A new potential protagonist has emerged in the appeal of Sion Jenkins against his conviction for the terrible murder of Billie-Jo, his foster daughter. We are now told that a "psychiatric patient" was in the neighbourhood that fateful day.
This shadowy figure may never be heard of again or may come to assume a major role in this awful case. Either way, it's yet another instance of how the public association of mental ill-health with violence is reinforced almost daily in the British media. One study found that two-thirds of all references to mental health in the media included an association with violence; in the tabloids, 40% of such references are liberally sprinkled with derogatory terms such as "nutter" or "loony".
In fact, for every murder by someone with a psychiatric disorder, 70 people are killed in car accidents. Men between 16 and 30 are more likely to commit a murder. Yet no one suggests that cars be banned or young men be locked up, unlike the extraordinary "lock 'em up" response to those with mental disorders. No, this is one subject of such deep, irrational fear that it is rarely amenable to a sense of proportion. All too often, the media falls back on their oldest ruse to attract readers and viewers - fear. A murder involving someone with a psychiatric disorder offers three bites at the cherry: the murder itself, the trial and the inevitable inquiry. And then there will always be a hapless psychiatrist or overstretched mental healthservice to blame.
For more than a decade, mental health organisations have campaigned against negative media stereotypes, arguing that stigma, discrimination and prejudice against those who are mentally ill are more of a problem than their underlying condition. They have seen huge progress against every other form of discrimination - race, sex, age, HIV, other forms of disability - but not mental health. This is the last taboo.
It seems to be driven by a fear that is so deep-rooted that we want to demonise those with mental disorders in order to keep clear blue water between us and them; we don't want to empathise, identify or even understand. We don't want to know even the basic facts about the prevalence of mental health conditions - that one in six of us has a mental health problem at any one time. We don't want to hear anything that brings this terror closer to home. Try listening to yourself, just begin to hear how often you use "loony" or "nutter", or even plain "mad", as adjectives to convey scorn, contempt, the ultimate worthlessness. Watch out for how often mental disorder is the object of humour. I did and it wasn't edifying.
The past few weeks have seen something of a breakthrough: the government has finally put funding into tackling this culture of stigma. A five-year £1.1m strategy was announced last week, following the publication of a Social Exclusion Unit report on mental health in which, for the first time, the government response was not shaped either by the law-and-order agenda or the medical agenda of treatment and cure. Its argument was that those with a mental disorder are one of the most marginalised groups in society: they have the lowest employment rate of any group with a disability; and the total of more than 900,000 claiming sickness and disability benefits for mental health conditions is larger now than the total of unemployed on jobseeker's allowance. Many would like to work, but run up against the prejudice of employers.
There's an obvious reason why this kind of exclusion is at last capturing serious attention within government - it costs a small fortune to have nearly a million people out of the labour market. But there are two other reasons why this last taboo needs to be breached. First, mental ill-health is on the increase; the research on depression has reached a consensus that it is not just the reporting but the occurrence of the condition that is on the rise. The World Health Organisation has warned that by 2020 depression will be the major cause of disability, and the second-biggest contributor to the global burden of disease. Second, the level of discrimination seems on the increase. Several surveys have found signs that we are getting more harsh and judgmental about mental illness, and in particular younger people are more likely to be prejudiced. The two could even be related: the more mental illness there is, the more stigma there seems to be.
So why is it that this is the last taboo, the last socially acceptable prejudice? Many in the mental health field point at the government, arguing that it has singularly failed to provide the kind of legislative leadership that has proved crucial in tackling other forms of discrimination. Instead, its draft mental health bill has succeeded in antagonising the entire mental health world over the past two years, from the Royal College of Psychiatrists to Mind, and uniting them (no mean feat) in outrage over its powers to confine almost anyone with any kind of mental illness, even a mild breakdown or a period of alcoholism. There are tricks that the government appears to be deliberately dodging: the Disability Discrimination Act of 1995, a landmark piece of legislation for disability, is riddled with loopholes that allow legal discrimination of those against a mental disorder.
Others look to the mental health organisations themselves for singularly failing to promote to leadership positions those who have mental disorders, and thus personal experience of the discrimination that accompanies them. David Crepaz-Keay, the chief executive of Mental Health Media, is an exception. He points out that his six psychiatric diagnoses haven't impeded his career; and of his 20 staff, half also have a psychiatric diagnosis. "If you came into the office, you couldn't tell," he says. He argues that the best campaigners against discrimination in the past two decades have always proved to be those who have experienced it - as with the gay lobby's success on homophobia.
But the rule of thumb over the past decade has been for both government and mental health organisations to repeatedly pin the blame on the media. This is an easy - and not blameless - target, but has conveniently let them off the hook. Meanwhile, as the blame is passed around, we manage to dodge the uncomfortable truth that on this issue few of us are as progressive or tolerant as we would like. Conventions on what is acceptable emotional behaviour and what are appropriate understandings of reality remain as rigidly imposed today as they were in the time of Bedlam. On this issue, fear and ignorance are mutually reinforcing: too frightened to want to know; too ignorant not to be fearful.
· Madeleine Bunting's Willing Slaves: How the Overwork Culture is Ruling our Lives is published by HarperCollins. To order a copy for £10.99 plus p&p, call the Guardian book service on 0870 836 0875
