Foreword to Dear Luise

“Mom, won’t you tell the world how we’re treated?” This was Luise’s last request to her mother, Dorrit Cato Christensen. She wanted her to describe the treatment she had received in the Danish mental health care system. With this book Dorrit fulfills her daughter’s wish.

What follows is a heartrending account of a life in our psychiatric care system, a life cut tragically short – the same fate suffered by many vulnerable people being treated for mental health problems. Every year more at-risk psychiatric patients end up like Luise – we know that this population’s lifespan averages 15 to 20 years less than others in their age group. This is a clear sign that we have to change the way we treat psychiatric patients.

We must improve conditions by offering quality time, attentiveness, compassion, evenhandedness and respect to every patient, so we can design the best treatment solution for each person. We need to talk openly about mental health issues and strengthen our networks of patients, families and friends. To this end I have set up a virtual meeting place, the website Psykisksaarbar.dk, now consulted by a growing population in Denmark. In 2009 I took the initiative to found an association called Det Sociale Netværk af 2009 (The Social Network of 2009), bringing together a wide range of national voluntary mental health organizations in a joint effort to improve conditions in Denmark for the mentally ill and their relatives. The organization of which Dorrit Cato Christensen is president, Død i Psykiatrien (Death in Psychiatric Treatment), is now part of our network.

I come in contact with many people who have been, or currently are, admitted to a psychiatric ward. Most have inside experience of various facilities and all agree that there are significant differences in approach from one institution to the next. A young girl said to me: “As soon as you set foot in the ward you know what kind of hospital stay you’re in for. Whether the mind-set is caring and responsive, or whether the place is ruled by coercion, constant evaluation and a staff that ignores you.”

We should not, in all conscience, allow sub-standard treatment in a country like Denmark, yet it happens all the time. I have often heard patients say: “You must be strong to be psychologically vulnerable.” When studies show that psychiatric caregivers harbor more negative expectations and prejudices about the mentally vulnerable than the general population, it means there is a problem inherent in our mental health care system. This is exacerbated by a dreadful lack of resources in psychiatric treatment wards.

The most important thing to remember is that first and foremost we are all human beings. We must not forget this for one second, before any incapacity or vulnerability is analyzed, defined and written down. This is why it is so important to see behind the facade of a diagnosis. A diagnosis is like an overcoat – the real person is found underneath it. This is one part of her daughter’s life story that Dorrit describes so movingly for us – her personhood, her humor, her compassion and her zest for life.

When I meet people who support The Social Network, who form networks on our website Psykisksårbar.dk, or participate in our regular Sunday get-togethers, it strikes me how similar we humans really are and how much we have in common. There is basically no real difference between you and me and a person who happens to have been given a psychiatric diagnosis. It is not a question of these people being completely different, but more that sometimes they may experience so much inner noise that they are thrown off-balance and become vulnerable.

The most important thing we can do for psychiatric patients is not to keep them isolated. Loneliness is their worst enemy. And it is crucial that we nurture hope, that we hope and believe we can find the best in each other, and that we make room for the individual. Hope is the vital life-giving elixir for the soul, mind and body – to be able to sense that the people around you believe in you, that you are valued, that you are needed. We become whole when others believe in us. And we’re most likely to find this when we feel the solidarity of good fellowship.

I would like to thank Dorrit Cato Christensen for her work with mental health patients and their families and friends, and for the very important work she is doing as president of the association Død i Psykiatrien. Her book is a poignant contribution to the debate, in which she openly and candidly tells the story of her daughter’s sad fate and gives us a glimpse of our mental health care system groping for the right treatment. Luise’s hospital records show that she told her caregivers she felt she could not tolerate the drug treatment they prescribed and wanted them to phase it out. But instead of less medication, she got more. This turned out to be fatal.

Many patients and relatives will already be familiar with the situations and events Dorrit portrays here. Many will see their own lives reflected in this story and perhaps even find the energy to fight for a dignified life. I also hope that mental health practitioners will read the book, then stop and think carefully about how they can deepen their professional skills through respect for the individual. We can be certain of one thing – pills are not and never will be enough. We must constantly listen to our patients and think carefully about whether we are giving the right medicine to the right person. The “medicine” that always works for the psychologically vulnerable is to approach them with compassion, nurturing, trust and calmness.

Poul Nyrup Rasmussen
Danish Prime Minister 1993-2001
Member of European Parliament 2004-2009

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