Sometimes new sayings enter the language and, before you know it, you seem to hear them over, and over, and over again. And, usually, they do my head in.
Two recent examples spring to mind: ‘It is what it is’, and ‘it’s what we do’. I don’t know why these sayings have caught on, but I’m going to give ‘it’s what we do’ a bit of a break today. Why? Because right now and more than ever, when it comes to mental health it’s what we do that matters.
We have heard an awful lot in recent years about how important it is to talk about mental health. We even have a day dedicated to just that each February, ‘Time to Talk Day’. This is part of the fantastic Time to Change campaign which I am very privileged to be part of. The campaign does a huge amount to raise awareness of mental health, and to decrease the stigma that, for so long, has led to so many suffering in silence, trapped in the prison of mental illness. A prison from which too many are unable to escape.
Attitudes are changing, but in spite of this the cost of mental ill health to individuals, and to society, remains shockingly high. Over 72 million working days are lost to mental ill health each year, costing £34.9 billion to the UK economy. And in 2018, 6,154 people took their own lives. That is an average of 16 people per day.
One of the misconceptions about mental health can be highlighted by drawing comparison between how our attitudes to it compare to those we have to physical health. When asked to throw out words that the term ‘physical health’ brings to mind, people will tend to offer up things like being strong, fit, active, and having a balanced diet.
What comes to mind when we ask about mental health?
For most of us it is things like depression, anxiety, stress, pressure, struggle, and inability to cope.
Can you see the difference?
Where one focuses on health, the other is focused on illness. Why does it matter? Because when we confuse mental health with mental illness, we miss the core fact that all of us have mental health; it is all of our concern. Just like our physical health, our mental health can be good, it can be bad, and it can be all things in between. And just as any of us can suffer a heart attack, so any of us can experience a mental health problem. We’re all made of the same stuff, after all.
Mental health is about resilience, coping with the day-to-day stresses of our lives, contributing to our communities and working productively. Mental health is about thriving, it is about wellbeing. And never has it been more important to commit to long-term, dedicated action to support and improve the nation’s mental health than now.
Loneliness, isolation, bereavement, uncertainty, financial worries, redundancy, health concerns… all are potentially contributory factors to poor mental health. And all of these issues are writ large across the UK right now, as we face the unprecedented challenges to our health, our livelihoods and our lifestyles, that Covid-19 has imposed upon us.
More than ever, people are aware of how our mental wellbeing can be impacted by events beyond our control. And the impact will be felt for some time to come; the legacy of lockdown and the pandemic will last long beyond the lifting of restrictions. Thousands will still be bereaved, having been unable to suitably mourn and be there for their dying loved ones. Multitudes will still experience health and social anxiety. Countless families will still be facing extreme financial worries and joblessness.
Now, more than ever before, we need to invest in mental health support services. We have increased awareness; what we need now is action. We need investment.
What good is talk without action?
I sometimes worry that talking is presented as a panacea, a magic cure for our mental health problems. We are told how important it is to talk, we are actively encouraged to have conversations about our mental health, and we hear about how talking can feel like a weight being lifted. All of this is true. But talking is merely a first step on what can be for many, a very long, very difficult journey.
What happens once we talk to someone about struggling with our mental health?
If we are lucky, we will be listened to, with patience, and without judgement. We may feel the relief of sharing our burden; however the burden is still ours to carry. Talking isn’t so much a cure, but a single step – a huge one for many of us, given the stigma – towards finding a cure.
If our luck continues we may get to speak with a sympathetic GP, who may prescribe medication that relieves our symptoms, and we may be referred for talking therapy. If luck stays on our side, we may access counselling without having to wait for weeks or even months. We may be referred for the right kind of therapy, to the right counsellor or therapist for us. Some of us may be able to afford to pay for private counselling, and be seen quickly by someone that we have chosen ourselves.
None of this happens without significant resource, and it can be a terrible truth for those of us that suffer that the resources allocated for supporting our mental health are simply not enough. They are nowhere near what is needed, and that was before Covid-19 made its entrance.
This has to change, or the human cost of this horrible pandemic is going to be felt for months and years to come. We may not have the figures reported to us each day at press briefings, but you can be sure that the impact on mental health is every bit as real, and potentially every bit as frightening, debilitating, and, in some cases, deadly as coronavirus.
I don’t say this to try and establish some kind of hierarchy of illness, with mental illness at the top. I say it in the hope that mental health may someday soon gain parity of esteem with physical health. Suicide is, after all, the biggest killer of men under 45 in the UK.
Let me ask you a question: if you go to the doctor or hospital with a physical ailment, injury or illness, how long do you expect to be treated for? Until you’re better, right?
When offered talking therapy for a mental health problem, you will typically be offered six to twelve sessions. That may work for some, but for others it will barely touch the surface, particularly where there are complex circumstances and histories that need to be unpicked. A counsellor friend recently told me that for some people she works with, it may take over a year of counselling before they are ready and prepared to confront the real, deep, and underlying issues that they need to address.
Another issue to be aware of is that when offered only six sessions the patient can feel a huge amount of pressure to get better in that time, and fear what will happen if they don’t. Sometimes the issues that they are seeking help for will have been debilitating them for many years. This time-limited pressure to recover can also play into the sense that their illness is somehow their fault, and a lack of progress in that limited time can amplify negative self-perceptions.
Significantly greater resourcing is needed. And while the cost of battling coronavirus has been huge and will only increase, the question shouldn’t be whether we can afford it, but whether we can afford not to.
There is hope. While medical and counselling support is essential, there are many other ways that we can tackle poor mental health within our communities. Local charities, sports clubs, and community groups, for example, are all able to provide support and services that can facilitate better mental health in myriad ways, including through increasing physical activity, encouraging and developing creativity, and enabling social connections.
Speaking from personal experience, I am particularly keen to see more projects using creativity as a tool for improving mental health. A creative outlet such as painting, or in my case poetry, can be a great way to express thoughts and feelings that can be difficult to verbalise and otherwise articulate. It can help us to gain new insights into ourselves, and discovering and developing a talent can increase feelings of self-worth. Furthermore, creating something beautiful out of suffering can give purpose and meaning to our struggles. Creativity-based approaches can also help people to make new connections, and can turn what can be a solo endeavour into an activity that can foster a sense of belonging and community.
A real positive that could emerge from the unprecedented challenges of 2020 could be the strengthening of local community, and there are few places where community is more valued than Teesside. We have a whole range of voluntary and charitable organisations, and kind, caring, big-hearted individuals, who, with the right kinds of advice, guidance and, where needed, investment, can develop projects and support networks that could make a real difference to some of our community’s most vulnerable members.
It’s time to rise to the challenge. It’s time to act on mental health.
Matthew Williams is a middle-aged single dad of two from Middlesbrough who is grimly hanging onto his hair – which remains its original colour – and teeth. He started writing in 2015 following divorce and the strange, alternative reality of online dating. Matthew published his first book in December 2017 and never looked back. He’s a passionate advocate for mental health and has developed a unique new personal development course, ‘Change’, based around storytelling principles and designed to help people to make positive changes in their lives.
Find out more about Matthew’s work at www.afamiliarstranger.co.uk
Something Changed – Stumbling Through Divorce, Dating and Depression, August 2017, Sixth Element Publishing
A Familiar Stranger, December 2019, Sixth Element Publishing