Mental health is about everybody

I want to agree with the Guardian’s Suzanne Moore in her recent article The lesson of Prince Harry’s grief? We need mental health services for all. And mostly I do. But I think she’s missed the most important thing about mental health.

The context of this article is in the headline. It Prince Harry’s recent interview in which he talked frankly about how he failed to deal with the grief caused by his mother’s death for a decade or more. He was bottling it all up with a stiff upper lip, with dire consequences for his life. He then sought help, and now feels able to talk about it. I applaud Prince Harry’s intervention. It is part of a general process of talking about mental health to make it less of a taboo topic. He is doing this in the best possible way: by sharing his experiences and not ramming any particular view down our throats. Mental health is one of the critical issues of our time and we need to talk about it more, and we need to be able to share more. But, alas, keeping the topic repressed for so long has left its legacy of muddled attitudes – even among the most liberal minded.

Ms Moore starts with a condemnation of the Royal Family’s lack of emotional intelligence at the time of Princess Diana’s death. In particular she feels that her two sons should not have been made to walk behind the coffin. She noticed that almost nobody showed personal warmth towards the pair during the service – so keen were they to show proper dignity and decorum. I think she’s only half right there. Some open warmth towards the boys during the service by their near relatives would certainly have been in order. But dignity and decorum have a useful purpose too. That long walk behind the coffin was not wrong in itself – it just needed to be balanced by something more intimate and informal.

Still, that isn’t the main problem I have with the article. This came as I read this:

Harry has rightly been praised for talking personally and thus destigmatising mental health issues. This is no doubt excellent. The normalising of mental health problems, which it is estimated will affect a quarter of us at one time or another, is necessary, but so too is funding. Mental health services are in a very poor state and it is almost impossible to get help. Many people in Harry’s situation would not get access to counselling and would be offered antidepressants and possibly a short course of cognitive behavioural therapy, as this is considered most cost-effective. In acute cases, people in a state of severe breakdown are now forced to go to hospitals far from their homes because there are no beds to be found nearby. This is a real crisis, and it is more visible by the day on our streets.

Yes, mental health services are neglected and need to be given a higher priority. But this will not work unless we start to think about mental health differently. Ms Moore’s article perpetuates the idea that dealing with mental health is about dealing with mental illness – depression, anxiety and so forth, and that this illnesses only affect a minority of us (even if it is as high as one in four). But mental health “problems” affect everybody. If you don’t suffer from depression and anxiety in some form regularly you are not healthy at all. It is how you manage it that is the thing – and it is something we all need to learn. And as we learn how to manage our emotions and anxieties better – and learn how to help our friends, relatives and neighbours, then fewer people will be left with the unmanageable symptoms that we call “mental illness”. And when we do suffer from those symptoms, society as a whole will be better able to deal with it.

And here’s the thing: the real problem is pretending that everything is OK when it is not – and this comes through from Prince Harry’s interview. We all know that a bit of anguish is normal. We also know, intuitively, that continually talking about our own emotions is self-indulgent and can undermine relationships with others. We also know that seeking professional help is a drastic step that you only take after other avenues have been exhausted – and is as likely to be a method for avoiding deeper issues as it is for confronting them. So it is the most natural thing in the world to weather our own problems, and then to assume that we are coping with them rather than bottling them up. But equally thinking that all you need to do when you feel down is to pop a pill to make you happy, then you are in even more trouble.

It is actually very hard. So the temptation is to try make the whole thing the exclusive domain of experts, whom we consult as required. And by trying to divert Prince Harry’s intervention into a call for more funding for experts, Ms Moore falls straight into this trap. But mental health isn’t just for experts, it is for everybody. We all need to be able to sense issues in those around us, and have an idea of what is going to help – and, of course, learn how to be more honest with ourselves, and have ideas about how we handle our own problems, beyond externalising it to a professional.

