years, with a fanbase of up to 15 million listeners. I’m definitely too young to have heard Archie at the time, but you can now catch him on an archive website, and his jokes are still laugh-out-loud brilliant. Archie is supposed to be a child (his voice ‘operated’ by Peter Brough), whose ‘tutors’ include Tony Hancock, Harry Secombe and Hattie Jacques. (Julie Andrews makes a fleeting appearance as an astonishingly original singer.) The strange thing is none of the jokes depend literally on Archie being a ventriloquist’s puppet. It’s not the ventriloquism that’s funny; it’s the way Archie recaptures the surreal jokes of childhood.
Now ventriloquism is back for real; perhaps as a response to the topsy-turvy times we live in. (The episode of Educating Archie I listened to had a running gag about cheating the taxman.) In Yes, Nina Conti Really Is on the Radio on Radio 4 (produced by Bill Dare), Nina Conti acts like a classic stand-up comedian (with studio audience laughing on cue), except that her fallguy is a whole cast of soft-clothed puppets who playon the idea of having words put into their mouths. ‘Stop laughing, Nina,’ says Monkey. ‘When you laugh, I can’t finish my sentences.’
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