The public profile of mental health experienced another boost this week, thanks to some moving comments made by Prince Harry and the Duke of Cambridge about the impact of their mother’s death, nearly 20 years ago. The two royals are working for the Heads Together campaign, which seeks to combat the stigma surrounding mental health issues, and to encourage people to speak more openly about their difficulties.
Harry’s admission that he had ignored his own emotional distress for several years before eventually having counselling was a valuable contribution, from a figure more commonly associated with laddish machismo. William’s focus on male suicide statistics was also a good use of his celebrity.
The royal family cannot get involved in divisive party political issues, and so we can only conclude from these interventions that mental health is something that exists beyond the fray of politics. Breaking the “stigma” surrounding mental health issues is certainly not something that one would want to identify as a leftwing or a rightwing agenda.
There is no more damning indictment on British society in 2017 than the prevalence of mental distress among children
On the other hand, political parties have been keen to make the mental health agenda their own. Theresa May has established mental health as one of the key areas where she hopes to signal her government’s concern for everyday human suffering, making a high-profile speech in January that also stressed the importance of breaking the stigma that clouds the issue.
All of this presents something of a riddle. Mental health problems have risen in profile to the point where the prime minister and the heir to the throne are personally committed to combating them. Yet there is scarcely any public discussion about where they actually stem from. Losing a parent at a vulnerable age, as Harry did, is terrible and harmful – but epidemics do not arise purely out of private tragedies.
The stigma attached to mental health is a real problem in workplaces and schools, as are the benefits of overturning it. But stigma can scarcely be viewed as the cause of what it stigmatises.
The orthodoxy that has taken root since the 1980s is that mental health problems are disorders of the brain. The success of SSRIs since the launch of Prozac in 1987 has helped to entrench this view. This doesn’t mean that mental illness can’t be treated with “talking cures”, such as cognitive behavioural therapy or by being more open about one’s emotions, as Prince Harry has argued. But the idea that mental health problems are illnesses just like any other illnesses has become one of the main ways in which the stigma is challenged. Comparisons with cancer have become common.
The idea that one is simply “unwell” no doubt provides comfort to many people wrestling with their own depression or anxiety. But it also blocks out a whole host of more fundamental cultural, political and economic questions regarding the distribution of distress in our society – the sorts of questions that the Duke of Cambridge would be less likely to grapple with.
There is no more damning indictment on British society in 2017 than the prevalence of mental distress among children. Nearly a quarter of a million are receiving mental health treatment from the NHS, and those contacting Childline complaining of anxiety and exam-related stress have been climbing year-on-year. Rates of self-harm amongst young girls have risen by 42% in a decade.
Are we to believe that it was simply “stigma” that swept all this under the carpet in the past? Or might children be telling the truth, when they say they feel overwhelmed by the requirement to perform, excel, keep up? The NSPCC reports that some children are having to sit mock exams just a few weeks after returning from the summer holidays. Think about what that means and does psychologically. What does Theresa May have to say about that? British children have become damagingly competitive, and less forgiving of failure. Which minister will have the guts to stand up and say to children that being average is OK?
Adult mental health problems may present themselves as medical and be treated as such, but they are not immune to sociological analysis. Researchers have found that adult mental health is worse among those who frequently moved house as a child. Today’s housing crisis is tomorrow’s mental health crisis.
Rising household indebtedness is another major culprit, especially the kinds of problem debts that are associated with week-by-week financial precarity. Children suffer when their parents are too stressed or depressed to listen to them or play with them. Debt problems break up families.
Austerity has been disastrous for the nation’s mental health. The British Psychological Society has called for a termination of benefit sanctions (which are effectively designed to produce anxiety); academics have shown the deep emotional harm wrought by the bedroom tax. Teachers, who live under the constant spectre of monitoring and performance assessment, are seeking medical help for stress in shocking numbers.
The seductive concept of “public sector productivity gains” conceals thousands of personal tragedies among doctors, paramedics and local government service providers, many of whom cling to a dream of exiting their profession. And these are the same people who look after the wellbeing of our children and mental health patients.
No doubt mental health will feature prominently in party manifestos, now that it’s gone mainstream. Whether any of the above gets a look-in remains to be seen. Labour should be shouting about it, and not allow the hypocritical architects of austerity an inch of this territory. Next time a Labour politician is patronised as being too leftwing by a journalist, the evidence on what inequality does to our minds should be slung back.
So, yes, we need to talk more. And, yes, stigma surrounding depression and anxiety makes things worse. But it’s not just ourselves and our medical histories we need to talk about. We also need to talk about what sort of society we’ve built, and what the alternative might look like. For all their good intentions, Harry and Wills might need to sit that one out.
On mental health, the royal family is doing more than our government | William Davies
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