We need to weep over the wreckage of mental illness

While its now OK to talk about mental illnesses, we need to weep over the harm caused and how we’ve tried to treat them, writes Rachael Newham.

Rachael Newham

Rachael is an author and theology of mental health specialist.

A grey and white wall graffited with a tag a image of a person crumpled and crying.

Today, February 1st, is Time to Talk Day. It's part of a long-running campaign encouraging people to have open and honest conversations about mental health. It's aim is to break down the barriers of stigma and misunderstanding. It has been a staggering success - what was a fringe issue talked by those only affected by mental illness a decade ago is now part of common parlance. Mental health training is widely available, and the charity’s work has been seen to have a significant positive impact on the mental health conversation

However, as our familiarity with the language of mental health has grown so too has the way we use it. People might talk about having PTSD after a bad date, or their friend being ‘so OCD’ about the way they organise. Unwittingly, as psychotherapist and author Julia Samuels points out, “[we have] awareness without real understanding.”

However, awareness without understanding means we actually don’t reach those most impacted by mental illness. We know about mental health in the way we know about our physical health - but we are no more aware about the serious, sometimes lifelong mental illnesses which rob people of hope, joy and vitality - sometimes leaving them with lifelong disability.

If you ask most people about mental illness they may tell you about depression and anxiety; the two most common mental illnesses which have become the acceptable face of mental illness. It’s reflected in the way funding is channeled to interventions that get people with mental illnesses back to work, or to NHS ‘Talking Therapies’ which offers short term psychological therapies (both of which are important initiatives) but have cut the number of inpatient beds from over 50,000 in 2001 to under 25,000 in 2022[3] which means those at the more severe end of the spectrum of mental health to mental illness are left to travel 300 miles for the care they need.

We have to survey the wreckage that severe and enduring mental illness causes, before we can begin to rebuild a society that is kinder - without prejudice or stigma.

Whilst it’s right that we have raised awareness about the most common conditions, we can’t ignore the illnesses which are termed ‘severe and enduring mental illnesses’ which include those such as bipolar disorder, major depression, schizophrenia and complex post-traumatic stress disorder.

For people living with these conditions, the general mental health advice that we give; for example getting enough sleep and time outdoors may not be enough to keep the symptoms at bay. Just as general physical health advice like getting your five a day will not cure or prevent all severe physical illnesses. Medication, hospitalisation, and at times even restrictions of freedom like being detained under the mental health act might be necessary to save lives.

These are stories that we need to hear. The debilitating side effects of life saving medications that can raise blood pressure, cause speech impediments. The injustices to confront (such as the fact that black people are five times more likely to be detained under the mental health act than their white counterparts) and the adjustments to life that those with disabilities are required to make to their lives.

We have to survey the wreckage that severe and enduring mental illness causes, before we can begin to rebuild a society that is kinder - without prejudice or stigma. We have to listen to the perhaps devastating, perhaps uncomfortable stories of those who live with severe and enduring mental illness. The mental health npatient units miles from home, the lack of freedom, the searing - unending grief.

Weep for the lives lost, the crumbling systems, the harm caused both by mental illness and the way we’ve tried to treat them.

By hearing these stories, we are accepting them as a part of reality. For those of us in churches it might be that the healing didn’t come in the way we expected, it might be also be all of us accepting that the systems designed to care for those with mental illness have in fact, caused more harm. It’s seeing the injustices and understanding that we, our systems and professionals need to change our attitudes.

Understanding and acceptance of the injustice are the way forward- that’s the only way change can come.

It might look like standing in the rubble, it might feel too huge and all but hopeless.

And yet in scripture and in life that is so often the only way we can begin to rebuild.

In the book of Nehemiah, one of the Old Testament prophets who had lived in exile far away from home for his whole life, we see that upon hearing about the state of the walls of Jerusalem, before he did any of the things we expect heroes and innovators to do- he wept. In fact, it’s estimated that for four months he wept over the state of the place that had once been the envy of the ancient world.

Perhaps we too need hear the stories and then weep.

Weep for the lives lost, the crumbling systems, the harm caused both by mental illness and the way we’ve tried to treat them and then slowly, we can begin the work of rebuilding.

It isn’t a work that can be done alone by a single agency much less a single person - it requires society to hear stories of the more than just ‘palatable’ mental illnesses with neat and tidy endings to the messy and sometimes traumatic stories that are there if we just care to listen to them. It might be reflected in the petitions we sign, the way we vote, the stories we choose to read.

So ,this Time to Talk Day - I’m saying let’s continue the amazing work of talking about mental health - we need to keep talking about anxiety and depression. But let us also make conversations wider, so that they encompass the whole continuum of mental health and illness.

We’ve seen the difference Time to Talk can make - now it’s time to talk about severe and enduring mental illnesses, too.

Review

Books

Culture

29 April 2024

6 min read

Are we being anxious about anxiety?

Haidt's diagnosis of a 'doomed' youth is off. Instead, we should learn from them.

Henna Cundill

Henna is a researcher with the Centre for Autism and Theology at the University of Aberdeen.

A child sits atop a bunk bed holding a phone in front.

It’s common these days to hear about social anxiety, health anxiety, or climate anxiety – but I think I can see that a new pathology is beginning to emerge: anxiety anxiety. This is where parents, politicians, academics, or just members of society in general, start to get anxious about the fact that everybody is anxious. Diagnosis rates of clinical anxiety have shown a steep increase in the past decade, and numbers, we assume, don’t lie.

