Mental Health Recovery

The Covid-19 crises will almost certainly increase existing mental health problems in society. There is understandable focus on economic recovery given the scale of the job losses in particular sectors of the economy. There is a significant link between unemployment and mental health problems. As the Institute for Work & Health[1] points out, there are likely to be a range of issues, including; loss of self-esteem, loss of income with resultant fall of living standards, and loss of social contacts. Though, there is a cause and effect situation with people not in employment suffering from mental health problems and those with mental health problems finding it hard to get into employment.

According to the Scottish Association of Mental Health (SAMH), mental health problems affects one in four people in Scotland[2]. Mental health problems encompass a wide range of conditions, including; anxiety, depression, bipolar disorder, schizophrenia, panic attacks, psychosis, and personality disorders[3].

There are likely to be a range of factors as to why people develop mental health problems. They commonly include; childhood trauma, abuse or neglect, genetic factors, bereavement, domestic violence, alcohol and drugs, significant trauma, poor housing and homelessness, long-term or severe stress, and social isolation or loneliness[4].

Loneliness has become increasingly prevalent in our society. Traditionally it was viewed as a circumstance of older people living alone. However, even significant numbers of millennials are reporting feeling lonely[5]. There may be a wide range of reasons for this, ranging from projects closing down through lack of funding to increased reliance on social media. Those suffering from prolonged loneliness have a higher risk of depression, cognitive decline and dementia.

As a Hypnotherapist, I often see people who struggle to manage stress. This has a detrimental affect on their life, often resulting in disrupted sleep and exhaustion. Stress is a necessary component of life. The problems arise when people feel they can’t manage their stress levels. Prolonged stress can lead to a range of problems, including; lowering of immune system, headaches, stomach issues, muscle pain, and depression.

The Scottish Government’s Mental Health Strategy: 2017– 2027[6], illustrates actions to improve services to people experiencing mental health problems. These include; increasing the number of mental health workers in hospitals, GPs, police stations and prisons and improving support for prevention in child and adolescent mental health services (CAMHS).

However, many young people are having to wait a significant time to have support through CAMHS, the Scottish Government has a target of 90% of young people starting treatment with CAMHS within 18 weeks. However, only around two thirds of young are being seen within this time period[7]. There is also clearly a need to increase the capacity of services with mental health professionals so that people do not need to wait for months to get help, as well as provision in schools to offer relaxation techniques and coping strategies.

The past ten years have also witnessed a closure in many projects which provided a place and service for people to socialise and develop. For example, in 2015, The Engine Shed in Edinburgh closed after 25 years of helping vulnerable adults develop skills and act as a stepping stone to employment. These projects are really important to tackle loneliness and stress.   Though, we are facing an economic crisis, it is an investment to provide such services and can reduce costs if it prevents people reaching a crisis point.

There are changes which could be made to reduce stress, such as to Universal Credit, which has caused misery to many claimants. The five-week wait for a payment, has led to increased demand for foodbanks and increased debt[8]. Though Universal Credit is reserved to the UK government.

Similarly, there is research evidence from Finland that a Universal Basic Income (UBI) can improve confidence, mental wellbeing and life satisfaction[9]. A full national roll out of UBI may be very challenging given the current constitutional arrangements, though a pilot scheme could be on the cards[10].

One of the aspects of the Covid-19 lockdown was the significant rise in people working from home. There is some evidence that flexible working patterns can improve job satisfaction[11] and likely reduce stress through fitting around existing commitments and less commuting. In Finland, the majority of full-time employees have the right to decide where and when they work for at least half their working hours[12]. The Fairer Scotland Action Plan published in 2016 contained an action to help more people in Scotland work more flexibly[13], though at present employment law is not devolved to Scotland[14].

Mental health tends to deteriorate when people do not feel in control of their surroundings. Lesley Riddoch has written on local authorities in Scotland being too weak and large[15] and therefore often detached from constituents needs. What would be empowering for residents is a radical reshaping of local government in this country, possibly from far more powerful community councils, with their own budgets and decision making, that locals can readily get involved in.

