Article
Comment
Mental Health
4 min read

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 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. 

  

Snippet
Comment
Identity
Justice
Politics
3 min read

Deeper conversations on gender will continue after this court ruling

Can the whole mystery of gender be conceded to brute biological fact?
A paiting shows four panels featuring women lawyers over a century
Legacy, by Catherine Yass, hangs in the Supreme Court and celebrates one hundred years of women in law.
The Supreme Court.

Every now and again, a society has to have a word with itself about something. Most social changes happen quite organically without a need for this kind of self-conscious dialogue. Hat-wearing in public was almost ubiquitous, for example, until about the middle of the twentieth century, when it simply stopped. No major debate happened about this - the hat simply sidled out of fashion. Western society just sort of internally worked out that the absence of a hat was not improper.  

Whether or not gender is something real is not like whether it is polite to wear a hat. It requires a very hard conversation - one which pushes on some of the most fundamental differences people can have about politics, the world, and perhaps things even bigger than that. Whether one agrees with it or not, yesterday was a significant development in that very public conversation: the Supreme Court of the United Kingdom ruled that the Equality Act is predicated on a classic gender ontology (i.e. the ‘realness’ of male and female).  

What is at stake here? For some, the expansion of categories like ‘man’ and ‘woman’ to those who have undergone a clinical transition, and those who have an official certificate legally recognising their self-identified gender, is a crucial bellwether of our commitment to equality and freedom. They cite the rates of depression and suicide in this demographic, where an imposed gender causes deep distress. 

Opponents of this move (like J. K. Rowling, who will be celebrating right now, no doubt) cite the dangers that de-anchoring gender from biological markers, like chromosomes or reproductive organs, will have. The justification of single-sex spaces is at least partially balanced on the idea that men and women are different, and separation of them is key for our sense of dignity or safety.  

But both sides agree that we need copper-bottoms for our terms. All humans want to feel like our words are not empty gestures. Biological sex realists want to hold out for fundamentals which can be observed scientifically. This tallies with lots of observable features, history, and culture - but those who hold out for a definition of gender rooted in self-identification are not wrong to point out that overly medicalised definitions will struggle to divide all of the data without remainder. There are genuine cases of intersex people, for example. 

What does a Christian like me think? Someone who is tied to what the Church has historically taught might look to the New Testament, where Jesus, for example, teaches that ‘male and female’ is a good, given aspect of our reality by God. That much might be consoling about the court’s decision. But a Christian may also feel a little cold about conceding the whole mystery of gender to brute biological fact. Surely there is something about being a woman or a man that is more than merely possession of certain physical features, as gender-critical activists claim? 

St Paul, in one of his New Testament letters, says that men and women are an expression of something even more fundamental than chromosomes: “I speak of Christ and the Church”. But this does not make our genders into shadowy symbols. Rather, it says our gender difference is more real for pointing at is something beyond the physical. It is rooted in the most real thing a Christian knows: that God reconciles the world to himself through Jesus as if it was a cosmic marriage. On this view, maleness and femaleness is not a tick-list of attributes, but a goal at which we are all striving. It will require humility, mutual service, and love. 

Society will keep on having its conversation about what exactly men and women are. But if it is to make sense of what things are really like, it may have to keep digging yet. 

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