In December 2022, the British Association of Counselling and Psychotherapy published a challenging article by academic psychologist, Dr Lucy Foulkes. She wrote about the explosion of charitable and state initiatives since 2007 which aim to raise awareness of issues around mental health. Whether it is celebrities, politicians, royals or footballers, everybody seems to be talking about mental health. But Dr Foulkes asks a question that I and many of my colleagues have also been thinking about: has this been helpful?
I think most people would agree that the core message is important: if you are struggling with your mental health, help is available if you look for it. It is surely good that there are professionals, helplines and support groups which can offer you a space to speak about what is troubling you. You do not need to suffer alone.
However, one of the problems with this message is that it suggests that the solution to all our problems is already within our hands – just set your mind to it and you will be able to sort this out. This has lead to an explosion of ‘wellbeing’ initiatives promising that exercise, healthy eating, meditation, medication or reframing your thoughts will help us change our lives. Of course, there are many external factors that cause human unhappiness and where change is possible things may well improve. But I do wonder whether the ‘solution is in your hands’, ‘self-help’ message might just be a rebranded version of ‘sort yourself out’ or ‘pull your socks up’. Many people who experience low mood, anxiety, paranoia or disordered eating are not mentally ill. Rather, as Foulkes points out, they are deeply unhappy and unable to cope because awful things are happening or have happened to them. Exercising and mindfulness are not going to help someone who is trapped in a system or a circumstance that contributes to their suffering.
Alongside encouraging everyone to seek help, Foulkes suggests that campaigns about ‘mental health problems’ have also been confusing. At times, the term is used to refer to passing, unpleasant feelings or thoughts. At others, it is used as a casual, friendly way to talk about severe mental illness or a crisis such as suicide or a life-threatening eating disorder. When a term is used so broadly it becomes almost meaningless. On one hand, the danger is that many ordinary, negative emotions or thoughts are labelled as disorders. This does not help people build resilience as they come to believe that sadness, frustration and difficulty are medical problems when, in fact, they may be reasonable responses to difficult circumstances in life or the challenges of growing and developing. On the other hand, someone who is seriously unwell, perhaps suicidal, ends up googling their way to advice about taking a warm bath or a brisk walk when, in fact, they may well need professional help.
The truth is that mental health, like so many other things in life, exists on a huge and complicated spectrum. Whether we are seriously ill, struggling with external circumstances or managing occasional difficult feelings or thoughts, sharing what is going on with a professional can be a valuable experience. A trained, experienced psychotherapist is familiar with mental health disorders and able to offer a safe space to think about whatever is going in your life. You can find someone locally in the UK using the directories on websites such as the British Association of Counselling and Psychotherapy or the United Kingdom Council for Psychotherapy.
Foulkes concludes that the next generation of mental health campaigns needs to be realistic about the breadth and complexity of mental health problems. They need to be clearer about the different levels of support and help that might be appropriate. In this way, hopefully, we might bring about a reduction in suffering across the board.