There is a well-recognised link between mental health and nature[16]. Being surrounded by nature can reduce the stress hormone cortisol and blood pressure. What would be beneficial is utilising urban wasteland and increasing the number of urban forests, community orchards and allotments. Exercise is also key to improving mental and physical health. Indeed, a significant increase in safe cycle lanes and better walking paths would be helpful. As well as an increase in access to low cost gyms and exercise groups, such as walking groups, yoga and pilates.

Stress and poor mental health can blight people’s lives. The Covid-19 crises has highlighted existing mental health challenges. As we renew our economy, lets take the opportunity to properly invest in all aspects to improve our mental health, and with that benefit our economy and society.



















Comments (10)

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  1. Mark Bevis says:

    We need to add that work itself can lead to mental health problems. Being “in work” is not the panacea that neo-liberal economics suggest.
    Indeed, I go so far as to say that work as a modern concept is so fundamentally flawed that it needs abolishing. Looking at the history of the commons, it is clear that wage slavery is no better than fuedal slavery, except that the slave owners now don’t have to provide water, food and living space.

    Doing, as apposed to working, is a far better use of a human’s time, and far better for mental health.
    We are not wired to be individually competitive, nor to push numbers round computers for that matter, and the whole narrative of the regimented school-work-breed-retire-die of toxins life cycle is completely destructive to mental health.

    An abandonment of GDP, phasing out of “bullshit jobs”, the introduction of UBI and UBS (Universal Basic Services) and more local ownership of assets and politics will go a long way to reducing the current mental health epidemic. Ending the assumption that at 15 years of age everyone knows exactly what they want to do with the rest of their lives would help too, and ending the narrative that pupils are only future economic units for a parasitic elite.
    I didn’t know until I was 25 by which time I’d done the wrong academic path. Which means I cannot get qualifications in what I’m good at. Not that I’m bothered now, at 57, but it might have made a difference 30 years ago.

    Over and above this is the threat of climate catastrophe, which is leading to another layer of anxieties and fears, which our societies will have to take on board on top of all the other stressors.

    1. Anndrais mac Chaluim says:

      Well, there’s work and there’s work.

      The trouble with work under our present relations of production is that the individual is deprived of the power to direct and determine the character of their own work; that is, to own it.

      Although the worker is subjectively an autonomous self-creative being, objectively, as an economic entity, this same worker is directed to goals and diverted to activities and relationships that are dictated by their employers, who own their labour through the wage-system, and by the state, which owns their labour through the benefits system.

      This disconnect between one’s subjective and objective being is one of the key structural causes of mental ill-health. Mental ill-health is a disorder of society rather than a medical condition.

  2. Chris Ballance says:

    Yes to all of that. But note that 14 common causes of mental distress are listed. Of these only one (genetic factors) is likely to be best treated by drugs. But Big Pharma ensures that the first treatment the NHS is likely to provide is drugs. Nature therapy, exercise, art therapy, talking therapies – have been around for over a hundred years – but seem to be the poor cousins in most mental health services. AS the writer points out, mental health problems are exacerbated when someone doesn’t feel in control of their life – which is exactly what prozac and the like do to a patient. Whilst drugs do have a role to play, particularly in acute treatment, person-centred remedies, especially when organised by mental health survivors themselves, are the best ways to allow the patient to take back control (excuse me, I couldn’t help it) of their life, and must be at the heart of mental health care.

  3. SleepingDog says:

    I am happy that we are not stigmatizing those with mental health issues here. However, the article (and SAMH booklet linked to) are silent on a major and critical source of mental ill health: a guilty mind (or in legal terms, mens rea). This guilt may be proportionate or unproportionate, deserved or undeserved. Furthermore, creating an eternal sunshine of spotless minds for those with very spotty minds is not in society’s, or the environment’s, best interest.

    How many abusers, rapists, maim/kill-drivers, cheaters, war criminals and so on are there in Scotland? Count up all the known wrong-doers, add in a guess for the unknown ones, and a goodly proportion of them will suffer mentally to some degree. Not so much the psychopaths.

