A parting of the minds

To drug or not to drug? Two leading charities are locked in fierce debate over the treatment of the mentally ill. Polly Toynbee hears the views of Marjorie Wallace, head of Sane, while below, Liz Hunt explains why Mind thinks she is wrong

A tide flows in the affairs of successful campaigns: triumph is followed by tribulation, usually brought on by jealousy. Charismatic leaders bask in public eulogy until that story grows stale. Then comes the inside dirt, a "dark side" revealed. That tide has just washed over Marjorie Wallace of Sane, the high-profile campaigner for the mentally ill.

As I sat in her office, two of Sane's trustees arrived from a meeting with the police. Sir Campbell Adamson and Sir Brian Hayes reported that the police were taking very seriously threats against her on the Internet. There is a suspicion that these threats may be written by a cult.

"Threaten me with death?" she laughs wryly. "Why should they bother?" Her own possible death sentence hangs over her, marked in the lines of her face. Last year, she underwent nine months of chemotherapy for breast cancer and wrote about the experience. On her desk are hundreds of letters of support for Sane, in the face of the recent public attack on her.

In June, Sane, together with the president of the Royal College of Psychiatry, Dr Anthony Clare, and other distinguished mental health professionals, wrote to the Independent to protest about a fundraising circular from Mind, another mental health campaigning group. In it, Mind asked for funds for a campaign to restrict the use of anti-psychotic drugs, because, it claimed, one person a week was dying from them. Sane protested that no statistics supported Mind's claims (Mind quoted the work of a doctor who actually signed Sane's letter). It accused Mind of frightening the mentally ill into refusing their medication.

Carter Ruck, the libel lawyers, obtained an injunction to prevent the magazine Time Out publishing allegations against her and Sane. A couple of weeks later, an article did appear containing a mish-mash of other charges and innuendos.

Ms Wallace is unbowed but somewhat shaken. She is combative by nature. She launched the campaign in 1986 into a whirlwind of ideological controversy. Newcomers to the not-so-nice charity world are often greeted with less than enthusiasm by the established incumbents.

Sane challenged the prevailing orthodoxy represented by Mind, which was founded in 1946 but gained its reputation in the Sixties with its campaign to close mental hospitals and let inmates into the community. Labour and Conservative governments subsequently closed expensive institutions, sold off the property and lost thousands of beds. Many patients were given a new chance in life. But many of the mentally ill, who need care during the worst periods of their illness, lost a safe haven.

Mind also championed mental patients' civil rights and pointed to the darkest aspects of long-stay mental hospitals, particularly the use of drugs. Mind was influenced by RD Laing's idea that mental illness is a sane response to a mad world, stressing social and psychological causes. The charity is sceptical of drugs as a liquid cosh with nasty side-effects.

Sane grew out of Ms Wallace's campaigning journalism in which she chronicled the desperate lives of schizophrenics and manic depressives. Mental hospitals had closed and care in the community was largely a figment of politicians' rhetoric. Many mentally ill patients were not taking the drugs that kept their illness at bay. Ms Wallace's work captured the terror of these illnesses, the resulting high rate of suicide and the Catch 22 of the over-stretched community: if a schizophrenic asks for help, he is sane enough not to need it, but once he sinks into a state beyond asking, he refuses it anyway.

Time Out alleged that Sane took money from Sandoz, a drug company. First, says Ms Wallace, Sandoz contributes 2.08 per cent of Sane's income. Second, virtually every mental health charity accepts money from drug companies, including the Royal College of Psychiatry whose latest depression campaign was 80 per cent sponsored by drug companies. It is no dark secret. Third, Sane believes the right drugs regime is the best treatment for the acutely mentally ill.

The Time Out article, quoting Mind's national director, also challenged Ms Wallace's estimate that 100 people a year are murdered by the mentally ill. Ms Wallace gives chapter and verse on the government report from which the figure is drawn, which she and the others claim Mind misreads. The article said she highlights the dangers to raise funds, yet makes people more fearful of mental illness.

"Most mentally ill people are not violent," Ms Wallace replies, "but if you deny the dangers of not treating mental illness, you will never get the resources."

Few award-winning journalists at the peak of their careers give up scrutinising others to attempt to right the wrongs they describe. Ms Wallace saw that Sane was struggling and took over as chief executive in 1989. She works obsessively, non-stop at home and at work. When undergoing chemotherapy, she took morphine for the pain and only took two days off work. She admits she has been something of a Mrs Jellaby mother to her four children, the youngest of whom is 10, who have grown up with the idea that a weekend treat might be a visit to Broadmoor.

Sane's Helpline gets 3,000 calls a week, but so far only has resources to receive 1,000. It has a unique database of every mental illness, every treatment, every side-effect. People calling in distress can be got emergency help while they are on the line.

Since taking over, Ms Wallace has raised about pounds 6m. Prince Charles has taken the cause to heart, and she has collected money from the Sultan of Brunei, King Fahd of Saudi Arabia, and other foreign millionaires. She stresses this is not money diverted from other charities, but new money.

This high-life approach has caused a cultural clash with Mind. Marjorie Wallace's first husband was a Polish count and she has always moved between the low life in her reporting, and the highest of high society. The tin- shaking ethos takes umbrage at the thwack of polo mallets on behalf of homeless schizophrenics muttering in cold doorways.

Ms Wallace admits she is not always easy to work with. Ruthless, single-minded and fearless, reaching for almost impossible targets, she gets results. She has a fierce mission which gleams impressively in her eye. No doubt Florence Nightingale would have had people grumbling to the press if she were at work now.