There's been growing understanding around mental illness in the past few years.

These days you can't open a newspaper or switch on the TV without hearing someone talk about it - even the Royal Family are doing it.

While there is still considerable stigma and mental health continues to receive less funding and recognition than other areas of medicine, things are changing.

But according to the Daily Mail, there is a sinister element to this new-found sympathy: people now invoke mental illness as an excuse for bad behaviour.


Consider Harvey Weinstein, the Hollywood producer at the centre of a storm of sexual assault allegations this week. No sooner had the news broke than he was claiming to be addicted to sex and checking in to an exclusive clinic.

This is a well-worn, PR-managed response to any indiscretion by the rich and famous.
Caught in a compromising position, pants around your ankles?

Quick, get into rehab. No one will dare criticise you then because you're unwell; it's not your fault. In fact, you're actually the victim here because you have a cruel illness. Poor you.

What tosh. In reality, these 'rehab' clinics are often little more than five-star hotels with therapists, who will nod sympathetically, tagged on.

Let's be clear here: being a crass, offensive, misogynistic lech is not a medical condition.

Sexually assaulting women is not a mental illness. Sex addiction is not a medical diagnosis. It is not a clinical condition recognised in either of the main diagnostic manuals used by psychiatrists.

It is a made-up condition invented to absolve the lecherous and the unfaithful from responsibility. It has been used to explain away the behaviour of selfish, wealthy, powerful men who don't see why they should play by the same rules as the rest of us. Because once something has a label, any criticism is deemed heartless and uncaring.

In fact, the entire idea of addiction as a 'disease' is highly contentious within medicine. It first started being widely promoted within the medical community in the late Nineties in the U.S., where there is no free public healthcare. Some have argued that this was so health insurance companies couldn't wriggle out of funding treatment for alcoholics.


However, the idea soon took hold over here. It was argued that although the use of substances was voluntary to start with, in some individuals it "flicked a switch" in the brain that meant they could no longer stop.

But a recent review published in the highly respected medical journal The Lancet Psychiatry concluded the research into addiction does not support this simplified view.

In fact, many doctors reject the idea that alcoholism and drug addiction are diseases, myself included. And that's because it doesn't actually help the person with the addiction.

I have spent many years working in the NHS, the charitable sector and privately with people who use drugs and alcohol. What always strikes me is how, regardless of wealth or privilege, addiction typically comes down to poor coping strategies for emotional pain and psychological distress.

Rather than being a switch that is flicked on in their brains and that they can't shut off again, it's that they're using sex or alcohol, or whatever it is, as a crutch.

So calling addiction a disease is not only unhelpful, but actively counter-productive. The term removes any sense of responsibility or ownership and flies in the face of much of the psychological work that is done with addicts.

People do choose to drink alcohol or inject drugs. It is an active decision they make each day and pretending otherwise is to rob them of the fact that they can choose a different path.

The process of recovering from addiction involves taking responsibility and realising that you are the architect of your own - and often others' - misery.