A report into mental health care released this week by an NHS England Taskforce contains a stark statistic: severe and prolonged mental illness can shorten life expectancy by 15 to 20 years.
The equivalent statistic for chronic smoking is 10 years.
It's scary stuff -- and a call to action.
Of course, not everyone with a mental illness has a 'severe and prolonged' problem -- no more than everyone with a stomach ache has appendicitis. The issue is, we're happy to attend to the stomach ache -- but we don't apply the same care to mental health problems. Yet both can become major health issues.
The NHS report focusses on care and treatment, but the solution does not start with treatment. Nor, even, does it start with early identification. It starts with understanding and normalisation -- understanding mental health and why it should be treated in exactly the same manner as physical health.
We can view the mind as a mechanism, the same as the body -- an infinitely more complex and more opaque mechanism, one which neuroscience is still trying to sort out, but still a mechanism.
The body processes nutrients and the like and produces a robust physical self; the mind processes information from our senses and produces both dispositions and instructions (such as 'walk over there', or 'say hello'.) Importantly, the two work in tandem: the body gives the mind sensory data, the mind gives the body the instructions -- if one breaks, neither can work as they should.
If something goes wrong with the body mechanism -- say, we get food poisoning -- it stops working properly; it's painful, so we fix it. If something goes wrong with the mind mechanism, it also stops working properly (say, we're depressed); it's painful, and equally we should fix it.
And just as food poisoning can become a bigger problem, small mental problems can become much bigger ones. Professor Dan Siegel of UCLA identifies a progression -- how a simple behaviour can become a habit; which can then become a trait, and then a state. Each one more entrenched, bigger, and potentially more of a problem. So, for example, worry can develop into anxiety.
Small mental health issues can become large ones. And really, these days it's more likely that we are going to get stressed, angry or anxious than food poisoning.
It's almost inevitable: we have to deal with it. There is no value judgement in getting food poisoning. And there's no value judgement in being depressed, it simply happens.
This must be the starting point. Initiatives by the NHS are, of course, essential but real change starts with us. We must understand and normalise mental health issues if we are to change things in the long-term.
Here are a few tips to help:
1. Start with yourself. Meditation is a good place to start, and there are plenty of apps available to help. Choose one that offers additional education to help keep you get the most out of it.
2. Kids are different. Kids need their own programme. There is an on-line programme specifically for school kids, or plenty of child psychology books from which to start.
3. Stay open and aware. We all know when something is not quite right, but often we won't admit it. But it's OK, it happens: be aware of your feelings, and be open to admitting how you feel.
4. Talk freely at home. Make feelings an open topic with your partner and your kids: sadness, frustration, joy, happiness -- these should be talked about openly.
5. Be positive. Monitoring mental health doesn't mean looking for problems: seek out and acknowledge all the positive things in your life, and take joy in them.