Clare Haughey: 'Mental illness is not something you have to hide'

When Clare Haughey began training as a mental health nurse 34 years ago, she met a patient who had been admitted to hospital with postnatal depression.

But this woman wasn’t a new mum struggling with the demands of caring for a new baby while battling depression.

She had been, once. Fifty years previously. But there she was, half a century later, completely institutionalised by the place she had trusted at her most vulnerable point in life to help her get better.

It’s perhaps no coincidence, then, that Haughey went on to help set up Scotland’s first mother and baby unit in Glasgow to help women like her patient, a unit she continued to volunteer at until she was appointed mental health minister last June.

“It was really sad when you got to know some of the patients and heard how they ended up in hospital,” recalls Haughey. “It wouldn’t happen now. There was someone who had become depressed after she had a baby, had been admitted to hospital, and 50 years later, she was still there.

“Patients became really institutionalised, they lost contact with their families – remember, you’re talking about a time when there was a huge stigma around mental illness – they were shunned by their families, or abandoned by their families, people just didn’t want to know them. It was a hugely different landscape to what we have now.”

Haughey’s training coincided with a monumental shift in that landscape as measures were taken to move patients out of the massive institutions, first built by the Victorians on the outskirts of towns and cities, and instead treat them in the community.

It was a huge transformation, one that Haughey describes as a “revolution” in mental healthcare. And she believes that we are in the midst of a similar revolution right now in terms of how we, as a society, view mental illness.

“Things quite rapidly began changing in those early years of my career in terms of community psychiatric nurses and community mental health teams. They closed down a lot of those institutions, the long-term patients moved back out into communities, some to group homes, some to their own accommodation, so there was much more of a focus on rehabilitation, people not coming into hospital to stay but coming in to be treated and to go home,” Haughey tells Holyrood.

“I was there on the cusp of things changing. Looking back, it was quite a revolution, really, in terms of how services were delivered and how people were treated and how they were offered treatment. There was much more scope for people to stay at home and be treated, and that’s become the norm, whereas before, the norm was you went to hospital.

“I’ve been fortunate in the time that I’ve had a career in mental health that I have seen such huge changes and the changes that we’re seeing now in terms of societal changes are as revolutionary as those ones were in terms of people talking about how they feel, being open to listening to other people, people not feeling like they’ve got to hide when they’re not feeling well, people being able to say that they’ve had depression or a psychotic illness or bipolar disorder. It’s not seen as something that you’ve got to hide.”

Haughey says that she is confident talking about her own mental health and admitting when she’s feeling low and has always encouraged her three sons to have that open dialogue.

“I have been fortunate in that, like everyone, I’ve had times of stress, felt anxious, felt low in mood…everyone does, we’re all on a spectrum, so I feel quite confident being able to speak about that. What’s important is having someone to do that with, you might not necessarily tell everyone you feel like that, but having a relationship or relationships that you can go to that you can confide in that person and say, ‘I don’t feel good’. And that’s important for everyone.

“Families talk about it. When I think back to around the time I started my training, people didn’t talk about cancer. It was referred to as ‘The Big C’. If you didn’t talk about it, it didn’t exist. I think we’re seeing those changes in terms of mental health and mental illness. I’ve got three sons and we do talk openly. They are pretty open, they tell you about what’s going on in their life, about their friends and the difficulties they’re having or their friends are having.”

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She laughs: “I try to be as open as I can – but they don’t always tell their parents everything.”

There’s no doubt that Haughey speaks from the heart, and her enthusiasm and passion for advocating on behalf of those with mental illness is genuine.

She is approachable, warm and open – the kind of qualities you would hope go hand in hand with someone who worked in healthcare – so it’s perhaps no surprise that she spent more than three decades as a nurse.

But was nursing a career path she had yearned to follow all her life?

“Do you want me to be brutally honest?” Haughey laughs. “I was working in another job and decided I wanted a change. I went into the job centre as it was at that point in time when you actually had jobs up on the wall. I looked at job adverts and there was one for mental health nursing – or at that point, psychiatric nursing – and I applied for it! So, I hadn’t had a burning ambition to be a nurse.

“Although, ironically, my mum worked as a nurse, both my brothers trained as nurses, one is still a nurse, my sister-in-law’s a nurse, my husband’s a nurse. But I just hadn’t thought about nursing as a career.”

In fact, Haughey actually harboured ambitions to be a politician when she was a little girl – though she admits she still doesn’t quite know how she ended up being Scotland’s mental health minister.

“I was always interested in politics and what was going on in the news,” she recalls. “I remember being in primary four and the teacher was asking everyone what they wanted to be and I said I wanted to be an MP – at that point, there wasn’t an MSP. It was around about the time there had been an election. So right back to that point in time, I was always interested in politics.”

Her political interest wasn’t something she inherited from her parents. In fact, she describes herself as being “quite weird” in her family in that respect but her enthusiasm continued throughout her teenage years and she became quite politically active, getting involved in protests against the poll tax and nuclear weapons on the Clyde.

However, in her own words, “life rolls on” and her involvement in politics became less and less until it eventually waned completely.

It wasn’t until the independence referendum got underway that Haughey’s passion for politics was reignited, but it was the Labour Party, not the SNP, she was campaigning for at that time.

