This is Mental Health Awareness Week. The necessity of such an event is without question. Despite the anti-stigma charity Time to Change showing improving attitudes in over four million people in the UK between 2008 and 2016, misconceptions about mental health still exist amongst the general public. Royals, celebrities, and activists like myself who’ve had their own experience of mental health problems, will get together this week to promote better understandings of psychological health and wellbeing - fighting the stigma we’ve all-to-often experienced first-hand.
Yet, despite my own difficulties and lending my voice to awareness campaigns, more and more I am left feeling uneasy by all this talk about mental health. With each year that goes by, I become more convinced that if things really are to change, then so much more is needed than conversations - however valuable they are. Awareness is essential but is only the starting point when it comes to promoting mental health and wellbeing.
These are my reasons why:
1) Talking about mental health isn’t a substitute for treatment
The stigma around mental health still has a damaging impact on people living with mental health problems - so much so that some people report the stigma they’ve experienced as even harder to deal with than the mental health problem itself. I only have to look at my own story to see how the systems around me were unwilling or unable to provide a supportive environment because of a lack of awareness about mental health.
My school treated me as badly-behaved rather than understanding the barriers I faced to attend school when I had anorexia. My employer threatened me with disciplinary action when I became too unwell to work but hadn’t previously disclosed my eating disorder for fear of not getting the job in the first place. My friends and family had no support, didn’t know how to talk about eating disorders and struggled to support me in my recovery.
Of course I wish this had been different. But not even the most understanding employer, helpful school or well-supported family would have meant that I didn’t also need specialist treatment. I would still have been unwell.
Being able to talk about your problems, however cathartic, is not the same as therapy or treatment. Yes, silence and secrecy are extremely powerful factors that can fuel the loneliness, pain and suffering of a mental health problem, and breaking the silence may be enough support for some people. But for others, it’s specialist support from qualified professionals that is needed.
We would never expect social support and the absence of stigma to be enough for a cancer or diabetes patient to feel well - they’d still need treatment. The focus on raising awareness shouldn’t divert our energies from also calling for people to be able to access mental health services that are equipped to offer them the right treatment at the right time.
2) Political will on mental health needs to move beyond talk
It seems lately that more and more politicians have mastered the ability and willingness to talk openly about mental health. But when it comes to taking action, talk is all there seems to be. Whilst Theresa May decries the “burning injustices” faced by those with mental health problems, any changes in policy have only resulted in a continuation of chronic underinvestment in services.
A meaningful commitment to improving mental health would mean responding to the level of need in the population, which is simply not happening. Meanwhile, services such as libraries and parks - which have been shown to prevent mental health problems in the first place - have been cut left, right and centre.
A perfect example of the mismatch between political rhetoric and reality on mental health is the recent Green Paper on the mental health of children and young people. Whilst the government boasts about their “trailblazing” and “substantive” plans, in reality they are offering an insecure and insufficient amount of funding for a programme that will benefit only 20-25% of young people by 2022-23.
We’ve had enough of talk and warm, vote-winning words. Now is the time to act, and act in a way that doesn’t prop up the failing status quo.
3) We should talk more about promoting good mental health
As well as helping people become more aware of different types of mental health problems and how to seek help, mental health awareness events are at their best when they focus also on prevention. In themselves, they help by creating an environment where it is OK to talk about your thoughts and feelings - the perfect antidote to the toxic culture (especially amongst men) of bottling things up.
Awareness campaigns are also the ideal platform for helping people identify those things that keep them well. This year’s campaign for example focusses on the day-to-day stresses that can contribute to becoming unwell. But coping with stress is more than a personal responsibility. Schools, employers and policy-makers need to act to reduce stresses on our mental health - from academic pressures and social media to poverty and inequality.
4) People are encouraged to seek help that isn’t there, or is too hard to access
Whilst it’s great for people to feel able to seek support as a result of more awareness around mental health, this isn’t the same as that support being readily available. There’s widespread acknowledgement that early intervention is key to the success of mental health interventions and chances of chances. Yet the bar to accessing services is set too high, and the safety net too low.
I hear countless stories of people being told they are “not sick enough” for treatment. In my own experience I felt like I was being incentivised to lose weight and be a “better anorexic” in order for my referral to a specialist to be accepted. The failure of government to match increased demand with increased resources means that our stretched mental health services can only see the most unwell or risky patients. This directly undoes the good of anti-stigma campaigns by sending the message to the everyone else that their problems aren’t real or serious enough to warrant attention.
The truth is however that all of our experiences are valid, and that all struggles with mental health are worthy of receiving the support they need. For some, social support will be enough, whilst others will need more specialist treatment. For all of us, our mental health is dependent on the systems within which we live our lives, and this is absolutely a political issue. The revolution in social attitudes must be matched with radical action on a structural level, so that awareness can be driver of change.