The Government seems to talk about raising awareness but does very little | #socialmedia


We are all aware of mental health these days, aren’t we? There are Government campaigns, TV programmes, books, tweets and posters about it.

During the pandemic, the Government launched Every Mind Matters, a campaign that encouraged people to go online and get a free personalised action plan with practical tips to help them deal with stress and anxiety.

Workplaces send emails about wellbeing, there’s Mental Health Awareness week, Prince Harry’s mental health TV series The Me You Can’t See, and ITV recently called on former Love Island stars Kem Cetinay and Amber Rose Gill for a mental health series called The Full Treatment.

Pop star Frankie Bridge has recently published Grow: Motherhood, Mental Health & Me, a book about her depression. And Sunday is World Mental Health Day, which heralds the launch of various campaigns and announcements by charities. Awareness is good. It can lead to people feeling less alone in their suffering, it can help people open up, it can reduce the silence and shame around certain mental health struggles. It can save lives.

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“I think raising awareness of mental health is in itself a good thing,” says Alastair Santhouse, a consultant psychiatrist and author of Head First: A Psychiatrist’s Stories of Mind and Body.

“It has been very helpful for a number of people, particularly in that it tends to reduce stigma, which for a lot of people is probably one of the main reasons why they would not come forward before.”

Yet, for all this mental health awareness, the UK is struggling with a mental health crisis. By the middle of 2020, one in five people in Britain was suffering from depression, twice the number in 2019, according to the most recent data released by the Office for National Statistics.

The number of children and young people needing emergency care because they were in a mental health crisis rose by 20 per cent to 18,269. Yet, while mental health accounts for 28 per cent of the burden of disease in the UK – all of this worsened by the pandemic – mental health services only receive 13 per cent of the spending.

Prince William, Duke of Cambridge attends an event hosted by Mind, at Harrow College to mark World Mental Health Day in 2015 (Photo: Arthur Edwards/Getty)

This underfunding means long waiting lists and a fragmented, stretched service, with charities often filling the gaps when mental health crisis teams are unavailable.

In 2020, the Royal College of Psychiatrists found that those living with severe mental illness including bipolar, eating disorders and post-traumatic stress, were waiting up to two years for treatment, while 38 per cent of patients ended up contacting emergency or crisis services while waiting.

Its most recent findings, published today, show that at least 1.5 million in people in England are waiting for treatment but a tenth of consultant psychiatrist posts are empty.

Official figures also show that the number of NHS mental health beds is down by 25 per cent since 2010, with almost 6,000 fewer beds for people with conditions such as schizophrenia or eating and personality disorders.

So how helpful is raising awareness, really? “While raising awareness is good,” says Santhouse, “in my experience many people with mental health problems know they have got mental health problems; the issue is that they are not easily able to access help.

“If you have reduced the stigma and someone feels less worried about what people might think, then they are asking: ‘Can you really help me? What is the service for me?’ If you are not able to provide that service, then the raising of awareness can lead to a disillusionment.

“The problem with raising awareness is that it does not tend to come with funding or anything else. That really is what we need to see in health services.”

Experienced Samaritans volunteer Kalpana Mehta remembers Rehan*, the 12-year-old who had to be excused from his favourite class because his mother had an appointment for him at child and adolescent mental health services.

“His GP had diagnosed him with obsessive compulsive disorder and referred him for cognitive behavioral therapy,” she says. “The child was assessed, along with other children, by a psychologist, psychiatrist and nurse.

The others had a series of anxiety-related disorders. What followed was a series of group therapy sessions, both with and without their guardians.

“The specialists assessed the needs of the group and decided that they could only afford to take two members for further face-to-face therapy. The other four would simply have to learn to live with their poor mental health. How would public debate and raised awareness about mental health alone help Rehan and his group? They need treatment.

“Talking openly and honestly about mental health issues is, of course, commendable, but it is difficult to believe that a modern, developed society is unable to dedicate the resources to support the vulnerable, that various charities are having to provide temporary relief to complex conditions.”

Comedian Ruby Wax has spoken publicly about her depression, and she set up Frazzled Café, a charity that hosts a series of weekly meetings across the UK where people can share, talk and listen.

“I love the fact that people feel free enough to say what’s going on in their minds,” says Ms Wax.

“It means that the heat is taken off of all the shame. I always say that talking is half the cure. It’s such a healthy, healthy sign.”

She’s all for talking and how it helps mental wellbeing. However, she is also horrified by what she sees as the failings of government when it comes to genuine mental illness.

“The gap between what the Government says and does is profound to me.”

She says that for all its mental health campaigns, it’s let mentally unwell people down. In 2020 the Government pledged £500m of extra spending on mental health service to address waiting times for specialists, which can stretch to months and more, and to invest in the workforce.

However, many people working in mental health have called the funding “a drop in the ocean” in the context of how colossal the problem is.

‘The gap between what the Government says and does is profound to me’ says Ruby Wax (Photo: Matthew Horwood/Getty)

Nadine Dorries, a former minister of state for mental health, suicide prevention and patient safety, tweeted in July: “The pandemic has been tough for everyone but we are not in the middle of a mental health crisis.”