“Once the independence referendum kicked off, I got involved and that’s what really drove me back into politics,” she says. “I was a member of the Labour Party so I campaigned with Labour for Independence and got involved with ‘yes’ groups.

“After the independence referendum, I could no longer be part of the Labour Party. I’d come to that conclusion before the actual referendum day and joined the SNP and continued campaigning. I hadn’t been a councillor or anything. I had been a very bad party member of the Labour Party in terms of I didn’t do anything, I didn’t go out campaigning or whatever, I was just a member, but the independence referendum really sparked my political interest again.

“I joined the SNP, campaigned for our local candidate in the general election in 2015 and then put myself forward as a potential candidate and went through vetting for the SNP. My passion for an independent Scotland just drove me. I had no intention of coming into politics. I didn’t think, ‘I want to stand for election’, it was the furthest thing from my mind at that point in time but sometimes, you just get involved in things and they snowball.

“There’s still times that I pinch myself and say, how did I end up here?”

She has been ‘here’, in her position as mental health minister, for almost a year now and in that short time has overseen the creation of a taskforce to review children’s and adolescent mental health services (CAMHS) after an audit highlighted the scale of rejected referrals; the launch of Scotland’s Suicide Prevention Action Plan to reduce suicide rates by 20 per cent by 2022; a £50m investment to support expectant and new mothers; and a commitment to recruit 800 dedicated mental health staff by 2022.

And that’s without even mentioning the recently-announced independent review of the Mental Health Act, which will examine developments in mental health law and practice on compulsory detention and on care and treatment since the current legislation came into force in 2005.

She admits that not only could she never have imagined being in this position professionally, she also could never have imagined, in those early days training at Leverndale Hospital in Glasgow, that as a society, we would have such a strong focus on mental health and that mental illness would no longer be seen as a taboo subject.

“Over the last decade, there’s been a snowball effect where things have changed,” she says. “It’s really good that people are being much more open. Society has changed. Our attitudes have changed. It always helps when you get someone who has got a public profile talking about how they feel. Things like ‘See Me’ have really challenged stigma round about mental illness and mental ill-health. There’s been lots of elements, lots of pieces of the jigsaw that just seem to have come together.

“Lots and lots of people are now feeling much more comfortable about saying how they’ve felt or they’ve been unwell in the past and they’ve recovered.

“I’ve spent the vast majority of my adult life working in mental health services with people who are unwell, but knowing that when people do become unwell, that they can recover, is a message that we do need to get out there. Getting in early and preventing people from becoming unwell is obviously best, but that won’t work for everyone and it’s not a failure if you become unwell and it’s not that something’s not worked right. Any of us can become mentally unwell regardless of your socio-economic class or what have you. It doesn’t discriminate.

“We get lots of messages about our physical health, your five a day, everybody knows what that is. Ensuring that we have that public health message going out about how to look after your mental health, that’s a big conversation that we need to start having with the general public.”

With growing pressure to look ‘Insta perfect’ all the time, Haughey wants to get this message out to young people in particular.

She has real concerns for the mental health of the younger generation as she regularly spends time with groups of teenagers when she visits schools in Rutherglen, where she grew up and still lives, and hears first-hand what is worrying them.

“That’s what young people tell me when I go into a modern studies class to do a Q&A, that’s what young people say, it’s social media. I don’t think even kids/young people who are 20, 21, 22 have experienced it the same way that our current teenagers have.

“As a society, we need to start challenging these images, challenging the perception that that is the norm. Kids want to be on social media, that’s part of their lives now so you can’t just say, ‘you’re not doing it’, so we have to ensure that what you see is real, or as close to real as possible.

“Adverts have always painted a glamorous side, that’s how they sell products, but this is something else, this is something different. It’s that 24/7…there’s no escape from it and nobody puts online their bad hair day.

“It’s a worrying phenomenon and that’s affecting people’s self-esteem, people’s perception of themselves and of what is normal. I think young men face similar pressures to what young women do in terms of body image and how your life should be, they’re not immune to that either.”

She adds: “Even just from talking to my own kids, I think young men are better at talking about how they feel, about expressing feeling sad or low or whatever. They’re better with their peers than perhaps several generations ago. I think that has changed. Schools have played a huge part in that in PSE [personal and social education] and as a society, we are a bit more open to saying, ‘I’m not OK, I’m feeling down’. Whether that be through life events, being dumped by your girlfriend, or whether that be through mental ill-health.”

While that may be true, there have also been a number of high-profile male suicides recently – including Scottish singer Scott Hutchison, The Prodigy’s Keith Flint and Love Island contestant Mike Thalassitis – which have been widely reported in the media.

“We’ve seen over recent years there’s been more men-only charities set up, Brothers in Arms, for example, about men talking to men, opening up about feeling low or sad or suicidal,” Haughey says.

“I think most people’s lives have been touched by suicide in some way. It’s a death like no other. I think now people talk about it whereas before, it just wouldn’t have been mentioned about how they died – they just died. I’ve had patients who’ve died, I’ve had colleagues who’ve died. Like I say, it’s a death like no other, you never forget that person, they always come back to you at some point in time.”

It’s this lived experience and genuine empathy for others that answers the question of how Haughey “ended up here” as Scotland’s mental health minister.

She adds: “I still think of myself as a nurse. People say to me, ‘oh, you used to be a nurse’ and I say, ‘I still am, I still am’.”