Of the many outcomes of ‘anxiety anxiety’, one is going to be people who (with the absolute best intentions) want to suggest solutions. One such person is Jonathan Haidt, with his book The Anxious Generation: How the Great Rewiring of Childhood is Causing an Epidemic of Mental Illness.

From the spaceman on the cover to the opening vignette about sending our children to Mars, Haidt’s premise is clear: smartphones are the alien invaders of our society. These electronic parasites are feasting on the brain matter of our young people, directly causing what is now an epidemic of clinical anxiety and depression.

I’m quite ready to read a sensible analysis of the impact of smartphone culture on mental health, so I was disappointed to find that Haidt’s book falls so far short of that. From a scientific perspective, the argument is a barrage of statistics, arranged to the tune of ‘correlation equals causation’. Given Haidt’s seniority in his field, this approach is surprisingly unsubtle, something which has already been heavily criticised by peer review. Numbers, it seems, do lie – or at least they can be easily curated to prove your point.

But even if we accept Haidt’s point – which is that rates of smart-phone use (particularly social media) and rates of young people being diagnosed with anxiety disorders have increased over the same time period – what can be done? Haidt’s solution is to ban young people from owning smartphones at all until the age of 14, and from using social media until the age of 16, or even better 18. In this way, owning and managing one’s own device and its access becomes a rite of passage into adulthood. But note: whilst parents are urged to implement these unyielding boundaries for their children’s device-habits, Haidt does not ask grown-ups to make any changes to their own. Adults can continue with their current norms of smartphone use, ostensibly because their brains are fully developed, and they therefore have the maturity to handle their own risk to mental health.

Smartphones are not aliens – they were designed by humans, and are willingly bought by humans, in response to the human need to communicate.

Of course, it does not suit Haidt’s argument to analyse why adult mental health is also seeing an increase in diagnosis of anxiety disorders. It may be true to say that rates are rising more quickly amongst young people, but there is still no consensus as to how much of that can be attributed to young people simply being better informed about mental health and more empowered to seek help than the generations before them. Noticeably, young people today have a language to talk about anxiety that simply didn’t exist when I was a teenager in the 1990s, and ironically enough, it is social media that has made that possible. Although suicide rates are on the rise, they are still quite significantly lower among young people than they are for those aged over 35, and it should be noted that a proven pathway to suicide prevention amongst young people is access to self-help via smartphone apps.

So whilst I am quite ready to believe that smartphone culture is one of many factors impacting the health and wellbeing of young people today, I think characterising smartphones as alien invaders, or as invasive parasites that have been selectively bred by Silicon Valley billionaires to infest the minds of our young people, seems to be a disingenuous response – and one that only serves to increase parental anxiety by implying that smartphones are sly, sentient beings, and out of our control.

Smartphones are not aliens – they were designed by humans, and are willingly bought by humans, in response to the human need to communicate and a perfectly natural human desire to seek out entertainment and culture. True, technology and software are developed by billionaires, and marketing and algorithms can influence our choices – but at the end of the day, any developer will tell you that products only ever evolve in response to what the market demands. Adults: we have the money in our pockets; we are the market.

As a more empathetic and intelligent generation, it seems they could probably teach us a few things about how to harness smartphone culture.

In other words, we (the adults) selectively bred these ‘aliens’ ourselves – and rather than try (and no doubt fail) to lock up our experiment in a lab (or, as Haidt suggests, a lockable phone-pouch) we, the adults, have more than enough agency to continue that process of developing smartphones into devices that meet needs and provide entertainment in the way that they were always meant to do. In his defence, Haidt does refer to this approach briefly, but still only with a view to making the phones be for ‘us’ (the adults) and not ‘them’ (the young people) by removing content that appeals to a younger audience. To me feels like we are victim shaming the youth of today for the fact that they have inherited a problem created by their parents.

One day when Jesus was teaching a crowd of followers, he advised them “Why do you look at the speck of sawdust in your brother’s eye and pay no attention to the plank in your own eye? How can you say to your brother, ‘Let me take the speck out of your eye,’ when all the time there is a plank in your own?” His point was about hypocrisy – it is far easier to judge someone else’s behaviour than it is to take responsibility for our own. Where did any of us last read or hear terrifying information about the decline in young people’s mental health? Was it on our smartphones?

Here are a few things that Haidt’s selection of statistics doesn’t say about the youth of today. They are the most compassionate and empathetic generation that we have seen for decades (Konrath et. al., 2023). They are able to wait longer for rewards than their parent’s generation (Protzko, 2020), they are also less lazy, less narcissistic, more cooperative and more intelligent (Kriegel, 2016). In addition, whilst obvious damage is done by ‘filters’ on Instagram photos, making some young people strive for unattainable standards of beauty, it was the previous generation of smartphone users who began this trend, and it is the current generation of young people who can be credited with the #nofilter #nomakeup countertrends. This same generation is now fuelling the rise of insurgent social media sites such as Bereal, which emphasise the importance of authentic photos and meaningful connection with friends online.

Overall, perhaps instead of restricting and controlling our young people’s online lives, as Haidt would have us do, we ought to be talking to them? As a more empathetic and intelligent generation, it seems they could probably teach us a few things about how to harness smartphone culture and develop it towards solutions to the problems that we ourselves created.