    Now add all those people who have caused harm accidentally, perhaps just sticking with the most serious harms (and not recklessness that fortunately avoided physical harm). Some of the thousands of yearly accidental deaths will be attributed to others. There is more, much more.

    What about all those people who have caused emotional or financial distress, or have gravely disappointed loved ones? All the effects of addictions, petty jealousies, sudden rages?

    There’s still more. What about all that background stuff? If we were talking about chattel slavery or gunboat diplomacy or running opium into China, we might expect people to have at least qualms about their complicity. These have modern counterparts. How easy are people about the modern slaves making their goods and clothing? About the countries we invade for their oil? About the evil regimes our state props up, and about their victims?

    Yet more: what about the climate emergency? What about the planet we are poisoning? About the species we are killing off? About lying to our children about how things are OK? Or worse, about a fake golden past or some moral superiority that somehow justifies our first world lifestyles?

    All those people self-medicating their guilt with cycle-feeding drugs and alcohol?

    So I think it is time we grew up and stopped avoiding these unmentioned causes of mental ill health, and look at curing society and human relationships with the living planet.

    1. Anndrais mac Chaluim says:

      Feelings (like guilt) aren’t illnesses. Our feelings just are what they are. It’s the ways in which we respond to such natural stimuli that are either enabling or disabling in purely functional (i.e. non-medicalising and non-moralising) terms.

      There are five classic responses to feelings of guilt:

      – We can repress them. However, if this defence fails, our feelings of guilt over past transgressions can amplify and/or become chronic, which in turn can be functionally disabling.

      – We can project them; e.g. blame others for our transgressions and punish them accordingly. When this defence fails, however, and we recognise that our projections are unjust, our feelings of guilt can accumulate, which can again be functionally disabling.

      – We can share our feelings – e.g. through art, joke-telling, or confession, etc. – and assuage them thereby. The risk here lies in how our those expressions are received; being mocked, patronised, or otherwise bullied for them can also be functionally disabling.

      – We can self-harm to compensate the object of our transgression; e.g. by damaging our own bodies or by not allowing ourselves to enjoy opportunities open to us or benefits due to us. This response is not just functionally disabling; it can lead to literally self-destructive consequences.

      – We can offer compensation to and/or seek forgiveness from the object of our transgression, thereby discharging the ‘debt’ we owe them in virtue of that transgression. This last response is by far the most productive; for even if the offer is rejected, our ‘debt’ is cancelled and our guilt purged in the offering/seeking.

      It’s no coincidence, I think, that the root of our word ‘guilt’ is the Old English ‘gieldan’, which means ‘debt’.

      1. SleepingDog says:

        @ Anndrais mac Chaluim, thanks for your neat summary. Indeed, I was implying that it was the way that we handle guilt can lead to mental ill health, rather than natural feelings of guilt themselves. I would add a sixth response: acceptance. That is, if I have understood your line of thought correctly, something along the lines of the ethical life (as in perhaps Søren Kierkegaard’s Either/Or).

        Society is not helped by a catholic priest forgiving someone’s grievous sins against a third party, not a protestant minister condemning a soul to hellfire for small infractions of the Sabbath.

        If we need to spell out that we are thinking intersectionally, rather than just lumping people into one-note classes, then we should say that many perpetrators are also victims, many victims also perpetrators. And there is a multi-dimensional aspect of the continua of culpability and harm.

        And I would also add a special class of those who lie or keep secrets on behalf of the state, those slaves of the Official Secrets Act, whose consciences occasionally result in whistleblowing. Naturally, there are other liars and secret-keepers, journalists and adverteers (although the latter may tend towards unrepentant psychopathy). And all those knowingly pushing black propaganda.

        Without including all these, neither the article or the linked SAMH guide hold out any prospect of help for these people. It is as if to say they are not welcome. Take one section of SAMH’s causes:
        “significant trauma as an adult, such as military combat, being involved in a serious incident in which you feared for your life, or being the victim of a
        violent crime”
        Well, what about the committing of wrongdoings, ordered or unordered, in military service; or the (perceived) failure to prevent harm to a comrade, or to prevent a war crime by one’s own side? What about involvement in an accident where you were a cause of someone else getting seriously hurt or killed or narrowly missing harm? What if you were the perpetrator of violent crime?