Which is why the first response to the issues raised by Prince Harry is not to rush out and boost mental health services – it is to tackle school curriculums. Above all it is at school that we learn excessive stiff upper lip (incidentally I feel strongly that stiff upper lips have their place – but that is another story). Great advances have been made here, but often in spite of government initiatives instead of because of them. The government’s recent recognition of personal, social and health education (PSHE ) is a welcome change from the bizarre antics of the previous Education Secretary Michael Gove – who dismissed such stuff as a distraction form proper academic education. This incidentally recognises something very important – that there is a strong social dimension to managing mental health.

Mental health is a positive and it is for everybody. By talking about it only when it goes wrong, and talking about the negative, we can make things worse, not better. That is what I take away from Prince Harry’s welcome intervention.

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6 thoughts on “Mental health is about everybody”

  1. Very interesting Matthew. But my concern is what happens to the mental health of this generation of children who are raised on iPads and social media and who can’t seem to differentiate between a ‘friend’ on Facebook and a friend you can call for a chat, or on whom you can rely when things go wrong?

    1. Well maybe because I don’t have children of my own, but I tend to be more sanguine about younger people. They have always suffered from a lot of stress, it just takes different forms in different ages. It’s the time of life when you find things out the hard way. A lot of things are better than when I was that age and a lot of things worse. But I absolutely think that schools need to be proactive about talking to children about stress and anxiety – and that somehow this should involve parents too. Far too many horrible things happen

  2. I don’t know if I can find it now but I seem to remember reading that people in Northern Ireland had fewer mental health problems, and lower suicide rates than elsewhere in the UK when the troubles were at their height.

    A counter – intuitive finding maybe. But there could be something in it. People perhaps felt more needed by their communities in those circumstances. Those of us in post-war generation will have noticed just how much the previous generation talked about the war. How they never saw a banana or an orange for years. How they were expected to do hard days work and then come come and do fire watch duties etc. Or they had to join the armed forces etc. Yes there was hardship but it was aImost as if they were enjoying it. It certainly seemed to me that they lived their lives more intensively then than either before or since.

    It is when people feel surplus to requirements that the depression sets in. In younger people that can lead to criminality, drug abuse and a sense of hopelessness too. The cost to society of all that is never factored in when we are told that we “can’t afford” this or that. But that’s as close as I’m going to come to an economic comment on this post!

    1. I think that’s a very interesting point – though comparisons are hard to make. We hear now about a lot of domestic violence and child abuse that used to happen, and this may reflect that mental health was not as good in the “old days” as we might think from reported problems. Still, the evidence that trauma and stress can be good for mental wellbeing is strong, and I think that a victim culture, where people compete to show how “traumatised” they are by events is just as unhealthy as pretending nothing much happened. But your observation that feeling surplus to requirements is bad for you is completely on the money. And giving people a pay-off as “citizen’s income” is no substitute for full employment.

      1. But Matthew, we may be well moving into a time due to automation and AI where full employment is no longer an available option. We need to re-think where we are going and what needs to change. Also Globalisation, the time when the Developed World can compete on Labour costs is long gone.

        1. I hear a lot of that idea Martha – and I can certainly think of some jobs under threat. But I also see a lot of jobs that need doing that are just going begging. I would like to think that we can marry the need for jobs with the need for workers – but that will be require a big reordering of the way we do things (so I agree about the re-think). Starting with a new attitude to education.

          Also I think you are wrong about globalisation and labour costs. The developing world (and I’m thinking China especially) is catching up with the developed world on labour costs, and in turn will be competing for the remaining pool of cheap labour. I think that is one of the reasons, ironically, for slow growth in the developed world. Much of the growth before the financial crisis derived from harnessing cheap labour from the developing world – that is now going into reverse. Hence stagnant productivity and stagnant economic growth. The good news is that should reduce the costs of globalisation. The bad news is that it is reducing the benefits of globalisation too, which we had come to rely on.

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