Ruby Wax is furious about claims such as this. “I think the Government has no understanding of what mental illness is. What the problem is in the country has to be articulated.

“It isn’t: ‘Oh mental health will be the next pandemic. It is the pandemic right now. But let’s get specific. What is that pandemic, and how do you deal with it? It’s like we’re just chickens running blind.”

She is also worried about how the term mental health encompasses a huge spectrum of psychological feelings, from stress to psychosis.

“What exactly are we talking about when we talk about mental health?” she asks.

“If we’re talking about people who are mentally ill, they need professional support, and maybe medication. And where are they going to get it? Because there’s not that much available help.

“Then there’s people who are just frazzled, and they just need to talk. So we have to make that differentiation. The Government doesn’t even seem to discuss the difference between national malaise and serious mental illness. It’s like the difference between having acne and cancer.”

As World Mental Health Day approaches, politicians will gather and discuss crucial issues. That could have great outcomes, if it’s not a tokenistic box-ticking exercise and makes a genuine difference on the ground. Yet is there also a danger that in the flurry of discussions, campaigns and hashtags, we might feel we’ve solved the problem and now can move on?

“Raising awareness is very well-meaning usually,” says Nathan Filer, qualified mental health nurse and author of This Book Will Change Your Mind About Mental Health.

“And talking is in itself a good thing, but the issue is we can begin to believe that’s the end goal in itself. Talking is just the first step. There are so many other issues we then need to contend with like discrimination, social problems, the economic problems that are making or keeping people unwell, and then we need to educate people how to respond to that specifically.

“It’s all well and good when a colleague of yours feels more able to tell you in the workplace that they’re really struggling. But if they’re really struggling, they may be in danger of harming themselves, and you need the resources and knowledge to respond to that.”

There’s also the reality that while awareness has improved our understanding of some mental illness, many diagnoses are still misunderstood by the public and misrepresented by the media.

Some mental health struggles have, happily, become palatable and de-stigmatised, while others have a very long way to go.

“We see people talking, tweeting, placing messages on social media about stigma, how we need to deal with stigma,” says Filer, “but that word in itself is quite woolly. What do people mean by stigma? I think there would be arguably very little stigma attached to something like anxiety, or depression in many families now across the UK. “We’ve even medicalised anxiety to some extent; we now ‘have’ anxiety rather than ‘feel’ anxiety.”

Filer says that these days mental illness diagnosis can be slightly similar to brands. He says he’s “loathe to use that word”, but he feels it makes the point.

“You have the more popular brands – not popular to feel, obviously – like depression and anxiety which get more public empathy, there’s therapies created for them, and are largely de-stigmatised now. “The less popular brands of diagnosis are the ones more culturally laden with stereotypes and stigma. They get left behind. And so what sort of equity is forged?”

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One of the less popular “brands” would be psychotic disorders. In the UK, psychoses affect one in 100 people and 80 per cent of all first psychotic episodes take place before the age of 24, according to the British Journal of Psychiatry.

Figures show that black men experience psychosis 10 times more frequently than white men, and are four times more likely to be detained under the Mental Health Act, according to the charity Mind.

“I’ve very rarely heard a celebrity say: ‘These were my delusional beliefs and my hallucinations and all the things that I was doing’,” says Santhouse.

“And I don’t think I’ve heard a celebrity say: ‘I had a paralysed right leg, it lasted for six months, and it turned out to have a psychological cause.’ There are still some things that we don’t really want to talk about.”

He cites the rare example of actor David Harewood, who, on World Mental Health Day in 2017 spoke publicly about his psychotic breakdown and sectioning, and made a documentary about it called Psychosis & Me.

David Harewood spoke out about his experience in ‘Psychosis and Me’ (Photo:Sebastian Rabbas/BBC)

In an interview with i earlier this year, Harewood said: “We talk about bipolar disorder, anxiety and depression but no one talks about psychosis. It’s the one where you lose your mind and get taken away,” he says.

“It’s very common and happens to a lot of people. I don’t think there’s any reason why people should feel ashamed of it.”

Santhouse says that Harewood’s openness “was striking because it was uncommon to talk about those things”. He cites schizophrenia as another diagnosis that gets left out.

“People with experiences like that often don’t have advocates and aren’t really visible in awareness campaigns. That’s a problem because there are many people with long-term mental illness who just remain marginalised because they may never be as functional, or easy to help or understand.”

World Mental Health Day’s theme this year is “mental health in an unequal world”. People are encouraged to buy green ribbon badges to raise awareness, and organisers say the day “provides an opportunity for us to come together and act together to highlight how inequality can be addressed to ensure people are able to enjoy good mental health”.

The raising of awareness won’t stop anytime soon – and nor should it, when done with nuance and knowledge.

“Celebrities, sports people and royalty coming forward and being open is important”, says Mehta, who weekly speaks to some of the millions of people ringing Samaritans for mental health support.

“They validate the sentiment that anyone can have mental health issues and it’s a bonus if the publicity results in more knowledge about the conditions.

But at a time when there is so much that is pushing our mental wellbeing to its limits – loneliness, poverty – and there is insufficient help, talk alone may not be enough.”



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