Mental Health is a subject very close to my heart. I have experienced my own difficulties with mental health early in life and then experienced it later in life, professionally as a mental health nurse. As a result, I get very passionate about it, frustrated with commonly held beliefs, annoyed with some professionals having their ‘expert’ competitions with one another, deflated with social media coverage about it and struggle with the idea that we’re all suffering from mental illness when really, much mental ill-health is distress produced as a normal human reaction.
So, this blog post is a mad ramble along the road of a few of my thoughts:
When I’m doing a workshop on mental health awareness, I ask people to create their own definition of mental health. This is because there are many misunderstandings about mental health and mental illness. For example, the terms are often used interchangeably, with people saying ‘I’ve got mental health’ when they mean they experience issues. I think generally speaking, we have a clearer idea about what it is to be mentally unhealthy. This is because there is so much media coverage with loads of personal experiences on social media, the portrayal of mental illness in films, and it has become a common topic of conversation and of general chit-chat.
Collectively we seem to know more about when things are wrong than when they’re right. So, let’s flip that idea and look at what it is to be mentally well.
The World Health Organisation defines mental health as:
“…..More than just the absence of mental disorders or disabilities.
Mental health is a state of well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to his or her community.
Mental health is fundamental to our collective and individual ability as humans to think, emote, interact with each other, earn a living and enjoy life. On this basis, the promotion, protection and restoration of mental health can be regarded as a vital concern of individuals, communities and societies throughout the world.”
This definition is quite wordy and doesn’t resonate with me at all. So, in workshops I pester people to come up with their own definition. I always ask: What is your personal definition of mental health? What is it like when you feel balanced, well and at your best?
Now, part of the reason I ask people to do this is to try and get people to look clearly at the distinctions between mental health vs mental illness. But I also want people to be clear about themselves as individuals. This is because we are constantly being bombarded with information about who we are and constantly being told how to think and feel. One of the difficulties in terms of knowing what mental wellness is or is not, is the sheer amount of wellbeing information being produced on a daily basis. Everyone is an expert – everyone from Sue down the road to a clinical psychologist with many letters after their name. And all this information is readily available via media outlets, pretty-much every minute of the day.
And this is why I get people to define their own mental health. Because it is this definition which will help them understand what is normal for them, whether they feel comfortable with what’s going on for them and when to reach out for support when they need it. It’s about knowing your need as an individual. Because in the field of mental health whilst there are certain ‘rules’ to human behaviour, there are just as many ‘anomalies’ or exceptions to that rule.
My own experience of illness led me to feel that a genuine connection with another human being was most curative element when providing help for someone with problems. I ended up with the view that somewhere between Sue down the road and an expert in psychology, is a professional with a human touch. And this is another hazy area, the idea that there is someone out there who knows so much about what it is to be human, that they are gifted with the skill of being able to cure those with mental illness. Prior to forming my own conclusion, I spent many years wishing that there was some kind of holy guru who could show me what it was to be human without experiencing distress. Of course, as I discovered, ‘cure’ does not actually lie in someone else waving a magic wand and indeed there is no final ‘cure’ to being human. The journey towards mental health is definitely a process rather than a fixed destination. It has always fascinated me that if this is the case, and we never reach that final point of perfection with mental health, it potentially means that we all have some degree of ‘madness’.
“Approximately 1 in 4 people in the UK will experience a mental health problem each year.
In England, 1 in 6 people report experiencing a common mental health problem (such as anxiety and depression) in any given week.”
So, now let’s look at mental illness.
The study of psychology has been around since the ancient Greeks gave us philosophy.
But the way we understand mental health as a practical discipline today predominantly comes from what is called a medical model – a framework, known as psychiatry. This framework, came about in the late 19th century when doctors such as Emil Kraepelin working within asylums, tried to understand ‘the bewildering mass and jumble’ of his observations. In an attempt to get a grasp of what he saw, he ended up classifying illnesses. We still use a classification system within psychiatry today. But are these labels useful?
When we talk about mental health, we can’t remove the wide array of responses and reactions the labels provoke. We tend to attach a stereotyped idea to a particular label, for example schizophrenia – and the response is usually negative. I think this comes from the fact that collectively we still do not understand what mental illness is. In spite of scientifically proven or disproven ideas about causes, such as genetics or chemical imbalance or trauma, we are still left with an unknown within society. Unfortunately, as a society in Western culture this ‘not knowing’ manifests in stigma and us not being sure what to ‘do’ with ‘mad’ people.
Stigma is defined as: a mark of disgrace associated with a particular circumstance, quality, or person.
For example: people with mental illness are lazy; people with mental illness can’t hold down a job; people with mental illness are attention seeking; people with mental illness are dangerous.
One of the ways stigma manifests itself is self-stigma – when, or whether we ask for help or not. People are very good at denying there’s an issue, or they’re ashamed that there’s an issue – treating it as a personal failure, or they just don’t prioritise it.
“A study by the World Health Organization, or WHO, found that between 30 and 80 percent of people with mental health issues don’t seek treatment. This includes 50 percent of people with bipolar disorder, 55 percent of people with panic disorder, 56 percent of people with major depression, and a stunning 78 percent of people with alcohol-use disorder.”
Another example of how stigma affects people with mental health issues, is to do with what help is actually available. And I think this is one of the most stigmatising things. Because what we do collectively, is peddle an idea of mental health perfection whilst not creating the right sort of help for anyone who is somehow not meeting this mark of perfection. So, whilst we have many ideas, voices, notions and opinions about mental health being bandied around, these voices and ideas collectively are existentially of no help. Many ‘expert’ ideas about mental health come from ego, or you can easily find the latest quack idea, or there are theories about mental illness which tend to come from a place bereft of any spirituality in the general sense, or there are celebrity experts etc, etc, and these are spewed onto social media and the news, forgetting about the effect of contagion, domino effect or indeed of triggering. I think too much wellbeing information is doing us a disservice. It appears to me to be a token gesture and ultimately cruel and stigmatising, because the grim reality is that real, practical and useful help in the form of mental health services in this country are generally speaking, dysfunctional.
So, I think after all my ranting, there are two things going on. The first, is that as individuals we need to take responsibility for our own mental health. This is because we are subject to all kinds of conflicting and sometimes unhelpful messages about how we should or shouldn’t be. I think, one of these unhelpful messages is that mental health feels like a perfect goal we should all aspire to. I do not believe this to be the case. I think that mental health is a very personal and individual thing affected by internal and external factors. It can go up and down and round and round, but above all it is a process which changes with time. So, you should refer to your personal definition of mental health. At this point in a workshop, I always add the caveat that a personal view should try and be as balanced as possible – on the one hand don’t aim for perfection, but likewise try not to pathologise every normal mood and reaction.
The second thing going on, is how we deal with mental illness as a society. It is very difficult for individuals to have good mental health if the standard that defines what it is to be mentally well, is, dysfunctional itself. Providing lots of conflicting, existentially unsettling information and then patting ourselves on the back for talking about mental illness on social media isn’t enough. It’s disingenuous. When people actually, genuinely need support because they are experiencing distress, then help should be there in the form of a kind, genuine professional. An app really isn’t enough.
So that was a little journey around some of my ideas about mental health. I apologise if I sound like a pessimistic doom-merchant. These are just my opinions of course. As I have described, there are hundreds of other views out there too. But I do try and be honest with myself as an individual, and ultimately, I believe that unless we collectively look at reality square in the face and be honest, then we cannot begin to put things right.