David Payne: MPs and their mental health

David Payne In a Guardian newspaper article this week Juliette Jowitt caught up with four MPs—including the former GP Sarah Wollaston, who stood up in the House of Commons last month to talk about their mental illnesses.

Wollaston had described her experience of postnatal depression and panic attacks previously, but Conservative MP Charles Walker had only confided in one other Parliamentary colleague about his obsessive compulsive disorder. He stood up and announced to his fellow MPs he was a “practising fruitcake.” His local paper reported the story under a headline: “Fruitcake MP praised for bravery.”

According to Jowitt, in the week following the debate the four had more than 1000 emails, letters, and phone calls between them. Many were from fellow MPs.

I was particularly interested in Alastair Campbell’s take on the story. Tony Blair’s former spin doctor spoke eloquently about his own mental illness when he addressed the BMJ Group Awards in May.

Days after the four MPs talked about their own depression, Campbell addressed a “behind the scenes” discussion at Kings Place in London about Westminster life and again talked about his own mental health. How did Blair first find out that his communications supremo had first hand experience of depression?

Campbell told the audience that he mentioned one day that he was depressed. Blair simply asked if it was clinical. Campbell said yes. What did he make of the MPs standing up?

He said: “The Time to Change campaign says one in four have a mental illness. If it is one in four, then there are still 170 to go in the Commons. You still have the stigma, otherwise you would not have just four MPs.”

Campbell’s silent 170 are in distinguished company. When I think of mental illness and MPs, I think not of Wollaston, Walker, Kevan Jones, and Andrea Leadsom. Instead I think of World War Two Prime Minister Winston Churchill, plagued by the “black dog” of depression from a young age.

According to The Bipolar Lives website, Churchill knew he had a medical condition. In 1911, he wrote excitedly to his wife about a friend who had apparently been cured.

A year earlier, as home secretary, he reportedly experienced his most severe bout of depression, according to an extract from Nassir Ghaemi’s book A First-Rate Madness, later telling his doctor Lord Moran that he had thought of killing himself in the past.

Ghaemi argues that Churchill, unlike his level-headed predecessor Neville Chamberlain, saw the truth behind Hitler. And the difference was that Chamberlain was happy and healthy, and Churchill was not. Ghaemi explains more in an interview to publicise his book:

“Chamberlain shows that mentally healthy people can run cities and countries when times are prosperous and people are doing well. But when Hitler and the Nazis arose, Chamberlain tried to address them like they were a normal problem. He said, “What does Hitler want? Let’s try to give it to him.”

“But Hitler wasn’t thinking that way. Churchill realized this and I think it’s a reasonable judgment to say Churchill’s depression and abnormality made him more aware of that—while Chamberlain’s supreme sanity made him unable to think any other way about Hitler than he did.”

What is less clear, at least to me, is how much the public knew about Churchill’s depression during his lifetime. I assume nothing. A blog post by Sandra Vandenhoff claims he was more open during his life about his depression than about his hearing loss.

I am not sure that’s the case. Churchill was an aristocrat who lived in a more deferential age when people tended not to talk about their mental health. Talking about such things beyond one’s immediate circle of friends and colleagues would have been very unusual. A BMJ editorial published in January 1965 to mark Churchil”s death mentions how accidents and bouts of ill health brought him close to the medical profession, but his bouts of depression are not mentioned.

Campbell, in contrast, gives a vivid account of his own depression. A bit like Charles Walker’s “fruitcake” reference, he admitted to struggling with the relentless negativity surrounding the dying days of Blair’s premiership, particularly given his wife Fiona Millar’s opposition to the war in Iraq. She, in turn, described him as “obsessed.” His passion for running (Campbell decided to run a marathon within days of starting running), was for her, he said, “a mania.”

These days Campbell actively campaigns to fight mental health discrimination, along with cuts to services in Camden, where he lives. He had a ringside seat during the Blair/Brown years, and his entertaining and colourful accounts of that time will continue to draw the crowds.

I was struck by his description of Gordon Brown, Blair’s successor, as a “brilliant nightmare,” a “depressive personality” who was “deranged by jealousy and frustration.”

One of Brown’s Cabinet colleagues reportedly described him as “fucking insane” as he walked past one day while she was chatting to Campbell. In 1998 Observer columnist Andrew Rawnsley wrote that an ally of Blair’s thought Brown had “psychological flaws.”

One is left with the conclusion that members of the “Westminster village” seem obsessed with each others’ sanity. Is it any wonder that just four of them have admitted to having mental health problems?

David Payne is editor, bmj.com