There seems to be a fairly obvious hole in mental health advocacy and awareness. Whilst there has been a welcome (if only recent) change in public attitude towards conditions like anxiety and depression, other conditions —from eating disorders, to psychotic illnesses, to personality disorders— have been largely ignored. Not only that, but the discourse around anxiety and depression themselves is so surface level that claiming to speak in the advocacy of those who suffer from them can act as a stand in for just about any statement you want.
“Everyone should exercise because it’s good for mental health!”
“You should consume more Vitamin D; it’s been linked to reductions in anxiety.”
“Marijuana should be illegal because it causes mental health problems.”
Perhaps the most pernicious example of this type of thing can be found in the discourse surrounding Coronavirus restrictions. I’ve lost count of the number of times I heard some Tory politician advocate for the lifting of lockdown with the justification that it was causing harm to people’s mental health. These are the same people who have spent the last 12 years cutting the funding for mental health services, of all kinds, and for all ages, making accessing effective treatment almost impossible without either waiting up to a year, or shilling out thousands to have it privately.
Perhaps this is revealing of the British Conservative mindset; they view a nice walk in the park or getting drunk with friends as the sole protector from a massive nervous breakdown. Perhaps that would explain all the partying that they did during lockdown. It could also explain why their government have enacted policies and cuts that suggest people simply don’t need timely and effective mental health support; just go out and be social. I strongly suspect, however, that their championing of mental health was a cover for what they really wanted from the ending of restrictions: for all of us to go back to mode of operation where caring about other people was less important; for us to get back to the unacceptable normal of exploitation and austerity that they’re used to. This constituted a hideous and (I’d warrant) unforgivable exploitation of the subject of mental health, but it wasn’t a surprising one. We all know that Tories don’t really care about anybody but themselves. What surprised me slightly more was the same type of incantation coming not from the mouths of overtly horrible politicians, but from those I know personally, and who I know to be otherwise good people.
When Christmas last year was “cancelled” (Christmas still went ahead, by the way, we didn’t skip the 25th of December) I saw quite a few posts on social media (not an accurate barometer of public attitude, granted) telling people that if not seeing their families over Christmas would impact on their mental health, then they should break the rules and go and see them anyway. Far be it from me to tell people how to look after themselves, I would like to point out that these postings and opinions contained next to nothing in terms of other sources of information regarding mental health. There were no hotlines, no links to services, no informational websites, and no delineations of the different types of mental health conditions and their respective treatments. Where did this attitude leave people struggling with their mental health who didn’t want to break the rules? Where did this advice leave people suffering with mental health conditions prior to the pandemic whose bandwidth of advocacy had been taken up by people who simply wanted restrictions to end? It seems to me, that the deployment of mental health relating to COVID-19 focused not on society as a whole, but on the relatively wealthy middle classes suffering with two particular types of mental health struggles: anxiety and depression.
Don’t get me wrong, wealth is not necessarily an indicator of mental wellbeing, and it is just as possible for the middle classes to develop mental health problems as anybody else. Likewise, anxiety and depression are extremely debilitating conditions which still need much more research, public awareness, and advocacy. But this advocacy should have gone much further than telling people to ignore coronavirus restrictions, as if the only thing a mental health professional would ever recommend is to see one’s family and go to a house party. I would like to remind everyone who lazily employed the “mental health” line over the past year that the Mental Health Act (not an entirely infallible document, mind) includes those with learning disabilities as part of the group of people that the act was design to protect the rights of. One need only to look at the appalling statistics showing the disparity in COVID related deaths between the learning disabled and the rest of the population (people with learning disabilities were up to 6 times more likely to die from COVID) to see that advocating for the easing of restrictions on the grounds of mental health in fact does the opposite of what it claims to be doing. So where was the public outcry with regards to mental health when all of this was happening?
Not once did I see anybody mention those with psychotic illnesses. I can’t imagine the pandemic has made the lives of people suffering with schizophrenia any less difficult. How about eating disorders? A lot of people who suffer from eating disorders need quite detailed treatment plans involving many different professionals, whether they be dieticians, therapists, or general practitioners, and whose needs aren’t going to be specifically met simply by lifting restrictions. Are the people suddenly championing mental health at all concerned about both voluntary and involuntary inpatients? People detained under the Mental Health Act have found it more difficult to access advocacy services because of the restrictions, and because the physical estates of inpatient facilities are yet to be up-to-par, controlling infections and illness in these environments is much more difficult. When Boris Johnson referred to peoples’ mental health as part of his justification for ending restrictions, was he at all thinking about parents and pregnant people with either a personal or family history of post-partum illness’s, and who couldn’t be with their significant others during the birth because of the infection rates in hospitals? When you posted on Facebook about how coronavirus restrictions should be gone away with because of mental health, were you thinking at all about the mental health of prisoners whose mental health has been shown to have rapidly deteriorated over the course of the pandemic, and who live in an environment so overwhelmingly unequipped for infection control that their already fragmented lives have been shaken up in entirely new ways? It’s also difficult to ignore the trauma on the faces of those working on the front line in the pandemic. Even when we had a lockdown in place, nurses and hospital staff (including mental health nurses who have also been on the front line since the start) were consistently dealing with death all around them. Seeing people die in such volumes as to only be comparable with war zones has quite a devastating impact on mental health too. More—I’d warrant— than most of us could even imagine.
The truth is, and always was, that when pandemics are left uncontained, healthcare systems collapse. This means a shortage of mental health beds, a lack of inpatient facilities, failure of pharmacology to distribute medications, a lack of resources to halfway houses and rehabilitation centres, and so much more. In much the same way as it was never truly a battle between public health and the economy, it wasn’t one between pandemic response measures and mental health; the two are interlinked. The worse a pandemic, the worse an economy; the worse a pandemic, the worse the mental health crisis.
Every time a (Tory) politician mentions the impact on mental health because of lockdowns a massive elephant appears in the room. To consistently cut the funding for mental health services one day (or rather, for over a decade) and the next pretend to champion the rights for people to maintain good mental health is so insulting that I almost (almost), impressed at their brass neck. What we desperately needed was proper funding and research into mental health, and a movement of advocacy and awareness that encompassed the entire spectrum of disorders, from depression and anxiety to personality disorders and psychotic illnesses. What they got was empty gestures and their illness being used as a battering ram for Conservative economic interests and peoples’ own selfish wants to get drunk with their friends. Isolation, lack of social contact, a lack of routine, unemployment; all of these things create negative impacts on mental health. This is not —nor should it be— a surprise to anyone. However, those (both in politics and in public) who lazily referred to “mental health” (as if people with mental health conditions can’t speak for themselves) as a means of advocating for relaxing or ending restrictions have displayed an attitude towards the mentally ill that is at best uninformed, and at worse ableist. There is a healthy dose of shame that people should feel, but it doesn’t look like an apology is forthcoming.