Approaching 30, I’ve spent time looking back over my life so far, wondering about where I will be in the future, and trying to be happy with where I’m at right now. I feel blessed to have a very rich and rewarding life. From teaching yoga and studying psychology to working as a mental health campaigner, I feel a sense of meaning and purpose that wasn’t always there.
Yet I still live with a daily struggle with my mental health that has been there since my teens. Despite all the good stuff, looking back and seeing how over half of my life has been dominated by mental health problems is deeply upsetting. My experience of OCD and depression started over 15 years ago, and the constant companions of anorexia and bulimia appeared not long after. I am sad that I can’t remember what it is like to have a relationship with my body that isn’t something like a war, and that I have permanent damage to show for it.
I could spend days sitting and wondering why I became unwell, and why I haven’t managed to recover. I often ask myself, “what could have been done differently?”, and “will I still be living with a chronic eating disorder when I am approaching 40?”. Most of all, I spend day after day continuing to struggle with my health, and my worse days are those when I begin to lose hope that things will ever change.
As well as sadness about what I have lost, the tiredness of fighting to keep what I have, and the hopelessness that can creep in when I think nothing will change - I am angry. I’m not angry at the GPs who have prescribed me medications in a trial-and-error approach to managing my symptoms. I’m not angry at the psychiatrists who have referred me around services, disagreed over my diagnosis and ultimately denied me treatment for over 6 years because I was so underweight they thought nothing would help. I’m not even angry at the consultant who told me I would “grow out of attention-seeking”, or the doctor who told me eating disorders were a personality trait that couldn’t be fixed.
I am angry at the state of knowledge about mental health that has lead to these attitudes.
I’m frustrated that my treatment pathway was so chaotic because nobody knew what to do. I’m exasperated that the consequence of living in an age where we don’t have enough research into mental health problems is that people like me have had to go without support, treatment and the hope that things can be better.
We can’t imagine living in an era where if you had diabetes and went to the doctor they would tell you that they didn’t know what caused your condition, how it might best be treated or the likely outcomes from treatment. To an extent, we are still in the dark ages with mental health problems. Eating disorders have an average duration of over ten years, and even despite their detrimental impact on social, vocational, psychological, and physical health, systematic reviews report recovery rates of less than 50% for the best treatments that we currently have. We clearly have a long way to go.
Yet a new report by the mental health research charity MQ shows that funding for mental health research has been static over the ten years up to 2017. Per person affected by a mental health problem, only £9 is spent on research per year, even though the costs to the economy and NHS services is huge (for example, depression is the leading cause of days taken off work). With eating disorders, this figure is even worse, with just 96p spend on research per person affected - despite anorexia posing the greatest risk to mortality of all mental health problems. By comparison, cancer research receives 25 times more in research funding per person, even though the disease burden for cancer is lower than that for mental health.
Things have to change.
I want to look back in the future and see that from prevention and early intervention to treatment and ongoing management of mental health problems, we know what we are doing in the same way as we do with physical health. Parity of esteem between mental health and physical health isn’t just about removing the shame around talking about mental health problems, or making sure they have the same status in law. It’s also about parity in knowledge and research, investment into learning about what works in treating and promoting mental health, and why. And we cannot afford the costs of not investing in research. The costs aren’t just economic - they are in the stories of people like me, and the lives that are blighted by suffering that might not have been necessary.
Framing investment in mental health as an individual pursuit - where recovery happens through individual determination - overlooks the wider factors at play in determining health and illness. Investment in mental health requires an equity between funding for research into physical health and mental health, both of which are intertwined anyway. Only then will we make sure that the 21st century sees the progress in treatments for mental health problems that we saw in the 20th century for physical health. It is research that will provide the hope for millions of people living with mental health problems that their problems are understood, and that effective help based on individual need and rigorous evidence is available.