We Need to do More than Talk about Mental Health
When Ruth Davidson spoke out on her experience of depression and self-harm earlier this week, I, like many others, reflected on the best ways to raise awareness on the prevalence of mental ill-health and, importantly, how to address it.
Out of this reflection came a rare realisation: I disagree with myself. Specifically, I disagree with an article I wrote for ‘The F Word’ last year on my own experience of self-harm and how the issue was depicted in the Netflix series 13 Reasons Why.
I don’t disagree with the main thrust of the piece, which was that this particular series did little to shed light on the complexities of mental health and sent the wrong message on how to deal with it.
Where I do now find my analysis lacking is in my argument that the external circumstances leading to poor mental health were less important than the inner workings of the individual’s mind.
Mental health is a deeply personal issue, and the stigma surrounding it ensures that it remains so. But while mental ill-health is certainly complex and cannot be explained solely by identifiable ‘reasons’, this cannot – must not – prevent us from understanding the trends driving our mental health crisis.
I can’t help feeling that by promoting a narrative which sees mental health as an individual concern, to be resolved through individual responsibility, we are inadvertently allowing our physiology to be scapegoated for systemic problems.
Collective experiences require collective responses – and for those with an interest in maintaining the status quo and its structures of inequality and injustice, this is a scenario best avoided.
This brings me to Ruth Davidson and the discussion around her disclosure of self-harm and suicidal thoughts as a student. Many have pointed out, rightly, that public figures speaking openly about these experiences can help reduce stigma and spread understanding that this can happen to anyone – even those who appear from the outside to be strong and successful.
Others have warned against using this as an opportunity to make political points, for example that the Conservative UK Government’s austerity agenda has pushed people into poverty – known to be closely linked to higher rates of mental health problems – or that they have drastically increased the numbers of rejected applications for Employment and Support Allowance and Personal Independence Payments – benefits designed to help people with mental and physical illness or disability.
The problem I have with this warning is that the personal is the political. In trying to understand why an increasingly consumerist, detached, individualist, and profoundly unequal society might be plagued with growing numbers of people who are struggling, mentally, emotionally, just to get through the day, it simply won’t do to view these experiences in isolation.
Official statistics in Scotland show a clear correlation between the level of deprivation in an area and the rates of mental health diagnoses, drug and alcohol misuse, and suicide.
The most disadvantaged in our society, including those who go on to have regular interactions with the criminal justice system and even end up in prison, have rates of mental ill-health we would certainly label a ‘crisis’ if these groups weren’t also the easiest for our politicians to ignore.
At the same time, we know that men are less likely than women to be prescribed medication for depression or anxiety – two of the most common mental health issues – whilst being more likely to successfully commit suicide.
Research suggests the suicide differential is down to men using typically more ‘violent’ methods in their attempts than women, while it is thought that men – who attend their GPs less often overall – are less likely to seek help with their mental health problems.
Both men and women’s experience of mental health and how they deal with it are impacted by the gendered expectations placed on their lives and behaviours – and until we confront these underlying, cultural issues, the statistics will not change.
People’s mental health also suffers as a result of discrimination and bullying, making the promotion of equality, acceptance and representation of diverse
identities and experiences an integral part of boosting mental wellbeing across all sections of society.
For too long, we’ve absolved of responsibility those with the power to either strengthen, chip away at or tear down the structures which create the conditions in which mental ill-health arises and thrives. Our society is broken, and it’s no wonder so many people within it feel broken too.
This is why it is relevant to raise Ruth Davidson’s politics in response to her account of her personal experiences. This is why it’s a matter of urgency that such disclosures are met with more than yet another chorus of how ‘okay’ it is to talk about it.
Removing the stigma associated with experiencing mental ill-health is important, but to really help people we must also remove the stigma of seeking help and – where appropriate – treatment, and, vitally, ensure that support and treatment is available when people need it.
More than this, though, it’s essential to promote mental wellbeing and prevent the circumstances arising which are likely to instigate and exacerbate mental health issues – including poverty, unstable employment, discrimination, abuse, trauma, isolation.
All of these are issues we recognise as acutely personal and undeniably political at once. Only by understanding mental health in the same way can we make a real and lasting difference, for all of us.
The approach I’m describing might be called ‘prevention’, but achieving this in any meaningful sense requires radical, whole-systems, cultural change. Of course, sticking on a plaster is far easier than conducting open heart surgery – but when the latter is called for, anything less can only delay the inevitable.