So, fellow mental patients, just how mad should we be getting about Asda’s Halloween “mental patient fancy dress costume,” complete with strait jacket, fake blood and cleaver? After all, the supermarket has now apologised for any upset caused, withdrawn the item from sale and promised to donate “a sizeable amount” to Mind. So no point going psycho now. Let’s all calm down, keep taking the tablets and leave the normal people alone.

Given the degree to which mental health stigma has seeped into our everyday language, it’s not all that surprising when retailers think it’s okay to make fancy dress costumes based on The Mad. You can see how it happens. The mentally ill, when they’re not being dismissed as everyday malingerers, tend to assume a mythical status. They’re lurking in the shadows, never to be seen in broad daylight. How can you offend a thing that isn’t even real?

Asda aren’t the only retailer to have fallen into this trap. There’s Tesco with their “psycho patient” costume and Simply Fancy Dress with their “women’s mental patient” garb, although to be fair, the latter is exactly what I looked like when I was hospitalised for anorexia in 1994 (though god knows why I was walking around with a dead-eyed doll when all the male patients had hunting knives and massive injection needles. Guess those are just the gender-based rules for accessorizing while clinically insane!).

The real experience of mental illness is of course not like this (I was only kidding about the dress. I looked horrifying in a far more acceptable, London-Fashion-Week-emaciated manner).  Whatever the headlines say, the average schizophrenic does not frighten others by appearing round street corners with murder on his or her mind, while the average anorexic is not a ghost-train prop roused to life. Mental illness is terrifying in far more subtle, insidious ways.

It’s terrifying because external observers don’t understand it while sensing that they too, could fall prey to it.  No one wants to have a mind that feels broken. They othering of mental health patients persuades “the sane” that mental illness won’t happen to them, while the mix of demonization and disbelief in portrayals of madness makes ongoing failures to integrate mentally ill people into public space seem reasonable. Like Norman Bates, the mentally ill are evil but they’re also not quite real. It’s okay to mock them because they won’t answer back.

Despite all the fuss about Asda’s costume, and the swift response, in the back of my mind I suspect plenty of people will think it’s an over-reaction. After all, the psycho killer is a well-known figure in slasher flicks. People must know, mustn’t they, that it’s that which is being referred to, and not all those friends, relatives, colleagues and lovers who’ve struggled with mental illness themselves? I’m not so sure they do.

The overlap in the language we use to describe those who are ill and those who are no more than dark creations of fiction makes the world a more hostile place for the former. Mentally ill people may be more likely to be victims of violence themselves but you wouldn’t think it by looking at this year’s batch of Halloween costumes. Perhaps next year we should ask for something more accurate and far more terrifying; not fake blood and plastic cleavers, but faces that tell you you’ll always be judged and there’s nothing you can ever do to escape.