The Importance of a Broad Understanding of Mental health

Olly Donnelly explores how a binary perception of mental health can stigmatise and prevent appropriate government action.

COMMENT

I went to the gym once. It might have been twice. Either way, I recall a lot of people who seemed very focused on being ‘healthy’. Whether that was a matter of lifting a set of 200 lb weights and a small elephant or, like me, doing 5 laps and then sitting in the steam room for 25 minutes.

I’ve recently started asking for all the salad when I go to Subway. Some people eat kale.  Health is a relative concept, and we all have a different perception of our own physical goals, and where we want to be. It’s also a spectrum; I don’t (quite) have a six pack and I occasionally struggle with jars (don’t we all?), but I’d still confidently say I was ‘healthy-ish’, physically. Certainly, and thankfully, I can say that I don’t have any kind of debilitating physical conditions that take away from the length or quality of my life, and I’m incredibly lucky in that regard. At the same time, I know that I could do better, if I were to jog, or drink more water, or eat kale.

A Binary Conception of Mental Health

In contrast to this ‘scale’ of physical health, mental health seems to be perceived in a strangely binary manner. If you have a medically diagnosed mental illness, you’re sick. If you don’t you’re fine. Anyone who’s ever had the common cold knows that a doctor doesn’t need to tell you you’re not in a perfect condition, and yet this is exactly how society (and government policy) conceives of mental illness. In reality however, mental health varies in exactly same way that physical health does. If you look after yourself, have the advantages that allow you to do so (like a good wage and a low-stress job), and you avoid being unlucky, you’re more likely to be happier, and healthier.

The way we view mental health can make a massive difference to the lives of people who need help. A societal conception of people being ‘broken’ if they have a mental illness stigmatises, but also disempowers people who don’t see themselves like that. I’ve talked to a lot of people about depression lately, and it’s helped me immensely in restoring myself from a really dark and detached place. I wouldn’t have called myself ‘depressed’, or thought to see a doctor, or done anything about the way I felt really, because in my own head I was feeling a little sad, but I refused to believe that anything was ‘wrong’ with me.

Stigma

Too often, reaching out can feel like admitting that you’re not ‘right’, or that you’re abnormal, or that everyone else is able to manage and you can’t. Coming to terms with the fact that you need help is incredibly difficult, because the common view of mental illness means that to seek help feels either like you’re giving up on yourself, or like you’re making a big fuss over something that feels smaller than the stereotype of depression.

There is a certain irony in the stigmatisation of mental illness due to how surprisingly widespread it actually is. RCSI reported in 2013 that one in five young people in Ireland had a mental health problem, roughly the same as the proportion of people in Ireland that smoke. Think of the number of people you know that are smokers. If the same number of people have mental illness, why does smoking seem so normal by contrast?

We all have somewhat of an idea of how to look after our physical health: Eat healthily, exercise, drink lots of water, etc. Until recently, I had absolutely no idea what things I could do to look after my mental health, what I was doing wrong, and who I could talk to to find out. I would hazard a guess that I was not alone in that regard, and that’s really frustrating. For example, it’s hard to articulate in words how important it is, for everyone, to talk to people regularly about the way you feel, and to make those feelings somewhat clear to yourself and others. Life, and college in particular, are stressful. The little things like the bad essay grade, the person who hasn’t texted you back, and the cliquey social politics can become all-consuming. When you’re dealing with it alone, the smallest problem can feel like a leviathanesque maw designed to ruin your life and those of your family, your friends, your future children and your dog. Having someone else offer a perspective on it usually makes you feel a lot better, and even if it doesn’t, it’s nice to know that someone else has your back.

Given that, talking is really, really, important. It’s immensely frustrating that it’s so hard to come out and say that you need help. I know of people who accused me of ‘attention seeking’ when I first talked about feeling depressed, as I’ve seen a million times with other people. I’ve heard derogatory terms about mental illness thrown around like they were nothing. I’ve seen shifting glances when my friends have taken their medicine, and heard people argue with them at the same time.

Why is it acceptable to tell someone with depression that the treatments they rely on are ‘unnatural’ or ‘not part of them’, when we certainly wouldn’t say the same thing to someone taking drugs for a physical illness? We should all get a little better at looking after our own heads. Even people without a ‘problem’ as such could benefit from being in a mind-set that makes them feel healthier, and makes a problem less likely to emerge. This seems deeply unlikely in a society that doesn’t want us to talk about mental health, and where we do, seeks to treat the disease and ignore the cause.

Inadequate Government Action

Mental health provision in Ireland, under the status quo, is woefully inadequate. The current budget of around €35 million has recently been targeted for a €12 million cut, leaving around €4.50 per person per year for specific Government spending on Mental health. Here’s what that under-funding looks like: Yourmentalhealth.ie, a government supported website designed to provide the public with information on Mental health services, was last updated in 2014, according to a banner on the page. The equivalent government webpage for young people, headspaceireland.ie, was, according to the site, last updated in 2010. Although the hideous neon colour scheme, and the stock photos clearly designed to look ‘hip’ and ‘edgy’ are more indicative of the mid-eighties.

The massive lack of resources also leads to a system focused on exclusion, rather than inclusion. Treatment is denied based on consumption of drugs, or in some cases, based on not ‘looking like’ one has an eating disorder, words which would be hugely unsettling to be told by a medical professional, or indeed anyone. No-one should have to prove that they’re worth treatment, nor should they have to beg to find it. In spite of this, the Irish mental health infrastructure already limits the access to treatment and does not provide for a satisfactory infrastructure for people to find information from sources other than their GP or a psychiatrist.

Counselling should be available to anyone who needs or wants it, freely and conveniently. In my own experience of trying to access Trinity’s Student Counselling Service, I was told to ‘try’ to get a lunch-time fit-in appointment, having been referred by my Academic Tutor in relation to my ability to engage with my studies. The service is excellent, but it’s spread so thin, and is a privilege many people don’t have access to.

Anyone with a mind has reason to think about mental health, and a reason to look after themselves. This can mean different things for different people: taking on a little less work, having a run, or taking up mindfulness (I highly recommend this personally). Some who need help are denied it by a culture of silence which both limits our freedom to talk, and dampens the voice that legislators hear. Talking about mental health is hard at first, because we make it hard, because we push people to hush. So I’ll ask two things: If you’re worried about your mental health, at all, please speak up. And if you’re not, please listen. If you don’t like what you hear, that’s just another reason to demand something better for the rest of us.