        Which brings me to confession. Too often today we see ‘bad feelings’ presented as some inconvenient cramp to your lifestyle that you take a pill for, or take some self-help guru’s advice on eliminating, or join a yoga class or something. Well, that’s just poison for society. For a healthy society, say in an Independent Scotland, we will need some pretty frank and full disclosures, and an end to a culture where people are encouraged to do wrong and manage the consequences.

        1. Anndrais mac Chaluim says:

          I don’t find the medical metaphor at all helpful in psychology; in fact, I find the whole ‘mental health’ metaphor to be a somewhat destructive response to the feelings we experience.

          Having read Kierkegaard’s novel, Either/Or, you’ll appreciate that its dialectic points beyond both the aesthetic life and the ethical life to the overcoming of both in the religious life. The religious life (in Kierkegaard’s typically idiosyncratic sense of the term) is the third of the Stages on Life’s Way to human perfection, of which he treats in this sequel to Either/Or, and which he considers to be in all probability ultimately unattainable but worth pursuing nevertheless.

          Your allusion to Kierkegaard is a fortuitous one, however. He has some interesting things to say in both Either/Or and Stages on Life’s Way about psychological guilt (as distinct from the moral guilt – and the acceptance thereof – you’re trying to smuggle into this psychological discussion) and its role in personal growth. I can therefore recommend that you read Stages of LIfe’s Way too.

          To be honest, I find it difficult to give a toss about moral guilt. Moral guilt is just a cultural device that ‘apollonian’ societies use to control individuals (especially children) and maintain social order by swaying them into norm-obedience and conformity. Fuck that!… as Kierkegaard himself might have said to Judge William, the character who, as you’ll know, advocates the ethical life against the aesthetic life in Either/Or.

          I’m much more concerned about psychological guilt, the choice we have in how we respond to those feelings, whether creatively or destructively, and the role of therapy in freeing that choice.

          1. SleepingDog says:

            @Anndrais mac Chaluim, I may have read large chunks of Either/Or decades ago, skimming the rest. Anyway, I have a hazy memory of the Ethical choice involving acceptance of one’s responsibility for one’s own mental state, in that we cannot choose many things that happen to us, but we can (to a significant extent) choose how we respond (particularly mentally). Or that may have come from elsewhere in our section on existentialism.

            At one level, I am more concerned about transparent government and the minimisation of spin. To give one example, when I hear of Blairite spin-doctor Alistair Campbell’s depression, I am not surprised. That kind of sustained lying, bullying and abuse of a public position should take its toll. At another level, I think of all the real harm done to people around the world due to the unhealthy mindsets of British officials, corporate media people, and a whole constellation of other nogoodniks. And we remain in the era of MADness (Mutually Assured Destruction).

          2. Anndrais mac Chaluim says:

            Well, your memory fails you: in Either/Or ‘ethics’ is synonymous with the Hegelian notion of ‘Sittlichkeit’, or customary mores. In this sense, ‘ethics’ represents the ‘universal’ or, more accurately, the prevailing social norms, which are used as reasons to make sense of and/or justify an action within a community, and the ethical life is living in conformity with those norms. Moral guilt is the infliction of psychological punishment for transgressing those norms; the acceptance of moral guilt is the acceptance of this punishment. Thus it is doubly oppressive, politically and psychologically, and Kierkegaard’s ‘religious life’ can thus be read as a way of living that liberates one from that psychological oppression.

          3. Anndrais mac Chaluim says:

            You also speak of Alastair Campbell as if his transgressive behaviour when he worked for Tony Blair caused his depression. Campbell’s depression – ‘all the stuff that happened in my head and the drink and the psychosis and the hospitalisation and getting arrested’ – began long before he worked for Blair. Perhaps his ‘unhealthy mindsets’, as you stigmatise them, were a response to his depression rather than its cause.

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